Tongue Squamous Cell Carcinoma Research Articles

GenAI synthesis of histopathological images from Raman imaging for intraoperative tongue squamous cell carcinoma assessment

The presence of a positive deep surgical margin in tongue squamous cell carcinoma (TSCC) significantly elevates the risk of local recurrence. Therefore, a prompt and precise intraoperative assessment of margin status is imperative to ensure thorough tumor resection. In this study, we integrate Raman imaging technology with an artificial intelligence (AI) generative model, proposing an innovative approach for intraoperative margin status diagnosis. This method utilizes Raman imaging to swiftly and non-invasively capture tissue Raman images, which are then transformed into hematoxylin-eosin (H&E)-stained histopathological images using an AI generative model for histopathological diagnosis. The generated H&E-stained images clearly illustrate the tissue’s pathological conditions. Independently reviewed by three pathologists, the overall diagnostic accuracy for distinguishing between tumor tissue and normal muscle tissue reaches 86.7%. Notably, it outperforms current clinical practices, especially in TSCC with positive lymph node metastasis or moderately differentiated grades. This advancement highlights the potential of AI-enhanced Raman imaging to significantly improve intraoperative assessments and surgical margin evaluations, promising a versatile diagnostic tool beyond TSCC.

Expression of interleukin-17 in oral tongue squamous cell carcinoma and its effect on biological behavior

Tongue squamous cell carcinoma (TSCC) is a common malignant oral cancer characterized by substantial invasion, a high rate of lymph node and distant metastasis, and a high recurrence rate. This study aims to provide new ideas for the diagnosis and treatment of TSCC patients by exploring the related mechanisms that affect the migration and invasion of TSCC and inhibit the migration and spread of cancer cells. The results indicated the rate of high expression of IL-17 in cancer tissues was greater than that in tongue tissues, and the expression of IL-17 was related to the TNM stage. The expression of IL-17 in Cal-27 cells was greater than that in HOEC. With increasing IL-17 concentration, cell proliferation, migration, and invasion increased, and the apoptosis rate decreased. After adding the IL-17 inhibitor, the cell proliferation, invasion, and migration abilities decreased, the apoptosis rate increased, and the expression of JAK1and p-STAT3 decreased.IL-17 is highly expressed in oral tongue squamous cell carcinoma and is involved in the occurrence and development of TSCC, possibly through the JAK‒Stat signaling pathway. This study provides a new target and theoretical basis for treating tongue squamous cell carcinoma.

Synergistic anticancer effects of cisplatin and phenolic aglycones of the aerial part of Rumex dentatus L. in tongue squamous cell carcinoma: insights from network pharmacology and biological verification

BackgroundOral squamous cell carcinoma (OSCC) ranks as the sixth most common malignancy globally. Cisplatin is the standard chemotherapy for OSCC, but resistance often reduces its efficacy, necessitating new treatments with fewer side effects. Rumex dentatus L., from the Polygonaceae family, is known for its medicinal properties, but its anticancer potential has not been thoroughly explored. This study aimed to investigate the synergy between cisplatin and an extract from the aerial parts of R. dentatus L. in treating tongue carcinoma (HNO97) in vitro, using network pharmacology, biological verification, and phytochemical analysis.MethodsThe study included UPLC-ESI–MS/MS analysis, cytotoxicity assays, cell cycle analysis, apoptosis assessment, and RT-qPCR for gene expression of Bcl2, p53, and ATG7. Potential targets were identified, and mechanisms of action were examined through online databases and enrichment analyses.ResultsThe R. dentatus L. extract contained 14 phenolic aglycons. Combining cisplatin and R. dentatus L. was more effective in inhibiting proliferation, inducing cell cycle arrest and apoptosis, and reducing autophagy in HNO97 cells than cisplatin alone. KEGG analysis indicated that the drug combination might work through pathways like PI3K-Akt signaling, microRNAs in cancer, and EGFR tyrosine kinase inhibitor resistance.ConclusionsCombining cisplatin with R. dentatus L. may be a promising approach for treating tongue carcinoma by affecting multiple pathways, providing a new perspective for developing more effective treatments for OSCC.

