Can MRI-derived depth of invasion predict nodal recurrence in oral tongue cancer?

Abstract

Objectives

To evaluate the prognostic value of preoperative radiological findings for nodal recurrence in clinically node-negative (cN0) patients with oral tongue squamous cell carcinoma (SCC).

Methods

The study population consisted of 52 patients with cT1-2N0 oral tongue SCC classified according to the 7th edition of the Union for International Cancer Control (UICC) staging system. The subjects had undergone preoperative radiological examinations, including magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography. All patients were treated with local resection and watchful waiting for neck management. Using an unpaired t test, Pearson’s chi-squared test, and the Kaplan–Meier method, the MRI-derived depth of invasion (DOI), the standardized uptake value (SUV) on FDG-PET, and the T stage according to the 7th and 8th UICC were assessed as prognostic factors.

Results

The MRI-derived DOI was recorded as ≤ 5 mm in 24 patients and > 5 mm in 28 patients. During the follow-up period, nine patients exhibited nodal recurrence, with the MRI-derived DOI being significantly higher in patients with positive than in those with negative (p = 0.011). The SUV was not significant. Five-year cumulative nodal recurrence probabilities were 4.5% for patients with an MRI-derived DOI ≤ 5 mm, while it was 32.1% for > 5 mm (p = 0.013). Although the T classifications were not significant, none of our patients whose T stage according to the 8th UICC was T1 suffered nodal recurrence.

Conclusions

MRI-derived DOI can predict nodal recurrence, while preoperative information may assist in treatment planning for oral tongue SCC.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing. This work was supported by JSPS KAKENHI Grant Number 18K07757.

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Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RM, FS, RY, JS, AH, KK, and KY. The first draft of the manuscript was written by AM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ryuji Murakami.

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All authors declare that they have no conflict of interest.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

The institutional review board of our institute approved this retrospective study (RINRI Number 1427). Informed consent was waived due to the retrospective nature of this study.

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Minamitake, A., Murakami, R., Sakamoto, F. et al. Can MRI-derived depth of invasion predict nodal recurrence in oral tongue cancer?. Oral Radiol (2021). https://doi.org/10.1007/s11282-020-00505-3

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Keywords

  • Depth of invasion
  • 18F-fluorodeoxyglucose-positron emission tomography
  • Magnetic resonance imaging
  • Nodal recurrence
  • Oral tongue cancer