Tongue Cancer Patients Research Articles

Comparison of the subjective satisfaction of the donor site morbidity: Free radial forearm flap versus anterolateral thigh flap for reconstruction in tongue cancer patients.

BackgroundThe purpose of the study was to compare the differences of the subjective satisfaction of the donor site morbidity between the free radial forearm flap (FRFF) and anterolateral thigh flap (ALTF) for tongue reconstruction.Material and MethodsOne hundred and nineteen patients underwent FRFF or ALTF reconstruction were retrospectively evaluated by a standardized self-established donor site morbidity questionnaire which included 5 domains, sensibility, movement disabilities, cosmetics, social activities and general impacts on the quality of life.ResultsThe Cronbach’s coefficient alpha of the questionnaire was 0.707. The exploratory factor analysis revealed that the 5 items of the questionnaire might load onto two distinct subscales. Patients with ALTF had higher scores in the sensibility, cosmetics and the composite score (P< 0.05). No significant differences were found in the movement disabilities, social activities and general impacts on the quality of life between the two groups (P > 0.05).ConclusionsALTF has the advantage of better results of donor site morbidity, such as sensibility and cosmetics, over FRFF. Key words:Quality of life, tongue cancer, free radial forearm flap, anterolateral thigh flap, donor site morbidity.

Minimally invasive neck dissection: A 3-year retrospective experience of 45 cases.

Objective:Robot-assisted neck dissection requires a larger wound, is expensive and requires specialised equipment which is not easily available. We have developed an inexpensive minimally invasive neck dissection (MIND) procedure using simple endoscopic instruments in the past. This study was conducted to evaluate the safety, efficacy and reproducibility of the technique.Materials and Methods:From January 2013 to December 2016, we performed MIND on 45 patients with oral cancer using the standard endoscopic equipment. CO2 gas insufflation was used to create the working space. Intra-operative data, post-operative data and pathological characteristics were evaluated and overall survival (OS) and disease-free survival (DFS) Kaplan–Meier curves were compared using the Log-Rank test.Results:Median operative time was 130 (80–190) min with a mean blood loss of 63 (20–150) ml. Major intra-operative complications were not observed. The median number of nodes retrieved was 14 (range: 7–38). Three patients with a positive lymph node were advised to undergo adjuvant radiotherapy. After consultation, 12 out of 13 tongue cancer patients with a tumour depth >3 mm underwent adjuvant radiotherapy. Mean follow-up period was 31.5 (95% confidence interval [CI] 27.9–35.1) months and 27.8 (95% CI 23.6–32.1) months for OS and DFS, respectively. Four (8.9%) deaths and 8 (17.8%) recurrences were observed. The 3-year OS and DFS was 91.1% and 82.2%, respectively.Conclusion:MIND is aesthetically better than conventional procedures for oral cancer patients due to its safety, efficacy and reproducibility at any centre using the standard laparoscopic equipment.

Association of neck dissection with survival for early stage N0 tongue cancer: A SEER population-based study.

The management of the node negative neck in patients with tongue cancer remains a complex and controversial issue, especially in those with early stage tumors. Patients with negative cervical lymph nodes generally have a good prognosis. However, in patients without neck dissection, neck recurrences may occur after excision of the primary tumor due to occult cervical metastases. It often results in poor salvage therapy options and short survival. We used Surveillance, Epidemiology, and End Results data from 2004 to 2013 to investigate the association of neck dissection with survival among early stage tongue cancer patients with negative lymph node metastasis. A total of 4274 eligible patients were subdivided into 2 groups according to their neck management strategies: neck dissection and observation. Univariate and multivariate Cox proportional hazards regression models were used to determine the independent factors of survival. The Kaplan-Meier method was employed for survival analysis. In the overall cohort, patients who underwent neck dissection had better survival than those who were managed with observation in both tongue cancer specific survival and overall survival. After adjusting for confounding variables, neck dissection strategy remains an independent prognostic factor for better survival. When stratifying the patients according to age, gender, race, marital status, histologic grade, stage and radiotherapy, patients in the neck dissection group had significantly better survival than those in the observation group. Neck dissection may improve survival for early stage tongue cancer patients with negative lymph node metastasis. These results may assist clinicians in selecting the most appropriate neck management strategy for individual patients.