Potassium titanyl phosphate laser resection of tongue T1/T2 squamous cell carcinoma - a cross-sectional study of quality of life and nutritional outcomes.

Increasing emphasis has been placed on measurement of quality of life (QOL) as a central criterion for assessment of success of any medical treatment. The aim of our study was to assess the nutritional and quality of life of patient-reported outcomes among patients who have undergone laser resection of tongue cancer. A cross-sectional study was undertaken of patients treated with KTP laser resection of T1/T2 tongue squamous cell carcinoma (SCC) between 2011-2019. University of Washington Quality of life 4 questionnaire (UW-QOL) and the abridged scored patient-generated subjective global assessment (AB PG-SGA) were used. Scores were correlated to analyse the QOL and nutritional status. 20 patients participated and were categorised into three groups based on AB PG-SGA score. The physical and social-emotional QOL scores were higher for patients who had a better nutritional status. There was a linear negative correlation between the AB PG-SGA score, physical and social-emotional domains of the QOL. No association was found between histopathological differentiation, neck dissection surgeries and the AB PG-SGA score. The use of the KTP laser to excise tongue T1 and T2 SCC yields acceptable results in terms of QOL and patient-reported nutritional outcomes. There is a significant trend identifying that as a patient's nutritional status improves quality of life is enhanced and vice versa. The QOL and the nutritional status of patients were not affected by the different histopathological grades of SCC or whether they had undergone a neck dissection or not.

Long-term survival and risk factors of synchronous bone metastasis in oral tongue squamous cell carcinoma patients.

The objective of this study was to analyze the risk factors for synchronous bone metastases in patients with oral tongue squamous cell carcinomas (OTSCC). OTSCC patients were extracted from the Surveillance, Epidemiology and End Results database between 2014 and 2017. We examined the association between risk factors and synchronous bone metastases using Chi-squared tests. Predictors of survival rates were assessed using univariate and multivariate analyses. A total of 3902 patients were analyzed, which include 12 patients (0.3%) with synchronous bone metastases and 3890 patients without synchronous bone metastases (99.7%). Multivariate logistic regression analysis showed that highly differentiated disease, lower T classification, and lower N classification were associated with a significantly lower risk of bone metastases (P < 0.05, respectively). Unmarried and elderly patients who harbored with poorly differentiated disease, higher T or N classification, multiple sites of metastases, and no surgical therapy to primary tumor were more likely to influence patients' survival. By analyzing data from a large cohort, factors affecting bone metastases are primarily related to grade, T classification and N classification. Multivariable analysis showed that unmarried and elderly patients who harbored with poorly differentiated disease, higher T or N classification, multiple sites of metastases, and no surgical therapy to primary tumor were more likely to influence patients' survival. More accurate assessments of bone metastasis will be imperative for early diagnosis and treatment in poorly differentiated disease, higher T classification or N classification patients.

Assessment of Surgical Margin of Tongue Squamous Cell Carcinoma via Raman Mapping.

This study introduces a novel classification approach that combines convolutional neural network (CNN) and Raman mapping to differentiate between tongue squamous cell carcinoma (TSCC) and non-tumorous tissue, as well as to identify different histological grades of TSCC. In this study, 240 Raman mappings data from 30 tissue samples were collected from 15 patients who had undergone surgical resection for TSCC. A total of 18,000 sub-mappings extracted from Raman mappings were then used to train and test a CNN model, which extracted feature representations that were subsequently processed through a fully connected network to perform classification tasks based on the Raman mapping data. The experimental results indicated that the proposed method achieved competitive classification accuracy above 83%. To further validate the effectiveness of the Raman mapping, its performance was compared with Raman spectroscopy, demonstrating a competitive accuracy rate. The promising outcomes from this application of CNN in Raman mapping suggest that this technique could be a reliable method for intraoperative assessment of surgical margins, potentially leading to shorter detection times.

