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Sellæg K, Schwienbacher R, Kranz M, Aamodt AE, Wirsing AM, Berge G, Hadler-Olsen E, Magnussen SN. 4-nitroquinoline 1-oxide-induced oral epithelial lesions exhibit time- and stage-dependent changes in the tumor immune microenvironment. Front Oncol 2024; 14:1343839. [PMID: 38812785 PMCID: PMC11133644 DOI: 10.3389/fonc.2024.1343839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/29/2024] [Indexed: 05/31/2024] Open
Abstract
Oral tongue squamous cell carcinoma (OTSCC) is the most common cancer of the oral cavity and is associated with high morbidity due to local invasion and lymph node metastasis. Tumor infiltrating lymphocytes (TILs) are associated with good prognosis in oral cancer patients and dictate response to treatment. Ectopic sites for immune activation in tumors, known as tertiary lymphoid structures (TLS), and tumor-associated high-endothelial venules (TA-HEVs), which are specialized lymphocyte recruiting vessels, are associated with a favorable prognosis in OSCC. Why only some tumors support the development of TLS and HEVs is poorly understood. In the current study we explored the infiltration of lymphocyte subsets and the development of TLS and HEVs in oral epithelial lesions using the 4-nitroquinoline 1-oxide (4NQO)-induced mouse model of oral carcinogenesis. We found that the immune response to 4NQO-induced oral epithelial lesions was dominated by T cell subsets. The number of T cells (CD4+, FoxP3+, and CD8+), B cells (B220+) and PNAd+ HEVs increased from the earliest to the latest endpoints. All the immune markers increased with the severity of the dysplasia, while the number of HEVs and B cells further increased in SCCs. HEVs were present already in early-stage lesions, while TLS did not develop at any timepoint. This suggests that the 4NQO model is applicable to study the dynamics of the tumor immune microenvironment at early phases of oral cancer development, including the regulation of TA-HEVs in OTSCC.
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Affiliation(s)
- Kjersti Sellæg
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø (UiT) – The Arctic University of Norway, Tromsø, Norway
| | - Ruth Schwienbacher
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø (UiT) – The Arctic University of Norway, Tromsø, Norway
- Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway
| | - Mathias Kranz
- PET Imaging Center Tromsø, University Hospital of North Norway, Tromsø, Norway
| | - Anna Engan Aamodt
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø (UiT) – The Arctic University of Norway, Tromsø, Norway
| | - Anna M. Wirsing
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø (UiT) – The Arctic University of Norway, Tromsø, Norway
| | - Gerd Berge
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø (UiT) – The Arctic University of Norway, Tromsø, Norway
| | - Elin Hadler-Olsen
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø (UiT) – The Arctic University of Norway, Tromsø, Norway
- The Public Dental Health Competence Center of Northern Norway, Tromsø, Norway
| | - Synnøve Norvoll Magnussen
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø (UiT) – The Arctic University of Norway, Tromsø, Norway
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Rapado-González Ó, Costa-Fraga N, Bao-Caamano A, López-Cedrún JL, Álvarez-Rodríguez R, Crujeiras AB, Muinelo-Romay L, López-López R, Díaz-Lagares Á, Suárez-Cunqueiro MM. Genome-wide DNA methylation profiling in tongue squamous cell carcinoma. Oral Dis 2024; 30:259-271. [PMID: 36398465 DOI: 10.1111/odi.14444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/14/2022] [Accepted: 11/05/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To provide a comprehensive characterization of DNA methylome of oral tongue squamous cell carcinoma (OTSCC) and identify novel tumor-specific DNA methylation markers for early detection using saliva. MATERIAL AND METHODS Genome-wide DNA methylation analysis including six OTSCC matched adjacent non-tumoral tissue and saliva was performed using Infinium MethylationEPIC array. Differentially methylated levels of selected genes in our OTSCC cohort were further validated using OTSCC methylation data from The Cancer Genome Atlas database (TCGA). The methylation levels of a set of tumor-specific hypermethylated genes associated with a downregulated expression were evaluated in saliva. Receiver operating characteristic (ROC) curves were performed to assess the diagnostic value of DNA methylation markers. RESULTS A total of 25,890 CpGs (20,505 hypomethylated and 5385 hypermethylated) were differentially methylated (DMCpGs) between OTSCC and adjacent non-tumoral tissue. Hypermethylation of 11 tumor-specific genes was validated in OTSCC TCGA cohort. Of these 11 genes, A2BP1, ANK1, ALDH1A2, GFRA1, TTYH1, and PDE4B were also hypermethylated in saliva. These six salivary methylated genes showed high diagnostic accuracy (≥0.800) for discriminating patients from controls. CONCLUSIONS This is the first largest genome-wide DNA methylation study on OTSCC that identifies a group of novel tumor-specific DNA methylation markers with diagnostic potential in saliva.
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Affiliation(s)
- Óscar Rapado-González
- Department of Surgery and Medical-Surgical Specialties, Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Galician Precision Oncology Research Group (ONCOGAL), Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Liquid Biopsy Analysis Unit, Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red en Cáncer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Nicolás Costa-Fraga
- Galician Precision Oncology Research Group (ONCOGAL), Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Epigenomics Unit, Cancer Epigenomics, Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago (IDIS), University Clinical Hospital of Santiago (CHUS, SERGAS), Santiago de Compostela, Spain
- Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Aida Bao-Caamano
- Galician Precision Oncology Research Group (ONCOGAL), Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Epigenomics Unit, Cancer Epigenomics, Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago (IDIS), University Clinical Hospital of Santiago (CHUS, SERGAS), Santiago de Compostela, Spain
- Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - José Luis López-Cedrún
- Department of Oral and Maxillofacial Surgery, Complexo Hospitalario Universitario de A Coruña (CHUAC, SERGAS), A Coruña, Spain
| | - Roberto Álvarez-Rodríguez
- Department of Pathology, Complexo Hospitalario Universitario de A Coruña (CHUAC, SERGAS), A Coruña, Spain
| | - Ana Belén Crujeiras
- Epigenomics in Endocrinology and Nutrition Group, Epigenomics Unit, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago (CHUS, SERGAS), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Laura Muinelo-Romay
- Galician Precision Oncology Research Group (ONCOGAL), Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Liquid Biopsy Analysis Unit, Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red en Cáncer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Rafael López-López
- Galician Precision Oncology Research Group (ONCOGAL), Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red en Cáncer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (CHUS, SERGAS), Santiago de Compostela, Spain
| | - Ángel Díaz-Lagares
- Galician Precision Oncology Research Group (ONCOGAL), Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red en Cáncer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Epigenomics Unit, Cancer Epigenomics, Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago (IDIS), University Clinical Hospital of Santiago (CHUS, SERGAS), Santiago de Compostela, Spain
| | - María Mercedes Suárez-Cunqueiro
- Department of Surgery and Medical-Surgical Specialties, Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Galician Precision Oncology Research Group (ONCOGAL), Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red en Cáncer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (CHUS, SERGAS), Santiago de Compostela, Spain
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Obayashi F, Koizumi K, Ito N, Higaki M, Ishida Y, Hamada A, Yamasaki S, Tani R, Yanamoto S. A Study of the Prognostic Factors for Late Cervical Lymph Node Metastasis and Distant Metastasis in Patients with cT1-2N0 Tongue Cancer. J Clin Med 2024; 13:976. [PMID: 38398289 PMCID: PMC10889310 DOI: 10.3390/jcm13040976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Early-stage tongue cancer has a good prognosis in general; however, high-risk patients with late cervical lymph node and distant metastases have a poor prognosis. Elective neck dissection and postoperative chemoradiotherapy are considered for these patients, although no clear criteria have been identified for their evaluation. Methods: This retrospective observational study aimed to determine the predictive factors for late cervical lymph node and distant metastases in 102 patients with cT1-2N0 tongue cancer. The data regarding the demographic characteristics, as well as the depth of invasion, tumor budding, histological grade, and tumor-stromal ratio, among other things, were extracted from medical records. Results: We found that the potential lymph node metastasis rate was 27.5%. The significant clinical predictors of late cervical lymph node metastasis were the tumor thickness and endophytic growth pattern and the significant histopathological factors were poorly and moderately differentiated tumors and ≥3 tumor buds. In addition, the prognostic factors for distant metastasis included ≥4 lymph node metastases, ≥7 tumor budding, and moderate and poor tumor differentiation. Conclusions: The usefulness of tumor budding as a predictor of metastasis for tongue cancer was suggested. The findings of this study can help establish the criteria for evaluating the metastasis risk and prognosis of patients with tongue cancers.
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Affiliation(s)
- Fumitaka Obayashi
- Department of Oral Oncology, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8553, Japan
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Navarro Cuéllar I, Espías Alonso S, Alijo Serrano F, Herrera Herrera I, Zamorano León JJ, Del Castillo Pardo de Vera JL, López López AM, Maza Muela C, Arenas de Frutos G, Ochandiano Caicoya S, Tousidonis Rial M, García Sevilla A, Antúnez-Conde R, Cebrián Carretero JL, García-Hidalgo Alonso MI, Salmerón Escobar JI, Burgueño García M, Navarro Vila C, Navarro Cuéllar C. Depth of Invasion: Influence of the Latest TNM Classification on the Prognosis of Clinical Early Stages of Oral Tongue Squamous Cell Carcinoma and Its Association with Other Histological Risk Factors. Cancers (Basel) 2023; 15:4882. [PMID: 37835576 PMCID: PMC10571553 DOI: 10.3390/cancers15194882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 09/17/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The American Joint Committee on Cancer (AJCC), in its 8th edition, introduces modifications to the previous TNM classification, incorporating tumour depth of invasion (DOI). The aim of this research is to analyse the prognosis (in terms of disease-free survival and overall survival) of clinical early stage (I and II) squamous cell carcinomas of the oral tongue according to the DOI levels established by the AJCC in its latest TNM classification to assess changes to the T category and global staging system and to evaluate the association between DOI and other histological risk factors. METHODS A retrospective longitudinal observational study of a series of cases was designed. All patients were treated with upfront surgery at our institution between 2010 and 2019. The variables of interest were defined and classified into four groups: demographic, clinical, histological and evolutive control. Univariate and multivariate analyses were carried out and survival functions were calculated using the Kaplan-Meier method. Statistical significance was established for p values below 0.05. RESULTS Sixty-one patients were included. The average follow-up time was 47.42 months. Fifteen patients presented a loco-regional relapse (24.59%) and five developed distant disease (8.19%). Twelve patients died (19.67%). Statistically significant differences were observed, with respect to disease-free survival (p = 0.043), but not with respect to overall survival (p = 0.139). A total of 49.1% of the sample upstaged their T category and 29.5% underwent modifications of their global stage. The analysis of the relationship between DOI with other histological variables showed a significant association with the presence of pathological cervical nodes (p = 0.012), perineural invasion (p = 0.004) and tumour differentiation grade (p = 0.034). Multivariate analysis showed association between depth of invasion and perineural invasion. CONCLUSIONS Depth of invasion is a histological risk factor in early clinical stages of oral tongue squamous cell carcinoma. Depth of invasion impacts negatively on patient prognosis, is capable per se of modifying the T category and the global tumour staging, and is associated with the presence of cervical metastatic disease, perineural invasion and tumoural differentiation grade.
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Affiliation(s)
- Ignacio Navarro Cuéllar
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
| | | | | | - Isabel Herrera Herrera
- Radiology Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
| | - José Javier Zamorano León
- Public Health and Maternal & Child Health Department, School of Medicine, Universidad Complutense, 28040 Madrid, Spain;
| | | | - Ana María López López
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
| | - Cristina Maza Muela
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
| | - Gema Arenas de Frutos
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
| | - Santiago Ochandiano Caicoya
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
| | - Manuel Tousidonis Rial
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
| | - Alba García Sevilla
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
| | - Raúl Antúnez-Conde
- Oral and Maxillofacial Surgery Department, Hospital Universitario Ruber Juan Bravo, 28006 Madrid, Spain;
| | - José Luis Cebrián Carretero
- Oral and Maxillofacial Surgery Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.L.C.C.); (M.B.G.)
| | | | - José Ignacio Salmerón Escobar
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
| | - Miguel Burgueño García
- Oral and Maxillofacial Surgery Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.L.C.C.); (M.B.G.)
| | - Carlos Navarro Vila
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
| | - Carlos Navarro Cuéllar
- Oral and Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (I.N.C.); (A.M.L.L.); (C.M.M.); (G.A.d.F.); (S.O.C.); (M.T.R.); (A.G.S.); (J.I.S.E.); (C.N.V.); (C.N.C.)
