1
|
Badanale R, Mohta V, Wagh A, Singh K. Prognostic Role of Tumor Budding and Worst Pattern of Invasion in Lymph Node Metastasis and Disease-Free Survival in Oral Squamous Cell Cancer Patients: Result from Central India's Regional Cancer Centre. Indian J Otolaryngol Head Neck Surg 2024; 76:3261-3270. [PMID: 39130226 PMCID: PMC11306858 DOI: 10.1007/s12070-024-04661-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/20/2024] [Indexed: 08/13/2024] Open
Abstract
Aim To study the role of pattern of invasion, tumor budding and other clinicopathological parameters in determining the risk of nodal metastases and disease-free survival in oral squamous cell cancer patients. Method The data of 90 patients with oral squamous cell carcinoma who underwent surgery as their primary modality of treatment were retrospectively analysed. Predictive significance of clinicopathological parameters was assessed with Univariate analysis with Fisher exact test and unpaired t-test. The factors which were significant on Univariate analysis were then analysed with multivariate analysis using logistic regression model to find independent predictors. P value < 0.05 was considered significant. Disease free survival analysis was performed using Kaplan-Meier method and comparison done using the log-rank test for each group. Result The age of the patients ranged from 22yrs to 72 years with male predominance (81.1%). The most common site of involvement was buccal mucosa. Significant factors predicting nodal metastases on univariate analysis were site (p = 0.031), grade (p = 0.012), T stage (p = < 0.001), Depth of invasion (p = < 0.001), perineural invasion (p = < 0.001), lymphovascular emboli (p = 0.018), tumor budding (p = < 0.001), pattern of invasion (p = < 0.001) and stroma (p = 0.037). On multivariate analysis tumor budding (p = 0.016), depth of invasion (p = 0.016) and perineural invasion (p = 0.044) were predictive of nodal metastasis. A statistically significant difference in 3year disease free survival was seen in infiltrative pattern of invasion and tumor budding which showed a p-value of 0.0372 and 0.0489 respectively. Conclusion Based on the findings of the present study and review of previous articles tumor budding, worst pattern of invasion, host lymphocyte response should also be included in routine histopathology reporting of OSCC.
Collapse
Affiliation(s)
- Renuka Badanale
- Department of Pathology, Government Medical college, Nagpur, India
| | - Vandana Mohta
- Department of Head and neck Oncology, Rashtrasant Tukdoji Cancer Hospital, Nagpur, India
| | - Aniruddha Wagh
- Department of Head and neck Oncology, Rashtrasant Tukdoji Cancer Hospital, Nagpur, India
| | - Kartar Singh
- Department of Radiation Oncology, Rashtrasant Tukdoji Cancer Hospital, Nagpur, India
| |
Collapse
|
2
|
Selvaraj FM, Joseph AP, Pillai VR, Ramani P, Pazhani J, Mony V. Significance of tumour budding and invasive characteristics in grading of oral squamous cell carcinoma. J Oral Maxillofac Pathol 2023; 27:642-648. [PMID: 38304506 PMCID: PMC10829472 DOI: 10.4103/jomfp.jomfp_410_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/03/2023] [Accepted: 10/27/2023] [Indexed: 02/03/2024] Open
Abstract
Background Tumour budding has been recognized as a morphologic marker of tumour invasion. Invasive characteristics such as depth of invasion, mode of invasion and worst pattern of invasion are potentially powerful parameters predicting the regional metastasis. Aim This study was done to understand the significance of tumour budding and various characteristics of invasion and their impact on grading of oral squamous cell carcinoma. Materials and Methods An immunohistochemical study was performed on tissue sections obtained from 34 paraffin-embedded blocks of clinically and histologically diagnosed cases of oral squamous cell carcinoma. The sections were stained with pan cytokeratin and observed under high power magnification. Results Tumour budding and the invasive patterns were found to be significant in OSCC. A proposed grading system based on tumour budding and cell nest was found to have a significant correlation with the WHO grading system. Conclusion This study demonstrated the importance of using tumour buds as an additional parameter in the grading system and also assessed the importance of invasive patterns, cellular atypia and stromal contents in OSCC.
Collapse
Affiliation(s)
- Freeda M. Selvaraj
- Department of Oral and Maxillofacial Pathology, PMS College of Dental Sciences, Trivandrum, Kerala, India
| | - Anna P. Joseph
- Department of Oral and Maxillofacial Pathology, PMS College of Dental Sciences, Trivandrum, Kerala, India
| | - Varun Raghavan Pillai
- Department of Oral and Maxillofacial Pathology, PMS College of Dental Sciences, Trivandrum, Kerala, India
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Pratibha Ramani
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Jayanthi Pazhani
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
- Department of Oral and Maxillofacial Pathology, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - Vinod Mony
- Department of Oral and Maxillofacial Pathology, Asan Memorial Dental College and Hospital, Chengalpattu, Tamil Nadu, India
| |
Collapse
|
3
|
Anto R, Vidya K, Thomas M, Tirkey AJ, Agarwal M, Riju J, Patil S, Bhandari S, Rekha. Worst Pattern of Invasion as an Independent Predictor of Lymph node Metastasis and Prognosis in oral Cavity Squamous cell carcinoma - A Retrospective Cohort Study. Indian J Otolaryngol Head Neck Surg 2023; 75:440-449. [PMID: 37275086 PMCID: PMC10235229 DOI: 10.1007/s12070-022-03193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 09/23/2022] [Indexed: 11/28/2022] Open
Abstract
Although Worst pattern of invasion (WPOI) is one of the histopathological (HP) markers that has been utilized in risk stratification of oral squamous cell carcinoma (OSCC) patients, its potential as an independent predictive factor for lymph node metastasis (LNM) and prognosis is least analyzed. Aim of the study is to analyze the relationship of various HP parameters to WPOI, their propensity for lymph node metastasis and prognostic value. This retrospective study included 140 patients diagnosed with resectable OSCC who underwent definitive surgery. Multiparametric HP risk assessment was done on the postoperative specimen and patients were categorized as low-risk WPOI (Type 1-3), and high-risk group (type 4 and 5). After categorization, 36.1% patients had low-risk WPOI and 63.9% had high-risk WPOI. Significant association was noted between WPOI and patient's age (p = 0.001), nodal stage (p = 0.001), lymphovascular invasion (LVI) (p = 0.006) and neural invasion (p = 0.001). 87% patients with nodal metastasis had high risk WPOI. LVI (p = 0.014) and WPOI (p < 0.001) had significant predictive role in LNM. High-risk WPOI and bone involvement were found to be predictive factors for overall survival, and only high risk WPOI had strong correlation with disease free survival having significant poor prognosis. Analyzing WPOI is essential in reporting HP specimens in OSCC. High-risk WPOI can act as an independent predictor for LNM, early recurrence and poor prognosis. Incorporation of WPOI into TNM staging is recommended to improve clinician's ability to prognosticate and individualize treatment strategies.
Collapse
Affiliation(s)
| | - Konduru Vidya
- Department of head and neck surgery, Christian Medical College, Vellore, India
| | - Meera Thomas
- Department of Pathology, Christian Medical College, Vellore, India
| | - Amit Jiwan Tirkey
- Department of head and neck surgery, Christian Medical College, Vellore, India
| | - Mansi Agarwal
- Department of head and neck surgery, Christian Medical College, Vellore, India
| | - Jeyashanth Riju
- Department of head and neck surgery, Christian Medical College, Vellore, India
| | | | | | - Rekha
- Department of Biostatistics, Christian Medical College, Vellore, India
| |
Collapse
|
4
|
Lakhera KK, Nama Y, Maan P, Jindal R, Patel P, Singh S, Hussain A, Sharma RG. Worst Pattern of Invasion as a Predictor of Nodal Metastasis in Early-Stage Oral Squamous Cell Carcinoma. Indian J Surg Oncol 2023; 14:160-168. [PMID: 36891424 PMCID: PMC9986178 DOI: 10.1007/s13193-022-01639-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/23/2022] [Indexed: 11/26/2022] Open
Abstract
About one-third of early stage oral cancer patients have occult nodal metastasis. High grade worst pattern of invasion (WPOI) is associated with an increased risk of nodal metastasis and poor prognosis. However, it still remains unanswered whether to perform an elective neck dissection for clinically node-negative disease or not. This study aims to evaluate the role of histological parameters including WPOI in predicting nodal metastasis in early-stage oral cancers. This analytical observational study comprised 100 patients of early-stage, node-negative, oral squamous cell carcinoma, admitted in the Surgical Oncology Department from April, 2018 till the sample size was reached. The socio-demographic data, clinical history, and findings of clinical and radiological examination were noted. The association of nodal metastasis with various histological parameters like tumour size, degree of differentiation, depth of invasion (DOI), WPOI, perineural invasion (PNI), lymphovascular invasion (LVI) and lymphocytic response was determined. SPSS 20.0 statistical tool; student's 't' test and chi-square tests were applied. While the buccal mucosa was the commonest site, the rate of occult metastasis was highest in the tongue. Nodal metastasis was not significantly associated with age, sex, smoking and primary site. While the nodal positivity was not significantly associated with tumour size, pathological stage, DOI, PNI and lymphocytic response, it was associated with LVI, degree of differentiation and WPOI. Increasing WPOI grade correlated significantly with the nodal stage, LVI and PNI, but not with DOI. WPOI is not only a significant predictor of occult nodal metastasis but can also be a novel therapeutic tool in the management of early-stage oral cancers. In patients with an aggressive WPOI pattern or other high-risk histological parameters, the neck can be addressed with either elective neck dissection or radiotherapy after wide excision of the primary tumor; otherwise, an active surveillance approach can be followed.
Collapse
Affiliation(s)
- Kamal Kishor Lakhera
- Department of Surgical Oncology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan India
| | - Yashwant Nama
- Department of General Surgery, District Hospital, Tonk, Rajasthan India
| | - Pratibha Maan
- Department of Pathology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan India
| | - Rohit Jindal
- Department of Surgical Oncology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan India
| | - Pinakin Patel
- Department of Surgical Oncology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan India
| | - Suresh Singh
- Department of Surgical Oncology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan India
| | - Akhlak Hussain
- Department of Surgical Oncology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan India
| | - Raj Govind Sharma
- Department of Surgical Oncology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan India
| |
Collapse
|
5
|
Farah M, Milton DR, Gross ND, Nagarajan P, Gu J, Curry JL, Ivan D, Torres-Cabala CA, Myers JN, Prieto VG, Aung PP. Histopathologic features predictive of metastasis and survival in 230 patients with cutaneous squamous cell carcinoma of the head and neck and non-head and neck locations: a single-center retrospective study. J Eur Acad Dermatol Venereol 2022; 36:1246-1255. [PMID: 35426183 DOI: 10.1111/jdv.18147] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/18/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Staging systems for cutaneous squamous cell carcinoma (cSCC) produce inconsistent risk stratification. OBJECTIVE The aim of this study was to identify further prognostic parameters for better stratification. METHODS We retrospectively analysed the prognostic significance of clinicopathologic parameters of 230 patients who underwent primary excision of invasive cSCC of the head and neck (n = 115) and non-head and non-neck (n = 115) locations. In addition to known high-risk features, we analysed tumour nest shape, invasion pattern, lymphoid response pattern and tumour budding. RESULTS On multivariable analysis, lymphovascular invasion (LVI) and high tumour budding predicted worse disease-specific survival, and ulceration, LVI and high tumour budding predicted worse overall survival. Only ulceration was independently associated with risk of nodal metastasis. CONCLUSION High tumour budding, LVI and ulceration are independently associated with poor outcome in cSCC and may be used to refine cSCC prognostic stratification, which is crucial to optimize clinical decision and to identify patients who are more likely to benefit from more aggressive interventions or clinical trials.
