Invasive tumor front in oral squamous cell carcinoma: an independent prognostic factor
Keywords:OSCC, Invasive tumor front, HNSCC, Prognostic factor, TNM
Background: Head and neck squamous cell carcinoma (HNSCC) is one of the most aggressive and invasive cancer types. Squamous cell carcinomas of the oral cavity are among the ten most common cancers in the world, and accounts for almost 3-5% of all malignancies. The invasive edges of head and neck squamous cell carcinomas often display different morphological and molecular characteristics than more superficial parts of the same tumor.
Methods: In our 2 year retrospective study, carried at a tertiary care centre of north India, main aim was to evaluate the prognostic significance of several parameters of the modified Bryne’s grading system along with probability of survival in OSCC patients.
Results: Out of 60 cases 40 were males and 20 were females. Tumor differentiation was assessed which showed that 90% of the tumors were well differentiated, 6.6% of the tumors were moderately differentiated and 3.4% of the tumors were poorly differentiated. The predominant POI in the primary OSCC was pattern 2 (63.4% in 38 cases) followed by pattern 3, pattern 1and pattern 4 (28.4% in17 cases, 6.6% in 4 cases and 1.6% in 1 case) respectively.
Conclusions: Distributing all the cases according to the Bryne’s prognostic groups we found that 13 (21.7%) cases belonged to group with a score of <9, and 47 cases (78.3%) had a score of >9. The 5-year tumour-specific survival in OSCC patients with invasive front score of <9 was 95% compared to 46.25% in patients with high invasive front score >9.
Probert JC, Thompson RW, Bagshaw MA. Patterns of spread of distant metastases in head and neck cancer. Cancer. 1974;33:127-33.
Weir JC, Davenport WD, Skinner RL. A diagnostic and epidemiologic survey of 15,783 oral lesions. J Am Dent Assoc. 1987;115:439-42.
Varsha BK, Radhika MB, Makarla S, Kuriakose MA, Kiran GS, Padmalatha GV. Perineural invasion in oral squamous cell carcinoma: Case series and review of literature. J Oral Maxillofac Pathol. 2015;19:335‑41.
Park K. Preventive and social medicine, 18th Ed. India: Bhanot;2005.
Reinberg S. Cancer to suppress heart disease as a world killer. Oral Cancer. 2008;1:24-8.
Marur S, Forastiere AA. Head and neck cancer: changing epidemiology, diagnosis and treatment. Mayo Clin Proc. 2008;83:489–501.
Magne Bryne N, Ina J, Morten B. Histological grading in the deep invasive front of T1 and T2 glottic squamous cell carcinomas has high prognostic value. Virchows Arch. 1995;427:277-81.
Broders AC. Squamous cell epithelioma of the lip. JAMA. 1920;74:656-64.
Broders AC. The microscopic grading of cancer. Surg Clin North Amer. 1941;21:947-62.
Anneroth G, Batsakis J and Luna M. Review of literature and a recommended system of malignancy grading in oral squamous cell carcinomas. Sc J Dental Res. 1987;95:229-49.
Bryne M, Koppang HS, Lilleng R. New malignancy grading is a better prognostic indicator than Borders’ grading in oral squamous cell carcinomas. J Oral Pathol Med. 1989;18:432–7.
Upul Dissanayake. Malignancy grading of invasive fronts of oral squamous cell carcinomas: Correlation with overall survival. Translational Res Oral Oncol. 2017;2:1–8.
Yuen AP, Wei WI, Lam LK, Ho WK, Kwong D. Results of surgical salvage of loco-regional recurrence of carcinoma of the tongue after radiotherapy failure. Ann Otol Rhinol Laryngol. 1997;106:779‑82.
Nadaf A, Bavle RM, Soumya M, D'mello S,Kuriakose MA, Govindan S. Analysis of the invasive edge in primary and secondary oral squamous cell carcinoma: An independent prognostic marker: A retrospective study. J Oral Maxillofac Pathol. 2016;20:239-45.
Taghavi N, Yazdi I. Prognostic factors of survival rate in oral squamous cell carcinoma: Clinical, histologic, genetic and molecular concepts. Arch Iran Med. 2015;18:314‑9.
Brandwein‑Gensler M, Teixeira MS, Lewis CM, Lee B, Rolnitzky L, Hille JJ. Oral squamous cell carcinoma: Histologic risk assessment, but not margin status, is strongly predictive of local disease‑free and overall survival. Am J Surg Pathol. 2005;29:167-78.
Pericot J, Escriba JM, Valdes A. Survival evaluation of treatment modality in squamous cell carcinoma of the oral cavity and oropharynx. J Cranio-Maxillofacial Surg. 2000;28:49–55.
Rodrigues PC, Miguel MCC, Bagordakis E. Clinicopathological prognostic factors of oral tongue squamous cell carcinoma: a retrospective study of 202 cases. Int J Oral Maxillofac Surg. 2014;43:475–81.
Rikardsen OG, Bjerkli IH, Uhlin-Hansen L. Clinicopathological characteristics of oral squamous cell carcinoma in Northern Norway: a retrospective study. BMC Oral Health. 2014;14:103.
Monteiro LS, Amaral JB, Vizcaino JR. A clinical, pathological and survival study of oral squamous cell carcinomas from a population of the north of Portugal. Med Oral Path Oral Cir Bucal. 2014;19(2):120–6.
Arduino PG, Carrozzo M, Chiecchio A. Clinical and histopathologic independent prognostic factors in oral squamous cell carcinoma: a retrospective study of 334 cases. J Oral Maxillofac Surg. 2008;66:1570–9.
Piffko, A BAnkfaIvi, D Ofner, M Bryne, D Rasch, U Joos', W Bocker and KW Schmid. Prognostic value of histo-biological factors (malignancy grading and AgNOR content) assessed at the invasive tumour front of oral squamous cell carcinomas. British J Cancer. 1997;75(10):1543-6.
Bryne M, Koppang HS, Lilleng R. Malignancy grading of deep invasive margins of oral squamous cell carcinomas has high prognostic value. J Pathol. 1992;166:375–81.
Heerema MG, Melchers LJ, Roodenburg JL. Reproducibility and prognostic value of pattern of invasion scoring in low-stage oral squamous cell carcinoma. Histopathology. 2016;68(3):388–97.
Almangush A, Bello IO, Keski Santti H. Depth of invasion, tumor budding, and worst pattern of invasion: prognostic indicators in early-stage oral tongue cancer. Head Neck. 2014;36(6):811–818.
Huang SH, Hwang D, Lockwood G. Predictive value of tumor thickness for cervical lymph-node involvement in squamous cell carcinoma of the oral cavity: a meta-analysis of reported studies. Cancer. 2009;115(7):1489–97.
Sawazaki-Calone I, Rangel A, Bueno AG. The prognostic value of histo-pathological grading systems in oral squamous cell carcinomas. Oral Dis. 2015;21(6):755–61.