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Kaundiyal S, Chandra S, Arora A. Study of tumor budding and its association with clinicopathological parameters in breast carcinoma. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20240173. [PMID: 39166665 PMCID: PMC11329258 DOI: 10.1590/1806-9282.20240173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 04/19/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVE Tumor budding is a phenomenon in which the tumor cells detach from the main mass and are present at the invasive front. The present study was conducted to study tumor budding in invasive breast carcinoma and to correlate it with clinicopathological parameters and molecular subtypes. METHODS The study was conducted over a period of 1 year, and tumor budding was studied as a single or group of cells at the invasive front of breast carcinoma counted in a high-power field (40×). The grading was statistically correlated with tumor size, grade, lymph node status, lymphovascular invasion, pathological TNM staging, molecular subtype, and survival of patients. RESULTS A total of 50 cases of invasive breast carcinoma were included, out of which 66% (n=33) showed high-grade tumor budding, which was statistically significantly higher in grade 2 invasive ductal carcinoma (p<0.05). High tumor budding was associated with lymphovascular invasion, lymph node metastasis, and a high Ki-67 proliferative index. All cases showing low-grade budding were alive until 6 months of diagnosis, but there was no statistically significant association between stage and budding. CONCLUSION Tumor buds are significantly higher in grade 2 invasive ductal carcinoma with lymphovascular invasion, lymph node metastasis, and a high Ki-67 proliferative index. Immunohistochemistry may prove helpful in distinguishing tumor buds from their mimickers. Further studies with extended follow-up are recommended to predict tumor budding as a prognostic marker in breast carcinoma, which may play an important role in cancer therapy.
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Affiliation(s)
- Suresh Kaundiyal
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Pathology – Dehradun, India
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Surgery – Dehradun, India
| | - Smita Chandra
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Pathology – Dehradun, India
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Surgery – Dehradun, India
| | - Anshika Arora
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Pathology – Dehradun, India
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Surgery – Dehradun, India
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Ahn B, Park HJ, Kim HJ, Hong SM. Radiologic tumor border can further stratify prognosis in patients with pancreatic neuroendocrine tumor. Pancreatology 2024; 24:753-763. [PMID: 38796309 DOI: 10.1016/j.pan.2024.05.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/30/2024] [Accepted: 05/14/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND AND OBJECTIVES Pancreatic neuroendocrine tumor (PanNET), although rare in incidence, is increasing in recent years. Several clinicopathologic and molecular factors have been suggested for patient stratification due to the extensive heterogeneity of PanNETs. We aimed to discover the prognostic role of assessing the tumor border of PanNETs with pre-operative computed tomography (CT) images and correlate them with other clinicopathologic factors. METHODS The radiologic, macroscopic, and microscopic tumor border of 183 surgically resected PanNET cases was evaluated using preoperative CT images (well defined vs. poorly defined), gross images (expansile vs. infiltrative), and hematoxylin and eosin-stained slides (pushing vs. infiltrative). The clinicopathologic and prognostic significance of the tumor border status was compared with other clinicopathologic factors. RESULTS A poorly defined radiologic tumor border was observed in 65 PanNET cases (35.5 %), and were more frequent in male patients (P = 0.031), and tumor with larger size, infiltrative macroscopic growth pattern, infiltrative microscopic tumor border, higher tumor grade, higher pT category, lymph node metastasis, lymphovascular and perineural invasions (all, P < 0.001). Patients with PanNET with a poorly defined radiologic tumor border had significantly worse overall survival (OS) and recurrence-free survival (RFS; both, P < 0.001). Multivariable analysis revealed that PanNET with a poorly defined radiologic border is an independent poor prognostic factor for both OS (P = 0.049) and RFS (P = 0.027). CONCLUSION Pre-operative CT-based tumor border evaluation can provide additional information regarding survival and recurrence in patients with PanNET.
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Affiliation(s)
- Bokyung Ahn
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyo Jung Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyoung Jung Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Seung-Mo Hong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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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.
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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
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Jain PV, Mallick I, Manikantan K, Chatterjee S, Arun I, Roy P, Zameer L, Arun P. Prognostic triad: a novel method for decision-making for adjuvant treatment in stage I-II oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00215-7. [PMID: 39003151 DOI: 10.1016/j.ijom.2024.07.004] [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: 10/27/2023] [Revised: 06/21/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024]
Abstract
This study proposes a scoring system for adjuvant irradiation for stage I/II oral squamous cell carcinoma (OSCC). Derivation cohort (119 patients, operated between 2011 and 2014) and a validation cohort (204 patients, operated between 2016 and 2019) were included. In derivation cohort, on univariate analysis, tumor size >2 cm [3-year Disease Free Survival (DFS) 72.5% vs 95.6%, P = 0.039], lymphovascular invasion (58.3% vs 83.6%, P = 0.024), perineural invasion (75% vs 85.6%, P = 0.013), and depth of invasion ≥0.5 cm (73.8% vs 97.5%, P = 0.017) predicted 3-year DFS. Tongue lesions and poor differentiation were added as poor prognosticators based on previously published reports. Patients were grouped as low risk (<3 risk factors) and high risk (≥3 risk factors), with only high-risk group receiving adjuvant irradiation in validation cohort. Overall, 47/119 (39.5%) patients in the derivation cohort and 50/204 (24.5%) patients in validation cohort received adjuvant irradiation. In derivation cohort, 3-year DFS was 93% and 72.5% in the low and high-risk group, respectively. 3-year DFS was 90.7% and 85.8% in the low and high-risk group, respectively for validation cohort. The proposed scoring system reduced the use of adjuvant irradiation by 38%, with similar DFS.
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Affiliation(s)
- P V Jain
- Department of Head and Neck Surgery, Tata Medical Centre, Kolkata, West Bengal, India.
| | - I Mallick
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - K Manikantan
- Department of Head and Neck Surgery, Tata Medical Centre, Kolkata, West Bengal, India.
| | - S Chatterjee
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - I Arun
- Department of Pathology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - P Roy
- Department of Pathology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - L Zameer
- Department of Pathology, Tata Medical Centre, Kolkata, West Bengal, India.
| | - P Arun
- Department of Head and Neck Surgery, Tata Medical Centre, Kolkata, West Bengal, India.
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Zheng Z, Yang HX, Fang YH, Wang J, Fu SW, Ouyang QM. Tumor budding is an optimal indictor of occult cervical metastasis in clinical early-stage buccal mucosa squamous cell carcinoma. J Oral Pathol Med 2024; 53:386-392. [PMID: 38772727 DOI: 10.1111/jop.13533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 02/16/2024] [Accepted: 03/26/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Buccal mucosa squamous cell carcinoma (BMSCC) is an aggressive disease. This study investigated the clinicopathological significance of tumor budding (TB), depth of invasion (DOI), and mode of invasion (MOI) on occult cervical metastasis (CM) of BMSCC. METHODS Seventy-one cT1-2N0 BMSCC patients were included in this retrospective study. TB, DOI, MOI, and other clinicopathological features were reviewed. Risk factors for occult CM, locoregional recurrence-free survival (LRRFS), and overall survival (OS) were analyzed using logistic regression and Cox's proportional hazard models, respectively. RESULTS Multivariate analysis with the logistic regression model revealed that MOI, DOI, and TB were significantly associated with occult CM in early-stage BMSCC after adjusting for variates. However, multivariate analysis with the Cox's proportional hazard model found only TB to be a prognostic factor for LRRFS (hazard ratio 15.03, 95% confidence interval [CI] 1.94-116.66; p = 0.01; trend test p = 0.03). No significant association was found between MOI, DOI, or TB and OS. CONCLUSIONS The optimal predictor of occult CM and prognosis of early-stage BMSCC is TB, which may assist clinicians in identifying patients at high risk of cervical metastasis.
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Affiliation(s)
- Zhi Zheng
- Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huan-Xing Yang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yi-Hong Fang
- Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jin Wang
- Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Shi-Wei Fu
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Qi-Ming Ouyang
- Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China
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Panchannavar GS, Angadi PV. Tumor budding is a prognostic marker for overall survival and not for lymph node metastasis in Oral Squamous Cell Carcinoma - Systematic Review Update and Meta-Analysis. J Oral Biol Craniofac Res 2024; 14:362-369. [PMID: 38832296 PMCID: PMC11144740 DOI: 10.1016/j.jobcr.2024.04.013] [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: 01/14/2024] [Revised: 03/17/2024] [Accepted: 04/30/2024] [Indexed: 06/05/2024] Open
Abstract
Objective Tumor budding (TB) has shown promising results as a prognostic marker in several cancers such as colorectal carcinoma, breast carcinoma etc. It has been co-related to aggressiveness of the tumor and can also predict the metastasis to the lymph nodes. This systematic review evaluates the prognostic potential of TB in predicting lymph node metastasis (LNM) in OSCC. Data sources Systematic search was carried out in the electronic data-bases i.e. PubMed, Cochrane and Google scholar for original studies related to TB in OSCC. The assessment of risk bias was done using QUIPS tool. Meta-analysis was done using STATA software. Results A total of 25 articles were included. A significant association was noted for overall survival and prognosis but not for TB LNM in OSCC. Meta-analysis revealed a pooled estimate i.e odds ratio of 2.10 (CI - 0.00 - 4.20) for TB and LNM while for overall survival, it was 2.29 (CI-1.81-2.76). Conclusion Tumor budding though is strongly associated with LNM in OSCC did not show significant relationship in this systematic review but demonstrated a higher correlation with overall survival. It highlights that TB is an important parameter for prognosis of oral cancer but its potential in prediction of LNM needs further validation.
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Affiliation(s)
| | - Punnya V. Angadi
- Department of Oral Pathology and Microbiology, VK Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER), Belgaum, 590010, Karnataka, India
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Hakim SG, Alsharif U, Falougy M, Tharun L, Rades D, Jensen J. The impact of tumor budding and single-cell invasion on survival in patients with stage III/IV locally advanced oral squamous cell carcinoma- results from a prospective cohort study. Front Oncol 2024; 14:1404361. [PMID: 38741775 PMCID: PMC11089200 DOI: 10.3389/fonc.2024.1404361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction Tumor budding (TB) refers to the presence of small clusters of tumor cells at the invasive front of a malignant tumor. Single tumor cell invasion (SCI) is an extreme variant of TB, in which individual loose tumor cells are present at the invasive front. Both TB and SCI are important histomorphologic risk factors postulated to indicate loss of cellular cohesion. In this study, we investigated the influence of TB and SCI on different survival outcomes in patients with locally advanced oral squamous cell carcinoma (OSCC). Methods We included 129 patients with locally advanced OSCC (pT3-4) from a single-center, prospectively maintained cohort. We examined the association of TB and SCI with the presence of occult lymph node metastasis using a logistic regression model. Survival probabilities were estimated using the Kaplan-Meier method and cumulative incidence functions. The association of TB and SCI on overall survival (OS), oral cancer-specific survival (OCSS), and local recurrence-free survival (LRFS) was investigated using Cox's proportional hazards regression models. Results TB was detected in 98 (76%) of the tumors, while SCI was observed in 66 (51%) patients. There was a significant association between TB and the occurrence of occult lymph node metastasis (OR=3.33, CI: 1.21-10.0). On multivariate analysis, TB had no detectable impact on survival outcomes. However, SCI showed a higher risk for local recurrence (Hazards ratio (HR): 3.33, CI: 1.19 - 9.27). Discussion This study demonstrates that TB and SCI in locally advanced OSCC function as an independent risk factor for occult lymph node metastases, as well as local recurrences. Both histomorphologic risk factors could serve as an additional parameter for stratifying therapy and escalating multimodal treatment approaches.
