Oral squamous cell carcinoma (OSCC) is the most frequent malignancy of the oral cavity; many doubts and differences of approach still exist about the therapy of T1-T2 N0 OSCCs, and precisely about the effective necessity to perform or not elective neck dissection or a biopsy of sentinel lymph nodes in the extremely doubtful cases, considering that it is generally accepted these patients have a 2 years survival of more than 85% but the incidence of occult metastases at presentation is reported to range from 20% to 30%. Preliminarily, in a study on 85 cases, 73 (88%) patients have a minimal follow-up of two years, intending that patients were completely free of disease and neck was clinically and radiografically negative; the remaining 12 patients (14%) were died because of the disease. Of all 73 patients disease-free, 48 (almost 66%) had a tumour thickness <4mm and a depth of infiltration <3mm; in 58 instances (80%) the type of infiltration was pushing-like or with wide groups of cells, muscle infiltration was observable in 34 cases; vascular and perineural infiltration, was present only in 9 cases; salivary gland ducts were infiltrated only in 8 instances and bone invasion was observed in an isolated case; in the 98% of cases an inflammatory infiltrate was observable. In the 12 cases with poor prognosis, tumour thickness and depth of infiltration values were obviously exceeding the median values and the association with other negative prognostic factors was present. This preliminary data show through our experience what values of tumour thickness and other histological parameters we used to select high risk patients and in which way we approach to T1/T2 cN0 patients; all our data will be supported by further studies.
: T1-T2/NO squamous cell carcinoma of the oral cavity: correlation between clinical/histological prognostic factors and survival. Our experience in a preliminary mono-institutional (southern Italy) study
MAIORANO, Eugenio;LACAITA, Maria Grazia;FAVIA, Gianfranco
2007-01-01
Abstract
Oral squamous cell carcinoma (OSCC) is the most frequent malignancy of the oral cavity; many doubts and differences of approach still exist about the therapy of T1-T2 N0 OSCCs, and precisely about the effective necessity to perform or not elective neck dissection or a biopsy of sentinel lymph nodes in the extremely doubtful cases, considering that it is generally accepted these patients have a 2 years survival of more than 85% but the incidence of occult metastases at presentation is reported to range from 20% to 30%. Preliminarily, in a study on 85 cases, 73 (88%) patients have a minimal follow-up of two years, intending that patients were completely free of disease and neck was clinically and radiografically negative; the remaining 12 patients (14%) were died because of the disease. Of all 73 patients disease-free, 48 (almost 66%) had a tumour thickness <4mm and a depth of infiltration <3mm; in 58 instances (80%) the type of infiltration was pushing-like or with wide groups of cells, muscle infiltration was observable in 34 cases; vascular and perineural infiltration, was present only in 9 cases; salivary gland ducts were infiltrated only in 8 instances and bone invasion was observed in an isolated case; in the 98% of cases an inflammatory infiltrate was observable. In the 12 cases with poor prognosis, tumour thickness and depth of infiltration values were obviously exceeding the median values and the association with other negative prognostic factors was present. This preliminary data show through our experience what values of tumour thickness and other histological parameters we used to select high risk patients and in which way we approach to T1/T2 cN0 patients; all our data will be supported by further studies.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
