Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma
IntroductionAlthough patients with oral squamous cell carcinoma who develop contralateral neck metastasis (CLNM) have worse survival outcomes than those without CLNM, accurate prediction of occult CLNM in clinically negative contralateral neck (contralateral cN0) remains difficult. This study aimed...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-10-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1010252/full |
| _version_ | 1811234682482720768 |
|---|---|
| author | Maki Akamatsu Maki Akamatsu Takuma Makino Shinya Morita Yohei Noda Shin Kariya Tomoo Onoda Mizuo Ando Yoshihiro Kimata Kazunori Nishizaki Mitsuhiro Okano Aiko Oka Kengo Kanai Yoshihiro Watanabe Yorihisa Imanishi |
| author_facet | Maki Akamatsu Maki Akamatsu Takuma Makino Shinya Morita Yohei Noda Shin Kariya Tomoo Onoda Mizuo Ando Yoshihiro Kimata Kazunori Nishizaki Mitsuhiro Okano Aiko Oka Kengo Kanai Yoshihiro Watanabe Yorihisa Imanishi |
| author_sort | Maki Akamatsu |
| collection | DOAJ |
| description | IntroductionAlthough patients with oral squamous cell carcinoma who develop contralateral neck metastasis (CLNM) have worse survival outcomes than those without CLNM, accurate prediction of occult CLNM in clinically negative contralateral neck (contralateral cN0) remains difficult. This study aimed to identify clinicopathological factors that could reliably predict CLNM in patients with locally advanced (clinical T3 and T4a) tongue squamous cell carcinoma (TSCC).Patients and methodsThe medical data of 32 patients with cT3–4a TSCC who underwent curative surgery between 2010 and 2017 were retrospectively analyzed. The correlation of clinicopathological variables with CLNM was examined using logistic regression analysis. The diagnostic performance of significant variables was evaluated using the area under the receiver operating characteristic curves (AUC). Overall survival (OS) and disease-free survival (DFS) were assessed using a Cox proportional hazards model.ResultsCLNM was eventually confirmed in 11 patients (34.4%). Multivariate logistic regression showed that midline involvement [odds ratio (OR) = 23.10, P = 0.017] and perineural invasion (PNI, OR = 14.96, P = 0.014) were independent predictors of CLNM. Notably, the prediction model comprising a combination of midline involvement and PNI exhibited superior diagnostic performance with an even higher OR of 80.00 (P < 0.001), accuracy of 90.3%, and AUC of 0.876. The multivariate Cox hazards model revealed independent significance of CLNM as an unfavorable prognostic factor for both OS [hazard ratio (HR) = 5.154, P = 0.031] and DFS (HR = 3.359, P = 0.038), as well as that of PNI for OS (HR = 5.623, P = 0.033).ConclusionOur findings suggest that coexisting midline involvement and PNI of the primary tumor is highly predictive of CLNM development, which independently affects both OS and DFS in patients with locally advanced TSCC. Such reliable prediction enables efficient control of CLNM by optimizing management of the contralateral cN0 neck, which will likely contribute to improved prognosis of those patients without unnecessarily compromising their quality of life. |
| first_indexed | 2024-04-12T11:40:52Z |
| format | Article |
| id | doaj.art-7bc86eedbb3a478aa24a0c2be1eaac63 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T11:40:52Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-7bc86eedbb3a478aa24a0c2be1eaac632022-12-22T03:34:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-10-011210.3389/fonc.2022.10102521010252Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinomaMaki Akamatsu0Maki Akamatsu1Takuma Makino2Shinya Morita3Yohei Noda4Shin Kariya5Tomoo Onoda6Mizuo Ando7Yoshihiro Kimata8Kazunori Nishizaki9Mitsuhiro Okano10Aiko Oka11Kengo Kanai12Yoshihiro Watanabe13Yorihisa Imanishi14Department of Otorhinolaryngology–Head and Neck Surgery, Okayama University, Graduate School of Medicine, Okayama, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, Okayama University, Graduate School of Medicine, Okayama, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, Okayama University, Graduate School of Medicine, Okayama, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, Okayama University, Graduate School of Medicine, Okayama, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, Okayama University, Graduate School of Medicine, Okayama, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, Okayama University, Graduate School of Medicine, Okayama, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, Okayama University, Graduate School of Medicine, Okayama, JapanDepartment of Plastic and Reconstructive Surgery, Okayama University, Graduate School of Medicine, Okayama, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, Okayama University, Graduate School of Medicine, Okayama, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, JapanDepartment