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Affiliation(s)
- Samer G. Hakim
- Department of Maxillofacial Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany
- Department of Oral and Maxillofacial Surgery, Helios Medical Center, Schwerin, Germany
| | - Ubai Alsharif
- Department of Oral and Maxillofacial Surgery, Dortmund General Hospital, Dortmund, Germany
- Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Mohamed Falougy
- Department of Maxillofacial Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Lars Tharun
- Department of Pathology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Dirk Rades
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Justus Jensen
- Department of Maxillofacial Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany
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Bhuyan G, Hazarika P, Rabha AM. Evaluation of the significance of tumor stromal patterns and peri-tumoral inflammation in head and neck squamous cell carcinoma with special reference to the Yamamoto-Kohama classification. INDIAN J PATHOL MICR 2024; 67:340-348. [PMID: 38427768 DOI: 10.4103/ijpm.ijpm_426_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/26/2023] [Indexed: 03/03/2024] Open
Abstract
INTRODUCTION Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with 878,348 new cases. Cancer-associated fibroblasts (CAFs) are the predominant cell type in tumor stroma and are important promoters of tumor progression. OBJECTIVE The aim of the study was to evaluate the pattern of desmoplastic stromal reaction and peri-tumoral inflammatory infiltrate with the histological grade and clinical data. MATERIALS AND METHODS A total of 60 cases of HNSCC were included in the study. The hematoxylin and eosin (H and E)-stained sections from all cases were examined by two experienced pathologists for the grade, nature of stomal reaction (SR), peri-tumoral inflammatory infiltration, Yamamoto-Kohama classification grade, worst pattern of invasion (WPOI), depth of invasion (DOI), and other histopathological parameters. Correlation analysis was conducted using the Chi-square test. P- value less than 0.05 was considered statistically significant. RESULTS Immature SR was not observed in any of the well-differentiated squamous cell carcinoma (SCC) cases. However, one (3.7%) case of moderately differentiated SCC and two (28.6%) cases of poorly differentiated SCC showed signs of immature SR. In the case of the higher grades of the YK classification, specifically grades 4C and 4D, a more profound depth of tumor cell invasion, equal to or exceeding 10 mm, was evident in six (66.67%) and two (28.57%) cases, respectively. Additionally, among the seven (11.7%) cases classified as poorly differentiated carcinoma, three (42.85%) displayed a WPOI score of 5. CONCLUSION SR and the tumor invasive pattern in HNSCC are related to prognosis and may indicate tumor aggressiveness.
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Affiliation(s)
- Geet Bhuyan
- Department of Pathology, Jorhat Medical College and Hospital, Jorhat, Assam, India
| | - Prabir Hazarika
- Department of Pathology, Tezpur Medical College and Hospital, Jorhat, Assam, India
| | - Anju M Rabha
- Department of Pathology, Tezpur Medical College and Hospital, Jorhat, Assam, India
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Zanoletti E, Daloiso A, Nicolè L, Cazzador D, Mondello T, Franz L, Astolfi L, Marioni G. Tumor budding to investigate local invasion, metastasis, and prognosis of head and neck carcinoma: A systematic review. Head Neck 2024; 46:651-671. [PMID: 38013617 DOI: 10.1002/hed.27583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Abstract
The aim of this systematic review is to shed light on the role of tumor budding (TB) in the biology, behavior, and prognosis of head and neck squamous cell carcinoma (HNSCC). A search was run in PubMed, Scopus, and Embase databases following PRISMA guidelines. After full-text screening and application of inclusion/exclusion criteria, 36 articles were included. Several investigations support the prognostic role of TB, which might play a role in selecting rational treatment strategies. To achieve this goal, further research is needed for greater standardization in TB quantification. Although TB is not included as a negative prognostic factor in the current management guidelines, it might be reasonable to consider a closer follow-up for HNSCC cases with high histopathological evidence of TB.
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Affiliation(s)
- Elisabetta Zanoletti
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Antonio Daloiso
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Lorenzo Nicolè
- Department of Medicine (DIMED), University of Padova, Padova, Italy
- Pathology & Cytopathology Unit, Ospedale dell'Angelo, Venezia-Mestre, Italy
| | - Diego Cazzador
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Tiziana Mondello
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Leonardo Franz
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Laura Astolfi
- Bioacoustics Research Laboratory, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
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Meirelles DP, Da Costa AAS, Sousa-Neto SS, Cardoso SV, de Mendonça EF, Caldeira PC, De Aguiar MCF. Methodological challenges in identifying histological prognostic markers for squamous cell carcinoma of the lip, mouth, and oropharynx. Oral Oncol 2024; 149:106665. [PMID: 38141327 DOI: 10.1016/j.oraloncology.2023.106665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 12/25/2023]
Affiliation(s)
- Daniela Pereira Meirelles
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Sérgio Vitorino Cardoso
- Department of Oral and Maxillofacial Pathology, Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Patricia Carlos Caldeira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maria Cássia Ferreira De Aguiar
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Deshpande NS, Munemane AB, Karle RR, Dongre SD. Relevance of Tumor Budding and Pattern of Invasion in Oral Squamous Cell Carcinoma. Int J Appl Basic Med Res 2024; 14:29-34. [PMID: 38504839 PMCID: PMC10947764 DOI: 10.4103/ijabmr.ijabmr_391_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: 08/29/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 03/21/2024] Open
Abstract
Background Standard histopathological parameters such as depth of invasion (DOI), lymphovascular invasion (LVI), and perineural invasion (PNI) are known parameters that can correlate with the prognosis and aggressiveness of oral squamous cell carcinomas (OSCCs). Tumor budding (TB) (≤5 tumor cells at infiltrating borders) and pattern of invasion (POI) are emerging histopathological parameters that have shown promising results as reliable risk factors in predicting nodal metastasis in early OSCCs. Aim The aim of the study was to assess TB and POI in OSCCs. Materials and Methods A total of 33 surgical resection specimens of OSCC, including buccal mucosa and tongue with neck dissection, were selected. TB and POI along with standard parameters such as grade, DOI, LVI, PNI, lymph node status, and pathological staging were evaluated. These parameters were analyzed in comparison with lymph node involvement and pathological stage of the tumor using the Chi-square and Fischer's exact test. The SPSS software, v21, was used for statistical analyses. Results Most of OSCC were moderately differentiated tumors (63.64%). TB was present in 23 cases, in which 69.57% of cases showed low TB (<5 buds), while 30.43% of cases had higher TB (>5 buds). The worst POI (Patterns 4 and 5) was seen in 75.76% of cases. TB, POI, grade, PNI, DOI, and stromal pattern were significantly associated with the pathological stage of the tumor. Conclusion TB and POI are important and reliable in histopathological parameters in OSCCs.
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Affiliation(s)
- Nikhil Sanjay Deshpande
- Department of Pathology, Dr. BVP Rural Medical College, Pravara Institute of Medical Sciences (DU), Ahmednagar, Maharashtra, India
| | - Anil B. Munemane
- Department of Pathology, Dr. BVP Rural Medical College, Pravara Institute of Medical Sciences (DU), Ahmednagar, Maharashtra, India
| | - Ravindra Raosaheb Karle
- Department of Pathology, Dr. BVP Rural Medical College, Pravara Institute of Medical Sciences (DU), Ahmednagar, Maharashtra, India
| | - Suryakant Dattatreya Dongre
- Department of Pathology, Dr. BVP Rural Medical College, Pravara Institute of Medical Sciences (DU), Ahmednagar, Maharashtra, India
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Chang HY, Hang JF, Kuo YJ. New Histopathologic Risk Model for Early T-stage Oral Squamous Cell Carcinoma: Focusing on a Modified Worst Pattern of Invasion System and a New Tumor Budding Score. Am J Surg Pathol 2024; 48:59-69. [PMID: 37779502 DOI: 10.1097/pas.0000000000002136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Oral squamous cell carcinoma (OSCC) is treated based on the TNM staging. However, early T-stage OSCC still exhibits substantial nodal metastasis and death rates. Recent literature highlights the independent prognostic value of worst pattern of invasion (WPOI) and tumor budding in OSCC. Nevertheless, WPOI-5 is uncommon in early T-stage OSCC, and the definitions of tumor budding and WPOI-4 overlap. Moreover, WPOI assessment is subjective, and tumor budding evaluation varies across studies. To address these limitations, we aimed to develop a modified WPOI system and a novel tumor budding scoring system that assesses single cells and high-density tumor budding. We also evaluated a new histopathologic risk model for early T-stage OSCC. The study cohort comprised 37 pT1 and 64 pT2 OSCCs. The modified WPOI demonstrated superior interobserver agreement compared with the original system (κ value: 0.98 vs. 0.53). In the multivariate analysis, modified WPOI and tumor budding score were independent prognostic factors for nodal metastasis and disease-free survival, while modified WPOI predicted disease-specific survival. By integrating these factors, our risk model stratified the patients into 3 groups. Notably, the intermediate-risk and high-risk groups exhibited significantly higher rates of nodal metastasis, recurrence, and tumor-related death. Conversely, none in the low-risk group had nodal metastasis or succumbed to the disease. Our model offered simplified scoring and potentially improved prognostic predictions. In conclusion, we've developed a modified WPOI system, a new tumor budding scoring system, and a reliable risk model that classifies early T-stage OSCC patients into distinct risk groups with significant prognostic differences.
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Affiliation(s)
- Hsin-Yi Chang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital
| | - Jen-Fan Hang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital
- School of Medicine
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ying-Ju Kuo
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital
- School of Medicine
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13
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Silva FFVE, Caponio VCA, Pérez-Sayáns M, Padín-Iruegas ME, Mascitti M, Chamorro-Petronacci CM, Suaréz-Peñaranda JM, Lorenzo-Pouso AI. Tumor budding is a prognostic factor in head and neck squamous cell carcinoma: A comprehensive meta-analysis and trial sequential analysis. Crit Rev Oncol Hematol 2024; 193:104202. [PMID: 37989426 DOI: 10.1016/j.critrevonc.2023.104202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Mortality is linked to tumor budding (TB) in certain neoplasms. TB as a relevant histopathological feature is conditioned by tumor site, a specific study on head and neck squamous cell carcinoma (HNSCC) is needed. METHODS A comprehensive meta-analysis was undertaken to investigate the relationship between TB and HNSCC-related outcomes. RESULTS Overall 42 studies were included. Patients harboring high TB reported an Overall Survival (OS) Hazard Ratio (HR) of 2.63 (95% confidential interval (CI) 2.04-3.39; p-value < 0.001), Disease-free Survival (DFS) HR of 1.88 (95%CI 1.57-2.24; p-value <0.001) and Disease-specific Survival (DSS) HR of 2.14 (95%CI 1.81-2.52; p-value <0.001). Lymph Node Metastasis (LNM) studies harbored null heterogeneity and marked association with TB (Odds Ratio (OR) = 4.48, 95%CI 2.97-6.76; p-value < 0.001). Trial Sequential Analysis (TSA) supported definitive results for DSS. CONCLUSION The study has provided compelling evidence that there is a significant association between TB and a worse prognosis for HNSCC.
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Affiliation(s)
- Fábio França Vieira E Silva
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain
| | | | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain
| | - María Elena Padín-Iruegas
- ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain; Human Anatomy and Embriology Area, Departament of Funcional Biology and Health Sciences, University of Vigo, Lagoas-Marcosende, s/n, 36310 Vigo, Spain.
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Cintia Micaela Chamorro-Petronacci
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain
| | - José Manuel Suaréz-Peñaranda
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain
| | - Alejandro Ismael Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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Hurník P, Režnarová J, Chyra Z, Motyka O, Putnová BM, Čermáková Z, Blažek T, Fománek M, Gaykalova D, Buchtová M, Ševčíková T, Štembírek J. Enhancing oral squamous cell carcinoma prediction: the prognostic power of the worst pattern of invasion and the limited impact of molecular resection margins. Front Oncol 2023; 13:1287650. [PMID: 38188288 PMCID: PMC10766711 DOI: 10.3389/fonc.2023.1287650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Objective Oral squamous cell carcinoma (OSCC) originates from the mucosal lining of the oral cavity. Almost half of newly diagnosed cases are classified as advanced stage IV disease, which makes resection difficult. In this study, we investigated the pathological features and mutation profiles of tumor margins in OSCC. Methods We performed hierarchical clustering of principal components to identify distinct patterns of tumor growth and their association with patient prognosis. We also used next-generation sequencing to analyze somatic mutations in tumor and marginal tissue samples. Results Our analyses uncovered that the grade of worst pattern of invasion (WPOI) is strongly associated with depth of invasion and patient survival in multivariable analysis. Mutations were primarily detected in the DNA isolated from tumors, but several mutations were also identified in marginal tissue. In total, we uncovered 29 mutated genes, mainly tumor suppressor genes involved in DNA repair including BRCA genes; however none of these mutations significantly correlated with a higher chance of relapse in our medium-size cohort. Some resection margins that appeared histologically normal harbored tumorigenic mutations in TP53 and CDKN2A genes. Conclusion Even histologically normal margins may contain molecular alterations that are not detectable by conventional histopathological methods, but NCCN classification system still outperforms other methods in the prediction of the probability of disease relapse.
