A histopathological evaluation and potential prognostic implications of oral squamous cell carcinoma with adverse features. (August 2019)

• Record Type: Journal Article
• Authors: Chang, Wei-Chin; Chang, Ching-Fen; Li, Yu-Hsuan; Yang, Cheng-Yu; Su, Ruei-Yu; Lin, Chih-Kung; Chen, Yuan-Wu
• Is Part Of: Oral oncology. Volume 95(2019)
• Page Start: 65
• Page End: 73
• Publication Date: 2019-08
• Subjects: Oral squamous cell carcinoma -- Prognosis -- Adverse feature -- Surgical margins -- Depth of invasion -- Lymphovascular invasion -- Perineural invasion -- Extranodal extension; AJCC American Joint Committee on Cancer -- ECS extracapsular nodal spread -- ENE extranodal extension -- EORTC European Organization for Research and Treatment of Cancer -- LVSI lymphovascular space invasion -- OS overall survival -- OSCC oral squamous cell carcinoma -- PFS progression-free survival -- PNI perineural invasion -- RT radiotherapy -- RTOG radio therapy oncology group; 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.2019.06.012
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: This study evaluated the correlation between adverse features of OSCC and survival. All known adverse factors had significant negative impact on survival in pN0 cases. Only extranodal extension negatively affected survival in pN-positive cases. Abstract: Objectives: This study aimed to evaluate the adverse clinicopathologic features of oral squamous cell carcinoma (OSCC), including margin status, depth of invasion, lymphovascular invasion, perineural invasion, and extranodal extension that significantly affect survival outcomes. Materials and methods: This retrospective cross-sectional study included 341 patients with OSCC who underwent therapeutic surgical treatment in Taiwan. The Kaplan–Meier method was used to estimate survival outcomes. A multivariable Cox regression model was used to evaluate the associations of various clinicopathologic features with 5-year overall survival (OS) outcomes in patients with pN0 and pN+ tumors. Results: Overall, the patients had 5-year OS and progression-free survival rates of 60.0 and 47.9%, respectively. In the pN0 group, the multivariate analysis identified a positive margin (odds ratio [OR] = 16.3, 95% confidence interval [95% CI]: 3.7–72.3; P = 0.001), depth of invasion >5 mm (OR = 2.1, 95% CI: 1.2–3.7; P = 0.012), presence of lymphovascular space invasion (OR = 5.4, 95% CI: 1.3–22.0; P = 0.018), and presence of perineural invasion (OR = 4.3, 95% CI: 1.7–11.1; P = 0.002) as independent and significant prognosticators of OS. In the pN+ group, only the presence of extranodal extension independently predicted OS (OR = 1.7, 95% CI: 1.1–2.7; P = 0.0026). Conclusions: When determining survival prognosis for patients with a pN0 status, we recommended including all adverse features. In contrast, extranodal extension was the most important prognostic factor for patients with a pN+ status.