Worst pattern of invasion and other histopathological features in oral cancer as determinants of prognosis and survival rate: A retrospective cohort analysis

Marzouki,Hani Z.; Bukhari,Afnan F.; Al‑Ghamdi,Doaa A.; Abdullah,Reem M.; Al‑Hajeili,Marwan; Khayyat,Shadi; Alzahrani,Reem M.; Alotaibi,Yara R.; Al‑Wassia,Rolina; Al‑Marzouki,Hatim; Merdad,Mazin

doi:10.3892/ol.2023.13661

Worst pattern of invasion and other histopathological features in oral cancer as determinants of prognosis and survival rate: A retrospective cohort analysis

Authors:
- Hani Z. Marzouki
- Afnan F. Bukhari
- Doaa A. Al‑Ghamdi
- Reem M. Abdullah
- Marwan Al‑Hajeili
- Shadi Khayyat
- Reem M. Alzahrani
- Yara R. Alotaibi
- Rolina Al‑Wassia
- Hatim Al‑Marzouki
- Mazin Merdad
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Affiliations: Department of Otolaryngology‑Head and Neck Surgery, King Abdulaziz University, Jeddah 23624, Kingdom of Saudi Arabia, Department of Anatomical Pathology and Laboratory Medicine, King Fahad Medical City, Riyadh 12231, Kingdom of Saudi Arabia, Department of Medicine, King Abdulaziz University, Jeddah 23624, Kingdom of Saudi Arabia, Department of Internal Medicine, King Abdulaziz University, Jeddah 23624, Kingdom of Saudi Arabia, Department of Otolaryngology‑Head and Neck Surgery, King Fahad General Hospital, Jeddah 23325, Kingdom of Saudi Arabia, Department of Radiation Oncology, King Abdulaziz University, Jeddah 23624, Kingdom of Saudi Arabia, Department of Radiology, King Abdulaziz University, Jeddah 23624, Kingdom of Saudi Arabia
Published online on: January 4, 2023 https://doi.org/10.3892/ol.2023.13661
Article Number: 75
Copyright: © Marzouki et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Oral cavity squamous cell carcinoma (OCSCC) is a well‑recognized malignancy of the head and neck. Studies on patients with early‑stage oral cancer have shown that they develop locally recurring and/or regional lymph node metastasis, which results in disease‑associated mortality. Thus, early‑stage oral cancer does not always present good prognoses. The present study aimed to determine the efficacy of using worst pattern of invasion (WPOI) and other histopathological features, such as prognostic factors in OCSCC, and analyze the impact of resection margin status and histopathological prognostic indicators on local recurrence (LR) and overall survival (OS) in patients with OCSCC. A retrospective cohort study was conducted by reviewing the charts of 63 patients with OCSCC treated with primary surgery at King Abdulaziz University Hospital between 2012 and 2019. An author and an experienced pathologist reviewed pathology slides. Associations of histopathological factors, including differentiation, stage, lymphovascular invasion, extracapsular extension, perineural invasion (PNI), WPOI and surgical margins, with LR or disease‑free survival (DFS) were evaluated. Univariate analysis identified WPOI and PNI, and multivariate analysis identified the WPOI as predictive factors for LR and DFS. Kaplan‑Meier analysis identified the WPOI and PNI as predictive factors for OS and WPOI as a predictive factor for DFS. Therefore, it may be concluded that WPOI and PNI are significant independent prognostic factors for local tumor control and DFS in patients with OCSCC.