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Selvaraj FM, Joseph AP, Pillai VR, Ramani P, Pazhani J, Mony V. Significance of tumour budding and invasive characteristics in grading of oral squamous cell carcinoma. J Oral Maxillofac Pathol 2023; 27:642-648. [PMID: 38304506 PMCID: PMC10829472 DOI: 10.4103/jomfp.jomfp_410_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/03/2023] [Accepted: 10/27/2023] [Indexed: 02/03/2024] Open
Abstract
Background Tumour budding has been recognized as a morphologic marker of tumour invasion. Invasive characteristics such as depth of invasion, mode of invasion and worst pattern of invasion are potentially powerful parameters predicting the regional metastasis. Aim This study was done to understand the significance of tumour budding and various characteristics of invasion and their impact on grading of oral squamous cell carcinoma. Materials and Methods An immunohistochemical study was performed on tissue sections obtained from 34 paraffin-embedded blocks of clinically and histologically diagnosed cases of oral squamous cell carcinoma. The sections were stained with pan cytokeratin and observed under high power magnification. Results Tumour budding and the invasive patterns were found to be significant in OSCC. A proposed grading system based on tumour budding and cell nest was found to have a significant correlation with the WHO grading system. Conclusion This study demonstrated the importance of using tumour buds as an additional parameter in the grading system and also assessed the importance of invasive patterns, cellular atypia and stromal contents in OSCC.
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Affiliation(s)
- Freeda M. Selvaraj
- Department of Oral and Maxillofacial Pathology, PMS College of Dental Sciences, Trivandrum, Kerala, India
| | - Anna P. Joseph
- Department of Oral and Maxillofacial Pathology, PMS College of Dental Sciences, Trivandrum, Kerala, India
| | - Varun Raghavan Pillai
- Department of Oral and Maxillofacial Pathology, PMS College of Dental Sciences, Trivandrum, Kerala, India
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Pratibha Ramani
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Jayanthi Pazhani
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
- Department of Oral and Maxillofacial Pathology, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - Vinod Mony
- Department of Oral and Maxillofacial Pathology, Asan Memorial Dental College and Hospital, Chengalpattu, Tamil Nadu, India
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Joshi S, Bagade S, Naik C, Deore P, Garad A. Accuracy of Magnetic Resonance Imaging in Detecting Tumor Depth of Invasion in Squamous Cell Carcinoma of the Tongue: A Systematic Review. J Maxillofac Oral Surg 2023; 22:720-727. [PMID: 37534361 PMCID: PMC10390425 DOI: 10.1007/s12663-023-01886-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/01/2023] [Indexed: 08/04/2023] Open
Abstract
Objective The objective of the study was to detect the accuracy of Magnetic Resonance Imaging (MRI) in assessing tumor depth of invasion (DOI) in squamous cell carcinoma (SCC) of the tongue. Material and Methods The electronic search of PubMed (including MEDLINE), COCHRANE CENTRAL and Google Scholar search engine for articles published from January 1, 2000, to September 31, 2021, was conducted and also searched the lists of references of relevant articles and reviews for studies involving patients with squamous cell carcinoma of the tongue. Results A total of 5362 articles were retrieved in the initial search. After the initial search process, 13 full-text articles were reviewed. Out of these 13 articles, seven met the inclusion criteria and were thus included in this systematic review. Conclusion The MRI-determined DOI based on T1-weighted sequences increases with increasing T stage. There is the highest correlation between the MRI-derived DOI and the histopathological DOI with increasing T stage. Therefore, MRI provides satisfactory diagnostic accuracy for measuring tumor DOI and, thus, may be considered a predictor of tumor stage.
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Affiliation(s)
- Sanjay Joshi
- Present Address: Department of Oral and Maxillofacial Surgery, TPCT’s Terna Dental College and Hospital, Plot No 12, opposite to Nerul West Railway station, sector 22, Nerul, Navi Mumbai, Maharashtra 400706 India
| | - Sachin Bagade
- Present Address: Department of Oral and Maxillofacial Surgery, TPCT’s Terna Dental College and Hospital, Plot No 12, opposite to Nerul West Railway station, sector 22, Nerul, Navi Mumbai, Maharashtra 400706 India
| | - Charudatta Naik
- Present Address: Department of Oral and Maxillofacial Surgery, TPCT’s Terna Dental College and Hospital, Plot No 12, opposite to Nerul West Railway station, sector 22, Nerul, Navi Mumbai, Maharashtra 400706 India
| | - Prachi Deore
- Present Address: Department of Oral and Maxillofacial Surgery, TPCT’s Terna Dental College and Hospital, Plot No 12, opposite to Nerul West Railway station, sector 22, Nerul, Navi Mumbai, Maharashtra 400706 India
| | - Aarti Garad
- Present Address: Department of Oral and Maxillofacial Surgery, TPCT’s Terna Dental College and Hospital, Plot No 12, opposite to Nerul West Railway station, sector 22, Nerul, Navi Mumbai, Maharashtra 400706 India
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Kato K, Miyazawa H, Kobayashi H, Kishikawa Y, Funaki H, Noguchi N, Ooi K, Kawashiri S. The pattern and spread of invasion can predict late cervical lymph node metastasis in early tongue squamous cell carcinoma. Diagn Pathol 2023; 18:87. [PMID: 37537639 PMCID: PMC10398901 DOI: 10.1186/s13000-023-01371-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/06/2023] [Indexed: 08/05/2023] Open
Abstract
To determine the predictive indexes of late cervical lymph node metastasis in early tongue squamous cell carcinoma (TSCC). We retrospectively analyzed the cases of 25 patients with stage I/II TSCC who had undergone surgical treatment without elective neck dissection. We evaluated the relationships between clinicopathologic factors and the occurrence of late cervical lymph node metastasis. Of the 25 cases, metastasis to the cervical lymph nodes was observed in nine cases (36.0%). The clinicopathological factors associated with late cervical lymph node metastasis were the mode of invasion (MOI, p = 0.032), depth of invasion (DOI, p = 0.004), and perineural invasion (PNI, p = 0.040). A multivariate analysis revealed that only the DOI was an independent predictor of late cervical lymph node metastasis. The combination of the DOI and MOI or the PNI and MOI was significantly correlated with late cervical lymph node metastasis (p = 0.004 and p = 0.012, respectively). Our findings suggest that combinations of the MOI, DOI, and PNI could be used as an index for predicting late cervical lymph node metastasis in early TSCC.
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Affiliation(s)
- Koroku Kato
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan.
| | - Hiroki Miyazawa
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Hisano Kobayashi
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Yoshiaki Kishikawa
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Hayato Funaki
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Natsuyo Noguchi
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Kazuhiro Ooi
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
| | - Shuichi Kawashiri
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, 920-8641, Japan
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Atasever Akkas E, Erdis E, Yucel B. Prognostic value of the systemic immune-inflammation index, systemic inflammation response index, and prognostic nutritional index in head and neck cancer. Eur Arch Otorhinolaryngol 2023; 280:3821-3830. [PMID: 37029321 DOI: 10.1007/s00405-023-07954-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/28/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE This study sought to investigate the prognostic value of the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and prognostic nutritional index (PNI) in patients with head and neck cancer. METHODS The data of 310 patients with head and neck cancer who were referred to the Radiation Oncology Clinic of Sivas Cumhuriyet University Faculty of Medicine (n = 271, 87%) and to S.B.U. Dr. Abdurrahman Yurtaslan Ankara Oncology Health Practice and Research Centre (n = 39, 13%) between January 2009 and March 2020 were retrospectively analysed. At the time of diagnosis, patients' neutrophil, lymphocyte, monocyte, platelet and albumin levels were used to calculate their SII, SIRI and PNI indices. RESULTS Multivariate analysis found the after variables to be independent prognostic factors for overall survival (OS): SII [hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.18-2.47; p = 0.002] and PNI (HR 0.66, 95% CI 0.43-0.97; p = 0.038), stage (HR 2.11, 95% CI 1.07-4.16; p = 0.030), fraction technique (HR 0.49, 95% CI 0.28-0.85; p = 0.011) and age (HR 2.51, 95% CI 1.77-3.57; p = 0.001).The following variables were found to be independent prognostic factors for disease-free survival (DFS) in multivariate analysis: SII (HR 2.16, 95% CI 1.22-3.83; p = 0.008), fractionation technique (HR 0.17, 95% CI 0.004-0.64; p = 0.017) and age (HR 2.11, 95% CI 1.13-3.93; p = 0.019). CONCLUSION This study found a high SII to be an independent poor prognostic factor for both OS and DFS, while a low PNI was found to be an independent poor prognostic factor only for OS.
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Affiliation(s)
- Ebru Atasever Akkas
- Department of Radiation Oncology, Medical Faculty of Saglik Bilimleri University, Dr. Abdurrahman Yurtarslan Oncology Research and Training Hospital, Ankara, Turkey.
| | - Eda Erdis
- Department of Radiation Oncology, Medical Faculty of Cumhuriyet University, Sivas, Turkey
| | - Birsen Yucel
- Department of Radiation Oncology, Medical Faculty of Cumhuriyet University, Sivas, Turkey
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9
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Fatapour Y, Abiri A, Kuan EC, Brody JP. Development of a Machine Learning Model to Predict Recurrence of Oral Tongue Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:2769. [PMID: 37345106 DOI: 10.3390/cancers15102769] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 06/23/2023] Open
Abstract
Despite diagnostic advancements, the development of reliable prognostic systems for assessing the risk of cancer recurrence still remains a challenge. In this study, we developed a novel framework to generate highly representative machine-learning prediction models for oral tongue squamous cell carcinoma (OTSCC) cancer recurrence. We identified cases of 5- and 10-year OTSCC recurrence from the SEER database. Four classification models were trained using the H2O ai platform, whose performances were assessed according to their accuracy, recall, precision, and the area under the curve (AUC) of their receiver operating characteristic (ROC) curves. By evaluating Shapley additive explanation contribution plots, feature importance was studied. Of the 130,979 patients studied, 36,042 (27.5%) were female, and the mean (SD) age was 58.2 (13.7) years. The Gradient Boosting Machine model performed the best, achieving 81.8% accuracy and 97.7% precision for 5-year prediction. Moreover, 10-year predictions demonstrated 80.0% accuracy and 94.0% precision. The number of prior tumors, patient age, the site of cancer recurrence, and tumor histology were the most significant predictors. The implementation of our novel SEER framework enabled the successful identification of patients with OTSCC recurrence, with which highly accurate and sensitive prediction models were generated. Thus, we demonstrate our framework's potential for application in various cancers to build generalizable screening tools to predict tumor recurrence.
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Affiliation(s)
- Yasaman Fatapour
- Department of Biomedical Engineering, University of California, Irvine, CA 92617, USA
| | - Arash Abiri
- Department of Biomedical Engineering, University of California, Irvine, CA 92617, USA
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA 92604, USA
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA 92604, USA
| | - James P Brody
- Department of Biomedical Engineering, University of California, Irvine, CA 92617, USA
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10
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Yosefof E, Tzelnick S, Wallach L, Miller Y, Strenov Y, Bachar G, Shpitzer T, Mizrachi A. Tumor Satellites Are Associated With Poor Outcome in Patients With Oral Cancer. Laryngoscope 2023; 133:336-343. [PMID: 35543405 DOI: 10.1002/lary.30156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Tumor satellites are defined as islands of tumor cells completely separated from the border of the main tumor. They are believed to be a sign of aggressive disease. Our goal was to investigate the association between tumor satellites and outcome in patients with oral squamous cell carcinoma. MATERIALS AND METHODS A retrospective analysis of all patients treated for oral squamous cell carcinoma at a university-affiliated tertiary care center between 2010 and 2018 was performed. Data collected included demographics, clinical and pathological features including tumor satellites, staging, treatment modalities, and outcomes. RESULTS A total of 144 patients were included. The mean age of all patients was 63.5 and 50.7% were males. The mean follow-up time was 40.5 months. Seventeen patients (11.8%) had tumor satellites. These patients had a higher rate of involved margins, peri-neural invasion, lympho-vascular invasion, and extra-nodal extension. Tumor, nodal and overall classification were significantly more advanced in patients with satellites. Disease-specific and overall survival rates were significantly lower among satellites patients (28.7% vs. 59.7% and 28.7% vs. 54.9%, respectively). CONCLUSIONS Tumor satellites are associated with several adverse features and advanced locoregional disease. Patients with satellites should be treated aggressively with a combination of surgery aimed at achieving free surgical margins and adjuvant treatment, as they have a worse prognosis compared with patients without satellites. Further prospective studies are mandatory to consolidate the importance of adjuvant treatment in these patients. LEVEL OF EVIDENCE 3 Laryngoscope, 133:336-343, 2023.
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Affiliation(s)
- Eyal Yosefof
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Tzelnick
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Leemor Wallach
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Miller
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yulia Strenov
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pathology, Rabin Medical Center, Petah Tikva, Israel
| | - Gideon Bachar
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Thomas Shpitzer
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviram Mizrachi
- Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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11
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Radiation modulates expression and related activities of c-Met protein in oral tongue squamous cell carcinoma cell lines. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04307-4. [PMID: 36053327 DOI: 10.1007/s00432-022-04307-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES c-Met, a receptor tyrosine kinase, is involved in the growth, invasion and metastasis of a variety of cancers. In a set of cell lines from several solid tumors, a five-fold increase in c-Met expression after irradiation has been reported. This study aimed to assess if c-Met is likewise abundantly expressed in oral tongue squamous cell carcinoma (OTSCC) upon exposure to irradiation, followed by a Met-induced biological response. MATERIALS AND METHODS Six OTSCC cell lines were exposed to gamma radiation doses of 2, 4, and 6 Gray. The changes in c-Met protein levels were assessed by western blot and flow cytometry. c-Met gene expression, cell migration, proliferation and cell cycle assays were performed as phenotypic readouts. RESULTS Irradiation resulted in upregulation of c.Met in all cell lines with different time kinetics. On average the cells displayed minimal c-Met expression on their surface ranging from 5 to 30% of total protein. Abrupt downregulation of c-Met surface expression occurred one hour after radiation but recovered 48 h post-radiation. Intracellularly, the highest level of expression was found on day 5 after radiation exposure. Irradiation induced aggressive invasive potential of the cells as determined in cell migration assays, particularly in cell lines with the highest c-Met expression. CONCLUSIONS These results provide novel insights into both intracellular and extracellular dynamics of c-Met expression profiles upon irradiation of OTSCC cells in vitro. It might also suggest that radiation enhances cell migration, indicative of invasiveness, through c-Met up-regulation, at least for certain types of OTSCC cells.