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Affiliation(s)
- Pavel Hurník
- Institute of Clinical and Molecular Pathology, University Hospital Ostrava, Ostrava, Czechia
- Institute of Clinical and Molecular Pathology, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Jana Režnarová
- Department of Oral and Maxillofacial Surgery, University Hospital Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, Ostrava University, Ostrava, Ostrava, Czechia
| | - Zuzana Chyra
- Department of Hematooncology, University Hospital Ostrava, Ostrava, Czechia
| | - Oldřich Motyka
- Department of Environmental Engineering, VSB-Technical University of Ostrava, Ostrava, Czechia
| | - Barbora Moldovan Putnová
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Brno, Czechia
- Department of Pathological Morphology and Parasitology, University of Veterinary Sciences Brno, Brno, Czechia
| | - Zuzana Čermáková
- Department of Oncology, University Hospital Ostrava, Ostrava, Czechia
| | - Tomáš Blažek
- Department of Oncology, University Hospital Ostrava, Ostrava, Czechia
| | - Martin Fománek
- Department of Otorhinolaryngology, University Hospital Ostrava, Ostrava, Czechia
| | - Daria Gaykalova
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Otorhinolaryngology-Head and Neck Surgery, Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland Medical Center, Baltimore, MD, United States
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, United States
| | - Marcela Buchtová
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Brno, Czechia
- Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czechia
| | - Tereza Ševčíková
- Department of Hematooncology, University Hospital Ostrava, Ostrava, Czechia
| | - Jan Štembírek
- Department of Oral and Maxillofacial Surgery, University Hospital Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, Ostrava University, Ostrava, Ostrava, Czechia
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Brno, Czechia
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15
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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.
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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
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Kakuguchi W, Ashikaga Y, Yanagawa-Matsuda A, Kuribayashi K, Shinohara S, Ogawa N, Maishi N, Hida K, Fang CY, Ohiro Y. Significant association of Yamamoto-Kohama classification and pathological depth of invasion with cervical lymph node metastasis in early-stage tongue squamous cell carcinoma (Stage I/II). J Dent Sci 2023; 18:1663-1668. [PMID: 37799930 PMCID: PMC10547951 DOI: 10.1016/j.jds.2023.01.036] [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: 12/28/2022] [Revised: 01/27/2023] [Indexed: 02/10/2023] Open
Abstract
Background/purpose Tongue squamous cell carcinoma (SCC) has a poor prognosis due to a high rate of cervical lymph node metastasis (CLNM). We aimed to determine clinicopathological features related to the prediction of CLNM in tongue carcinomas (Stage Ⅰ/Ⅱ). Materials and methods Data from 89 patients with tongue SCC (Stage I/II) were analyzed retrospectively. Patients were treated only with partial glossectomy and not with chemotherapy or radiotherapy until CLNM was observed. No cervical lymph node metastasis survival (NCLNMS) was estimated using the Kaplan-Meier method. The difference in NCLNMS between the groups with and without CLNM was compared using the log-rank test. The Cox regression model was used to estimate hazard ratios and the associated 95% confidence interval. Results Clinical T2, clinical and pathological depth of invasion (cDOI and pDOI, respectively) > 5 mm, Yamamoto-Kohama (YK)-4c, tumor budding ≥5, worst pattern of invasion -4/5, muscle invasion, perineural invasion, and grade of differentiation 3 were found to be significant CLNM risk factors. Conclusion CLNM was observed in 25.8% of early-stage tongue carcinomas (Stage I/II). YK-4c and pDOI >5 mm were the most important CLNM risk factors identified. Close follow-up is needed after partial glossectomy when patients with tongue SCC have other risk factors, particularly YK-4c and pDOI >5 mm.
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Affiliation(s)
- Wataru Kakuguchi
- Department of Oral and Maxillofacial Surgery, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yuichi Ashikaga
- Department of Oral and Maxillofacial Surgery, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Aya Yanagawa-Matsuda
- Department of Vascular Biology and Molecular Pathology, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kazuyo Kuribayashi
- Department of Oral and Maxillofacial Surgery, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Saki Shinohara
- Department of Oral and Maxillofacial Surgery, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
- Department of Dentistry and Oral Surgery, Kushiro Red Cross Hospital, Kushiro, Japan
| | - Naohiro Ogawa
- Department of Oral and Maxillofacial Surgery, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
- Department of Dentistry and Oral Surgery, Azabu Kitami Triology Hospital, Kitami, Japan
| | - Nako Maishi
- Department of Vascular Biology and Molecular Pathology, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kyoko Hida
- Department of Vascular Biology and Molecular Pathology, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Chih-Yuan Fang
- Department of Oral and Maxillofacial Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yoichi Ohiro
- Department of Oral and Maxillofacial Surgery, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
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Ciflik KB, Dogan HT, Dogan E, Ciflik BO, Kocer B, Karaoglanoglu N, Yekeler E. Can tumour budding change the future of pulmonary adenocarcinoma? Pathol Res Pract 2023; 250:154808. [PMID: 37748210 DOI: 10.1016/j.prp.2023.154808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/24/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Pulmonary adenocarcinoma shows different prognosis even in the same pathological subtype and stage. In this study, it is aimed to investigate the relationship between tumour budding and known prognostic values and clinicopathological features in pulmonary adenocarcinoma. METHODS In this study, there have been 77 patients diagnosed with primary pulmonary adenocarcinoma. In the evaluation process, the number of budding between 0 and 4 is accepted as low budding (Bd1), the number of budding between 5 and 9 is considered as medium budding (Bd2), and the number of budding above 10 is considered as high budding (Bd3). RESULTS According to the findings of the study, it can be seen that there is a statistical difference between tumour budding and stromal fibrosis (p < 0.001). The presence of pleural invasion, lymph vascular invasion and perineural invasion in patients with Bd3 is found to be statistically higher than the patients with Bd1 (p = 0.048) (p = 0.041) (p = 0.029). CONCLUSIONS Tumour budding has been associated with pleural invasion, lymph vascular invasion, perineural invasion, and stromal fibrosis. This study is the first to show the relationship between tumour budding and stromal fibrosis in pulmonary adenocarcinomas. The role of tumour budding in lung cancers remains to be clarified.
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Affiliation(s)
| | - Hayriye Tatli Dogan
- Department of Pathology, Ankara Yildirim Beyazit University, Ankara, Turkey.
| | - Elif Dogan
- Department of Pathology, Ankara City Hospital, Ankara, Turkey.
| | | | - Bulent Kocer
- Department of Thoracic Surgery, Ankara City Hospital, Ankara, Turkey.
| | | | - Erdal Yekeler
- Department of Thoracic Surgery, Ankara City Hospital, Ankara, Turkey.
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18
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Binmadi NO, Mohamed YA. Impact of worst pattern of invasion on prognosis of oral squamous cell carcinoma: a systematic review and meta-analysis. J Int Med Res 2023; 51:3000605231206260. [PMID: 37871621 PMCID: PMC10594968 DOI: 10.1177/03000605231206260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/21/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE The relationship between the worst pattern of invasion (WPOI) and the prognosis of oral squamous cell carcinoma (OSCC) remains controversial. This systematic review and meta-analysis was performed to determine the impact of the WPOI on the prognosis of OSCC. METHODS Studies from six databases were assessed for quality using the Newcastle-Ottawa Scale, and data were analyzed using Stata software. RESULTS Eighteen studies involving 3954 patients showed that patients with a WPOI of 4 to 5 had significantly worse overall survival, disease-specific survival, and disease-free survival than patients with a WPOI of 1 to 3. Significant associations of the WPOI with locoregional recurrence and mortality were found. CONCLUSION A higher WPOI was significantly associated with a worse prognosis of OSCC across various outcomes. Incorporating the WPOI into standard histopathological assessments may guide personalized treatments and improve outcomes.
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Affiliation(s)
- Nada O. Binmadi
- Department of Oral Diagnostic Sciences, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Yassmin A. Mohamed
- Oral Maxillofacial Surgery and Oral Pathology Department, Faculty of Dentistry, University of Khartoum
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19
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Chiesa-Estomba CM, Thompson L, Agaimy A, Zidar N, Simpson RHW, Franchi A, Rodrigo JP, Mäkitie AA, Almangush A, Leivo I, Ferlito A. Predictive value of tumor budding in head and neck squamous cell carcinoma: an update. Virchows Arch 2023; 483:441-449. [PMID: 37642731 DOI: 10.1007/s00428-023-03630-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
Head and neck squamous cell carcinoma forms an anatomically and functionally complex group of malignancies. The significant local aggressiveness and frequent regional relapses motivate ongoing research to identify more reliable and sensitive prognostic and predictive biomarkers. One emerging area of cancer biology is the evaluation of tumor budding at the advancing invasive front of various types of epithelial cancers. Recent studies suggest that tumor budding is a relatively common phenomenon in cancer progression and that it may have important prognostic implications for patients due to its potential to provide valuable insights into the biology and clinical behavior of head and neck cancer. In this review, we aim to provide information about tumor budding in head and neck squamous cell carcinoma. Thus, we hope to shed light on the complex biology of these malignancies, as well as aiding diagnostic, classification, and better characterization and thereby, looking for new avenues for improving patient outcomes.
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Affiliation(s)
- Carlos M Chiesa-Estomba
- Department of Otorhinolaryngology, Osakidetza, Donostia University Hospital, Biodonostia Research Institute, 20014, San Sebastian, Spain.
- Otorhinolaryngology Department, Faculty of Medicine, Deusto University, Bilbao, Spain.
| | - Lester Thompson
- Head and Neck Pathology Consultations, Woodland Hills, CA, 91364, USA
| | - Abbas Agaimy
- Institut Für Pathologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nina Zidar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, 1000, Ljubljana, Slovenia
| | | | - Alessandro Franchi
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, 56126, Pisa, Italy
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Program in Systems Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Alhadi Almangush
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, Turku, Finland
| | - Alfio Ferlito
- Coordinator of the International Head and Neck, Scientific Group, Padua, Italy
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20
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Kato K, Miyazawa H, Kobayashi H, Kishikawa Y, Funaki H, Noguchi N, Ooi K, Kawashiri S. The pattern and spread of invasion can predict late cervical lymph node metastasis in early tongue squamous cell carcinoma. Diagn Pathol 2023; 18:87. [PMID: 37537639 PMCID: PMC10398901 DOI: 10.1186/s13000-023-01371-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/06/2023] [Indexed: 08/05/2023] Open
Abstract
To determine the predictive indexes of late cervical lymph node metastasis in early tongue squamous cell carcinoma (TSCC). We retrospectively analyzed the cases of 25 patients with stage I/II TSCC who had undergone surgical treatment without elective neck dissection. We evaluated the relationships between clinicopathologic factors and the occurrence of late cervical lymph node metastasis. Of the 25 cases, metastasis to the cervical lymph nodes was observed in nine cases (36.0%). The clinicopathological factors associated with late cervical lymph node metastasis were the mode of invasion (MOI, p = 0.032), depth of invasion (DOI, p = 0.004), and perineural invasion (PNI, p = 0.040). A multivariate analysis revealed that only the DOI was an independent predictor of late cervical lymph node metastasis. The combination of the DOI and MOI or the PNI and MOI was significantly correlated with late cervical lymph node metastasis (p = 0.004 and p = 0.012, respectively). Our findings suggest that combinations of the MOI, DOI, and PNI could be used as an index for predicting late cervical lymph node metastasis in early TSCC.
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Affiliation(s)
- Koroku Kato
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan.
| | - Hiroki Miyazawa
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Hisano Kobayashi
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Yoshiaki Kishikawa
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Hayato Funaki
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Natsuyo Noguchi
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Kazuhiro Ooi
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Shuichi Kawashiri
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
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21
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Feitosa SG, de Oliveira RV, Bezerra TMM, Chaves FN, Viana KF, de Oliveira DFG, Pereira KMA. Tumor Budding and Poor Prognosis in Oral Cancer: A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2023; 24:2565-2573. [PMID: 37642041 PMCID: PMC10685247 DOI: 10.31557/apjcp.2023.24.8.2565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Tumor budding (TB) has been investigated in several types of solid tumors. In oral cancer, studies show its association with survival. However, for its implementation in routine histological analyses, results with a high certainty of evidence are needed. Therefore, the aim of this systematic review is to explore the association between tumor budding and overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) in oral cancer. METHODS A search was performed in Embase, PubMed, Scopus, Livivo, Web of Science, and Google Scholar. We adopted the following inclusion criteria: studies that evaluate tumor budding in oral cancer, that investigate survival, and presenting cohort design. We excluded reviews and studies without hazard-ratio (HR) data. RESULTS This systematic review included 22 studies and showed an association between TB and survival. High-grade TB is associated with a worse OS in univariate analysis (HR = 3.11; 95% CI: 2.06-4.69, p<0.01) and multivariate analysis (HR = 2.62; 95% CI: 1.64-4.20, p<0.01); with a poorer DSS in univariate (HR = 2.43; 95% CI: 1.94-3.03, p<0.01) and multivariate analysis (HR = 2.01; 95% CI: 1.43-2.83, p< 0.01); and with a worse DFS in univariate (HR = 1.94; 95% CI: 1.44-2.62, p<0.01) and multivariate analysis (HR = 2.15; 95% CI: 1.31-3.53, p< 0.01). Sensitivity analysis showed that the results are robust, and no significant publication bias was identified in univariate analysis for DFS (Egger's test: p = 0.94). The certainty of the evidence was graded as low or very low. CONCLUSION Our findings indicate that TB is an independent prognostic factor of OS, DSS, and DFS in oral cancer. However, further studies are needed to increase the certainty of the evidence.
