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Review
. 2021 Aug;43(8):2510-2522.
doi: 10.1002/hed.26718. Epub 2021 Apr 24.

High-risk early-stage oral tongue squamous cell carcinoma, when free margins are not enough: Critical review

Andrea Galli  1 , Stefano Bondi  1 , Carla Canevari  2 , Michele Tulli  1 , Leone Giordano  1 , Davide Di Santo  1 , Luigi Gianolli  2 , Mario Bussi  1
Affiliations
Review

High-risk early-stage oral tongue squamous cell carcinoma, when free margins are not enough: Critical review

Andrea Galli et al. Head Neck. 2021 Aug.

Abstract

Oral tongue squamous cell carcinoma (OTSCC) is a quite peculiar disease from an anatomical and biological standpoint. An increasing amount of literature highlights the existence of a small subset of T1-T2N0 OTSCC, properly resected on a margin-dependent basis, which conversely proved higher than expected rates of loco-regional/distant failure and disease-specific mortality. These specific high-risk tumors might not have a margin-dependent disease and could possibly benefit from a more aggressive upfront loco-regional treatment, especially addressing the so-called T-N tract. Widespread adoption of a histopathological risk model would allow early recognition of these high-risk diseases and, consequently, intensification of the traditional treatment strategies in that specific niche. We reviewed the available knowledge trying to shed light on the potential determinants of the dismal prognosis of these high-risk OTSCC, with special reference to the role of overlooked T-N tract involvement and possible alternatives in terms of elective neck management and risk stratification.

Keywords: T-N tract; early stage; oral cancer; risk model; tongue cancer.

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References

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