Depth of Invasion and Extranodal Extension: the Influential Factors to Predict Survival Rate of Patients with Oral Tongue Squamous Cell Carcinoma

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2024 Oct 10

PMID 39390390

Authors

Maedeh Ghorbanpour

Samaneh Salarvand

Sahar Salarvand

Fatemeh Shahsavari

Mohammad Shirkhoda

Pouyan Amini Shakib

Reza Ghalehtaki

Affiliations

Soon will be listed here.

Abstract

Background: Cancer staging is essential in determining patients' prognoses and designing the appropriate treatment strategy. American Joint Committee on Cancer has released the latest version of the staging system for tongue SCC. However, it is interesting to know whether this change in staging and the addition of depth of invasion (DOI) and the extra-nodal extension (ENE) have any influence on patients' prognosis.

Methods: In this retrospective cohort study, the pathology records of patients with tongue SCC who underwent surgery at the Pathology Department of Cancer Institute Hospital, 2017-2021, were collected by referring to the hospital information system. Then the rate of change of pT, pN, and overall stage were assessed based on American Joint Committee on Cancer 7th and 8th editions.

Results: The records of 204 patients were included in the final analysis. Significant changes in the staging system 2021 resulted in upstaging 64 patients (31.4%) in the overall stage, 91 patients (44.6%) in pT, and 30 patients (14.7%) in pN. The survival of upstaged patients was inferior compared to those without upstaging. However, this was not statistically significant for tumor and overall upstaging in the univariate analysis, while those with upstaged pN had significantly shorter survival. In the multivariate analysis, pT upstage also significantly impacted survival.

Conclusion: This study showed the importance of pathology reports based on the latest edition of the American Joint Committee on Cancer, the accuracy in examining factors such as depth of invasion and extra-nodal extension.

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References

Kano S, Sakashita T, Tsushima N, Mizumachi T, Nakazono A, Suzuki T . Validation of the 8th edition of the AJCC/UICC TNM staging system for tongue squamous cell carcinoma. Int J Clin Oncol. 2018; 23(5):844-850. DOI: 10.1007/s10147-018-1276-5. View

Ng J, Iyer N, Tan M, Edgren G . Changing epidemiology of oral squamous cell carcinoma of the tongue: A global study. Head Neck. 2016; 39(2):297-304. DOI: 10.1002/hed.24589. View

Matos L, Dedivitis R, Kulcsar M, de Mello E, Alves V, Cernea C . External validation of the AJCC Cancer Staging Manual, 8th edition, in an independent cohort of oral cancer patients. Oral Oncol. 2017; 71:47-53. DOI: 10.1016/j.oraloncology.2017.05.020. View

Kato M, Baek C, Chaturvedi P, Gallagher R, Kowalski L, Leemans C . Update on oral and oropharyngeal cancer staging - International perspectives. World J Otorhinolaryngol Head Neck Surg. 2020; 6(1):66-75. PMC: 7221211. DOI: 10.1016/j.wjorl.2019.06.001. View

Mascitti M, Zhurakivska K, Togni L, Caponio V, Almangush A, Balercia P . Addition of the tumour-stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma. Histopathology. 2020; 77(5):810-822. DOI: 10.1111/his.14202. View

Kim Y, Kim J . Increasing incidence and improving survival of oral tongue squamous cell carcinoma. Sci Rep. 2020; 10(1):7877. PMC: 7217912. DOI: 10.1038/s41598-020-64748-0. View

Arun I, Maity N, Hameed S, Jain P, Manikantan K, Sharan R . Lymph node characteristics and their prognostic significance in oral squamous cell carcinoma. Head Neck. 2020; 43(2):520-533. DOI: 10.1002/hed.26499. View

Yu S, Yu Z, Ye Z, Jia J . Comparative study on classifications of AJCC 8th and 7th in the patients with tongue squamous cell carcinoma. Oral Dis. 2022; 29(4):1542-1549. DOI: 10.1111/odi.14178. View

Thiagarajan S, Nair S, Nair D, Chaturvedi P, Kane S, Agarwal J . Predictors of prognosis for squamous cell carcinoma of oral tongue. J Surg Oncol. 2014; 109(7):639-44. DOI: 10.1002/jso.23583. View

10.

Ling W, Mijiti A, Moming A . Survival pattern and prognostic factors of patients with squamous cell carcinoma of the tongue: a retrospective analysis of 210 cases. J Oral Maxillofac Surg. 2012; 71(4):775-85. DOI: 10.1016/j.joms.2012.09.026. View

11.

Jardim J, Francisco A, Gondak R, Damascena A, Kowalski L . Prognostic impact of perineural invasion and lymphovascular invasion in advanced stage oral squamous cell carcinoma. Int J Oral Maxillofac Surg. 2014; 44(1):23-8. DOI: 10.1016/j.ijom.2014.10.006. View

12.

Ganly I, Patel S, Shah J . Early stage squamous cell cancer of the oral tongue--clinicopathologic features affecting outcome. Cancer. 2011; 118(1):101-11. DOI: 10.1002/cncr.26229. View

13.

Almangush A, Makitie A, Triantafyllou A, de Bree R, Strojan P, Rinaldo A . Staging and grading of oral squamous cell carcinoma: An update. Oral Oncol. 2020; 107:104799. DOI: 10.1016/j.oraloncology.2020.104799. View

14.

Pollaers K, Hinton-Bayre A, Friedland P, Farah C . AJCC 8th Edition oral cavity squamous cell carcinoma staging - Is it an improvement on the AJCC 7th Edition?. Oral Oncol. 2018; 82:23-28. DOI: 10.1016/j.oraloncology.2018.04.018. View

15.

Kumar M, Nanavati R, Modi T, Dobariya C . Oral cancer: Etiology and risk factors: A review. J Cancer Res Ther. 2016; 12(2):458-63. DOI: 10.4103/0973-1482.186696. View

16.

Troeltzsch M, Knosel T, Eichinger C, Probst F, Troeltzsch M, Woodlock T . Clinicopathologic features of oral squamous cell carcinoma: do they vary in different age groups?. J Oral Maxillofac Surg. 2014; 72(7):1291-300. DOI: 10.1016/j.joms.2014.01.009. View

17.

Durr M, van Zante A, Li D, Kezirian E, Wang S . Oral tongue squamous cell carcinoma in never-smokers: analysis of clinicopathologic characteristics and survival. Otolaryngol Head Neck Surg. 2013; 149(1):89-96. DOI: 10.1177/0194599813482876. View

18.

Li Y, Zhao Z, Liu X, Ju J, Chai J, Ni Q . Nomograms to estimate long-term overall survival and tongue cancer-specific survival of patients with tongue squamous cell carcinoma. Cancer Med. 2017; 6(5):1002-1013. PMC: 5430099. DOI: 10.1002/cam4.1021. View

19.

Tan W, Chia C, Tan H, Soo K, Iyer N . Prognostic significance of invasion depth in oral tongue squamous cell carcinoma. ORL J Otorhinolaryngol Relat Spec. 2012; 74(5):264-70. DOI: 10.1159/000343796. View

20.

Mascitti M, Rubini C, De Michele F, Balercia P, Girotto R, Troiano G . American Joint Committee on Cancer staging system 7th edition versus 8th edition: any improvement for patients with squamous cell carcinoma of the tongue?. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 126(5):415-423. DOI: 10.1016/j.oooo.2018.07.052. View