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12
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Yu B, Huang C, Xu J, Liu S, Guan Y, Li T, Zheng X, Ding J. Prediction of the degree of pathological differentiation in tongue squamous cell carcinoma based on radiomics analysis of magnetic resonance images. BMC Oral Health 2021; 21:585. [PMID: 34798867 PMCID: PMC8603498 DOI: 10.1186/s12903-021-01947-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/03/2021] [Indexed: 12/24/2022] Open
Abstract
Background Tongue squamous cell carcinoma (TSCC) is one of the most difficult malignancies to control. It displays particular and aggressive behaviour even at an early stage. The purpose of this paper is to explore the value of radiomics based on magnetic resonance fat-suppressed T2-weighted images in predicting the degree of pathological differentiation of TSCC. Methods Retrospective analysis of 127 patients with TSCC who were randomly divided into a primary cohort and a test cohort, including well-differentiated, moderately differentiated and poorly differentiated. The tumour regions were manually labelled in fat-suppressed T2-weighted imaging (FS-T2WI), and PyRadiomics was used to extract radiomics features. The radiomics features were then selected by the least absolute shrinkage and selection operator (LASSO) method. The model was established by the logistic regression classifier using a 5-fold cross-validation method, applied to all data and evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity and specificity. Results In total, 1132 features were extracted, and seven features were selected for modelling. The AUC in the logistic regression model for well-differentiated TSCC was 0.90 with specificity and precision values of 0.92 and 0.78, respectively, and the sensitivity for poorly differentiated TSCC was 0.74. Conclusions The MRI-based radiomics signature could discriminate between well-differentiated, moderately differentiated and poorly differentiated TSCC and might be used as a biomarker for preoperative grading.
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Affiliation(s)
- Baoting Yu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130021, China
| | - Chencui Huang
- Department of Research Collaboration, R&D Center, Beijing Deepwise & League of PHD Technology Co., Ltd, No. 829 of Xinmin Street, Chaoyang District, Beijing, 100080, China
| | - Jingxu Xu
- Department of Research Collaboration, R&D Center, Beijing Deepwise & League of PHD Technology Co., Ltd, No. 829 of Xinmin Street, Chaoyang District, Beijing, 100080, China
| | - Shuo Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130021, China
| | - Yuyao Guan
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130021, China
| | - Tong Li
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130021, China
| | - Xuewei Zheng
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130021, China
| | - Jun Ding
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130021, China. .,Department of Research Collaboration, R&D Center, Beijing Deepwise & League of PHD Technology Co., Ltd, No. 829 of Xinmin Street, Chaoyang District, Beijing, 100080, China.
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13
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Paparella ML, Ferri DM, Villegas KM, Raimondi AR. Quantitative analysis of KLF4 and SOX2 expression in oral carcinomas reveals independent association with oral tongue subsite location and histological grade. Cancer Biomark 2021; 32:37-48. [PMID: 34092609 DOI: 10.3233/cbm-203086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Stemness factors associated with tumorigenesis in different types of cancers have not been specifically studied in oral tongue SCC (OTSSC). Here, we aimed to quantify expression levels and distribution of KLF4 and SOX2, two relevant stemness factors, in oral SCC including OTSCC samples from different subsites. METHODS AND RESULTS We determined KLF4 and SOX2 expression levels by immunostaining 35 biopsies of OSCC. Stained wholeslide images were digitized and subjected to automatic cell detection and unbiased quantification using Qupath software. We found statistically significant reduction in KLF4 positive cells density (p= 0.024), and fraction (p= 0.022) in OTSCC from tongue borders compared with other tongue subsites. Instead, quantitative SOX2 analysis did not show differences in expression levels between OTSCC from the borders versus OTSCC developed in others subsites. Notably SOX2 expression was revealed increased in moderately and poorly differentiated OSCC compared with well differentiated ones (positive cells density p= 0.025, fraction p= 0.006). No significant correlation between KLF4 and SOX2 expression was observed, neither in OSCC nor in OTSCC. CONCLUSIONS KLF4 and SOX2 exhibit opposite expression profiles regarding subsite localization and differentiation level in OSCC. Our study prompts future OTSCC prospective studies looking for clinical prognosis to incorporate detailed subsite information in the analysis.
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Affiliation(s)
- María Luisa Paparella
- School of Dentistry, Oral Pathology Department, Surgical Pathology Laboratory, University of Buenos Aires, Buenos Aires, Argentina
| | - Dario Martin Ferri
- Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE-UBACONICET), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires y Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Krissya María Villegas
- School of Dentistry, Oral Pathology Department, Surgical Pathology Laboratory, University of Buenos Aires, Buenos Aires, Argentina
| | - Ana Rosa Raimondi
- School of Dentistry, Oral Pathology Department, Surgical Pathology Laboratory, University of Buenos Aires, Buenos Aires, Argentina.,Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE-UBACONICET), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires y Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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14
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Luan CW, Tsai YT, Yang HY, Chen KY, Chen PH, Chou HH. Pretreatment prognostic nutritional index as a prognostic marker in head and neck cancer: a systematic review and meta-analysis. Sci Rep 2021; 11:17117. [PMID: 34429476 PMCID: PMC8385102 DOI: 10.1038/s41598-021-96598-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/09/2021] [Indexed: 12/11/2022] Open
Abstract
The predictive value of the pretreatment prognostic nutritional index (PNI) for head and neck cancer (HNC) remains controversial. We conducted a meta-analysis to assess the predictive value of PNI in HNC patients. A systematic search through internet databases including PubMed, Embase, and Cochrane Library for qualified studies estimating the association of PNI with HNC patient survival was performed. Overall survival (OS), progression-free survival (PFS), disease-specific survival (DSS), disease-free survival (DFS) and distant metastasis-free survival (DMFS) data were collected and evaluated. A random-effects model was used to calculate the pooled hazard ratios (pHRs) and corresponding 95% confidence intervals (CIs). A total of 7815 HNC patients from 14 eligible studies were involved. Pooled analysis showed that low pretreatment PNI was correlated with poor OS (pHR: 1.93, 95% CI 1.62–2.30, p < 0.001), PFS (pHR: 1.51, 95% CI 1.19–1.92, p = 0.008), DSS (pHR: 1.98, 95% CI 1.12–3.50, p < 0.001), DFS (pHR: 2.20, 95% CI 1.66–2.91, p < 0.001) and DMFS (pHR: 2.04, 95% CI 1.74–2.38, p < 0.001). Furthermore, low pretreatment PNI was correlated with poor OS despite variations in the cancer site, sample size, PNI cut-off value, analysis method (multivariate analysis or univariate analysis) and treatment modality in subgroup analysis. Elevated pretreatment PNI is correlated with a superior prognosis in HNC patients and could be used as
a biomarker in clinical practice for prognosis prediction and treatment stratification.
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Affiliation(s)
- Chih-Wei Luan
- Department of Otorhinolaryngology-Head and Neck Surgery, LO-Sheng Hospital Ministry of Health and Welfare-Home, New Taipei City, Taiwan.,Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Hsin-Yi Yang
- Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Kuan-Yin Chen
- School of Dentistry, National Yang Ming University, Taipei, Taiwan
| | - Po-Hsien Chen
- Department of Pediatrics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539, Zhongxiao Road, 600, Chiayi, Taiwan.
| | - Hsin-Hsu Chou
- Department of Pediatrics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539, Zhongxiao Road, 600, Chiayi, Taiwan. .,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
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15
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Zhang J, Wu J, Chen Y, Zhang W. Dlx5 promotes cancer progression through regulation of CCND1 in oral squamous cell carcinoma (OSCC). Biochem Cell Biol 2021; 99:424-434. [PMID: 34283652 DOI: 10.1139/bcb-2020-0523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Genetic studies have revealed a critical role of the distal-less homeobox gene 5 (Dlx5) in the pathogenesis of ovarian cancer, lung cancer, and T-cell lymphoma; however, the role and underlying mechanisms of Dlx5 in oral squamous cell carcinoma (OSCC) are largely unknown. In this study, we demonstrated that Dlx5 is up-regulated in OSCC tissues and cell lines, compared with their control groups. The results from our immunohistochemistry (IHC) analyses show that high expression levels of Dlx5 correlated with advanced TNM stages (P = 0.0001), lymph node metastasis (P = 0.0049), poor cellular differentiation (P = 0.0491), location of the tumors (P = 0.0132), and poor prognosis for the patient. We also demonstrated that knockdown of Dlx5 inhibited the viability, proliferation, and colony formation of OSCC cell lines CAL-27 and WSU-HN6 cells, probably by blocking cell cycle in the G1 phase. Furthermore, we revealed that Dlx5 exerts its biological functions via direct regulation of CCND1 in CAL-27 and WSU-HN6 cells. Ultimately, we have demonstrated that silencing of Dlx5 inhibits the growth of xenograft tumors in vivo, and that Dlx5 affects the progression of OSCC both in vitro and in vivo via directly regulating CCND1, providing a potential diagnostic biomarker and therapeutic target for OSCC.
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Affiliation(s)
- Jianfei Zhang
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China.,Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Jinyang Wu
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China.,Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Yang Chen
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China.,Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
| | - Wenbin Zhang
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China.,Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai 200011, China
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16
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Konishi M, Sakamoto S, Ogawa I, Yoshioka Y, Ono S, Kakimoto N. Relationships between intraoral ultrasonographic and histopathological findings in patients with tongue cancer. Head Neck 2021; 43:2778-2785. [PMID: 34050571 DOI: 10.1002/hed.26763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/14/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In this study, we aimed to investigate the relationships between histopathological and intraoral ultrasonographic (IUS) findings in patients with tongue cancer. METHODS IUS and histopathological findings in 46 patients with tongue cancer were considered for this study. We assessed the relationships between IUS findings regarding tumor thickness, margin type, border type, and internal echo intensity; internal/peripheral Doppler findings; and muscle invasion and histopathological findings regarding tumor thickness, differentiation, Yamamoto-Kohama (YK)-classification grade, blood vessel invasion, lymphatic invasion, perineural invasion, and muscle invasion. RESULTS Statistical associations were found between the following findings: between thickness determined through IUS measurement and that determined through histopathological measurement, between the IUS findings regarding tumor margin and border types and the histopathologically determined YK-classifications grades, and between a Doppler image of the internal area of tongue lesions and lymphatic invasion. CONCLUSIONS IUS findings may be used to predict histopathological findings about tumor thickness and YK-classification grades.
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Affiliation(s)
- Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Shinnichi Sakamoto
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Ikuko Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Yoshioka
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigehiro Ono
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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17
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Boldrup L, Coates P, Gu X, Wang L, Fåhraeus R, Wilms T, Sgaramella N, Nylander K. Low potential of circulating interleukin 1 receptor antagonist as a prediction marker for squamous cell carcinoma of the head and neck. J Oral Pathol Med 2021; 50:785-794. [PMID: 33880804 DOI: 10.1111/jop.13187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/21/2021] [Accepted: 04/12/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Circulating markers are attractive molecules for prognosis and management of cancer that allow sequential monitoring of patients during and after treatment. Based on previous protein profiling data, circulating interleukin 1 receptor antagonist (IL-1Ra) was evaluated as a potential diagnostic and prognostic marker for squamous cell carcinomas of the head and neck (SCCHN). In this study, we aimed at confirming the clinical relevance of plasma IL-1Ra in SCCHN and exploring its potential as a prediction marker for SCCHN. METHODS Plasma from 87 patients with SCCHN, control plasma from 28 healthy individuals and pre-diagnostic plasma from 44 patients with squamous cell carcinoma of the oral tongue (SCCOT) and 88 matched controls were analysed with IL-1Ra electrochemiluminescence immunoassays from mesoscale diagnostics. RESULTS Plasma IL-1Ra was found to be up-regulated in patients with oral tongue, gingiva and base of tongue tumours compared to healthy individuals (p < 0.01). IL-1Ra levels positively correlated with tumour size (p < 0.01) and body mass index (p = 0.013). Comparing pre-diagnostic plasma to the matched controls, similar IL1-Ra levels were seen (p = 0.05). CONCLUSION The anti-inflammatory cytokine IL-1Ra could be a diagnostic marker for SCCHN, whereas its potential as a cancer prediction marker was not supported by our data.
