When should MRI be recommended for the accurate clinical staging of base of tongue carcinoma?
OBJECTIVE
According to the American Joint Committee on Cancer (AJCC) cancer staging criteria (6th edition), cross-sectional imaging for base of tongue carcinoma is recommended when the deep tissue extent of a primary tumor is in question. The aim of this study was to establish which group of patients MRI might most benefit from accurate clinical staging of base of tongue carcinomas.


METHODS
The clinical stagings of 33 patients with pathologically proven squamous cell carcinomas of the base of tongue were performed by two otorhinolaryngologic surgeons. Their results were compared with the results from MRI interpreted by a neuroradiologist and the numbers of patients being upstaged, downstaged or with an unchanged stage were recorded and analyzed.


RESULTS
The tumor stages were changed in 13 of 33 patients (39.4%, 95% CI: 23.9-57.87%) and the overall stage groupings were changed in 10 (30.3 %, 95%CI: 15.6-48.7%) after performing MRI. Mis-staging by clinical examination in the overall stage grouping was as high as 83.3% (95%CI: 35.9-99.6%) in stages II and III and 85.7% (95% CI: 42.1-99.6%) in T3.


CONCLUSIONS
MRI should be recommended in base of tongue carcinoma whenever clinical examination suggests overall stage groupings II, III or tumor stage T3.
Hirunpat
Siriporn
S
Department of Radiology, Prince of Songkla University Hospital, Hat-Yai, Songkla, Thailand. hirsirip@hotmail.com
Jongsatitpaiboon
Jaturong
J
Angunsri
Nakarin
N
Chowchuvech
Vorapong
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D015203:Reproducibility of Results; D014062:Tongue Neoplasms / Q000473:pathology*