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1	Silverman S Jr: Demographics and occurrence of oral and pharyngeal cancers. The outcomes, the trends, the challenge. J Am Dent Assoc. 132 (Suppl):7S–11S. 2001. View Article : Google Scholar : PubMed/NCBI
2	Swango PA: Cancers of the oral cavity and pharynx in the United States: An epidemiologic overview. J Public Health Dent. 56:309–318. 1996. View Article : Google Scholar : PubMed/NCBI
3	Chen JK, Katz RV and Krutchkoff DJ: Intraoral squamous cell carcinoma. Epidemiologic patterns in Connecticut from 1935 to 1985. Cancer. 66:1288–1296. 1990. View Article : Google Scholar : PubMed/NCBI
4	Silverman S Jr and Gorsky M: Epidemiologic and demographic update in oral cancer: California and national data-1973 to 1985. J Am Dent Assoc. 120:495–499. 1990. View Article : Google Scholar : PubMed/NCBI
5	Llewellyn CD, Johnson NW and Warnakulasuriya KA: Risk factors for squamous cell carcinoma of the oral cavity in young people-a comprehensive literature review. Oral Oncol. 37:401–418. 2001. View Article : Google Scholar : PubMed/NCBI
6	Chen YK, Huang HC, Lin LM and Lin CC: Primary oral squamous cell carcinoma: An analysis of 703 cases in southern Taiwan. Oral Oncol. 35:173–179. 1999. View Article : Google Scholar : PubMed/NCBI
7	Silverman S Jr: Epidemiology. Silverman S Jr: Oral Cancer. 4th edition. Hamilton, ON, Canada: B C Decker Inc.; pp. 1–6. 1998
8	Johnson NW, Jayasekara P and Amarasinghe AA: Squamous cell carcinoma and precursor lesions of the oral cavity: Epidemiology and aetiology. Periodontol. 2000.57:19–37. 2011. View Article : Google Scholar : PubMed/NCBI
9	Jones KR, Lodge-Rigal D, Reddick RL, Tudor GE and Shockley WW: Prognostic factors in the recurrence of stage I and II squamous cell cancer of the oral cavity. Arch Otolaryngol Head Neck Surg. 118:483–485. 1992. View Article : Google Scholar : PubMed/NCBI
10	Woolgar JA: Histopathological prognosticators in oral and oropharyngeal squamous cell carcinoma. Oral Oncol. 42:229–239. 2006. View Article : Google Scholar : PubMed/NCBI
11	Massano J, Regateiro FS, Januário G and Ferreira A: Oral squamous cell carcinoma: Review of prognostic and predictive factors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 102:67–76. 2006. View Article : Google Scholar : PubMed/NCBI
12	Binmadi NO and Basile JR: Perineural invasion in oral squamous cell carcinoma: A discussion of significance and review of the literature. Oral Oncol. 47:1005–1010. 2011. View Article : Google Scholar : PubMed/NCBI
13	Brandwein-Gensler M, Smith RV, Wang B, Penner C, Theilken A, Broughel D, Schiff B, Owen RP, Smith J, Sarta C, et al: Validation of the histologic risk model in a new cohort of patients with head and neck squamous cell carcinoma. Am J Surg Pathol. 34:676–688. 2010. View Article : Google Scholar : PubMed/NCBI
14	Sessions DG, Spector GJ, Lenox J, Haughey B, Chao C and Marks J: Analysis of treatment results for oral tongue cancer. Laryngoscope. 112:616–625. 2002. View Article : Google Scholar : PubMed/NCBI
15	World Health Organization (WHO) classification, . (4th edition). 2017.
16	O'Sullivan B, Huang SH, Su J, Garden AS, Sturgis EM, Dahlstrom K, Lee N, Riaz N, Pei X, Koyfman SA, et al: Development and validation of a staging system for HPV-related oropharyngeal cancer by the International Collaboration on Oropharyngeal cancer Network for Staging (ICON-S): A multicentre cohort study. Lancet Oncol. 17:440–451. 2016. View Article : Google Scholar : PubMed/NCBI
17	Maleki S, Schlecht NF, Keller C, Diaz J, Moss J, Prystowsky MB, Macian F and Brandwein-Gensler M: Lymphocytic host response to oral squamous cell carcinoma: An adaptive T-cell response at the tumor interface. Head Neck Pathol. 5:117–122. 2011. View Article : Google Scholar : PubMed/NCBI
18	Morse DE, Psoter WJ, Cleveland D, Cohen D, Mohit-Tabatabai M, Kosis DL and Eisenberg E: Smoking and drinking in relation to oral cancer and oral epithelial dysplasia. Cancer Causes Control. 18:919–929. 2007. View Article : Google Scholar : PubMed/NCBI
19	Krishna Rao SV, Mejia G, Roberts-Thomson K and Logan R: Epidemiology of oral cancer in Asia in the past decade-an update (2000–2012). Asian Pac J Cancer Prev. 14:5567–5577. 2013. View Article : Google Scholar : PubMed/NCBI
