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Year : 2021  |  Volume : 4  |  Issue : 4  |  Page : 677-683

Imaging-based T stage (iT) as a predictive and prognostic marker for outcome in T4 stage tongue carcinomas: A narrative review

1 Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
2 Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Abhishek Mahajan
Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Room No. 125, Dr. E Borges Road, Parel, Mumbai - 400 012,Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/crst.crst_132_21

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Preoperative imaging is essential for staging carcinomas of the oral tongue in addition to clinical staging. The current TNM staging of the oral cavity according to the 8th edition of the American Joint Committee on Cancer is appropriate for buccal mucosal carcinomas due to their proximity to and frequent involvement of the skin, bone, and masticator space in case of advanced disease. However, it is inadequate for the subclassification of tongue carcinomas. Tongue cancers, even those in the advanced stage, do not frequently involve these structures, thus leading to understaging of these tumors. We observed that the preoperative radiological markers such as perineural invasion, hyoid bone involvement, extrinsic muscle involvement up to their origin, and distance of the paralingual septum from the tumor are better predictors of prognosis of carcinoma of the tongue. In this article, we review the existing literature on T4 staging of tongue carcinomas and also propose a few modifications to the current staging system from a radiological perspective. A comprehensive search of abstracts of prognostic markers in tongue carcinoma and their impact on T4 stage was done. The PubMed and the Cochrane library were used. The keywords for Medical Subject Headings were as follows: Magnetic resonance imaging, Neurovascular bundle, Oral tongue, Perineural invasion, Squamous cell carcinoma, Extrinsic muscle invasion, Hyoid bone involvement, and Paralingual septum distance. The reference lists of included studies and review articles were checked manually. Unpublished data were not included in this review. We suggest a radiological T4 staging system which is more suitable for staging tongue cancers.

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