Relationship of biopsy and final specimens in evaluation of tumor thickness in floor of mouth carcinoma.
ABSTRACT A number of studies have suggested that tumor thickness may be a valuable prognostic indicator in the evaluation of head and neck cancers. This study examined the relationship between tumor thickness measured in preliminary biopsy specimens with the final specimens obtained in 31 patients with floor of mouth epidermoid carcinoma. There was a significant statistical correlation between biopsy and final specimens. The Pearson's product-moment correlation coefficient was 0.58, which corresponded to a significance level of P < .0005. The results of this study showed that those patients who had biopsies with a thickness less than or equal to 1 mm were likely to have final specimens with a thickness less than 2 mm. All patients with a thickness greater than 2 mm had a final specimen with a thickness greater than 3.5 mm. Modification of current biopsy techniques may result in values more predictive of final thickness measurements.
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ABSTRACT: To determine the prognostic significance of depth of invasion in laryngeal cancer, the depth of invasion of tumor was measured with an ocular micrometer on the laryngectomy specimens of 94 surgically treated patients with T1, T2, and T3 laryngeal cancer and was expressed in millimeters. There was a significant negative correlation between the depth of invasion and disease-free survival. The tumors with no clinical involvement of regional lymph nodes in neck (NO neck) had significantly less depth of invasion than those with involvement (N+ neck). The tumors with pathologically confirmed cervical lymph node metastasis had significantly more depth of invasion than those without metastasis. For tumors with a depth of invasion equal to or greater than 3.25 mm, the rate of cervical metastasis in this study has always been significantly higher than for those with a depth of invasion less than 3.25 mm (P < .05). The mean depths of invasion for cases with and without recurrence were not significantly different. According to the multivariate analysis, depth of invasion (P = .047) and patient age (P = .113) significantly affected the disease-free survival independently. The depth of invasion did not significantly affect the recurrence and the interval between surgery and the development of recurrence (P > .15). The depth of invasion should be measured in every laryngectomy specimen. The depth of invasion influences the cervical metastasis and disease-free survival significantly but does not affect the recurrence rate. The depth of invasion plays an independent role in determining the disease-free survival.The Laryngoscope 05/1998; 108(5):764-8. DOI:10.1097/00005537-199805000-00025 · 2.03 Impact Factor
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ABSTRACT: Carcinoma of the oral cavity is most often treated by surgical resection, is associated with clinically evident neck disease in one third of cases, and has a high rate of occult metastasis in the N0 neck. When patients have clinically evident neck disease, comprehensive neck dissection is usually performed. Establishing an approach to the N0 neck has been somewhat more difficult and controversial. The presence of occult neck metastasis carries both prognostic and therapeutic implications. The most reliable factor in determining the presence of metastasis is pathological evaluation; this is the rationale for performing staging neck dissections in patients with tumors of the oral cavity. Since two-thirds of these dissections will yield no tumor, the type of neck dissection should yield the most prognostic information while causing the least morbidity. A selective neck dissection encompassing Levels I-III satisfies these requirements well.Operative Techniques in Otolaryngology-Head and Neck Surgery 12/2004; 15(4):264-268. DOI:10.1016/j.otot.2004.05.009