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Affiliation(s)
- Sthefane Gomes Feitosa
- Postgraduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
| | - Rafael Vidal de Oliveira
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
| | - Thâmara Manoela Marinho Bezerra
- Postgraduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
| | - Filipe Nobre Chaves
- School of Dentistry, Federal University of Ceará Campus Sobral, Sobral, Brazil.
| | - Khalil Fernandes Viana
- Postgraduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
| | | | - Karuza Maria Alves Pereira
- Postgraduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil.
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, Brazil.
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22
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Stögbauer F, Beck S, Ourailidis I, Hess J, Poremba C, Lauterbach M, Wollenberg B, Buchberger AMS, Jesinghaus M, Schirmacher P, Stenzinger A, Weichert W, Boxberg M, Budczies J. Tumour budding-based grading as independent prognostic biomarker in HPV-positive and HPV-negative head and neck cancer. Br J Cancer 2023; 128:2295-2306. [PMID: 37045906 PMCID: PMC10241901 DOI: 10.1038/s41416-023-02240-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The prognostic significance of tumour budding (TB) and minimal cell nest size (MCNS) was shown in human papillomavirus (HPV)-negative head and neck squamous cell carcinomas (HNSCC). However, the optimisation of cutpoints, the prognostic impact in HPV-positive HNSCC, and the comparison with other histopathological grading systems are insufficiently investigated. METHODS TB and MCNS were analysed digitally in 1 and 10 high-power fields (HPF) of 331 HPV-positive and HPV-negative cases from TCGA. Optimising the cutpoints a new cellular dissociation grading (CDG) system was defined and compared to the WHO grading and the Brandwein-Gensler (BG) risk model. RESULTS The two-tiered CDG system based solely on TB yielded optimal prognostic stratification with shortened overall survival for CDG-high cases. Optimal cut-offs were two buds (1 HPF) and six buds (10 HPF), respectively. Analysing MCNS did not add prognostic significance to quantifying TB. CDG was a significant prognostic marker in HPV-negative and HPV-positive tumours and prognostically superior to the WHO and BG systems. High CDG was associated with clinically occult lymph-node metastases. CONCLUSIONS The most comprehensive study of TB in HNSCC so far confirmed its prognostic impact in HPV-negative tumours and for the first time in HPV-positive tumours. Further studies are warranted to evaluate its applicability for therapy guidance in HNSCC.
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Grants
- Speaker’s fees: AstraZeneca, Incyte, Janssen. Advisory Boards: BMS, MSD, AstraZeneca, Roche. Funding for research: Roche, Chugai, BMS, Novartis.
- Advisory Board/Speaker’s Bureau: Astra Zeneca, AGCT, Bayer, BMS, Eli Lilly, Illumina, Janssen, MSD, Novartis, Pfizer, Roche, Seattle Genetics, Takeda, Thermo Fisher. Grants: Bayer, BMS, Chugai, Incyte.
- Advisory Boards and speaker’s fees: Roche, MSD, BMS, AstraZeneca, Pfizer, Merck, Lilly, Boehringer, Novartis, Takeda, Bayer, Amgen, Astellas, Eisai, Illumina, Siemens, Agilent, ADC, GSK and Molecular Health. Funding for research: Roche, MSD, BMS and AstraZeneca.
- Deutsche Krebshilfe (German Cancer Aid)
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Affiliation(s)
- Fabian Stögbauer
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany
| | - Susanne Beck
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Iordanis Ourailidis
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Jochen Hess
- Section Experimental and Translational Head and Neck Oncology, Department of Otolaryngology, Head and Neck Surgery, University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | | | - Maren Lauterbach
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
| | - Barbara Wollenberg
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
| | - Anna Maria Stefanie Buchberger
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
| | - Moritz Jesinghaus
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany
- Institute of Pathology, University Hospital Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Peter Schirmacher
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany
| | - Albrecht Stenzinger
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany
| | - Wilko Weichert
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany
| | - Melanie Boxberg
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany.
- Pathologie München-Nord, 80992, Munich, Germany.
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany.
| | - Jan Budczies
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany.
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany.
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23
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Beute JE, Greenberg LA, Wein LE, Kapustin DA, Fan J, Dowling EM, Samankan S, Matloob A, Xing M, Modica I, Chung D, Carroll W, Rosenthal EL, Khan MN, Chai RL, Brandwein-Weber MS, Urken ML. WPOI-5: Accurately Identified at Intraoperative Consultation and Predictive of Occult Cervical Metastases. Head Neck Pathol 2023; 17:479-486. [PMID: 36849672 PMCID: PMC10293149 DOI: 10.1007/s12105-023-01533-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/12/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Frozen section analysis of oral cancer specimens is ideal for assessing margin distances and depth of invasion (DOI); the latter impacts intraoperative decisions regarding elective neck dissection (END). Here, we show that intraoperative determination of worst pattern of invasion (WPOI), specifically WPOI-5, has a high level of accuracy. This relates to our demonstration herein that WPOI-5 predicts occult cervical metastases (OCM) for pT1 oral squamous carcinoma (OSC). METHODS The presence of OCM was correlated with WPOI in 228 patients with primary T1/T2/cN0 OSC undergoing resection and END. Concordance between intraoperative and final pathology WPOI determination was assessed on 51 cases of OSC. RESULTS WPOI-5 predicts OCM in pT1 patients, compared with WPOI-4/WPOI-3 (p < 0.0001). Most pT1 WPOI-5 tumors had DOI of 4-5 mm (24/59 or 40.7%). Only two pT1 WPOI-5 tumors had DOI < 4 mm (3.0 and 3.5 mm). If END were performed in this pT1 cohort for all WPOI-5 OSC patients regardless of DOI, OR all OSC patients with DOI ≥ 4 mm regardless of WPOI, then no OCM would be missed (p = 0.017, 100% sensitivity, 29% specificity, 77% positive predictive value, 23% negative predictive value). With respect to intraoperative WPOI-5 determination, the accuracy, sensitivity, and specificity was 92.16, 73.33, and 100.0%, respectively. CONCLUSIONS DOI ≥ 4 mm is the dominant predictor of OCM. For the rare WPOI-5 OSC with DOI < 4 mm, it is reasonable to suggest that surgeons perform END. WPOI-5 may be accurately determined intraoperatively. As microscopic instruction is needed to accurately assess WPOI-5, a teaching link is included in this manuscript.
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Affiliation(s)
- John E Beute
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Lily A Greenberg
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Lauren E Wein
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Danielle A Kapustin
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, 10003, USA.
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 5B, New York, NY, 10003, USA.
| | - Jun Fan
- Department of Pathology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY, 10029, USA
| | - Eric M Dowling
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Shabnam Samankan
- Department of Pathology, George Washington University, 2300 M Street NW, 7Th Floor, Washington, DC, 20037, USA
| | - Ammar Matloob
- Department of Pathology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY, 10029, USA
| | - Monica Xing
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Ippolito Modica
- Department of Pathology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY, 10029, USA
| | - Daniel Chung
- Department of Pathology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY, 10029, USA
| | - William Carroll
- Department of Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eben L Rosenthal
- Department of Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21St Avenue South Suite 6310, Medical Center East - South Tower, Nashville, TN, 37232-8605, USA
| | - Mohemmed Nazir Khan
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Raymond L Chai
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
| | - Margaret S Brandwein-Weber
- Department of Pathology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY, 10029, USA
| | - Mark L Urken
- Thyroid, Head and Neck Cancer (THANC) Foundation, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 5B, New York, NY, 10003, USA
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24
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Hyytiäinen A, Mroueh R, Peltonen J, Wennerstrand P, Mäkitie A, Al-Samadi A, Ventelä S, Salo T. Prognostic histological markers in oral tongue squamous cell carcinoma patients treated with (chemo)radiotherapy. APMIS 2023; 131:142-151. [PMID: 36695633 DOI: 10.1111/apm.13298] [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: 10/17/2022] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Abstract
Treatment of oral tongue squamous cell carcinoma (OTSCC) frequently includes surgery with postoperative radiotherapy (RT) or chemoradiotherapy (CRT). Resistance to RT or CRT remains a major clinical challenge and highlights the need to identify predictive markers for it. We included 71 OTSCC patients treated with surgery combined with RT or CRT. We evaluated the association between tumor budding, tumor-stroma ratio (TSR), depth of invasion (DOI), tumor-infiltrating lymphocytes (TILs), hypoxia-inducible factor-1alpha (HIF-1alpha) expression, octamer-binding transcription factor 4 (OCT4) expression, high-endothelial venules (HEVs), and disease-free survival (DFS) using uni- and multivariate analyses. No significant association was observed between the different histological and molecular markers (TSR, DOI, TILs, HEV, HIF-1alph, OCT4) and DFS. However, an associative trend between DOI, budding, and DFS was noted. Further studies with larger cohorts are needed to explore the prognostic value of DOI and budding for OTSCC patients treated with postoperative RT or CRT.
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Affiliation(s)
- Aini Hyytiäinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Rayan Mroueh
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.,Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer and Research, Helsinki, Finland
| | - Johanna Peltonen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Pia Wennerstrand
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sami Ventelä
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland.,Department for Otorhinolaryngology, Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland.,FICAN West Cancer Centre, Turku, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland.,Department of Pathology, Helsinki University Hospital (HUS), Helsinki, Finland
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25
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[Staging cancers of the oral cavity according to the 8th edition of AJCC TNM system: Issues and recommendations]. Ann Pathol 2023:S0242-6498(22)00209-7. [PMID: 36822900 DOI: 10.1016/j.annpat.2022.12.003] [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: 02/22/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 02/23/2023]
Abstract
Stage of cancer at the time of the diagnosis is a key factor for the prognosis and the determination of appropriate treatment. Several cancer staging systems are used worldwide. The most useful staging system is the tumor, node and metastasis (TNM) staging system develop by the American Joint Committee on Cancer (AJCC) in collaboration with the Union for International Cancer Control (UICC) referred to as the AJCC TNM staging system. The AJCC TNM system classifies cancers by the size and extend of the primary tumor (T), involvement of regional lymph nodes (N) and the presence of distant metastases (M). AJCC and UICC periodically modify the AJCC TNM staging system according to newly acquired clinical, pathological and biological data improving understanding of cancer physiopathology. The 8th edition of AJCC TNM system is effective for cancer patients diagnosed on or after January 1, 2018. Here, we report the issues of the staging cancers of the oral cavity according to the 8th edition of AJCC TNM system. We focus on 2 new concepts defined in the 8th edition of AJCC TNM system: depth of invasion (DOI) and extranodal extension (ENE).
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26
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Yosefof E, Tzelnick S, Wallach L, Miller Y, Strenov Y, Bachar G, Shpitzer T, Mizrachi A. Tumor Satellites Are Associated With Poor Outcome in Patients With Oral Cancer. Laryngoscope 2023; 133:336-343. [PMID: 35543405 DOI: 10.1002/lary.30156] [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: 12/24/2021] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Tumor satellites are defined as islands of tumor cells completely separated from the border of the main tumor. They are believed to be a sign of aggressive disease. Our goal was to investigate the association between tumor satellites and outcome in patients with oral squamous cell carcinoma. MATERIALS AND METHODS A retrospective analysis of all patients treated for oral squamous cell carcinoma at a university-affiliated tertiary care center between 2010 and 2018 was performed. Data collected included demographics, clinical and pathological features including tumor satellites, staging, treatment modalities, and outcomes. RESULTS A total of 144 patients were included. The mean age of all patients was 63.5 and 50.7% were males. The mean follow-up time was 40.5 months. Seventeen patients (11.8%) had tumor satellites. These patients had a higher rate of involved margins, peri-neural invasion, lympho-vascular invasion, and extra-nodal extension. Tumor, nodal and overall classification were significantly more advanced in patients with satellites. Disease-specific and overall survival rates were significantly lower among satellites patients (28.7% vs. 59.7% and 28.7% vs. 54.9%, respectively). CONCLUSIONS Tumor satellites are associated with several adverse features and advanced locoregional disease. Patients with satellites should be treated aggressively with a combination of surgery aimed at achieving free surgical margins and adjuvant treatment, as they have a worse prognosis compared with patients without satellites. Further prospective studies are mandatory to consolidate the importance of adjuvant treatment in these patients. LEVEL OF EVIDENCE 3 Laryngoscope, 133:336-343, 2023.