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Affiliation(s)
- Linda Boldrup
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Philip Coates
- Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Xiaolian Gu
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Lixiao Wang
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Robin Fåhraeus
- Department of Medical Biosciences, Umeå University, Umeå, Sweden.,Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Institute of Molecular Genetics, University of Paris St. Louis Hospital, Paris, France
| | - Torben Wilms
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | | | - Karin Nylander
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
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18
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Lalfamkima F, Georgeno GL, Rao NK, Selvakumar R, Devadoss VJ, Rajaram N, Farid S, Lalchhuanawma T, Nayyar AS. Clinical diagnostic criteria versus advanced imaging in prediction of cervical lymph node metastasis in oral squamous cell carcinomas: A magnetic resonance imaging based study. J Carcinog 2021; 20:3. [PMID: 34211339 PMCID: PMC8202445 DOI: 10.4103/jcar.jcar_27_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/02/2021] [Accepted: 02/19/2021] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND AIM: The inaccuracies in clinical examination have been well documented, while advanced imaging modalities, including computed tomography and magnetic resonance imaging (MRI), have been shown to have superior diagnostic accuracy in detecting occult and nodal metastasis. The aim of the present study was to identify as well as evaluate the inaccuracies in clinical examination and of clinical diagnostic criteria in known cases of oral squamous cell carcinomas (OSCCs) with the help of MRI. MATERIALS AND METHODS: A total of 24 patients attending as outpatients were included in the study, while clinically diagnosed and histopathologically proven cases of OSCC were examined clinically and then subjected to advanced imaging with the help of MRI. STATISTICAL ANALYSIS USED: Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA), while paired t-test was performed for evaluating the size of tumor and lymph node recorded on clinical and imaging findings. A P < 0.05 was considered statistically significant. RESULTS: Detection of tumor size and lymph node metastasis was found to be higher in case of MRI than when accomplished by clinical staging alone, while paired t-test values for difference in results were found to be statistically significant (P < 0.05). CONCLUSIONS: The present study showed that clinical diagnostic criteria alone were not sufficient and reliable for detecting metastatic lymphadenopathy, highlighting the significance of advanced imaging modalities such as MRI for an efficient preoperative diagnostic workup, as well a tool for planning treatment in patients with OSCCs.
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Affiliation(s)
- F Lalfamkima
- Consultant Dental Surgeon, Selection Grade, Dental Department, Civil Hospital, Aizawl, Mizoram, India
| | - G L Georgeno
- Consultant Dental Surgeon, Selection Grade, Dental Department, Civil Hospital, Aizawl, Mizoram, India
| | - N Koteswara Rao
- Department of Oral and Maxillofacial Surgery, Rajas Dental College and Hospital, Kavalkinaru, Tirunelveli, India
| | - Rajkumar Selvakumar
- Department of Oral and Maxillofacial Surgery, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinoutpalli, Gannavaram Mandal, Krishna District, Andhra Pradesh, India
| | - Vimal Joseph Devadoss
- Consultant Dental Surgeon, Selection Grade, Dental Department, Civil Hospital, Aizawl, Mizoram, India
| | - Niroshini Rajaram
- Department of Oral and Maxillofacial Surgery, Rajah Muthiah Dental College and Hospital, Annamalai University, Annamalai Nagar, Cuddalore, India
| | - Shomaila Farid
- Department of Oral Pathology and Microbiology, RVS Dental College and Hospital, Sulur, Coimbatore, Tamil Nadu, India
| | - T Lalchhuanawma
- Consultant Dental Surgeon, Selection Grade, Dental Department, Civil Hospital, Aizawl, Mizoram, India
| | - Abhishek Singh Nayyar
- Consultant, Division of Infection Prevention and Control, Infection Control Department, Security Forces Specialized Health Center, Taif, Kingdom of Saudi Arabia, India
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Luan CW, Yang HY, Tsai YT, Hsieh MC, Chou HH, Chen KS. Prognostic Value of C-Reactive Protein-to-Albumin Ratio in Head and Neck Cancer: A Meta-Analysis. Diagnostics (Basel) 2021; 11:diagnostics11030403. [PMID: 33652976 PMCID: PMC7996835 DOI: 10.3390/diagnostics11030403] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/21/2022] Open
Abstract
The C-reactive protein-to-albumin ratio is a proven prognostic predictor of nasopharyngeal carcinoma. However, the role of the C-reactive protein-to-albumin ratio in other head and neck cancers remains unclear. This meta-analysis explored the prognostic value of the C-reactive protein-to-albumin ratio in head and neck cancers. A systematic search was conducted. Outcomes of interest included overall survival, disease-free survival, and distant metastasis-free survival. The hazard ratio with 95% confidence interval was pooled using a random-effects model. A total of 11 publications from the literature were included, allowing for the analysis of 7080 participants. Data pooling demonstrated that pretreatment C-reactive protein-to-albumin ratio had a hazard ratio of 1.88 (95% CI: 1.49-2.37, p < 0.001) for predicting overall survival, 1.91 (95% CI: 1.18-3.08, p = 0.002) for disease-free survival, and 1.46 (95% CI: 1.08-1.96, p = 0.001) for distant metastasis-free survival. Subgroup analysis showed that the C-reactive protein-to-albumin ratio is a significant prognostic marker for various head and neck cancers. An elevated pretreatment C-reactive protein-to-albumin ratio predicts a worse prognosis for patients with head and neck cancers. Therefore, the C-reactive protein-to-albumin ratio could serve as a potential prognostic biomarker facilitating treatment stratification.
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Affiliation(s)
- Chih-Wei Luan
- Department of Otorhinolaryngology-Head and Neck Surgery, LO-Sheng Hospital Ministry of Health and Welfare-Home, New Taipei City 242, Taiwan;
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Hsin-Yi Yang
- Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan;
| | - Yao-Te Tsai
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Meng-Chiao Hsieh
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi 613, Taiwan;
| | - Hsin-Hsu Chou
- Department of Pediatric, Chiayi Christian Hospital, Chiayi City 600, Taiwan;
| | - Kuo-Su Chen
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan
- Correspondence: ; Tel.: +886-2-2431-3131
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20
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Sethi S, Ohri S, Aggarwal P, Grewal H. Histopathological Factors in Oral Squamous Cell Carcinoma-Should a Clinician Look Beyond Clinical Staging? J Oral Maxillofac Surg 2021; 79:1694-1705. [PMID: 33744240 DOI: 10.1016/j.joms.2021.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Several researchers have proposed and investigated the prognostic implications of various parameters, but have failed to provide concrete evidence regarding the inclusion or exclusion of histopathological features while clinically managing an oral squamous cell carcinoma (OSCC) case. The study purpose was to measure the prognostic values of a set of key histologic features and its association with its clinical outcome-5-year survival. MATERIALS AND METHODS This is a prospective cohort study and the sample was composed of patients treated for OSCC (April 2014 - March 2015). The predictor variables included pattern of tumor invasion (POI), stromal inflammation, angiogenesis, and vascular invasion with the outcome being survival of subjects observed over this 5-year period. Sociodemographic data (age, sex, marital status, systemic disease, habits etc), clinical staging and TNM staging were also recorded. We used multivariate regression analysis for predictor analysis; Kaplan-Meier survival curves and Cox hazard modeling was also performed using the data. RESULTS This article includes 50 subjects with a mean age of 54.94 years and 58% were male and their characteristics collected at the baseline and at a 12-, 24-, 36-, 48-, and 60-month follow-up. The overall 5-year survival was 48%. We saw a significant association between N-stage and POI (0.027), T-stage and mean vascular density (0.042), and T-stage and vascular invasion (0.046). POI, angiogenesis, and vascular invasion were found as significant predictors of overall 5-year survival (P < .001). CONCLUSIONS This study shows that histopathological parameters such as POI are important while determining the clinical outcome of OSCC. Histopathological parameters such as angiogenesis and vascular invasion can provide valuable information about the overall survival and prognosis.
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Affiliation(s)
- Sneha Sethi
- Research Officer, Australian Research Center for Population Oral Health, Adelaide Dental School, University of Adelaide, Australia.
| | - Samagra Ohri
- Associate General Dentist and Casual Supervisor, Oral Health Centre, University of Queensland, Australia
| | - Pratul Aggarwal
- Research Officer, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Harshaminder Grewal
- Consultant Oral Pathologist, Department of Oral Pathology, Waryam Singh Hospital, Haryana, India
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21
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Newman M, Dziegielewski PT, Nguyen NTA, Seikaly HS, Xie M, O'Connell DA, Harris JR, Biron VL, Gupta MK, Archibald SD, Jackson BS, Young JEM, Keyes KJ, Nichols DS, Zhang H. Relationship of depth of invasion to survival outcomes and patterns of recurrence for T3 oral tongue squamous cell carcinoma. Oral Oncol 2021; 116:105195. [PMID: 33618103 DOI: 10.1016/j.oraloncology.2021.105195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/06/2021] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Current research is elucidating how the addition of depth of invasion (DOI) to the 8th edition of the American Joint Committee on Cancer (AJCC) TNM staging for oral cavity squamous cell carcinoma influences its prognostic accuracy. However, there is limited research on survival in pT3N0M0 oral tongue SCC (OTSCC) patients when stratifying by DOI. OBJECTIVES Determine 5-year overall survival (OS), and cancer-specific survival (CSS) for patients with pT3N0M0 oral OTSCC based on shallow DOI (<10 mm) and deep DOI (10-20 mm). METHODS Retrospective review involving three tertiary care cancer centers in North America. cT3N0M0 OTSCC patients receiving primary surgical treatment from 2004 to 2018 were identified. Inclusion: age > 18 years old and confirmation of pT3N0M0 OTSCC on surgical pathology. Exclusion: patients undergoing palliative treatment or previous head and neck surgery/radiotherapy. Analysis comprised two groups: shallow pT3 (tumor diameter > 4 cm, DOI < 10 mm) and deep pT3 (DOI 10 mm-20 mm). RESULTS One hundred and four patients with pT3N0M0 OTSCC were included. Mean age was 59.1 years (range: 18-80.74). Age, gender, and Charlson Comorbidity Index were similar between the two groups (p > 0.05). Recurrence, LVI, PNI, and positive margins were more common in deep T3 tumors (P < 0.05). 5-year OS (50% vs 26%, p = 0.006) and CSS (72% vs 24%, p = 0.005) were worse in deep pT3 tumors. Deep pT3 disease was an independent predictor of OS (p = 0.004) and CSS (p = 0.01) on Cox-Regression analysis. CONCLUSION DOI is an independent predictor of poor survival in pT3N0M0 OTSCC patients. Consideration should be given to escalating adjuvant therapy for deep pT3N0M0 OTSCC patients.
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Affiliation(s)
- M Newman
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada.
| | - P T Dziegielewski
- Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainsville, FL, United States
| | - N T A Nguyen
- Division of Radiation Oncology, McMaster University, Hamilton, Ontario, Canada
| | - H S Seikaly
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - M Xie
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
| | - D A O'Connell
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - J R Harris
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - V L Biron
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - M K Gupta
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
| | - S D Archibald
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
| | - B S Jackson
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
| | - J E M Young
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
| | - K J Keyes
- Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainsville, FL, United States
| | - D S Nichols
- Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainsville, FL, United States
| | - H Zhang
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
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Choi KY, Park SC, Kim JH, Lee DJ. The occult nodal metastasis rate of early tongue cancer (T1-T2): A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24327. [PMID: 33546063 PMCID: PMC7837872 DOI: 10.1097/md.0000000000024327] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 12/20/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES In this study, a meta-analysis was conducted to evaluate the occult lymph node metastasis rate in patients with early-stage (T1-T2) oral tongue squamous cell carcinoma. Also, the correlation between occult lymph node metastasis rate and T2 ratio among T1-T2 or the reported year of each study was analyzed to adjust other confound variables. STUDY DESIGN Literature search. METHODS A systematic computerized search of the electronic databases was carried out for articles published between January 1, 1980, and December 31, 2018, which reported occult nodal metastasis rate in T1 and T2 (separately) tongue cancer patients. Statistical analysis was performed using Comprehensive Meta Analysis version 3.3.070. Publication bias was assessed by the Egger test and Begg funnel plot method. The correlation between occult nodal metastasis rate and T2 ratio or reported year, respectively, was assessed by meta-regression analysis. RESULTS From 19 studies, a total of 1567 cases were included in the meta-analysis. By random effects model, the mean occult cervical lymph node metastasis was 24.4% (95% confidence interval; 0.205-0.248). The meta-regression revealed that the T2 ratio and the reported year of the studies did not have a significant effect on the occult metastasis rate (correlation coefficient = 0.531 and 0.002, respectively, and P = .426 and 0.921, respectively). CONCLUSION The meta-analysis revealed that the early-stage oral tongue squamous cell carcinoma had a rate of 24.4% for occult nodal metastasis. The occult nodal metastasis rate was not significantly affected by neither T2 ratio among T1-T2 nor reported year of the studies.
