Top

Clinical Oral Investigations

Published in:

01-05-2019 | Original Article

Is skip metastases associated with tumor thickness and tumor size in tongue carcinoma patients?

Authors: Sanjay Rastogi, Ashish Sharma, Hessa Al Wayli, Rupshikha Choudhury, Siddhi Tripathi, Saurav Kumar

Published in: Clinical Oral Investigations | Issue 5/2019

Abstract

Objective

To assess the correlation of skip metastases associated with increase in tumor thickness and size of the tumor.

Material and methods

A retrospective analysis was carried out from August 2009 to August 2015. In this study, a total number of 33 carcinoma tongue patients having T1, T2, and T3 sizes with N0 and N+ clinical necks who were treated by supraomohyoid neck dissection, extended supraomohyoid neck dissection, and modified radical neck dissection were analyzed. The data was assessed using Shapiro-Wilk W test, Nagelkerke R² regression model, mean, and standard deviation.

Results

Metastasis to lymph nodes was present in 75% of patients. Level I and level II were the commonest sites to be involved, i.e., 20 patients. Three patients had skip metastasis out of which two patients had metastasis at level III (6%), and one patient had skip metastasis at level IV (3%).

Conclusion

The incidence of skip metastasis increases with tumor thickness and tumor size in tongue carcinoma patients.

Clinical relevance

The article reveals the positive relationship between tumor thickness, tumor size, and skip metastasis. The analysis shows tumor thickness as a higher predictor for skip metastasis with odds ratio of 5.5 compared to the tumor size having odd ratio 2.

Ferlito A, Rinaldo A, Devaney KO, MacLennan K, Meyers JN, Petruzzelli GJ (2002) Prognostic significance of microscopic and macroscopic extracapsular spread from metastatic tumor in the cervical lymph nodes. Oral Oncol 38:747–751CrossRefPubMed

Magnano M, De Stefani A, Lerda W, Usai A, Ragona R, Bussi M, Cortesina G (1997) Prognostic factors of cervical lymph node metastasis in head and neck squamous cell carcinoma. Tumori 83:922–926CrossRefPubMed

Mamelle G, Pampurik J, Luboinski B, Lancar R, Lusinchi A, Bosq J (1994) Lymph node prognostic factors in head and neck squamous cell carcinomas. Am J Surg 168:494–498CrossRef

Weiss MH, Harrison LB, Issacs RS (1994) Use of decision analysis in planning a management for N0 neck. Arch Otolaryngol Head Neck Surg 120:699–702CrossRef

Balasubramanian D, Thankappan K, Battoo AJ, Rajapurkar M, Kuriakose MA, Iyer S (2012) Isolated skip nodal metastasis is rare in T1 and T2 oral tongue squamous cell carcinoma. Otolaryngol Head Neck Surg 147(2):275–277. https://doi.org/10.1177/0194599812439664 CrossRefPubMed

Huang SH, Hwang D, Lockwood G, Goldstein DP, O'Sullivan B (2009) Predictive value of tumor thickness for cervical lymph-node involvement in squamous cell carcinoma of the oral cavity: a meta-analysis of reported studies. Cancer 115(7):1489–1497. https://doi.org/10.1002/cncr.24161 CrossRefPubMed

Woolgar JA (1999) Histological distribution of cervical lymph node metastases from intraoral/oropharyngeal squamous cell carcinomas. Br J Oral Maxillofac Surg 37(3):175–180. https://doi.org/10.1054/bjom.1999.0036 CrossRefPubMed

Davidson BJ, Kulkarny V, Delacure MD, Shah JP (1993) Posterior triangle metastases of squamous cell carcinoma of the upper aerodigestive tract. Am J Surg 166(4):395–398CrossRefPubMed

Sparano A, Weinstein G, Chalian A, Yodul M, Weber R (2004) Multivariate predictors of occult neck metastasis in early oral tongue cancer. Otolaryngol Head Neck Surg 131(4):472–476CrossRefPubMed

10.

Woolgar JA (1999) T2 carcinoma of the tongue: the histopathologist's perspective. Br J Oral Maxillofac Surg 37(3):187–193. https://doi.org/10.1054/bjom.1999.0034 CrossRefPubMed

11.

Byers RM, El-Naggar AK, Lee YY, Rao B, Fornage B, Terry NH, Sample D, Hankins P, Smith TL, Wolf PJ (1998) Can we detect or predict the presence of occult nodal metastases in patients with squamous carcinoma of the oral tongue? Head Neck 20(2):138–144CrossRefPubMed

12.

S V, Rohan V (2014) Cervical node metastasis in T1 squamous cell carcinoma of oral tongue- pattern and the predictive factors. Indian J Surg Oncol 5(2):104–108. https://doi.org/10.1007/s13193-014-0301-z CrossRefPubMedPubMedCentral

Title: Is skip metastases associated with tumor thickness and tumor size in tongue carcinoma patients?
Authors: Sanjay Rastogi
Ashish Sharma
Hessa Al Wayli
Rupshikha Choudhury
Siddhi Tripathi
Saurav Kumar
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 5/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2589-5

At a glance: The STEP trials

Springer Medicine

Is skip metastases associated with tumor thickness and tumor size in tongue carcinoma patients?

Abstract

Objective

Material and methods

Results

Conclusion

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Material and methods

Results

Conclusion

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 5/2019

Effects of topical applications of porcine acellular urinary bladder matrix and Centella asiatica extract on oral wound healing in a rat model

Bone-anchored maxillary protraction in patients with unilateral complete cleft lip and palate and Class III malocclusion

Prevention of oral carcinogenesis in rats by Dracaena cinnabari resin extracts

Ion release, antimicrobial and physio-mechanical properties of glass ionomer cement containing micro or nanosized hexametaphosphate, and their effect on enamel demineralization

ConsEuro Conference 2019, Berlin, June 14-15

Impact of endodontic post material on longitudinal changes in interproximal bone level: a randomized controlled pilot trial