ABSTRACT
The purpose of this study was to investigate the effectiveness of tumour variables measured on magnetic resonance imaging (MRI) to predict 2-year disease-related survival and occult cervical lymph node metastasis in oral carcinoma. In this retrospective, dual-centre study the volume and thickness of tumours were measured using archived MRI staging scans of 199 patients who had curative primary resection for histologically confirmed oral carcinoma. Tumour volume predicted survival when grouped using the median (3.0 cm(3), HR 3.41, p 0.005) and first and third quartiles (0.5 cm(3), HR 8.22, p 0.04; 8.0 cm(3), HR 18.6, p 0.005). Tumour thickness predicted survival using a median of 11.0 mm (HR 2.65, p 0.02). Volume predicted occult cervical lymph node metastasis using a median of 3.0 cm(3) (HR 5.02, p<0.001) and quartiles of 0.5 cm(3) (HR 6.92, p=0.01) and 8.0 cm(3) (HR 11.3, p 0.005); thickness predicted it using a median of 11.0 mm (HR 4.39, p 0.002) and quartiles of 4.0 mm (HR 4.33, p 0.06) and 16 mm (HR 11.9, p 0.003). The thickness and volume of tumour measured on MRI may predict 2-year disease-related survival and occult cervical lymph node metastasis in oral cancer.
Subject(s)
Carcinoma, Squamous Cell/pathology , Lymphatic Metastasis/pathology , Magnetic Resonance Imaging/methods , Mouth Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/secondary , Carcinoma, Squamous Cell/surgery , Elective Surgical Procedures/methods , Female , Follow-Up Studies , Forecasting , Humans , Male , Middle Aged , Mouth Neoplasms/surgery , Neck Dissection/methods , Neoplasm Invasiveness , Neoplasm Staging , Neoplasms, Unknown Primary/pathology , Retrospective Studies , Survival Rate , Tumor Burden , Young AdultABSTRACT
PURPOSE: The current T4a subclassification of the TNM staging system for oral malignancies has been criticised as based almost exclusively on anatomical data. The aim of this study was to provide anatomical confirmation of the muscular constraints of T4a classification of oral tongue tumours. METHODS: A detailed anatomical study describing and measuring the adjacency of the named extrinsic tongue muscles to the lateral tongue surface was completed on the Visible Human Female (VHF). The distance of styloglossus and hyoglossus to the over lying mucosa were determined. RESULTS: The appearance, position, orientation and anatomical relationships of the lateral tongue extrinsic muscles, with comparison to their classical descriptions are described. The right VHF styloglossus was 1.3 mm (0.33-1.48) and left 2.91 mm (0.66-7.68) from the mucosal surface in the axial plane. The right VHF hyoglossus was 2.93 mm (1.48-4.96) and left 4.33 (1.68-8.71) from the mucosal surface in the axial line. CONCLUSIONS: In the lateral tongue, styloglossus and hyoglossus are very superficial. The inclusion criteria of hyoglossus and styloglossus in the T4a staging does not appear justified based upon their anatomical position.
