Chromosome instability in tumor resection margins of primary OSCC is a predictor of local recurrence. (March 2017)

• Record Type: Journal Article
• Authors: Pierssens, Damiana D.C.G.; Borgemeester, Maarten C.; van der Heijden, Stijn J.H.; Peutz-Kootstra, Carine J.; Ruland, Andrea M.; Haesevoets, Annick M.; Kessler, Peter A.W.H.; Kremer, Bernd; Speel, Ernst-Jan M.
• Is Part Of: Oral oncology. Volume 66(2017)
• Page Start: 14
• Page End: 21
• Publication Date: 2017-03
• Subjects: OSCC oral cavity squamous cell carcinoma -- FISH fluorescence in situ hybridization -- CI chromosomal instable neoplasia -- CIS carcinoma in situ -- LOH loss of heterozygosity -- MPTC Maastricht Pathology Tissue Collection Department -- CNV copy number variations; Chromosomal instability -- Aneuploidy -- Copy number variation -- Resection margins -- Oral squamous cell carcinoma -- Recurrence -- FISH -- p53; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2016.12.029
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Recurrence rates in OSCC remains stable for decades despite therapeutic improvements. The pathologic examination of the resection margins shows inter- and intraobserver variability. Detection of CI using FISH of chromosomes 1 and 7 predict higher risk of recurrence. Adding FISH to current routine diagnostics may aid in better treatment. Abstract: Background: The local recurrence rate in oral squamous cell cancer (OSCC) hardly decreases. This is partly due to the presence of (pre)malignant cells in the remaining tissue after resection, that may lead to the development of a new tumor in time. Detection of histologically (pre)malignant cells in the tumor resection margins should predict these patients at risk for recurrence, however this appears to be difficult in routine practice. Purpose of this study was to apply easy-to-use molecular tests for more accurate detection of (pre)malignant cells in histopathologically tumor-free margins, to improve diagnosis of patients at risk. Methods: 42 patients with firstly diagnosed, radically resected primary OSCC with histopathologically confirmed tumor-free resection margins (treated between 1994 and 2003) were included. Inclusion criteria comprised of follow-up ⩾5 years, and radical surgery without postoperative treatment. Formalin-fixed paraffine-embedded tissue sections of 42 tumors, 290 resection margins, and 11 recurrences were subjected to fluorescence in situ hybridization (FISH) to examine chromosome 1 and 7 copy number variations (CNV), and to p53 immunohistochemistry (IHC). Results: 11 out of the 42 patients developed a local recurrence within 5 years. FISH analysis showed that nine of eleven recurrences exhibited CI in at least one of the resection margins (p = 0.008). P53 overexpression and routine histopathologic classification were not correlated with recurrent disease. The presence of CI in the resection margins revealed a significantly worse progression-free survival (log-rank p = 0.012). Conclusions: CI in the resection margins of OSCC can reliably identify patients at risk for developing a local recurrence.