Best of five
- A. The patient’s age alone
- B. Depth of invasion and the resulting occult nodal-risk estimate
- C. Whether the ulcer is painful
- D. A negative palpation examination alone
- E. The presence of oral candidiasis
FRCS (ORL-HNS) · SECTION 1 SBA
Oral cancer depth of invasion
A 9 mm lateral-tongue squamous carcinoma has a depth of invasion of 7 mm and no clinical nodes. What feature most strongly drives elective neck management?
B. Depth of invasion and the resulting occult nodal-risk estimate
For early oral cancer, tumour thickness/depth substantially affects occult metastasis risk and the value of sentinel-node biopsy or elective neck treatment.
Why every option is right or wrong
A. The patient’s age alone: Age affects fitness but is not the principal tumour-risk variable.
B. Depth of invasion and the resulting occult nodal-risk estimate: For early oral cancer, tumour thickness/depth substantially affects occult metastasis risk and the value of sentinel-node biopsy or elective neck treatment.
C. Whether the ulcer is painful: Pain does not reliably stage occult nodal disease.
D. A negative palpation examination alone: A clinically N0 neck can still contain micrometastases.
E. The presence of oral candidiasis: This does not determine regional oncological treatment.
What if the scenario changed?
If the lesion were extremely superficial with a very low estimated nodal risk, observation or less invasive staging could be discussed.
Independent Clinora preparation material; not official JCIE content, an accredited programme or a substitute for local policy and specialist judgement.
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