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Janović A, Bracanović Đ, Antić S, Marković-Vasiljković B. Demographic and imaging features of oral squamous cell cancer in Serbia: a retrospective cross-sectional study. BMC Oral Health 2024; 24:141. [PMID: 38287310 PMCID: PMC10823646 DOI: 10.1186/s12903-024-03869-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/06/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The mortality of oral squamous cell cancer (OSCC) in Serbia increased in the last decade. Recent studies on the Serbian population focused mainly on the epidemiological aspect of OSCC. This study aimed to investigate the demographic and imaging features of OSCC in the Serbian population at the time of diagnosis. METHODS We retrospectively analyzed computed tomography (CT) images of 276 patients with OSCC diagnosed between 2017 and 2022. Age, gender, tumor site, tumor volume (CT-TV, in cm3), depth of invasion (CT-DOI, in mm), and bone invasion (CT-BI, in %) were evaluated. TNM status and tumor stage were also analyzed. All parameters were analyzed with appropriate statistical tests. RESULTS The mean age was 62.32 ± 11.39 and 63.25 ± 11.71 for males and females, respectively. Male to female ratio was 1.63:1. The tongue (36.2%), mouth floor (21.0%), and alveolar ridge (19.9%) were the most frequent sites of OSCC. There was a significant gender-related difference in OSCC distribution between oral cavity subsites (Z=-4.225; p < 0.001). Mean values of CT-TV in males (13.8 ± 21.5) and females (5.4 ± 6.8) were significantly different (t = 4.620; p < 0.001). CT-DOI also differed significantly (t = 4.621; p < 0.001) between males (14.4 ± 7.4) and females (10.7 ± 4.4). CT-BI was detected in 30.1%, the most common in the alveolar ridge OSCC. T2 tumor status (31.4%) and stage IVA (28.3%) were the most dominant at the time of diagnosis. Metastatic lymph nodes were detected in 41.1%. CONCLUSION Our findings revealed significant gender-related differences in OSCC imaging features. The predominance of moderate and advanced tumor stages indicates a long time interval to the OSCC diagnosis.
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Affiliation(s)
- Aleksa Janović
- School of Dental Medicine, Center of Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11000, Republic of Serbia.
| | - Đurđa Bracanović
- School of Dental Medicine, Center of Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11000, Republic of Serbia
| | - Svetlana Antić
- School of Dental Medicine, Center of Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11000, Republic of Serbia
| | - Biljana Marković-Vasiljković
- School of Dental Medicine, Center of Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11000, Republic of Serbia
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Gao D, Ou J, Tan BG, Yu ZY, Li KY, Li R, Zhang XM, Chen TW, Zhou HY. A novel quantitative model based on gross tumor volume corresponding to anatomical distribution measured with multidetector computed tomography to determine the resectability of non‑distant metastatic esophageal squamous cell carcinoma. Oncol Lett 2023; 26:485. [PMID: 37818136 PMCID: PMC10561156 DOI: 10.3892/ol.2023.14072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/12/2023] [Indexed: 10/12/2023] Open
Abstract
It is important to accurately determine the resectability of thoracic esophageal squamous cell carcinoma (ESCC) for treatment decision-making. Previous studies have revealed that the CT-derived gross tumor volume (GTV) is associated with the staging of ESCC. The present study aimed to explore whether the anatomical distribution-based GTV of non-distant metastatic thoracic ESCC measured using multidetector computed tomography (MDCT) could quantitatively determine the resectability. For this purpose, 473 consecutive patients with biopsy-confirmed non-distant metastatic thoracic ESCC who underwent contrast-enhanced CT were randomly divided into a training cohort (TC; 376 patients) and validation cohort (VC; 97 patients). GTV was retrospectively measured using MDCT. Univariate and multivariate analyses were performed to identify the determinants of the resectability of ESCC in the TC. Receiver operating characteristic (ROC) analysis was performed to clarify whether anatomical distribution-based GTV could help quantitatively determinate resectability. Unweighted Cohen's Kappa tests in VC were used to assess the performance of the previous models. Univariate analysis demonstrated that sex, anatomic distribution, cT stage, cN stage and GTV were related to the resectability of ESCC in the TC (all P<0.05). Multivariate analysis revealed that GTV [P<0.001; odds ratio (OR) 1.158] and anatomic distribution (P=0.027; OR, 1.924) were independent determinants of resectability. ROC analysis revealed that the GTV cut-offs for the determination of the resectability of the upper, middle and lower thoracic portions were 23.57, 22.89 and 22.58 cm3, respectively, with areas under the ROC curves of >0.9. Unweighted Cohen's Kappa tests revealed an excellent performance of the ROC models in the upper, middle and lower thoracic portions with Cohen k-values of 0.913, 0.879 and 0.871, respectively. On the whole, the present study demonstrated that GTV and the anatomic distribution of non-distant metastatic thoracic ESCC may be independent determinants of resectability, and anatomical distribution-based GTV can effectively be used to quantitatively determine resectability.