Collapse
Affiliation(s)
- M Farah
- Department of Pathology, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - D R Milton
- Department of Biostatistics, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - N D Gross
- Head and Neck Surgery, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P Nagarajan
- Department of Pathology, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Gu
- Cytogenetic Technology Program, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J L Curry
- Department of Pathology, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - D Ivan
- Department of Pathology, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C A Torres-Cabala
- Department of Pathology, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J N Myers
- Head and Neck Surgery, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - V G Prieto
- Department of Pathology, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P P Aung
- Department of Pathology, School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
6
|
Rhutso Y, Kakoti LM, Sharma JD, Kalita M. Significance of Pattern of Invasion in Tongue Squamous Cell Carcinoma—A Retrospective Study from a Regional Cancer Center of North-East India. South Asian J Cancer 2022; 11:140-145. [DOI: 10.1055/s-0041-1736201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Introduction Many multiparametric models and scoring systems had been proposed in oral tongue squamous cell carcinoma (OTSCC) to predict the survival and recurrence, out of which pattern of invasion (POI) is gaining focus recently.
Objective We conducted a retrospective study with the aim to see the prognostic significance of the POI and other parameters such as depth of invasion, perineural invasion (PNI), and lymph node status in OTSCC.
Materials and Methods The slides of already diagnosed OTSCC cases were prepared from January 2015 to December 2017 records and studied by two pathologists for different patterns using Brandwein-Gensler scoring system. The different clinicopathologic parameters were compared with different POI. Statistical analysis was performed to present cumulative survival outcomes and for comparison.
Results Most of our patients were > 40 years of age with male preponderance. Tumor differentiation pattern was assessed using Broders' system of grading that showed 85% of tumors were well, 12.5% tumors were moderately differentiated, and 2.5% tumors were poorly differentiated. The worst POI was predominantly pattern III (50%) followed by pattern II (32.5%) and pattern IV (13.8%). Most patients were in stage II (33.8%) followed by stage III (32.5%), stage IV (26.3%), and stage I (7.5%). There was an inverse relationship between POI with tumor stage and recurrence. A strong statistically significant association was found between POI with perineural infiltration and lymph node metastasis.
Conclusion We concluded from our study that worst POI is significantly associated with number of lymph nodes metastasis and perineural infiltration and hence can be used as an independent prognostic factor.
Collapse
Affiliation(s)
- Yopovinu Rhutso
- Department of Oncoathology, Dr. B.Borooah Cancer Institute, Guwahati, Assam, India
| | - Lopa M. Kakoti
- Department of Oncoathology, Dr. B.Borooah Cancer Institute, Guwahati, Assam, India
| | - Jagannath D. Sharma
- Department of Oncoathology, Dr. B.Borooah Cancer Institute, Guwahati, Assam, India
| | - Manoj Kalita
- Department of Epidemiology and Statistics, Dr. B.Borooah Cancer Institute, Guwahati, Assam, India
| |
Collapse
|
7
|
Konishi M, Sakamoto S, Ogawa I, Yoshioka Y, Ono S, Kakimoto N. Relationships between intraoral ultrasonographic and histopathological findings in patients with tongue cancer. Head Neck 2021; 43:2778-2785. [PMID: 34050571 DOI: 10.1002/hed.26763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/14/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In this study, we aimed to investigate the relationships between histopathological and intraoral ultrasonographic (IUS) findings in patients with tongue cancer. METHODS IUS and histopathological findings in 46 patients with tongue cancer were considered for this study. We assessed the relationships between IUS findings regarding tumor thickness, margin type, border type, and internal echo intensity; internal/peripheral Doppler findings; and muscle invasion and histopathological findings regarding tumor thickness, differentiation, Yamamoto-Kohama (YK)-classification grade, blood vessel invasion, lymphatic invasion, perineural invasion, and muscle invasion. RESULTS Statistical associations were found between the following findings: between thickness determined through IUS measurement and that determined through histopathological measurement, between the IUS findings regarding tumor margin and border types and the histopathologically determined YK-classifications grades, and between a Doppler image of the internal area of tongue lesions and lymphatic invasion. CONCLUSIONS IUS findings may be used to predict histopathological findings about tumor thickness and YK-classification grades.
Collapse
Affiliation(s)
- Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Shinnichi Sakamoto
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Ikuko Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Yoshioka
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigehiro Ono
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
8
|
Clinicopathologic Characteristics of Young Patients with Oral Squamous Cell Carcinoma. Head Neck Pathol 2021; 15:1099-1108. [PMID: 33797696 PMCID: PMC8633158 DOI: 10.1007/s12105-021-01320-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/23/2021] [Indexed: 12/16/2022]
Abstract
Oral squamous cell carcinoma (OSCC) occasionally occurs in young patients and is likely to be distinct from OSCC in older patients. In this retrospective study, we described the clinicopathologic features and outcome of 150 OSCCs that were diagnosed in patients 40-year-old or younger. Most patients (63%) were non-smokers. The most common site of the primary tumor was oral tongue (n = 131, 87%), followed by gingiva (n = 9), buccal mucosa (n = 8) and lip (n = 2). The median patients' age at presentation was 34 (range: 16-40). Seven patients (5%) had Fanconi anemia with the gingiva being the most common location (4/7, 57%). All OSCCs were of keratinizing type. All cases tested for high-risk HPV (n = 34) were negative. On univariate analysis, high tumor budding was associated with decreased overall survival (OS) and distant metastasis free survival (DMFS), pattern of invasion correlated with OS and tumors with high stromal tumor infiltrating lymphocytes (sTIL) were associated with improved locoregional recurrence free survival (LRFS). Compared with patients 31 to 40-year-old, OSCC in the younger group was associated with significant less alcohol consumption (p = 0.011) and decreased DSS (p = 0.003) and DMFS (p = 0.023). On multivariate analysis, younger age (30 years or younger) was an independent prognostic factor for worse OS and DSS, whereas histologic grade was an independent prognostic factor for DSS. In summary, most OSCC in young patients occurred in non-smokers and did not occur in association with Fanconi anemia. Independent prognostic factors included age at presentation (30 years or younger) for OS and DSS, and histologic grade for DSS.
Collapse
|
9
|
Yamada SI, Kondo E, Hashidume M, Sakurai A, Otagiri H, Matsumura N, Kubo K, Hakoyama Y, Yajima J, Morioka M, Akahane Y, Anzai K, Goto K, Uehara T, Sakai H, Kurita H. A retrospective investigation of minor risk factors as prognostic predictors and treatment indications in oral squamous cell carcinoma. J Dent Sci 2020; 16:445-452. [PMID: 33384833 PMCID: PMC7770354 DOI: 10.1016/j.jds.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/23/2020] [Indexed: 11/12/2022] Open
Abstract
Abstract Background/purpose The clinical significance of minor risk factors remins uncertain in oral squamous cell carcinoma (OSCC) patients. The purpose of this study was to investigate the clinical impact of minor risk factors in OSCC patients. Materials and methods The cases of OSCC patients that underwent surgery were retrospectively analyzed. Patients with major risk factors for recurrence, such as positive surgical margins or extracapsular spread, were excluded. The impact of possible minor risk factors on treatment outcomes was analyzed. One hundred and seventy-five patients with primary OSCC that underwent surgery were included in this study. Results The 5-year overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) rates were 81.2%, 91.0%, and 72.4%, respectively. In multivariate analyses, RFS exhibited a significant association with the pattern of invasion (grade 4 vs. grades 1–3: hazard ratio: 3.096, 95% confidence interval: 1.367–6.884, p < 0.01), OS exhibited a tendency towards associations with the pattern of invasion and perineural invasion, and CSS displayed a tendency towards an association with perineural invasion. The prognosis of the patients with ≥2 minor risk factors was significantly worse than that of the patients with 0 or 1 minor risk factor(s) (OS: 91.6% vs. 64.5%, respectively, p < 0.01; CSS: 98.9% vs. 78.9%, respectively, p < 0.001; and RFS: 81.2% vs. 58.5%, respectively p < 0.05). Conclusion Grade 4 invasion and perineural invasion might be significant minor risk factors in OSCC patients. The presence of ≥2 minor risk factors might be a predictor of a poor prognosis in OSCC patients.
Collapse
Affiliation(s)
- Shin-Ichi Yamada
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Eiji Kondo
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masao Hashidume
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Akinari Sakurai
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroki Otagiri
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naoki Matsumura
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kiriko Kubo
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yusuke Hakoyama
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Junichi Yajima
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masafumi Morioka
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yukiko Akahane
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazunori Anzai
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Koichi Goto
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takeshi Uehara
- Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hironori Sakai
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| |
Collapse
|
10
|
Chatterjee D, Bansal V, Malik V, Bhagat R, Punia RS, Handa U, Gupta A, Dass A. Tumor Budding and Worse Pattern of Invasion Can Predict Nodal Metastasis in Oral Cancers and Associated With Poor Survival in Early-Stage Tumors. EAR, NOSE & THROAT JOURNAL 2019; 98:E112-E119. [PMID: 31072197 DOI: 10.1177/0145561319848669] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The management and prognosis of oral squamous cell carcinoma (OSCC) depend on tumor stage and lymph node (LN) metastasis status. Early-stage (T1/T2 N0M0) OSCC comprises a heterogeneous group. We evaluated the role of histological parameters including worst pattern of invasion (WPOI) and tumor budding to determine the risk of LN metastasis in cases of OSCC and to determine the risk of recurrence and death in early-stage OSCC in north Indian patients. All cases of buccal mucosa and tongue SCC which underwent excision over 4 and half years were reviewed for histological parameters including histologic grade, WPOI, tumor budding, lymphovascular emboli (LVE), perineural invasion (PNI), depth of invasion (DOI), host lymphocyte response, and stromal response and compared to LN metastasis. Clinical follow-up of early-stage tumor was obtained and compared. A total of 126 cases of OSCC were included, of which 48 showed LN metastasis. Histological grade, WPOI, tumor budding (≥3/×40 field), LVE, and PNI were significantly associated with risk of LN metastasis. On multivariate analysis, WPOI and tumor budding were 2 most significant factors. Among the early-stage tumors with available follow up (n = 48), DOI, WPOI, tumor budding, and LVE were associated with a shorter overall survival, although it was not statistically significant. To conclude, WPOI and tumor budding are important risk factors for predicting LN metastasis in all stages of OSCC and associated with a poorer outcome in early-stage tumors. These are easy and reliable prognostic factors and should be included in the histopathological reporting guidelines.