Tongue squamous cell carcinoma-targeting Au-HN-1 nanosystem for CT imaging and photothermal therapy

Tongue squamous cell carcinoma (TSCC) is a prevalent malignancy that afflicts the head and neck area and presents a high incidence of metastasis and invasion. Accurate diagnosis and effective treatment are essential for enhancing the quality of life and the survival rates of TSCC patients. The current treatment modalities for TSCC frequently suffer from a lack of specificity and efficacy. Nanoparticles with diagnostic and photothermal therapeutic properties may offer a new approach for the targeted therapy of TSCC. However, inadequate accumulation of photosensitizers at the tumor site diminishes the efficacy of photothermal therapy (PTT). This study modified gold nanodots (AuNDs) with the TSCC-targeting peptide HN-1 to improve the selectivity and therapeutic effects of PTT. The Au-HN-1 nanosystem effectively targeted the TSCC cells and was rapidly delivered to the tumor tissues compared to the AuNDs. The enhanced accumulation of photosensitizing agents at tumor sites achieved significant PTT effects in a mouse model of TSCC. Moreover, owing to its stable long-term fluorescence and high X-ray attenuation coefficient, the Au-HN-1 nanosystem can be used for fluorescence and computed tomography imaging of TSCC, rendering it useful for early tumor detection and accurate delineation of surgical margins. In conclusion, Au-HN-1 represents a promising nanomedicine for imaging-based diagnosis and targeted PTT of TSCC.

Sodium nitrite orchestrates macrophage mimicry of tongue squamous carcinoma cells to drive lymphatic metastasis.

Tongue squamous cell carcinoma (TSCC) is a malignant oral cancer with unclear pathogenesis that shows a tendency for early-stage lymphatic metastasis. This results in a poor prognosis, with a low 5-year survival rate. Dietary sodium nitrite (NaNO2) has proposed associations with disease, including cancer. However, a direct relationship between NaNO2 and TSCC has not been established. In vitro and in vivo assays were used to investigate the role of NaNO2 in TSCC. Protein expression in TSCC specimens was detected by immunohistochemistry and immunofluorescence. The molecular mechanism was determined using RT-qPCR, western blot, RNA-seq, luciferase reporter assays, migration assays, and FACS analysis. More detail of methods can be found in the Materials and methods section. The data in this study showed that NaNO2 did not initiate carcinogenesis in the tongue but improved the lymphatic metastatic potential of TSCC cells in the specified experimental period. During metastasis to lymph nodes, monocyte-macrophage markers were upregulated in TSCC cells, whereas keratin markers were downregulated. Specifically, expression of the CD68 gene was high in TSCC cells following NaNO2-induced TSCC phenotypic switching. These phenotypic changes were associated with activation of transcription factor cyclic-AMP response binding protein (CREB1), which directly targets CD68 transcription. Furthermore, blocking CREB1 activity either through gene knockout or specific inhibitor treatment decreased the migration ability of TSCC cells and suppressed CD68 expression. Our findings highlight the role of NaNO2 in enabling macrophage mimicry in TSCC cells through the CREB1-CD68 signaling pathway, which promotes lymphatic metastasis. Shedding light on drivers of lymphatic metastasis in TSCC and providing a new perspective on dietary strategies to improve outcomes of patients with TSCC.

Preparation of anterolateral thigh flap from polio-affected lower limb: A safe surgical option that preserves patient's motor function.

The anterolateral thigh (ALT) flap is a commonly used donor site for reconstructive surger, especially in head and neck reconstructions. The flap's success is primarily determined by the quality and quantity of its perforating vessels, which is why clinicians typically prefer harvesting from a healthy leg with intact vascular anatomy. Poliomyelitis typically causes unilateral lower limb paralysis, resulting in muscle atrophy and deformities. Harvesting the ALT flap from the paralyzed leg could preserve the function of the unaffected limb, but this approach is complicated by the atrophy and deformities present in the affected leg, creating substantial challenges. We here report the successful ALT flap harvesting from the polio-affected leg in a 55-year-old male patient for the reconstruction of a tongue defect. The patient diagnosed with Left tongue squamous cell carcinoma, and underwent tongue cancer excision and a modified radical neck dissection. The flap survived and healed well with the patient's tongue tissue. The wound at the donor site on the thigh also healed well. There were no complications observed in either the flap or the donor site. Our experience suggests that harvesting from the paralyzed leg is a safe and feasible procedure that preserves the function of the unaffected limb and may enhance the postoperative quality of life for polio survivors.