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Affiliation(s)
- Dan Gao
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
- Department of Radiology, Qionglai Medical Center Hospital, Chengdu, Sichuan 611530, P.R. China
| | - Jing Ou
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Bang-Guo Tan
- Department of Radiology, Panzhihua Central Hospital, Panzhihua, Sichuan 617067, P.R. China
| | - Zi-Yi Yu
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Ke-Ying Li
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Rui Li
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Xiao-Ming Zhang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Tian-Wu Chen
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Hai-Ying Zhou
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
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Kuznetsov S, Yu Q, Spieler B, Hartsough R, Zhu X, Murnan E, Hironaka M, Zaid W. Can Radiographic Tumor Volume of Oral Squamous Cell Carcinoma Help Predict Clinical and Pathological Tumor Features? J Oral Maxillofac Surg 2021; 79:2582-2592. [PMID: 34252366 DOI: 10.1016/j.joms.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Radiographic tumor volume (RTV) of oral squamous cell carcinoma (SCC) is seldom measured in practice. Aims of the study are to estimate RTV of SCC and to investigate its relationship with clinical and pathological stage, tumor margin status, recurrence, and need for chemo/radiation. METHODS The Design is a retrospective cohort study. The predictor variable is SCC RTV. The primary outcome variables are clinical and pathological tumor size. The secondary outcomes are margin status and postoperative chemo/radiation. Tumor dimensions were measured on preoperative maxillofacial or neck computer tomography images with contrast. Information on patient and tumor characteristics was obtained. Pearson correlation, t test, ANOVA and log rank test were used for statistical analysis. The significance level was set at .05. RESULTS Thirty-Six subjects aged 36 to 86 were included in the study. Positive association was found between clinical T stage and RTV (P = .0003) and between pathologic T stage and RTV (P = .002). Mean value of RTV was significantly higher in group with positive margins (P = .0004). RTV was significantly higher in cancers requiring adjuvant chemo/radiation (P = .033). Mean RTV for patients with recurrence was 1.86 cm3 as compared to 1.29 cm3 for patients with no recurrence. Higher tumor volumes were more likely to be associated with recurrence. CONCLUSIONS RTV is a variable that is readily available to head and neck surgeons. RTV is associated with clinical and pathological tumor sizes, margin status, need for adjuvant chemo/radiation and tumor recurrence.
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Affiliation(s)
- Sergei Kuznetsov
- Resident. Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.
| | - Qingzhao Yu
- Professor. Department of Biostatistics, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Bradley Spieler
- Associate Professor of Diagnostic Radiology. Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Richard Hartsough
- Fellow. Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Xiaodan Zhu
- Research Assistant. Department of Biostatistics, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Eric Murnan
- Resident. Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Michael Hironaka
- Resident. Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Waleed Zaid
- Associate Professor. Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA
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Wang SM, Yin SC, Su XZ, Xu Q, Liu YH, Xu ZF. Magnitude of radial forearm free flaps and factors associated with loss of volume in oral cancer reconstructive surgery: Prospective study. Head Neck 2021; 43:2405-2413. [PMID: 33847445 DOI: 10.1002/hed.26704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/23/2021] [Accepted: 03/30/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Adequate flap volume is key to maintaining oral function after oral cancer surgery. This study aimed to evaluate changes in radial forearm free flap (RFFF) volumes after 1 year of follow-up following ablative tumor surgery in the head and neck. METHODS A prospective study that recorded the clinical data of 20 patients with head and neck cancer who underwent RFFF reconstruction. Magnetic resonance (MR) and Mimics Research 19.0 software were used to measure the RFFF volumes at 1, 3, 6, and 12 postoperative months. RESULTS Compared with one postoperative month, the RFFF volume decreased by 15.5%, 29.4%, and 42.0% at 3, 6, and 12 months, respectively, after surgery. A significant positive correlation between postoperative radiotherapy and RFFF volume changes was detected. CONCLUSION The volume of RFFF decreases with time. It is recommended to use overcorrection, with a 40% increase in RFFF volume, to reconstruct head and neck tumor-related defects.