Sentinel lymph node biopsy for early stage tongue cancer—a 14-year single-centre experience

This study was performed to report the usage of sentinel lymph node biopsy (SLNB) in clinical stage I or II tongue cancer patients with cN0 necks seen over a 14-year period. Data were collected prospectively, and a retrospective analysis was performed of 41 patients with early stage oral squamous cell carcinoma of the tongue and a cN0 neck. Sentinel lymph node (SLN)-positive patients underwent elective neck dissection, whereas SLN-negative patients were kept under careful observation. Seven of the 41 (17%) patients enrolled in the study were found to have occult metastases. The patients were followed up for a mean duration of 92 months (range 60–144 months). The neck recurrence rate for SLN-positive patients was 0% and for SLN-negative patients was 3%. The authors recommend the routine use of SLNB in patients with early stage oral squamous cell carcinoma of the tongue and a cN0 neck. Furthermore, special focus should be placed on isolated tumour cells, as their presence is of high clinical relevance.

Influence of graphic type health education combined with empowerment theory on phonetic function and swallowing function in tongue cancer patients after surgery

Objective To evaluate the influence of graphic type health education combined with empowerment theory on phonetic function and swallowing function in tongue cancer patients after surgery. Methods A total of 86 tongue cancer patients after surgery in the First Affiliated Hospital of Zhengzhou University from June 2014 to June 2017 were selected by convenience sampling method, and divided into control group and experimental group, with 43 cases in each group. The control group received graphic type health education, while the experimental group received graphic type health education combined with empowerment theory. The phonetic function and swallowing function were collected and compared before and after intervention between two groups. Results Before the intervention, there was no statistical significance in the difference of patients' phonetic function between the two groups (P>0.05) . However, after the intervention, the phonetic function improved than before, and it in the experimental group was higher than that in the control group (P 0.05) . After the intervention, swallowing function of the two groups were higher than those before intervention, and the experimental group was higher than that of the control group (P<0.05) . Conclusions Graphic type health education combined with empowerment theory is helpful for the recovery of phonetic function and swallowing function in tongue cancer patients after surgery, it is worthy of clinical promotion. Key words: Tongue neoplasms; Graphic type health education; Empowerment theory; Phonetic function; Swallowing function

Post-operative speech and swallowing in partial glossectomy patients: role of effective rehabilitation

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The tongue is a frequent site for oral carcinoma. Quality of life in such patients is often compromised post treatment in terms of speech and swallowing functions. Although swallowing and speech are included in several health-related quality of life scales, postoperative rehabilitation that influences these domains is not very well studied. This study was conducted to assess the speech and swallowing impairment after partial glossectomy for the tongue cancer patients and role of speech therapy and swallowing rehabilitation exercises in effective postoperative rehabilitation.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 50 patients of carcinoma of the tongue managed with partial glossectomy as the definitive treatment were included in the study. Postoperative rehabilitation was offered to all patients, however 10 defaulted. Improvement in speech intelligibility, articulation and swallowing at 15 days, 1 month, 3 months and 06 months after surgery were recorded. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; All three parameters of speech intelligibility, articulation and swallowing which were analysed showed improvements during each follow-up visit. Results obtained for both groups, on comparison showed statistically significant earlier improvement in patients who were receiving rehabilitation therapy versus those who were not receiving any rehabilitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Postop speech and swallowing rehabilitation can be an effective tool for improving quality of life. It is imperative to develop easy and simple modules for rehabilitation for patients of oral cancers that can be practiced during the postop follow up and at home with the assistance of family members to ensure uncompromised quality of life post treatment.&lt;/p&gt;

Randomized phase III study to evaluate the value of omission of prophylactic neck dissection for stage I/II tongue cancer: Japan Clinical Oncology Group study (JCOG1601, RESPOND)

For stage I/II tongue cancer patients, it is controversial whether prophylactic neck dissection should be performed with partial glossectomy. Based on the evidence of the primary tumor's depth of invasion as a predictive factor of occult lymph node metastases and a prognostic factor of disease-free survival, randomized phase III trial was initiated in November 2017 to evaluate the omission value for prophylactic neck dissection for stage I/II tongue cancer with 3-10 mm of depth of invasion. In 5 years, 440 patients will be accrued from 28 institutions. The primary end point of the study is the overall survival, whereas the secondary end points are relapse-free survival, local relapse-free survival, proportion of unresectable relapse and of cervical lymph node relapse, post-operative function (paralysis of the accessory and facial nerves and subjective symptoms) and adverse events. This trial has been registered with the UMIN Clinical Trials Registry (registration number: UMIN000030098; http://www.umin.ac.jp/ctr/index.htm).

