The prognostic role of histologic grade, worst pattern of invasion, and tumor budding in early oral tongue squamous cell carcinoma: a comparative study

Xu, Bin; Salama, Abeer M.; Valero, Cristina; Yuan, Amy; Khimraj, Anjanie; Saliba, Maelle; Zanoni, Daniella Karassawa; Ganly, Ian; Patel, Snehal G.; Katabi, Nora; Ghossein, Ronald

doi:10.1007/s00428-021-03063-z

Cited by 51 publications

(97 citation statements)

References 35 publications

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“…Although WPOI was recently reported as a strong pathological predictor for locoregional recurrence in OTSCC, 16,36–38 it has not been considered in treatment planning of early‐stage OTSCC until now. Most of the recent studies have confirmed the prognostic significance of WPOI in head and neck SCC 66 …”

Section: Discussionmentioning

confidence: 84%

“…Most of the recent studies have confirmed the prognostic significance of WPOI in head and neck SCC. 66 Most of the studies on histopathological prognostic markers (e.g., depth of invasion, degree of differentiation, pattern of invasion, and mitotic activity) in conventional HE-stained samples have focused on cancer cells. However, tumor progression has also been reported to depend on the stroma surrounding the tumor.…”

Section: Discussionmentioning

confidence: 99%

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Emerging histopathologic markers in early‐stage oral tongue cancer: A systematic review and meta‐analysis

et al. 2022

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Although there are many histopathologic prognosticators, grading of early oral tongue squamous cell carcinoma (OTSCC) is still based on morphological cell differentiation which has low prognostic value. Here we summarize the emerging histopathological markers showing powerful prognostic value, but are not included in pathology reports. Using PubMed, Scopus, Ovid Medline, and Web of Science databases, a systematic literature search was preformed to identify early OTSCC studies that investigated the prognostic significance of hematoxylin-eosin-based histopathologic markers. Our meta-analysis showed that tumor budding was associated with overall survival (hazard ratio[HR] 2.32; 95% CI 1.40-3.84; p < 0.01) and disease-specific survival (DSS) (1.89; 95% CI 1.13-3.15; p = 0.02). Worst pattern of invasion was associated with disease-free survival (DFS) (1.95; 95% CI 1.04-3.64; p = 0.04). Tumor-Alhadi Almangush and Tuula Salo jointly supervised this work.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Emerging histopathologic markers in early‐stage oral tongue cancer: A systematic review and meta‐analysis

et al. 2022

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“…The heterogeneity was significantly high only for OS, and the exclusion of study of Xu et al. ( 33 ) changed notably the results (HR: 4.14, 95% CI: 2.55–6.72, p < 0.00001, I 2 = 0%).…”

Section: Resultsmentioning

confidence: 94%

“…The presence of high bud activity was highly associated with poor OS (HR: 2.96, 95% CI: 1.36-6.45, p = 0.006, I 2 = 73%) (Supplementary Figure S13A), DSS (HR: 1.72, 95% CI: 1.35-2.18, p < 0.00001, I 2 = 0%) (Supplementary Figure S13B) and DFS (HR: 2.02, 95% CI: 1.50-2.71, p < 0.00001, I 2 = 30%) (Supplementary Figure S13C). The heterogeneity was significantly high only for OS, and the exclusion of study of Xu et al (33) changed notably the results (HR: 4.14, 95% CI: 2.55-6.72, p < 0.00001, I 2 = 0%).…”

Section: Tumor Buddingmentioning

confidence: 90%

The Impact of Histopathological Features on the Prognosis of Oral Squamous Cell Carcinoma: A Comprehensive Review and Meta-Analysis

et al. 2021

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ObjectiveOver many decades, studies on histopathological features have not only presented high-level evidence of contribution for treatment directions and prognosis of oral squamous cell carcinoma (OSCC) but also provided inconsistencies, making clinical application difficult. The 8th TNM staging system of OSCC has acknowledged the importance of some histopathological features, by incorporating depth of invasion (DOI) to T category and extranodal extension (ENE) to N category. The aim of this systematic review with meta-analysis is to determine the most clinically relevant histopathological features for risk assessment and treatment planning of OSCC and to elucidate gaps in the literature.MethodsA systematic review was conducted using PRISMA guidelines, and the eligibility criteria were based on population, exposure, comparison, outcome, and study type (PECOS). PubMed, Cochrane, Scopus, and Web of Science were searched for articles exploring the impact of histopathological features on OSCC outcomes with Cox multivariate analysis. Pooled data were subjected to an inverse variance method with random effects or fixed effect model, and the risk of bias was evaluated using quality in prognosis studies (QUIPS). Quality of evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.ResultsThe study included 172 articles published from 1999 to 2021. Meta-analyses confirmed the prognostic potential of DOI, ENE, perineural invasion, lymphovascular invasion, and involvement of the surgical margins and brought promising results for the association of bone invasion, tumor thickness, and pattern of invasion with increased risk for poor survival. Although with a small number of studies, the results also revealed a clinical significance of tumor budding and tumor-stroma ratio on predicted survival of patients with OSCC. Most of the studies were considered with low or moderate risk of bias, and the certainty in evidence varied from very low to high.ConclusionOur results confirm the potential prognostic usefulness of many histopathological features and highlight the promising results of others; however, further studies are advised to apply consistent designs, filling in the literature gaps to the pertinence of histopathological markers for OSCC prognosis.Systematic Review RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO), identifier CRD42020219630.

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“…22 The HPV-negative keratinizing squamous cell carcinoma is traditionally graded as well-differentiated, moderately differentiated, and poorly differentiated using a three-tiered grading system. 23 Before the identification of HPV-positive OPSCC, many of these tumors were graded as poorly differentiated given their histologic resemblance of a poorly differentiated highly aggressive HPV-negative basaloid squamous cell T A B L E 1 Fundamental pathologic differences between HPV-positive and HPV-negative head and neck squamous cell carcinoma (HNSCC) carcinoma. 24 It is now known that the HPV-positive status trumps the histologic appearance to indicate a favorable prognosis.…”

Section: Basic Biology Of Hpv and Carcinogenesis Of Hpv-related Hncmentioning

confidence: 99%

HPV‐related head and neck cancers: Pathology and biology

Saliba

Ghossein

2021

Journal of Surgical Oncology

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Discovering the key role HPV plays in head and neck carcinogenesis has revolutionized our approach to cancers such as oropharyngeal carcinomas. As the role of HPV expands beyond the oropharynx, there is a pursued need to understand the oncogenic mechanisms of HPV-driven tumorigenesis and their implications. Optimizing HPV detection methods all while acknowledging their limitations will ensure our ability to diagnose HPV-driven neoplasia wherever clinically relevant.

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The prognostic role of histologic grade, worst pattern of invasion, and tumor budding in early oral tongue squamous cell carcinoma: a comparative study

Cited by 51 publications

References 35 publications

Emerging histopathologic markers in early‐stage oral tongue cancer: A systematic review and meta‐analysis

Emerging histopathologic markers in early‐stage oral tongue cancer: A systematic review and meta‐analysis

The Impact of Histopathological Features on the Prognosis of Oral Squamous Cell Carcinoma: A Comprehensive Review and Meta-Analysis

HPV‐related head and neck cancers: Pathology and biology

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