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Invasion characteristics of oral tongue cancer
Cancer, 06/26/09

Goodman M et al. - In a study to assess the use of a 2000 College of American Pathologists (CAP) guideline recommending that a characterization of carcinomas of the upper aerodigestive tract, including tongue cancer, should include depth of invasion (DI) and presence of lymphovascular invasion (LVI) or perineural invasion (PNI), current results indicated the importance of reporting tumor invasion characteristics for pts diagnosed with cancer of the oral tongue. Findings underscore the need for continuous monitoring of adherence to the CAP protocol.

• This study included pts who were diagnosed with cancer of the oral tongue, who underwent tumor resection, and who were reported to either the Metropolitan Atlanta and Rural Georgia Surveillance, Epidemiology, and End Results (SEER) registry or Los Angeles SEER registry.
• Completeness of pathology reporting was assessed with respect to documentation of PNI or LVI and DI.
• Generalized estimating equations were used to examine factors that influenced reporting while taking into consideration clustering of observations within the hospitals.
• Univariate and multivariate survival analyses were conducted to examine the impact of tumor invasion characteristics on mortality while controlling for other prognostic factors.

• DI reporting increased from 13% between 1997 and 1999 to 23% between 2000 and 2004 after the CAP issued its recommendations; whereas mode of invasion (presence of LVI and/or PNI) reporting for the same period increased from 13% to 38%.
• Observed increase in reporting was most pronounced in the first 2 yrs (2000 and 2001) and appeared to decline again afterward.
• Tumor invasion >3 mm in depth and presence of PNI were among the strongest predictors of survival in multivariate analyses.

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