Sentinel Lymph Node Centered Selective Neck Dissection Does Not Have Benefits Over Supraomohyoid Neck Dissection in Patients with cT1T2N0 Tongue Cancer

Background and Objectives This study aimed to evaluate the clinical efficacy of sentinel node centered selective neck dissection in patients with early stage tongue cancer (T1T2N0). Subjects and Method Lymphoscintigraphy was performed for 12 patients, subsequently followed by sentinel node centered selective neck dissection. The location of the sentinel node, pathological confirmation of node metastasis, and follow-up recurrence were analyzed. Results In total, 19 sentinel lymph nodes were identified. Of these, 18 were located in levels I to III, and one in level IV. After surgery, 3 patients (25%) were diagnosed with neck node metastasis: two experienced sentinel node metastasis and one experienced skipped metastasis. During follow-up, 3 of the 12 patients (25%) experienced recurrence. Conclusion The recurrence of lymph node could be covered with supraomohyoid neck dissection, which indicates that it has superiority over sentinel node centered selective neck dissection in preventing recurrence in T1T2N0 tongue cancer patients. Key words: Lymphoscintigraphy ㆍ Neck dissection ㆍ Sentinel lymph node ㆍ Tongue cancer

Value of Volumetric Staging and Hematologic Indices As an Alternative to the TNM Staging in Radiation Therapy for Tongue Cancer

To evaluate correlation of volumetric staging, hematologic indices and TNM staging with efficacy of radiotherapy (RT) and chemoradiation (ChRT) for tongue cancer. The study included 61 patients (47 male, 14 female) diagnosed with tongue cancer (squamous cell carcinoma in 97% cases) aged 40-83 (median 59, mean 60) treated by RT/ChRT. Regional lymph nodes were involved in 70% of patients. Inclusion criteria were: RT or ChRT as radical therapy and no other forms of therapy. In 10 cases (16%) RT was primary choice of radical treatment. The remaining patients were disqualified from surgical approach due to comorbidities (28%), extent of the disease (39%), localization of primary lesion (10%) or lack of consent (7%). The TNM stage varied from I to IVb. Tumor and nodal volume ranged from 3.7 to 113.1cm3 and 0 to 46.1cm3, respectively. Total tumor and nodal volumes combined (GTV) were further divided into 3 risk groups with cutoff values of 15 and 70cm3. Chemotherapy (cisplatin-based) was applied in 14 patients. Total dose of 60 to 74Gy in fractions of 1.1 to 2.2Gy (combined with brachytherapy boost of 15-18Gy in 6 cases) was delivered. Blood tests were taken before RT. Statistical analysis included log-rank test, Kaplan Meier estimator, Cox proportional hazards model and Spearman’s rho. Follow-up ranged from 0 to 130 months (median 14.6 months, 4 cases without follow-up). 5-year overall survival (OS) was 37.5%. Progression of the disease was noted in 24 patients and 1-year progression free survival (PFS) defined as local, nodal and distant control was 48%. GTV divided into risk groups correlated with 1-year PFS, 3-year OS and 5-year OS (p values of 0.04, 0.04 and 0.05, respectively). Absolute values of GTV volumes correlated with 1-year PFS and 3-year OS. For TNM stage, both considered as separate groups and when comparing 0-III vs IVa-IVc stage patients no correlations with RT results were found. Neutrophils-to-lymphocyte ratio above upper or below lower quartile and higher values of hemoglobin count correlated with better 1-year PFS. There was a negative correlation between neutrophil level and treatment results. Present results suggest that for tongue cancer patients, TNM stage poorly correlates with results of RT and its prognostic value is inferior to GTV-based volumetric stage. Volumetric staging alone or combined with hematologic indices seems to be more optimal staging system than TNM.

Swallowing function in advanced tongue cancer patients before and after bilateral neck dissection following superselective intra-arterial chemoradiotherapy for organ preservation: a case-control study.

