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Updated: Aug 6, 2026
Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
Published on: June 9, 2023
Radiologic 3D tumor volume predicts cervical metastasis in oral squamous cell carcinoma
A Schmitz1, V Corneo2, C Rendenbach2
1Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. alina-marie.schmitz@charite.de.
Objectives:
To test whether pre-operative primary CT-based 3D tumor volume (TV) improves prediction of cervical spread in oral squamous cell carcinoma (OSCC) beyond conventional size metrics.
Materials And Methods:
We retrospectively analyzed 132 consecutive primary OSCC patients (2014-2019). Contrast-enhanced CT datasets were semi-automatically segmented to obtain 3D TV (cm3), verified by a second observer. Multivariable logistic regression related log-TV to pathologic lymph-node metastasis (LNM), extranodal extension (ENE), and skip metastasis. Performance of radiologic TV, depth of invasion (DOI), and ellipsoid pathologic volume was compared by ROC/AUC and decision-curve analyses.
Results:
Median CT-derived TV was 12.6 cm3. Log-TV independently predicted LNM (odds ratio 3.00, 95% CI 1.21-7.68; AUC 0.815), outperforming DOI (AUC 0.541) and pathologic volume (AUC 0.498). A non-linear pattern linked very small (< 1.8 cm3) and large (> 16 cm3) tumors to increased skip-metastasis probability (AUC 0.733). Radiologic and pathologic volumes showed minimal concordance (R2 = 0.0002). Decision-curve analysis demonstrated consistent net benefit of the volume model across clinically relevant threshold probabilities for elective neck dissection.
Conclusions:
CT-based 3D volumetry is an independent pre-operative predictor of cervical LNM, flags tumors prone to skip spread, and offers greater clinical utility than linear measures.
Clinical Relevance:
Integrating radiologic volumetry into staging could refine nodal management-particularly in clinically node-negative patients-by supporting risk-adapted selection between sentinel lymph-node biopsy and elective neck dissection; prospective validation is warranted.
