Correlation Between Tumor Thickness in Tongue Squamous Cell Carcinoma and Cervical Lymph Node Metastasis

ABSTRACT Background Oral squamous cell carcinoma (OSCC) is one of the most common malignancies in the head and neck. We aimed to investigate the relationship between the tumor thickness in tongue SCC and the cervical lymph node (LN) metastasis to obtain the optimal cut‐off level of tumor thickness for neck dissection. Methods All patients diagnosed with lateral tongue SCC between March 2011 and March 2018 were included in our study. LN metastasis was evaluated in all patients, and tumor thickness was histopathologically measured. The receiver operating characteristic (ROC) curve and logistic regression model explored the optimal cut‐off level and the relationship between patient and tumor‐related variables with LN involvement. Results A total of 142 patients with lateral tongue SCC, comprising 79 males and 63 females with a mean age of 59.9 years, were included in the study. The mean tumor thickness was 12.1 (8.5) mm. Several variables including tumor thickness, vascular invasion, perineural invasion, and moderate and poor differentiation were significantly associated with cervical LN metastasis. The ROC curve analysis showed that the optimal cut‐off level for tumor thickness was 7 mm with a sensitivity of 81.8% and a specificity of 42.5%. The negative and positive predictive values were 78.7% and 47.4%, respectively. Conclusion We showed the importance of tumor thickness in predicting cervical LN metastasis in patients with tongue SCC. This may help in managing cervical LN involvement in patients with oral cavity SCC, which currently relies on TNM staging. Incorporating additional prognostic factors, such as tumor thickness, could improve cancer management.