Importance and implications of neurovascular bundle involvement and other MRI findings of oral tongue squamous cell carcinoma (OTSCC) on prognosis. (September 2021)

• Record Type: Journal Article
• Authors: Shah, Snehal; Mahajan, Abhishek; Thiagarajan, Shivakumar; Chidambaranathan, Nithyanand; Sutar, Meena; Sable, Nilesh; Chaukar, Devendra
• Is Part Of: Oral oncology. Volume 120(2021)
• Publication Date: 2021-09
• Subjects: Neurovascular bundle -- MRI -- Perineural invasion -- Oral tongue -- Squamous cell carcinoma; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2021.105403
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Relation of the tumor with the neurovascular bundle on MRI is important. The tumor abutting or encasing the neurovascular bundle is seen mostly in advanced oral tongue cancer. The above is associated with presence of PNI in the final histopathology and may impact treatment outcomes. The neurovascular bundle is involved by the tumor at a DOI of 15.5 mm on MRI. Abstract: Background: The description for T4a oral tongue cancer in the 8th edition AJCC staging can be improved further. In this article we attempted to identify the important radiological (MRI) findings that could possibly be included in the staging eventually. Methods: We included all oral tongue squamous cell carcinoma patients who underwent surgery at TMH between Jan 2012 to Dec 2018 and whose MRIs were available for review. The relation of the tumor to the neurovascular bundle (NVB) on MRI was classified as Type I to IV. The association of the type of NVB involvement with DFS and the presence of PNI in the final HPR was analyzed. Results: Two-hundred and fifty-nine patients satisfied the eligibility criteria. The majority of them were men (82.6%), with a median age of 49 Yrs. Sixty-nine percent of patients had either abutment (Type III) or encasement (Type IV) of the NVB. The presence of Abutment/encasement of the NVB was significantly associated with the presence of PNI in the final HPR (p < 0.001). This abutment/encasement was seen in clinically advanced T-stage tumors. However, the presence of abutment/encasement of the NVB influenced the DFS in the univariate analysis only. Conclusion: Abutment/encasement of the NVB in patients with carcinoma oral tongue is often seen in advanced-stage tumors and is significantly associated with the presence of PNI in the final HPR. Hence, the relation of the tumor with the NVB should be further assessed to understand its importance and its possible inclusion in the AJCC T-staging.