title: For early-stage oral tongue cancer, depth of invasion and worst pattern of invasion are the strongest pathological predictors for locoregional recurrence and mortality.
abstract: Despite early diagnosis and treatment, almost 20% of patients with early-stage (cT1-cT2N0) oral tongue squamous cell carcinoma (OTSCC) still die of their disease. The prognosis of OTSCC patients is influenced by several demographic, clinical, and histopathologic factors. The aim of this multicenter international study was to find which of the factors age, gender, stage, grade, lymphocytic host response, perineural invasion, worst pattern of invasion, or depth of invasion has the strongest prognostic power in early-stage OTSCC. Patient data of 479 patients with early-stage (cT1-2N0) OTSCC in Finland, Brazil, and the USA were retrieved and analyzed using Cox proportional hazards regression models. Our results indicate that depth of invasion (DOI) and worst pattern of invasion (WPOI) are the strongest pathological predictors for locoregional recurrence, with a hazard ratio (HR) for 4 mm DOI of 1.67 (95% confidence interval (CI) 1.07-2.60) and HR for WPOI of 1.46 (95% CI 0.95-2.25). In addition, mortality from early OTSCC was also predicted by DOI (HR 2.44, 95% CI 1.34-4.47) and by WPOI (HR 2.34, 95% CI 1.26-4.32). We suggest that clinically early-stage oral tongue carcinomas 4 mm or deeper, or with a growth pattern of small cell islands or satellites, should be considered as high-risk tumors which require multimodality treatment.
authors.affiliation: Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland.
authors.forename: Alhadi
authors.initials: A
authors.lastname: Almangush
authors.forename: Ibrahim O
authors.initials: IO
authors.lastname: Bello
authors.forename: Ricardo D
authors.initials: RD
authors.lastname: Coletta
authors.forename: Antti A
authors.initials: AA
authors.lastname: Mäkitie
authors.forename: Laura K
authors.initials: LK
authors.lastname: Mäkinen
authors.forename: Joonas H
authors.initials: JH
authors.lastname: Kauppila
authors.forename: Matti
authors.initials: M
authors.lastname: Pukkila
authors.forename: Jaana
authors.initials: J
authors.lastname: Hagström
authors.forename: Jussi
authors.initials: J
authors.lastname: Laranne
authors.forename: Ylermi
authors.initials: Y
authors.lastname: Soini
authors.forename: Veli-Matti
authors.initials: VM
authors.lastname: Kosma
authors.forename: Petri
authors.initials: P
authors.lastname: Koivunen
authors.forename: Natalie
authors.initials: N
authors.lastname: Kelner
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
authors.forename: Reidar
authors.initials: R
authors.lastname: Grénman
authors.forename: Ilmo
authors.initials: I
authors.lastname: Leivo
authors.forename: Esa
authors.initials: E
authors.lastname: Läärä
authors.forename: Tuula
authors.initials: T
authors.lastname: Salo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D002648:Child; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D000077195:Squamous Cell Carcinoma of Head and Neck; D014062:Tongue Neoplasms / Q000401:mortality / Q000473:pathology*
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