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Affiliation(s)
- Eyal Yosefof
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Tzelnick
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Leemor Wallach
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Miller
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yulia Strenov
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pathology, Rabin Medical Center, Petah Tikva, Israel
| | - Gideon Bachar
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Thomas Shpitzer
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviram Mizrachi
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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27
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de Morais EF, de Farias Morais HG, de Moura Santos E, Barboza CAG, Téo FH, Salo T, Coletta RD, de Almeida Freitas R. TWIST1 regulates proliferation, migration, and invasion and is a prognostic marker for oral tongue squamous cell carcinoma. J Oral Pathol Med 2023; 52:127-135. [PMID: 36285599 DOI: 10.1111/jop.13377] [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: 09/16/2022] [Accepted: 10/04/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Epithelial-mesenchymal transition is one of the main mechanisms for tumor progression and metastasis. Transcription factors such as TWIST1 are key regulators of the epithelial-mesenchymal transition and are regarded as potential therapeutic targets for the treatment of cancer. The purpose of this study was to examine TWIST1 as a possible epithelial-mesenchymal transition-related prognostic biomarker in oral epithelial dysplasia and oral tongue squamous cell carcinomas, as well as the biological behavior of TWIST1-silencing in oral tongue squamous cell carcinomas cell lines. METHODS Immunohistochemical analysis of TWIST1, E-cadherin, and N-cadherin was carried out in 47 samples representing oral epithelial dysplasia and 41 oral tongue squamous cell carcinomas. The suppression of TWIST1 expression was performed using shRNA-expression vectors in HSC-3 and SCC-9 cells to investigate in vitro the impact of TWIST1 on proliferation, apoptosis, viability, migration, and invasion of SCC-9 and HSC-3 cells. RESULTS The expression of nuclear TWIST1 was significantly higher in oral tongue squamous cell carcinomas than in oral epithelial dysplasis (p < 0.0001), whereas TWIST1 in the cytoplasm was more expressed in oral epithelial dysplasis (p = 0.012). The high cytoplasmic expression of TWIST1 was significantly associated with shortened overall survival (p < 0.05), and increased nuclear TWIST1 expression was significantly related to high risk of recurrence (p = 0.03). Knockdown of TWIST1 in oral tongue squamous cell carcinomas cells induced the expression of E-cadherin and inhibited N-cadherin, which were followed by decreased proliferation, migration, and invasion. CONCLUSIONS Our research suggests that TWIST1 is linked to the development of oral tongue carcinogenesis and may be used as a prognostic indicator and therapeutic target for oral tongue squamous cell carcinomas patients.
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Affiliation(s)
| | | | | | | | - Fábio Haach Téo
- Department of Oral Diagnosis, School of Dentistry, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Tuula Salo
- Cancer and Translational Medicine Research Unit, Faculty of Medicine and Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.,Department of Pathology, Helsinki University Hospital, Institute of Oral and Maxillofacial Disease, University of Helsinki, and HUSLAB, Helsinki, Finland
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, University of Campinas (UNICAMP), Piracicaba, Brazil.,School of Dentistry, University of Campinas, Piracicaba, Brazil
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28
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Derani H, Becker AS, Hakenberg O, Erbersdobler A. Evaluation of the Cellular Dissociation Grading, Based on Tumor Budding and Cell Nest Size, in Squamous Cell Carcinoma of the Penis. Cancers (Basel) 2022; 14:4949. [PMID: 36230870 PMCID: PMC9564293 DOI: 10.3390/cancers14194949] [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: 08/25/2022] [Revised: 09/23/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
The "Cellular Dissociation Grade" (CDG) is based on tumor cell budding and cell nest size. Many studies have examined the CDG in squamous cell carcinomas of other organs such as the lungs, oral cavity, pharynx, larynx, cervix and esophagus. In this study, the CDG was examined in 109 cases of invasive penile squamous cell carcinoma that were treated at the University Medicine Rostock between 2014 and 2022. Furthermore, its correlation with the pathologic status of regional lymph nodes (pN) as the main prognostic factor was verified. Finally, cellular dissociation grading was compared with classic WHO grading. The results showed that pN in penile squamous cell carcinoma showed a highly significant association with the CDG and no statistically significant association with WHO grading. These results support the notion that cellular dissociation grading is an important prognostic factor for squamous cell carcinoma.
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Affiliation(s)
- Hayel Derani
- Institute of Pathology, University Medicine Rostock, 18055 Rostock, Germany
| | - Anne-Sophie Becker
- Institute of Pathology, University Medicine Rostock, 18055 Rostock, Germany
| | - Oliver Hakenberg
- Department of Urology, University Medicine Rostock, 18055 Rostock, Germany
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29
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Fan J, DeFina SM, Wang H. Prognostic Value of Selected Histologic Features for Lung Squamous Cell Carcinoma. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2022; 7:165-168. [PMID: 36247021 PMCID: PMC9563092 DOI: 10.14218/erhm.2021.00071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The recent histologic subtyping of lung adenocarcinoma has demonstrated the prognostic values of histologic patterns in this malignancy. However, the histological features of lung squamous cell carcinoma (SCC) are much less established. This short review discusses several promising histological prognostic markers for SCC, including tumor budding, tumor cell nesting, and the spreading of tumors through air spaces. Wherever appropriate, the biological significance of these morphological features was also discussed. The investigators consider that histological prognostic markers are highly valuable in understanding the cancer biology of SCC, and in guiding clinical treatment. However, larger clinical cohorts are needed to better establish the prognostic values of the aforementioned histological markers. The application of modern technologies, including machine-learning, would make the histological analysis accurate and reproducible.
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Affiliation(s)
- Justine Fan
- The Haverford School, 450 Lancaster Ave., Haverford, PA, USA
| | - Samuel M. DeFina
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - He Wang
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
- Correspondence to: He Wang, Department of Pathology, Yale University School of Medicine, New Haven, CT 06510, USA. Tel: +1-203-214-2786, Fax: +1-203-214-5007,
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30
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Kligerman MP, Moon PK, Tusty M, Cloutier JM, Ma Y, Holsinger CF, Divi V. Impact of Histologic Risk Factors on Recurrence Rates for Oral Cavity Squamous Cell Carcinoma. Ann Otol Rhinol Laryngol 2022:34894221111223. [PMID: 35899590 DOI: 10.1177/00034894221111223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study assesses the impact of adverse histologic risk factors including worst pattern of invasion (WPOI), predominant pattern of invasion (PPOI), tumor budding, and tumor infiltrating lymphocytes (TILS), on risk of recurrence in patients with early-stage Oral Cavity Squamous Cell Carcinoma (OCSCC). METHODS Retrospective chart review was performed at a single institution to identify patients with OCSCC who underwent surgical excision. Inclusion criteria included T1-T2 stage disease based on AJCC seventh edition guidelines, no cervical lymph node involvement, no perineural invasion (PNI), no lymphovascular invasion (LVI), no post-operative adjuvant radiation therapy, and cancer involving only the oral tongue or floor of mouth. Patients were excluded if they had positive final margins. A subset of 35 patients were selected for additional histologic review to determine WPOI, PPOI, TB, and TILS. Bivariable and multivariable cox analysis were performed to determine variables associated with recurrence. RESULTS One hundred and sixty-one patients met criteria and were included in the analysis. Variables that were significantly associated with recurrence on bivariable analysis included tumors with high risk PPOI (groups 4 and 5; P = .021), TB with 10 or more buds (P = .021), T-stage (P = .001), neck dissection (P = .03), and depth of invasion (DOI) >4 mm (P = .044). Multivariable cox proportional hazards found T-stage (HR: 6.40; 95% CI 1.67, 24.50; P = .007), neck dissection (HR: 0.23; 95% CI 0.07, 0.82; P = .023), and TBs (HR: 1.17; 95% CI 1.05, 1.30; P = .006) to be most predictive of recurrence. CONCLUSIONS TB is a strong predictor of recurrence. WPOI, PPOI, and TILS were not statistically significant risk factors for recurrence.
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Affiliation(s)
- Maxwell P Kligerman
- Department of Otolaryngology/Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | - Peter K Moon
- School of Medicine, Stanford University, Stanford, CA, USA
| | - Mahbuba Tusty
- School of Medicine, Stanford University, Stanford, CA, USA
| | | | - Yifei Ma
- Department of Otolaryngology/Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | | | - Vasu Divi
- Department of Otolaryngology/Head and Neck Surgery, Stanford University, Stanford, CA, USA
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The Emerging Impact of Tumor Budding in Oral Squamous Cell Carcinoma: Main Issues and Clinical Relevance of a New Prognostic Marker. Cancers (Basel) 2022; 14:cancers14153571. [PMID: 35892830 PMCID: PMC9332070 DOI: 10.3390/cancers14153571] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023] Open
Abstract
Tumor Budding (TB) represents a single cancer cell or a small cluster of less than five cancer cells on the infiltrative tumor front. Accumulating evidence suggests TB is an independent prognostic factor in oral squamous cell carcinoma (OSCC). However, its exact role is not yet elucidated, and a standardized scoring system is still necessary. The study aims to extensively review the literature data regarding the prognostic role of TB in OSCC. The results of TB are an independent prognostic factor of poor survival outcomes in OSCC. To date, the manual detection of hematoxylin and eosin-staining or pancytokeratin-immunostaining sections are the most commonly used methods. Between the several cut-offs, the two-tier system with five buds/field cut-offs provides better risk stratification. The prognostic role of the BD model in predicting survival outcomes was extensively validated; however, the inclusion of DOI, which is already a staging parameter, encouraged other authors to propose other models, integrating TB count with other adverse risk factors, such as the tumor–stroma ratio and tumor-infiltrated lymphocytes. The prognostic relevance of TB in OSCC highlights its evaluation in daily pathological practice. Therefore, the TB detection method and the TB scoring system should be validated based on tumor stage and site.
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Yoshizawa K, Kimura Y, Moroi A, Ishii H, Sakurai D, Saitoh M, Oishi N, Kondo T, Toyoura M, Ueki K. Loss of intercellular bridges in the depth of invasion measurement area is a novel negative prognostic factor for oral squamous cell carcinoma: A retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:84-92. [PMID: 35595622 DOI: 10.1016/j.oooo.2022.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/27/2022] [Accepted: 02/28/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aimed to evaluate intercellular bridges in the depth of invasion (DOI) measurement area as prognostic factors in oral squamous cell carcinoma (OSCC). STUDY DESIGN The mode of invasion was determined based on the Yamamoto-Kohama classification system by observing the hematoxylin-eosin-stained whole-slide images of specimens obtained from 78 patients with OSCC, and the clinicopathologic features were characterized. The presence of intercellular bridges was analyzed in 46 patients with Yamamoto-Kohama classification grade ≥3 whose DOI was measured by dividing the measurement area into 3 parts: the surface, center, and front of the tumor. RESULTS Univariate analyses identified lymph node metastasis, loss of intercellular bridges in the DOI measurement area, DOI of ≥4500 µm, and pattern of invasion 4C-4D as negative prognostic factors. Multivariate analyses revealed that lymph node metastasis and the loss of intercellular bridges in the entire area were independent factors, with hazard ratios of 9.34 (95% confidence interval, 2.09-42.03; P = .003) and 3.64 (95% confidence interval, 1.10-11.99; P = .045), respectively. CONCLUSIONS Loss of intercellular bridges in the DOI measurement area is a negative prognostic factor for OSCC and may be useful in selecting treatment.
