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



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.


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.


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.

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Correspondence to Ali-Farid Safi.

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Due to the retrospective nature of this study, it was granted an exemption in writing by the University Hospital of Cologne IRB. Our investigation followed the guidelines of the Helsinki Declaration. This article does not contain any studies with human participants or animals performed by any of the authors.

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Safi, A., Grochau, K., Drebber, U. et al. A novel histopathological scoring system for patients with oral squamous cell carcinoma. Clin Oral Invest 23, 3759–3765 (2019). https://doi.org/10.1007/s00784-019-02804-4

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  • Prognosis
  • Oral cancer
  • Histological
  • Survival
  • Recurrence
  • Score