Effect of Oral Inflammatory Burden on Size and Stage of Oral Tongue Cancer.

Oral tongue squamous cell carcinoma is an aggressive life-threatening disease, the prognosis of which is affected by tumor stage and size. We retrospectively studied whether oral inflammatory burden and established tongue carcinoma etiological factors exert an impact on tumor size and stage. Medical records of 183 subjects diagnosed with tongue carcinoma at Helsinki University Hospital were investigated. Data on sex, smoking habits, alcohol consumption, and oral inflammatory burden were assessed by the Periodontal Burden Index, Total Dental Index, and Panorama Tomography Index. In addition, Candida hyphae in histological samples, and tumor size and stage were recorded and analyzed. History of oral potentially malignant disorders was also investigated. Increased oral inflammatory burden, male sex, and smoking were associated significantly with larger size and advanced stage of cancer, whereas oral Candida hyphae were not associated with size of tongue carcinoma but were associated with female sex. Male sex, oral inflammatory burden, and smoking were more common in patients with a large and advanced stage of tongue carcinoma. Thus, oral and periodontal infections and their pro-inflammatory effects may eventually promote carcinoma growth and advance the stage, especially in males.

Na+-Complexed Dendritic Polyglycerols for Recovery of Frozen Cells and Their Network in Media.

In this study, a novel phenomenon is identified where precise control of topology and generation of polyglycerol induce the retention of Na+ ions in biological buffer systems, effectively inhibiting ice crystal growth during cryopreservation. Unlike linear and hyperbranched counterparts, densely-packed hydroxyl and ether groups in 4th-generation dendritic polyglycerol interact with the ions, activating the formation of hydrogen bonding at the ice interface. By inhibiting both intra- and extracellular ice growth and recrystallization, this biocompatible dendritic polyglycerol proves highly effective as a cryoprotectant; hence, achieving the cell recovery rates of ≈134-147%, relative to those of 10% dimethyl sulfoxide, which is a conventional cryoprotectant for human tongue squamous carcinoma (HSC-3) cell line and human umbilical vein endothelial (HUVEC) cells. Further, it successfully recovers the network-forming capabilities of HUVEC cells to ≈89% in tube formation after thawing. The Na+ ion retention-driven ice-growth inhibition activity in biological media highlights the unique properties of dendritic polyglycerol and introduces a new topological concept for cell-cryoprotectant development.

Differential Gene Expression Analysis of The Cancer Genome Atlas Messenger Ribonucleic Acid Sequencing Data from Male Patients with and without Lymph Node Metastasis in Tongue Cancer

Gene expression plays a crucial role in progression, invasion, and metastasis in many groups of oral squamous cell carcinoma. Based on extensive patient data, no research has been done so far on the differences in gene expression between groups of male patients with tongue squamous cell carcinoma who drink alcohol and those who do not, about lymph node metastasis. Our study analysed differential gene expression in male patients with and without lymph node metastasis in tongue cancer, utilising messenger ribonucleic acid (mRNA) sequencing data from The Cancer Genome Atlas (TCGA) program. Analysis was performed using R and bioinformatics tools to process mRNA sequencing data, compare differential gene expression, and examine functional signaling pathways and survival analysis. After screening the database, 38 out of 74 cases with metastasis were selected for the analysis. The computational analysis identified a significant increase in cancer invasion transcription factors, such as GATA2, SP1 and MYC in the metastatic group, whereas CREB1 was more associated with the nonmetastatic group. Functional analysis suggested new prognostic biomarkers for unfavourable outcomes (TRIML2 and EXOSC4) and favourable outcomes (HS3ST4 and SFTPA1). New suggested markers for oral and tongue cancer such as TRIML2, EXOSC4 are known for their role in non-oral cancer including lung and liver cancer. Especially head and neck squamous cell carcinoma (HNSCC) survival analysis and protein atlas investigation confirmed the indirect biological roles of found markers. The study indicates that TRIML2 and EXOSC4 could serve as biological markers for predicting lymph node metastasis in tongue squamous cell carcinoma among male patients who consume alcohol. These findings suggest that gene expression profiles may play a role in the progression and metastasis of tongue cancer. Further research is needed to validate these results and to develop targeted therapies for patients with tongue cancer.