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Affiliation(s)
- Kunio Yoshizawa
- Associate Professor, Department of Oral and Maxillofacial Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan.
| | - Yujiro Kimura
- Graduate Student, Department of Oral and Maxillofacial Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Akinori Moroi
- Lecturer, Department of Oral and Maxillofacial Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Hiroki Ishii
- Lecturer, Department of Otolaryngology-Head and Neck Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Daiju Sakurai
- Professor, Department of Otolaryngology-Head and Neck Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Masao Saitoh
- Professor, Center for Medical Education and Sciences, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Naoki Oishi
- Associate Professor, Department of Pathology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Tetsuo Kondo
- Professor, Department of Pathology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Masahiro Toyoura
- Associate Professor, Department of Computer Science and Engineering, Faculty of Engineering, University of Yamanashi, Kofu, Yamanashi, Japan
| | - Koichiro Ueki
- Professor, Department of Oral and Maxillofacial Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
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Kallarakkal TG, Siriwardena BSMS, Samaranayaka A, De Silva R, Tilakaratne WM. A validated predictive model for risk of nodal metastasis in node negative oral squamous cell carcinoma of the buccal mucosa and tongue. J Oral Pathol Med 2022; 51:436-443. [PMID: 35315944 DOI: 10.1111/jop.13294] [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: 11/21/2021] [Revised: 01/25/2022] [Accepted: 03/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Lymph node metastasis in oral squamous cell carcinoma (OSCC) is influenced by clinical and histopathological variables. The aim of this study was to develop a simple model to predict nodal metastasis of OSCC in clinically negative necks (cN0). METHODS Data from patients who underwent surgery for treatment of OSCC of the tongue or buccal mucosa with neck dissection were used for model development and validation. RESULTS Nodal metastasis was significantly associated with gender, age, tumor size, site, pattern of invasion and depth of invasion on univariate analysis. All the five variables except age were retained at the variable selection step of the model development and were used in the final model because it was not significant at 0.10 significance level after adjusting for other variables. Regression coefficients of the model were used to estimate risks of nodal metastases for each combination of clinicopathological characteristics. A 10-fold cross-validation was used to assess the model. The average of the resultant 10 AUCs (along with its 95% confidence interval estimated using bootstrap) was used as the overall validated measure of the model. A risk chart was produced using probability of nodal metastasis predicted by the model for each combination of five characteristics. The model's ability to identify patients with nodal metastases as assessed by the area under the ROC curve (AUC) was 0.752. CONCLUSION The model based on established clinicopathological variables has been internally validated on a large cohort of patients and offers practicability for use in OSCCs of the tongue and buccal mucosa.
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Affiliation(s)
- Thomas George Kallarakkal
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Ariyapala Samaranayaka
- Biostatistics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Rohana De Silva
- Oral and Maxillofacial Surgery, Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Wanninayake M Tilakaratne
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Laksmi LI, Seja IA, Warli SM. The Association between Tumor Budding Peritumoral and Histologic Grade in Penile Squamous Cell Carcinoma. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
ABSTRACTIntroduction Squamous cell carcinoma (SCC) is the largest type of Penile Cancer, which is usually lymphomatous that spreads to the inguinal lymph nodes. Inguinal lymph node metastases are the most important factor in predicting survival in penile SCC and therapy choices. Tumor budding is a biological phenomenon that has been described in malignancies and have both predictive and independent significant prognostic. Lack of information about tumor budding in penile SCC. This study determines whether there is a correlation between tumor budding peritumoral with histological grade in penile SCC.
Materials and Methods : Samples are taken from the paraffin blocks of patients diagnosed with penile SCC. The tumor budding peritumoral evaluation was classified as less 5 buds (low grade) and five or more buds (high grade) using H&E staining. Histological grade of penile SCC is assessed based on the WHO, and ISUP grade scoring system evaluated based on nuclear pleomorphism with varying amounts of keratin production, which is divided into 3 grade; grade I (well-differentiated carcinoma), grade II (moderately differentiated carcinoma), grade III (poorly differentiated carcinoma). The correlation of tumor budding peritumoral with histopathological grade in penile SCC was analyzed statistically.
Results The mean age of SCC patient was 51.16 years old with range 60-69 years old had the most respondents. The glans penis is the most prevalent site for a tumor, with stage IIIB is being the most dominant stage. The majority of the samples were from lymph node metastases. The majority of peritumoral budding tumors (60.7 percent) had high-grade budding.
Conclusions This research discovered a significant correlation between peritumoral budding tumors and grade histopathology of Penile SCC (p-value = 0.0005).
Keywords: Tumor budding, peritumoral, histopathological grade, penile SCC
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Li ZW, He L, Zheng Z, Zhang Q, Xu YT, Chen JY, Shi J, Huang WB, Fan XS. Combined assessment of tumor cell nest size and desmoplastic reaction as an excellent prognostic predictor in esophageal squamous cell carcinoma. Histopathology 2022; 80:1112-1120. [PMID: 35353393 DOI: 10.1111/his.14657] [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: 01/18/2022] [Revised: 03/08/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022]
Abstract
AIMS Tumor budding (TB) activity, cell nest size (CNS) and desmoplastic reaction (DR) have been confirmed to be significantly correlated with prognosis in esophageal squamous cell cancer (ESCC) recently. However, there is limited data on the prognostic significance of combined assessment of cellular dissociation and tumor stroma in ESCC. METHODS 265 cases with resected ESCCs diagnosed between January 2018 and August 2019 were retrospectively reviewed. All slides were reviewed for assessing TB, CNS and DR. Cellular Dissociation Grading and our Combined CNS and DR (CNS/DR) Grading system was adopted to re-grade ESCCs. RESULTS High TB activity, small CNS and immature DR had a strong association with shorter overall survival (OS) and progression-free survival (PFS) (P<0.001, respectively) in ESCC. Combined assessment of CNS and DR in a 4-tiered grading system displayed a prognostic excellence for survival (P<0.001), and outperformed the Cellular Dissociation Grading for both OS (area under the curve [AUC], 0.728 vs 0.644, P=0.043) and PFS (AUC, 0.763 vs 0.667, P=0.018) by Receiver operator characteristic curves. Besides, Combined CNS/DR Grading showed superiority in recognizing G4 subgroup with the worst outcome in our cohort, to whom the most urgent attention needs to be called. CONCLUSIONS This is the first study to propose a novel Combined Grading system based on CNS and DR in ESCC,which has been demonstrated to be relatively superior to Cellular Dissociation Grading in predicting prognosis. The findings shed new light on the histopathological grading of ESCC and facilitate identifying biologically aggressive ESCCs.
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Affiliation(s)
- Zhi-Wen Li
- Department of Pathology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.,Department of Pathology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Lu He
- Department of Pathology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Zhong Zheng
- Department of Pathology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Qian Zhang
- Department of Pathology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
| | - Yu-Ting Xu
- Department of Pathology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Jie-Yu Chen
- Department of Pathology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Jiong Shi
- Department of Pathology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Wen-Bin Huang
- Department of Pathology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
| | - Xiang-Shan Fan
- Department of Pathology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
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Mascitti M, Togni L, Caponio C, Zhurakivska K, Lo Muzio L, Rubini C, Santarelli A, Troiano G. Prognostic significance of tumor budding thresholds in oral tongue squamous cell carcinoma. Oral Dis 2022. [PMID: 35316866 DOI: 10.1111/odi.14193] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/28/2022] [Accepted: 03/15/2022] [Indexed: 11/26/2022]
Abstract
Oral tongue squamous cell carcinoma (OTSCC) represents the most common malignancy of the oral cavity. Tumor budding (TB) is a reliable prognostic factor in OTSCC; however, a standardized scoring system is not still validated. The study aims to evaluate the prognostic role of TB in 211 OTSCC patients treated between 1997-2018. TB was evaluated on haematoxylin and eosin-stained sections in the hotspot area of the infiltrative front (×200-magnification). It was scored using a two-tier, a three-tier system, and according to BD-model and revised-Grading system. Univariate and multivariate Cox regression analyses of disease-specific survival (DSS) and disease-free survival (DFS) were performed. A p-values<0.05 was considered as statistically significant. The two-tier and three-tier system resulted an independent prognostic factor of DSS. High-risk patients had a 2.21 and 3.08 times-increased probability of poor DSS compared to low-risk group. It is significantly increased even for intermediate-risk group. No significant differences emerged classifying patients according to BD-model and revised-Grading. These data confirm the prognostic value of TB in predicting DSS in OTSCC. Classifying patients in two groups using the 5-buds cut-off significantly discriminates their outcomes. Since the established role of DOI and the poor prognostic value of grading, TB could be considered an independent prognostic marker.
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Affiliation(s)
- Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Lucrezia Togni
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Carlo Caponio
- Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy
| | | | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy
| | - Corrado Rubini
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Andrea Santarelli
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy.,National Institute of Health and Science of Ageing, IRCCS INRCA, Ancona, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy
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Almangush A, Mäkitie AA, Leivo I. Cellular dissociation: a missing item in the pathology report and histologic grading of oral tongue cancer? Virchows Arch 2022; 480:717-718. [PMID: 35013773 DOI: 10.1007/s00428-022-03270-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 12/22/2021] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Alhadi Almangush
- Department of Pathology, University of Helsinki, 3 (P.O. Box 21), N00014, HaartmaninkatuHelsinki, Finland. .,Faculty of Medicine, Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland. .,Institute of Biomedicine, Pathology, University of Turku, Turku, Finland. .,Faculty of Dentistry, Misurata University, Misurata, Libya.
| | - Antti A Mäkitie
- Faculty of Medicine, Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland.,Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, Turku, Finland.,Turku University Central Hospital, Turku, Finland
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38
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Jiang H, Yang Y, Qian Y, Shao C, Lu J, Bian Y, Zheng J. Tumor Budding Score Is a Strong and Independent Prognostic Factor in Patients With Pancreatic Ductal Adenocarcinoma: An Evaluation of Whole Slide Pathology Images of Large Sections. Front Oncol 2021; 11:740212. [PMID: 34917500 PMCID: PMC8668607 DOI: 10.3389/fonc.2021.740212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/08/2021] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVE We aimed to develop the tumor budding (TB) score and to explore the association between the TB score and overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS In this retrospective study, 130 consecutive patients with PDAC underwent surgical resection between July 2016 and March 2019. The location and counts of TB were assessed based on the digitalized whole slide hematoxylin and eosin images. The TB score was achieved using the Cox regression equation. The cutoff point for the TB score was determined by X-tile. Univariate and multivariate Cox regression models were used to analyze the association between the TB score and OS. RESULTS The TB score was 0.49 (range = 0-1.08), and the best cutoff for the TB score was 0.62. The duration of survival in individuals with a low TB score [median = 21.8 months, 95% confidence interval (CI) = 15.43-25.50] was significantly longer than that in those with a high TB score (median = 11.33 months, 95% CI = 9.8-14.22). Univariate analysis revealed that the TB score was significantly associated with OS [hazard ratio (HR) = 2.71, 95% CI = 1.48-4.96, p = 0.001]. Multivariate analysis revealed a strong and independent association between the TB score and OS (HR = 2.35, 95% CI = 1.27-4.33, p = 0.03). The high TB score group had a 2.14 times higher mortality than the low TB score group. CONCLUSION The TB score is strongly and independently associated with the risk of OS in PDAC.
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Affiliation(s)
- Hui Jiang
- Department of Pathology, Changhai Hospital, The Naval Military Medical University, Shanghai, China
| | - Yelin Yang
- Department of Pathology, Changhai Hospital, The Naval Military Medical University, Shanghai, China
| | - Yuping Qian
- Department of Pathology, Changhai Hospital, The Naval Military Medical University, Shanghai, China
| | - Chengwei Shao
- Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jianping Lu
- Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yun Bian
- Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jianming Zheng
- Department of Pathology, Changhai Hospital, The Naval Military Medical University, Shanghai, China
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Müller T, Demes M, Lehn A, Köllermann J, Vallo S, Wild PJ, Winkelmann R. The peri- and intratumoral immune cell infiltrate and PD-L1 status in invasive squamous cell carcinomas of the penis. Clin Transl Oncol 2021; 24:331-341. [PMID: 34449004 PMCID: PMC8794908 DOI: 10.1007/s12094-021-02694-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/08/2021] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Penile carcinomas are rare tumors throughout Europe. Therefore, little attention is drawn to this disease. That makes it important to study tumor-associated key metrics and relate these to known data on penile neoplasias. MATERIALS AND METHODS A cohort of 60 well-defined penile invasive carcinomas with known human papillomavirus (HPV) infection status was investigated. Data on tumor type, grading and staging were recorded. Additionally, data on the peri- and intratumoral immune cell infiltrate in a semiquanititave manner applying an HE stain were assessed. RESULTS Our study showed a significant correlation of immune cell infiltrate and pT stage with overall survival. Therefore, in a subset of tumors, PD-L1 staining was applied. For tumor proportion score (TPS), 26 of 30 samples (87%) were scored >0%. For the immune cell score (IC), 28 of 30 samples (93%) were defined as >0% and for CPS, 29 of 30 samples (97%) scored >0. PD-L1 expression was not associated with overall survival. CONCLUSION PD-L1 is expressed in penile carcinomas, providing a rationale for targeted therapy with checkpoint inhibitors. We were able to show that immune reaction appears to be prognostically relevant. These data enhance the need for further studies on the immune cell infiltrate in penile neoplasias and show that PD-L1 expression is existent in our cohort, which may be a potential target for checkpoint inhibitor therapy.
