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Lymph node ratio as a predictor for outcome in oral squamous cell carcinoma: a multicenter population-based cohort study
Spoerl, Steffen
, Gerken, Michael, Mamilos, Andreas, Fischer, René, Nieberle, Felix, Klingelhöffer, Christoph, Meier, Johannes K., Spoerl, Silvia, Ettl, Tobias, Spanier, Gerrit
and Reichert, Torsten E.
(2020)
Lymph node ratio as a predictor for outcome in oral squamous cell carcinoma: a multicenter population-based cohort study.
Clinical Oral Investigations 25 (4), pp. 1705-1713.
Date of publication of this fulltext: 05 Feb 2021 10:20
Article
DOI to cite this document: 10.5283/epub.44771
This is the latest version of this item.
Abstract
Objectives The present study evaluated the predictive value of staging and grading parameters concerning the presence of lymph-node metastases, overall survival (OS), and relapse-free survival (RFS) of patients with oral squamous cell carcinoma (OSCC). Materials and methods HE-stains of 135 surgically treated (R0) primary OSCCs were analyzed using a both microscopic and software-based approach. ...
Objectives The present study evaluated the predictive value of staging and grading parameters concerning the presence of lymph-node metastases, overall survival (OS), and relapse-free survival (RFS) of patients with oral squamous cell carcinoma (OSCC). Materials and methods HE-stains of 135 surgically treated (R0) primary OSCCs were analyzed using a both microscopic and software-based approach. Depth of invasion (DOI) and resection margins (RM) were measured, and each case was graded according to the malignancy grading system as described by Anneroth et al. and Bryne et al. on two different sites of the tumor (surface and invasion front; TS and IF). Results Parameters that could be identified as significant predictors of OS and RFS were UICC cancer stage (p = 0.009 andp = 0.012); pT-stage as defined in the 7th edition (p = 0.029 and 0.015) and, after restaging using DOI, 8th edition (p = 0.023 andp = 0.005) of the TNM classification of malignant tumors; the presence of lymphonodular metastases (LM) (p = 0.004 andp = 0.011); degree of keratinization (p = 0.029 andp = 0.042); and pattern of growth (p = 0.029 andp = 0.024) at the TS after applying a binary scale for both parameters. Also, when directly comparing the most extreme subgroups (scores 1 and 4) of lymphoplasmacytic infiltration at the IF, there was a significant difference in OS (p = 0.046) and RFS (p = 0.005). Invasion of blood vessels (p = 0.013) and perineural invasion (p = 0.023) were significantly associated with a lower OS. Age lower than 60 years (univariatep = 0.029, multivariatep = 0.031), infiltration of lymphatic vessels (p = 0.003), infiltration of nerves (p = 0.010), pT-stage (8th edition) (p = 0.014), degree of keratinization at the IF (p = 0.033), and nuclear polymorphism at the IF (p = 0.043) after conversion to a binary scale were found to be significant prognostic parameters regarding the presence of LM. DOI evolved as a significant predictor for OS (p = 0.006), RFS (p = 0.003), and LM (p = 0.032) in metric and grouped analysis. Conclusions The current evaluation revealed depth of invasion as strongest histologic predictor of metastatic tumor growth, overall survival, and relapse-free survival in OSCC, confirming the current adaption of the T-classification. Other distinct histologic grading parameters investigated during this study can give valuable indications of a tumor's potential aggressiveness, but the exact site, mode, and procedure need further exploration.
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| Item type | Article | ||||
| Journal or Publication Title | Clinical Oral Investigations | ||||
| Publisher: | Springer | ||||
|---|---|---|---|---|---|
| Place of Publication: | HEIDELBERG | ||||
| Volume: | 25 | ||||
| Number of Issue or Book Chapter: | 4 | ||||
| Page Range: | pp. 1705-1713 | ||||
| Date | 4 August 2020 | ||||
| Institutions | Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie Medicine > Lehrstuhl für Pathologie Medicine > Lehrstuhl für Pathologie Medicine > Zentren des Universitätsklinikums Regensburg > Tumorzentrum e.V. Medicine > Institut für Epidemiologie und Präventivmedizin > Tumorzentrum e.V. Leibniz Institute for Immunotherapy (LIT) | ||||
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| Keywords | PRIMARY SURGERY; SURVIVAL RATES; HEAD; CAVITY; TONGUE; CANCER; RECURRENT; SYSTEM; FRONT; CHEMOTHERAPY; Oral squamous cell carcinoma; Depth of invasion; Resection margin; Malignancy grading | ||||
| Dewey Decimal Classification | 600 Technology > 610 Medical sciences Medicine | ||||
| Status | Published | ||||
| Refereed | Yes, this version has been refereed | ||||
| Created at the University of Regensburg | Yes | ||||
| URN of the UB Regensburg | urn:nbn:de:bvb:355-epub-447713 | ||||
| Item ID | 44771 |
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