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: Oral mucosa squamous cell carcinoma (OSCC) has locoregional evolution, with frequent neck involvement (the most important parameter for prognosis). There are still many doubts concerning the best way to approach N0 neck disease in early-stage lesions (T1 and T2). Many parameters have been studied to identify N0 patients with a high likelihood of harboring occult node metastases or of having them develop. A review of the studies analyzing "tumor thickness"/"depth of invasion" in predicting regional metastases and survival was undertaken. The literature suggests that "tumor thickness"/"depth of invasion" is a reliable parameter for predicting regional nodal involvement and survival in OSCC. Authors are in substantial agreement regarding the reliability of tumor thickness. The lack of comparable study groups, measurement techniques, and cut-off values points to the need for further studies so as to reach a consensus and to develop therapy protocols that include tumor thickness.Head & Neck 01/2006; 27(12):1080-91. · 2.83 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 01/2004; 15(4):264-268.
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ABSTRACT: The aim of this study was to determine whether tumor depth affects upstaging of the clinically node-negative neck, as determined by sentinel lymph node biopsy with full pathologic evaluation of harvested nodes including step-serial sectioning (SSS) and immunohistochemistry (IHC). One hundred seventy-two patients with cT1/2 N0 squamous cell carcinoma (SCC) of the oral cavity/oropharynx undergoing primary resection and either sentinel node biopsy (SNB) or SNB-assisted neck dissection as a staging tool for the cN0 neck. Harvested nodes were examined with hematoxylin-eosin staining, SSS, and IHC. Patients upstaged by SSS/IHC were denoted pN1mi. One hundred one of 172 patients were staged pN0, with 71 (41%) patients upstaged. Increasing tumor depth was associated with higher likelihood of upstaging (P < .001). Tumor depth showed a positive correlation with nodal stage according to TNM classification (P < .001). Tumor depth greater than 4 mm appears to be the most appropriate cutoff for risk stratification, although tumors in the oropharynx may require a lower value. Tumor depth is an important prognostic factor for patients with SCC of the oral cavity or oropharynx. Tumors greater than 4 mm are associated with greater risk of upstaging; however, this optimum cutoff value may vary between primary tumor sites.The Laryngoscope 04/2008; 118(4):629-34. · 1.98 Impact Factor