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Bera R, Singh A, Anandkumar J, Krishnan A, Rajpoot R. Primary tumour characteristics poorly correlate with extracapsular spread and cervical sublevel IIb metastasis in patients with oral squamous cell carcinoma and clinically N0 neck: A retrospective study. Ann Maxillofac Surg 2021; 11:274-279. [PMID: 35265498 PMCID: PMC8848704 DOI: 10.4103/ams.ams_41_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/02/2021] [Accepted: 07/23/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction: Nodal metastasis reduces the survival by 50% in head-and-neck squamous cell carcinomas. The presence of nodal extension/extracapsular spread (ECS) further reduces survival. Current literature favors a selective level IIb sparing neck dissection in clinically N0 neck. Studies have evaluated the role of primary tumour size, number of lymph nodes, and depth of invasion (DOI) with the occurrence of extranodal extension (ENE). Patients and Methods: Patients were retrospectively reviewed who presented with oral cavity carcinomas and clinically N0 neck. Relationship was sought between tumour site, size, histological grading, DOI, and the occurrence of level IIb metastasis and ECS. A P < 0.05 was considered statistically significant. Results: The relationship showed insignificant correlation with P values (0.6643, 0.6704, 0.6779, and 0.6779) between site, size, grading, DOI, and level IIb and ENE. Discussion: Previous studies have shown DOI >5 mm and lymph node size 15 mm and multiple lymph nodes predict ECS. DOI and primary site with more than 20% for occult metastasis predicts elective neck treatment. However, in our study, no correlation was found between primary tumour characteristics and ECS or level IIb metastasis. Elective neck dissection is the standard surgical protocol from both diagnostic and therapeutic viewpoints. The only criterion for level IIb dissection is concomitant presence of level IIa involvement intraoperatively. Since ENE can occur early in the disease process, elective neck dissection remains the standard of care.
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Wang X, Liu K, Gong H, Li D, Chu W, Zhao D, Wang X, Xu D. Death by histone deacetylase inhibitor quisinostat in tongue squamous cell carcinoma via apoptosis, pyroptosis, and ferroptosis. Toxicol Appl Pharmacol 2020; 410:115363. [PMID: 33290780 DOI: 10.1016/j.taap.2020.115363] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 11/03/2020] [Accepted: 12/01/2020] [Indexed: 12/20/2022]
Abstract
Tongue cancer is one of the most common oral malignancies. Quisinostat is a histone deacetylase inhibitor with antitumor activity. The aim of this study was to evaluate the effects of quisinostat on the viability of tongue squamous cell carcinoma (TSCC) cells (CAL-27, TCA-8113) in vitro and in vivo. Cell viability, cell morphological observation, scratch wound-healing assay, transwell migration assay, transmission electron microscope, flow cytometry and cellular reactive oxygen species were assessed in vitro. The results showed that quisinostat can significantly inhibit the viability, growth and migration of TSCC cells. And quisinostat could significantly induce TSCC cells apoptosis, pyroptosis, and ferroptosis. Quisinostat significantly inhibited tumor tissue growth in animal experiments. Up-regulation of the expression of Bax, cleaved-caspase3, caspase-1, p53, phospho-p53 and down-regulated of the expression of caspase-3, Bcl-2, GPX4 in cell lines and tumor tissues of nude mice were observed by Western blotting analysis. Up-regulation of the expression of caspase-1, Bax, cleaved-caspase3, p53 and down-regulated of the expression of ki67, caspase-3, Bcl-2, GPX4 in tumor tissues of nude mice were observed by immunohistochemistry. TUNEL analysis showed that quisinostat could increase the apoptosis rate in the tumor tissues of nude mice. Up-regulation of the expression of p53 and down-regulated expression of GPX4 in cell lines were observed by immunofluorescent staining, and the expression locations of p53 and GPX4 proteins in TSCC cells were observed. Based on these findings, quisinostat may be a potential drug for the treatment of tongue squamous cell carcinoma.
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Affiliation(s)
- Xinhuan Wang
- Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, PR China
| | - Ke Liu
- Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, PR China
| | - Huimin Gong
- Department of Oral, Dalian Stomatological Hospital, Dalian, Liaoning 116021, PR China
| | - Dezhi Li
- Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, PR China
| | - Wenfeng Chu
- Department of Pharmacology (The State-Province Key Laboratories of Biomedicine Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, Heilongjiang 150081, PR China
| | - Dan Zhao
- Department of Clinical Pharmacy (Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment), the 2nd Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, PR China
| | - Xiaofeng Wang
- Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, PR China.
| | - Dongyang Xu
- Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, PR China.
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Sethi S, Grewal H, Aggarwal P, Narad C. Pattern of tumor invasion, stromal inflammation, angiogenesis and vascular invasion in oral squamous cell carcinoma - A prognostic study. Curr Probl Cancer 2020; 45:100647. [PMID: 32893000 DOI: 10.1016/j.currproblcancer.2020.100647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/23/2020] [Accepted: 08/24/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Oral cancer is one of the leading causes of mortality, and its worsening impact on the society has revealed the danger it poses in the coming future. Several researchers proposed and investigated the prognostic implications of various clinicopathologic and histopathologic parameters. AIM AND OBJECTIVES The aim of this study--assessing significance of histopathological features like pattern of tumor invasion, stromal inflammation, angiogenesis and vascular invasion on the clinical outcome of oral squamous cell carcinoma any possible correlations between the parameters, TNM Staging and prognosis were assessed and evaluated for a 5-year period. MATERIALS AND METHODS This study includes description of 50 diagnosed cases (mean age: 61.40, 29 males, and 21 females) of oral squamous cell carcinoma and their characteristics collected at baseline and at a 12-month follow up. The cases were grouped on the basis of their histological grade (well-differentiated, moderately differentiated, and poorly-differentiated). RESULTS All the data collected was tabulated in a baseline descriptive table, and all the parameters were compared between the 3 different histological groups. On cross-tabulations we found statistical significant difference the parameters of stromal inflammation with recurrence, clinical stage with T-stage, T-stage with N-stage, and N-stage with clinical stage. On analysis of the follow up we found 16 patients (32%) with recurrence and 9 patients (18%) succumb to the disease. CONCLUSION This study provides a significant insight on the importance of a combined histopathological analysis and clinical staging process to deliver an accurate prognostic opinion and also subsequently effect the treatment protocol.
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Affiliation(s)
- Sneha Sethi
- Australian Research Center for Population Oral Health, Adelaide Dental School, University of Adelaide, Australia.
| | - Harshaminder Grewal
- Consultant Oral Pathologist, Waryam Singh Yamunanagar, Haryana 135001 Desh Bhagat Dental Hospital, Ludhiana, Punjab, India
| | - Pratul Aggarwal
- Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Chintan Narad
- Head and Neck Surgical Oncology Unit, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
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Matsuzaki Y, Watabe Y, Enatsu K, Shigematsu S, Shibahara T. Actinin-4 Expression Predicts Poor Disease-free Survival and Correlates with Delayed Lymph Node Metastasis in Patients with Completely Resected Oral Squamous Cell Carcinoma. THE BULLETIN OF TOKYO DENTAL COLLEGE 2020; 61:179-186. [PMID: 32801264 DOI: 10.2209/tdcpublication.2019-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Oral squamous cell carcinoma is generally characterized by poor prognosis, and biomarkers are needed for development and selection of therapy. The purpose of this study was to assess expression of actinin-4, which has been implicated in cancer invasion and metastasis, to determine its viability as a prognostic indicator in oral squamous cell carcinoma. Clinical factors and tumor samples immunohistochemically stained for actinin-4 were retrospectively investigated in 55 patients who underwent curative surgery for oral squamous cell carcinoma. Overall survival and disease-free survival were estimated by Kaplan-Meier analysis. Significant differences were detected using the Pearson's chi-square and Fisher's exact tests. Univariate and multivariate analyses were performed with the Cox regression model. No association was found between expression of actinin-4 and clinical factors, including age or sex, or histopathological factors, including vascular invasion, lymphatic invasion, stage, mode of invasion, or histological atypicality. Expression of actinin-4 showed a positive correlation with delayed cervical lymph node metastasis. Disease-free survival was significantly lower in patients who were positive for expression of actinin-4 (p=0.010); overall survival showed no difference between patients with or without expression of actinin-4, however. The results revealed that actinin-4 was an independent prognostic factor for disease-free survival. Expression of actinin-4 showed a 73% sensitivity and 68% specificity for prediction of delayed cervical lymph node metastasis. In conclusion, actinin-4 may potentially be a useful biomarker for prediction of delayed cervical lymph node metastasis.
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Affiliation(s)
- Yusuke Matsuzaki
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College.,Department of Dentistry and Oral Surgery, Tokyo Metropolitan Tama Medical Center
| | - Yukio Watabe
- Department of Dentistry and Oral Surgery, Tokyo Metropolitan Tama Medical Center
| | - Kazuaki Enatsu
- Department of Pathology, Tokyo Metropolitan Tama Medical Center
| | - Shiro Shigematsu
- Department of Dentistry and Oral Surgery, Tokyo Metropolitan Tama Medical Center
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27
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Haraguchi K, Yoshiga D, Oda M, Tabe S, Mitsugi S, Takahashi O, Habu M, Sasaguri M, Morimoto Y, Yoshioka I, Tominaga K. Depth of invasion determined by magnetic resonance imaging in tongue cancer can be a predictor of cervical lymph node metastasis. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:231-240. [PMID: 32800495 DOI: 10.1016/j.oooo.2020.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/29/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES We evaluated the relationships between depth of invasion (DOI) of tongue cancer, as measured with preoperative T1- and T2-weighted magnetic resonance imaging (MRI) and postoperative histopathologic (Path) specimens, with cervical lymph node metastasis (CLNM) and tumor stage. We also calculated the correlation of MRI and Path DOI measurements. STUDY DESIGN This retrospective study included 101 patients who had squamous cell carcinoma of the tongue and were treated surgically. Two observers measured DOI on all 3 modalities. RESULTS DOI thresholds for predicting CLNM with high diagnostic efficacy were 6.99 mm and 8.32 mm for MRI and 5 mm for Path. DOI values from all modalities were significantly different for tumors with and without CLNM (P < .01) and for the 4 TNM stages (P ≤ .05), with increasing values corresponding to advancement in tumor stage. Addition of DOI changed the T level of many tumors based on the new TNM (tumor-node-metastasis) classification. The correlation coefficient between DOI calculated on each MRI sequence and Path was 0.90. CONCLUSIONS MRI-derived DOI accurately reflected the subsequent metastatic status and degree of progression of tumor stages, with a strong positive correlation to Path values, and may be considered a predictor of tumor stage and CLNM.
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Affiliation(s)
- Kazuya Haraguchi
- Department of Science of Physical Functions, Division of Oral and Maxillofacial Surgery, Kyushu Dental University, Kitakyushu, Japan
| | - Daigo Yoshiga
- Department of Science of Physical Functions, Division of Oral Medicine, Kyushu Dental University, Kitakyushu, Japan.
| | - Masafumi Oda
- Department of Oral Diagnostic Science, Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu, Japan
| | - Shirou Tabe
- Department of Science of Physical Functions, Division of Oral and Maxillofacial Surgery, Kyushu Dental University, Kitakyushu, Japan
| | - Sho Mitsugi
- Department of Science of Physical Functions, Division of Oral and Maxillofacial Surgery, Kyushu Dental University, Kitakyushu, Japan
| | - Osamu Takahashi
- Department of Science of Physical Functions, Division of Oral and Maxillofacial Surgery, Kyushu Dental University, Kitakyushu, Japan
| | - Manabu Habu
- Department of Science of Physical Functions, Division of Oral and Maxillofacial Surgery, Kyushu Dental University, Kitakyushu, Japan
| | - Masaaki Sasaguri
- Department of Science of Physical Functions, Division of Oral and Maxillofacial Surgery, Kyushu Dental University, Kitakyushu, Japan
| | - Yasuhiro Morimoto
- Department of Oral Diagnostic Science, Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu, Japan
| | - Izumi Yoshioka
- Department of Science of Physical Functions, Division of Oral Medicine, Kyushu Dental University, Kitakyushu, Japan
| | - Kazuhiro Tominaga
- Department of Science of Physical Functions, Division of Oral and Maxillofacial Surgery, Kyushu Dental University, Kitakyushu, Japan
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Carta F, Quartu D, Mariani C, Tatti M, Marrosu V, Gioia E, Gerosa C, Zanda JSA, Chuchueva N, Figus A, Puxeddu R. Compartmental Surgery With Microvascular Free Flap Reconstruction in Patients With T1-T4 Squamous Cell Carcinoma of the Tongue: Analysis of Risk Factors, and Prognostic Value of the 8th Edition AJCC TNM Staging System. Front Oncol 2020; 10:984. [PMID: 32760667 PMCID: PMC7372302 DOI: 10.3389/fonc.2020.00984] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
Compartmental surgery and primary reconstruction with microvascular free flaps represent the gold-standard in the treatment of oral tongue squamous cell carcinoma (OTSCC). However, there are still unclear clinical features that negatively affect the outcomes. This retrospective study included 80 consecutive patients with OTSCC who underwent compartmental surgery and primary reconstruction by free flap. The oncologic outcomes, the reliability of the 8th edition American Joint Committee on Cancer (AJCC) staging system and the prognostic factors were evaluated. Fifty-nine males and 21 females (mean age 57.8 years, range 27-81 years) were treated between November 2010 and March 2018 (one patient had two metachronous primaries). Seventy-one patients (88.75%, 52 males, 19 females, mean age of 57.9 years, range of 27-81 years) had no clinical history of previous head and neck radiotherapy and were considered as naive. Histology showed radical surgery on 80/81 lesions (98.8%), with excision margins >0.5 cm, while in 1 case (1.2%), a close posterior margin was found. According to the 8th AJCC classification, 37 patients (45.7%) were upstaged shifting from the clinical to the pathological stage, and 39 (48.1%) showed an upstaging while shifting from the 7th to the 8th AJCC staging system (no tumors were downstaged). Nodal involvement was confirmed in 33 patients (40.7%). Perineural and lymphovascular invasion were present in 9 (11.1%) and 11 (13.6%) cases, respectively. Twenty-two patients (27.1%) underwent adjuvant therapy. The 5-years disease-specific, overall, overall relapse-free, locoregional relapse-free and distant metastasis-free survival rates were 73.2, 66.8, 62.6, 67.4, and 86%, respectively. Patients with a lymph node ratio >0.09 experienced significantly worse outcomes. Univariate analysis showed that patients with previous radiotherapy, stage IV disease, nodal involvement, and lymphovascular invasion had significantly worse outcomes. Multivariate analysis focused naive patients and showed that lymphovascular invasion, advanced stage of disease, and node involvement resulted reliable prognostic factors, and patients with the same tumor stage and histological risk factors who did not undergo adjuvant therapy experienced significantly worse outcomes. In our series, surgery played a major role in the treatment of local extension; adjuvant therapy resulted strictly indicated in patients with advanced-stage disease associated with risk factors.