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Affiliation(s)
- T Müller
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - M Demes
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - A Lehn
- Institute of Biostatistics and Mathematical Modeling, Goethe University, Frankfurt am Main, Germany
| | - J Köllermann
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - S Vallo
- Institute of Virology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - P J Wild
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany.,Frankfurt Institute for Advanced Studies (FIAS), Frankfurt am Main, Germany
| | - R Winkelmann
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany.
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Bruschini R, Maffini F, Chiesa F, Lepanto D, De Berardinis R, Chu F, Tagliabue M, Giugliano G, Ansarin M. Oral cancer: changing the aim of the biopsy in the age of precision medicine. A review. ACTA ACUST UNITED AC 2021; 41:108-119. [PMID: 34028455 PMCID: PMC8142729 DOI: 10.14639/0392-100x-n1056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/03/2021] [Indexed: 01/15/2023]
Abstract
Oral cancer is a heterogeneous disease that develops through a complex, multi-step process. Precision medicine should help to better understand its molecular basis, integrate traditional classifications and have a positive impact on cancer management. To apply this information in clinical practice, we need to define its histology and identify biomarkers expressed by the tumour that provide useful information for planning tailored treatment. The most reliable information currently derives from evaluation of biomarkers on post-operative samples. To plan personalised treatment, oncologists need to assess these markers on biopsy samples. We reviewed the recent literature and identified 6 of 184 publications that compared markers measured on biopsy and post-operative samples or assessed their predictivity for the development of lymph node metastases. Data from these studies suggest that markers measured on biopsy samples can provide useful indications for tailoring treatments. However, due to their heterogeneity and low level of evidence, these results need to be confirmed by clinical studies on a large population to standardise and validate biomarkers in biopsies and to assess their reliability in other diagnostic mini-invasive procedures such as radiomics and liquid biopsy.
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Affiliation(s)
- Roberto Bruschini
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Fausto Chiesa
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Daniela Lepanto
- Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Rita De Berardinis
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesco Chu
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Marta Tagliabue
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Gioacchino Giugliano
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Mohssen Ansarin
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
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Hori Y, Kubota A, Yokose T, Furukawa M, Matsushita T, Katsumata N, Oridate N. Prognostic Role of Tumor-Infiltrating Lymphocytes and Tumor Budding in Early Oral Tongue Carcinoma. Laryngoscope 2021; 131:2512-2518. [PMID: 33955550 PMCID: PMC8518756 DOI: 10.1002/lary.29589] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/02/2021] [Accepted: 04/14/2021] [Indexed: 12/15/2022]
Abstract
Objectives/Hypothesis Occult lymph metastasis is an important prognosticator for the treatment of early oral tongue squamous cell carcinoma (SCC). The objective of this study was to evaluate the prognostic significance of tumor‐infiltrating lymphocytes (TILs) in early oral tongue SCC. The combination of the TIL subtype and intermediate‐ or high‐grade budding scores was investigated as a prognostic marker for occult neck metastases. Study Design Retrospective study. Methods Specimens from 62 patients with early oral tongue SCC treated with only primary surgery were analyzed by immunohistochemistry for CD4+, CD8+, FoxP3+, and CD45RO+ T cells and CD163+ macrophages. The highest number of each TIL subtype was counted in two areas of parenchyma and stroma in the tumor (Tumor) and peripheral stroma of the invasion margin. Results Based on multivariate analysis, a high density of Tumor CD163+ macrophages served as the poorest prognostic factor for regional control (RC) and disease‐free survival (DFS). Patients with both a high density of Tumor CD163+ macrophages and an intermediate‐ or a high‐grade budding score had a poor prognosis for RC according to the log‐rank test. Conclusions In summary, each TIL subtype may use different mechanisms during early and advanced stages of oral tongue SCC. A high density of Tumor CD163+ macrophages was determined to be a risk factor for RC and DFS as well as an additional stratification factor for RC in patients with intermediate‐ or high‐grade budding scores. Therefore, identifying TIL subtypes in daily clinical practice can help determine a more successful and individualized therapeutic approach for early oral tongue SCC. Level of Evidence Step 4 (Level 4) Laryngoscope, 131:2512–2518, 2021
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Affiliation(s)
- Yukiko Hori
- Department of Otorhinolaryngology, Shinshu Ueda Medical Center, Ueda, Nagano, Japan.,Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Akira Kubota
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.,Department of Otorhinolaryngology, Hiro Yama Clinic, Tokyo, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Madoka Furukawa
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Takeshi Matsushita
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.,Department of Otorhinolaryngology, Yokosuka General Hospital Uwamachi, Yokosuka, Kanagawa, Japan
| | - Noriyuki Katsumata
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Nobuhiko Oridate
- Department of Otolaryngology Head and Neck Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
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Kwak MS, Eun YG, Lee JW, Lee YC. Development of a machine learning model for the prediction of nodal metastasis in early T classification oral squamous cell carcinoma: SEER-based population study. Head Neck 2021; 43:2316-2324. [PMID: 33792112 DOI: 10.1002/hed.26700] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 03/01/2021] [Accepted: 03/16/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND This study aimed to develop and compare machine learning (ML) based predictive models for lymph node metastasis (LNM) in early T classification oral squamous cell carcinoma (OSCC). METHODS We used data from the Surveillance Epidemiology and End Results Database to develop and validate the predictive models for LNM in patients with T1, T2 OSCC. Using simple clinical and histopathological data, we developed six ML algorithms to predict LNM. The predictive performance of models was compared. RESULTS The areas under the receiver operating characteristic curves (AUCs) of the six models ranged from 0.768 to 0.956. The best prediction performance was achieved with a XGBoost (AUC = 0.956). Permutation importance analysis showed that tumor size is the most important feature in predicting metastasis. CONCLUSIONS We developed a simplified and reproducible ML-based predictive model for metastasis in early T classification OSCC that could be helpful for the decision of a treatment strategy.
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Affiliation(s)
- Min Seob Kwak
- Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Young-Gyu Eun
- Department of Otolaryngology - Head and Neck surgery, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Jung-Woo Lee
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Young Chan Lee
- Department of Otolaryngology - Head and Neck surgery, School of Medicine, Kyung Hee University, Seoul, South Korea
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Kimura S, Noguchi H, Nanbu U, Nakayama T. Macrophage CCL22 expression promotes lymphangiogenesis in patients with tongue squamous cell carcinoma via IL-4/STAT6 in the tumor microenvironment. Oncol Lett 2021; 21:383. [PMID: 33777206 PMCID: PMC7988704 DOI: 10.3892/ol.2021.12644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/15/2021] [Indexed: 01/04/2023] Open
Abstract
The C-C motif chemokine ligand 22 (CCL22) chemokine is produced by M2-like tumor-associated macrophages (TAMs) in the tumor microenvironment. Chemokine C-C motif receptor 4 (CCR4), the CCL22 receptor, on T helper2 (Th2) cells leads to a Th2 cytokine-dominant environment. In our previous study, lymph node metastasis was the main predictor of tongue squamous cell carcinoma (SCC) via CCL22. Therefore, the present study aimed to investigate the effects of CCL22 and a Th2 cytokine-predominant tumor microenvironment on vascular endothelial growth factor (VEGF)-C expression and lymphangiogenesis. The post-operative courses of 110 patients with early-stage tongue SCC with a histopathological diagnosis based on the 8th TNM classification were followed up (mean/median follow-up time, 47.1/42.0 months) from surgery until death or the last follow-up visit, and subsequent lymph node relapse was assessed. Lymphangiogenesis and the immunohistochemical expression of several markers (CCL22, CCR4 and VEGF-C) were evaluated. The Kaplan-Meier method was used to plot lymph node relapse-free survival and overall survival curves, which were compared using the log-rank test. In vitro, the association between CCL22 and VEGF-C by interleukin (IL)-4/signal transducer and activator of transcription 6 (STAT6) stimulation was examined. Lymphangiogenesis was significantly associated with lymph node relapse (P<0.001) and a CCL22+ macrophage ratio (P<0.001). CCL22+ TAMs were positive for VEGF-C and surrounded by CCR4+ cells. Additionally, VEGF-C expression was increased in IL-4/STAT6-stimulated macrophages. In addition, the STAT6 signaling pathway was activated in the SCC cells in the deeply invaded part of the tumor along with the aggregated macrophages. In conclusion, TAM CCL22 expression led to lymph node relapse via VEGF-C expression within the tumor microenvironment and the IL-4/STAT6 signaling pathway in early stage tongue SCC. Additionally, the worst pattern of invasion and depth of invasion were revealed to be useful parameters for lymph node relapse in patients with tongue SCC. The present study suggested that CCL22 contributed to the role of M2-like differentiated TAMs in prognosis and lymph node relapse via IL-4/STAT6 and VEGF. The IL-4/STAT6 signaling pathway may be a new molecular target for tongue SCC.
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Affiliation(s)
- Satoshi Kimura
- Department of Clinical Pathology, Kitakyushu City Yahata Hospital, Kitakyushu, Fukuoka 805-8534, Japan.,Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Hirotsugu Noguchi
- Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Uki Nanbu
- Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Toshiyuki Nakayama
- Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
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Xu B, Salama AM, Valero C, Yuan A, Khimraj A, Saliba M, Zanoni DK, Ganly I, Patel SG, Katabi N, Ghossein R. The prognostic role of histologic grade, worst pattern of invasion, and tumor budding in early oral tongue squamous cell carcinoma: a comparative study. Virchows Arch 2021; 479:597-606. [PMID: 33661329 DOI: 10.1007/s00428-021-03063-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/28/2021] [Accepted: 02/16/2021] [Indexed: 12/15/2022]
Abstract
Major pathology guidelines often mandate stating the histologic grade as a component of the pathology report for various types of cancer. However, the prognostic value of histologic grade in head and neck squamous cell carcinoma (HNSCC) is controversial at best, and there is a need for more reliable prognostic histologic factors to better stratify and manage patients with HNSCC. In this study, we compared three relevant histopathologic features (histologic grade, worst pattern of invasion (WPOI), and tumor budding) in a large single-center retrospective cohort of early oral tongue squamous cell carcinoma (OTSCC) with tumor greatest dimension ≤ 4 cm. Only histologic grade predicted distant metastasis free survival (DMFS) on univariate analysis. Tumor budding was associated with nodal metastasis, overall survival (OS), regional recurrence-free survival (RRFS), and DMFS and was a significant predictor for nodal metastasis on the multivariable logistic regression model. WPOI 5 was associated with high frequency of nodal metastasis and shortened OS and was an independent adverse prognostic factor for OS on multivariate analysis using the Cox proportional hazards model. WPOI and tumor budding were prognostically more relevant than histologic grade. Consideration should be given to include WPOI and tumor budding in the pathology reporting of OTSCC.
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Affiliation(s)
- Bin Xu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Abeer M Salama
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Cristina Valero
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Avery Yuan
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anjanie Khimraj
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Maelle Saliba
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Daniella K Zanoni
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ian Ganly
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Snehal G Patel
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nora Katabi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Ronald Ghossein
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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45
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Kim SK, Kim JH, Han JH, Cho NH, Kim SJ, Kim SI, Choo SH, Kim JS, Park B, Kwon JE. TERT promoter mutations in penile squamous cell carcinoma: high frequency in non-HPV-related type and association with favorable clinicopathologic features. J Cancer Res Clin Oncol 2021; 147:1125-1135. [PMID: 33635430 PMCID: PMC7954710 DOI: 10.1007/s00432-021-03514-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/09/2021] [Indexed: 01/14/2023]
Abstract
Purpose Penile carcinoma is a rare malignant neoplasm with a largely unknown molecular pathogenesis. Telomerase reverse transcriptase promoter (TERT-p) mutations have been detected in several types of human malignancies. The aim of this study was to investigate the presence of TERT-p mutations in penile squamous cell carcinomas (SCCs) and their associations with clinicopathologic features. Methods In this retrospective study, Sanger sequencing was performed to detect TERT-p mutations in formalin-fixed paraffin-embedded tissue samples from 37 patients with penile SCC, 16 patients with cutaneous SCC, and 4 patients with non-neoplastic penile/skin tissue. The expression of p16INK4a and Ki-67 was investigated via immunohistochemistry. Associations of TERT-p mutation with clinicopathological factors, immunohistochemical results, and clinical outcome were statistically analyzed. Results Recurrent TERT-p mutations were identified in 18 out of 37 (48.6%) penile SCCs, including all 3 carcinoma in situ cases. TERT-p mutations were significantly more frequent in non-human papilloma virus (HPV)-related penile SCC types than in non-HPV-related penile SCC based on both histologic classification and p16INK4a immunoreactivity. Furthermore, TERT-p mutation was associated with a low histologic grade, low mitotic count, absence of necrosis, low Ki-67/MIB-1 labeling index, and absence of lymph node or distant metastasis. Conclusion Our study shows TERT-p mutations are the most frequent somatic mutations in penile SCC. In addition, TERT-p mutations are far more frequent in non-HPV-related penile SCC than in HPV-related penile SCC, indicating TERT-p mutations may have a role in tumorigenesis distinct from HPV-related penile SCC. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-021-03514-9.