Collapse
Affiliation(s)
- Debajyoti Chatterjee
- 1 Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Vinisha Bansal
- 1 Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Vipra Malik
- 1 Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Ranjeev Bhagat
- 1 Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Rajpal Singh Punia
- 1 Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Uma Handa
- 1 Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Anand Gupta
- 2 Department of Dentistry, Government Medical College and Hospital, Chandigarh, India
| | - Arjun Dass
- 3 Department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College and Hospital, Chandigarh, India
| |
Collapse
|
11
|
Lee H, Roh J, Cho K, Choi S, Nam SY, Kim SY. Number of positive lymph nodes better predicts survival for oral cavity cancer. J Surg Oncol 2019; 119:675-682. [DOI: 10.1002/jso.25386] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Hojun Lee
- Department of OtolaryngologyAsan Medical Center, University of Ulsan College of MedicineSeoul Republic of Korea
| | - Jong‐Lyel Roh
- Department of OtolaryngologyAsan Medical Center, University of Ulsan College of MedicineSeoul Republic of Korea
| | - Kyung‐Ja Cho
- Department of PathologyAsan Medical Center, University of Ulsan College of MedicineSeoul Republic of Korea
| | - Seung‐Ho Choi
- Department of OtolaryngologyAsan Medical Center, University of Ulsan College of MedicineSeoul Republic of Korea
| | - Soon Yuhl Nam
- Department of OtolaryngologyAsan Medical Center, University of Ulsan College of MedicineSeoul Republic of Korea
| | - Sang Yoon Kim
- Department of OtolaryngologyAsan Medical Center, University of Ulsan College of MedicineSeoul Republic of Korea
| |
Collapse
|
12
|
Shimura S, Ogi K, Miyazaki A, Shimizu S, Kaneko T, Sonoda T, Kobayashi J, Igarashi T, Miyakawa A, Hasegawa T, Hiratsuka H. Selective Neck Dissection and Survival in Pathologically Node-Positive Oral Squamous Cell Carcinoma. Cancers (Basel) 2019; 11:cancers11020269. [PMID: 30823588 PMCID: PMC6406756 DOI: 10.3390/cancers11020269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 12/03/2022] Open
Abstract
The most important prognostic factor in oral squamous cell carcinoma (OSCC) is neck metastasis, which is treated by neck dissection. Although selective neck dissection (SND) is a useful tool for clinically node-negative OSCC, its efficacy for neck node-positive OSCC has not been established. Sixty-eight OSCC patients with pN1–3 disease who were treated with curative surgery using SND and/or modified-radical/radical neck dissection (MRND/RND) were retrospectively reviewed. The neck control rate was 94% for pN1–3 patients who underwent SND. The five-year overall survival (OS) and disease-specific survival (DSS) in pN1-3 OSCC patients were 62% and 71%, respectively. The multivariate analysis of clinical and pathological variables identified the number of positive nodes as an independent predictor of SND outcome (OS, hazard ratio (HR) = 4.98, 95% confidence interval (CI): 1.48–16.72, p < 0.01; DSS, HR = 6.44, 95% CI: 1.76–23.50, p < 0.01). The results of this retrospective study showed that only SND for neck node-positive OSCC was appropriate for those with up to 2 lymph nodes that had a largest diameter ≤3 cm without extranodal extension (ENE) of the neck and adjuvant radiotherapy. However, the availability of postoperative therapeutic options for high-risk OSCC, including ENE and/or multiple positive lymph nodes, needs to be further investigated.
Collapse
Affiliation(s)
- Shunichi Shimura
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Kazuhiro Ogi
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Akihiro Miyazaki
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Shota Shimizu
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Takeshi Kaneko
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Tomoko Sonoda
- Department of Public Health, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Junichi Kobayashi
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Tomohiro Igarashi
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Akira Miyakawa
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| | - Hiroyoshi Hiratsuka
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
| |
Collapse
|
13
|
Govers TM, Rovers MM, Brands MT, Dronkers EA, Baatenburg de Jong RJ, Merkx MA, Takes RP, Grutters JP. Integrated prediction and decision models are valuable in informing personalized decision making. J Clin Epidemiol 2018; 104:73-83. [DOI: 10.1016/j.jclinepi.2018.08.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 08/13/2018] [Accepted: 08/22/2018] [Indexed: 11/24/2022]
|
14
|
De Silva RK, Siriwardena BSMS, Samaranayaka A, Abeyasinghe WAMUL, Tilakaratne WM. A model to predict nodal metastasis in patients with oral squamous cell carcinoma. PLoS One 2018; 13:e0201755. [PMID: 30091996 PMCID: PMC6084951 DOI: 10.1371/journal.pone.0201755] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 07/20/2018] [Indexed: 12/18/2022] Open
Abstract
Difficulty in precise decision making on necessity of surgery is a major problem when managing oral squamous cell carcinomas (OSCCs) with clinically negative neck. Therefore, use of clinical and histopathological parameters in combination would be important to improve patient management. The main objective is to develop a model that predicts the presence of nodal metastasis in patients with OSCC.623 patients faced neck dissections with buccal mucosal or tongue squamous cell carcinoma (SCC) were selected from patients’ records. Demographic data, clinical information, nodal status, Depth of invasion (DOI) and pattern of invasion (POI) were recorded. The parameters which showed a significant association with nodal metastasis were used to develop a multivariable predictive model (PM). Univariate logistic regression was used to estimate the strengths of those associations in terms of odds ratios (OR). This showed statistically significant associations between status of the nodal metastasis and each of the following 4 histopathological parameters individually: size of the tumour (T), site, POI, and DOI. Specifically, OR of nodal metastasis for tongue cancers relative to buccal mucosal cancers was 1.89, P-value < 0.001. Similarly, ORs for POI type 3 and 4 relative to type 2 were 1.99 and 5.83 respectively. A similar relationship was found with tumour size; ORs for T2, T3, and T4 compared to T1 were 2.79, 8.27 and 8.75 respectively. These four histopathological parameters were then used to develop a predictive model for nodal metastasis. This model showed that probability of nodal metastasis is higher among tongue cancers with increasing POI, with increasing T, and with larger depths while other characteristics remained unchanged. The proposed model provides a way of using combinations of histopathological parameters to identify patients with higher risks of nodal metastasis for surgical management.
Collapse
Affiliation(s)
- R. K. De Silva
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- * E-mail: (RKDeS); (WMT)
| | - B. S. M. S. Siriwardena
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - A. Samaranayaka
- Department of Preventive and Social Medicine, Faculty of Medicine, University of Otago, Dunedin, New Zealand
| | - W. A. M. U. L. Abeyasinghe
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - W. M. Tilakaratne
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- * E-mail: (RKDeS); (WMT)
| |
Collapse
|
15
|
Ghantous Y, Bahouth Z, Abu El-Naaj I. Clinical and genetic signatures of local recurrence in oral squamous cell carcinoma. Arch Oral Biol 2018; 95:141-148. [PMID: 30118965 DOI: 10.1016/j.archoralbio.2018.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 07/13/2018] [Accepted: 07/30/2018] [Indexed: 01/14/2023]
Abstract
PURPOSE Recurrent and metastatic Oral Squamous Cell Carcinoma (OSCC) is often incurable. There are large gaps in the understanding of the clinical course, biology and genetic biomarkers of OSCC which could help us identify patients with high-risk of recurrence who may benefit from intensified therapy or novel targeted therapy trials. The purpose of this study was to identify significant clinical, pathological and genomic risk factors for local recurrence in OSCC. PATIENTS AND METHODS Molecular data sets and clinicopathological characteristics of 159 head and neck carcinoma patients were obtained from The Cancer Genome Atlas (TCGA) data portal and analyzed using the Genome Data Analysis Center and cBioPortal to find significant risk factors for tumor recurrence. RESULTS The local recurrence rate was 24%. OSCC originating from the buccal mucosa composed 13% of all the tumors in the recurrent group, making it a statistically significant risk of recurrence (P value = 0.03). Likewise, positive surgical margins, pathological T staging, and alcohol consumption were found to be significantly associated with recurrence (P value < 0.05). Genetic profiling revealed the top 5 mutated genes (using the MutSigCV analysis). Only one of these genes, CASP8 was the only gene that was significantly altered only in the recurrent group (Q value = 8.7 × 10-11). The fingerprint of 5 mutated genes was found in 97% of the patients in the recurrence group. Moreover, copy number alterations in cytoband 5p15.33, which involved amplification in telomerase reverse-transcriptase (TERT) gene, was found to be significant only in the recurrent group. CONCLUSIONS In the current study, we found several clinical and genetic characteristics that could define patients with high-risk of OSCC recurrence. This provides a means of identifying patients that may benefit from intensified therapy or novel targeted therapy trials.
Collapse
Affiliation(s)
- Yasmine Ghantous
- The Maxillo-Facial Surgery Department, Baruch Padeh Medical Center, The Faculty of Medicine, Bar Ilan University, Galilee, Israel.
| | - Zaher Bahouth
- Department of Urology, Bnai-Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel
| | - Imad Abu El-Naaj
- The Maxillo-Facial Surgery Department, Baruch Padeh Medical Center, The Faculty of Medicine, Bar Ilan University, Galilee, Israel
| |
Collapse
|
16
|
LpMab-23-recognizing cancer-type podoplanin is a novel predictor for a poor prognosis of early stage tongue cancer. Oncotarget 2018; 9:21156-21165. [PMID: 29765527 PMCID: PMC5940393 DOI: 10.18632/oncotarget.24986] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/12/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose We report that the reactivity of a novel monoclonal antibody LpMab-23 for human cancer-type podoplanin (PDPN) is a predictor for a poor prognosis of tongue cancer. Patients and Methods The association between LpMab-23-recognizing cancer-type PDPN expression and clinical/pathological features were analyzed on 60 patients with stage I and II tongue cancer treated with transoral resection of the primary tumor. Results In the mode of invasion, the LpMab-23-dull/negative cases were significantly larger in cases with low-grade malignancies and without late cervical lymph node metastasis, than in cases with high-grade malignancies and the metastasis. In the high-grade malignant cases, LpMab-23-positive cases were significantly larger than LpMab-23-dull/negative cases. The Kaplan–Meier curves of the five-year metastasis-free survival rate (MFS) were significantly lower in the LpMab-23 positive patients than in LpMab-23 dull/negative patients. The LpMab-23-dull/negative cases showed the highest MFS in all of the clinical/pathological features and particularly, the MFS of the LpMab-23 positive cases decreased to less than 60% in the first year. In the Cox proportional hazard regression models a comparison of the numbers of LpMab-23 dull/negative with positive cases showed the highest hazard ratio with statistical significance in all of the clinical/pathological features. Conclusions LpMab-23 positive cases may be considered to present a useful predictor of poor prognosis for early stage tongue cancer.
