title: The prognostic value of histopathological grading systems in oral squamous cell carcinomas.
abstract: OBJECTIVE
  This study evaluated the association of four histopathological grading systems (WHO grading system, malignancy grading of the deep invasive margins (MG), histological risk (HR) model, and tumor budding and depth of invasion (BD) model) with clinicopathological parameters and outcome of 113 oral squamous cell carcinomas to identify their roles in prognosis.
  
  
  METHODS
  Demographic and clinical features were obtained from patients' records. Sections from all paraffin-embedded blocks were evaluated according to the four grading systems. Demographic and clinical associations were analyzed using chi-square test, and correlations between the grading systems were established with the Spearman's rank correlation test. Survival curves were performed with Kaplan-Meier method, and multivariate analysis based on Cox proportional hazard model was calculated.
  
  
  RESULTS
  Significant associations with survival were observed for WHO grading system and BD model in the univariate analysis, but only the BD model was significantly associated with disease outcome as an independent prognostic marker. Age, tumor size, and presence of regional metastasis were also independent markers of reduced survival.
  
  
  CONCLUSIONS
  A significant association between the BD model and outcome of OSCC patients was observed, indicating this new histopathological grading system as a possible prognostic tool.
authors.affiliation: Oral Pathology and Oral Medicine, Dentistry School, Western Paraná State University, Cascavel, Brazil.|Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
authors.forename: I
authors.initials: I
authors.lastname: Sawazaki-Calone
authors.affiliation: Oral Pathology and Oral Medicine, Dentistry School, Western Paraná State University, Cascavel, Brazil.
authors.forename: Alca
authors.initials: A
authors.lastname: Rangel
authors.affiliation: ANATOM Anatomic Pathology Laboratory, Cascavel, Brazil.
authors.forename: A G
authors.initials: AG
authors.lastname: Bueno
authors.affiliation: APC Anatomic Pathology Laboratory, Cascavel, Brazil.
authors.forename: C F
authors.initials: CF
authors.lastname: Morais
authors.affiliation: UOPECCAN Cancer Hospital, Cascavel, Brazil.
authors.forename: H M
authors.initials: HM
authors.lastname: Nagai
authors.affiliation: Oncology Center of Cascavel (CEONC), Cascavel, Brazil.
authors.forename: R P
authors.initials: RP
authors.lastname: Kunz
authors.affiliation: Oral Pathology and Oral Medicine, Dentistry School, Western Paraná State University, Cascavel, Brazil.
authors.forename: R L
authors.initials: RL
authors.lastname: Souza
authors.affiliation: Oral Pathology and Oral Medicine, Dentistry School, Western Paraná State University, Cascavel, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Rutkauskis
authors.affiliation: Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.|Department of Diagnostics and Oral Medicine, Institute of Dentistry and Oulu University Hospital, University of Oulu, Oulu, Finland.|Institute of Dentistry, University of Helsinki, Helsinki, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Salo
authors.affiliation: Department of Diagnostics and Oral Medicine, Institute of Dentistry and Oulu University Hospital, University of Oulu, Oulu, Finland.|Institute of Dentistry, University of Helsinki, Helsinki, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Almangush
authors.affiliation: Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
authors.forename: R D
authors.initials: RD
authors.lastname: Coletta
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D060787:Neoplasm Grading / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate; D047368:Tumor Burden
keywords: histopathological grading system; oral cancer; oral squamous cell carcinoma; prognosis; survival analysis