Evaluation of Tumour Volume as a Prognostic Factor in Carcinoma Buccal Mucosa
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ORIGINAL ARTICLE
Evaluation of Tumour Volume as a Prognostic Factor in Carcinoma Buccal Mucosa H. S. Brindha1
•
S. M. Azeem Mohiyuddin1 • T. N. Suresh2
Received: 17 August 2020 / Accepted: 12 October 2020 Ó Association of Otolaryngologists of India 2020
Abstract (1) To determine tumor volume by clinical measurement, imaging and histopathological examination in patients with squamous carcinoma of buccal mucosa. (2) To correlate tumor volume with lymph-node metastasis and loco-regional control. Retrospective Observational Study. Rural tertiary care hospital. 75 Patients undergoing surgery for T2 (68%) and T3 (32%) Oral squamous carcinomas were included in this observational study. Tumor volume—a product of maximum length, breadth and thickness, was determined clinically and by imaging. Tumor volume on histopathology was documented and correlated with lymph-node metastasis. After 13 months minimum follow-up, tumor volume was correlated with loco-regional control. Recurrences were analysed with regard to tumor volume, depth of invasion, lymph-node metastasis and resection margins. Average tumor volume was 7.1 cm3among T2 and 14.4 cm3among T3. 25% of T2 tumors had metastatic lymph-nodes compared to 33.3% in T3. There was positive correlation between tumor volume and lymph-node metastasis. Lymph-node metastasis was absent when tumor volume was \ 8 cm3. There were 4 local and 2 regional recurrences in this study. Average histopathological tumor volume among patients who had & S. M. Azeem Mohiyuddin [email protected] H. S. Brindha [email protected] T. N. Suresh [email protected] 1
Department of Otorhinolaryngology, Sri Devaraj Urs Medical College, Kolar, India
2
Department of Pathology, Sri Devaraj Urs Medical College, Kolar, India
local recurrence was 12.95 cm3. Regional recurrences occurred in tumors staged N2b and N3b on histopathology. Average depth of invasion in patients with recurrence was 10.33 mm.. Tumor volume represents actual tumor load and correlates with lymph node metastasis and prognosis in oral cancers. Depth of invasion and tumor thickness influence staging and prognosis. Large volume tumors have poor oncological outcome. Keywords Tumour volume Buccal mucosa Squamous cell carcinoma Tumour thickness Depth of invasion Lymph node metastasis
Introduction Head and neck cancers account for 30–35% of all malignancies in India and oral cancers constitute almost 50% of head and neck malignancies [1]. 80% of these patients present with advanced disease in our region. Therefore, Head and Neck cancers are a major public health problem in developing countries due to addictions and change in life style [2]. Treatment protocol and prognosis vary widely and are based on the TNM staging of the disease at the time of diagnosis. Till 2017 Tumour (T)—was classified by a subjective and two-dimensional measurement. However, From 2018 Depth of invasion has been incorporated in T-classification. T-classification fails to define the true three-dimensional volume which is more accurate in depicting
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