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

Research output: Contribution to journalArticleAcademicpeer-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.
LanguageEnglish
JournalHead & Neck
DOIs
Publication statusE-pub ahead of print - 2019

Cite this

@article{ebdb5c92ae9f43328c1a64cd9de1a3a5,
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.",
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",
note = "{\circledC} 2019 The Authors. Head & Neck published by Wiley Periodicals, Inc.",
year = "2019",
doi = "10.1002/hed.25665",
language = "English",
journal = "Head and Neck",
issn = "1043-3074",
publisher = "Wiley Subscription Services, Inc., A Wiley Company Hoboken",

}

Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy. / den Toom, Inne J.; Janssen, Luuk M.; van Es, Robert J. J.; Karagozoglu, K. Hakki; de Keizer, Bart; van Weert, Stijn; Willems, Stefan M.; Bloemena, Elisabeth; Leemans, C. René; de Bree, Remco.

In: Head & Neck, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

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

N1 - © 2019 The Authors. Head & Neck published by Wiley Periodicals, Inc.

PY - 2019

Y1 - 2019

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.

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