Collapse
|
17
|
Shimizu S, Miyazaki A, Sonoda T, Koike K, Ogi K, Kobayashi JI, Kaneko T, Igarashi T, Ueda M, Dehari H, Miyakawa A, Hasegawa T, Hiratsuka H. Tumor budding is an independent prognostic marker in early stage oral squamous cell carcinoma: With special reference to the mode of invasion and worst pattern of invasion. PLoS One 2018; 13:e0195451. [PMID: 29672550 PMCID: PMC5909609 DOI: 10.1371/journal.pone.0195451] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/22/2018] [Indexed: 12/17/2022] Open
Abstract
Pathologically proven regional lymph node metastasis affects the prognosis in early stage oral cancer. Therefore we investigated invasive tumor patterns predicting nodal involvement and survival in patients with clinically node-negative T1 and T2 oral squamous cell carcinoma (cT1,2N0M0 OSCC). Ninety-one cases of cT1,2N0M0 OSCC treated with transoral resection of the primary tumor were assessed based on 3 types of invasive tumor patterns on histopathologic and pancytokeratin-stained immunohistological sections: the mode of invasion, worst pattern of invasion (WPOI), and tumor budding. The correlations among invasive tumor patterns, regional metastasis, and disease-free survival were analyzed. Of the 91 cases, 22 (24%) had pathologically proven regional metastasis. The mode of invasion (p<0.01) and tumor budding (p<0.01) were associated with regional metastasis as well as lymphovascular invasion (p = 0.04) in univariate analysis. In logistic regression analysis, however, tumor budding was the only independent predictor of regional metastasis (hazard ratio (HR) = 3.05, 95% confidence interval (CI) = 0.29–5.30, p<0.01). All three invasive patterns, the mode of invasion, WPOI, and tumor budding, were found to be significant predictors of 5-year disease-free survival (p<0.01, p = 0.03, and p<0.01, respectively) as well as lymphovascular invasion (p = 0.02) and perineural invasion (p = 0.02). A final model for Cox multivariate analysis identified the prognostic advantage of the intensity of tumor budding (HR = 2.19, 95% CI = 1.51–3.18, p<0.01) compared with the mode of invasion and WPOI in disease-free survival. Our results indicate that the intensity of tumor budding may be a novel diagnostic biomarker, as well as a therapeutic tool, for regional metastasis in patients with cT1,2N0M0 OSCC. If the pancytokeratin-based immunohistochemical features of more than five buds, and a grade 4C or 4D mode of invasion are identified, careful wait-and-see follow-up in a short period with the use of imaging modalities is desirable. If there are more than ten buds, a grade 4D mode of invasion, or WPOI-5 in the same section, wide resection of the primary tumor with elective neck dissection should be recommended.
Collapse
Affiliation(s)
- Shota Shimizu
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akihiro Miyazaki
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomoko Sonoda
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kazushige Koike
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kazuhiro Ogi
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Jun-ichi Kobayashi
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takeshi Kaneko
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomohiro Igarashi
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Megumi Ueda
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hironari Dehari
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akira Miyakawa
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroyoshi Hiratsuka
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
- * E-mail:
| |
Collapse
|
18
|
Deneuve S, Bodard AG, Delquignies E, Janot F, Zrounba P, Julieron M. Can Early Dissection of Cervical Lymph Nodes Improve Prognosis in Squamous Cell Carcinomas of the Hard Palate. ORL J Otorhinolaryngol Relat Spec 2017; 79:314-322. [DOI: 10.1159/000480351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/14/2017] [Indexed: 11/19/2022]
|
19
|
Son HJ, Roh JL, Cho KJ, Choi SH, Nam S, Kim S. Nodal factors predictive of recurrence and survival in patients with oral cavity squamous cell carcinoma. Clin Otolaryngol 2017; 43:470-476. [DOI: 10.1111/coa.12995] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2017] [Indexed: 12/30/2022]
Affiliation(s)
- H.-J. Son
- Department of Otolaryngology-Head and Neck Surgery; Daegu Catholic University College of Medicine; Daegu Korea
| | - J.-L. Roh
- Department of Otolaryngology; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| | - K.-J. Cho
- Department of Pathology; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| | - S.-H. Choi
- Department of Otolaryngology; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| | - S.Y. Nam
- Department of Otolaryngology; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| | - S.Y. Kim
- Department of Otolaryngology; Asan Medical Centre; University of Ulsan College of Medicine; Seoul Korea
| |
Collapse
|
20
|
Development of a New Outcome Prediction Model in Early-stage Squamous Cell Carcinoma of the Oral Cavity Based on Histopathologic Parameters With Multivariate Analysis: The Aditi-Nuzhat Lymph-node Prediction Score (ANLPS) System. Am J Surg Pathol 2017; 41:950-960. [PMID: 28346327 DOI: 10.1097/pas.0000000000000843] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to evaluate the histopathologic parameters that predict lymph node metastasis in patients with oral squamous cell carcinoma (OSCC) and to design a new assessment score on the basis of these parameters that could ultimately allow for changes in treatment decisions or aid clinicians in deciding whether there is a need for close follow-up or to perform early lymph node dissection. Histopathologic parameters of 336 cases of OSCC with stage cT1/T2 N0M0 disease were analyzed. The location of the tumor and the type of surgery used for the management of the tumor were recorded for all patients. The parameters, including T stage, grading of tumor, tumor budding, tumor thickness, depth of invasion, shape of tumor nest, lymphoid response at tumor-host interface and pattern of invasion, eosinophilic reaction, foreign-body giant cell reaction, lymphovascular invasion, and perineural invasion, were examined. Ninety-two patients had metastasis in lymph nodes. On univariate and multivariate analysis, independent variables for predicting lymph node metastasis in descending order were depth of invasion (P=0.003), pattern of invasion (P=0.007), perineural invasion (P=0.014), grade (P=0.028), lymphovascular invasion (P=0.038), lymphoid response (P=0.037), and tumor budding (P=0.039). We designed a scoring system on the basis of these statistical results and tested it. Cases with scores ranging from 7 to 11, 12 to 16, and ≥17 points showed LN metastasis in 6.4%, 22.8%, and 77.1% of cases, respectively. The difference between these 3 groups in relation to nodal metastasis was very significant (P<0.0001). A patient at low risk for lymph node metastasis (score, 7 to 11) had a 5-year survival of 93%, moderate-risk patients (score, 12 to 16) had a 5-year survival of 67%, and high-risk patients (score, 17 to 21) had a 5-year survival of 39%. The risk of lymph node metastasis in OSCC is influenced by many histologic parameters that are not routinely analyzed in pathologic reports. These significant independent factors were graded to design a scoring system that permits accurate evaluation of the risk of metastasis with accuracy independent of the traditional TNM system or isolated histologic parameters. The need for neck node dissection can be predicted depending upon the scores obtained.
Collapse
|
21
|
Sagheb K, Blatt S, Kraft IS, Zimmer S, Rahimi-Nedjat RK, Al-Nawas B, Walter C. Outcome and cervical metastatic spread of squamous cell cancer of the buccal mucosa, a retrospective analysis of the past 25 years. J Oral Pathol Med 2017; 46:460-464. [PMID: 27935122 DOI: 10.1111/jop.12537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Because of the low proportion of squamous cell carcinomas (SCCs) of the buccal mucosa within the carcinomas of the oral cavity in the Western population, data concerning metastatic pattern are sparse. Therefore, this retrospective study is focusing on the occurrence of cervical metastases (CM) and the overall outcome of this tumor entity. MATERIALS AND METHODS From January 1988 to October 2013, 113 patients were treated in the Department of Oral and Maxillofacial Surgery, Mainz, for an oral SCC of the cheek. Metastatic pattern and clinical parameters that are possibly associated with an increased risk for CM as well as overall outcome were analyzed. RESULTS The average follow-up was 48 months (range: 1-248 months). A total of 55 (49%) patients were female and 58 (51%) male, with an average age of 65 ± 13 years (♀68 ± 14 years; ♂63 ± 11 years). In total, 55% of the patients either smoked and/or consumed alcohol. In total, 34% of the patients had a stage III or IV tumor, with overall 23% having CM at the time of diagnosis. During the follow-up, 50% (n = 56) of the patients developed a relapse after 12 months (median). Tumor size (P = 0.002*) and grading (P < 0.001*) are significantly associated with the occurrence of CM. Metastases (P = 0.008*) and advanced tumor size (P = 0.018) had an influence on the survival, whereas the relapse had no significant influence (P = 0.928). Five-year survival rate was 80%. CONCLUSIONS SCC of the buccal mucosa shows aggressive behavior with a considerably high proportion of relapse. Since overall outcome is significantly decreased by the cervical metastatic pattern, a selective, ipsilateral neck dissection for this patient group is recommended as the primary management.
Collapse
Affiliation(s)
- Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sebastian Blatt
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Ina Sophie Kraft
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Stefanie Zimmer
- Department of Pathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Roman-Kia Rahimi-Nedjat
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christian Walter
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
22
|
Subramaniam N, Balasubramanian D, Murthy S, Limbachiya S, Thankappan K, Iyer S. Adverse pathologic features in early oral squamous cell carcinoma and the role of postoperative radiotherapy-a review. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:24-31. [PMID: 28506568 DOI: 10.1016/j.oooo.2017.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/01/2017] [Indexed: 10/20/2022]
Abstract
The use of postoperative radiotherapy (PORT) in early stage oral cancer with adverse pathologic features (APFs) is controversial. Prognostically relevant APFs reviewed were perineural invasion, lymphovascular invasion, depth of invasion, worst pattern of invasion, and margin status. The current literature remains divided with regard to the benefit of treatment escalation in these patients; although these patients are at high risk for recurrence, the morbidity of PORT needs to be balanced against the likely benefit in disease control. A wide heterogeneity in the literature exists, likely as a result of differences in treatment protocols. We performed a literature review of the role of PORT in early-stage oral cancer with APFs. Based on the current evidence, the decision to administer adjuvant therapy needs to be made on an individual basis; patients with >1 APF are likely to benefit from PORT, and the use of risk-scoring systems may help in decision making.
