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Histopathologic prognostic indices in tongue squamous cell carcinoma

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Abstract

Purpose

Consistent prognosticators are needed to guide adjuvant treatment in tongue squamous cell carcinoma (SCC). We validate the prognostic significance of histopathologic parameters in surgically treated tongue SCC.

Methods

Archival specimens of 88 consecutive patients who were treated surgically for tongue SCC from 2003 to 2016 were re-analyzed by one pathologist. Patient records were retrospectively reviewed. Prognosticators of recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS) were identified using multivariate analysis.

Results

Tumor depth of invasion (DOI) > 6 mm (OR 4.76; 95%CI 1.22–18.5; p = 0.024) and lymphovascular invasion (OR 5.61; 95%CI 1.00–31.5; p = 0.05) were independent predictors of nodal metastases. The overall 5-year RFS, OS and DSS were 70%, 82% and 84% respectively. Positive margins predicted poor RFS (HR 3.91; 95%CI 1.58–9.65; p = 0.003) and local recurrence-free survival (HR 4.96; 95%CI 1.36–18; p = 0.015). Presence of nodal metastases (HR 5.03; 95%CI 1.73–14.6; p = 0.003), tumor DOI > 6 mm (HR 9.91; 95%CI 1.26–78.0; p = 0.029) and positive margins (HR 8.26; 95%CI 2.75–24.8; p < 0.001) were independent predictors of poor OS. Presence of nodal metastases (HR 3.87; 95%CI 1.17–12.8; p = 0.027) and positive margins (HR 12.3; 95%CI 3.54–42.9; p < 0.001) also independently predicted poor DSS.

Conclusion

Margins’ status was the only independent predictor of local recurrence. Tumor DOI, nodal and margin status were key prognosticators of survival and may determine the necessity for adjuvant therapy.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore, Singapore

    Linus Lau, Donovan Eu & Thomas Loh

  2. Department of Pathology, National University Hospital, Singapore, Singapore

    Qasim Ahmed

  3. Department of Otorhinolaryngology–Head and Neck Surgery, Singapore General Hospital, 20 College Road, Academia Building Level 5, Singapore, 169856, Singapore

    Chwee Ming Lim

  4. Surgery ACP, Duke NUS Medical School, Singapore, Singapore

    Chwee Ming Lim

Authors
  1. Linus Lau
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  2. Donovan Eu
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  3. Thomas Loh
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  4. Qasim Ahmed
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  5. Chwee Ming Lim
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Contributions

All authors contributed equally to study conception and design. Material preparation, data collection and analysis were performed by LL, DE, QA, and CML. The first draft of the manuscript was written by LL, and CML and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Chwee Ming Lim.

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This study was approved by the National Healthcare Group Institutional Review Board (DSRB reference number: 2014/00016).

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Lau, L., Eu, D., Loh, T. et al. Histopathologic prognostic indices in tongue squamous cell carcinoma. Eur Arch Otorhinolaryngol 278, 2461–2471 (2021). https://doi.org/10.1007/s00405-020-06329-5

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  • DOI: https://doi.org/10.1007/s00405-020-06329-5

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