Association Study Between Tumor Volume And Prognosis Of Tongue Squamous Cell Carcinoma

Objective:The total tumor volume and volume of invasion of tongue squamous cell carcinoma were measured by magnetic resonance imaging,and the relationship between tumor volume and prognosis of tongue squamous cell carcinoma was studied.Materials and Methods:The inpatient information of patients with squamous cell carcinoma of tongue treated in Oral and Maxillofacial Surgery Department of the First Affiliated Hospital of Fujian Medical University from August 2008 to November 2016were collected.According to the inclusion and exclusion criteria,180 patients were included in the study.The clinical data and survival status of these patients were collected.The tumor thickness,depth of invasion,total tumor volume and volume of invasion of tongue squamous cell carcinoma were measured on magnetic resonance imaging using the Ray Station radiotherapy treatment planning system of Radiology Department of the First Affiliated Hospital of Fujian Medical University.Epidata3.1was used to double-input the data,and death was used as the ending event.The overall survival was calculated by Kaplan-Meier method.According to the optimal cutoff values of the four parameters obtained from the ROC curve,the subjects were divided into two groups.Log-rank test was used to compare the difference of overall survival rate in different groups and the survival curve was drawn.The effects of tumor thickness,depth of invasion,total tumor volume and volume of invasion on the prognosis of patients with tongue squamous cell carcinoma were analyzed by Cox proportional hazard model.C-index,Akaike information criterion and Area under the receiver operating characteristic curve were used to compare the prediction performance to the overall survival of the patient of tumor thickness,depth of invasion,total tumor volume and volume of invasion.Results:The subjects were divided into two groups according to the best cut-off value obtained by ROC curve(tumor thickness was 1.28 cm,depth of invasion was 1.10 cm,tumor volume was 4.54 cm~3,volume of invasion was 4.54 cm~3).Univariate analysis showed that there was significant difference between the two groups(P<0.05).After adjusting for age,sex,chemotherapy,radiotherapy and other factors,further analysis showed that there was significant difference between the two groups(P<0.05).The survival curves of different tumor thickness,depth of invasion,tumor volume and volume of invasion on survival time of patients with tongue squamous cell carcinoma showed that the overall 5-year survival rate was 58.91%when the tumor thickness was greater than or equal to 1.28 cm.And when the tumor thickness was less than 1.28 cm,the overall 5-year survival rate was 73.60%(P<0.001).When the depth of invasion was greater than or equal to 1.10 cm,the 5-year overall survival rate was 52.58%.And when the depth of invasion was less than 1.10 cm,the 5-year overall survival rate was77.63%(P<0.001).When the total tumor volume was greater than or equal to 4.54cm~3,the 5-year overall survival rate was 57.18%.And when the total tumor volume was smaller than 4.54 cm~3,the 5-year overall survival rate was 75.15%(P<0.002).When the volume of invasion was greater than or equal to 4.54 cm~3,the 5-year overall survival rate was 51.43%.And when the volume of invasion was smaller than 4.54 cm~3,the 5-year overall survival rate was 85.74%(P<0.001).C-index of tumor thickness,depth of invasion,total tumor volume and volume of invasion were 0.717,0.751,0.680and 0.775.AIC of tumor thickness,depth of invasion,total tumor volume and volume of invasion were 369.890,361.250,376.000 and 360.297.AUC of tumor thickness,depth of invasion,total volume and volume of invasion were 0.711,0.708,0.695 and0.819.Conclusion:In predicting the survival rate of patients with squamous cell carcinoma of tongue,the predictive performance of volume of invasion is better than that of tumor thickness,depth of invasion and total tumor volume,which is a reliable index for predicting the prognosis of patients with tongue squamous cell carcinoma.The total volume of tumor and the volume of invasion can affect the survival of the patients,and they are the factors affecting the prognosis of the patients.When the total tumor volume was greater than or equal to 4.54 cm~3,the prognosis of the patients was worse.When the volume of invasion was greater than or equal to 4.54 cm~3,the prognosis of the patients was worse.