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Tumor-host interface in oral squamous cell carcinoma: Impact on nodal metastasis and prognosis

  • Head and Neck
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A Correction to this article was published on 04 May 2021

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Abstract

Purpose

To evaluate tumor-host interface in oral squamous cell carcinoma (OSCC) by the Brandwein-Gensler histological risk score (BG risk score); to assess its association with clinicopathological features and impact on survival outcomes in a contemporary cohort staged as per AJCC 8th edition pTNM classification.

Methods

This retrospective cohort study at a tertiary care centre included 178 cases of OSCC treated by primary surgical resection from 2013 to 2016. Pathological lymph node status, disease-free survival (DFS), overall survival (OS) were assessed.

Results

BG risk score assessment categorized 25 (14%) cases as low-risk, 93 (52%) as intermediate-risk, and 60 (34%) as high-risk. BG risk score category progression from low to intermediate to high risk was associated with an incremental risk of worsening pN status, DFS, and OS. BG risk score categories significantly demarcated 2-year DFS (96% in low-risk, 51.6% in intermediate-risk, 15% in high-risk; p < 0.001) and OS (96% in low-risk, 66.7% in intermediate-risk, 31.3% in high-risk; p < 0.001). On stratified analysis, BG risk score could further demarcate prognosis in early (I/II) and late (III/IV) stage subgroups (p < 0.001). Multivariate analysis indicated the prognostic impact of BG risk score categories to be additional to, and of equal magnitude to, impact of pTNM stage.

Conclusions

BG risk score is a powerful prognostic tool in OSCC additional to pTNM staging. It can enable risk stratification and inform decisions regarding post-surgical adjuvant treatment. It is undertaken with routine histopathological evaluation, with no increased expense or turnaround time. A case is made for its inclusion in OSCC reporting guidelines.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Author notes

  1. Aanchal Kakkar and Alok Thakar have contributed equally to the manuscript and should be considered as co-corresponding authors.

Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Rishikesh Thakur & Alok Thakar

  2. Delhi Cancer Registry, BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

    Rajeev K. Malhotra

  3. Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India

    Atul Sharma

  4. Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Aanchal Kakkar

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  1. Rishikesh Thakur
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  4. Atul Sharma
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Correspondence to Alok Thakar or Aanchal Kakkar.

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Ethical approval

Approved by institute ethical committee.

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All authors have approved the manuscript.

Authorship

All authors contributed to the study conception and design. Clinical material preparation, data collection and analysis were performed by Rishikesh Thakur, Alok Thakar and Atul Sharma. Histopathological material preparation and analysis were performed by Aanchal Kakkar. Statistical analysis was performed by Rajeev K. Malhotra. All authors read and approved the final manuscript.

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Thakur, R., Thakar, A., Malhotra, R.K. et al. Tumor-host interface in oral squamous cell carcinoma: Impact on nodal metastasis and prognosis. Eur Arch Otorhinolaryngol 278, 5029–5039 (2021). https://doi.org/10.1007/s00405-021-06756-y

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  • DOI: https://doi.org/10.1007/s00405-021-06756-y

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