Lauren Hum1, Daniel Bethmann2, Zipei Feng3, Shu-Ching Chang4, Alexander Eckert5, Carmen Ballesteros-Merino6, Claudia Keschke2, Matthias Kappler5, Carlo B Bifulco6, Claudia Wickenhauser2, Barbara Seliger7, Bernard A Fox6,8, Richard Bryan Bell6,9. 1. Department of Oral and Maxillofacial Surgery, Oregon Health & Science University, Portland, Oregon, USA. 2. Institute of Pathology, University Hospital Halle, Halle, Germany. 3. Department of Otolaryngology, Baylor College of Medicine, Houston, Texas, USA. 4. Medical Data Research Center, Providence St. Joseph Health, Portland, Oregon, USA. 5. Department of Oral and Maxillofacial Plastic Surgery, University Hospital Halle, Halle, Germany. 6. Earle A. Chiles Research Institute at Robert W. Franz Cancer Center, Providence Cancer Institute, Portland, Oregon, USA. 7. Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle, Germany. 8. Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, Oregon, USA. 9. Providence Head and Neck Cancer Program and Clinic, Providence Cancer Institute, Portland, Oregon, USA.
Abstract
BACKGROUND: This study aimed to analyze margin status and the impact of the immune elements on recurrence in patients with oral squamous cell carcinoma (OSCC), employing a prognostic biomarker, cumulative suppressive index (CSI), which reflects FoxP3+, PD-L1+, and CD8+ cell spatial relationships in the tumor microenvironment. METHODS: Cox proportional hazards regression was used to evaluate the interactive effect of the margin by CSI discrepancy (high, 3-4 vs low, 0-2) on recurrence free survival (RFS) and overall survival (OS) in 119 patients with stage I to IVA OSCC. RESULTS: In cases with negative margins, multivariable analysis showed high CSI was significantly associated with worse RFS (HR = 2.59, 95% CI [1.03, 6.49], P = .04) and OS (HR = 5.49, 95% CI [1.48, 20.35], P = .01) compared to low CSI. However, high CSI was not significantly associated with recurrence in cases with positive margins. CONCLUSIONS: Immune architecture analysis can augment our current histopathological risk assessment of margin status.
BACKGROUND: This study aimed to analyze margin status and the impact of the immune elements on recurrence in patients with oral squamous cell carcinoma (OSCC), employing a prognostic biomarker, cumulative suppressive index (CSI), which reflects FoxP3+, PD-L1+, and CD8+ cell spatial relationships in the tumor microenvironment. METHODS: Cox proportional hazards regression was used to evaluate the interactive effect of the margin by CSI discrepancy (high, 3-4 vs low, 0-2) on recurrence free survival (RFS) and overall survival (OS) in 119 patients with stage I to IVA OSCC. RESULTS: In cases with negative margins, multivariable analysis showed high CSI was significantly associated with worse RFS (HR = 2.59, 95% CI [1.03, 6.49], P = .04) and OS (HR = 5.49, 95% CI [1.48, 20.35], P = .01) compared to low CSI. However, high CSI was not significantly associated with recurrence in cases with positive margins. CONCLUSIONS: Immune architecture analysis can augment our current histopathological risk assessment of margin status.
Authors: Stanley P Leong; Isaac P Witz; Orit Sagi-Assif; Sivan Izraely; Jonathan Sleeman; Brian Piening; Bernard A Fox; Carlo B Bifulco; Rachel Martini; Lisa Newman; Melissa Davis; Lauren M Sanders; David Haussler; Olena M Vaske; Marlys Witte Journal: Clin Exp Metastasis Date: 2021-05-10 Impact factor: 5.150