Therapeutic patterns and outcomes in older patients (aged≥65 years) with stage III-IVB inoperable oral cavity squamous cell carcinoma (OCSCC): an investigational study from the SEER database

ABSTRACT Background The aim of this retrospective study is to explore therapeutic patterns and survival outcomes for a cohort of older patients with stage III-IVB inoperable oral squamous cell carcinoma (OCSCC) patients receiving radiation therapy (RT) with or without chemotherapy (CT). Methods This study conducted a retrospective review of 316 patients ≥ 65 aged years with stage III-IVB OCSCC from the Surveillance, Epidemiology, and End Results (SEER) registry (2010–2015). It compared RT alone (n = 109) with RT+CT (n = 207), utilizing Kaplan-Meier and Log-rank tests. Results The estimated overall survival (OS) and cancer-specific survival (CSS) rates at 3 years were 20.6% and 25.9%, respectively. Both univariate and multivariate analyses identified that age and treatment option as independent prognosticators of OS and CSS. Further subgroup analyses showed that the combination of RT and CT significantly improved OS for all OCSCC patients, except those with hard palate tumors. Moreover, this combined treatment approach was linked to enhanced CSS in patients with gingival and tongue squamous cell carcinoma. Conclusion RT+CT significantly enhanced survival in elderly OCSCC patients, particularly those with gingival and tongue cancers, but not in those with hard palate tumors.

Radiological Sublingual Space Invasion in Tongue Squamous Cell Carcinoma: Clinicopathological Associations and Impact on Survival.

We investigate if sublingual space invasion (SLI) determined on magnetic resonance imaging confers differences in clinicopathological manifestations and treatment outcomes of oral tongue squamous cell carcinoma (OTSCC). Retrospective cohort study. Tertiary Academic Medical Center. 221 OTSCC patients were included. Cox regression models and Kaplan-Meier methods were used, and nomogram construction was performed, incorporating SLI with other adverse factors, to predict the prognosis. On multivariable analysis, the following were associated with cervical nodal metastasis: (1) greater MRI T classification of T3/T4 versus T1/T2: adjusted odds ratio (aOR) 2.784, 95% CI = 1.459 to 5.313, P = .001; (2) gender (female vs male): aOR 4.117, 95% CI = 1.602 to 10.576, P = .003; (3) presence of MRI-determined SLI: aOR 2.588, 95% CI = 1.393 to 4.808, P = .002. For survival outcomes, extranodal extension (adjusted hazard ratio [aHR]: 3.380, 95% CI = 2.024-5.644, P < .001), poorly-differentiated type (aHR: 1.720, 95% CI = 1.006-2.943, P = .047), lymphovascular invasion (aHR: 2.100, 95% CI = 1.220-3.614, P = .007), and SLI (aHR: 1.700, 95% CI = 1.086-2.661, P = .020) were statistically significant prognosticators of disease-free survival. In overall survival, when controlled for age, gender, overall TNM stage, Charlson morbidity index, surgical margins, depth of invasion and adjuvant therapy, SLI was a statistically significant prognosticator (aHR: 1.622, 95% CI = 1.012-2.602, P = .044). A proposed novel nomogram for overall survival combining SLI and other risk factors showed a higher concordance index compared to a nomogram with TNM staging alone (0.783 vs 0.629, P < .001). SLI is an independent prognostic factor for treatment outcomes in OTSCC. Incorporating SLI into a novel nomogram demonstrated improved predictive accuracy for post-treatment outcomes.

