Alhadi Almangush1,2,3, Ilkka Heikkinen1,4, Nassira Bakhti5, Laura K Mäkinen6, Joonas H Kauppila7,8, Matti Pukkila9, Jaana Hagström1,10,11, Jussi Laranne12, Ylermi Soini13, Luiz P Kowalski14, Reidar Grénman15, Caj Haglund11,16, Antti A Mäkitie6,17, Ricardo D Coletta18, Ilmo Leivo2, Tuula Salo1,4,7. 1. Department of Pathology, University of Helsinki, Helsinki, Finland. 2. Department of Pathology, University of Turku, Turku, Finland. 3. Institute of Dentistry, University of Misurata, Misurata, Libya. 4. Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland. 5. Master of Biostatistics, Department of Statistics, Faculty of Sciences, Hasselt University, Hasselt, Belgium. 6. Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 7. Cancer and Translational Medicine Research Unit, Medical Research Centre Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland. 8. Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. 9. Department of Otorhinolaryngology and Head and Neck Surgery, Kuopio University Hospital, Kuopio, Finland. 10. HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland. 11. Research Programmes Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland. 12. Department of Otorhinolaryngology and Head and Neck Surgery, Tampere University Hospital, Tampere, Finland. 13. Department of Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland. 14. Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Centre, São Paulo-SP, Brazil. 15. Department of Otorhinolaryngology and Head and Neck Surgery, Turku University Hospital, University of Turku, Turku, Finland. 16. Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 17. Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. 18. Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil.
Abstract
AIMS: Oral tongue squamous cell carcinoma (OTSCC) has a relatively poor outcome, and there is a need to identify better prognostic factors. Recently, tumour-stroma ratio (TSR) has been associated with prognosis in several cancers. The aim of this multi-institutional study was to evaluate the prognostic value of TSR from original haematoxylin and eosin (HE)-stained tumour-resection slides in a series of early-stage (cT1-2N0) OTSCC patients. METHODS AND RESULTS: A TSR cutoff value of 50% was used to divide the patients into stroma-rich (≥50%) and stroma-poor (<50%) groups. The relationships between TSR and clinicopathological characteristics of 311 early-stage OTSCC cases were analysed. The prognostic value of TSR in OTSCC was calculated separately and in combination with a previously published cancer cell budding and depth of invasion (BD) prognostic model. A total of 89 cases (28.6%) belonged to the stroma-rich group. In a multivariate analysis, the stroma-rich group had worse disease-free survival, with a hazard ratio (HR) of 1.81 [95% confidence interval (CI) 1.17-2.79, P = 0.008], and higher cancer-related mortality (HR 1.71, 95% CI 1.02-2.86, P = 0.03). The combination of the highest-risk parameter scores of TSR and the BD model showed significant correlations with recurrence rate (HR 3.42, 95% CI 1.71-6.82, P = 0.004) and cancer-related mortality (HR 11.63, 95% CI 3.83-35.31, P < 0.001). CONCLUSIONS: We conclude that TSR is a simple histopathological feature that is useful for prognostication of early-stage OTSCC, and suggest that TSR analyses in association with BD score could be included in routine clinical pathology reports for HE-stained slides.
AIMS: Oral tongue squamous cell carcinoma (OTSCC) has a relatively poor outcome, and there is a need to identify better prognostic factors. Recently, tumour-stroma ratio (TSR) has been associated with prognosis in several cancers. The aim of this multi-institutional study was to evaluate the prognostic value of TSR from original haematoxylin and eosin (HE)-stained tumour-resection slides in a series of early-stage (cT1-2N0) OTSCC patients. METHODS AND RESULTS: A TSR cutoff value of 50% was used to divide the patients into stroma-rich (≥50%) and stroma-poor (<50%) groups. The relationships between TSR and clinicopathological characteristics of 311 early-stage OTSCC cases were analysed. The prognostic value of TSR in OTSCC was calculated separately and in combination with a previously published cancer cell budding and depth of invasion (BD) prognostic model. A total of 89 cases (28.6%) belonged to the stroma-rich group. In a multivariate analysis, the stroma-rich group had worse disease-free survival, with a hazard ratio (HR) of 1.81 [95% confidence interval (CI) 1.17-2.79, P = 0.008], and higher cancer-related mortality (HR 1.71, 95% CI 1.02-2.86, P = 0.03). The combination of the highest-risk parameter scores of TSR and the BD model showed significant correlations with recurrence rate (HR 3.42, 95% CI 1.71-6.82, P = 0.004) and cancer-related mortality (HR 11.63, 95% CI 3.83-35.31, P < 0.001). CONCLUSIONS: We conclude that TSR is a simple histopathological feature that is useful for prognostication of early-stage OTSCC, and suggest that TSR analyses in association with BD score could be included in routine clinical pathology reports for HE-stained slides.
Authors: Alhadi Almangush; Antti A Mäkitie; Jaana Hagström; Caj Haglund; Luiz Paulo Kowalski; Pentti Nieminen; Ricardo D Coletta; Tuula Salo; Ilmo Leivo Journal: BMC Cancer Date: 2020-09-03 Impact factor: 4.430
Authors: Alhadi Almangush; Rasheed Omobolaji Alabi; Giuseppe Troiano; Ricardo D Coletta; Tuula Salo; Matti Pirinen; Antti A Mäkitie; Ilmo Leivo Journal: BMC Cancer Date: 2021-04-30 Impact factor: 4.430
Authors: Marco Mascitti; Lucrezia Togni; Corrado Rubini; Giuseppe Troiano; Lorenzo Lo Muzio; Andrea Santarelli Journal: Histol Histopathol Date: 2020-09-28 Impact factor: 2.303
Authors: Tuula Salo; Ilmo Leivo; Alhadi Almangush; Ibrahim O Bello; Ilkka Heikkinen; Jaana Hagström; Caj Haglund; Luiz Paulo Kowalski; Pentti Nieminen; Ricardo D Coletta; Antti A Mäkitie Journal: Virchows Arch Date: 2020-09-21 Impact factor: 4.064