Histological features and survival in young patients with HPV‐negative oral squamous cell carcinoma

Mascitti, Marco; Tempesta, Angela; Togni, Lucrezia; Capodiferro, Saverio; Troiano, Giuseppe; Rubini, Corrado; Maiorano, Eugenio; Santarelli, Andrea; Limongelli, Luisa

doi:10.1111/odi.13479

Cited by 24 publications

(23 citation statements)

References 45 publications

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“…41 Indeed, recent studies have suggested PNI as a predictor of decreased 5-year survival in OSCC patients. [42][43][44] Although PNI is a well-recognised prognostic factor in OSCC, it is not required for stage grouping in the 8th edition AJCC staging system. 45 Furthermore, the different prognostic significance levels of unifocal and multifocal PNI remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Among the advantages of using PNI are the ease of evaluation and the lack of influence from the anatomical characteristics of different oral subsites 41 . Indeed, recent studies have suggested PNI as a predictor of decreased 5‐year survival in OSCC patients 42–44 . Although PNI is a well‐recognised prognostic factor in OSCC, it is not required for stage grouping in the 8th edition AJCC staging system 45 .…”

Section: Discussionmentioning

confidence: 99%

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Addition of the tumour–stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma

et al. 2020

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Aims One of the objectives of current research is to customise the treatment of cancer patients. The achievement of this objective requires stratification of patients based on the most significant prognostic factors. The aims of this study were to evaluate the prognostic value of the tumour–stroma ratio (TSR), defined as the proportion of tumour cells relative to surrounding stroma, in patients with oral tongue squamous cell carcinoma (OTSCC), and to develop a prognostic nomogram based on the most significant clinicopathological features. Methods and results Clinicopathological data of 211 patients treated at ‘Ospedali Riuniti’ General Hospital (Ancona, Italy) for OTSCC were collected. One hundred and thirty‐nine patients were restaged according to the 8th edition American Joint Committee on Cancer (AJCC) staging system. Evaluation of the TSR was performed on haematoxylin and eosin‐stained slides, and correlation with survival outcomes was evaluated. In addition, with the aim of integrating the independent value of the TSR with the 8th edition AJCC staging system, a prognostic nomogram for OTSCC has been developed. OTSCC with a low TSR (i.e. a high proportion of stroma and a low proportion of tumour cells) was shown to have negative prognostic value in terms of disease‐specific survival, with a hazard ratio (HR) of 1.883 and a 95% confidence interval (CI) of 1.033–3.432 (P = 0.039), and overall survival (HR = 1.747, 95% CI 0.967–3.154; P = 0.044), independently of other histological and clinical parameters. For the cohort of 139 patients restaged according to the 8th edition AJCC staging system, variables correlating with a poor prognosis were: the TSR, perineural invasion, and sex. The nomogram built on these parameters showed good predictive capacity, outperforming the 8th edition AJCC staging system in stratifying disease‐specific survival in OTSCC patients. Conclusions Including the TSR in the predictive model could improve risk stratification of OTSCC patients and aid in making treatment decisions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Addition of the tumour–stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma

et al. 2020

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“…Our methodology may be applied in future larger cohorts to generate uniformly applicable and objective imaging biomarkers for prognostic risk-stratification of OPSCC. Additionally, our approach enables inclusion of additional prognostic variables into PFS and OS models for risk-stratification of head/neck cancer subgroups [29].…”

Section: Discussionmentioning

confidence: 99%

Potential Added Value of PET/CT Radiomics for Survival Prognostication beyond AJCC 8th Edition Staging in Oropharyngeal Squamous Cell Carcinoma

