Depth of invasion and extranodal extension: the influential factors to predict survival rate of patients with oral tongue squamous cell carcinoma

BMC Cancer. 2024 Oct 10;24(1):1256. doi: 10.1186/s12885-024-12997-x.

Abstract

Background: Cancer staging is essential in determining patients' prognoses and designing the appropriate treatment strategy. American Joint Committee on Cancer has released the latest version of the staging system for tongue SCC. However, it is interesting to know whether this change in staging and the addition of depth of invasion (DOI) and the extra-nodal extension (ENE) have any influence on patients' prognosis.

Methods: In this retrospective cohort study, the pathology records of patients with tongue SCC who underwent surgery at the Pathology Department of Cancer Institute Hospital, 2017-2021, were collected by referring to the hospital information system. Then the rate of change of pT, pN, and overall stage were assessed based on American Joint Committee on Cancer 7th and 8th editions.

Results: The records of 204 patients were included in the final analysis. Significant changes in the staging system 2021 resulted in upstaging 64 patients (31.4%) in the overall stage, 91 patients (44.6%) in pT, and 30 patients (14.7%) in pN. The survival of upstaged patients was inferior compared to those without upstaging. However, this was not statistically significant for tumor and overall upstaging in the univariate analysis, while those with upstaged pN had significantly shorter survival. In the multivariate analysis, pT upstage also significantly impacted survival.

Conclusion: This study showed the importance of pathology reports based on the latest edition of the American Joint Committee on Cancer, the accuracy in examining factors such as depth of invasion and extra-nodal extension.

Keywords: Extra-nodal extension; Head and neck neoplasms; Neoplasm staging; Squamous cell carcinoma of head and neck; Survival; Tongue.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Extranodal Extension / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness*
  • Neoplasm Staging*
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Tongue Neoplasms* / mortality
  • Tongue Neoplasms* / pathology
  • Tongue Neoplasms* / surgery