TY - JOUR
T1 - Influence of tumor volume on survival in patients with oral squamous cell carcinoma
AU - Mücke, Thomas
AU - Mitchell, David A.
AU - Ritschl, Lucas M.
AU - Tannapfel, Andrea
AU - Wolff, Klaus Dietrich
AU - Kesting, Marco R.
AU - Loeffelbein, Denys J.
AU - Kanatas, Anastasios
N1 - Publisher Copyright:
© 2014, Springer-Verlag Berlin Heidelberg.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Purpose: The TNM classification is used to assess cancers of the oral cavity, and advancements in imaging techniques have revealed clear variations in tumor volume at presentation. This study therefore aimed to clarify whether preoperative imaging, with exact measurements of the tumor, could affect post-surgery survival after controlling for demographic, clinical, and tumor characteristics.Methods: We included 437 patients with histologically confirmed, stage T1–4, N1–3, M0, invasive squamous cell carcinoma of the tongue. Participants were assessed for recurrence every 3 months for the first 2 years, every 6 months for another 2 years, and annually thereafter; routine computed tomography was performed annually. Associations were determined using the Kaplan–Meier estimator, univariate log-rank test, and Cox proportional hazards regression models.Results: The mean survival of all patients was 68.1 ± 48.2 months. The 2- and 5-year overall survival rates were 82.2 and 66.7 %, respectively. The mean primary tumor volume was 7.14 cm3 with a range of 1.3–24.21 cm3. The ROC curve and Youden Index analysis revealed that the optimal cutoff volume was between ≤5.9 and ≤18.3 cm3 for three different volume groups (p < 0.0001). Large tumor volume was associated with a significantly poorer overall survival (p < 0.0001).Conclusions: Tumor volume was significantly associated with the overall survival of patients. This has both prognostic and reconstructive implications that will affect health-related quality of life. In addition, this will inform surgical planning and the allocation of resources.
AB - Purpose: The TNM classification is used to assess cancers of the oral cavity, and advancements in imaging techniques have revealed clear variations in tumor volume at presentation. This study therefore aimed to clarify whether preoperative imaging, with exact measurements of the tumor, could affect post-surgery survival after controlling for demographic, clinical, and tumor characteristics.Methods: We included 437 patients with histologically confirmed, stage T1–4, N1–3, M0, invasive squamous cell carcinoma of the tongue. Participants were assessed for recurrence every 3 months for the first 2 years, every 6 months for another 2 years, and annually thereafter; routine computed tomography was performed annually. Associations were determined using the Kaplan–Meier estimator, univariate log-rank test, and Cox proportional hazards regression models.Results: The mean survival of all patients was 68.1 ± 48.2 months. The 2- and 5-year overall survival rates were 82.2 and 66.7 %, respectively. The mean primary tumor volume was 7.14 cm3 with a range of 1.3–24.21 cm3. The ROC curve and Youden Index analysis revealed that the optimal cutoff volume was between ≤5.9 and ≤18.3 cm3 for three different volume groups (p < 0.0001). Large tumor volume was associated with a significantly poorer overall survival (p < 0.0001).Conclusions: Tumor volume was significantly associated with the overall survival of patients. This has both prognostic and reconstructive implications that will affect health-related quality of life. In addition, this will inform surgical planning and the allocation of resources.
KW - Oral squamous cell carcinoma of the tongue
KW - Reconstructive surgery
KW - TNM classification
KW - Tumor volume
UR - http://www.scopus.com/inward/record.url?scp=84937965277&partnerID=8YFLogxK
U2 - 10.1007/s00432-014-1881-2
DO - 10.1007/s00432-014-1881-2
M3 - Article
C2 - 25423880
AN - SCOPUS:84937965277
SN - 0171-5216
VL - 141
SP - 1007
EP - 1011
JO - Journal of Cancer Research and Clinical Oncology
JF - Journal of Cancer Research and Clinical Oncology
IS - 6
ER -