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Affiliation(s)
- Si-Min Wang
- Department of Oral Maxillofacial-Head and Neck Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Shou-Cheng Yin
- Department of Oral Maxillofacial-Head and Neck Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Xing-Zhou Su
- Department of Oral Maxillofacial-Head and Neck Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Qiang Xu
- Department of Oral Maxillofacial-Head and Neck Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Yi-Hao Liu
- Department of Oral Maxillofacial-Head and Neck Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Zhong-Fei Xu
- Department of Oral Maxillofacial-Head and Neck Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
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Lalfamkima F, Georgeno GL, Rao NK, Selvakumar R, Devadoss VJ, Rajaram N, Farid S, Lalchhuanawma T, Nayyar AS. Clinical diagnostic criteria versus advanced imaging in prediction of cervical lymph node metastasis in oral squamous cell carcinomas: A magnetic resonance imaging based study. J Carcinog 2021; 20:3. [PMID: 34211339 PMCID: PMC8202445 DOI: 10.4103/jcar.jcar_27_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/02/2021] [Accepted: 02/19/2021] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND AIM: The inaccuracies in clinical examination have been well documented, while advanced imaging modalities, including computed tomography and magnetic resonance imaging (MRI), have been shown to have superior diagnostic accuracy in detecting occult and nodal metastasis. The aim of the present study was to identify as well as evaluate the inaccuracies in clinical examination and of clinical diagnostic criteria in known cases of oral squamous cell carcinomas (OSCCs) with the help of MRI. MATERIALS AND METHODS: A total of 24 patients attending as outpatients were included in the study, while clinically diagnosed and histopathologically proven cases of OSCC were examined clinically and then subjected to advanced imaging with the help of MRI. STATISTICAL ANALYSIS USED: Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA), while paired t-test was performed for evaluating the size of tumor and lymph node recorded on clinical and imaging findings. A P < 0.05 was considered statistically significant. RESULTS: Detection of tumor size and lymph node metastasis was found to be higher in case of MRI than when accomplished by clinical staging alone, while paired t-test values for difference in results were found to be statistically significant (P < 0.05). CONCLUSIONS: The present study showed that clinical diagnostic criteria alone were not sufficient and reliable for detecting metastatic lymphadenopathy, highlighting the significance of advanced imaging modalities such as MRI for an efficient preoperative diagnostic workup, as well a tool for planning treatment in patients with OSCCs.
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Affiliation(s)
- F Lalfamkima
- Consultant Dental Surgeon, Selection Grade, Dental Department, Civil Hospital, Aizawl, Mizoram, India
| | - G L Georgeno
- Consultant Dental Surgeon, Selection Grade, Dental Department, Civil Hospital, Aizawl, Mizoram, India
| | - N Koteswara Rao
- Department of Oral and Maxillofacial Surgery, Rajas Dental College and Hospital, Kavalkinaru, Tirunelveli, India
| | - Rajkumar Selvakumar
- Department of Oral and Maxillofacial Surgery, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinoutpalli, Gannavaram Mandal, Krishna District, Andhra Pradesh, India
| | - Vimal Joseph Devadoss
- Consultant Dental Surgeon, Selection Grade, Dental Department, Civil Hospital, Aizawl, Mizoram, India
| | - Niroshini Rajaram
- Department of Oral and Maxillofacial Surgery, Rajah Muthiah Dental College and Hospital, Annamalai University, Annamalai Nagar, Cuddalore, India
| | - Shomaila Farid
- Department of Oral Pathology and Microbiology, RVS Dental College and Hospital, Sulur, Coimbatore, Tamil Nadu, India
| | - T Lalchhuanawma
- Consultant Dental Surgeon, Selection Grade, Dental Department, Civil Hospital, Aizawl, Mizoram, India
| | - Abhishek Singh Nayyar
- Consultant, Division of Infection Prevention and Control, Infection Control Department, Security Forces Specialized Health Center, Taif, Kingdom of Saudi Arabia, India
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Ye LL, Rao J, Fan XW, Ji QH, Hu CS, Ying HM. Impact of tumor dimensions and lymph node density on the survival of patients with hypopharyngeal squamous cell carcinoma. Cancer Manag Res 2018; 10:4679-4688. [PMID: 30425568 PMCID: PMC6201846 DOI: 10.2147/cmar.s178750] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose To analyze the potential variables affecting the survival of patients undergoing primary surgery for hypopharyngeal squamous cell carcinoma. Patients and methods Between August 2007 and December 2016, 93 patients with primary hypopharyngeal squamous cell carcinomas undergoing radical surgery at Fudan University Shanghai Cancer Center were reviewed. The clinicopathological features were analyzed retrospectively. The optimal cutoff values were determined based on the receiver operating characteristic curve analysis. Pearson correlation coefficients were used to assess the correlations between variables. The Kaplan–Meier and Cox proportional hazard methods were used to evaluate the impact of variables on overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). Results Cox multivariate analysis revealed that a depth of invasion (DOI) ≥ 4.3 mm was correlated with inferior OS (P=0.045), DSS (P=0.046), and DFS (P=0.046). A primary tumor volume (PTV) ≥0.36 mL was related to poor OS (P=0.018), DSS (P=0.026), and DFS (P=0.036). A lymph node density (LND) ≥0.07 was also associated with worse OS (P=0.014) and DSS (P=0.045). Moreover, additional prognostic value was observed in the combined use of PTV and LND. Conclusion The DOI, PTV, and LND obtained from the surgical specimens could provide additional valuable information for prognostic stratification and allowed the more appropriate selection of suitable candidates for more aggressive adjuvant therapy.
