Reframing Histological Risk Assessment of Oral Squamous Cell Carcinoma in the Era of UICC 8th Edition TNM Staging
| Autor: | Brendan Conn, William A. Wallace, Morna MacNeill, Naomi Rahman |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Pathology Perineural invasion Kaplan-Meier Estimate Risk Assessment Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Statistical significance Lymphocytic host response medicine Clinical endpoint Humans Oral squamous cell carcinoma Pattern of invasion Stage (cooking) Aged Neoplasm Staging Aged 80 and over Original Paper Framingham Risk Score Squamous Cell Carcinoma of Head and Neck business.industry 030206 dentistry Middle Aged Prognosis Otorhinolaryngology 030220 oncology & carcinogenesis Disease Progression T-stage Female Mouth Neoplasms business Risk assessment |
| Zdroj: | Head and Neck Pathology |
| ISSN: | 1936-0568 |
| DOI: | 10.1007/s12105-020-01201-8 |
| Popis: | Objectives To assess whether application of the risk model originally proposed by Brandwein-Gensler, influences survival and disease progression in patients treated for oral squamous cell carcinoma (OSCCs) Materials and Methods Tumours from 134 T1 and T2 OSCC resections (7th edition) were scored independently by 3 histopathologists according to worst pattern of invasion (WPOI), lymphocytic host response (LHR) and perineural invasion (PNI) and categorised according to risk score. Local recurrence, locoregional recurrence, disease progression and overall survival were study endpoints. Interobserver variability of pathologist scoring was also assessed. Results Seventy-two patients (54%) were classified with low or intermediate risk and 62 (46%) patients were ‘high risk’. The inter-observer agreement was in moderate to strong agreement with the consensus scores (k range = 0.45–0.82). There was statistical significance between distant metastasis and ‘high risk’ tumours. Thirty tumours were upstaged to T3 in the 8th edition TNM staging, of which 83% had high risk scores. Overall risk score and TNM8 T stage has significant correlation with overall survival in comparison to the TNM 7 T stage. Conclusion ‘High risk’ tumours were significantly associated with distant metastasis possibly due to the greater likelihood of aggressive features such as WPOI and PNI. Primary tumours are more likely to express high risk features with increasing T stage. None of the patients classified as ‘low risk’ died perhaps suggesting these tumours represent a rare variant of OSCC with excellent prognosis. |
| Databáze: | OpenAIRE |
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