Collapse
Affiliation(s)
- Narayana Subramaniam
- Senior Resident, Head and Neck Oncology, Amrita Institute of Medical Sciences, AIMS Road, Kochi, Kerala, India
| | | | - Samskruthi Murthy
- Senior Resident, Head and Neck Oncology, Amrita Institute of Medical Sciences, AIMS Road, Kochi, Kerala, India
| | - Shashikant Limbachiya
- Senior Resident, Head and Neck Oncology, Amrita Institute of Medical Sciences, AIMS Road, Kochi, Kerala, India
| | - Krishnakumar Thankappan
- Professor, Head and Neck Oncology, Amrita Institute of Medical Sciences, AIMS Road, Kochi, Kerala, India
| | - Subramania Iyer
- Professor and Head, Head and Neck Oncology, Amrita Institute of Medical Sciences, AIMS Road, Kochi, Kerala, India
| |
Collapse
|
23
|
Minamiyama S, Mitsudo K, Hayashi Y, Iida M, Iwai T, Nakashima H, Oguri S, Ozawa T, Koizumi T, Hirota M, Kioi M, Tohnai I. Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for T2-4N0 tongue cancer: control of occult neck metastasis. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:16-23. [PMID: 28434836 DOI: 10.1016/j.oooo.2017.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 01/19/2017] [Accepted: 02/13/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the therapeutic results and control of occult neck metastasis in patients with T2-4N0 oral tongue squamous cell carcinoma treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy. STUDY DESIGN Forty-two patients with T2-4N0 tongue cancer (17 with late T2; 13 with T3; and 12 with T4a disease, M0) were treated with intra-arterial chemoradiotherapy. Treatment consisted of retrograde superselective intra-arterial chemotherapy (docetaxel 50-70 mg/m2, cisplatin 125-175 mg/m2) and daily concurrent radiotherapy (50-70 Gy) for 5-7 weeks. RESULTS The median follow-up for all patients was 46.5 months (range, 8-105 months). Primary-site complete response was achieved in 42 of 42 cases (100%). Three-year overall survival, progression-free survival, and local control rates were 85.0%, 77.8%, and 91.7%, respectively. Delayed neck metastasis was detected in 5 of 42 cases (11.9%). Grade 3 or 4 toxic changes included oral mucositis in 92.9%, neutropenia in 21.4%, and thrombocytopenia in 4.8%. Grade 3 toxicities included anemia in 16.7%, radiation dermatitis in 9.5%, nausea in 4.8%, and fever in 2.4%. CONCLUSIONS Retrograde superselective intra-arterial chemotherapy for T2-4N0 tongue cancer provided good overall survival and local control rates and was effective for occult neck metastasis.
Collapse
Affiliation(s)
- Shuhei Minamiyama
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan; Department of Dentistry and Oral Surgery, Yamato Municipal Hospital, Yamato City, Kanagawa, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
| | - Yuichiro Hayashi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Masaki Iida
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Hideyuki Nakashima
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Senri Oguri
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Tomomichi Ozawa
- Department of Dentistry and Oral Surgery, Yamato Municipal Hospital, Yamato City, Kanagawa, Japan
| | - Toshiyuki Koizumi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Makoto Hirota
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Mitomu Kioi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Iwai Tohnai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| |
Collapse
|
24
|
Niu LX, Feng ZE, Wang DC, Zhang JY, Sun ZP, Guo CB. Prognostic factors in mandibular gingival squamous cell carcinoma: A 10-year retrospective study. Int J Oral Maxillofac Surg 2016; 46:137-143. [PMID: 28029423 DOI: 10.1016/j.ijom.2016.09.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 07/22/2016] [Accepted: 09/15/2016] [Indexed: 10/20/2022]
Abstract
The mandibular gingiva is the second most common site of oral cavity squamous cell carcinoma. This retrospective study was designed to determine the clinicopathological features of squamous cell carcinoma of the mandibular gingiva (MGSCC) and to establish a new risk model to predict overall survival. The study included 207 patients with primary MGSCC from January 2000 to September 2009. The medical charts were reviewed and data related to clinical characteristics, treatment provided, histopathological analysis, and follow-up were recorded. All patients underwent surgery as the first-line therapy; follow-up ranged from 1 to 171 months (median 63 months). Clinical characteristics and pathological outcomes were analyzed with respect to the 5-year overall survival rate. A survival risk model was established, and patients were classified into low-, moderate-, and high-risk groups based on the prognostic index designed in this study. The 5-year overall survival rates for the low-, moderate-, and high-risk groups were 92.3%, 76.9%, and 34.2%, respectively. Pathological node metastasis, perineural invasion, and extracapsular spread were the most significant predictive factors for 5-year overall survival. MGSCC is not aggressive, and the survival outcomes of MGSCC are better than those of squamous cell carcinoma (SCC) at other sites. It is suggested that patients with T2-T4 tumours undergo elective neck dissection and those with T1 tumours be followed up without addressing the neck.
Collapse
Affiliation(s)
- L X Niu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Z E Feng
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Capital Medical University, Beijing, China
| | - D C Wang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Peking University, Beijing, China
| | - J Y Zhang
- Department of Oral Pathology, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Z P Sun
- Department of Oral and Maxillofacial Radiology, School and Hospital of Stomatology, Peking University, Beijing, China
| | - C B Guo
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Peking University, Beijing, China.
| |
Collapse
|
25
|
Min SK, Myoung H, Lee JH, Kim MJ. Muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge is associated with cervical lymph node metastasis. J Korean Assoc Oral Maxillofac Surg 2016; 42:133-8. [PMID: 27429934 PMCID: PMC4940197 DOI: 10.5125/jkaoms.2016.42.3.133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 01/11/2016] [Accepted: 01/15/2016] [Indexed: 11/14/2022] Open
Abstract
Objectives To assess the association between muscle invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis on the basis of preoperative magnetic resonance imaging (MRI). Materials and Methods Twenty-six patients with oral squamous cell carcinoma of the posterior mandibular alveolar ridge were evaluated by MRI. The associations between cervical lymph node metastasis and independent factors evaluated by MRI were analyzed. Overall survival was also analyzed in this manner. Representative biopsy specimens were stained with anti-podoplanin and anti-CD34 antibodies. Results Mylohyoid muscle invasion was associated with cervical lymph node metastasis. A combinational factor of mylohyoid and/or buccinator muscle invasion was also associated with cervical lymph node metastasis. Cervical lymph node metastasis and masticator space invasion had a negative effect on overall survival. No lymphatic vessels were identified near the tumor invasion front within the mandible. In contrast, lymphatic vessels were identified near the front of tumor invasion in the muscles. Conclusion This study demonstrates an association between muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis.
Collapse
Affiliation(s)
- Seung-Ki Min
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Myung-Jin Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| |
Collapse
|
26
|
Cervical Metastases Behavior of T1-2 Squamous Cell Carcinoma of the Tongue. J Maxillofac Oral Surg 2016; 16:300-305. [PMID: 28717287 DOI: 10.1007/s12663-016-0936-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 06/17/2016] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION The cervical lymph node metastasis (CM) is one of the most important prognostic factors for oral squamous cell carcinoma. Although the frequency and distribution of CM for tongue carcinoma (TC) are well documented in the literature, there is only little data on metastasis patterns depending on the location of the cancer within the tongue. MATERIALS AND METHODS In a retrospective study all patients with a T1-T2 TC who were treated between 1997 and 2013 were analysed regarding epidemiological data, risk factors, and tumour parameters such as exact localization, CM. RESULTS 204 patients (59 ± 15 years; ♀37 %, ♂63 %) were included. At the initial diagnosis 23 % had an advanced tumour stage (III-IV) due to CM. The occurrence of CM was significantly higher for T2, advanced G-status and the localization in the posterior area of the tongue. The presence of CM-but not the recurrence-had a significant influence on the survival rate. CONCLUSION The small TC has an aggressive metastatic behaviour depending not only on the classical prognostic factors such as grading and tumour size, but is also strongly influenced by the posterior location within the tongue.
Collapse
|
27
|
Cervical metastases behavior of T1-2 squamous cell cancer of the oral mucosa. Clin Oral Investig 2016; 21:931-935. [PMID: 27183826 DOI: 10.1007/s00784-016-1845-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The clinical management of the neck of patients with early-stage oral squamous cell cancer (OSCC) is still controversially discussed in the current literature. This study analyzes histo-clinical factors influencing the occurrence of cervical lymph node metastases (CM). MATERIALS AND METHODS In a retrospective mono-center study, patients with a primary T1-2 OSCC between 2000 and 2014 were analyzed regarding histo-clinical parameters possibly influencing the CM rate and the outcome. RESULTS Two hundred eighty-five patients (66 %) were male and 146 female (44 %), with a mean age of 60 ± 12 years at the time of diagnosis. Seventy-seven percent showed a positive risk profile (nicotine/alcohol) and 69 % underlying diseases. Forty-four percent of the patients were staged as T2 (30 % with CM). Advanced tumor size (T1 vs. T2) and grading (G1-2 vs. G3) were statistically significantly (p < 0.001) associated with the occurrence of CM. The localization within the oral cavity, age, gender, risk profile, or underlying diseases had no influence on CM occurrence. During the follow-up, tumor size (p = 0.001), CM (p < 0.001), and tumor relapse (p < 0.001) were significantly associated with a worse outcome. CONCLUSIONS Early-stage OSCC showed aggressive lymphatic metastatic behavior that depends on the size and the grading of the tumor. CLINICAL RELEVANCE A watch-and-wait policy as the primary management for cN0 may likely be inferior to a selective neck dissection for this patient group and should only be considered for very small tumors with a good differentiation.
