Depth Of Invasion and Level IV Metastases in Clinically N0 Tongue Cancer Running Title : Level IV Metastases in Tongue Cancer

Abstract

Abstract Background: This study investigates the relationship between the depth of invasion and level IV nodal metastasis in tongue squamous cell carcinoma. The depth of the level IV metastasis and the invasion relationship was not evaluated. Methods: We retrospectively investigated clinically N0 patients who underwent glossectomy and level I-IV neck dissections. We examined lymph node metastases, risk factors, and the relationship between depth of invasion and metastasis. Results: Our study included 58 patients. Tumor size, depth of invasion, differentiation, and perineural invasion were statistically significant for Level IV metastasis. The critical size for level IV metastasis was found to be 2.5 cm, with a cut-off value of the depth of invasion being 8 mm for both neck and level IV metastases. Conclusion: Based on our findings, we recommend that level IV dissection should be considered for poorly differentiated tumors, tumors greater than 2.5 cm in size, and deeper than 0.8 mm.