Histopathologic prognostic indices in tongue squamous cell carcinoma
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Histopathologic prognostic indices in tongue squamous cell carcinoma Linus Lau1 · Donovan Eu1 · Thomas Loh1 · Qasim Ahmed2 · Chwee Ming Lim3,4 Received: 20 June 2020 / Accepted: 28 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Consistent prognosticators are needed to guide adjuvant treatment in tongue squamous cell carcinoma (SCC). We validate the prognostic significance of histopathologic parameters in surgically treated tongue SCC. Methods Archival specimens of 88 consecutive patients who were treated surgically for tongue SCC from 2003 to 2016 were re-analyzed by one pathologist. Patient records were retrospectively reviewed. Prognosticators of recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS) were identified using multivariate analysis. Results Tumor depth of invasion (DOI) > 6 mm (OR 4.76; 95%CI 1.22–18.5; p = 0.024) and lymphovascular invasion (OR 5.61; 95%CI 1.00–31.5; p = 0.05) were independent predictors of nodal metastases. The overall 5-year RFS, OS and DSS were 70%, 82% and 84% respectively. Positive margins predicted poor RFS (HR 3.91; 95%CI 1.58–9.65; p = 0.003) and local recurrence-free survival (HR 4.96; 95%CI 1.36–18; p = 0.015). Presence of nodal metastases (HR 5.03; 95%CI 1.73–14.6; p = 0.003), tumor DOI > 6 mm (HR 9.91; 95%CI 1.26–78.0; p = 0.029) and positive margins (HR 8.26; 95%CI 2.75–24.8; p 6 mm.
Predictors of nodal metastases ROC curve analysis showed that a DOI > 6 mm had the highest sensitivity (82%) and specificity (56%) for predicting nodal metastases. Table 2 shows the clinicopathologic predictors of nodal metastases in univariate and multivariate analysis. Advanced T3–4 cancers (p = 0.033), DOI > 6 mm (p = 0.001), positive LVI (p = 0.03) and positive PNI (p 6 mm (OR 4.76; 95% CI 1.22–18.5; p = 0.024) and positive LVI (OR 5.61; 95% CI 1.00–31.5; p = 0.05) were independent predictors of nodal metastases.
Depth Of invasion and clinicopathologic parameters The overall mean and median tumor DOI were 9.7 mm and 8 mm respectively. Table 3 illustrates the significant associations between increasing DOI and advanced pT classification (p
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