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Affiliation(s)
- Filippo Carta
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Daniela Quartu
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Cinzia Mariani
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Melania Tatti
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Valeria Marrosu
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Edoardo Gioia
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Clara Gerosa
- Unit of Pathology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Jacopo S A Zanda
- Unit of Pathology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Natalia Chuchueva
- ENT Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Andrea Figus
- Unit of Plastic Surgery, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Roberto Puxeddu
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
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Terada H, Sasaki E, Suzuki H, Nishikawa D, Beppu S, Hanai N. An examination of the cutoff value of the depth of invasion for prophylactic neck dissection in stage I/II tongue cancer. Acta Otolaryngol 2020; 140:422-426. [PMID: 32022616 DOI: 10.1080/00016489.2020.1717606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: In stage-I/stage-II oral tongue cancer, the cutoff value of depth of invasion (DOI) for prophylactic neck dissection is controversial.Objectives: To examine the relationship between the DOI and the rate of occult lymph node metastasis. In addition, to examine the relationship between the DOI evaluated by magnetic resonance imaging (MRI) and pathological DOI.Materials and methods: In this retrospective study, 95 patients with clinical T1-2/N0M0 oral tongue cancer were enrolled. The rate of occult lymph node metastasis per DOI between 2 and 11 mm was calculated from the total pathological lymph node metastasis and delayed neck metastasis cases. We measured DOI using MRI and compared DOI obtained from pathology.Results: The total rate of occult lymph node metastasis was 23.9%. In the rate of occult lymph node metastasis per DOI, there were two peaks at point of 5 to 6 mm and 9 to 10 mm. And there was a significant correlation between the DOI evaluated by MRI and the pathological DOI (Pearson's correlation coefficient was 0.87).Conclusions and significance: There was no consistent increase in the rate of occult lymph node metastasis per DOI. MRI was a useful modality to measure the DOI.
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Affiliation(s)
- Hoshino Terada
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Eiichi Sasaki
- Departments of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hidenori Suzuki
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Daisuke Nishikawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shintaro Beppu
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
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Tumor Budding and Cell Nest Size Are Highly Prognostic in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Further Evidence for a Unified Histopathologic Grading System for Squamous Cell Carcinomas of the Upper Aerodigestive Tract. Am J Surg Pathol 2020; 43:303-313. [PMID: 30475254 DOI: 10.1097/pas.0000000000001178] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Squamous cell carcinoma (SCC) is the most common cancer of the head and neck region including-among others-laryngeal (LSCC) and hypopharyngeal (HSCC) subsites. LSCC/HSCC are heterogenous diseases with respect to patient outcome. Currently, tumor stage-based patient stratification is essential to predict prognosis and thus selection of the appropriate treatment modalities. In contrast, the prognostic impact of the current HSCC/LSCC grading system according to the WHO classification is limited. Recently, a novel grading system based on tumor budding activity (BA) and cell nest size (CNS) has been introduced for SCC in different anatomic regions of the upper aerodigestive tract. To test and transvalidate this grading scheme in LSCC and HSCC, we retrospectively correlated BA, CNS, and additional histomorphologic parameters with clinicopathologic data of 157 treatment-naive patients. In doing so, we demonstrate that a 3-tiered novel grading system (well-differentiated [nG1], intermediately [nG2], and poorly differentiated [nG3]) based on a sum score for BA and CNS is highly and independently prognostic for patient survival in LSCC/HSCC, strongly outperforming the current WHO grading scheme with a hazard ratio for disease-specific survival of 6.6 for nG2 and 13.4 for nG3 cases (P<0.001). This finding contributes to a growing body of evidence that a CNS and BA-based pan-entity grading system in SCC might be useful and seems to capture differences in underlying SCC biology crucial for survival.
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Pantvaidya G, Rao K, D'Cruz A. Management of the neck in oral cancers. Oral Oncol 2020; 100:104476. [DOI: 10.1016/j.oraloncology.2019.104476] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 12/30/2022]
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Alabi RO, Elmusrati M, Sawazaki-Calone I, Kowalski LP, Haglund C, Coletta RD, Mäkitie AA, Salo T, Almangush A, Leivo I. Comparison of supervised machine learning classification techniques in prediction of locoregional recurrences in early oral tongue cancer. Int J Med Inform 2019; 136:104068. [PMID: 31923822 DOI: 10.1016/j.ijmedinf.2019.104068] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 12/10/2019] [Accepted: 12/26/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND The proper estimate of the risk of recurrences in early-stage oral tongue squamous cell carcinoma (OTSCC) is mandatory for individual treatment-decision making. However, this remains a challenge even for experienced multidisciplinary centers. OBJECTIVES We compared the performance of four machine learning (ML) algorithms for predicting the risk of locoregional recurrences in patients with OTSCC. These algorithms were Support Vector Machine (SVM), Naive Bayes (NB), Boosted Decision Tree (BDT), and Decision Forest (DF). MATERIALS AND METHODS The study cohort comprised 311 cases from the five University Hospitals in Finland and A.C. Camargo Cancer Center, São Paulo, Brazil. For comparison of the algorithms, we used the harmonic mean of precision and recall called F1 score, specificity, and accuracy values. These algorithms and their corresponding permutation feature importance (PFI) with the input parameters were externally tested on 59 new cases. Furthermore, we compared the performance of the algorithm that showed the highest prediction accuracy with the prognostic significance of depth of invasion (DOI). RESULTS The results showed that the average specificity of all the algorithms was 71% . The SVM showed an accuracy of 68% and F1 score of 0.63, NB an accuracy of 70% and F1 score of 0.64, BDT an accuracy of 81% and F1 score of 0.78, and DF an accuracy of 78% and F1 score of 0.70. Additionally, these algorithms outperformed the DOI-based approach, which gave an accuracy of 63%. With PFI-analysis, there was no significant difference in the overall accuracies of three of the algorithms; PFI-BDT accuracy increased to 83.1%, PFI-DF increased to 80%, PFI-SVM decreased to 64.4%, while PFI-NB accuracy increased significantly to 81.4%. CONCLUSIONS Our findings show that the best classification accuracy was achieved with the boosted decision tree algorithm. Additionally, these algorithms outperformed the DOI-based approach. Furthermore, with few parameters identified in the PFI analysis, ML technique still showed the ability to predict locoregional recurrence. The application of boosted decision tree machine learning algorithm can stratify OTSCC patients and thus aid in their individual treatment planning.
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Affiliation(s)
- Rasheed Omobolaji Alabi
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland.
| | - Mohammed Elmusrati
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | - Iris Sawazaki-Calone
- Oral Pathology and Oral Medicine, Dentistry School, Western Parana State University, Cascavel, PR, Brazil
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | - Caj Haglund
- Research Programs Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Tuula Salo
- Department of Pathology, University of Helsinki, Helsinki, Finland; Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland; Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland; Institute of Biomedicine, Pathology, University of Turku, Turku, Finland; Faculty of Dentistry, University of Misurata, Misurata, Libya
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, Turku, Finland
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Ariji Y, Fukuda M, Kise Y, Nozawa M, Nagao T, Nakayama A, Sugita Y, Katumata A, Ariji E. A preliminary application of intraoral Doppler ultrasound images to deep learning techniques for predicting late cervical lymph node metastasis in early tongue cancers. ACTA ACUST UNITED AC 2019. [DOI: 10.1002/osi2.1039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Motoki Fukuda
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Yoshitaka Kise
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Michihito Nozawa
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Atsushi Nakayama
- Department of Oral and Maxillofacial Surgery Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Yoshihiko Sugita
- Department of Oral Pathology Aichi‐Gakuin University School of Dentistry Nagoya Japan
| | - Akitoshi Katumata
- Department of Oral Radiology Asahi University School of Dentistry Mizuho Japan
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology Aichi‐Gakuin University School of Dentistry Nagoya Japan
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Migueláñez-Medrán BC, Pozo-Kreilinger JJ, Cebrián-Carretero JL, Martínez-García MA, López-Sánchez AF. Oral squamous cell carcinoma of tongue: Histological risk assessment. A pilot study. Med Oral Patol Oral Cir Bucal 2019; 24:e603-e609. [PMID: 31422411 PMCID: PMC6764715 DOI: 10.4317/medoral.23011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/28/2019] [Indexed: 11/24/2022] Open
Abstract
Background More than 90% of malignant tumors diagnosed in the oral cavity are Oral Squamous Cell Carcinomas (OSCC) whose preferred location is the tongue. Classically, this disease has affected men preferentially, although recent studies suggest that trends are changing and the proportion of women with OSCC is increasing. In addition, the prevalence of oral cancer is also determined by some risk factors as alcohol consumption and tobacco. Currently, the Tumor, Node, Metastasis (TNM) classification is employed to defined tumor stage and based on this guide specific treatments are established. However, 5-year-survival does not exceed 50% of cases. The objective of this study is to determine whether a histological risk pattern indicative of higher recurrence might be present in T1-T2 tumors located in the anterior two thirds of the tongue. Material and Methods Samples from 26 patients with OSCC were analyzed and histological risk pattern of recurrent and non-recurrent tumors were compared. We have analyzed histological variables described in Anneroth and Brandwein-Gensler classifications. Additionally, we have also examined both clinical variables such as age, sex or comorbidities, as well as habits such as tobacco or alcohol consumption. Results We found that sex (male) and keratinization degree (high or moderate) are directly related with OSCC recurrence. In fact, free illness time is lower in men and higher in those cases with minimal or no keratinization. Conclusions Based on the variables analyzed, it has not been possible to establish a histological risk pattern that, complementary to the TNM classification, could have a predictive role in these early-stage tongue carcinomas. Key words:Oral cancer, oral squamous cell carcinoma, histologic risk assessment, oral cancer recurrence.
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Affiliation(s)
- B-C Migueláñez-Medrán
- Faculty of Odontology, Rey Juan Carlos University, Avenida de Atenas s/n, 28922 Alcorcón, Madrid (Spain),
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Sharma K, Ahlawat P, Gairola M, Tandon S, Sachdeva N, Sharief MI. Prognostic factors, failure patterns and survival analysis in patients with resectable oral squamous cell carcinoma of the tongue. Radiat Oncol J 2019; 37:73-81. [PMID: 31266288 PMCID: PMC6610009 DOI: 10.3857/roj.2018.00577] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 05/27/2019] [Indexed: 12/21/2022] Open
Abstract
PURPOSE There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC. MATERIALS AND METHODS It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated. RESULTS The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3-102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS. CONCLUSION Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.
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Affiliation(s)
- Kanika Sharma
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Parveen Ahlawat
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Munish Gairola
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Sarthak Tandon
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Nishtha Sachdeva
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
| | - Muhammed Ismail Sharief
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
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Hanai N, Asakage T, Kiyota N, Homma A, Hayashi R. Controversies in relation to neck management in N0 early oral tongue cancer. Jpn J Clin Oncol 2019; 49:297-305. [PMID: 30668761 DOI: 10.1093/jjco/hyy196] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/22/2018] [Accepted: 12/21/2018] [Indexed: 02/05/2023] Open
Abstract
The standard local treatment for early-stage tongue cancer with no clinical lymph node metastases is partial glossectomy. The frequency of occult lymph node metastasis is ~20-30%. Thus, whether prophylactic neck dissection with glossectomy or glossectomy alone should be performed has been a controversial issue since the 1980s. Both treatments have advantages and disadvantages; however, especially in cases involving prophylactic neck dissection, surgical invasion and complications including the cosmetic disadvantage caused by neck skin incision, accessory nerve paralysis or facial nerve (mandibular marginal branch) paralysis, stiffness of the shoulder or neck and a feeling of neck tightness have been considered issues that could be solved by providing less-invasive treatment to the 70-80% of patients without occult lymph node metastasis. A more accurate preoperative diagnosis and strict follow-up are required to provide minimally invasive treatment while ensuring the therapeutic effect. It is also necessary to narrow down the target based on the risk-benefit balance. The depth of invasion should be considered in cases involving oral cavity malignancies. This was also taken into account in recent revisions of eighth edition of the TNM Classification of Malignant Tumors and it is an important factor for N0 neck management. This review article summarizes previous and recent reports on neck management, focusing on the risk-benefit and future perspectives of the diagnosis and treatment of early-stage oral tongue cancer. This effort is an attempt to establish treatment from the patient's point of view, with the patient's quality of life taken into account.