Clinical and dosimetric feasibility of sparing submandibular gland in patients with oral cavity squamous cell carcinoma

Background To investigate the incidence of submandibular gland (SMG) involvement and explore the feasibility of sparing SMG in the oral cavity squamous cell carcinoma (OSCC). Methods This study retrospectively analyzed patients between January 2018 to October 2022. Ten patients with tongue squamous cell carcinoma receiving postoperative radiotherapy were replanned to investigate the feasibility of sparing SMG. The dose constraint for the SMG was a mean dose (Dmean) <39 grey (Gy). Results A total of 238 patients were identified and 105 had metastatic neck lymph nodes. Level II was the most common site of metastasis (n = 94, 89.5%), followed by level IB (n = 37, 35.2%), level III (n = 26, 24.8%), level IA (n = 3, 2.6%), and level IV (n = 2, 1.9%). A total of 50 metastatic lymph nodes were located at the level IB, of which 18 (36.0%), 29 (58.0%), and 3 (6%) were located in the lateral, anterior, and inferior aspect of the SMG. No metastatic lymph nodes were found within or on the medial aspect of the SMG. The Dmean of the SMG was <39 Gy in all patients with a Dmean of 38.8 Gy. The median dose of PTV54 D95% was 53.8 Gy, which met the prespecified allowable coverage goal. Conclusions Our study suggests that SMG involvement is rare in OSCC. With strict imaging and clinical evaluation, sparing SMG during radiotherapy is feasible.

Epidemiological landscape of tongue cancer in younger patients in a National Cancer Center in Brazil

This study investigates the changing epidemiological profile of tongue squamous cell carcinoma (SCC) to young patients, highlighting its rising incidence among non-traditional risk groups. A retrospective descriptive study was conducted, covering data from medical records between 2000 and 2012. Patients were categorised into two age groups (≤ 40 years; 41–50 years). Sociodemographic and clinicopathological characteristics were evaluated. A total of 108 patients participated, mostly aged 41–50. Alcohol consumption (43.3%) surpassed smoking. Majority (56.7%) aged ≤ 40 never smoked. Lateral tongue border was most affected, with stages III and IV prevalent. Patients aged ≤ 40 were mostly eligible for surgery (44%). Survival tied to staging and surgery; age had no significant impact. Young squamous cell carcinoma patients often lacked traditional risk factors like smoking, underwent surgery, and typically had disease-free margins. The study underscores the importance of broad external policies for early diagnosis, beyond just traditional risk groups.

Diagnostic performance of depth of invasion, thickness, and styloglossus and hyoglossus muscle invasion on magnetic resonance imaging in predicting potential neck lymph node metastasis in clinical N0 tongue cancer.

To evaluate previously reported quantitative (tumor thickness 11mm and depth of invasion [DOI] 7.5mm) and qualitative (styloglossus/hyoglossus muscle invasion [SHMI]) magnetic resonance imaging (MRI) parameters for predicting occult neck node metastasis in clinical N0 oral tongue squamous cell carcinoma. This single-center retrospective study included 76 patients. MRI images were independently reviewed by two radiologists for tumor thickness, DOI, and SHMI. Statistical analysis assessed the predictive capability of these parameters for 2-year potential lymph node metastasis. Among the 76 cases, 30.2% developed 2-year potential lymph node metastasis. For tumor thickness ≥ 11mm, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 0.46, 0.68, 0.37, 0.75, and 0.61, respectively. DOI ≥ 7.5mm exhibited a sensitivity, specificity, PPV, NPV, and accuracy of 0.73, 0.59, 0.42, 0.84, and 0.63, respectively. SHMI demonstrated a sensitivity, specificity, PPV, NPV, and accuracy of 0.87, 0.51, 0.46, 0.89, and 0.63, respectively. DOI ≥ 7.5mm and SHMI demonstrated comparable diagnostic accuracy in predicting neck metastasis, surpassing tumor thickness of > 11mm. These findings underscore their potential utility in guiding decisions concerning elective neck dissection.