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Affiliation(s)
- Sang Kyum Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jang-Hee Kim
- Department of Pathology, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Jae Ho Han
- Department of Pathology, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Nam Hoon Cho
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Se Joong Kim
- Department of Urology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sun Il Kim
- Department of Urology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seol Ho Choo
- Department of Urology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Ji Su Kim
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovation, Ajou University Medical Center, Suwon, Republic of Korea
| | - Bumhee Park
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovation, Ajou University Medical Center, Suwon, Republic of Korea.,Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Ji Eun Kwon
- Department of Pathology, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
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46
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Mozarowski P, Rasaiah B, Reed M, Lewis A, Walde N, Voutsadakis IA. Prognostic Role of Tumor Budding in Breast Cancer Patients Receiving Neo-Adjuvant Therapy. J Clin Med 2021; 10:jcm10040827. [PMID: 33670512 PMCID: PMC7922902 DOI: 10.3390/jcm10040827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/11/2021] [Accepted: 02/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Isolated tumor cells or small clusters of tumor cells observed in the vicinity of the main tumor mass in pathology sections, termed tumor budding, are common in cancers and have been associated with prognosis in some settings. This study examined the clinical associations and treatment efficacy implications of tumor budding in breast cancer patients receiving neo-adjuvant therapy. Methods: Breast cancer patients that received neo-adjuvant therapy before definitive surgical treatment in a single cancer center over a 7-year period were included, and their records were reviewed. Data extracted included patient demographics, tumor characteristics and pathologic response to treatment at surgery. The initial breast cancer biopsy before any therapy was reviewed by two pathologists, and a hot spot area was evaluated for tumor budding (defined as 1 to 5 cancer cells observed detached from the main tumor mass). Results: Seventy-five patients who received neo-adjuvant therapy (73 received chemotherapy and 2 received hormonal therapy) were included. Tumor budding was observed in two-thirds of the patients. There were no significant differences in patient (age and menopause status) and tumor (stage, histology and molecular sub-type equivalent) characteristics between the group that had tumor budding and the group that did not have tumor budding in the pre-treatment biopsy. Likewise, no statistically significant differences were observed in the frequency of complete or partial responses between the two groups. Conclusion: In this cohort of breast cancer patients receiving neo-adjuvant therapy, tumor budding was frequent, but it was not associated with tumor characteristics or pathologic responses to treatment. The value of tumor budding as a prognostic factor in the neo-adjuvant setting within the general breast cancer population could not be confirmed, but such a value in specific sub-groups deserves further investigation, given the pathophysiologic rationale and data from other settings.
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Affiliation(s)
- Paul Mozarowski
- Department of Pathology, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (P.M.); (B.R.)
| | - Bhubendra Rasaiah
- Department of Pathology, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (P.M.); (B.R.)
| | - Melissa Reed
- Clinical Trials Unit, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (M.R.); (A.L.); (N.W.)
- Faculty of Medicine, University of Ottawa School of Medicine, Ottawa, ON KK1H 8M5, Canada
| | - Alexis Lewis
- Clinical Trials Unit, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (M.R.); (A.L.); (N.W.)
- Department of Biology, Algoma University, Sault Ste. Marie, ON P6A 2G4, Canada
| | - Natalie Walde
- Clinical Trials Unit, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (M.R.); (A.L.); (N.W.)
| | - Ioannis A. Voutsadakis
- Algoma District Cancer Program, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada
- Section of Internal Medicine, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada
- Correspondence:
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47
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Silva LABD, Lopes MLDDS, Sá MC, de Almeida Freitas R, Coletta RD, da Silveira EJD, da Costa Miguel MC. Histopathologic grading and its relationship with outcome in oral tongue squamous cell carcinoma. J Oral Pathol Med 2021; 50:183-190. [PMID: 33151566 DOI: 10.1111/jop.13118] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/16/2020] [Accepted: 08/22/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Histopathologic grading has been routinely used as a complement for clinical staging in the prognostication of patients with oral tongue squamous cell carcinoma (OTSCC). However, this subject remains contentious because there is no universally accepted grading system. OBJECTIVES This study compared the prognostic significance of four histopathologic grading systems in 80 cases of oral tongue squamous cell carcinoma (OTSCC). METHODS Clinical and follow-up information of the patients were obtained from medical records. Histopathologic malignancy grading of the tumor invasive front, Histologic risk assessment (HRA), World Health Organization (WHO) grading system, and Budding and Depth of invasion (BD) model were evaluated in the surgical specimens. RESULTS The HRA, histopathologic malignancy grading and WHO systems did not predict survival. Patients with larger tumor size [Hazard ratio (HR): 2.38; 95% confidence interval (CI): 1.07-5.27; P = 0.026] and patients with BD model high-grade tumors (HR: 2.99; 95% CI: 1.03-8.68; P = 0.034) were significantly associated with a poor 5-year overall survival rate. In the multivariate analysis, tumor size was identified as the only significant independent prognostic factor (HR: 2.23; 95% CI: 1.00-4.99; P = 0.050). None of the grading systems studied was associated with 5-year disease-free survival rates. CONCLUSIONS BD model was the only histopathologic grading system associated with the outcome of patients with OTSCC, indicating its potential value as an effective tool for the prognostication of OTSCC.
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Affiliation(s)
| | | | - Melka Coelho Sá
- Department of Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | | | - Ricardo Della Coletta
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, Brazil
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48
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Pu Y, Ding L, Wang Y, Wang Y, Chen S, Huang X, He Z, Ni Y, Hu Q. Biopsy pattern of invasion type to determine the surgical approach in early-stage oral squamous cell carcinoma. Virchows Arch 2021; 479:109-119. [PMID: 33438091 DOI: 10.1007/s00428-020-03008-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 12/03/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
Depth of invasion (DOI) and pattern of invasion (POI) indicate tumor invasiveness of oral squamous cell carcinoma (OSCC). However, preoperative DOI evaluation is challenging, and the correlations between DOI and POI are unknown. We aimed to assess DOI and worst pattern of invasion (WPOI) in early-stage OSCC, and evaluate the preoperative predictive ability of biopsy pattern of invasion (BPOI) for WPOI and DOI. This retrospective study included n = 444 OSCC patients with pT1-2N0M0. The prognostic value of DOI, WPOI, and BPOI and the predictive prognostic option for WPOI and DOI by BPOI were assessed. WPOI (1-3 vs 4-5), but not BPOI, predicted the lowest survival rate and highest DOI. To evaluate the difference between WPOI and BPOI, we conducted a POI type-matching analysis of patients with BPOI1-4 and WPOI1-5. Based on each WPOI type, the false-prediction rates (FPR) of BPOI types 1 (n = 23), 2 (n = 89), 3 (n = 252), and 4 (n = 80) were 52.17%, 52.81%, 36.90%, and 0%, respectively. BPOI4 perfectly predict WPOI 4-5. As the false-predicted BPOI 1-2 was almost WPOI2-3 (79.7%), regardless of the existed FPR, patients with BPOI1-2 have longer survival and lower DOI than those with BPOI 4. However, this phenomenon was not observed in BPOI3, because all false-predicted BPOI3 were WPOI4-5 with a high DOI. We provide an alternative predictive prognostic option for WPOI and DOI by evaluating BPOI during OSCC surgical planning, with the recommendation of conservative treatment in patients with BPOI 1-2.
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Affiliation(s)
- Yumei Pu
- Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Liang Ding
- Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Yujia Wang
- Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Yuxin Wang
- Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Sheng Chen
- Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Xiaofeng Huang
- Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Zhifeng He
- Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Yanhong Ni
- Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China. .,Central Laboratory, Nanjing Stomatological Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, Jiangsu, China.
| | - Qingang Hu
- Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China.
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Chaitra B, Burela M, Kasula L, Inuganti RV, Vaddatti T. Correlative study of tumor budding, mode of invasion and lymphocytic host response with known clinicopathological prognostic factors in oral squamous cell carcinoma. J Oral Maxillofac Pathol 2021; 24:484-491. [PMID: 33967485 PMCID: PMC8083440 DOI: 10.4103/jomfp.jomfp_178_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/14/2020] [Accepted: 10/05/2020] [Indexed: 11/04/2022] Open
Abstract
Background Oral squamous cell carcinoma (OSCC) is a significant public health problem in India, accounting to 30% of all cancers with a worrying rise in incidence and related mortality. Invasive tumor front (ITF) of OSCC has been an area of histopathologic research interest, where parameters like tumor budding (TB), mode of invasion (MOI) and lymphocytic host response (LHR) are being evaluated extensively. Objectives The aim is to study and evaluate the possible association of ITF histological parameters such as TB, LHR and MOI with known clinicopathological prognostic factors in cases of OSCC. Subjects and Methods We reviewed and analyzed 69 cases of OSCC for routine clinicopathological parameters, TB, MOI and LHR for any significant correlation (P < 0.05 by Chi-square test) with each other and with outcome in cases where follow-up was available. Results TB correlated significantly with histological grade, worst pattern of invasion (WPOI), Lymphnodal involvement (LNI), Lymphovascular invasion (LVI), Perineural invasion (PNI) and age; MOI correlated with WPOI, LNI, LVI and PNI; and LHR significantly correlated with WPOI, PNI, Tumor size (pT) and outcome. TB showed a strong correlation with MOI (P < 0.001) and LHR; and no significant association was noted between LHR and MOI. Among all the clinicopathological parameters, depth of invasion, pT, WPOI, PNI and LHR showed significant correlation with outcome. Conclusion TB, MOI and LHR showed good correlation with established parameters and as they are easy and helps in prognostication, they should be included in routine histopathological reporting guidelines.
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Affiliation(s)
- B Chaitra
- Department of Pathology, NRI Medical College, Chinakakani, Guntur, Andhra Pradesh, India
| | - Manasa Burela
- Department of Pathology, NRI Medical College, Chinakakani, Guntur, Andhra Pradesh, India
| | - Laxmi Kasula
- Department of Pathology, NRI Medical College, Chinakakani, Guntur, Andhra Pradesh, India
| | | | - Tejeswini Vaddatti
- Department of Pathology, NRI Medical College, Chinakakani, Guntur, Andhra Pradesh, India
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50
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Kim HN, Lee SY, Kim BH, Kim CY, Kim A, Kim H. Prognostic value of tumor budding in gallbladder cancer: application of the International Tumor Budding Consensus Conference scoring system. Virchows Arch 2021; 478:1071-1078. [PMID: 33398430 DOI: 10.1007/s00428-020-03012-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/21/2020] [Accepted: 12/27/2020] [Indexed: 02/06/2023]
Abstract
Tumor budding (TB), a histopathological manifestation of epithelial-mesenchymal transition, is an important step in cancer invasion and metastasis development. TB has been considered a strong prognostic indicator in colorectal cancer. The International Tumor Budding Consensus Conference (ITBCC) scoring system is the standardized method used for patient outcome prediction in several human tumors. We investigated the clinicopathological implications and applicability of TB measured using the ITBCC scoring system in gallbladder cancer (GBC). The TB grades assigned to the 78 GBC patients were as follows: Bd1 (low TB), 41 (52.6%) patients; Bd2 (intermediate TB), 22 (28.2%) patients; and Bd3 (high TB), 15 (19.2%) patients. A higher TB grade correlated with a poorer histological differentiation (P < 0.000), higher pT category (P < 0.000), the involvement of surgical resection margin (P = 0.005), presence of nodal metastasis (P < 0.000), lymphatic and venous invasion (P < 0.000), and perineural invasion (P = 0.004). Univariate Cox regression analysis revealed that a poor histological grade, high pT category, lymphatic invasion, perineural invasion, and intermediate to high TB grades were associated with worse 5-year overall survival and disease-free survival. TB was not significantly associated with death or recurrence risk in multivariate Cox analysis. The interobserver agreement of TB grading was substantial. This study is the first to apply the ITBCC scoring system and suggest the prognostic value of TB in GBC.
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Affiliation(s)
- Han-Na Kim
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Soo Yeon Lee
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Baek-Hui Kim
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Chung-Yeul Kim
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Aeree Kim
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Hayeon Kim
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
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