Background and objectives: The most important prognostic factor for survival in tongue cancer is the presence of cervical lymph node metastases. Their presence determines the therapeutic strategy. 20–30% of stages T1-2, N0 have micrometastases not detectable by conventional imaging. Tumor thickness is predictive for the presence of cervical metastasis in addition to being an independent prognostic factor for overall survival. MRI is the imaging test of choice in the preoperative study in tongue cancer. The goal of this work has been to study the effectiveness of the radiological thickness measurements in tongue cancer from presurgical studies using magnetic resonance imaging (MRI) compared to histopathologic thickness after tumor resection Methods: A retrospective analysis of 77 patients with tongue cancer treated in the Maxillofacial Surgery Department of Service HRU Carlos Haya in the period 2009–2011 was performed. Tumor thickness was measured by MRI on T1 with contrast and the correlation was studied in relation with the thickness of the surgical pathology specimen. The results were analized in different groups classified by tumor location. The presence of nodal metastasis and its relationship with the measurement of radiological tumor thickness were studied.
Results: Application of the test of Spearman’s showed a strong positive correlation (correlation index 0.828) within the two measurements. A linear relation was found between the radiological and the pathological thickness. In our study we found that a radiological thickness of 9.4 mm and higher predicts the presence of cervical metastasis. According to tumor location the correlation index is greater in lateral tongue (correlation index 0.857).
Conclusions: MRI is useful in the presurgical evaluation of tongue cancer and has proved to be a reliable diagnostic tool for measure of tumor thickness. Its reliability is greater in lateral tongue tumors.
Key words: tongue cancer; magnetic resonance imaging; tumor thickness; squamous cell carcinoma; nodal metastasis