Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy

Inne J. den Toom; Luuk M. Janssen; Robert J.J. van Es; K. Hakki Karagozoglu; Bart de Keizer; Stijn van Weert; Stefan M. Willems; Elisabeth Bloemena; C. René Leemans; Remco de Bree

doi:10.1002/hed.25665

Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy

Inne J. den Toom, Luuk M. Janssen, Robert J.J. van Es, K. Hakki Karagozoglu, Bart de Keizer, Stijn van Weert, Stefan M. Willems, Elisabeth Bloemena, C. René Leemans, Remco de Bree^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: To investigate if depth of invasion (DOI) can predict occult nodal disease in patients with cT1-2N0 (7th TNM) oral squamous cell carcinoma (OSCC) staged by sentinel lymph node biopsy (SLNB). Methods: In 199 OSCC patients, DOI measurements and SLNB were performed. Results: Metastases were found in 64 of 199 patients (32%). Of these 64 patients, the mean DOI was 6.6 mm compared to 4.7 mm in patients without metastases (P =.003). The ROC-curve showed an area under the curve of 0.65 with a most optimal cutoff point of 3.4 mm DOI (sensitivity 83% and specificity 47%). Regional metastases were found in 15% of patients with DOI ≤ 3.4 mm. Conclusion: DOI seems to be a poor predictor for regional metastasis in patients with cT1-2N0 OSCC. Therefore, staging of the neck using SLNB in patients with early stage oral cancer should also be performed in tumors with limited DOI and probably in T3 (8th TNM) OSCC ≤4 cm diameter.

Original language	English
Pages (from-to)	2100-2106
Number of pages	7
Journal	Head and Neck
Volume	41
Issue number	7
DOIs	https://doi.org/10.1002/hed.25665
Publication status	Published - 1 Jul 2019

Keywords

depth of invasion
lymph node metastases
Oral cancer
sentinel lymph node biopsy

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title = "Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy",

abstract = "Background: To investigate if depth of invasion (DOI) can predict occult nodal disease in patients with cT1-2N0 (7th TNM) oral squamous cell carcinoma (OSCC) staged by sentinel lymph node biopsy (SLNB). Methods: In 199 OSCC patients, DOI measurements and SLNB were performed. Results: Metastases were found in 64 of 199 patients (32%). Of these 64 patients, the mean DOI was 6.6 mm compared to 4.7 mm in patients without metastases (P =.003). The ROC-curve showed an area under the curve of 0.65 with a most optimal cutoff point of 3.4 mm DOI (sensitivity 83% and specificity 47%). Regional metastases were found in 15% of patients with DOI ≤ 3.4 mm. Conclusion: DOI seems to be a poor predictor for regional metastasis in patients with cT1-2N0 OSCC. Therefore, staging of the neck using SLNB in patients with early stage oral cancer should also be performed in tumors with limited DOI and probably in T3 (8th TNM) OSCC ≤4 cm diameter.",

keywords = "depth of invasion, lymph node metastases, Oral cancer, sentinel lymph node biopsy",

author = "{den Toom}, {Inne J.} and Janssen, {Luuk M.} and {van Es}, {Robert J.J.} and Karagozoglu, {K. Hakki} and {de Keizer}, Bart and {van Weert}, Stijn and Willems, {Stefan M.} and Elisabeth Bloemena and Leemans, {C. Ren{\'e}} and {de Bree}, Remco",

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year = "2019",

month = jul,

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doi = "10.1002/hed.25665",

language = "English",

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pages = "2100--2106",

journal = "Head and Neck",

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T1 - Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy

AU - den Toom, Inne J.

AU - Janssen, Luuk M.

AU - van Es, Robert J.J.

AU - Karagozoglu, K. Hakki

AU - de Keizer, Bart

AU - van Weert, Stijn

AU - Willems, Stefan M.

AU - Bloemena, Elisabeth

AU - Leemans, C. René

AU - de Bree, Remco

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Background: To investigate if depth of invasion (DOI) can predict occult nodal disease in patients with cT1-2N0 (7th TNM) oral squamous cell carcinoma (OSCC) staged by sentinel lymph node biopsy (SLNB). Methods: In 199 OSCC patients, DOI measurements and SLNB were performed. Results: Metastases were found in 64 of 199 patients (32%). Of these 64 patients, the mean DOI was 6.6 mm compared to 4.7 mm in patients without metastases (P =.003). The ROC-curve showed an area under the curve of 0.65 with a most optimal cutoff point of 3.4 mm DOI (sensitivity 83% and specificity 47%). Regional metastases were found in 15% of patients with DOI ≤ 3.4 mm. Conclusion: DOI seems to be a poor predictor for regional metastasis in patients with cT1-2N0 OSCC. Therefore, staging of the neck using SLNB in patients with early stage oral cancer should also be performed in tumors with limited DOI and probably in T3 (8th TNM) OSCC ≤4 cm diameter.

AB - Background: To investigate if depth of invasion (DOI) can predict occult nodal disease in patients with cT1-2N0 (7th TNM) oral squamous cell carcinoma (OSCC) staged by sentinel lymph node biopsy (SLNB). Methods: In 199 OSCC patients, DOI measurements and SLNB were performed. Results: Metastases were found in 64 of 199 patients (32%). Of these 64 patients, the mean DOI was 6.6 mm compared to 4.7 mm in patients without metastases (P =.003). The ROC-curve showed an area under the curve of 0.65 with a most optimal cutoff point of 3.4 mm DOI (sensitivity 83% and specificity 47%). Regional metastases were found in 15% of patients with DOI ≤ 3.4 mm. Conclusion: DOI seems to be a poor predictor for regional metastasis in patients with cT1-2N0 OSCC. Therefore, staging of the neck using SLNB in patients with early stage oral cancer should also be performed in tumors with limited DOI and probably in T3 (8th TNM) OSCC ≤4 cm diameter.

KW - depth of invasion

KW - lymph node metastases

KW - Oral cancer

KW - sentinel lymph node biopsy

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EP - 2106

JO - Head and Neck

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Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy

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