AUTHOR=Wu Yao , Zhang Xu , Dai Liyuan , Fang Qigen , Du Wei 

TITLE=Neck Management in cT1N0 Tongue Squamous Cell Carcinoma as Determined by Sonographic Depth of Invasion

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.786258

DOI=10.3389/fonc.2021.786258

ISSN=2234-943X

ABSTRACT=Objectives: To compare the oncologic outcomes in patients with cT1N0 tongue squamous cell carcinoma (SCC) who underwent different neck management strategies stratified by sonographic depth of invasion (DOI).
Methods: The included patients were retrospectively enrolled, and divided into two groups: observation (OBS) and elective neck dissection (END). The regional control (RC) and disease-specific survival (DSS) rates were compared and stratified by sonographic DOI.
Results: The mean sonographic and pathologic DOIs were 3.8 mm and 3.7 mm, respectively; the two DOIs were significantly correlated (Spearman correlation coefficient 0.974. p<0.001). In patients with sonographic DOI<4.0 mm, the 5-year RC rates were 73% and 89% in the OBS and END groups, respectively, and were not significantly different. However, in patients with sonographic DOI≥4.0 mm, the 5-year RC rate was significantly different between the OBS (57%) and END (80%) groups (p=0.031). In patients with sonographic DOI<4.0 mm, the 5-year DSS rates were 79% and 89% in OBS and END groups, respectively, and were not significantly different. However, in patients with sonographic DOI≥4.0 mm, the 5-year DSS rate was significantly different between the OBS (67%) and END (86%) groups (p=0.033). 
Conclusions: Sonographic DOI was notably correlated with pathologic DOI. Moreover, there was a significant survival difference between the OBS and END groups in cT1N0 tongue SCC patients with sonographic DOI≥4.0 mm but not in those with sonographic DOI<4.0 mm. Our study provides a useful method to aid decision-making in the clinical setting for this patient group.