of Otorhinolaryngology–Head and Neck Surgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, JapanIntroductionAlthough patients with oral squamous cell carcinoma who develop contralateral neck metastasis (CLNM) have worse survival outcomes than those without CLNM, accurate prediction of occult CLNM in clinically negative contralateral neck (contralateral cN0) remains difficult. This study aimed to identify clinicopathological factors that could reliably predict CLNM in patients with locally advanced (clinical T3 and T4a) tongue squamous cell carcinoma (TSCC).Patients and methodsThe medical data of 32 patients with cT3–4a TSCC who underwent curative surgery between 2010 and 2017 were retrospectively analyzed. The correlation of clinicopathological variables with CLNM was examined using logistic regression analysis. The diagnostic performance of significant variables was evaluated using the area under the receiver operating characteristic curves (AUC). Overall survival (OS) and disease-free survival (DFS) were assessed using a Cox proportional hazards model.ResultsCLNM was eventually confirmed in 11 patients (34.4%). Multivariate logistic regression showed that midline involvement [odds ratio (OR) = 23.10, P = 0.017] and perineural invasion (PNI, OR = 14.96, P = 0.014) were independent predictors of CLNM. Notably, the prediction model comprising a combination of midline involvement and PNI exhibited superior diagnostic performance with an even higher OR of 80.00 (P < 0.001), accuracy of 90.3%, and AUC of 0.876. The multivariate Cox hazards model revealed independent significance of CLNM as an unfavorable prognostic factor for both OS [hazard ratio (HR) = 5.154, P = 0.031] and DFS (HR = 3.359, P = 0.038), as well as that of PNI for OS (HR = 5.623, P = 0.033).ConclusionOur findings suggest that coexisting midline involvement and PNI of the primary tumor is highly predictive of CLNM development, which independently affects both OS and DFS in patients with locally advanced TSCC. Such reliable prediction enables efficient control of CLNM by optimizing management of the contralateral cN0 neck, which will likely contribute to improved prognosis of those patients without unnecessarily compromising their quality of life.https://www.frontiersin.org/articles/10.3389/fonc.2022.1010252/fullcontralateral neck metastasiscontralateral cN0 neckdiagnostic performancedisease-free survivallocally advanced tongue squamous cell carcinomamidline involvement |
| spellingShingle | Maki Akamatsu Maki Akamatsu Takuma Makino Shinya Morita Yohei Noda Shin Kariya Tomoo Onoda Mizuo Ando Yoshihiro Kimata Kazunori Nishizaki Mitsuhiro Okano Aiko Oka Kengo Kanai Yoshihiro Watanabe Yorihisa Imanishi Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma Frontiers in Oncology contralateral neck metastasis contralateral cN0 neck diagnostic performance disease-free survival locally advanced tongue squamous cell carcinoma midline involvement |
| title | Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma |
| title_full | Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma |
| title_fullStr | Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma |
| title_full_unstemmed | Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma |
| title_short | Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma |
| title_sort | midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease free survival in locally advanced oral tongue squamous cell carcinoma |
| topic | contralateral neck metastasis contralateral cN0 neck diagnostic performance disease-free survival locally advanced tongue squamous cell carcinoma midline involvement |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1010252/full |
| work_keys_str_mv | AT makiakamatsu midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT makiakamatsu midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT takumamakino midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT shinyamorita midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT yoheinoda midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT shinkariya midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT tomooonoda midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT mizuoando midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT yoshihirokimata midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT kazunorinishizaki midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT mitsuhirookano midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT aikooka midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT kengokanai midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT yoshihirowatanabe midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma AT yorihisaimanishi midlineinvolvementandperineuralinvasionpredictcontralateralneckmetastasisthataffectsoverallanddiseasefreesurvivalinlocallyadvancedoraltonguesquamouscellcarcinoma |