title: Poor Correlation of Histologic Parameters Between Biopsy and Resection Specimen in Early Stage Oral Squamous Cell Carcinoma.
abstract: OBJECTIVE
  Infiltration depth, perineural growth (PG), vascular invasive growth (VG), and infiltrative growth (IG) are associated with regional metastases in oral squamous cell carcinomas (OSCCs). Preoperative knowledge of these parameters could facilitate the treatment planning of the neck. The aim of this study was to evaluate if the biopsy specimen correlates with the resection specimen.
  
  
  METHODS
  In total, 149 patients with a pT1-2cN0 OSCC were included. Biopsy thickness and tumor thickness were analyzed. Occurrence of PG, VG, and IG was determined on biopsy and resection specimens and correlated with the N status and survival. Sensitivity, specificity, positive and negative predictive value, and diagnostic gain of the biopsy specimen were calculated.
  
  
  RESULTS
  N+ patients showed PG, VG, and IG significantly more often in the resection specimen compared with N- patients (P = .02, P = .001, and P = .001, respectively). Histologic parameters in the biopsy specimens did not correlate with N status or survival. The positive diagnostic gain for biopsy specimens with PG, VG, and IG was 57%, 40%, and 19%, respectively. The negative diagnostic gain was 2%, 0%, and 22%, respectively.
  
  
  CONCLUSIONS
  Histologic parameters in biopsy specimens do not represent the resection specimen. Determination of histologic parameters in routinely taken biopsy specimens of OSCC is not helpful in deciding whether to treat the neck.
authors.affiliation: From the Departments of Oral and Maxillofacial Surgery and Department of Cranio-maxillofacial Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. eric.dik@mumc.nl.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Dik
authors.affiliation: From the Departments of Oral and Maxillofacial Surgery and.
authors.forename: Norbertus A
authors.initials: NA
authors.lastname: Ipenburg
authors.affiliation: From the Departments of Oral and Maxillofacial Surgery and.
authors.forename: Sven O
authors.initials: SO
authors.lastname: Adriaansens
authors.affiliation: Department of Cranio-maxillofacial Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Kessler
authors.affiliation: From the Departments of Oral and Maxillofacial Surgery and.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: van Es
authors.affiliation: Pathology, University Medical Center Utrecht, Utrecht, the Netherlands; and.
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Willems
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality; D055088:Early Detection of Cancer; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000401:mortality; D009367:Neoplasm Staging / Q000379:methods; D019647:Oral Surgical Procedures; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: Biopsy; Histologic growth pattern; Intratumor heterogeneity; Node-negative neck; Oral squamous cell carcinoma