This study aimed to evaluate swallowing function in advanced tongue cancer patients before and after bilateral neck dissection following superselective intra-arterial chemoradiotherapy (CRT). A videofluoroscopic swallowing study (VFSS) was used to evaluate swallowing function in 10 patients with advanced tongue cancer before and after bilateral neck dissection. Laryngeal penetration increased in the postoperative VFSS. Temporal analysis comparing two time points revealed that, after surgery, oral transit time increased significantly, but there was no difference in pharyngeal delay time or pharyngeal transit time. Spatial analysis revealed significant decreases after surgery in the maximum distance of upper esophageal sphincter (UES) opening, the maximum distance of hyoid bone movement in both the anterior and superior direction, and the maximum velocity of hyoid bone movement. Laryngeal penetration and aspiration increased as a result of limited hyoid movement and diminished UES opening after bilateral neck dissection following superselective intra-arterial CRT for advanced tongue cancer.

Identification of ITGA3 as an Oncogene in Human Tongue Cancer via Integrated Bioinformatics Analysis.

Human tongue cancer (TC) is an aggressive malignancy with a very poor prognosis. There is an urgent need to elucidate the underlying molecular mechanisms involved in TC progression. mRNA expression profiles play a vital role in the exploration of cancer-related genes. Therefore, the purpose of our study was to identify the progression associated candidate genes of TC by bioinformatics analysis. Five microarray datasets of TC samples were downloaded from the Gene Expression Omnibus (GEO) database and the data of 133 TC patients were screened from The Cancer Genome Atlas (TCGA) head and neck squamous cell carcinoma (HNSC) database. The integrated analysis of five microarray datasets and the RNA sequencing data of TC samples in TCGA-HNSC was performed to obtain 1023 overlapping differentially expressed genes (DEGs) in TC and adjacent normal tissue (ANT) samples. Next, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was conducted to enrich the significant pathways of the 1023 DEGs and PI3KAkt signaling pathway (P=0.011) was selected to be the candidate pathway. A total of 23 DEGs with |log2 fold change (FC)| ≥1.0 in phosphatidylinositol 3-kinase-serine/threonine kinase (PI3K-Akt) signaling pathway were subjected to survival analysis of 125 eligible TC samples in TCGA database, indicating increased integrin-α3 gene (ITGA3) expression was significantly associated with poorer prognosis. Taken together, our study suggested ITGA3 may facilitate the development of TC via activating PI3K-Akt signaling pathway.

Tongue Cancer Patients Can be Distinguished from Healthy Controls by Specific N-Glycopeptides Found in Serum.

There are no blood biomarkers to detect early-stage oral cavity squamous cell carcinoma (OSCC) prior to clinical signs. Most OSCC incidence is associated with significant morbidity and poor survival. The authors aimed to use mass-spectrometry (MS) technology to find specific N-glycopeptides potentially serving as serum biomarkers for preclinical OSCC screening. Serum samples from 14 patients treated for OSCC (stage I or stage IV) with 12 age- and sex-matched controls are collected. Quantitative label-free N-glycoproteomics is performed, with MS/MS analysis of the statistically significantly different N-glycopeptides. Combined with a database search using web-based software (GlycopeptideID), MS/MS provided detailed N-glycopeptide information, including glycosylation site, glycan composition, and proposed structures. Thirty-eight tryptic N-glycopeptides are identified, having 19 unique N-glycosylation sites representing 14 glycoproteins. OSCC patients, including stage I tumors, can be differentiated from healthy controls based on the expression levels of these glycoforms. N-glycopeptides of IgG1, IgG4, haptoglobin, and transferrin have statistically significant different abundances between cases and controls. The authors are the first to suggest specific N-glycopeptides to serve as potential serum biomarkers to detect preclinical OSCC in patients. These N-glycopeptides are the lead candidates for validation as future diagnostic modalities of OSCC as early as stage I.

Prosthetic Rehabilitation with Implant-Supported Mandibular Overdenture after Partial Glossectomy and Radiation Therapy: A Case Report.