20	Jakobsson PA, Eneroth CM, Killander D, Killander D, Moberger G and Mårtensson B: Histologic classification and grading of malignancy in carcinoma of the larynx. Acta Radiol Ther Phys Biol. 12:1–8. 1973. View Article : Google Scholar : PubMed/NCBI
21	Anneroth G, Batsakis J and Luna M: Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas. Scand J Dent Res. 95:229–249. 1987.PubMed/NCBI
22	Bryne M, Koppang HS, Lilleng R, Stene T, Bang G and Dabelsteen E: New malignancy grading is a better prognostic indicator than Broders' grading in oral squamous cell carcinomas. J Oral Pathol Med. 18:432–437. 1989. View Article : Google Scholar : PubMed/NCBI
23	Bryne M, Jenssen N and Boysen M: Histologic grading in the deep invasive front of T1 and T2 glottic squamous cell carcinomas has high prognostic value. Virchows Arch. 427:277–281. 1995. View Article : Google Scholar : PubMed/NCBI
24	Mashberg A, Boffetta P, Winkelman R and Garfinkel L: Tobacco smoking, alcohol drinking, and cancer of the oral cavity and oropharynx among U.S. veterans. Cancer. 72:1369–1375. 1993. View Article : Google Scholar : PubMed/NCBI
25	Jovanovic A, Schulten EA, Kostense PJ, Snow GB and van der Waal I: Tobacco and alcohol-related to the anatomical site of oral squamous cell carcinoma. J Oral Pathol Med. 22:459–462. 1993. View Article : Google Scholar : PubMed/NCBI
26	Blot WJ, McLaughlin JK, Winn DM, Austin DF, Greenberg RS, Preston-Martin S, Bernstein L, Schoenberg JB, Stemhagen A and Fraumeni JF Jr: Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res. 48:3282–3287. 1998.PubMed/NCBI
27	Lewin F, Norell SE, Johansson H, Gustavsson P, Wennerberg J, Biörklund A and Rutqvist LE: Smoking tobacco, oral snuff, and alcohol in the etiology of squamous cell carcinoma of the head and neck: A population-based case-referent study in Sweden. Cancer. 82:1367–1375. 1998. View Article : Google Scholar : PubMed/NCBI
28	Brandwein-Gensler M, Teixeira MS, Lewis CM, Lee B, Rolnitzky L, Hille JJ, Genden E, Urken ML and Wang BY: 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. 29:167–178. 2005. View Article : Google Scholar : PubMed/NCBI
29	Chaturvedi A, Husain N, Misra S, Kumar V, Gupta S, Akhtar N, Lakshmanan M, Garg S, Arora A and Jain K: Validation of the Brandwein Gensler risk model in patients of oral cavity squamous cell carcinoma in North India. Head Neck Pathol. 14:616–622. 2020. View Article : Google Scholar : PubMed/NCBI
30	Almangush A, Bello IO, Keski-Säntti H, Mäkinen LK, Kauppila JH, Pukkila M, Hagström J, Laranne J, Tommola S, Nieminen O, et al: Depth of invasion, tumor budding, and worst pattern of invasion: Prognostic indicators in early-stage oral tongue cancer. Head Neck. 36:811–818. 2014. View Article : Google Scholar : PubMed/NCBI
31	Bundgaard T, Rossen K, Henriksen SD, Charabi S, Søgaard H and Grau C: Histopathologic parameters in the evaluation of T1 squamous cell carcinomas of the oral cavity. Head Neck. 24:656–660. 2002. View Article : Google Scholar : PubMed/NCBI
32	Hori Y, Kubota A, Yokose T, Furukawa M, Matsushita T and Oridate N: Association between pathological invasion patterns and late lymph node metastases in patients with surgically treated clinical No early oral tongue carcinoma. Head Neck. 42:238–243. 2020. View Article : Google Scholar : PubMed/NCBI
33	Guerra MFM, Gias LN, Campo FR and Perez JS: Marginal and segmental mandibulectomy in patients with oral cancer: A statistical analysis of 106 cases. J Oral Maxillofac Surg. 61:1289–1296. 2003. View Article : Google Scholar : PubMed/NCBI
34	Woolgar JA, Rogers SN, Lowe D, Brown JS and Vaughan ED: Cervical lymph node metastasis in oral cancer: The importance of even microscopic extracapsular spread. Oral Oncol. 39:130–137. 2003. View Article : Google Scholar : PubMed/NCBI
35	Jones HB, Sykes A, Bayman N, Sloan P, Swindell R, Patel M and Musgrove B: The impact of lymphovascular invasion on survival in oral carcinoma. Oral Oncol. 45:10–15. 2009. View Article : Google Scholar : PubMed/NCBI
36	Liu SA, Wang CC, Jiang RS, Lee FY, Lin WJ and Lin JC: Pathological features and their prognostic impacts on oral cavity cancer patients among different subsites-A singe institute's experience in Taiwan. Sci Rep. 7:74512017. View Article : Google Scholar : PubMed/NCBI