Tumor Satellite in Predicting Occult Nodal Metastasis of Tongue Cancer

Objective. Tongue cancer is well known to have a high poten- tial for locoregional metastasis. However, controversy about electively treating the neck in early-stage tongue cancer re- mains. Although many risk factors related to cervical occult nodal metastasis (ONM) have been investigated, the ability of the tumor to spread, a phenomenon that results from the intrinsic property of the tumor and its interaction with the surrounding environment, has seldom been addressed. Study Design. Retrospective case series with chart review. Setting. Tertiary referral hospital of university. Subjects. Patients with early-stage squamous cell carcinoma of the oral tongue. Results. In 71 eligible enrolled patients, ONM was detected in 19 (27%) patients, while the results were negative (ONM(−)) in 52 (73%) patients. The average tumor satellite distance (TSD) in the ONM(+) group was 4.1 ± 4.3 mm, in contrast to that in the ONM(−) group (1.0 ± 1.5 mm; P < .001). When stratified by increased TSD values, the significance of the dif- ference between the 2 groups increased. For clinical applica- tions, the optimal TSD threshold for determining the ONM probability was 3.5 mm. Multivariate analyses demonstrated that TSD was an independent prognosticator. Conclusions. The results indicate that TSD is a feasible pathologi- cal parameter that is useful for determining the status of cervical nodal metastasis. It can be used as an indicator of potential cervi- cal subclinical disease and as a guideline for deciding the necessity and modality of neck treatment.