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Depth of invasion, tumor budding, and worst pattern of invasion: Prognostic indicators in early‐stage oral tongue cancer

2013; Wiley; Volume: 36; Issue: 6 Linguagem: Inglês

10.1002/hed.23380

1097-0347

Alhadi Almangush, Ibrahim O. Bello, Harri Keski–Säntti, Laura K. Mäkinen, Joonas H. Kauppila, Matti Pukkila, Jaana Hagström, Jussi Laranne, Satu Tommola, Outi Nieminen, Ylermi Soini, Veli‐Matti Kosma, Petri Koivunen, Reidar Grénman, Ilmo Leivo, Tuula Salo,

Oral Health Pathology and Treatment

Oral (mobile) tongue squamous cell carcinoma (SCC) is characterized by a highly variable prognosis in early-stage disease (T1/T2 N0M0). The ability to classify early oral tongue SCCs into low-risk and high-risk categories would represent a major advancement in their management.Depth of invasion, tumor budding, histologic risk-assessment score (HRS), and cancer-associated fibroblast (CAF) density were studied in 233 cases of T1/T2 N0M0 oral tongue SCC managed in 5 university hospitals in Finland.Tumor budding (≥5 clusters at the invasive front of the tumor) and depth of invasion (≥4 mm) were associated with poor prognosis in patients with early oral tongue SCC (hazard ratio [HR], 2.04; 95% confidence interval [CI], 1.17-3.55; HR, 2.55; 95% CI, 1.25-5.20, respectively) after multivariate analysis. The HRS and CAF density did not predict survival. However, high-risk worst pattern of invasion (WPOI), a component of HRS, was also an independent prognostic factor (HR, 4.47; 95% CI, 1.59-12.51).Analyzing the depth of invasion, tumor budding, and/or WPOI in prognostication and treatment planning of T1/T2 N0M0 oral tongue SCC is recommended.