Collapse
|
28
|
Rahimi S, Kenward S, Glaysher S, Marani C, Brennan PA. Immunohistochemical expression of secreted frizzled receptor protein 1 in the invasive front of tongue squamous cell carcinoma. Eur J Oral Sci 2016; 124:158-63. [DOI: 10.1111/eos.12252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Siavash Rahimi
- Pathology Centre-Histopathology; Queen Alexandra Hospital; Portsmouth UK
| | - Susan Kenward
- Pathology Centre-Histopathology; Queen Alexandra Hospital; Portsmouth UK
| | - Sharon Glaysher
- Research and Innovation; Queen Alexandra Hospital; Portsmouth UK
| | - Carla Marani
- Division of Histopathology; Ospedale San Carlo di Nancy; Rome Italy
| | - Peter A. Brennan
- Department of Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
| |
Collapse
|
29
|
Zhang WB, Peng X. Cervical metastases of oral maxillary squamous cell carcinoma: A systematic review and meta-analysis. Head Neck 2016; 38 Suppl 1:E2335-42. [PMID: 26890607 DOI: 10.1002/hed.24274] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 07/17/2015] [Accepted: 09/12/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Wen-Bo Zhang
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Haidian District Beijing China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Haidian District Beijing China
| |
Collapse
|
30
|
Sagheb K, Sagheb K, Rahimi-Nedjat R, Taylor K, Al-Nawas B, Walter C. Sentinel lymph node biopsy in T1/T2 squamous cell carcinomas of the tongue: A prospective study. Oncol Lett 2015; 11:600-604. [PMID: 26870253 PMCID: PMC4727194 DOI: 10.3892/ol.2015.3933] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 09/25/2015] [Indexed: 02/06/2023] Open
Abstract
Commonly used staging procedures often cannot predict the absence of cervical metastases (CM) in squamous cell carcinomas (SCCs) of the oral cavity. Due to the high incidence of occult CM in numerous N0 cases in the clinic, an elective neck dissection (ND) is performed. The sentinel lymph node biopsy (SNB) is a common concept in the modern surgical therapy of malignancies. The present study evaluates the applicability of this concept for T1/T2-SCC of the tongue. In a prospective clinical study, 10 consecutive patients with T1/T2-SCC of the tongue and cN0 necks, were enrolled. Following sentinel lymph node (SLN) scintigraphy, all patients underwent SNB with a γ-probe and a subsequent ND. SNB specimens were compared with histopathological assessments of surgical specimens from the ND. A total of 5 female and 5 male patients (mean age, 52 years; women, 62 years; men, 42 years), with a median follow-up time of 33.5 months (range, 10–40 months), were treated. All patients presented with detectable SLNs. In 7 cases, the SLN(s) and the residual ND were negative for CM. In 3 cases, the SLN(s) were positive without further CM in the other neck nodes. Furthermore, 1 patient showed additional CMs after 10 months in the contralateral neck and lung metastasis after 18 months, but none at the time of the initial treatment. The concept of an SNB appears to be applicable to the management of the cN0 neck in small SCC of the tongue. The role of SNB in the management of SCC requires further investigation by prospective trials with larger patient numbers.
Collapse
Affiliation(s)
- Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Centre, Johannes Gutenberg-University of Mainz, Mainz 55131, Germany
| | - Kawe Sagheb
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Centre, Johannes Gutenberg-University of Mainz, Mainz 55131, Germany
| | - Roman Rahimi-Nedjat
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Centre, Johannes Gutenberg-University of Mainz, Mainz 55131, Germany
| | - Kathy Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg-University of Mainz, Mainz 55131, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Centre, Johannes Gutenberg-University of Mainz, Mainz 55131, Germany
| | - Christian Walter
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Centre, Johannes Gutenberg-University of Mainz, Mainz 55131, Germany
| |
Collapse
|
31
|
Zhang W, Wang Y, Mao C, Guo C, Yu G, Peng X. Cervical metastasis of maxillary squamous cell carcinoma. Int J Oral Maxillofac Surg 2015; 44:285-91. [DOI: 10.1016/j.ijom.2014.10.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/16/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
|
32
|
Bark R, Mercke C, Munck-Wikland E, Wisniewski NA, Hammarstedt-Nordenvall L. Cancer of the gingiva. Eur Arch Otorhinolaryngol 2015; 273:1335-45. [PMID: 25649283 DOI: 10.1007/s00405-015-3516-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 01/19/2015] [Indexed: 10/24/2022]
Abstract
Cancer of the gingiva is a rare disease in the Western World. It most commonly affects elderly population. Because of its rarity, the reporting on the disease is sparse and often grouped with other subsites of oral cancer, which makes conclusions difficult to interpret. The aim of this paper is to review the literature on gingival cancer as a specific subsite of oral cancer and report on published prognostic factors as well as treatment of local and regional disease. We also present differences between gingival cancer subgroups, mandibular and maxillary gingival cancer. In addition, both surgical and oncological treatments are reviewed. It seems that surgery is the preferred initial treatment approach for the majority of patients with gingival cancer, although adjuvant radiation, with or without chemotherapy, is commonly recommended to increase locoregional control.
Collapse
Affiliation(s)
- Rusana Bark
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, S-171 76, Stockholm, Sweden. .,Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska University Hospital, 17176, Stockholm, Sweden.
| | - Claes Mercke
- Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, S-171 76, Stockholm, Sweden
| | - Eva Munck-Wikland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, S-171 76, Stockholm, Sweden
| | | | - Lalle Hammarstedt-Nordenvall
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, S-171 76, Stockholm, Sweden
| |
Collapse
|
33
|
De Felice F, Musio D, Terenzi V, Valentini V, Cassoni A, Tombolini M, De Vincentiis M, Tombolini V. Treatment improvement and better patient care: which is the most important one in oral cavity cancer? Radiat Oncol 2014; 9:263. [PMID: 25479896 PMCID: PMC4263000 DOI: 10.1186/s13014-014-0263-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 11/15/2014] [Indexed: 11/10/2022] Open
Abstract
Due to substantial improvement in diagnosis and treatment of oral cavity cancer, a better understanding of the patient care needs to be revised. We reviewed literature related to OCC and discussed current general management approaches and related long-term radiation toxicities to emphasize the multidisciplinary team involvement. New technical modalities and patient quality of life parameters should be an integral and paramount state in the clinical evaluation to significantly contribute to reduce secondary side effects.
Collapse
Affiliation(s)
- Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I "Sapienza", University of Rome, Viale Regina Elena 326, 00161, Rome, Italy.
| | - Daniela Musio
- Department of Radiotherapy, Policlinico Umberto I "Sapienza", University of Rome, Viale Regina Elena 326, 00161, Rome, Italy.
| | - Valentina Terenzi
- Department of Maxillofacial Surgery, Policlinico Umberto I "Sapienza", University of Rome, Viale Regina Elena 326, 00161, Rome, Italy.
| | - Valentino Valentini
- Department of Maxillofacial Surgery, Policlinico Umberto I "Sapienza", University of Rome, Viale Regina Elena 326, 00161, Rome, Italy.
| | - Andrea Cassoni
- Department of Maxillofacial Surgery, Policlinico Umberto I "Sapienza", University of Rome, Viale Regina Elena 326, 00161, Rome, Italy.
| | - Mario Tombolini
- Department Organs of Sense, Policlinico Umberto I "Sapienza", University of Rome, Viale Regina Elena 326, 00161, Rome, Italy.
| | - Marco De Vincentiis
- Department Organs of Sense, Policlinico Umberto I "Sapienza", University of Rome, Viale Regina Elena 326, 00161, Rome, Italy.
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I "Sapienza", University of Rome, Viale Regina Elena 326, 00161, Rome, Italy. .,Spencer-Lorillard Foundation, Viale Regina Elena 262, 00161, Rome, Italy.
| |
Collapse
|
34
|
Hsin CH, Chen MK, Tang CH, Lin HP, Chou MY, Lin CW, Yang SF. High level of plasma matrix metalloproteinase-11 is associated with clinicopathological characteristics in patients with oral squamous cell carcinoma. PLoS One 2014; 9:e113129. [PMID: 25423087 PMCID: PMC4244114 DOI: 10.1371/journal.pone.0113129] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 10/20/2014] [Indexed: 12/01/2022] Open
Abstract
Background Matrix metalloproteinase-11 (MMP-11) is reported to be overexpressed in several cancers and may contribute to tumorigenesis. The current study investigated the association between the clinicopathological characteristics and plasma level of MMP-11 in oral squamous cell carcinoma (OSCC) patients. Methodology and Principal Findings The plasma MMP-11 concentration was determined by ELISA on 330 male OSCC patients. In addition, the metastatic effects of the MMP-11 knockdown on the oral cancer cells were investigated by cell migration assay. Our results showed that the plasma MMP-11 levels were significantly higher in patients with advanced T status (p = 0.001), lymph node metastasis (p = 0.006) and higher TNM stages (p<0.001). Moreover, treatment with the MMP-11 shRNA exerted an inhibitory effect on migration in SCC9 oral cancer cells. Conclusion Our study showed that plasma level of MMP-11 may be useful for assessment of the disease progression, especially lymph node metastasis, in patients with OSCC.
Collapse
Affiliation(s)
- Chung-Han Hsin
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Mu-Kuan Chen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Chih-Hsin Tang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
- Department of Biotechnology, College of Health Science, Asia University, Taichung, Taiwan
| | - Huang-Pin Lin
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ming-Yung Chou
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chiao-Wen Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail: (CWL); (SFY)
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail: (CWL); (SFY)
| |
Collapse
|
35
|
Vedasoundaram P, Prasanna AK, Ks R, Selvarajan G, Sinnatamby M, Ramapandian S, Kandasamy S. Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa. SPRINGERPLUS 2014; 3:590. [PMID: 25332889 PMCID: PMC4197196 DOI: 10.1186/2193-1801-3-590] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 09/29/2014] [Indexed: 12/25/2022]
Abstract
Background The study aimed to assess the effect of High Dose Rate (HDR) Interstitial Brachytherapy when used alone or in combination with External Beam Radiotherapy (EBRT), in early and locally advanced squamous cell carcinoma of buccal mucosa. Materials and methods Thirty three patients with histologically proven squamous cell carcinoma of the buccal mucosa received high dose rate interstitial brachytherapy either as primary treatment or as a boost from November 2008 to April 2013. Stage I patients received interstitial brachytherapy alone to a dose of 38.50 Gy, 3.5 Gy per fraction, twice daily at six hours apart for 11 fractions. Stage II patients received EBRT to a dose of 50 Gy in 25 fractions of two Gy each followed by brachytherapy boost to 21 Gy, 3.5 Gy per fraction, twice daily at six hours apart for six fractions. Stage III patients received the same radiotherapy schedule (i.e., same EBRT & Brachytherapy schedule) and with addition of Injection Cisplatin 70 mg/m2 in three divided doses every three weeks along with EBRT. Results Follow up ranged from 12 to 60 months, median follow up was 26 months. Complete response was observed in 28 patients. Five patients had residual disease and were referred for surgical salvage. One patient died of disease progression. Stage I patients had 100% local control, whereas Stage II and Stage III patients had 84.6% and 80% local control respectively. Conclusion HDR Interstitial Brachytherapy used either as a primary treatment modality or as a boost in buccal mucosal cancers provides results comparable to that of surgery, with the advantages of organ preservation, better cosmetic and functional outcomes.
