title: A simple novel prognostic model for early stage oral tongue cancer.
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.
authors.affiliation: Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland; Institute of Dentistry, University of Misurata, Misurata, Libya. Electronic address: alhadi.almangush@helsinki.fi.
authors.forename: A
authors.initials: A
authors.lastname: Almangush
authors.affiliation: Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil.
authors.forename: R D
authors.initials: RD
authors.lastname: Coletta
authors.affiliation: Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland; Department of Oral Medicine and Diagnostic Sciences, King Saud University, Riyadh, Saudi Arabia.
authors.forename: I O
authors.initials: IO
authors.lastname: Bello
authors.affiliation: Department of Diagnostics and Oral Medicine, Institute of Dentistry, University of Oulu, Oulu, Finland.
authors.forename: C
authors.initials: C
authors.lastname: Bitu
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Keski-Säntti
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: L K
authors.initials: LK
authors.lastname: Mäkinen
authors.affiliation: Departments of Surgery and Pathology, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors.forename: J H
authors.initials: JH
authors.lastname: Kauppila
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Kuopio University Hospital, Kuopio, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Pukkila
authors.affiliation: Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland; Department of Oral Pathology, Institute of Dentistry, University of Helsinki, Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Hagström
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Laranne
authors.affiliation: Department of Pathology, Tampere University Hospital, Tampere, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Tommola
authors.affiliation: Department of Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Y
authors.initials: Y
authors.lastname: Soini
authors.affiliation: Department of Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: V-M
authors.initials: VM
authors.lastname: Kosma
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Central Hospital, Oulu, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Koivunen
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Centre, São Paulo SP, Brazil.
authors.forename: L P
authors.initials: LP
authors.lastname: Kowalski
authors.affiliation: Department of Medical Informatics and Statistics, University of Oulu, Oulu, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Nieminen
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, University of Turku, Turku, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Grénman
authors.affiliation: Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland; Department of Pathology, University of Turku, Turku, Finland.
authors.forename: I
authors.initials: I
authors.lastname: Leivo
authors.affiliation: 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.
authors.forename: T
authors.initials: T
authors.lastname: Salo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D002648:Child; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D014062:Tongue Neoplasms / Q000401:mortality / Q000473:pathology*
keywords: BD model; depth of invasion; oral tongue squamous cell carcinoma; prognosis; tumour budding