Histologic and systemic prognosticators for local control and survival in margin‐negative transoral laser microsurgery treated oral cavity squamous cell carcinoma. Issue 1 (16th January 2014)

• Record Type: Journal Article
• Authors: Sinha, Parul; Mehrad, Mitra; Chernock, Rebecca D.; Lewis, James S.; El‐Mofty, Samir K.; Wu, Ningying; Nussenbaum, Brian; Haughey, Bruce H.
• Is Part Of: Head & neck. Volume 37:Issue 1(2015:Jan.)
• Page Start: 52
• Page End: 63
• Publication Date: 2014-01-16
• Subjects: Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.23553
• Languages: English
• ISSNs: 1043-3074

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="hed23553-sec-0001" sec-type="section"> <title>Background</title> <p>Appreciable local recurrence rates observed in patients with margin‐negative, transoral laser microsurgery (TLM)‐treated oral cavity squamous cell carcinoma (SCC) necessitate identification of new prognosticators for local control and survival. A histopathologic index (Brandwein–Gensler score [BGS]) and intrinsic/iatrogenic/chronic conditions causing immune compromise are investigated.</p> </sec> <sec id="hed23553-sec-0002" sec-type="section"> <title>Methods</title> <p>From a prospectively assembled database of TLM‐treated oral cavity SCC, specimens for 60 patients with a minimum of 2‐years follow‐up could undergo BGS assignment. Local control, disease‐specific survival (DSS), and overall survival (OS) were study endpoints.</p> </sec> <sec id="hed23553-sec-0003" sec-type="section"> <title>Results</title> <p>"Low‐BGS" was recorded in 28 patients (47%) and "high‐BGS" in 32 patients (53%), whereas immune compromise was observed in 18%. In multivariate analyses, immune compromise was the only predictor for local control. T classification and immune compromise were prognostic for DSS and OS. "High‐BGS" was prognostic only for OS.</p> </sec> <sec id="hed23553-sec-0004" sec-type="section"> <title>Conclusion</title> <p>"High‐BGS" was associated with recurrences but immune compromise was the most significant predictor of local control and survival in margin‐negative, TLM‐treated oral cavity SCC. Strategies that maintain/restore tumor‐specific immune responses in immune compromised oral cavity SCC hosts need to be developed. © 2014 Wiley Periodicals, Inc. <italic>Head Neck</italic><bold>37</bold>: 52–63, 2015</p> </sec> </abstract>