Implant-supported overdenture is a well-established treatment option for many patients who have functional problems with conventional dentures. It may be primary choice for patients with altered jaw anatomy, neuromuscular disorders, pronounced gag reflex, severe residual ridge resorption and oral tissue defects. In this article we describe a case report, where tongue cancer patients occlusion was rehabilitated with an implantretained overdenture. In 2001 patient was operated for squamous cell carcinoma on the left side of the tongue. Before preoperative radiation therapy, small residual mandibular dentition was removed because of its poor prognosis. Radiation dose on mandible was 57-66 Gy. After tumor surgery patient received conventional complete dentures. Ten years later, the patient was referred again to the Turku University Central Hospital due to constant ulceration under the mandibular denture. The residual ridge of the mandible was severely resorbed. Patient's existing lower complete denture was replaced with a milled bar-retained overdenture on four implants. Treatment turned out to be challenging due to severely restricted tongue movement and tissue defects.

Depth of invasion on pathological outcomes in clinical low-stage oral tongue cancer patients.

Depth of invasion was added to the eighth edition American Joint Committee on Cancer guidelines for T staging of HPV-negative oral cavity squamous cell carcinoma. Our aim was to determine the impact of depth of invasion on pathological variables and outcomes in low-stage tongue cancer patients. We also examine the impact of tumor thickness and tumor clinical staging for comparison. All clinical T1/T2 N0 HPV-negative tongue squamous cell carcinoma patients who received elective neck dissections at our institution between 2000 and 2015 were included. Logistic regression models and Cox proportional hazard models were used to examine pathological variables, recurrence, and 3-year disease-free survival. Sixty-seven patients met criteria; the mean age was 52.0 (SD: 17.7). Depth of invasion was a significant predictor of occult metastasis (OR: 2.0, p=0.05) and lymphovascular invasion (OR: 4.1, p=0.02), and tumor thickness was a significant predictor of lymphovascular invasion (OR: 3.3, p=0.04). None of the variables were predictive of recurrence or disease-free survival. Depth of invasion at biopsy may be a potential useful metric to inform on regional management selection in this radiographic node-negative population.

Tongue cancer patients can be distinguished from healthy controls by specific N-glycopeptides found in serum.

e18047Tongue cancer patients can be distinguished from healthy controls by specific N-glycopeptides found in serum. Background: There are no blood biomarkers to detect early-stage oral cavity squam...

Development of Short-Form of the Speech Handicap Index and Its Application to Tongue Cancer Patients

배경 및 목적: 말장애지수(Speech Handicap Index, SHI)는 말 평가에 필수적으로 실시되는 자기보고 평가로서, 구강이나 구인두암 환자의 말 기능과 심리사회적 기능을 평가하는 데 특화되어 개발된 도구이다. SHI가 말 문제를 평가하기에 적합하게 개발되었음에도 불구하고 30개라는 전체 문항 수는 시간적인 제약을 받는다. 따라서 이 연구에서는...

Clinical application of the bilateral radial forearm flap for tongue cancer reconstruction

The forearm radial flap is a reliable flap for the repair of the defect caused by tongue cancer resection. The clinical data of 11 tongue cancer patients that received this surgery were retrospectively analyzed. The clinical application of this technique is preliminarily discussed.

Application effect of case management pattern on tongue neoplasms surgery patients

Objective To study the effect of case management pattern on tongue cancer free flap repair patients. Methods A total of 148 cases of tongue cancer patients who were treated in the head and neck surgery department of Hu'nan Cancer Hospital from January 2015 to October 2016 were randomly selected as the research object. They were divided into intervention group (74 cases) and control group (74 cases) . The conventional management model of head and neck cancer was applied in the control group, at the same time, the intervention group adopted the case management pattern by assessing, planning, implementing, evaluating and responding to improve the effect of recovery and the tongue cancer patients' quality of life. University of Washington quality of life questionnaire (UW-QOL) , the health behavior of Omaha evaluation criteria, and mini-mental adjustment to cancer scale (Mini-MAC) were applied to evaluate patients' situation of the two groups 1 week and 6 months after surgery. Results At the time point of 1 week after surgery, the scores of the health behavior of Omaha evaluation criteria and Mini-MAC of the control group were (40.74±2.58) , (33.15±1.90) respectively, while the scores of the intervention group were (46.09±1.83) , (30.38±2.26) respectively, and there were statistical differences (P<0.05) . After 6 months, the scores of UW-QOL, the health behavior of Omaha evaluation criteria and Mini-MAC of the control group were (829.54±65.94) , (63.66±3.63) , (30.68±3.71) , and the intervention group scores were (1 124.13±46.74) , (75.54±1.36) , (27.61±2.31) respectively. The differences between two groups were statistically significant (t=-31.35, -26.38, 6.04; P<0.01) . Conclusions Case management model can effectively improve the quality of life in patients with tongue cancer after surgery. It was suggest to have positive effect on patients' health behavior and mental adaptation. Key words: Tongue neoplasms; Quality of life; Mental adaptation; Postoperative rehabilitation; Case management mode