Prognostic Effect of Patterns of Local Extension and Satellitosis in cT3 Squamous Cell Carcinoma of the Oral Tongue: A Prospective Observational Study.

The anatomy of the tongue is three-dimensionally complex and is thought to play a central role in the local growth of oral tongue squamous cell carcinoma (OTSCC). Understanding patterns of tumor extension could improve a multimodal therapeutic approach. Thus, the main aim of this study was to provide a histological and microanatomical analysis of surgical specimens after compartmental surgery for OTSCC. The present prospective observational study included primary cT3 OTSCC (according to the eighth edition of the TNM classification) treated in an academic tertiary referral center with curative compartmental surgery, from July 2016 to July 2019. Analysis of histologic macrosections allowed assessment of standard pathologic parameters as well as a detailed analysis of the position of OTSCC cells from microanatomic and topographic standpoints. Of the 28 patients included, 71.4% were males, with a mean age of 64.9 years. Nine (32.1%) patients presented satellitosis, which was always located within the T-N tract. OTSCCs displaying satellitosis had a significantly higher median pathologic depth of invasion (DOI). A radiologic and pathological DOI > 15 mm significantly predicted the presence of satellites. There was a significant relationship between the presence of satellites and both positive lymph nodes and distant metastases. Approximately one-third of cases of intermediate-to-advanced OTSCC are characterized by tumor satellites located in the T-N tract. DOI exceeding 15 mm and the presence of clinically appreciable nodal metastases best predict the presence of satellitosis. Satellite-bearing OTSCC behave more aggressively, with an increased risk of distant metastasis and reduced survival.

The role of postoperative radiation therapy in early-stage tongue carcinoma: A systematic review and meta-analysis.

Although the overall prognosis for early-stage oral tongue squamous cell carcinoma is good, a significant portion of patients still experience locoregional recurrence and affect the disease-specific survival. At present, whether more aggressive postoperative radiation therapy in this particular patient population should be taken is still controversial. The analysis exhibited that disease-free survival (OR = 0.53, 95 % CI:0.35-0.81; P = 0.003) and locoregional recurrence-free survival (OR = 0.59, 95 % CI:0.38-0.93; P = 0.022) was significant improved in patients received radiotherapy compared to surgery alone. However, radiotherapy failed to improve overall survival (HR = 1.06 95 % CI:0.42-2.64, P = 0.901). Furthermore, two studies reported overall survival based on depth of invasion as well. The pooled OR was 1.65 (95 % CI:0.31-8.91, P = 0.221) and no survival benefit was observed for early-stage patients underwent adjuvant radiotherapy according to depth of invasion. Current evidence is insufficient to independently support the depth of invasion as an effective indication for radiotherapy of early tongue cancer.

Impact of Close Margins on Oral Cancer Outcomes According to the Oral Subsite.

The prognostic significance of close margins in oral squamous cell carcinoma (OSCC) is controversial. We wished to investigate the impact of close margins on the risk of local recurrence (LR) in OSCC according to the oral subsite. A retrospective cohort study of 342 OSCC patients undergoing primary surgical treatment was conducted. Surgical margins were based on the main specimen and defined as positive (SCC at margins), close (< 5 mm), or clear (≥ 5 mm). Among tongue SCC cases, both positive (hazard ratio 13.48, 95% CI 2.03, 32.91) and close margins (hazard ratio 3.87, 95% CI 1.31, 11.34) were significantly associated with LR. Tongue margins < 4 mm were associated with higher LR. Among non-tongue SCC cases, only positive margins (hazard ratio 4.10, 95% CI 1.19, 14.21) were associated with LR. Close margins were not significant (hazard ratio 1.59, 95% CI 0.46, 5.42). Close margins appear to have a differential impact on LR in OSCC according to the oral subsite.