Oral squamous cell carcinoma grading systems – analysis of the best survival predictor

Journal of Oral Pathology and Medicine - Tập 41 Số 1 - Trang 34-39 - 2012
Rhayany de Castro Lindenblatt1, G. Martinez1, Licínio Esmeraldo da Silva1, P.S. Faria2, Danielle Resende Camisasca1, Simone de Queiroz Chaves Lourenço1
1Pathology Graduate Program, Fluminense Federal University , Niterói , Brazil
2Division of Pathology, National Cancer Institute (INCA‐RJ), Rio de Janeiro, Brazil

Tóm tắt

J Oral Pathol Med (2012) 41: 34–39Background:  The TNM system has been used for decades in an attempt to predict clinical behavior and appropriate therapy for oral squamous cell carcinomas. Histopathologic classifications can be useful as an additional predictive tool. The purpose of this study was to apply four grading systems (Multiparameter Grading System, Malignancy Grading of the Deep Invasive Margins, World Health Organization grading system, and Histologic Risk Assessment) to oral squamous cell carncinomas and evaluate each system based on clinicopathologic parameters and patient survival.Methods:  The files of 53 patients diagnosed with primary oral squamous cell carcinoma at the Brazilian National Cancer Institute were evaluated. All hematoxylin and eosin‐stained slides were reviewed to confirm the original diagnosis and to determine histopathologic grading. Clinicopathologic information was obtained from medical records and tumor registries. Statistical analysis was performed using Fisher’s exact test or the chi‐square test, the Kaplan–Meier method, and the log‐rank test.Results:  The Multiparameter Grading System was statistically associated with pathologic staging (P = 0.02) and lymph node involvement (P = 0.0009). Differences in overall 5‐year survival were significant for Histologic Risk Assessment (P = 0.015), pathologic staging (P = 0.001), lymph node status (P < 0.0001), and recurrence (P = 0.0001). Differences in cancer‐specific 5‐year survival were significant for Histologic Risk Assessment (P = 0.029), pathologic staging (P = 0.002), lymph node involvement (P < 0.0001), and recurrence (P < 0.0001). Poorly differentiated tumors were associated with the worst disease‐free survival (P = 0.031) and recurrence (P = 0.043).Conclusion:  Of the grading systems evaluated, Histologic Risk Assessment demonstrated the best results for survival prediction in oral squamous cell carcinoma.

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Tài liệu tham khảo

Sobin LH, 2002, TNM classification of malignant tumours

Anneroth G, 1987, Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas, Scand J Dent Res, 95, 229

10.1158/1078-0432.CCR-04-0372

Barnes L, 2005, World Health Organization classification of tumors

10.1097/01.pas.0000149687.90710.21

Broders AC, 1941, The microscopic grading of cancer, Surg Clin North Am, 21, 947

10.1002/path.1711660409

10.1288/00005537-199507000-00011

Anneroth G, 1986, Malignancy grading in oral squamous cell carcinoma in the floor of the mouth related to clinical evaluation, Scand J Dent Res, 94, 347

10.1111/j.1600-0714.1991.tb00946.x

Brandwein‐Gensler M, 2010, Validation of the histologic risk model in a new cohort of patients with head and neck squamous cell carcinoma, Am J Surg Pathol, 34, 677, 10.1097/PAS.0b013e3181d95c37

10.1016/j.oraloncology.2008.05.021

10.1177/0962280206070637

10.1590/S1517-74912002000300006

10.1016/j.oraloncology.2005.05.008

Yazdi I, 1999, Grading of oral cancer: comparison of different systems with respect to lymph node metastasis in tongue SCC, Arch Iran Med, 2, 87

10.1111/j.1600-0714.2009.00751.x

10.1590/S0034-72992005000200011

10.1016/j.oraloncology.2006.07.003

10.1590/S0034-72992004000100006

10.1016/j.ejso.2006.05.004

10.1016/j.joms.2006.02.007

10.1016/S1368-8375(98)00019-0

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Thông tin xuất bản

Journal of Oral Pathology and Medicine

Tập 41 Số 1

34-39

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