Evaluation of Depth of Invasion and Tumor Thickness as a Prognostic Factor for Early-Stage Oral Squamous Cell Carcinoma: A Retrospective Study

Abstract

The aim of this study was to compare the effect of using depth of invasion (DOI) versus tumor thickness (TT) as a prognostic factor for early-stage oral squamous cell carcinoma (OSCC). A total of 57 patients with early-stage OSCC treated surgically from 2009 to 2014 at our institution were reviewed retrospectively. Histopathological measurement of DOI and TT was performed. The validation of DOI and TT as prognostic factors was conducted using a Kaplan–Meier survival analysis. TT had no association with disease-specific survival (DSS) or progression-free survival (PFS) in this cohort; however, increased DOI was significantly associated with decreased DSS but not correlated to decreased PFS. The T category of the 7th edition of AJCC was statistically associated with both DSS and PFS; however, the T category of the 8th edition of the AJCC was only associated with DSS. In this study group, TT could not be used as a prognostic factor, and DOI was not by itself sufficient to predict prognosis for early-stage OSCC. The T category in AJCC 8th Edition cannot be considered the sole prognostic factor for early OSCC, so additional prognostic factors may need to be considered.

Understanding the approach to interpretation and challenges in measurement of pathological depth of invasion in oral squamous cell carcinoma: A cross-sectional survey of oral and maxillofacial pathologists in India

“…Studies have found DOI, but not TT to be an independent factor in predicting LN metastasis[ 8 , 9 , 14 , 20 ] and significantly associated with locoregional recurrence,[ 13 ] DSS[ 13 , 23 ] and progression-free survival. [ 23 ] A recent meta-analysis found higher DOI to have greater chance of LN metastasis, recurrence and lower survival, corroborating its incorporation for OSCC staging. [ 24 ] Others have found both TT and DOI to carry comparable prognostic significance.…”

“…Most authors in developed countries use whole slide imaging and carry out precise pDOI measurements. [ 23 ] AJCC recommends ocular micrometry but few authors have questioned its availability in resource-limited setting like India. [ 6 ] Ocular micrometry requires multiple movements of stage to capture entire depth at times or the use of 2× scanner objective and eyepiece.…”

“…Lee et al . [ 23 ] overcame comparable limitations by repeating DOI measurements for each slide three times from different points of adjacent rete ridges and using the mean value as final value. The interspersed invasive carcinoma between upper and lower limits of BM may be disregarded if the deepest point of hyperplastic rete ridge is considered; thus underestimating actual DOI.…”

Clinical Experience with Autofluorescence Guided Oral Squamous Cell Carcinoma Surgery

“…New effective examination and imaging techniques are being developed that allow the surgeon to better visualize the boundaries of the primary tumor before and during the surgery more precisely [12][13][14][15][16][17][18][19][20][21][22][23][24]. With the help of these techniques, it is possible, among other things, to have a positive impact on margin surveillance.…”

CircPUM1 Knockdown Confers Radiosensitivity in Oral Squamous Cell Carcinoma by Regulating the miR-580/STAT3 Pathway

“…Studies have shown that circular RNA (circRNA) is a kind of non-coding RNA, which has high stability due to its closed circular molecule ( Zheng et al, 2019 ). Studies have shown that circRNA can inhibit its expression by acting as a sponge molecule of microRNA (miRNA), thus regulating the biological processes of tumor cell proliferation, apoptosis, migration, and so on ( Lee et al, 2021 ). However, there are relatively few studies on circRNAs in oral squamous cell carcinoma.…”