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Affiliation(s)
- Lu-Lu Ye
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China,
| | - Jia Rao
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China, .,Department of Pathology
| | - Xing-Wen Fan
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China,
| | - Qing-Hai Ji
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China, .,Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China
| | - Chao-Su Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China,
| | - Hong-Mei Ying
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China,
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Mair M, Nair D, Nair S, Malik A, Mishra A, Kannan S, Bobdey S, Singhvi H, Chaturvedi P. Comparison of tumor volume, thickness, and T classification as predictors of outcomes in surgically treated squamous cell carcinoma of the oral tongue. Head Neck 2018; 40:1667-1675. [PMID: 29734474 DOI: 10.1002/hed.25161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 09/13/2017] [Accepted: 02/05/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND As per TNM classification, superficial tumors with a favorable prognosis are fallaciously clubbed together with unfavorable, deeply infiltrating lesions in the same classification. METHODS This is a retrospective study of 588 patients with treatment-naive oral tongue cancers. Binary logistic regression was used to identify predictors of nodal metastasis and extracapsular spread (ECS) using tumor volume and thickness as separate models. The C-index was generated to quantify predictive accuracy of T classification, thickness, and tumor volume for survival. RESULTS Compared to T classification, tumor volume and thickness were better predictors of nodal metastasis and ECS. Predictive accuracy for disease-free survival (DFS) and overall survival (OS) given by C-index was equal and better for thickness (0.60 and 0.69) and tumor volume (0.61 and 0.69) as compared to T classification (0.59 and 0.64, respectively). For early-stage T1 to T2 oral tongue cancer, thickness is a better predictor of nodal metastasis as compared to tumor volume and T classification. CONCLUSION Concordance between the tumor thickness and volume proves that tumor thickness can be taken as a surrogate and reliable predictor of outcomes instead of calculating the tumor volume.
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Affiliation(s)
- Manish Mair
- Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Deepa Nair
- Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Sudhir Nair
- Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Akshat Malik
- Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Aseem Mishra
- Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Sadhana Kannan
- Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Saurabh Bobdey
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, India
| | - Hitesh Singhvi
- Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Pankaj Chaturvedi
- Department of Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
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Hu H, Cheng KL, Xu XQ, Wu FY, Tyan YS, Tsai CH, Shen CY. Predicting the Prognosis of Oral Tongue Carcinoma Using a Simple Quantitative Measurement Based on Preoperative MR Imaging: Tumor Thickness versus Tumor Volume. AJNR Am J Neuroradiol 2015; 36:1338-42. [PMID: 25836729 DOI: 10.3174/ajnr.a4278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/03/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE Several studies indicated that tumor thickness or tumor volume might be helpful predictors for the prognosis of oral tongue squamous cell carcinoma. Our aim was to compare the value of tumor thickness versus tumor volume measurement based on preoperative MR imaging in predicting the prognosis of oral tongue squamous cell carcinoma, especially focusing on lymph node metastases and local recurrence. MATERIALS AND METHODS Clinical, pathologic, and imaging data of patients with 46 oral tongue squamous cell carcinomas were retrospectively studied. Logistic regression analysis was used to evaluate the prognostic value of tumor thickness and tumor volume based on MR imaging. Receiver operating characteristic analysis was applied for the optimal cutoff value for the identified risk variable for prognosis. RESULTS A higher intraclass correlation coefficient was achieved for the measurement of tumor thickness compared with tumor volume (0.990 versus 0.972). Multivariate analysis showed that tumor thickness was a significant predictor of lymph node metastases (P = .024), while tumor volume was not a significant predictor of either lymph node metastases or local recurrence (P > .05). Receiver operating characteristic results indicated that setting a tumor thickness of 8.5 mm as a cutoff value could achieve the optimal diagnostic efficiency for predicting lymph node metastases (area under the curve, 0.753; sensitivity, 0.889; specificity, 0.536). CONCLUSIONS Tumor thickness based on preoperative MR imaging was useful in predicting the prognosis of oral tongue squamous cell carcinoma, especially lymph node metastases, in our patient population, while tumor volume was not.
