A simple novel prognostic model for early stage oral tongue cancer

A Almangush; R D Coletta; I O Bello; C Bitu; H Keski-Säntti; L K Mäkinen; J H Kauppila; M Pukkila; J Hagström; J Laranne; S Tommola; Y Soini; V-M Kosma; P Koivunen; L P Kowalski; P Nieminen; R Grénman; I Leivo; T Salo

doi:10.1016/j.ijom.2014.10.004

A simple novel prognostic model for early stage oral tongue cancer

Int J Oral Maxillofac Surg. 2015 Feb;44(2):143-50. doi: 10.1016/j.ijom.2014.10.004. Epub 2014 Nov 11.

Authors

A Almangush¹, R D Coletta², I O Bello³, C Bitu⁴, H Keski-Säntti⁵, L K Mäkinen⁵, J H Kauppila⁶, M Pukkila⁷, J Hagström⁸, J Laranne⁹, S Tommola¹⁰, Y Soini¹¹, V-M Kosma¹¹, P Koivunen¹², L P Kowalski¹³, P Nieminen¹⁴, R Grénman¹⁵, I Leivo¹⁶, T Salo¹⁷

Affiliations

¹ Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland; Institute of Dentistry, University of Misurata, Misurata, Libya. Electronic address: alhadi.almangush@helsinki.fi.
² Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil.
³ Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland; Department of Oral Medicine and Diagnostic Sciences, King Saud University, Riyadh, Saudi Arabia.
⁴ Department of Diagnostics and Oral Medicine, Institute of Dentistry, University of Oulu, Oulu, Finland.
⁵ Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland.
⁶ Departments of Surgery and Pathology, University of Oulu and Oulu University Hospital, Oulu, Finland.
⁷ Department of Otorhinolaryngology and Head and Neck Surgery, Kuopio University Hospital, Kuopio, Finland.
⁸ Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland; Department of Oral Pathology, Institute of Dentistry, University of Helsinki, Helsinki, Finland.
⁹ Department of Otorhinolaryngology and Head and Neck Surgery, Tampere University Hospital, Tampere, Finland.
¹⁰ Department of Pathology, Tampere University Hospital, Tampere, Finland.
¹¹ Department of Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
¹² Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Central Hospital, Oulu, Finland.
¹³ Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Centre, São Paulo SP, Brazil.
¹⁴ Department of Medical Informatics and Statistics, University of Oulu, Oulu, Finland.
¹⁵ Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, University of Turku, Turku, Finland.
¹⁶ Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland; Department of Pathology, University of Turku, Turku, Finland.
¹⁷ Department of Diagnostics and Oral Medicine, Institute of Dentistry, University of Oulu, Oulu, Finland; Department of Diagnostics and Oral Medicine, Oulu University Hospital and Medical Research Centre, Oulu, Finland; Institute of Dentistry, University of Helsinki, Helsinki, Finland.

PMID: 25457829
DOI: 10.1016/j.ijom.2014.10.004

Abstract

The prognostication of patient outcome is one of the greatest challenges in the management of early stage oral tongue squamous cell carcinoma (OTSCC). This study introduces a simple histopathological model for the prognostication of survival in patients with early OTSCC. A total of 311 cases (from Finland and Brazil) with clinically evaluated early stage OTSCC (cT1-T2cN0cM0) were included in this multicentre retrospective study. Tumour budding (B) and depth of invasion (D) were scored on haematoxylin-eosin-stained cancer slides. The cut-off point for tumour budding was set at 5 buds (low <5; high ≥5) and for depth of invasion at 4mm (low <4mm; high ≥4mm). The scores of B and D were combined into one model: the BD predictive model. On multivariate analysis, a high risk score (BD score 2) correlated significantly with loco-regional recurrence (P=0.033) and death due to OTSCC (P<0.001) in early stage OTSCC. The new BD model is a promising prognostic tool to identify those patients with aggressive cases of early stage OTSCC who might benefit from multimodality treatment.

Keywords: BD model; depth of invasion; oral tongue squamous cell carcinoma; prognosis; tumour budding.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Brazil / epidemiology
Carcinoma, Squamous Cell / mortality
Carcinoma, Squamous Cell / pathology*
Child
Female
Finland / epidemiology
Humans
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment
Survival Analysis
Tongue Neoplasms / mortality
Tongue Neoplasms / pathology*