Andrew R Larson1, Jacquelyn Kemmer2, Eric Formeister1, Ivan El-Sayed1, Patrick Ha1, Jonathan George1, William Ryan1, Emily Chan3, Chase Heaton1. 1. Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A. 2. School of Medicine, University of California, San Francisco, San Francisco, California, U.S.A. 3. Department of Pathology, University of California, San Francisco, San Francisco, California, U.S.A.
Abstract
OBJECTIVE: In small (≤2 cm) oral tongue squamous cell carcinoma (OTSCC), we sought to clarify the contribution of pathologic features including perineural invasion (PNI), lymphovascular invasion (LVI), and worst pattern of invasion-5 (WPOI-5) to clinical outcomes relative to tumor depth of invasion (DOI) of > or ≤ 4 mm. METHODS: Cases of ≤2 cm OTSCC treated surgically between 2000 and 2017 at an academic cancer center were reviewed, with retrospective pathologic slide review of DOI, LVI, PNI, and WPOI-5. Primary outcome measures included occult nodal positivity, 2-year locoregional recurrence (LRR), disease-specific survival (DSS), and overall survival (OS). RESULTS: One hundred tumors were included in analyses; 50 had DOI ≤ 4 mm, while 50 had DOI > 4 mm. When DOI was ≤4 mm, the presence of PNI, LVI, or WPOI-5 was not associated with higher rates of occult cervical metastasis, LRR, or OS. When DOI was >4 mm, there was no difference in rates of occult cervical metastasis or LRR with each feature. On multivariate analysis, only the presence of two or more adverse features was associated with higher LRR (OR 5.7, P = .01) and worse DSS (HR 6.5, P = .02). CONCLUSION: The rate of occult cervical metastases in small (≤2 cm) OTSCC when DOI is ≤4 mm is very low even when PNI, LVI, or WPOI-5 is present, and 2-year LRR is no different. When DOI is >4 mm, the strongest predictor of recurrence and survival on multivariate analysis is the presence of two or more features in the tumor. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:1715-1720, 2020.
OBJECTIVE: In small (≤2 cm) oral tongue squamous cell carcinoma (OTSCC), we sought to clarify the contribution of pathologic features including perineural invasion (PNI), lymphovascular invasion (LVI), and worst pattern of invasion-5 (WPOI-5) to clinical outcomes relative to tumor depth of invasion (DOI) of > or ≤ 4 mm. METHODS: Cases of ≤2 cm OTSCC treated surgically between 2000 and 2017 at an academic cancer center were reviewed, with retrospective pathologic slide review of DOI, LVI, PNI, and WPOI-5. Primary outcome measures included occult nodal positivity, 2-year locoregional recurrence (LRR), disease-specific survival (DSS), and overall survival (OS). RESULTS: One hundred tumors were included in analyses; 50 had DOI ≤ 4 mm, while 50 had DOI > 4 mm. When DOI was ≤4 mm, the presence of PNI, LVI, or WPOI-5 was not associated with higher rates of occult cervical metastasis, LRR, or OS. When DOI was >4 mm, there was no difference in rates of occult cervical metastasis or LRR with each feature. On multivariate analysis, only the presence of two or more adverse features was associated with higher LRR (OR 5.7, P = .01) and worse DSS (HR 6.5, P = .02). CONCLUSION: The rate of occult cervical metastases in small (≤2 cm) OTSCC when DOI is ≤4 mm is very low even when PNI, LVI, or WPOI-5 is present, and 2-year LRR is no different. When DOI is >4 mm, the strongest predictor of recurrence and survival on multivariate analysis is the presence of two or more features in the tumor. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:1715-1720, 2020.
Authors: K Naik; M N Janal; J Chen; D Bandary; B Brar; S Zhang; J C Dolan; B L Schmidt; D G Albertson; A Bhattacharya Journal: J Dent Res Date: 2020-10-08 Impact factor: 6.116
Authors: Luca Calabrese; Maria Eleonora Bizzoca; Roberto Grigolato; Fausto Antonio Maffini; Marta Tagliabue; Rosa Negro; Stefania Leuci; Michele Davide Mignogna; Lorenzo Lo Muzio Journal: Life (Basel) Date: 2020-09-12
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