Survival outcomes after surgical treatment of oral squamous cell carcinoma.

OBJECTIVE: To identify the clinicopathological parameters that influence survival in patients with oral squamous cell carcinoma, in order to allow for the development of individualized surveillance programmes and reduce the delay in diagnosis of recurrence. MATERIALS AND METHODS: Retrospective chart review of 553 patients with a treatment-naïve primary oral squamous cell carcinoma, who underwent primarily curative intended surgery. Exclusion criteria were neoadjuvant radio(chemo)therapy, follow-up < 1 year, perioperative death, inoperable disease, synchronous multiple malignancies and inadequate information on clinicopathological parameters. RESULTS: The clinicopathological factors that influence overall survival, disease-free survival and locoregional control were calculated. In the multivariate survival analysis, the occurrence of recurrence, presence of extracapsular spread, T- and N-classification were shown to be independent risk factors for overall survival. CONCLUSION: The identification of these risk factors can lead to the development of individualized follow-up programmes based on risk stratification. This allows for the earliest possible diagnosis of relapse which is essential to offer the patient a realistic second treatment chance and to improve survival rates.

A novel histopathological scoring system for patients with oral squamous cell carcinoma.

OBJECTIVES: Tumor invasion into blood and/or lymphatic vessels, perineural invasion, and histopathological grading are evaluated to assess the biological aggressiveness of oral squamous cell carcinoma (OSCC). We aim to assess the prognostic impact of a novel scoring system, based upon the aforementioned histological parameters. MATERIALS AND METHODS: Retrospective chart review of 334 patients with treatment-naive squamous cell carcinoma of the oral cavity. Statistical analysis was performed using univariate and multivariate analysis. Histological grade G1 or G2 were assigned 0 points and G3 or G4 1 point. Invasion of the lymphatic vessels, blood vessels, or perineural space was given 1 point. Zero points were given, when invasion was not detectable. The final score was conducted through addition of each parameter. Therefore, our scoring system ranged between 0 and 4 points. RESULTS: T-classification (p < 0.001), N-classification (p < 0.001), UICC stage (p < 0.001), extracapsular spread (p < 0.001), locoregional recurrence (p < 0.001), and overall survival (p < 0.001) were significantly associated with the OSCC-Histoscore. In multivariate analysis, T-classification (p = 0.001), N-classification (p = 0.039), resection margins (p = 0.038), and OSCC-Histoscore (p < 0.001) were independent prognostic markers for overall survival rate. CONCLUSION: Our presented OSCC-Histoscore serves as a strong independent prognostic parameter for 5-year overall survival (OS) and predicts OS better than T-classification, N-classification, and resection margins. CLINICAL RELEVANCE: Our presented histoscore improves prediction of the overall survival of patients with OSCC.

Podoplanin expression in oral leukoplakia─a prospective study.

PURPOSE: The aim of this prospective work was to examine oral leukoplakia for their podoplanin expression to determine whether podoplanin expression is associated with the degree of dysplasia. MATERIALS AND METHODS: We took biopsy samples from 50 patients with oral leukoplakia in 2013. The preparations studied by immunohistochemistry were analyzed in correlation with the degree of dysplasia and other clinicopathological variables. RESULTS: The Chi-square test showed a significant correlation between podoplanin expression and the degree of dysplasia according to the squamous intraepithelial neoplasia (SIN) classification (p = 0.033). Also, a significant association between age grouping and podoplanin expression was found. We were able to show that the distribution is the same for both age groups in relation to the score of podoplanin expression (p = 0.003). CONCLUSION: In a comparable retrospective work of our working group, it could be shown that podoplanin is a reliable predictive marker for the assessment of the risk of malignant transformation. The present work was able to substantiate the assumption that podoplanin not only plays an important role in the context of malignant degeneration but also exerts a major influence in advance.