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Affiliation(s)
- H Hu
- From the Department of Radiology (H.H., X.-Q.X., F.-Y.W.), First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - K-L Cheng
- Departments of Medical Imaging (K.-L.C., Y.-S.T., C.-Y.S.) School of Medical Imaging and Radiological Sciences (K.-L.C., Y.-S.T., C.-Y.S.) Department of Veterinary Medicine (K.-L.C.), National Chung Hsing University, Taichung, Taiwan
| | - X-Q Xu
- From the Department of Radiology (H.H., X.-Q.X., F.-Y.W.), First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - F-Y Wu
- From the Department of Radiology (H.H., X.-Q.X., F.-Y.W.), First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Y-S Tyan
- Departments of Medical Imaging (K.-L.C., Y.-S.T., C.-Y.S.) School of Medical Imaging and Radiological Sciences (K.-L.C., Y.-S.T., C.-Y.S.) School of Medicine (Y.-S.T., C.-H.T., C.-Y.S.)
| | - C-H Tsai
- Pathology (C.-H.T.), Chung Shan Medical University Hospital, Taichung, Taiwan School of Medicine (Y.-S.T., C.-H.T., C.-Y.S.) Institute of Medicine (C.-H.T., C.-Y.S.), Chung Shan Medical University, Taichung, Taiwan
| | - C-Y Shen
- Departments of Medical Imaging (K.-L.C., Y.-S.T., C.-Y.S.) School of Medical Imaging and Radiological Sciences (K.-L.C., Y.-S.T., C.-Y.S.) School of Medicine (Y.-S.T., C.-H.T., C.-Y.S.) Institute of Medicine (C.-H.T., C.-Y.S.), Chung Shan Medical University, Taichung, Taiwan
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Relationships between Tumor Volume and Lymphatic Metastasis and Prognosis in Early Oral Tongue Cancer. Clin Exp Otorhinolaryngol 2013; 6:243-8. [PMID: 24353865 PMCID: PMC3863674 DOI: 10.3342/ceo.2013.6.4.243] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 09/27/2012] [Accepted: 11/02/2012] [Indexed: 11/08/2022] Open
Abstract
Objectives Although T stage is an important prognostic tool for oral tongue cancer, it fails to define the depth of invasion and true three-dimensional volume of primary tumors. The purpose of this paper is to determine the relations between tumor volume and lymph node metastasis and survival in early oral tongue cancer. Methods Forty-seven patients with T1-2 tongue cancer were included. Tumor volumes were measured by the computerized segmentation of T2-weighted magnetic resonance imaging. Results The overall average tumor volume was 27.7 cm3 (range, 1.4 to 60.1 cm3). A significant positive correlation was found between tumor volume and pathological T stage, depth of invasion, and cervical lymph node metastasis (P<0.001, P<0.001, and P=0.002, respectively). When the tumor volume exceeded 20 cm3, the cervical metastasis rate increased to 69.2%. The overall 5-year disease specific survival rate was 80%. There was a statistically significant association between large tumor volume (≥20 cm3) and the 5-year disease-specific survival (P=0.046). Conclusion Tumor volume larger than 20 cm3 was associated with greater risk cervical lymph node metastasis and poor 5-year disease-specific survival rate in early oral tongue cancer patients.
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Li R, Chen TW, Hu J, Guo DD, Zhang XM, Deng D, Li H, Chen XL, Tang HJ. Tumor volume of resectable adenocarcinoma of the esophagogastric junction at multidetector CT: association with regional lymph node metastasis and N stage. Radiology 2013; 269:130-8. [PMID: 23657894 DOI: 10.1148/radiol.13122269] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To determine whether the volume of resectable adenocarcinoma of the esophagogastric junction (AEG) measured at multidetector computed tomography (CT) is associated with regional lymph node metastasis and N stage. MATERIALS AND METHODS The study was approved by the institutional ethics committee, and written informed consent was obtained from each participant. Two hundred sixteen patients with resectable AEG prospectively underwent contrast material-enhanced thoracoabdominal multidetector CT less than 2 weeks before curative resection. Gross tumor volume was retrospectively measured on CT scans. Univariate and multivariate analyses were performed to identify whether gross tumor volume is associated with regional lymph node metastasis. The Mann-Whitney U test was performed to compare gross tumor volume among N stages, with Bonferroni correction for multigroup comparisons. Receiver operating characteristic analysis was performed to determine if gross tumor volume could help classify N stage. RESULTS Univariate analysis showed that gross tumor volume is associated with regional lymph node metastasis (P < .0001). Multivariate analysis revealed that gross tumor volume is an independent risk factor of lymph node metastasis (P = .023, odds ratio = 2.791). The Mann-Whitney U test showed that gross tumor volume could help differentiate between stage N0 and stages N1-N2 or N1-N3 disease and between stages N1-N2 and stage N3 disease (P < .0001 for all). In patients with stage T1-T3 AEG, gross tumor volume could help differentiate between stage N0 and stages N1-N2 (cutoff, 15.23 cm(3)) or N1-N3 (cutoff, 17.16 cm(3)) disease and between stages N1-N2 and stage N3 disease (cutoff, 33.96 cm(3)). In patients with stage T3 AEG, gross tumor volume could help differentiate stage N0 from stages N1-N2 (cutoff, 18.41 cm(3)) or N1-N3 (cutoff, 19.30 cm(3)) disease and stages N1-N2 from stage N3 disease (cutoff, 33.96 cm(3)). CONCLUSION Gross tumor volume of AEG measured with multidetector CT is associated with regional lymph node metastasis and N stage.
