Clin Exp Otorhinolaryngol.  2013 Dec;6(4):243-248.

Relationships between Tumor Volume and Lymphatic Metastasis and Prognosis in Early Oral Tongue Cancer

• Joo YH
• Hwang SH
• Sun DI
• Cho KJ
• Park JO
• Kim MS

Abstract

OBJECTIVES
Although T stage is an important prognostic tool for oral tongue cancer, it fails to define the depth of invasion and true three-dimensional volume of primary tumors. The purpose of this paper is to determine the relations between tumor volume and lymph node metastasis and survival in early oral tongue cancer.
METHODS
Forty-seven patients with T1-2 tongue cancer were included. Tumor volumes were measured by the computerized segmentation of T2-weighted magnetic resonance imaging.
RESULTS
The overall average tumor volume was 27.7 cm3 (range, 1.4 to 60.1 cm3). A significant positive correlation was found between tumor volume and pathological T stage, depth of invasion, and cervical lymph node metastasis (P<0.001, P<0.001, and P=0.002, respectively). When the tumor volume exceeded 20 cm3, the cervical metastasis rate increased to 69.2%. The overall 5-year disease specific survival rate was 80%. There was a statistically significant association between large tumor volume (> or =20 cm3) and the 5-year disease-specific survival (P=0.046).
CONCLUSION
Tumor volume larger than 20 cm3 was associated with greater risk cervical lymph node metastasis and poor 5-year disease-specific survival rate in early oral tongue cancer patients.

Keyword

Tongue neoplasms; Tumor burden; Lymphatic metastasis; Computer-assisted image processing; Magnetic resonance imaging

MeSH Terms

Humans
Image Processing, Computer-Assisted
Lymph Nodes
Lymphatic Metastasis*
Magnetic Resonance Imaging
Neoplasm Metastasis
Prognosis*
Survival Rate
Tongue Neoplasms*
Tongue*
Tumor Burden*

Figure

• 

  Fig. 1 Magnetic resonance images of a patient with tongue cancer and 3-dimensional reconstructed tongue cancer image. The periphery of tumor is outlined on the magnetic resonance images for tumor volume estimation. (A) Axial image, (B) coronal image, (C) sagittal image, (D) reconstructed image.

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  Fig. 2 Relationship between tumor volume and pathologic T stage. A significant relation was found between tumor volume and pathologic T stage. T1=9.49±10.46 cm3, T2=40.06±19.18 cm3, P<0.001.

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  Fig. 3 Relationship between tumor volume and depth of invasion.

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  Fig. 4 Relationship between tumor volume and cervical lymph node metastasis. A significant relation was found between tumor volume and the presence of cervical lymph node metastasis (tumor volume in cases with cervical lymph node metastasis=43.61±17.20 cm3, tumor volume in cases without cervical lymph node metastasis=16.91±18.34 cm3; P<0.001).

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  Fig. 5 Kaplan-Meier 5-year disease specific survival curves according to the tumor volume. There was a statistically significant association between tumor volume and the 5-year disease-specific survival (the 5-year disease-specific survival with a large tumor.

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