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Biopsy specimens from 103 patients with cT1–T2 tumors were analysed. Multivariate results identify budding score and pathological depth of invasion as independent risk factors, with group differences shown in 5-year disease-specific survival. The BD model offers the strongest specificity for CLM prediction.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/treatment-strategy-for-cervical-lymph-node-metastases-from-early-stage-tongue-and-floor-of-the-mouth-squamous-cell-carcinoma-using-tumour-budding-and-depth-of-invasion-as-predictors/329101/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/treatment-strategy-for-cervical-lymph-node-metastases-from-early-stage-tongue-and-floor-of-the-mouth-squamous-cell-carcinoma-using-tumour-budding-and-depth-of-invasion-as-predictors/329101.png","ImageObject",300,407,{"name":92,"@type":93},"Rowan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study’s main objective?","Question",{"text":112,"@type":113},"To determine whether elective neck dissection improves outcomes in early-stage tongue and floor of the mouth squamous cell carcinoma by analysing how biopsy-based information relates to cervical lymph node metastasis incidence and prognosis.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which biopsy parameters were identified as independent risk factors for cervical lymph node metastasis?",{"text":117,"@type":113},"Budding score (BS) ≥ 5 and pathological depth of invasion (pDOI) ≥ 5 mm were found to be independent risk factors for cervical lymph node metastasis.",{"name":119,"@type":110,"acceptedAnswer":120},"How does the study suggest managing occult cervical lymph node metastasis during initial surgery?",{"text":121,"@type":113},"For early-stage cases with maximum tumour diameter ≤ 20 mm, occult CLM may need treatment during initial surgery when preoperative criteria are met, such as pDOI ≥ 5 mm or BS ≥ 5 in biopsy specimens and DOI ≥ 8 mm on imaging.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},329101,1790151468,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},1099514067415,"https://ap-avatar.wpscdn.com/avatar/100002539d78ffe74a7?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779092875211072502","Clinical Oral Investigations (2024) 28:580  \n[https://doi.org/10.1007/s00784-024-05974-y](https://doi.org/10.1007/s00784-024-05974-y)  \nTreatment strategy for cervical lymph node metastases  \nfrom early‑stage tongue and floor of the mouth squamous cell carcinoma using tumour budding and depth of invasion as predictors  \nMasaru Ogawa1 · Satoshi Yokoo1 · Takahiro Yamaguchi1 · Keisuke Suzuki1 · Mai Seki1,2 · Takahiro Shimizu1 · Takaya Makiguchi1  \nReceived: 30 July 2024 / Accepted: 29 September 2024 / Published online: 9 October 2024 © The Author(s) 2024  \nAbstract  \nObjectives This study aimed to determine whether elective neck dissection can help improve outcomes in early-stage tongue and floor squamous cell carcinoma (SCC) by statistically analysing the relationship between information obtained from biopsy specimens and the incidence and prognosis of cervical lymph node metastasis (CLM) .  \nMaterials and methods Biopsy specimens of 103 patients diagnosed with early cT1–T2 cancer of the tongue and floor of the mouth were included.  \nResults Multivariate analysis showed that the three parameters significantly correlated with CLM, and univariate analyses showed that budding score (BS) ≥ 5 and pathological depth of invasion (pDOI) ≥ 5 mm were independent risk factors for CLM. There were significant differences in the 5-year cumulative disease-specific survival between the BS \u003C 5 and BS ≥ 5 groups, the pDOI \u003C 5 mm and pDOI ≥ 5 mm groups, and the positive and negative budding and depth of invasion (BD) score groups.  \nConclusion In early-stage tongue and floor of the mouth cancers with maximum tumour diameter ≤ 20 mm, it may be necessary to treat occult CLM during initial surgery based on the following preoperative criteria: pDOI ≥ 5 mm or BS ≥ 5 in biopsy specimens and DOI ≥ 8 mm on imaging. The BD model exhibited the highest specificity and proved helpful for CLM prediction.  \nClinical relevance pDOI ≥ 5 mm and BS ≥ 5 were independent predictors of CLM and prognosis in early-stage tongue and floor of the mouth cancers with a maximum tumour diameter of 20 mm.  \nKeywords Early tongue and floor of the mouth squamous cell carcinoma · Cervical lymph node metastasis · Biopsy · Tumour budding · Depth of invasion  \nBackground  \nCervical lymph node metastasis (CLM) is a prognostic factor in oral squamous cell carcinoma (SCC) including the tongue and floor of the mouth. Clinically diagnosed early-stage  \n* Masaru Ogawa [masaru0523@gunma-u.ac.jp](masaru0523@gunma-u.ac.jp)  \n1 Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi-city, Gunma 370-8511, Japan  \n2 Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi-city, Gunma, Japan  \noral SCC, including the tongue and floor of the mouth (T1/ T2N0M0), shows occult CLM in 20%–40% of cases [1–5] . Therefore, it is important to manage occult CLM at the time of initial treatment, and elective neck dissection (END) is one such treatment option. In cases of primary tumour resection requiring reconstruction with free tissue transfer or pedicle flap transfer, there is less confusion in determining the indication for END in terms of the surgical field, asthe extent of the reconstructive surgery extends to the neck. However, the primary site can often be directly closed after resection of the primary tumour in the early-stage tongue and floor of the mouth SCC. Even if the SCC is a high-grade type, there is often hesitation in performing END from the viewpoint of surgical invasion, and a wait-and-see policy is frequently adopted [3] . To further improve treatment  \noutcomes for early-stage tongue and floor of mouth SCC, it may be helpful to predict the possibility of occult CLM based on preoperative information and only indicate END for high-risk cases.  \nRecently, the biological characteristics of the tumour invasion front have been reported to be valuable","cbCaie6RvI66BCb2","https://ap.wps.com/l/cbCaie6RvI66BCb2","pdf",1302161,"English","# Objectives\n# Materials and methods\n# Results\n## Survival and risk factors\n# Conclusion\n# Clinical relevance\n# Background","[{\"question\":\"What was the study’s main objective?\",\"answer\":\"To determine whether elective neck dissection improves outcomes in early-stage tongue and floor of the mouth squamous cell carcinoma by analysing how biopsy-based information relates to cervical lymph node metastasis incidence and prognosis.\"},{\"question\":\"Which biopsy parameters were identified as independent risk factors for cervical lymph node metastasis?\",\"answer\":\"Budding score (BS) ≥ 5 and pathological depth of invasion (pDOI) ≥ 5 mm were found to be independent risk factors for cervical lymph node metastasis.\"},{\"question\":\"How does the study suggest managing occult cervical lymph node metastasis during initial surgery?\",\"answer\":\"For early-stage cases with maximum tumour diameter ≤ 20 mm, occult CLM may need treatment during initial surgery when preoperative criteria are met, such as pDOI ≥ 5 mm or BS ≥ 5 in biopsy specimens and DOI ≥ 8 mm on imaging.\"}]","Treatment strategy for cervical lymph node metastases from early-stage tongue and floor of the mouth squamous cell carcinoma using tumour budding and depth of invasion as predictors | PDF",1789982450,23]