The oral cavity tumor thickness: Measurement accuracy and consequences for tumor staging

S. G. Brouwer de Koning*, M. B. Karakullukcu, C. A.H. Lange, T. J.M. Ruers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

Introduction: In the 8th edition of the AJCC/UICC cancer staging system (AJCC8), the depth of invasion (DOI) of the oral cavity tumor is the discriminative factor in tumor staging over the previously used greatest dimension (GD). In order to obtain a complete representation of how accurate we stage oral cavity cancer clinically, we evaluated the accuracy of measurements of the tumor dimensions on ultrasound (US) and magnetic resonance (MR) imaging by comparing this with the histopathology as the “golden standard”. Secondly, we compared the pathological tumor staging of these tumors according to the AJCC7 and AJCC8, to evaluate the effect of the incorporation of the DOI in the AJCC8. Materials and methods: In a retrospective analysis, including 85 oral cavity tumors, the GD and tumor thickness (TT) measured on US and MR, were compared to histopathology with a Pearson correlation coefficient (R) and a Bland-Altman plot. The tumors were staged according to both the AJCC7 and AJCC8. Results: TT was more reliably measured with US (R = 0.67, limits of agreement = 10.7 mm), whereas GD was more reliably measured with MR (R = 0.69, limits of agreement = 25.7 mm). The AJCC8 staging resulted into a higher tumor stage in 21% of the cases, compared to the AJCC7. Conclusion: For preoperative tumor staging, the TT is best estimated by the use of US. The incorporation of DOI in the AJCC8 can result in a higher tumor stage in more than twenty percent of the patients, with an associated worse prognosis for the patient.

Original languageEnglish
Pages (from-to)2131-2136
Number of pages6
JournalEuropean journal of surgical oncology
Volume45
Issue number11
Early online date4 Jun 2019
DOIs
Publication statusPublished - 1 Nov 2019

Keywords

  • 8th edition of the AJCC/UICC cancer staging system
  • Histopathology
  • MR imaging
  • Oral cavity tumor
  • Tumor depth of invasion
  • Ultrasound

Fingerprint Dive into the research topics of 'The oral cavity tumor thickness: Measurement accuracy and consequences for tumor staging'. Together they form a unique fingerprint.

  • Cite this