Significance of tumour volume measurements in tongue cancer: A novel role in staging

Abstract

Background: Tongue cancers are staged by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer TNM staging systems. Cancer, however, evolves in a 3-D plane. Hence, using the largest tumour diameter will not reflect total cancer volume. We aim to evaluate the use of tongue cancer tumour volume (Tv) as a prognostic predictor of disease recurrence and survival. Methods: The study is a retrospective analysis of patients in Singapore General Hospital who underwent complete resection for histologically proven tongue carcinoma from 2000 to 2002. The Tv was measured on staging T2-weighted magnetic resonance imaging datasets by semiautomated methods. Results: Seventeen patients with a median follow-up duration of 57.9 months were studied. A wide range of volumes was noted in each T stage. The median time to relapse was 8.6 months for those with Tv ≥ 13 cc but was not achieved for those with Tv < 13 cc. The hazard ratio comparing Tv ≥13 cc versus