Pathology & Oncology Research

, Volume 25, Issue 1, pp 183–189 | Cite as

The Impact of Peritumoral Retraction Clefting & Intratumoral Eosinophils on Overall Survival in Oral Squamous Carcinoma Patients

  • Dhruv Jain
  • Gargi Tikku
  • Pallavi Bhadana
  • Chandrashekhar Dravid
  • Rajesh Kumar Grover
Original Article


This retrospective study aimed to investigate the impact of peritumoral retraction clefts (RC) and tumor-associated tissue eosinophilia (TATE) as predictors of overall survival (OS) in oral squamous cell carcinoma (OSCC) patients. Their relationships with tumor-factors were also examined. Eighty-seven OSCC cases (pTNM: I + II/III + IV; 32/55), post-curative surgery, comprised the study cohort. Three observers independently estimated the percent RC semi-quantitatively in the selected tumor sections. Additionally, stromal eosinophils were counted in ten consecutive high-power fields of intratumoral and peritumoral regions to evaluate the corresponding TATE. The percent RC ranged between 0% -90% (Mean ± SD: 16 ± 24%; Median: 5%). The stromal eosinophils were greater in peritumoral as compared to intratumoral region. The events of death and tumor recurrence were reached in 16 (18.4%) and 36 (41%) cases respectively. The 3-years OS was 69% [Median OS: 1880 days; Mean follow up: 471(Range; 36–1880) days]. Increased percent RC exhibited relationship with pathologic stage (pTNM III&IV), primary tumor (pT III&IV), tumor depth > 4 mm and categorical tumor recurrence. Additionally, peritumoral eosinophilic infiltrates increased with increasing tumor depths and muscle invasion. Kaplan-Meier curves revealed significantly reduced OS in OSCC cases exhibiting: increased percent RC (>2.5%), mild -moderate/absent intratumoral TATE (versus intense TATE) or categorical tumor recurrence. In subsequent multivariate tests, all the three variables retained significance. Additionally, intraclass correlation coefficient demonstrated acceptable internal consistency for the observers who estimated percent RC. In conclusion, RC and intratumoral TATE proved to be independent predictors of OS in our OSCC cohort. Additionally, increased percent RC pointed towards aggressive tumor behaviour.


Carcinoma Squamous cell Oral cavity Overall survival Tumor-associated tissue eosinophilia Retraction clefting 



We wish to thank all the residents, colleagues and technical staff of the Institute.


This study did not receive any funding.

Compliance with ethical standards

Disclosure of potential conflicts of interest (financial or non-financial)

The authors declare that there is no potential conflict of interest related to this manuscript.

Research involving Human Participants and/or Animals

For this type of retrospective study, formal consent was not required from Institutional Ethics Committee. However, every effort was made to maintain strict secrecy of the patients’ identity during all stages of the study.

Informed consent

Not applicable.


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Copyright information

© Arányi Lajos Foundation 2017

Authors and Affiliations

  • Dhruv Jain
    • 1
  • Gargi Tikku
    • 1
  • Pallavi Bhadana
    • 1
  • Chandrashekhar Dravid
    • 2
  • Rajesh Kumar Grover
    • 3
  1. 1.Department of OncopathologyDelhi State Cancer InstituteDelhiIndia
  2. 2.Department of Surgical OncologyDelhi State Cancer InstituteDelhiIndia
  3. 3.Department of Clinical OncologyDelhi State Cancer InstituteDelhiIndia

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