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Triple-positive Pathologic Findings in Oral Cavity Cancer Are Related to a Dismal Prognosis

Overview
Journal Laryngoscope
Date 2015 Jul 9
PMID 26152458
Citations 12
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Abstract

Objectives/hypothesis: Perineural invasion (PNI), lymphovascular invasion (LVI), and extracapsular spread (ECS) of lymph nodes are adverse histopathologic factors among patients with oral cancer. We analyzed the clinical impact of the combination of PNI, LVI, and ECS among patients with oral cancer.

Study Design: Retrospective analysis of patients with oral cancer that was treated primarily with surgery with at least 5 years of follow-up data in a tertiary referral center.

Methods: In total, 554 patients diagnosed with oral cavity squamous cell carcinoma who underwent operations consecutively between 2006 and 2008 in our hospital were enrolled. Clinical characteristics, 5-year survival rates, and local/regional control rates were analyzed.

Results: There were 41 females and 513 males. Patients with PNI, LVI, or ECS presented pathologically had 5-year overall survival rates of 58.4%, 50.4%, and 31.4%, respectively. Patients with both ECS and PNI or both ECS and LVI presented had 5-year overall survival rates of 31.5% and 22.2%, respectively. Patients presenting with triple-positive status (PNI, LVI, and ECS) had only a 20.0% 5-year overall survival rate. The 5-year local/regional control rate for patients with both ECS and PNI or both ECS and LVI was 26% and 44.4%, respectively; for all three factors, it was 26.7%.

Conclusion: Patients with triple-positive status (PNI, LVI, ECS), ECS and PNI, or ECS and LVI experienced very low 5-year local/regional control rates, 5-year overall, and disease-specific survival rates. Novel interventions are necessary to improve these clinical outcomes.

Level Of Evidence: 4.

Citing Articles

Perineural Invasion Unveiled: Deciphering the Prognostic Impact of Diameter and Quantity Subcategories in Oral Cancer.

Cheng H, Lin L, Lin H, Liu C J Otolaryngol Head Neck Surg. 2025; 54:19160216251316219.

PMID: 39902557 PMC: 11792026. DOI: 10.1177/19160216251316219.


Triple Positive Oral Squamous Cell Carcinoma Patients Predict Poor Survival Outcomes: Multiple Factor Positivity Warrants the Need for Modified Treatment Approaches.

Jain P, Sultania M, Muduly D, Chaudhary I, Ghalige H, Patro S J Maxillofac Oral Surg. 2024; 23(4):923-934.

PMID: 39118932 PMC: 11303734. DOI: 10.1007/s12663-024-02186-5.


Perineural Invasion Is a Significant Prognostic Factor in Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

Binmadi N, Alsharif M, Almazrooa S, Aljohani S, Akeel S, Osailan S Diagnostics (Basel). 2023; 13(21).

PMID: 37958235 PMC: 10649820. DOI: 10.3390/diagnostics13213339.


Association between Sarcopenia and Immediate Complications and Mortality in Patients with Oral Cavity Squamous Cell Carcinoma Undergoing Surgery.

Huang C, Lue K, Chen P, Hsieh T, Chou Y Cancers (Basel). 2022; 14(3).

PMID: 35159050 PMC: 8833832. DOI: 10.3390/cancers14030785.


Perineural invasion/lymphovascular invasion double positive predicts distant metastasis and poor survival in T3-4 oral squamous cell carcinoma.

Ting K, Lee T, Li W, Chang C, Chu P, Wang Y Sci Rep. 2021; 11(1):19770.

PMID: 34611254 PMC: 8492704. DOI: 10.1038/s41598-021-99280-2.