Clinicobiological progression and prognosis of oral squamous cell carcinoma in relation to the tumor invasive front: impact on prognosis

Abstract Conclusion: There are several factors that influence the final outcome when treating oral squamous cell carcinoma (OSCC). Invasive front phenomena and more importantly their clinicopathological translation can have a direct impact on survival, and subsequently on the decision for an adjuvant treatment. Objectives: In recent years, the concept of tumor–host interaction has been the subject of substantial efforts in cancer research. Tumoral behavior may be better understood when studying the changes occurring at the tumor–host interface. This study evaluated the influence of several clinicopathological features on the outcome of OSCCs. Methods: The clinical records and pathology specimens of 54 patients with OSCC treated by primary resection were reviewed retrospectively. The pathologic features reviewed were: invasive front grading (IFG), stromal reaction, lymphovascular invasion (LVI), perineural invasion (PNI), margin status, and depth of invasion. Results: High IFGs had a significant relationship with pT status and pN status. High IFGs were strongly correlated with nodal metastases (odds ratio (OR) = 4.77; confidence interaval (CI) = 1.37–16.64). Concerning survival, IFG had a strong impact on disease-free survival in patients treated unimodally, as did the depth of invasion in the same group. Lymphovascular involvement was found to have a negative impact on overall survival in patients treated multimodally.

[1]  S V Kane,et al.  Depth of invasion is the most significant histological predictor of subclinical cervical lymph node metastasis in early squamous carcinomas of the oral cavity. , 2006, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[2]  Margaret Brandwein-Gensler,et al.  Oral Squamous Cell Carcinoma: Histologic Risk Assessment, but Not Margin Status, Is Strongly Predictive of Local Disease-free and Overall Survival , 2005, The American journal of surgical pathology.

[3]  G. Thomas,et al.  The relationship of proliferating cell density at the invasive tumour front with prognostic and risk factors in human oral squamous cell carcinoma. , 2004, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[4]  B. Das,et al.  Oral cancer: reviewing the present understanding of its molecular mechanism and exploring the future directions for its effective management. , 2003, Oral oncology.

[5]  W. Wei,et al.  A comparison of the prognostic significance of tumor diameter, length, width, thickness, area, volume, and clinicopathological features of oral tongue carcinoma. , 2000, American journal of surgery.

[6]  R. Spiro,et al.  Pattern of invasion and margin assessment in patients with oral tongue cancer , 1999, Head & neck.

[7]  U. Brinck,et al.  Micrometastases in carcinoma of the upper aerodigestive tract: Detection, risk of metastasizing, and prognostic value of depth of invasion , 1995, Head & neck.

[8]  J. Woolgar,et al.  Prediction of cervical lymph node metastasis in squamous cell carcinoma of the tongue/floor of mouth , 1995, Head & neck.

[9]  C. N. Vila,et al.  Squamous cell carcinoma of the oral cavity: A clinicopathologic scoring system for evaluating risk of cervical lymph node metastasis , 1995, The Laryngoscope.

[10]  E. Dabelsteen,et al.  New malignancy grading is a better prognostic indicator than Broders' grading in oral squamous cell carcinomas. , 1989, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[11]  P. Slootweg,et al.  Mandibular invasion by oral squamous cell carcinoma. , 1989, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[12]  I Suzuki,et al.  Evaluation of histopathologic parameters in predicting cervical lymph node metastasis of oral and oropharyngeal carcinomas. , 1988, Oral surgery, oral medicine, and oral pathology.

[13]  R A Greenberg,et al.  Thickness as prognostic aid in upper aerodigestive tract cancer. , 1986, Archives of surgery.

[14]  C. O'brien,et al.  Neck dissection with and without radiotherapy: prognostic factors, patterns of recurrence, and survival. , 1986, American journal of surgery.

[15]  A. Leonard,et al.  Invasive front grading: reliability and usefulness in the management of oral squamous cell carcinoma. , 2003, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[16]  J. Olofsson,et al.  Prognostic factors in oral cavity carcinomas. , 1992, Acta oto-laryngologica. Supplementum.