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Prognostic Value of Cervical Nodal Necrosis Observed in Preoperative CT and MRI of Patients With Tongue Squamous Cell Carcinoma and Cervical Node Metastases: A Retrospective Study

 Sung Hyun Baik  ;  Ji Won Seo  ;  Jun-Hwee Kim  ;  Seung-Koo Lee  ;  Eun Chang Choi  ;  Jinna Kim 
 American Journal of Roentgenology, Vol.213(2) : 437-443, 2019 
Journal Title
 American Journal of Roentgenology 
Issue Date
CT ; MRI ; cervical node metastasis ; squamous cell carcinoma ; tongue cancer
OBJECTIVE. The prognosis of tongue squamous cell carcinoma (SCC) with cervical lymph node metastases is poor, and a subset of patients with aggressive disease experiences treatment failure. The current study evaluated the prognostic value of cervical nodal necrosis (CNN) observed on preoperative imaging studies of patients with tongue SCC and cervical node metastases. MATERIALS AND METHODS. We identified patients with tongue SCC who had undergone preoperative neck CT or MRI (or both) and retrospectively reviewed their demographic and clinical data. Patients with metastatic cervical lymph nodes were divided into two groups according to the presence (CNN group) or absence (non-CNN group) of necrosis, and radiologic extranodal extension (ENE) was assessed for all patients. Follow-up biopsy, imaging, and clinical examinations were used to determine survival and treatment failure. Cox proportional hazard regression analyses were performed to determine clinical, demographic, and pathologic factors for survival. RESULTS. Seventy-two patients with a mean follow-up period of 28.4 months were included. The incidence of CNN was 55.6% (40/72). In univariate analysis, patient age, evidence of CNN on preoperative imaging, radiologic ENE, clinical N classification, and overall stage were significantly associated with survival. The multivariate Cox proportional hazard model showed that patient age and CNN on preoperative imaging were independent negative prognostic factors. CONCLUSION. CNN observed on preoperative imaging studies is an independent predictor of a poor prognosis for patients with tongue SCC, and it may serve as a useful imaging biomarker for tailoring individual treatment regimens.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jun-Hwee(김준휘)
Kim, Jinna(김진아) ORCID logo https://orcid.org/0000-0002-9978-4356
Seo, Ji Won(서지원)
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Choi, Eun Chang(최은창)
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