Oral oncology · 2025
Tumor-width-to-tongue-width ratio: A novel predictor of cervical lymph node metastasis and prognosis in squamous cell carcinoma of the tongue.
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Hui Leonard Tan Toh, Yang Min-Chun, See Anna, Huang Yenlin, Tsai Tsung-You, Lee Chi-Yin, Huang Pin-Hsuan, Tseng Ti-Yung, Ng Shu-Hang, Chang Kai-Ping
Аннотация
OBJECTIVES: Squamous cell carcinoma of the tongue (SCCOT) with midline involvement has a higher risk of contralateral cervical metastasis. The aim of this study is to investigate the association between the tumor-width-to-tongue-width ratio (TWR) and unilateral/ contralateral cervical metastasis and prognosis in SCCOT.
MATERIALS & METHODS: 221 patients with SCCOT from 2002 to 2025 were enrolled. Eligible patients underwent magnetic resonance imaging and primary surgical treatment. The TWR was measured and its predictive value for cervical metastasis was analyzed using logistic regression. Survival outcomes were assessed using the Kaplan-Meier method and Cox regression analysis. A nomogram combining TWR and other clinicopathological factors was constructed.
RESULTS: 88.2 % of patients were male, and 11.8 % were female. The median age of the study population was 50.9 years old. 44 patients underwent bilateral neck dissection, and contralateral cervical metastasis was noted in 21 patients. Multivariate analysis confirmed TWR ≥ 0.33 and TWR ≥ 0.538 as an independent risk factor for unilateral and contralateral cervical metastasis (adjusted add ratio: 2.743 and 3.607, p = 0.016 and 0.043). Kaplan-Meier plots and multivariate analysis demonstrated that the groups with higher TWR values were associated with poorer overall survival and locoregional-free survival. The concordance index for overall survival prognosis was 0.778 using this nomogram compared to 0.684 using the TNM staging alone (p < 0.001).
CONCLUSIONS: TWR is a significant predictor of unilateral/ contralateral cervical metastasis and independently affects survival. A nomogram including TWR with other clinicopathological factors provided better predictive accuracy for prognosis in SCCOT patients.
MATERIALS & METHODS: 221 patients with SCCOT from 2002 to 2025 were enrolled. Eligible patients underwent magnetic resonance imaging and primary surgical treatment. The TWR was measured and its predictive value for cervical metastasis was analyzed using logistic regression. Survival outcomes were assessed using the Kaplan-Meier method and Cox regression analysis. A nomogram combining TWR and other clinicopathological factors was constructed.
RESULTS: 88.2 % of patients were male, and 11.8 % were female. The median age of the study population was 50.9 years old. 44 patients underwent bilateral neck dissection, and contralateral cervical metastasis was noted in 21 patients. Multivariate analysis confirmed TWR ≥ 0.33 and TWR ≥ 0.538 as an independent risk factor for unilateral and contralateral cervical metastasis (adjusted add ratio: 2.743 and 3.607, p = 0.016 and 0.043). Kaplan-Meier plots and multivariate analysis demonstrated that the groups with higher TWR values were associated with poorer overall survival and locoregional-free survival. The concordance index for overall survival prognosis was 0.778 using this nomogram compared to 0.684 using the TNM staging alone (p < 0.001).
CONCLUSIONS: TWR is a significant predictor of unilateral/ contralateral cervical metastasis and independently affects survival. A nomogram including TWR with other clinicopathological factors provided better predictive accuracy for prognosis in SCCOT patients.