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Affiliation(s)
- Rui Li
- Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Rd, Shunqing District, Nanchong 637000 Sichuan, China
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Tumour size of resectable oesophageal squamous cell carcinoma measured with multidetector computed tomography for predicting regional lymph node metastasis and N stage. Eur Radiol 2012; 22:2487-93. [PMID: 22653286 DOI: 10.1007/s00330-012-2512-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 04/15/2012] [Accepted: 04/19/2012] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To determine whether and how tumour size of resectable oesophageal squamous cell carcinoma (ESCC) measured with multidetector CT could predict regional lymph node metastasis (LNM) and N stage. METHODS Two hundred five patients with ESCC underwent radical oesophagectomy with three-field lymphadenectomy less than 3 weeks after contrast-enhanced CT. Tumour size of the ESCC (tumour length, maximal thickness and gross tumour volume, GTV) was measured on CT. Statistical analyses were performed to identify whether tumour size could predict regional LNM and N stage, and to determine how to use the size of ESCC to predict N stage. RESULTS Univariate analysis showed that tumour size could predict regional LNM (all P < 0.05). Logistic regression analysis revealed that GTV could independently predict regional LNM (P = 0.021, odds ratio = 1.813). Mann-Whitney tests showed that tumour size could distinguish grouped N stages (all P < 0.05). GTV might be a differentiating indicator between N0 and N1-3 stages (cutoff, 14.4 cm(3)), between N0-1 and N2-3 (cutoff, 15.9 cm(3)), and between N0-2 and N3 (cutoff, 26.1 cm(3)), with sensitivity of 76%, 63% or 75%, and specificity of 75%, 61% and 81%, respectively. CONCLUSIONS The GTV of ESCC measured with CT could be an indicator for predicting regional LNM and grouped N stages. KEY POINTS • Multidetector computed tomography (MDCT) allows accurate assessment of oesophageal tumour size • For resectable squamous cell tumours, size helped predict regional lymph node involvement • Gross tumour volume may predict the N stage of oesophageal squamous cell carcinoma.
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12
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Assessment of volume changes of radial forearm free flaps in head and neck cancer: Long-term results. Oral Oncol 2011; 47:72-5. [DOI: 10.1016/j.oraloncology.2010.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 11/01/2010] [Accepted: 11/01/2010] [Indexed: 11/20/2022]
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Cho KJ, Joo YH, Sun DI, Kim MS. Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps. Eur Arch Otorhinolaryngol 2010; 268:1061-5. [DOI: 10.1007/s00405-010-1450-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 11/23/2010] [Indexed: 11/30/2022]
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Rebol J. Volume determination of oral cavity tumors by 3-dimensional ultrasonography. J Oral Maxillofac Surg 2008; 66:2296-301. [PMID: 18940495 DOI: 10.1016/j.joms.2008.01.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2007] [Accepted: 01/11/2008] [Indexed: 11/30/2022]
Abstract
PURPOSE With the help of 3-dimensional (3D) ultrasound, the ultrasonographic determination of tumor volumes offers a new view of tumors in the oral cavity. These are classified according to their maximal diameter in TNM classification whereby the possibility exists in the high T category of overestimating small tumors that have spread into surrounding structures, and in the low T of underestimating large volume tumors that do not extend into surrounding structures. MATERIALS AND METHODS We analyzed a group of 49 patients with tumors of the oral cavity, all of whom underwent surgery. Tumor volumes were determined before surgery with 3D ultrasound aided by 3D View program software. After excision, the tumors were classified in pT categories based on pathologic findings. N stage was determined after neck dissection and correlation to tumor volume were performed. RESULTS The average volume of T1 tumors was 1.74 cm(3); T2 was 5.21 cm(3); T3 was 23.36 cm(3), and T4 was 13.53 cm(3). There were significant differences in tumor volumes between all T categories except T3 and T4. Tumor volumes in our patients did not correlate with N stage. CONCLUSION Volume determination of tumors with the help of 3D View software may categorize small tumors better and perhaps become a new refinement in TNM tumor classification. Results show that although T category in oral cavity tumors is determined by diameter in T1 to T3, the volumes match with T category. By using this method, a successful follow-up can be performed and the effects of radiotherapy or chemotherapy can be evaluated.