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Affiliation(s)
- Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Aichi, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naomi Kiyota
- Department of Medical Oncology/Hematology and Cancer Center, Kobe University Hospital, Hyogo, Japan
| | - Akihiro Homma
- Department of Otolaryngology--Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Ryuichi Hayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Chiba, Japan
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Mourad MA, Higazi MM. MRI prognostic factors of tongue cancer: potential predictors of cervical lymph nodes metastases. Radiol Oncol 2019; 53:49-56. [PMID: 30840589 PMCID: PMC6411025 DOI: 10.2478/raon-2019-0012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 01/15/2019] [Indexed: 11/22/2022] Open
Abstract
Background This study aimed to evaluate the efficacy of three MR imaging parameters, which are tumour thickness, para-lingual distance and apparent diffusion coefficient (ADC) value for prediction of cervical lymph nodes metastasis in cancer tongue patients. Patients and methods Fifty patients with proved cancer tongue by histopathological examination underwent MRI examination. T1 and T2- weighted MRI, diffusion-weighted images and post-contrast T1 fat suppression sequences were used. Results The patients were classified according to lymph nodes involvement as seen by MRI into two groups. Significant differences between positive and negative nodes groups were observed regarding tumour thickness and para-lingual distance (p-values = 0.008 and 0.003 respectively). ROC curve analyses revealed cut-off values >13.8 mm and ≤ 3.3 mm for tumour thickness and para-lingual distance respectively for prediction of nodes involvement. No significant differences between patients with and without cervical lymph nodes metastasis were found regarding corresponding ADC value of the tumour (p-value = 0.518). Conclusions Para-lingual distance and tumour thickness are factors that could influence pre-operative judgment and prognosis of tongue cancer patients. ADC value of the tumour itself seem not to be a reliable index of cancer progression to regional lymph nodes.
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Affiliation(s)
| | - Mahmoud M. Higazi
- Department of Radiology, Minia University, MiniaEgypt
- Mahmoud M. Higazi, M.D., Lecturer of Radiology, Minia University Egypt
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den Toom IJ, Janssen LM, van Es RJJ, Karagozoglu KH, de Keizer B, van Weert S, Willems SM, Bloemena E, Leemans CR, de Bree R. Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy. Head Neck 2019; 41:2100-2106. [PMID: 30688384 PMCID: PMC6618049 DOI: 10.1002/hed.25665] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/30/2018] [Accepted: 01/04/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND To investigate if depth of invasion (DOI) can predict occult nodal disease in patients with cT1-2N0 (7th TNM) oral squamous cell carcinoma (OSCC) staged by sentinel lymph node biopsy (SLNB). METHODS In 199 OSCC patients, DOI measurements and SLNB were performed. RESULTS Metastases were found in 64 of 199 patients (32%). Of these 64 patients, the mean DOI was 6.6 mm compared to 4.7 mm in patients without metastases (P = .003). The ROC-curve showed an area under the curve of 0.65 with a most optimal cutoff point of 3.4 mm DOI (sensitivity 83% and specificity 47%). Regional metastases were found in 15% of patients with DOI ≤ 3.4 mm. CONCLUSION DOI seems to be a poor predictor for regional metastasis in patients with cT1-2N0 OSCC. Therefore, staging of the neck using SLNB in patients with early stage oral cancer should also be performed in tumors with limited DOI and probably in T3 (8th TNM) OSCC ≤4 cm diameter.
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Affiliation(s)
- Inne J den Toom
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Luuk M Janssen
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robert J J van Es
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - K Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery / Oral Pathology, VU University Medical Center/Academic Center for Dentistry (ACTA) Amsterdam, Amsterdam, The Netherlands
| | - Bart de Keizer
- Department of Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stijn van Weert
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Stefan M Willems
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Elisabeth Bloemena
- Department of Oral and Maxillofacial Surgery / Oral Pathology, VU University Medical Center/Academic Center for Dentistry (ACTA) Amsterdam, Amsterdam, The Netherlands.,Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
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Shinn JR, Wood CB, Colazo JM, Harrell FE, Rohde SL, Mannion K. Cumulative incidence of neck recurrence with increasing depth of invasion. Oral Oncol 2018; 87:36-42. [DOI: 10.1016/j.oraloncology.2018.10.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/12/2018] [Accepted: 10/14/2018] [Indexed: 01/04/2023]
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Sekikawa S, Onda T, Miura N, Nomura T, Takano N, Shibahara T, Honda K. Underexpression of α-1-microglobulin/bikunin precursor predicts a poor prognosis in oral squamous cell carcinoma. Int J Oncol 2018; 53:2605-2614. [PMID: 30272341 DOI: 10.3892/ijo.2018.4581] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/24/2018] [Indexed: 11/06/2022] Open
Abstract
In the present study, in order to identify novel diagnostic biomarkers for the malignant behavior of oral squamous cell carcinoma (OSCC), we determined the proteomic profiles of several OSCC cell lines and keratinocytes by two-dimensional fluorescence difference gel electrophoresis and liquid chromatography tandem mass spectrometry. The protein expression level of α-1-microglobulin/bikunin precursor (AMBP) was found to be significantly lower in the OSCC cell lines than in the keratinocytes, and a significant decrease in AMBP mRNA expression was confirmed in the OSCC cell lines by RT-qPCR. To investigate the biological function of AMBP in OSCC, the cells were transiently transfected with an AMBP overexpression vector; the AMBP-overexpressing cells exhibited a significantly decreased invasion and migration in comparison to the mock-transfected control cells, although no significant changes in cell proliferation were observed. Immunohistochemistry revealed that the underexpression of AMBP was significantly associated with a high metastatic potential to cervical lymph nodes and a poor overall survival. Thus, the expression of AMBP is an independent predictive factor of cervical lymph node metastasis and a prognostic factor of overall survival, and it is involved in both cell invasion and metastasis in cervical lymph nodes in OSCC.
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Affiliation(s)
- Shoichi Sekikawa
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba 261-8502, Japan
| | - Takeshi Onda
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba 261-8502, Japan
| | - Nami Miura
- Department of Biomarkers for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Takeshi Nomura
- Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba 272-8513, Japan
| | - Nobuo Takano
- Oral Cancer Center, Tokyo Dental College, Chiba 272-8513, Japan
| | - Takahiko Shibahara
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba 261-8502, Japan
| | - Kazufumi Honda
- Department of Biomarkers for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo 104-0045, Japan
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Faccin TC, Cargnelutti JF, Rodrigues FDS, de Menezes FR, Piazer JVM, de Melo SMP, Lautert BF, Flores EF, Kommers GD. Bovine upper alimentary squamous cell carcinoma associated with bracken fern poisoning: Clinical-pathological aspects and etiopathogenesis of 100 cases. PLoS One 2018; 13:e0204656. [PMID: 30256853 PMCID: PMC6157896 DOI: 10.1371/journal.pone.0204656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 09/12/2018] [Indexed: 12/23/2022] Open
Abstract
Upper digestive tract (UDT) cancer is rare in cattle, however in Southern Brazil, the UDT squamous cell carcinomas (SCCs) are relatively common and have been associated with bracken fern consumption and the presence of papillomas. Although a theory of pathogenesis considers bovine papillomavirus type 4 (BPV-4) as a cofactor in the development of these SCCs, some aspects of the etiopathogenesis of this disease need to be more investigated. In fact, detection of BPV-4 in UDT papillomas is scarce in other regions of the world and has not been performed in Brazil. Therefore, this study had two aims: 1) to analyze the epidemiological, clinical and pathological aspects of 100 natural cases of SCCs in the UDT of cattle grazing on bracken fern (Pteridium arachnoideum) highly contaminated areas, investigating the associations between these parameters; and 2) to investigate the presence of papillomavirus DNA by polymerase chain reaction (PCR) in the UDT papillomas (n = 47) from 30 cattle that also had UDT SCCs. There were statistically significant associations between clinical signs and tumor localization in the UDT; between histological grade of differentiation and tumor localization; and a trend towards significant association between histological grade of differentiation and presence of metastases. The average age of cattle with oropharyngeal SCCs was 7.39 years, with statistically significant difference comparing to cattle with esophageal SCCs (8.6 years). No statistical association was observed among other clinical-pathological parameters (growth pattern and primary site of the tumor) analyzed. No BPV DNA was detected in papillomas by PCR. Therefore, these results suggest the possibility that papillomas of the UDT are not necessarily associated with BPV infection.
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Affiliation(s)
- Tatiane Cargnin Faccin
- Departamento de Patologia, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Juliana Felipetto Cargnelutti
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Fernando de Souza Rodrigues
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | | | | | | | - Betina Fabis Lautert
- Departamento de Patologia, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Eduardo Furtado Flores
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Glaucia Denise Kommers
- Departamento de Patologia, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
- * E-mail:
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Nomogram based on albumin and neutrophil-to-lymphocyte ratio for predicting the prognosis of patients with oral cavity squamous cell carcinoma. Sci Rep 2018; 8:13081. [PMID: 30166572 PMCID: PMC6117301 DOI: 10.1038/s41598-018-31498-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 08/13/2018] [Indexed: 12/14/2022] Open
Abstract
Increasing evidence indicates that inflammation plays a crucial role in cancer development. A novel scoring system based on albumin and the neutrophil-to-lymphocyte ratio (NLR) was developed and incorporated into a nomogram to create a more accurate prognostic tool for oral cavity squamous cell carcinoma (OSCC) patients. A retrospective review was performed on 613 consecutive patients undergoing ablative surgery for OSCC between September 2005 and December 2014. NLR and albumin were determined and used to calculate an albumin/NLR score (ANS). The nomogram was based on the ANS and several clinicopathological manifestations, and its accuracy was determined by the concordance index (c-index). A high ANS was significantly associated with aggressive tumor behaviors, such as T status, overall stage, extranodal extension, perineural invasion, tumor depth, and decreased overall survival (OS). Multivariate analysis indicated that age, overall stage, extranodal extension, and ANS were independent factors for OS. The c-index for OS prognosis was 0.750 using this nomogram compared to 0.688 using TNM staging alone. The prognostic accuracy for OS in OSCC patients can be significantly improved using a nomogram that incorporates the novel ANS and other clinicopathological variables.
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Faisal M, Abu Bakar M, Sarwar A, Adeel M, Batool F, Malik KI, Jamshed A, Hussain R. Depth of invasion (DOI) as a predictor of cervical nodal metastasis and local recurrence in early stage squamous cell carcinoma of oral tongue (ESSCOT). PLoS One 2018; 13:e0202632. [PMID: 30133515 PMCID: PMC6105019 DOI: 10.1371/journal.pone.0202632] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 08/07/2018] [Indexed: 01/09/2023] Open
Abstract
Background The new AJCC staging system (8th edition) incorporates depth of invasion to stage oral cancers. It is a recognized predictor for neck nodal metastasis and local recurrence, the associated risk is not well defined. The aim of this study was to explore the risk of occult neck nodal metastasis and local recurrence in relation to depth in early stage squamous cell carcinoma of oral tongue. Methods We have evaluated records of 179 patients with early tongue cancer treated in our unit from 2006–2015 with a mean age of 57.92 ± 11.93 years. Treatment modalities used were surgery (26%), surgery followed by radiotherapy (64%) and chemo-radiation (10%). Neck dissection was ipsilateral in 94% and bilateral in 6% of the patients. Patients were grouped according to the AJCC cut off points in 8th edition for depth; group A: 1–5 mm (35%), group B: 6–10 mm (47%) and group C: > 10 mm (18%). Results Risk of local recurrence and nodal metastasis for Group A was 15% (10/63) and 23% (15/63), group B 20% (17/84) and 34% (29/84), and group C 40% (13/32) and 53% (17/32). Conclusions Depth more than 10 mm is associated with significantly increased risk of recurrence and nodal metastasis. Elective neck dissection should be a consideration for tumors having depth less than 5mm.
