Prognosis of tongue squamous cell carcinoma associated with individual surgical margin and pathological features

Abstract

The specific muscular structure of the tongue greatly affects margin shrinkage and tumor invasion, making the optimal surgical margin controversial. This study investigated surgical margin correlated prognosis of TSCC (tongue squamous cell carcinoma) according to margin location and its value, and the histopathologic factors which are suggestive of tumor invasion. And we would like to propose defining of the surgical margin for TSCC via prognosis according to location and margin values. We reviewed 45 patients diagnosed with TSCC who visited Seoul National University Dental Hospital (SNUDH) (Seoul, Republic of Korea) from 2010 to 2019, who were managed by a single surgical team. Patient clinical and pathological data of patients were retrospectively reviewed, and in 36 out of 45 patients, the pathologic parameters including the worst pattern of invasion (WPOI) and tumor budding were investigated via diagnostic histopathology slide reading. When standardized with as 0.25 cm anterior margins, as 0.35 cm deep margin, there was no significant difference in disease specific survival (DSS) or loco-regional recurrence-free survival (LRFS). Additionally, there was a non-significant difference in DSS and LRFS at the nearest margin of 0.35 cm (P DSS =0.276, P LRFS =0.162). Aggressive WPOI and high tumor budding showed lower survival and recurrence-free survival, and there were significant differences in close margin and involved margin frequencies. In TSCC, the value and location of the surgical margin did not have a significant relationship with prognosis, but WPOI and tumor budding suggesting the pattern of muscle invasion affected survival and recurrence-free survival. WPOI and tumor budding should be considered when setting an optimal surgical margin.

Surgical margins in head and neck squamous cell carcinoma: a narrative review

“… 66 previously reported that there was no statistically significant correlation between the T stage and the SD in oral cancer ( P =0.193). A fourth consideration is the association between SD value and tumor aggressiveness 67 . Ota et al .…”

Therapeutic Targeting Tongue Squamous Cell Carcinoma via ICAM1 Antibody-Drug Conjugates in Preclinical Models

“…Additionally, tissue contraction during surgical resection may cause tumor cell clustering and unclear surgical margins 14 . Chemotherapy resistance is also a signi cant factor in postoperative recurrence cases 15 .…”