Oral surgery, oral medicine, oral pathology and oral radiology · 2020
Patterns of growth of lingual carcinoma on magnetic resonance imaging and correlations with clinicopathologic outcomes.
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Jani Khyati, Balasubramanian Deepak, Jayasankaran Sandya, Murthy Samskruthi, Vidyadaran Sivakumar, Thankappan Krishnakumar, Iyer Subramania
Аннотация
OBJECTIVE: The aim of this study was to identify patterns of tumor growth as revealed on magnetic resonance imaging (MRI) and to evaluate the correlation of these patterns with histopathologic features and rates of recurrence, disease-free survival (DFS), and overall survival (OS).
STUDY DESIGN: In a retrospective analysis of patients with tongue carcinoma, tumor advancing margins, patterns of tumor enhancement, and enhancement beyond tumor margins were studied on MRI. Histopathologic findings included differentiation, margin status, perineural invasion (PNI), and lymphovascular invasion (LVI). MRI and histopathologic features were correlated with outcomes.
RESULTS: Ill-defined tumor margins and enhancement beyond tumor margins were associated with recurrences (P ≤ .001) regardless of perineural invasion or LVI. DFS and OS were adversely affected by ill-defined tumor margins (P ≤ .010). DFS was also affected by enhancement beyond the tumor margins (P < .001). A heterogeneous pattern of enhancement showed a trend toward a decrease in DFS and OS (P = .088 and .092, respectively). Advancing tumor margins on MRI were independent predictors of overall survival. MRI characteristics exhibited significant associations with histopathologic margins, PNI, and LVI.
CONCLUSIONS: Ill-defined advancing tumor margins, a heterogeneous pattern of enhancement, and enhancement beyond the tumor margins on MRI adversely affect outcomes and prognosis in tongue carcinoma.
STUDY DESIGN: In a retrospective analysis of patients with tongue carcinoma, tumor advancing margins, patterns of tumor enhancement, and enhancement beyond tumor margins were studied on MRI. Histopathologic findings included differentiation, margin status, perineural invasion (PNI), and lymphovascular invasion (LVI). MRI and histopathologic features were correlated with outcomes.
RESULTS: Ill-defined tumor margins and enhancement beyond tumor margins were associated with recurrences (P ≤ .001) regardless of perineural invasion or LVI. DFS and OS were adversely affected by ill-defined tumor margins (P ≤ .010). DFS was also affected by enhancement beyond the tumor margins (P < .001). A heterogeneous pattern of enhancement showed a trend toward a decrease in DFS and OS (P = .088 and .092, respectively). Advancing tumor margins on MRI were independent predictors of overall survival. MRI characteristics exhibited significant associations with histopathologic margins, PNI, and LVI.
CONCLUSIONS: Ill-defined advancing tumor margins, a heterogeneous pattern of enhancement, and enhancement beyond the tumor margins on MRI adversely affect outcomes and prognosis in tongue carcinoma.