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Affiliation(s)
- Muhammad Faisal
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
- * E-mail:
| | - Muhammad Abu Bakar
- Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Albash Sarwar
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Mohammad Adeel
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Fatima Batool
- Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Kashif Iqbal Malik
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Arif Jamshed
- Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Raza Hussain
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
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Hussein AA, Forouzanfar T, Bloemena E, de Visscher J, Brakenhoff RH, Leemans CR, Helder MN. A review of the most promising biomarkers for early diagnosis and prognosis prediction of tongue squamous cell carcinoma. Br J Cancer 2018; 119:724-736. [PMID: 30131545 PMCID: PMC6173763 DOI: 10.1038/s41416-018-0233-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/11/2018] [Accepted: 07/25/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND There is a great interest in developing biomarkers to enhance early detection and clinical management of tongue squamous cell carcinoma (TSCC). However, the developmental path towards a clinically valid biomarker remains extremely challenging. Ideally, the initial key step in moving a newly discovered biomarker towards clinical implementation is independent replication. Therefore, the focus of this review is on biomarkers that consistently showed clinical relevance in two or more publications. METHODS We searched PubMed database for relevant papers across different TSCC sample sources, i.e., body fluids (saliva, serum/plasma) and tissues. No restriction regarding the date of publication was applied except for immunohistochemistry (IHC); only studies published between 2010 and June 2017 were included. RESULTS The search strategy identified 1429 abstracts, of which 96 papers, examining 150 biomarkers, were eventually included. Of these papers, 66% were exploratory studies evaluating single or a panel of biomarkers in one publication. Ultimately, based on studies that had undergone validation for their clinical relevance in at least two independent studies, we identified 10 promising candidates, consisting of different types of molecules (IL-6, IL-8, and Prolactin in liquid samples; HIF-1α, SOX2, E-cadherin, vimentin, MALAT1, TP53, and NOTCH1 in tissue biopsies) CONCLUSIONS: Although more exploratory research is needed with newer methods to identify biomarkers for TSCC, rigorous validation of biomarkers that have already shown unbiased assessment in at least two publications should be considered a high priority. Further research on these promising biomarkers or their combination in multi-institutional studies, could provide new possibilities to develop a specific panel for early diagnosis, prognosis, and individualized treatments.
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Affiliation(s)
- Aisha A Hussein
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Elisabeth Bloemena
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Jgam de Visscher
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Ruud H Brakenhoff
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Marco N Helder
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands.
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De Silva RK, Siriwardena BSMS, Samaranayaka A, Abeyasinghe WAMUL, Tilakaratne WM. A model to predict nodal metastasis in patients with oral squamous cell carcinoma. PLoS One 2018; 13:e0201755. [PMID: 30091996 PMCID: PMC6084951 DOI: 10.1371/journal.pone.0201755] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 07/20/2018] [Indexed: 12/18/2022] Open
Abstract
Difficulty in precise decision making on necessity of surgery is a major problem when managing oral squamous cell carcinomas (OSCCs) with clinically negative neck. Therefore, use of clinical and histopathological parameters in combination would be important to improve patient management. The main objective is to develop a model that predicts the presence of nodal metastasis in patients with OSCC.623 patients faced neck dissections with buccal mucosal or tongue squamous cell carcinoma (SCC) were selected from patients’ records. Demographic data, clinical information, nodal status, Depth of invasion (DOI) and pattern of invasion (POI) were recorded. The parameters which showed a significant association with nodal metastasis were used to develop a multivariable predictive model (PM). Univariate logistic regression was used to estimate the strengths of those associations in terms of odds ratios (OR). This showed statistically significant associations between status of the nodal metastasis and each of the following 4 histopathological parameters individually: size of the tumour (T), site, POI, and DOI. Specifically, OR of nodal metastasis for tongue cancers relative to buccal mucosal cancers was 1.89, P-value < 0.001. Similarly, ORs for POI type 3 and 4 relative to type 2 were 1.99 and 5.83 respectively. A similar relationship was found with tumour size; ORs for T2, T3, and T4 compared to T1 were 2.79, 8.27 and 8.75 respectively. These four histopathological parameters were then used to develop a predictive model for nodal metastasis. This model showed that probability of nodal metastasis is higher among tongue cancers with increasing POI, with increasing T, and with larger depths while other characteristics remained unchanged. The proposed model provides a way of using combinations of histopathological parameters to identify patients with higher risks of nodal metastasis for surgical management.
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Affiliation(s)
- R. K. De Silva
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- * E-mail: (RKDeS); (WMT)
| | - B. S. M. S. Siriwardena
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - A. Samaranayaka
- Department of Preventive and Social Medicine, Faculty of Medicine, University of Otago, Dunedin, New Zealand
| | - W. A. M. U. L. Abeyasinghe
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - W. M. Tilakaratne
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- * E-mail: (RKDeS); (WMT)
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Shah JP, Montero PH. New AJCC/UICC staging system for head and neck, and thyroid cancer. REVISTA MÉDICA CLÍNICA LAS CONDES 2018. [DOI: 10.1016/j.rmclc.2018.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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47
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Rajappa SK, Ram D, Bhakuni YS, Jain A, Kumar R, Dewan AK. Survival benefits of adjuvant radiation in the management of early tongue cancer with depth of invasion as the indication. Head Neck 2018; 40:2263-2270. [DOI: 10.1002/hed.25329] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/11/2018] [Accepted: 04/19/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Suhas Kodasoge Rajappa
- Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi-85; Rajiv Gandhi Cancer Institute and Research Centre; New Delhi India
| | - Dharma Ram
- Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi-85; Rajiv Gandhi Cancer Institute and Research Centre; New Delhi India
| | - Yogendra Singh Bhakuni
- Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi-85; Rajiv Gandhi Cancer Institute and Research Centre; New Delhi India
| | - Ankita Jain
- Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi-85; Rajiv Gandhi Cancer Institute and Research Centre; New Delhi India
| | - Rajeev Kumar
- Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi-85; Rajiv Gandhi Cancer Institute and Research Centre; New Delhi India
| | - Ajay K. Dewan
- Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi-85; Rajiv Gandhi Cancer Institute and Research Centre; New Delhi India
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Mair MD, Shetty R, Nair D, Mathur Y, Nair S, Deshmukh A, Thiagarajan S, Pantvaidya G, Lashkar S, Prabhash K, Chaukar D, Pai P, Cruz AD, Chaturvedi P. Depth of invasion, size and number of metastatic nodes predicts extracapsular spread in early oral cancers with occult metastases. Oral Oncol 2018; 81:95-99. [PMID: 29884420 DOI: 10.1016/j.oraloncology.2018.04.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 03/26/2018] [Accepted: 04/20/2018] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Presence of extracapsular spread (ECS) significantly decreases survival in oral cancer patients. Considering its prognostic impact, we have studied the incidence and factors predicting ECS in clinically node negative early oral cancers. MATERIALS AND METHODS We performed a retrospective chart review of 354 treatment naïve clinically node negative early oral cancer patients operated between 2012 and 2014. Chi-square test and logistic regression were used for identifying predictors of ECS, while cox-regression test was used for survival analysis. RESULTS The incidence of occult nodal metastasis was 28.5% (101/354). Among them, ECS was seen in 15.3%(54/354) patients. The incidence of ECS in T1 and T2 lesion was 13.4% (21/157) and 16.8% (33/197), respectively. The overall incidence of ECS was 48% and 29% in lymph nodes smaller than 10 mm and 5 mm respectively. We found that tumor depth of invasion (>5 mm; p-0.027) and node (metastatic) size >15 mm (p-0.018) were significant predictors of ECS. p N2b disease was seen in 41/354 (11.6%) of which 31/354 (8.7%) had ECS, i.e. 75.6% of pN2b patients been ECS positive (p-0.000). The 3-year OS of patients without nodal metastasis, nodal metastasis without ECS and nodal metastasis with ECS was 88.4%, 66.9% and 59.2% (p-0.000) respectively. CONCLUSION A significant number of patients with metastatic nodal size less than 1 cm have ECS which suggests aggressive behavior of the primary tumor. Thus, elective neck dissection is the only way of detecting ECS in these patients which may warrant treatment intensification.
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Affiliation(s)
- Manish D Mair
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Rathan Shetty
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Deepa Nair
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Yash Mathur
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Sudhir Nair
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Anuja Deshmukh
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | | | - Gouri Pantvaidya
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | | | - Kumar Prabhash
- Medical Oncologist, Tata Memorial Hospital, Mumbai, India
| | - Devendra Chaukar
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Prathmesh Pai
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
| | - Anil D Cruz
- Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
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Mitsudo K, Hayashi Y, Minamiyama S, Ohashi N, Iida M, Iwai T, Oguri S, Koizumi T, Kioi M, Hirota M, Koike I, Hata M, Tohnai I. Chemoradiotherapy using retrograde superselective intra-arterial infusion for tongue cancer: Analysis of therapeutic results in 118 cases. Oral Oncol 2018; 79:71-77. [PMID: 29598953 DOI: 10.1016/j.oraloncology.2018.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/29/2018] [Accepted: 02/02/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate the therapeutic results and rate of organ preservation in patients with squamous cell carcinoma of the tongue treated with retrograde superselective intra-arterial chemoradiotherapy. MATERIALS AND METHODS Between June 2006 and June 2015, 118 patients with tongue cancer were treated with intra-arterial chemoradiotherapy. Treatment consisted of radiotherapy (total 50-70 Gy) and daily concurrent intra-arterial chemotherapy (docetaxel, total 50-70 mg/m2; cisplatin, total 125-175 mg/m2) for 5-7 weeks. Locoregional control and overall survival rates were calculated by the Kaplan-Meier method. Cox's proportional hazards model was used for both univariate and multivariate analyses. RESULTS The median follow-up for all patients was 38.5 months (range, 3-129 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 113 (95.8%) of 118 cases. Three-year locoregional control and overall survival rates were 80.3% and 81.5%, respectively. Grade 3 or 4 toxicities included neutropenia in 16.1% and mucositis in 87.3%. Grade 3 toxicities included anemia in 12.7%, thrombocytopenia in 3.4%, nausea/vomiting in 3.4%, dermatitis in 45.7%, dysphagia in 74.6%, and fever in 2.5% of patients. Late toxicity consisting of grade 3 osteoradionecrosis of the jaw occurred in 4.2% of patients. On univariate analysis, T stage and overall stage were significantly associated with locoregional control, and N stage and overall stage were significantly associated with overall survival. On multivariate analysis, the only significant predictor of overall survival was overall stage classification. CONCLUSION Retrograde superselective intra-arterial chemoradiotherapy for tongue cancer provided good overall survival and locoregional control.
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Affiliation(s)
- Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
| | - Yuichiro Hayashi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Shuhei Minamiyama
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Nobuhide Ohashi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Masaki Iida
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Senri Oguri
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Toshiyuki Koizumi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Mitomu Kioi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Makoto Hirota
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Izumi Koike
- Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Masaharu Hata
- Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Iwai Tohnai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
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Sawant SS, Dongre H, Ahire C, Sharma S, Kannan S, Mahadik S, Chaukar D, Lukmani F, Patil A, D'Cruz A, Vaidya MM, Dongre P. A nomogram for predicting the risk of neck node metastasis in pathologically node-negative oral cavity carcinoma. Oral Dis 2017; 23:1087-1098. [PMID: 28580710 DOI: 10.1111/odi.12696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/08/2017] [Accepted: 05/23/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To generate a nomogram for predicting the risk of neck node metastasis in pathologically node-negative patients using a combination of variables comprising of protein expression, ultrastructural alterations and clinicopathological parameters. MATERIALS AND METHODS Surgically removed oral tumours (n = 103) were analysed for the expression of desmosomal and hemidesmosomal assembly proteins by immunohistochemistry and ultrastructural alterations by transmission electron microscopy (TEM). Protein expression, ultrastructural alterations and clinicopathological variables were used to construct nomogram from the training set in 75 patients. Clinical utility of the nomogram was validated in a discrete set of 28 patients. RESULTS Univariate and multivariate analyses were performed on the training set, and obtained significant variables comprising of integrin β4 expression (p = .027), number of hemidesmosomes (p = .027)/desmosomes (p = .046), tumour differentiation grade (p = .033) and tumour thickness (p = .024) were used for construction of the nomogram. The area under the curve was calculated for both training 0.821 (95% CI 0.725-0.918) and validation sets 0.880 (95% CI 0.743-1.000). The nomogram demonstrated a predictive accuracy of 73.3% and 78.6% with the sensitivity of 81.4% and 83.3% in the training and validation sets, respectively. CONCLUSIONS The nomogram constructed on postsurgical tumour samples will be a value addition to histopathology for the detection of neck node metastasis in pathologically node-negative patients.
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Affiliation(s)
- S S Sawant
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - H Dongre
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - C Ahire
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - S Sharma
- Oral Surgery Head and Neck Unit, Tata Memorial Hospital (TMH), Mumbai, Maharashtra, India
| | - S Kannan
- Epidemiology and Clinical Trials Unit, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Mumbai, Maharashtra, India
| | - S Mahadik
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - D Chaukar
- Oral Surgery Head and Neck Unit, Tata Memorial Hospital (TMH), Mumbai, Maharashtra, India
| | - F Lukmani
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - A Patil
- Department of Pathology, Tata Memorial Hospital (TMH), Mumbai, Maharashtra, India
| | - A D'Cruz
- Oral Surgery Head and Neck Unit, Tata Memorial Hospital (TMH), Mumbai, Maharashtra, India
| | - M M Vaidya
- Vaidya Laboratory, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, Maharashtra, India
| | - P Dongre
- Department of Biophysics, University of Mumbai, Mumbai, Maharashtra, India
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