Comparison of histopathological and clinical prognostic factors of oral squamous cell carcinomas
Authors:
J. Michálek 1; R. Pink 2; Z. Dvořák 2,3; S. Brychtová 1; D. Král 2; P. Tvrdý 2; Z. Kolář 1
Authors place of work:
Ústav klinické a molekulární patologie, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice, Olomouc
1; Klinika ústní, čelistní a obličejové chirurgie, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice, Olomouc
2; Klinika plastické a estetické chirurgie, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice u sv.
3
Published in the journal:
Česká stomatologie / Praktické zubní lékařství, ročník 119, 2019, 3, s. 68-79
Category:
Original articles
Summary
Introduction, aim: Oral carcinomas are a significant component of human tumors and their incidence has increased in recent years. The most important histopathological factors affecting the treatment and prognosis of oral squamous cell carcinoma include localization, size, depth of invasion, histological type, tumor grade, intravascular and perineural invasion, positivity of surgical margins and tumor to margin distance, metastases in regional lymph nodes, extracapsular spreading and type of bone invasion. The aim of the study is to evaluate the relationship of selected histopathological and clinical parameters to the stage of cancer in the group of patients operated for oral squamous cell carcinoma.
Methods: The group consisted of 42 patients (33 males and 9 females) operated for oral squamous cell carcinoma in 2005–2015, where the reconstruction phase of the operation was subsequently performed. Histological samples have been evaluated prospectively (after 2013) or re-evaluated with revision of pathological findings in biopsies prior to 2013. The values of clinical and pathological parameters were analyzed by the methods of descriptive statistics and their correlation was compared by Pearson χ2 test (Statistica 12, StatSoft), p values < 0.05 were considered statistically significant.
Results: The most common tumor location was at the floor of mouth and tongue, with spread to the lower jaw alveolar process. The treatment was initiated in stage II in 26% of patients, in stage III in 19% and in stage IV in 55%. With increasing tumor stage, there were higher rates of nodal metastases (p = 0.00004) extracapsular tumor spreading (p = 0.004), maximal depth of invasion, higher tumor grade (p = 0.001), higher recurrence rate (p = 0.039) and mortality (p = 0.003). In stage III and IV, a trend of increased frequency of perineural tumor spreading has been noted (p = 0.07). The local tumor recurrence in stage IV was associated with tumor-related death in 92,85% of cases and in the majority of cases with previous positive surgical margin.
Conclusion: In the oncology of oral carcinoma, close cooperation of all specialists involved in the diagnosis and treatment of these tumors (dentist, surgeon, pathologist, oncologist) is important. Histopathological examination of oral cancers is an important part of comprehensive patient care and provides the most important prognostic information. The goal of proper planning of the entire surgical procedure is to completely remove the tumor with healthy surgical margins as well as good aesthetic and functional results.
Keywords:
head and neck squamous cell carcinoma – oral cancer
Zdroje
1. Wong RJ, Keel SB, Glynn RJ, Varvares MA. Histological pattern of mandibular invasion by oral squamous cell carcinoma. Laryngoscope. 2000; 110: 65–72.
2. Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009; 45: 309–316.
3. Institute of Health Information and Statistics of the Czech Republic: Cancer incidence in the Czech republic, 2016 [cit. 10.6.2019] Dostupné z: http://www.uzis.cz/katalog/
zdravotnicka-statistika/novotvary.
4. Jimi E, Furuta H, Matsuo K, Tominaga K, Takahashi T, Nakanishi O. The cellular and molecular mechanisms of bone invasion by oral squamous cell carcinoma. Oral Dis. 2011; 17(5): 462–468.
5. Karaca IR, Ozturk DN. Oral cancer: Etiology and risk factors. J Cancer Res Ther. 2019; 15(3): 739.
6. Castellsagué X, Alemany L, Quer M, et al. HPV involvement in head and neck cancers: comprehensive assessment of biomarkers in 3680 patients. J Natl Cancer Inst. 2016; 108: djv403.
7. Sehnal B, Podlešák T, Kmoníčková E, Nipčová M, Driák D, Sláma J, Zikán M. Anogenital HPV infection as the potential risk factor for oropharyngeal carcinoma. Klin Onkol. 2018; 31(2): 103–109.
8. Slávik M, Kazda T, Selingerová I, Šána J, Ahmad P, Gurín D, Hermanová M, Novotný T, Červená R, Dymáčková R, Burkoň P, Slabý O, Šlampa P. Vliv velikosti nádorové masy a stavu p16 na léčebné výsledky – dosažení kompletní remise u prospektivně sledovaných pacientů s nádory orofaryngu. Klin Onkol. 2019; 32(1): 58–65.