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Affiliation(s)
- Janez Rebol
- Department of Otolaryngology, Maribor University Hospital, Maribor, Slovenia.
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Bergquist H, Johnsson A, Hammerlid E, Wenger U, Lundell L, Ruth M. Factors predicting survival in patients with advanced oesophageal cancer: a prospective multicentre evaluation. Aliment Pharmacol Ther 2008; 27:385-95. [PMID: 18081735 DOI: 10.1111/j.1365-2036.2007.03589.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Oesophageal cancer is often diagnosed at an advanced stage, with poor prognosis and severe morbidity. In majority of cases, palliative treatment is the only option available. AIM To find factors that can predict survival for patients with incurable cancer of the oesophagus or gastro-oesophageal junction and hence aid in the choice of treatment. METHODS Ninety-six patients were included. Health-related quality of life questionnaires (EORTC QLQ C-30 and QLQ OES18) were administered and computerized tomography-derived size assessment of the primary tumours was performed. Univariate and multivariate Cox-regression analyses were used to determine potential predictors of survival. RESULTS Karnofsky Index, occurrence of metastases (M-stage), Union International Contre le Cancer-stage, computerized tomography-derived tumour size assessment and 10 of 25 scales and single items from the health-related quality of life questionnaires were found to be related to survival. In the multivariate analysis, three of the health-related quality of life questionnaire scales (physical functioning, fatigue and reflux) were found to add prognostic information to M-stage, the single strongest predictor (HR 1.9, P < 0.01). CONCLUSION In addition to M-stage, the outcome of health-related quality of life questionnaires can sharpen the prediction of survival in patients with advanced cancer of the oesophagus or gastro-oesophageal junction and thus aid in the choice of palliative treatment strategy.
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Affiliation(s)
- H Bergquist
- Department of Otorhinolaryngology, Sahlgrenska University Hospital, Göteborg, Sweden.
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Kurokawa H, Yamashita Y, Matsumoto S, Takamori K, Igawa K, Kashima K, Zhang M, Fukuyama H, Takahashi T, Sakodal S. Predictive Markers for Late Cervical Lymph Node Metastasis in Patients with N0 Squamous Cell Carcinoma of the Tongue. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0915-6992(06)80006-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Jing J, Li L, He W, Sun G. Prognostic Predictors of Squamous Cell Carcinoma of the Buccal Mucosa With Negative Surgical Margins. J Oral Maxillofac Surg 2006; 64:896-901. [PMID: 16713803 DOI: 10.1016/j.joms.2006.02.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2005] [Indexed: 11/24/2022]
Abstract
PURPOSE To study the prognostic factors of squamous cell carcinoma of the buccal mucosa (BMSCC) with negative surgical margins. PATIENTS AND METHODS Forty-five untreated negative marginal cases were studied for predictors of recurrence, cervical lymph node metastasis, and survival. Clinicopathologic features included age, gender, duration of tumor, primary tumor (T) classification, pathologic clinical stage, tumor differentiation, tumor thickness, number of mitoses, and lymphocytic infiltration. RESULTS The recurrence and metastasis rate was 40% and 44.4%, respectively. With univariate analysis, the predictors of recurrence were T classification, tumor differentiation, pathologic clinical stage, and lymphocytic infiltration. Average tumor thickness was greater than 5.68 mm. For cervical lymph node metastasis, the predictors include T classification, tumor differentiation, and lymphocytic infiltration. Tumor thickness was greater than 5.17 mm; number of mitoses was greater than 2.92/high power field (HPF). With logistical regression, only tumor thickness was the predictor of recurrence. T classification and tumor thickness were the predictors for cervical lymph node metastasis. Using Cox multivariate proportional hazards regression model, the survival disadvantage factors were T classification and recurrence. The hazard grand for T classification was 2.185; for recurrence it was 74.808. CONCLUSIONS Because T classification (between T1+T2 and T3+T4) and tumor thickness (more than 5.17 mm) were the predictors for cervical lymph node metastasis, neck dissection should be carried out routinely in T3 and T4 patients; whereas for T1 and T2 patients, neck dissection is necessary if tumor thickness is greater than 5.17 mm. T classification and recurrence are predictive factors for survival.
