The prognostic value of individual histologic grading parameters in small lingual squamous cell carcinomas. The importance of the pattern of invasion

Abstract

Background. The histologic grading of the deep invasive margin of oral squamous cell carcinoma recently has been shown to have prognostic value, but previous series have not been homogeneous enough to allow grading parameters to be assessed individually. Methods. Forty‐seven small lingual carcinomas limited to the lateral border of the tongue and treated by radiotherapy were graded histologically at their deep invasive front. Clinical and grading parameters were correlated by statistical tests performed by permutational techniques. Results. Carcinoma recurred locally in 6 patients, and metastases developed in 19. Local recurrence correlated with Broders' grade (P = 0.0143), keratinization (P = 0.017) and pattern of invasion (P = 0.0195). Metastasis had a highly significant correlation with Broders' grade (P < 0.001), pattern of invasion (P < 0.001), and invasive front grading total score (P < 0.001). Seven of 8 carcinomas with diffuse infiltrating patterns metastasised, whereas only 4 of 25 with large islands or a broad infiltrating pattern metastasized. Conclusions. The usefulness of the deep invasive front grading system for small lingual carcinoma was demonstrated. The pattern of invasion was the component of the grading system that had the closest correlation with metastasis and recurrence in this type of carcinoma.

Validation of the Risk Model: High-Risk Classification and Tumor Pattern of Invasion Predict Outcome for Patients with Low-Stage Oral Cavity Squamous Cell Carcinoma

“…The Risk Model addresses this niche subgroup as a post-resection assessment that can be used to support the recommendation of adjuvant radiotherapy based on the weight of evidence. Multiparameter histological predictive models have been advocated in Europe since the 1970s and tumor pattern of invasion was a consistent component of these models [5][6][7][8][9][18][19][20][21][22]. Other components have included lymphocytic host response, exophytic versus endophytic growth pattern, mitotic rate, degree of keratinization, and nuclear pleomorphism.…”

Identification of site-specific prognostic biomarkers in patients with oral squamous cell carcinoma

“…Consistent findings reported by Costa et al [29] with high histological score in tongue carcinoma. In addition, several investigators have demonstrated a close relationship between the degree of histological differentiation and incidence of lymph node metastasis in OSCC [30,31]. In agreement to this, the present study demonstrated significant positive correlation between high histological grade of the tumors and tongue cancer indicating aggressive behavior of this anatomic site of the oral cavity.…”

Evaluation of Clinical and Histomorphological Parameters as Potential Predictors of Occult Metastases in Sentinel Lymph Nodes of Early Squamous Cell Carcinoma of the Oral Cavity

“…As in our study, many others failed to reveal a significant predictive value. 15,23,27,35,43 However, others were able to do so. 16,17,21,22,29,33,42 For the parameter muscle invasion there is only the report by Pimenta Amaral et al showing an association with nodal metastases.…”