Haider

Zeevi

Baumeister

et al. 2020

Cancers

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Accurate risk-stratification can facilitate precision therapy in oropharyngeal squamous cell carcinoma (OPSCC). We explored the potential added value of baseline positron emission tomography (PET)/computed tomography (CT) radiomic features for prognostication and risk stratification of OPSCC beyond the American Joint Committee on Cancer (AJCC) 8th edition staging scheme. Using institutional and publicly available datasets, we included OPSCC patients with known human papillomavirus (HPV) status, without baseline distant metastasis and treated with curative intent. We extracted 1037 PET and 1037 CT radiomic features quantifying lesion shape, imaging intensity, and texture patterns from primary tumors and metastatic cervical lymph nodes. Utilizing random forest algorithms, we devised novel machine-learning models for OPSCC progression-free survival (PFS) and overall survival (OS) using “radiomics” features, “AJCC” variables, and the “combined” set as input. We designed both single- (PET or CT) and combined-modality (PET/CT) models. Harrell’s C-index quantified survival model performance; risk stratification was evaluated in Kaplan–Meier analysis. A total of 311 patients were included. In HPV-associated OPSCC, the best “radiomics” model achieved an average C-index ± standard deviation of 0.62 ± 0.05 (p = 0.02) for PFS prediction, compared to 0.54 ± 0.06 (p = 0.32) utilizing “AJCC” variables. Radiomics-based risk-stratification of HPV-associated OPSCC was significant for PFS and OS. Similar trends were observed in HPV-negative OPSCC. In conclusion, radiomics imaging features extracted from pre-treatment PET/CT may provide complimentary information to the current AJCC staging scheme for survival prognostication and risk-stratification of HPV-associated OPSCC.

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“…Concerning the impact of chromosome 9 in the corresponding patients based on their age, our study showed no relation. Some studies have reported a borderline correlation between younger patients and specific genetic markers—combined or not with smoking status and HR-HPV persistent infection—in OSCC development and progression, but others support controversial results with no differences when comparing young to older patients [ 22 , 23 , 24 ]. In the current experimental study, we applied an innovative reference and calibration grid on conventional coverslips as a pilot screening mechanism for CISH slide evaluation.…”

Section: Discussionmentioning

confidence: 99%

Impact of Chromosome 9 Numerical Imbalances in Oral Squamous Cell Carcinoma: A Pilot Grid-Based Centromere Analysis

et al. 2020

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Oral squamous cell carcinoma (OSCC) is considered an aggressive malignancy, mainly due to its increased propensity to provide local and distant lymph node metastases. Gross chromosome instability (CI; polysomy/aneuploidy/monosomy), combined or not with specific gene alterations, is implicated in the development and progression of solid malignancies, including OSCC. In order to further study the relationship between these genetic alterations and the aggressive biological behavior of OSCCs, we investigated the frequency and impact of chromosome 9 numerical imbalances in these tumors. Fifty (n = 50) formalin-fixed, paraffin-embedded primary OSCC tissue sections were used. Chromogenic in situ hybridization (CISH) was implemented for detecting chromosome 9 (CEN—centromere enumeration) numerical alterations. Concerning the screening process in CISH slides, a novel, real-time reference and calibration grid platform was implemented. Chromosome 9 polysomy was observed in 8/50 (16%) tissue sections, whereas the rest of them demonstrated a normal, diploid pattern (42/50; 84%). Chromosome 9 polysomy was associated with the grade of differentiation of the examined tumors (p = 0.036). Chromosome 9 numerical imbalances (polysomy) were observed in sub-groups of OSCCs correlating with a progressive dedifferentiation of the malignant tissues. Concerning the implementation of the proposed grid-based platform as described above on CISH slides, it provides a novel, fast, and accurate screening mapping mechanism for detecting chromosome numerical imbalances.

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Histological features and survival in young patients with HPV‐negative oral squamous cell carcinoma

Cited by 24 publications

References 45 publications

Addition of the tumour–stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma

Addition of the tumour–stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma

Potential Added Value of PET/CT Radiomics for Survival Prognostication beyond AJCC 8th Edition Staging in Oropharyngeal Squamous Cell Carcinoma

Impact of Chromosome 9 Numerical Imbalances in Oral Squamous Cell Carcinoma: A Pilot Grid-Based Centromere Analysis

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