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Affiliation(s)
- Jie Jing
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Ningxia Medical College, Yinchuan, Ningxia, China, PRC
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Wong YK, Tsai WC, Lin JC, Poon CK, Chao SY, Hsiao YL, Chan MY, Cheng CS, Wang CC, Wang CP, Liu SA. Socio-demographic factors in the prognosis of oral cancer patients. Oral Oncol 2006; 42:893-906. [PMID: 16730220 DOI: 10.1016/j.oraloncology.2005.12.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Revised: 12/04/2005] [Accepted: 12/06/2005] [Indexed: 10/24/2022]
Abstract
The aim of this study was to determine the survival rate of oral cancer patients treated in a medical center in central Taiwan and to investigate whether socio-demographic factors influence their survival. We retrospectively reviewed 1010 chart records of oral cancer patients. Survival was analyzed by the Kaplan-Meier method and Cox proportional hazard model was used for investigating the relationship between socio-demographic factors and survival. The overall 5-year survival rate was 63.24%. Multivariate analysis revealed that those without religious belief tended to have higher probability of death than those who had religious belief (relative risk (RR): 2.057, p<0.001). In addition, those who were single, widow/widower or divorced/separated had a poorer prognosis than those who were married (RR: 1.528, p=0.008). Apart from clinical features, socio-demographic factors also significantly influenced the survival of oral cancer patients. Therefore, care providers should take socio-demographic issues into consideration aside from ordinary clinical health care.
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Affiliation(s)
- Yong-Kie Wong
- Department of Oral and Maxillofacial Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
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Cavalcanti MGP, Santos DTD, Perrella A, Vannier MW. CT-based analysis of malignant tumor volume and localization: a preliminary study. Braz Oral Res 2004; 18:338-44. [PMID: 16089267 DOI: 10.1590/s1806-83242004000400012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
The purpose of this study was to correlate 3D-CT (3D computed tomography) volume measurements of malignant tumors with the response to treatment, and to observe bone invasion in these lesions applying a specific imaging protocol. We analyzed 17 individuals with maxillofacial malignant lesions who were submitted to spiral CT (2D-CT). The original data were transferred to an independent workstation using a 3D volume rendering package software, which was used by two examiners to obtain area and volume measurements of the lesions, independently, three times each, prior to and after treatment. The segmentation protocol was applied for the assessment of bone involvement. The difference between imaging and gold standard values was not considered significant (p > 0.05). Regarding bone invasion, three false-negatives were obtained using MPR-CT (multiplanar reconstruction) and no false-negatives were obtained using the 3D segmentation protocol. The use of 3D-CT may be a differential and important factor for expanding options regarding the localization, dimension, and clarification of lesion components.
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Chong VFH, Zhou JY, Khoo JBK, Huang J, Lim TK. Tongue carcinoma: tumor volume measurement. Int J Radiat Oncol Biol Phys 2004; 59:59-66. [PMID: 15093899 DOI: 10.1016/j.ijrobp.2003.09.089] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2003] [Accepted: 09/08/2003] [Indexed: 10/26/2022]
Abstract
PURPOSE To validate the semiautomated methods of tongue carcinoma tumor volume measurement by comparing the conventional manual trace method with 2 semiautomated computer methods: seed growing and region deformation. MATERIALS AND METHODS The study population consisted of 16 patients with histology-proven tongue carcinoma. Two head-and-neck radiologists independently measured the tumor volume demonstrated on pretreatment T2-weighted magnetic resonance data sets. The tumor volumes were measured using manual tracing and semiautomated seed growing and region deformation algorithm. Data were recorded for analysis of interoperator variance and interobserver reliability at volume and pixel levels. RESULTS There was no significant difference between the manually traced volume and semiautomated segmentation volumes for both operators. No significant difference was found in interobserver variance among the 3 methods at volume level. However, there was significant difference between manual tracing and semiautomated segmentation methods in interobserver reliability at pixel level. CONCLUSION The semiautomated methods could achieve satisfactory segmentation results. They could also reduce interoperator variance and obtain a higher interobserver reliability. This study validates the use of semiautomated volume measurement methods for tongue carcinoma.
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Affiliation(s)
- Vincent F H Chong
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Republic of Singapore.
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Flint S, Glick M, Patton L, Tappuni A, Shirlaw P, Robinson P. Consensus guidelines on quantifying HIV-related oral mucosal disease. Oral Dis 2002; 8 Suppl 2:115-9. [PMID: 12164644 DOI: 10.1034/j.1601-0825.2002.00022.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The workshop agreed that the development of consensus quantification protocols was desirable, but that this whole field was underdeveloped, to date. The working goals were therefore redefined (vide infra). Three possible protocols were presented and discussed relating to oral hairy leukoplakia, oral ulceration (NOS) and oral candidiasis. There was agreement that different data-set protocols would have to be developed for specific HIV-related mucosal diseases. Furthermore, the data set should be consistent, standardized and disaggregated. In this way, with everyone working to the same standards of outcome, data from geographically, nationally, socially or culturally different areas could be readily compared. A future meeting to generate the disease-specific protocols would, most likely, be needed.
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Affiliation(s)
- S Flint
- Department of Oral Surgery, Oral Medicine and Oral Pathology, Dublin Dental Hospital and School of Dental Science, Trinity College, Ireland.
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