Clinicopathological and Prognostic Significance of Stromal Patterns in Oral Squamous Cell Carcinoma

Yusuke Amano; Atsushi Kihara; Masayo Hasegawa; Tamaki Miura; Daisuke Matsubara; Noriyoshi Fukushima; Hiroshi Nishino; Yoshiyuki Mori; Toshiro Niki

doi:10.3389/fmed.2022.859144

Clinicopathological and Prognostic Significance of Stromal Patterns in Oral Squamous Cell Carcinoma

Front Med (Lausanne). 2022 Apr 15:9:859144. doi: 10.3389/fmed.2022.859144. eCollection 2022.

Authors

Yusuke Amano¹, Atsushi Kihara¹, Masayo Hasegawa¹, Tamaki Miura¹, Daisuke Matsubara¹, Noriyoshi Fukushima¹, Hiroshi Nishino², Yoshiyuki Mori³, Toshiro Niki¹

Affiliations

¹ Department of Integrative Pathology, Jichi Medical University, Shimotsuke, Japan.
² Department of Otolaryngology, Jichi Medical University, Shimotsuke, Japan.
³ Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Shimotsuke, Japan.

Abstract

Background: Stromal patterns (SP), especially desmoplastic reactions, have recently gained attention as indicators of malignant potential in cancer. In this study, we explored the clinicopathological and prognostic significance of the SP in oral squamous cell carcinoma (OSCC).

Materials and methods: We reviewed 232 cases of surgically resected OSCC that were not treated with neoadjuvant chemoradiotherapy. We categorized the SP of the OSCC into four groups: immune/inflammatory (84 cases), mature (14 cases), intermediate (78 cases), or immature (56 cases).

Results: The SP category was significantly associated with various clinicopathological factors, such as the histological grade, lymphovascular invasion, neural invasion, and a diffuse invasion pattern. For each of the factors, the immune/inflammatory type was associated with favorable categories, while the immature type was associated with unfavorable categories (p ≤ 0.001). The SP category was also shown to be a prognostic predictor: the 5-year relapse-free survival (RFS) rate was 72.0% for the immune/inflammatory type, 66.7% for the intermediate/mature type, and 31.2% for the immature type (p < 0.0001), and the 5-year overall survival (OS) rate was 85.1% for the immune/inflammatory type, 76.4% for the intermediate/mature type, and 50.0% for the immature type (p < 0.0001). In multivariate analyses, the SP category was identified as an independent prognostic factor for RFS and OS.

Conclusion: Our SP categorization method provides valuable prognostic information in OSCC.

Keywords: desmoplastic reaction; epithelial-mesenchymal transition; oral squamous cell carcinoma; prognosis; stromal pattern.