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Value of radiological depth of invasion in non-pT4 Oral tongue squamous cell carcinoma: implication for preoperative MR T-staging

  • 0State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.
European Radiology +

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February 2, 2024

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February 2, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

This study developed a new preoperative MRI T-staging system for oral tongue squamous cell carcinoma (OTSCC). The system uses radiological depth of invasion (rDOI) measurements and accurately predicts patient survival, improving upon current pathological staging methods.

Area Of Science

  • Oncology
  • Radiology
  • Medical Imaging

Background

  • Oral tongue squamous cell carcinoma (OTSCC) prognosis relies heavily on pathological depth of invasion (pDOI).
  • Accurate preoperative staging is crucial for effective treatment planning in OTSCC.
  • Current staging systems may not fully capture prognostic information preoperatively.

Purpose Of The Study

  • To develop and validate a preoperative Magnetic Resonance (MR) T-staging system for non-pT4 OTSCC based on tumor size.
  • To assess the prognostic value of radiological depth of invasion (rDOI) in OTSCC.
  • To compare the performance of the proposed MR T-staging system with pathological staging.

Main Methods

  • Retrospective analysis of 280 non-metastatic, pT1-3 OTSCC patients treated between 2010-2017.
  • Utilized multiple MR sequences (T2WI, T1WI, CE-T1WI) to measure rDOI, tumor thickness, and diameter.
  • Employed intra-class correlation, univariate, and multivariate analyses for reproducibility and significance; established cutoff values using an exhaustive method.

Main Results

  • Excellent intra-observer (ICC=0.81-0.94) and inter-observer (ICC=0.79-0.90) reliability for rDOI measurements.
  • rDOI measurements significantly correlated with overall survival (OS) (p < .001).
  • The proposed MR T-staging system (rT1-3) using rDOI cutoffs of 8mm and 12mm on axial CE-T1WI showed superior prognostic capability (improved C-index 0.682 vs 0.639) compared to pathological staging.

Conclusions

  • Radiological depth of invasion (rDOI) is a critical predictor of OTSCC mortality.
  • The developed MR T-staging system for non-pT4 OTSCC is comparable to pathological staging and aids preoperative risk stratification.
  • This MR-based staging system merits consideration for future oral subsite MR T-staging protocols.

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