Article Figures & Data
Figures
- Fig 1.
A schematic representation of 3 main types of tumors. A, Flat tumors have the interpreted mucosal plane at the same level as the tumor; thus, depth of invasion and tumor thickness should be measured identically (TT = DOI). B, Exophytic/bulging tumors extend outward from the interpreted mucosal plane, leading to a situation in which tumor thickness can be larger than the depth of invasion (TT > DOI). C, Endophytic/ulcerated tumors have a gap between the interpreted mucosal plane and the tumor surface, and depth of invasion can be larger than tumor thickness (DOI > TT).
- Fig 2.
Distribution of radiologic and pathologic tumor thickness.
- Fig 3.
Prognostic value of rTT and rDOI for overall survival. AHR indicates adjusted hazard ratio, adjusted for age, seventh edition T-category, N-category, and Eastern Cooperative Oncology Group performance status.
Tables
Covariate Entire Cohort Oral Tongue Other Subsitea P Valueb Total case No. 335 189 (56%) 146 (44%) Age (median) (range) (yr) 62 (22–96) 60 (22–96) 64 (28–96.4) .004c Sex .260 Female 129 (39%) 78 (41%) 51 (35%) Male 206 (61%) 111 (59%) 95 (65%) Smoking PY (median) (range) 10 (0–100) 5 (0–100) 20 (0–86) <.001c pT Category (7th edition) <.001c T1 119 (36%) 47 (25%) 72 (49%) T2 161 (48%) 101 (53%) 60 (41%) T3 55 (16%) 41 (22%) 14 (10%) pN Category (7th edition) <.001c N0 181 (54%) 83 (44%) 98 (67%) pN+ 154 (46%) 106 (56%) 48 (33%) pTT (median) (range) (cm) 0.9 (0.1–4.0) 1.1 (0.1–4.0) 0.6 (0.1–3.9) <.001c rTT (median) (range) (cm) 1.0 (0.1–3.4) 1.2 (0.1–3.0) 0.6 (0.1–3.4) <.001c rTT on CT (median) (range) (cm) 1.0 (0.1–3.4) 1.3 (0.1–2.7) 0.7 (0.1–3.4) <.001c rTT on MR (median) (range) (cm) 1.2 (0.1–3.0) 1.3 (0.1–3.0) 0.3 (0.1–2.8) <.001c rDOI on CT (median) (range) (cm) 0.9 (0.0–3.1) 1.3 (0.1–2.7) 0.6 (0.0–3.1) <.001c rDOI on MR (median) (range) (cm) 1.1 (0.1–3.0) 1.3 (0.1–3.0) 0.3 (0.1–2.8) <.001c Note:—PY indicates pack-year; pN+, pathologic-positive lymph nodes.
↵a Other oral cavity subsite included the following: n = 75, floor of mouth; n = 37, buccal mucosa; n = 16, lower alveolar and gingiva; n = 8, retromolar trigone; n = 6, upper alveolar and gingiva; n = 4, hard palate.
↵b P value was for comparison between oral tongue and other oral cavity subsites.
↵c Significant.
- Table 2:
Radiologic-pathologic tumor thickness concordance adjusted for imaging-to-surgery time interval and diagnostic accuracy of rTT as the seventh edition T-category modifier
rTT vs pTT Spearman Correlation Coefficient (ρ) (95% CI) Shrinkage Factor Entire cohort (n = 335) 0.78 (0.73–0.82) 0.81 Oral tongue (n = 189) 0.74 (0.66–0.80) 0.90 Other subsites (n = 146) 0.74 (0.65–0.80) 0.71 Variable No Shrinkage Factor With Shrinkage Factor 0.8 rTT identifying 7th edition T1 tumor with pTT > 0.5 cm Total case No. 119 119 True positive 38 34 True negative 59 65 False positive 17 11 False negative 5 9 Sensitivity 88% (75–96) 79% (64–90) Specificity 78% (67–86) 86% (76–93) Positive predictive value 69% (55–81) 76% (60–87) Negative predictive value 92% (83–97) 88% (78–94) Accuracy 82% 83% rTT identifying 7th edition T2 tumor with pTT > 1.0 cm Total case No. 161 161 True positive 64 54 True negative 49 65 False positive 31 15 False negative 17 27 Sensitivity 79% (69–87) 67% (55–77) Specificity 61% (50–72) 81% (71–89) Positive predictive value 67% (57–77) 78% (67–87) Negative predictive value 74% (62–84) 71% (60–80) Accuracy 70% 74%
