title: Invasive front grading: reliability and usefulness in the management of oral squamous cell carcinoma.
abstract: BACKGROUND
  The value of histological grading was examined with emphasis on reliability of assessment in 102 cases of intraoral squamous cell carcinoma from Northern Ireland with known outcome.
  
  
  METHODS
  Two pathologists independently graded the invasive tumour front blinded to the stage and outcome.
  
  
  RESULTS
  Intraobserver agreement was acceptable but interobserver agreement was not satisfactory. The degree of keratinisation was assessed most consistently while nuclear polymorphism was the least reliable feature. Multivariate survival analysis showed that the total grading score was associated with overall survival while the pattern of tumour invasion was the most valuable feature in estimating regional lymph node involvement. The number of positive lymph nodes was strongly associated with regional relapse, while the treatment modality and status of the surgical margins correlated with local relapse.
  
  
  CONCLUSIONS
  Grading of selected features in OSCC is reliable and can facilitate treatment planning.
authors.affiliation: Department of Oral Pathology, Faculty of Dentistry, University of Jordan, Amman, Jordan.
authors.forename: Faleh A
authors.initials: FA
authors.lastname: Sawair
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Irwin
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Gordon
authors.forename: Alan G
authors.initials: AG
authors.lastname: Leonard
authors.forename: Mike
authors.initials: M
authors.lastname: Stephenson
authors.forename: Séamus S
authors.initials: SS
authors.lastname: Napier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007633:Keratins / Q000032:analysis; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009062:Mouth Neoplasms / Q000473:pathology*; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D015588:Observer Variation; D011110:Polymorphism, Genetic; D011379:Prognosis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D016019:Survival Analysis
chemical_list: D007633:Keratins