Collapse
Affiliation(s)
- Parthasarathy Vedasoundaram
- Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India
| | - Aravind Kumar Prasanna
- Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India
| | - Reddy Ks
- Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India
| | - Gangothri Selvarajan
- Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India
| | - Mourougan Sinnatamby
- Medical Physicists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Seenisamy Ramapandian
- Medical Physicists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Saravanan Kandasamy
- Medical Physicists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
36
|
Oliveira MVMD, Fraga CADC, Barros LO, Pereira CS, Santos SHS, Basile JR, Gomez RS, Guimarães ALS, De-Paula AMB. High expression of S100A4 and endoglin is associated with metastatic disease in head and neck squamous cell carcinoma. Clin Exp Metastasis 2014; 31:639-49. [PMID: 24798676 DOI: 10.1007/s10585-014-9655-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 04/20/2014] [Indexed: 01/22/2023]
Abstract
The presence of cervical metastasis is responsible for high morbidity and mortality rates in individuals with head and neck squamous cell carcinoma (HNSCC). S100A4, a pleiotropic EF-hand calcium-binding protein, is expressed in various normal and cancer cell types. During cancer progression, molecular disturbances in S100A4 can modulate the activity and expression of pre-metastatic and metastatic genes. In this study, we investigated the association between S100A4 methylation status and protein expression as well as the expression of the S100A4 related-proteins annexin A2 (ANXA2), matrix metallopeptidase-9, and endoglin, for metastasis and other clinicopathological parameters in HNSCC. Formalin-fixed, paraffin-embedded blocks of metastatic and non-metastatic HNSCC and matched cervical lymph node (LN) samples (metastatic LN = mLN, non-metastatic = nmLN, and control LN (lymphadenitis) = cLN) were submitted for methylation specific-polymerase chain reaction and immunohistochemistry. Our results showed that S100A4 methylation status failed to demonstrate association with cervical metastasis and other clinicopathological factors related to HNSCC. HNSCC samples from patients that presented with metastatic disease showed high S100A4 and endoglin expression (p < 0.05). In conclusion, molecular disturbances in S100A4 and endoglin expression might regulate the formation of cervical metastasis in HNSCC.
Collapse
Affiliation(s)
- Marcos Vinícius Macedo de Oliveira
- Nucleus of Epidemiological and Molecular Research Catrumano. Health Research Laboratory. Health Science Post-graduate Programme, Universidade Estadual de Montes Claros, Montes Claros, MG, 39401-001, Brazil
| | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Peng P, Shen J, Dong JB, Zhang Y. Preoperative plasma fibrinogen predicts cervical metastasis in patients with stage I/II carcinoma of the tongue. Int J Oral Maxillofac Surg 2014; 43:393-8. [DOI: 10.1016/j.ijom.2013.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 07/23/2013] [Accepted: 09/26/2013] [Indexed: 11/28/2022]
|
38
|
Hubert Low TH, Gao K, Elliott M, Clark JR. Tumor classification for early oral cancer: Re-evaluate the current TNM classification. Head Neck 2014; 37:223-8. [DOI: 10.1002/hed.23581] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2013] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tsu-Hui Hubert Low
- Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital and University of Sydney; New South Wales Australia
- Department of Otolaryngology; Royal Prince Alfred Hospital; New South Wales Australia
| | - Kan Gao
- Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital and University of Sydney; New South Wales Australia
| | - Michael Elliott
- Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital and University of Sydney; New South Wales Australia
- Central Medical School, University of Sydney; New South Wales Australia
| | - Jonathan R Clark
- Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital and University of Sydney; New South Wales Australia
- Central Medical School, University of Sydney; New South Wales Australia
| |
Collapse
|
39
|
Sagheb K, Sagheb K, Taylor KJ, Al-Nawas B, Walter C. Cervical metastases of squamous cell carcinoma of the maxilla: a retrospective study of 25 years. Clin Oral Investig 2013; 18:1221-1227. [PMID: 23934238 DOI: 10.1007/s00784-013-1070-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 07/22/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Squamous cell carcinomas (SCCs) of the maxilla are relatively rare; therefore, only little data is available regarding the frequency of cervical metastasis (CM) and therapy strategies. Most authors only undertake clinical observation of the lymph nodes. The aim of this retrospective study was to evaluate the manner of metastasis in SCC of the maxilla. MATERIALS AND METHODS All patient records from 1987 to 2011 were scanned for SCC of the maxilla. Patients with SCC limited to the maxilla were comprised. The cases were analyzed regarding tumor node metastasis staging system and any special occurrences in the follow-up time such as tumor recurrence, metastasis, and exitus letalis. Classification and staging were performed according to the 2003 UICC system. RESULTS One hundred thirty-eight patients were comprised of 36 % females and 64 % males (average age, 66 years; women, 71 years; men, 63 years). The average follow-up time was 43 months (range, 0-195). Fifty-eight percent smoked or declared regular consumption of alcohol. About 50 % of the patients had an advanced tumor stage (III-IV). At the time of the primary diagnosis, 38 % of the patients had CM. There is an increased risk for CM occurrence with increasing tumor size and grading and a tumor localized in the postcanine region. Contralateral CM arises frequently in T4 tumors and tumors localized in the postcanine region. CONCLUSION The data exhibit aggressive regional metastatic behavior of SCC of the maxilla. CLINICAL RELEVANCE Therefore, surgical treatment of the draining lymphatic system as a primary management strategy is recommended for patients with SCC of the maxilla.
Collapse
Affiliation(s)
- K Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - Ka Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - K J Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg-University of Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany
| | - B Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - C Walter
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg-University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
| |
Collapse
|
40
|
Wang LP, Chen SW, Zhuang SM, Li H, Song M. Galectin-3 accelerates the progression of oral tongue squamous cell carcinoma via a Wnt/β-catenin-dependent pathway. Pathol Oncol Res 2013; 19:461-74. [PMID: 23519607 DOI: 10.1007/s12253-013-9603-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 01/04/2013] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to elucidate the clinicopathological significance and mechanism of action of galectin-3 in oral tongue squamous cell carcinoma (OTSCC). Here, the expression of galectin-3 was quantified in OTSCC (n = 68) and paired OTSCC and normal surrounding tissues (n = 10) using immunohistochemical staining. Tca8113 OTSCC cells were transfected with a plasmid expressing galectin-3 cDNA or siRNA against galectin-3. Cell proliferation, migration and invasion were measured using the MTT assay, Matrigel-coated Transwell migration assay and wound healing assay. The effect of galectin-3 on the Wnt/β-catenin signaling pathway and epithelial mesenchymal transition (EMT) were investigated using a plasmid expressing the Wnt antagonist dickkopf 1 (DKK1) and Western blotting. Galectin-3 was expressed at significantly higher levels in OTSCC than the normal adjacent tissues; galectin-3 expression correlated strongly with pathological stage, pathological grade and lymph node invasion in OTSCC. Overexpression of galectin-3 promoted Tca8113 cell proliferation, migration and invasion, upregulated Wnt protein expression, activated β-catenin and induced the EMT; knockdown of galectin-3 had the opposite effects. Co-transfection of Tca8113 cells overexpressing galectin-3 with the Wnt antagonist DKK1 reduced the ability of galectin-3 to increase cell proliferation, migration and invasion, reduced upregulation of Wnt, inhibited β-catenin activation and abrogated the EMT, demonstrating that the Wnt/β-catenin signaling pathway mediated the effects of galectin-3. Galectin-3 plays an important role in the progression of OTSCC via activation of the Wnt/β-catenin signaling pathway.
Collapse
Affiliation(s)
- Li-Ping Wang
- State Key Laboratory of Oncology in South China and Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou 510060, People's Republic of China
| | | | | | | | | |
Collapse
|
41
|
Haksever M, Inançlı HM, Tunçel U, Kürkçüoğlu SS, Uyar M, Genç O, Irkkan C. The effects of tumor size, degree of differentiation, and depth of invasion on the risk of neck node metastasis in squamous cell carcinoma of the oral cavity. EAR, NOSE & THROAT JOURNAL 2012; 91:130-5. [PMID: 22430339 DOI: 10.1177/014556131209100311] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cervical lymph node metastasis is the most important prognostic factor in patients with head and neck carcinoma. We retrospectively analyzed the effects of three different variables-tumor size, degree of differentiation, and depth of invasion-on the risk of neck node metastasis in 50 adults who had been treated with surgery for primary squamous cell carcinoma of the oral cavity. Primary tumor depth and other pathologic features were determined by reviewing the pathology specimens. Preoperatively, 36 of the 50 patients were clinically N0; however, occult lymph node metastasis was found in 13 of these patients (36.1%). The prevalence of neck node metastasis in patients with T1/T2 and T3/T4 category tumors was 51.5 and 58.8%, respectively. The associations between the prevalence of neck node metastasis and both the degree of differentiation and the depth of invasion were statistically significant, but there was no significant association between neck node metastasis and tumor size. We conclude that the prevalence of neck lymph node metastasis in patients with squamous cell carcinoma of the oral cavity increases as the tumor depth increases and as the degree of tumor differentiation decreases from well to poor, as has been shown in previous studies. It is interesting that tumor size, which is the most important component of the TNM system, was not significantly associated with neck node involvement.
Collapse
Affiliation(s)
- Mehmet Haksever
- Department of Otorhinolaryngology-Head and Neck Surgery, Near East University Faculty of Medicine, Nicosia, Cyprus
| | | | | | | | | | | | | |
Collapse
|
42
|
Jung HM, Phillips BL, Patel RS, Cohen DM, Jakymiw A, Kong WW, Cheng JQ, Chan EKL. Keratinization-associated miR-7 and miR-21 regulate tumor suppressor reversion-inducing cysteine-rich protein with kazal motifs (RECK) in oral cancer. J Biol Chem 2012; 287:29261-72. [PMID: 22761427 DOI: 10.1074/jbc.m112.366518] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
MicroRNAs (miRNAs) are small non-coding RNAs that posttranscriptionally regulate gene expression during many biological processes. Recently, the aberrant expressions of miRNAs have become a major focus in cancer research. The purpose of this study was to identify deregulated miRNAs in oral cancer and further focus on specific miRNAs that were related to patient survival. Here, we report that miRNA expression profiling provided more precise information when oral squamous cell carcinomas were subcategorized on the basis of clinicopathological parameters (tumor primary site, histological subtype, tumor stage, and HPV16 status). An innovative radar chart analysis method was developed to depict subcategories of cancers taking into consideration the expression patterns of multiple miRNAs combined with the clinicopathological parameters. Keratinization of tumors and the high expression of miR-21 were the major factors related to the poor prognosis of patients. Interestingly, a majority of the keratinized tumors expressed high levels of miR-21. Further investigations demonstrated the regulation of the tumor suppressor gene reversion-inducing cysteine-rich protein with kazal motifs (RECK) by two keratinization-associated miRNAs, miR-7 and miR-21. Transfection of miR-7 and miR-21-mimics reduced the expression of RECK through direct miRNA-mediated regulation, and these miRNAs were inversely correlated with RECK in CAL 27 orthotopic xenograft tumors. Furthermore, a similar inverse correlation was demonstrated in CAL 27 cells treated in vitro by different external stimuli such as trypsinization, cell density, and serum concentration. Taken together, our data show that keratinization is associated with poor prognosis of oral cancer patients and keratinization-associated miRNAs mediate deregulation of RECK which may contribute to the aggressiveness of tumors.
