Long-term disease-free survival in surgically-resected oral tongue cancer: a 10-year retrospective study

Abstract

SUMMARY Early and loco-regionally advanced oral tongue squamous cell carcinoma (OTSCC) can be treated by surgery alone or followed by adjuvant radiotherapy or chemoradiotherapy. Nevertheless, up to 40% of patients develop tumour relapse. The aim of our study is to investigate the clinical and pathological features associated with reduced disease-free survival (DFS) in a cohort of surgically-resected OTSCC patients. One hundred and six patients surgically resected for OTSCC were retrospectively identified from clinical records. DFS was calculated according to the Kaplan–Meier method and differences between variables were assessed with Log-Rank test. A multivariable Cox regression model was used to analyse the impact of different prognostic factors on DFS. After a median of follow-up of 8.9 years, 22 events, including 11 deaths, were observed. Overall, the 5-year DFS-rate was 87.4%. The presence of extra-nodal extension (p = 0.023) and perineural invasion (p = 0.003) were significantly correlated with shorter DFS (in univariate analysis). In multivariable analysis, extra-nodal extension and perineural invasion confirmed their role as independent prognostic factors associated with an increased risk of disease recurrence [hazard ratio (HR) 2.87, 95% CI 1.11-7.42, p = 0.03; HR 3.85, 95% CI 1.49-9.96, p = 0.006, respectively]. p16 and p53 expressions in tumour cells were detected in 12% (n = 9) and 46% (n = 40) of cases, respectively. No differences in DFS were observed between p16+ and p16- (p = 0.125) and between p53+ and p53- tumours (p = 0.213). In conclusion, radical surgery, eventually followed by adjuvant radiotherapy or chemo-radiotherapy, can achieve high cure rates in OTSCC. After long-term follow-up, perineural invasion and extra-nodal extension confirmed their role as prognostic factors associated with reduced DFS in OTSCC patients.

Deregulation of extracellular matrix modeling with molecular prognostic markers revealed by transcriptome sequencing and validations in Oral Tongue squamous cell carcinoma

“…In the exclusive cohort of early stage patients treated by surgery, cervical node and peri-neural invasion significantly predicted failure in early stage OTSCC as reported earlier 76 , 77 . Loss of membrane ECAD at ITF predicted both risk of recurrence and death.…”

Prognostic Value of Perineural Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

“…Among the cohort studies, three ( 26 , 30 , 49 ) scored 7 stars, four ( 27 , 29 , 47 , 48 ) scored 8 stars, and two ( 44 , 45 ) scored 9 stars ( Supplementary Table S1 ). For the other studies evaluated using MINORS, one ( 32 ) scored 5 points, five ( 20 , 25 , 28 , 31 , 50 ) scored 6 points, and one ( 46 ) scored 8 points ( Supplementary Table S3 ).…”

“…A significant number of recently published research has outlined the contribution of PNI to clinical outcome in OTSCC (10,(19)(20)(21)(25)(26)(27)(28)(29)(30)(31)(32), but the results remain conflicting. Therefore, this meta-analysis aimed to determine whether patients with OTSCC with PNI have a worse prognosis than those without PNI.…”

“…Table 1 presents the characteristics of the studies (20,(25)(26)(27)(28)(29)(30)(31)(32)(43)(44)(45)(46)(47)(48)(49)(50), including one RCT (43), three prospective cohort studies (44)(45)(46), and 13 retrospective studies (20,(25)(26)(27)(28)(29)(30)(31)(32)(47)(48)(49)(50). Eight studies were from Asia (20,30,32,43,44,46,47,50), one was Australia (45), three were from Europe (25,28,29), and five were from North America (26,27,31,48,49). The 17 studies included a total of ...…”

“…PNI is associated with the depth of invasion of OTSCC (22) and cervical lymph node involvement and might suggest consideration for elective neck dissection (23), even in stage 1 and 2 diseases (24). A significant number of recently published research has outlined the contribution of PNI to clinical outcomes in OTSCC (10,(19)(20)(21)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Some authors advocate incorporating PNI in the staging systems for OTSCC (34).…”