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Depth of invasion, tumor budding, and worst pattern of invasion: Prognostic indicators in early‐stage oral tongue cancer
Author(s) -
Almangush Alhadi,
Bello Ibrahim O.,
Keski–Säntti Harri,
Mäkinen Laura K.,
Kauppila Joonas H.,
Pukkila Matti,
Hagström Jaana,
Laranne Jussi,
Tommola Satu,
Nieminen Outi,
Soini Ylermi,
Kosma VeliMatti,
Koivunen Petri,
Grénman Reidar,
Leivo Ilmo,
Salo Tuula
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23380
Subject(s) - tongue , tumor budding , hazard ratio , cancer , stage (stratigraphy) , medicine , tongue neoplasm , oncology , confidence interval , multivariate analysis , basal cell , proportional hazards model , t stage , pathology , gastroenterology , biology , metastasis , paleontology , lymph node metastasis
Abstract Background Oral (mobile) tongue squamous cell carcinoma (SCC) is characterized by a highly variable prognosis in early‐stage disease (T1/T2 N0M0). The ability to classify early oral tongue SCCs into low‐risk and high‐risk categories would represent a major advancement in their management. Methods Depth of invasion, tumor budding, histologic risk‐assessment score (HRS), and cancer‐associated fibroblast (CAF) density were studied in 233 cases of T1/T2 N0M0 oral tongue SCC managed in 5 university hospitals in Finland. Results Tumor budding (≥5 clusters at the invasive front of the tumor) and depth of invasion (≥4 mm) were associated with poor prognosis in patients with early oral tongue SCC (hazard ratio [HR], 2.04; 95% confidence interval [CI], 1.17–3.55; HR, 2.55; 95% CI, 1.25–5.20, respectively) after multivariate analysis. The HRS and CAF density did not predict survival. However, high‐risk worst pattern of invasion (WPOI), a component of HRS, was also an independent prognostic factor (HR, 4.47; 95% CI, 1.59–12.51). Conclusion Analyzing the depth of invasion, tumor budding, and/or WPOI in prognostication and treatment planning of T1/T2 N0M0 oral tongue SCC is recommended. © 2013 The Authors. Head Neck 36: 811–818, 2014