Staging and grading of oral squamous cell carcinoma: An update

Alhadi Almangush; Antti A Mäkitie; Asterios Triantafyllou; Remco de Bree; Primož Strojan; Alessandra Rinaldo; Juan C Hernandez-Prera; Carlos Suárez; Luiz P Kowalski; Alfio Ferlito; Ilmo Leivo

doi:10.1016/j.oraloncology.2020.104799

Staging and grading of oral squamous cell carcinoma: An update

Oral Oncol. 2020 Aug:107:104799. doi: 10.1016/j.oraloncology.2020.104799. Epub 2020 May 20.

Authors

Affiliations

¹ Department of Pathology, University of Helsinki, Helsinki, Finland; Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Institute of Biomedicine, Pathology, University of Turku, Turku, Finland; Faculty of Dentistry, University of Misurata, Misurata, Libya. Electronic address: alhadi.almangush@helsinki.fi.
² Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden. Electronic address: antti.makitie@helsinki.fi.
³ Department of Pathology, Liverpool Clinical Laboratories and School of Dentistry, University of Liverpool, Liverpool, UK. Electronic address: A.Triantafyllou@liverpool.ac.uk.
⁴ Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: r.debree@umcutrecht.nl.
⁵ Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia. Electronic address: pstrojan@onko-i.si.
⁶ University of Udine School of Medicine, Udine, Italy. Electronic address: alessandra.rinaldo@uniud.it.
⁷ Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA. Electronic address: Juan.Hernandez-Prera@moffitt.org.
⁸ Instituto de Investigacion Sanitaria del Principado de Asturias and (CIBERONC), ISCIII, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
⁹ Head and Neck Surgery and Otorhinolaryngology Department, A C Camargo Cancer Center, Sao Paulo, Brazil; Head and Neck Surgery, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil. Electronic address: lp_kowalski@uol.com.br.
¹⁰ Coordinator of the International Head and Neck Scientific Group, Padua, Italy. Electronic address: alfio.ferlito@uniud.it.
¹¹ Institute of Biomedicine, Pathology, University of Turku, Turku, Finland. Electronic address: ilmo.leivo@utu.fi.

PMID: 32446214
DOI: 10.1016/j.oraloncology.2020.104799

Abstract

Oral squamous cell carcinoma (OSCC) is a common malignancy of the head and neck region. OSCC has a relatively low survival rate and the incidence of the disease is increasing in some geographic areas. Staging and grading of OSCC are established prerequisites for management, as they influence risk stratification and are the first step toward personalized treatment. The current AJCC/UICC TNM staging (8th edition, 2017) of OSCC has included significant modifications through the incorporation of depth of invasion in the T stage and extracapsular spread/extranodal extension in the N stage. Further modifications for AJCC 8 have been suggested. On the other hand, the World Health Organization (WHO) classification (4th edition, 2017) still endorses a simple, differentiation-based histopathologic grading system of OSCC (despite its low prognostic value) and ignores factors such as tumor growth pattern and dissociation, stromal reactions (desmoplasia, local immune response), and tumor-stroma ratio. The various controversies and possible developments of the current staging and grading criteria of OSCC are briefly discussed in this update together with possible applications of artificial intelligence in the context of screening and risk stratification.

Keywords: Grading; Oral squamous cell carcinoma (OSCC); Prognosis; Staging.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Carcinoma, Squamous Cell
Female
Humans
Male
Mouth Neoplasms
Neoplasm Grading / methods*
Neoplasm Staging / methods*
Prognosis