9. Kumar M, Nanavati R, Modi TG, Dobariya C. Oral cancer: Etiology and risk factors:
A review. J Cancer Res Ther. 2016; 12(2): 458–463.
10. Rivera C. Essentials of oral cancer. Int J Clin Exp Pathol. 2015; 8(9): 11884–11894.
11. Jadhav KB, Gupta N. Clinicopathological prognostic implicators of oral squamous cell carcinoma: need to understand and revise. N Am J Med Sci. 2013; 5(12): 671–679.
12. Shah J, Lydiatt WM. Buccal mucosa, alveolus, retromolar trigone, floor of mouth, hard palate and tongue tumors. In: Thawley SE, ed. Comprehensive management of head and neck tumors. 2nd ed. WB Saunders: Philadelphia, 1999: 686–693.
13. Brierley JD, Gospodarowicz MK, Wittekind C. TNM Classification of Malignant Tumours.
8th ed. Wiley Blackwell; 2017.
14. Totsuka Y, Usui Y, Tei K, Fukuda H,Shindo M, Iizuka T, Amemiya A. Mandibular involvement by squamous cell carcinoma of the lower alveolus: analysis and comparative study of histologic and radiologic features. Head Neck. 1991; 13 (1): 40–50.
15. Slootweg PJ, Müller H. Mandibular invasion by oral squamous cell carcinoma. J Craniomaxillofac Surg. 1989; 17(2): 69–74.
16. Carter RL, Tsao SW, Burman JF, Pittam MR, Clifford P, Shaw, HJ. Patterns and mechanisms of bone invasion by squamous carcinomas of the head and neck. Am J Surg. 1983; 146(4): 451–455.
17. Shah JP, Gil Z. Current concepts in management of oral cancer-surgery. Oral Oncol. 2009; 45(4–5): 394–401.
18. Mohit-Tabatabai MA, Sobel HJ, Rush BF, Mashberg A. Relation of thickness of floor of mouth stage I and II cancers to regional metastasis. Am J Surg. 1986; 152: 351–353.
19. Urist MM, O’Brien CJ, Soong SJ, Visscher DW, Maddox WA. Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors. Am J Surg. 1987; 154: 411–414.
20. Lodder WL, Teertstra HJ, Tan IB, Pameijer FA, Smeele LE, van Velthuysen ML, van den Brekel MW. Tumour thickness in oral cancer using an intra-oral ultrasound probe. Eur Radiol. 2011; 21(1): 98–106.
21. Akhter M, Hossain S, Rahman QB, Molla MR. A study on histological grading of oral squamous cell carcinoma and its co-relationship with regional metastasis. J Oral Maxillofac Pathol. 2011; 15(2): 168–176.
22. Thomas B, Stedman M, Davies L. Grade as a prognostic factor in oral squamous cell carcinoma: a population-based analysis of the data. Laryngoscope. 2014; 124(3): 688–694.
23. Shah AK. Postoperative pathologic assessment of surgical margins in oral cancer: A contemporary review. J Oral Maxillofac Pathol. 2018; 22(1): 78–85.
24. Sutton DN, Brown JS, Rogers SN, Vaughan ED, Woolgar JA. The prognostic implications of the surgical margin in oral squamous cell carcinoma. Int J Oral Maxillofac Surg. 2003; 32(1): 30–34.
25. Binmadi NO, Basile JR. Perineural invasion in oral squamous cell carcinoma: a discussion of significance and review of the literature. Oral Oncol. 2011; 47(11): 1005–1010.
26. Agarwal JP, Kane S, Ghosh-Laskar S, Pilar A, Manik V, Oza N, Wagle P, Gupta T, Budrukkar A, Murthy V, Swain M. Extranodal extension in resected oral cavity squamous cell carcinoma: more to it than meets the eye. Laryngoscope. 2019; 129(5): 1130–1136.
Štítky
Maxillofacial surgery Orthodontics Dental medicineČlánok vyšiel v časopise
Czech Dental Journal
2019 Číslo 3
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
- The Importance of Limosilactobacillus reuteri in Administration to Diabetics with Gingivitis
Najčítanejšie v tomto čísle
- The bollard bone anchored miniplates in patients with skeletal class iii malocclusion
- Comparison of histopathological and clinical prognostic factors of oral squamous cell carcinomas
- The cytocompatibility of anodized surfaces for implant materials