Anna See, Min-Cun Yang, Yenlin Huang, Tsung-You Tsai, Chi-Yin Lee, Pin-Hsuan Huang, Ti-Yung Tseng, Shu-Hang Ng, Kai-Ping Chang
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引用次数: 0
Abstract
Objectives: We investigate if sublingual space invasion (SLI) determined on magnetic resonance imaging confers differences in clinicopathological manifestations and treatment outcomes of oral tongue squamous cell carcinoma (OTSCC).
Study design: Retrospective cohort study.
Setting: Tertiary Academic Medical Center.
Methods: 221 OTSCC patients were included. Cox regression models and Kaplan-Meier methods were used, and nomogram construction was performed, incorporating SLI with other adverse factors, to predict the prognosis.
Results: On multivariable analysis, the following were associated with cervical nodal metastasis: (1) greater MRI T classification of T3/T4 versus T1/T2: adjusted odds ratio (aOR) 2.784, 95% CI = 1.459 to 5.313, P = .001; (2) gender (female vs male): aOR 4.117, 95% CI = 1.602 to 10.576, P = .003; (3) presence of MRI-determined SLI: aOR 2.588, 95% CI = 1.393 to 4.808, P = .002. For survival outcomes, extranodal extension (adjusted hazard ratio [aHR]: 3.380, 95% CI = 2.024-5.644, P < .001), poorly-differentiated type (aHR: 1.720, 95% CI = 1.006-2.943, P = .047), lymphovascular invasion (aHR: 2.100, 95% CI = 1.220-3.614, P = .007), and SLI (aHR: 1.700, 95% CI = 1.086-2.661, P = .020) were statistically significant prognosticators of disease-free survival. In overall survival, when controlled for age, gender, overall TNM stage, Charlson morbidity index, surgical margins, depth of invasion and adjuvant therapy, SLI was a statistically significant prognosticator (aHR: 1.622, 95% CI = 1.012-2.602, P = .044). A proposed novel nomogram for overall survival combining SLI and other risk factors showed a higher concordance index compared to a nomogram with TNM staging alone (0.783 vs 0.629, P < .001).
Conclusion: SLI is an independent prognostic factor for treatment outcomes in OTSCC. Incorporating SLI into a novel nomogram demonstrated improved predictive accuracy for post-treatment outcomes.
期刊介绍：
Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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