Collapse
Affiliation(s)
- Hyun Min Jung
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL 32610, USA
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Factors influencing contralateral neck metastasis in oral squamous cell carcinoma. FORMOSAN JOURNAL OF SURGERY 2012. [DOI: 10.1016/j.fjs.2012.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
44
|
Bitu CC, Destro MFDSS, Carrera M, da Silva SD, Graner E, Kowalski LP, Soares FA, Coletta RD. HOXA1 is overexpressed in oral squamous cell carcinomas and its expression is correlated with poor prognosis. BMC Cancer 2012; 12:146. [PMID: 22498108 PMCID: PMC3351375 DOI: 10.1186/1471-2407-12-146] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 04/12/2012] [Indexed: 11/12/2022] Open
Abstract
Background HOX genes encode homeodomain-containing transcription factors involved in the regulation of cellular proliferation and differentiation during embryogenesis. However, members of this family demonstrated oncogenic properties in some malignancies. The present study investigated whether genes of the HOXA cluster play a role in oral cancer. Methods In order to identify differentially expressed HOXA genes, duplex RT-PCR in oral samples from healthy mucosa and squamous cell carcinoma was used. The effects of HOXA1 on proliferation, apoptosis, adhesion, invasion, epithelial-mesenchymal transition (EMT) and anchorage-independent growth were assessed in cells with up- and down-regulation of HOXA1. Immunohistochemical analysis using a tissue microarray (TMA) containing 127 oral squamous cell carcinomas (OSCC) was performed to determine the prognostic role of HOXA1 expression. Results We showed that transcripts of HOXA genes are more abundant in OSCC than in healthy oral mucosa. In particular, HOXA1, which has been described as one of the HOX members that plays an important role in tumorigenesis, was significantly more expressed in OSCCs compared to healthy oral mucosas. Further analysis demonstrated that overexpression of HOXA1 in HaCAT human epithelial cells promotes proliferation, whereas downregulation of HOXA1 in human OSCC cells (SCC9 cells) decreases it. Enforced HOXA1 expression in HaCAT cells was not capable of modulating other events related to tumorigenesis, including apoptosis, adhesion, invasion, EMT and anchorage-independent growth. A high number of HOXA1-positive cells was significantly associated with T stage, N stage, tumor differentiation and proliferative potential of the tumors, and was predictive of poor survival. In multivariate analysis, HOXA1 was an independent prognostic factor for OSCC patients (HR: 2.68; 95% CI: 1.59-2.97; p = 0.026). Conclusion Our findings indicate that HOXA1 may contribute to oral carcinogenesis by increasing tumor cell proliferation, and suggest that HOXA1 expression might be helpful as a prognostic marker for patients with OSCC.
Collapse
Affiliation(s)
- Carolina Cavalcante Bitu
- Department of Oral Diagnosis, School of Dentistry, State University of Campinas, CP 52, CEP 13414-018 Piracicaba, São Paulo, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Worsham MJ, Stephen JK, Lu M, Chen KM, Havard S, Shah V, Schweitzer VP. Disparate molecular, histopathology, and clinical factors in head and neck squamous cell carcinoma racial groups. Otolaryngol Head Neck Surg 2012; 147:281-8. [PMID: 22412179 DOI: 10.1177/0194599812440681] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE There is a lack of consensus regarding the causes of the differences in the higher incidence of and the mortality from head and neck squamous cell carcinoma (HNSCC) in African Americans (AA) versus Caucasian Americans (CA). We examined a comprehensive array of risk factors influencing health and disease in an access-to-care, racially diverse, primary HNSCC cohort. STUDY DESIGN Cross-sectional study. SETTING Primary care academic health care system. SUBJECTS AND METHODS The cohort of 673 patients comprised 391 CA and 282 AA (42%). Risk variables included demographic, histopathology, and clinical/epidemiologic factors. Tumor DNA was interrogated for loss and gain of 113 genes with known involvement in HNSCC/cancer. Logistic regression for univariate analysis was followed by multivariate modeling with determination of model predictability (c-index). RESULTS Of the 39 univariate differences between AA and CA, multivariate modeling (c-index = 0.81) retained 7 differences (P < .05). AA were less likely to be married and more likely to have tumor lymphocytic response, undergo radiation treatment, and smoke. Insurance type was a significant predictor of race. AA were more likely to have Medicaid, Medicare, and other HMO types. AA tumors were more likely to have loss of CDKN2A and gain of SCYA3 versus CA. CONCLUSIONS Multivariate modeling indicated significant differences between AA and CA HNSCC for histopathology, treatment, smoking, marital status, type of insurance, and tumor gene copy number alterations. Our data reiterate that for HNSCC, as in the case of other complex diseases, tumor genetics or biology is only one of many potential contributors to differences among racial groups.
Collapse
Affiliation(s)
- Maria J Worsham
- Department of Otolaryngology/Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan 48202, USA.
| | | | | | | | | | | | | |
Collapse
|
46
|
Lin YW, Li CF, Chen HY, Yen CY, Lin LC, Huang CC, Huang HY, Wu PC, Chen CH, Chen SC, Tai MH. The expression and prognostic significance of hepatoma-derived growth factor in oral cancer. Oral Oncol 2012; 48:629-35. [PMID: 22361040 DOI: 10.1016/j.oraloncology.2012.01.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 12/27/2011] [Accepted: 01/26/2012] [Indexed: 12/12/2022]
Abstract
Hepatoma-derived growth factor (HDGF) participates in oncogenic progression and represents a prognostic factor in several types of cancer. This study aimed to elucidate the role of HDGF during oral carcinogenesis. HDGF expression and the tumorigenic behaviors in human oral cell lines were investigated by immunoblotting, invasion and colony formation assays. Recombinant adenovirus vectors were employed to modulate the HDGF level in oral cancer cells. Immunohistochemical analysis using tissue microarray (TMA) consisting of surgically resected samples from 95 oral cancer patients was performed to delineate the correlation between HDGF expression and clinic-pathological parameters. HDGF expression was higher in malignant oral cancer cells than benign ones. Adenovirus-mediated HDGF overexpression and knockdown demonstrated the cellular HDGF level regulated the tumorigenic behaviors of oral cancer cells. Immunohistochemical analysis revealed increased HDGF expression in the nucleus and cytoplasm in oral cancer tissues. The nuclear HDGF expression was significantly correlated with tumor stage (P=0.004) and grade (P=0.013) while the cytoplasmic HDGF expression was associated with tumor necrosis (P=0.002). Kaplan-Meier analysis revealed that patients with high nuclear HDGF expression had significantly worse 5-year disease-specific survival (P=0.0069), metastasis-free survival (P=0.0168), and local recurrence-free survival (P=0.0047). Multivariate analysis indicated that the nuclear HDGF labeling index was an independent prognostic factor for disease-specific and local recurrence-free survival. HDGF overexpression contributes to the oncogenic processes in oral cancer cells and constitutes a novel prognostic factor for survival outcome of oral cancer patients.
Collapse
Affiliation(s)
- Yu-Wei Lin
- Department of Radiation Oncology, Division of Oral & Maxillofacial Surgery, Chi Mei Medical Center, Tainan, Taiwan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Beltramini GA, Massarelli O, Demarchi M, Copelli C, Cassoni A, Valentini V, Tullio A, Giannì AB, Sesenna E, Baj A. Is neck dissection needed in squamous-cell carcinoma of the maxillary gingiva, alveolus, and hard palate? A multicentre Italian study of 65 cases and literature review. Oral Oncol 2012; 48:97-101. [DOI: 10.1016/j.oraloncology.2011.08.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 08/12/2011] [Accepted: 08/17/2011] [Indexed: 02/06/2023]
|
48
|
Liao CT, Lin CY, Fan KH, Wang HM, Ng SH, Lee LY, Hsueh C, Chen IH, Huang SF, Kang CJ, Yen TC. Identification of a High-Risk Group Among Patients With Oral Cavity Squamous Cell Carcinoma and pT1–2N0 Disease. Int J Radiat Oncol Biol Phys 2012; 82:284-90. [DOI: 10.1016/j.ijrobp.2010.09.036] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 08/02/2010] [Accepted: 09/08/2010] [Indexed: 11/30/2022]
|
49
|
Wong YK, Lee LT, Liu CJ. Hypermethylation of MGMT and DAPK gene promoters is associated with tumorigenesis and metastasis in oral squamous cell carcinoma. J Dent Sci 2011. [DOI: 10.1016/j.jds.2011.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
|
50
|
Yang TL, Lou PJ, Chang YL, Wu CT, Wang CP, Ko JY. Tumor Satellite in Predicting Occult Nodal Metastasis of Tongue Cancer. Otolaryngol Head Neck Surg 2011; 145:599-605. [DOI: 10.1177/0194599811411635] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective. Tongue cancer is well known to have a high potential for locoregional metastasis. However, controversy about electively treating the neck in early-stage tongue cancer remains. Although many risk factors related to cervical occult nodal metastasis (ONM) have been investigated, the ability of the tumor to spread, a phenomenon that results from the intrinsic property of the tumor and its interaction with the surrounding environment, has seldom been addressed. Study Design. Retrospective case series with chart review. Setting. Tertiary referral hospital of university. Subjects. Patients with early-stage squamous cell carcinoma of the oral tongue. Results. In 71 eligible enrolled patients, ONM was detected in 19 (27%) patients, while the results were negative (ONM(−)) in 52 (73%) patients. The average tumor satellite distance (TSD) in the ONM(+) group was 4.1 ± 4.3 mm, in contrast to that in the ONM(−) group (1.0 ± 1.5 mm; P < .001). When stratified by increased TSD values, the significance of the difference between the 2 groups increased. For clinical applications, the optimal TSD threshold for determining the ONM probability was 3.5 mm. Multivariate analyses demonstrated that TSD was an independent prognosticator. Conclusions. The results indicate that TSD is a feasible pathological parameter that is useful for determining the status of cervical nodal metastasis. It can be used as an indicator of potential cervical subclinical disease and as a guideline for deciding the necessity and modality of neck treatment.
Collapse
Affiliation(s)
- Tsung-Lin Yang
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-Jen Lou
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yih-Leong Chang
- Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chen-Tu Wu
- Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Cheng-Ping Wang
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jenq-Yuh Ko
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| |
Collapse
|