Genomic characterization of tobacco/nut chewing HPV-negative early stage tongue tumors identify MMP10 as a candidate to predict metastases

ObjectivesNodal metastases status among early stage tongue squamous cell cancer patients plays a decisive role in the choice of treatment, wherein about 70% patients can be spared from surgery with an accurate prediction of negative pathological lymph node status. This underscores an unmet need for prognostic biomarkers to stratify the patients who are likely to develop metastases. Materials and methodsWe performed high throughput sequencing of fifty four samples derived from HPV negative early stage tongue cancer patients habitual of chewing betel nuts, areca nuts, lime or tobacco using whole exome (n=47) and transcriptome (n=17) sequencing that were analyzed using in-house computational tools. Additionally, gene expression meta-analyses were carried out for 253 tongue cancer samples. The candidate genes were validated using qPCR and immuno-histochemical analysis in an extended set of 50 early primary tongue cancer samples. Results and conclusionSomatic analysis revealed a classical tobacco mutational signature C:G>A:T transversion in 53% patients that were mutated in TP53, NOTCH1, CDKN2A, HRAS, USP6, PIK3CA, CASP8, FAT1, APC, and JAK1. Similarly, significant gains at genomic locus 11q13.3 (CCND1, FGF19, ORAOV1, FADD), 5p15.33 (SHANK2, MMP16, TERT), and 8q24.3 (BOP1); and, losses at 5q22.2 (APC), 6q25.3 (GTF2H2) and 5q13.2 (SMN1) were observed in these samples. Furthermore, an integrated gene-expression analysis of 253 tongue tumors suggested an upregulation of metastases-related pathways and over-expression of MMP10 in 48% tumors that may be crucial to predict nodal metastases in early tongue cancer patients. In overall, we present the first descriptive portrait of somatic alterations underlying the genome of tobacco/nut chewing HPV-negative early tongue cancer, and identify MMP10 asa potential prognostic biomarker to stratify those likely to develop metastases.

Cytoplasmic neuropilin 2 is associated with metastasis and a poor prognosis in early tongue cancer patients

Neuropilin 2 (Nrp2) plays an important role in regulating lymphangiogenesis. Nrp2 expression in early tongue cancer was investigated to predict lymph node metastasis and the long-term prognosis. The relationships between clinicopathological variables of cT1–T2N0 tongue squamous cell carcinoma (SCC) and overexpression of Nrp2, vascular endothelial growth factor C (VEGFC), vascular endothelial growth factor receptor 3 (VEGFR3), and semaphorin 3F (Sema3F) were analyzed. Expression levels were compared using oral SCC cell lines. The Nrp2 gene was silenced to determine the impact of Nrp2. Cytoplasmic Nrp2 overexpression predicted regional metastasis with sensitivity and specificity of 90.3% and 42.1%, respectively. Cytoplasmic Nrp2 overexpression (P<0.001) and VEGFC overexpression (P=0.006) were significantly related to regional metastasis (Student t-test). However, only cytoplasmic Nrp2 overexpression was an independent prognostic factor for both disease-free survival (DFS; P=0.008) and overall survival (OS; P=0.016) (Cox regression); the risk of recurrence was 12-times higher (P=0.015) and risk of mortality was 8-times higher (P=0.016). Co-localization of Nrp2 and VEGFC was greater within the cytoplasm of aggressive cell lines (HN12 and RCa-T). Nrp2 plays a role in tumourigenesis; VEGFC supplementation cannot rescue the biological function of Nrp2 in Nrp2-depleted cell lines. Cytoplasmic Nrp2 overexpression is associated with decreased OS and DFS. Cytoplasmic Nrp2 overexpression may be a reliable diagnostic and prognostic marker for early tongue SCC.