Predicting the Prognosis of Oral Squamous Cell Carcinoma After First Recurrence

Kernohan, Michael; Clark, Jonathan R.; Gao, Kan; Ebrahimi, Ardalan; Milross, Christopher G.

doi:10.1001/archoto.2010.214

Cited by 81 publications

(79 citation statements)

References 14 publications

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“…OSCC continues to show a poor prognosis and remains a lethal disease for >50% of cases diagnosed annually (3). In particular, its local recurrence is strongly related to a poor prognosis (4)(5)(6). Even when the surgical margins are diagnosed as tumor free by histopathological examination, the local recurrence rate is still 6.9-22.0% (4,5,7,8).…”

Section: Introductionmentioning

confidence: 99%

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Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Yanamoto

Yamada

Takahashi

et al. 2014

International Journal of Oncology

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Abstract. The efficacy of neoadjuvant chemotherapy (NAC) is controversial, and no report supports NAC with a high evidence level. Recently, we showed that a deep surgical margin was resected very close to the tumor site in many NAC-treated oral squamous cell carcinoma patients, suggesting that NAC may lead to local recurrence and poor outcomes. The purpose of this study was to evaluate the effect of NAC on tumor local recurrence using cancer stem cell marker immunohistochemistry. We retrospectively analyzed 89 patients who underwent radical surgery for tongue cancer, and examined the effect of NAC on tumor local recurrence. Cancer stem cell marker (CD44v6 and ABCG2) expression was detected by immunohistochemistry. In our study, the local recurrence rate was 12.4%. CD44v6 and ABCG2 expression was significantly associated with regional lymph node metastasis, pattern of invasion, depth of invasion, perineural invasion and local recurrence, respectively. Tumor local recurrence was a significant independent predictive factor of the 5-year disease specific survival. CD44v6 or ABCG2 positivity in NAC-treated patients was significantly associated with tumor local recurrence. It was suggested that local recurrence in NAC-treated cases is associated with cancer stem-like cells. We propose that NAC leads to the selection and/or residue of more aggressive cancer stem-like cells.

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Section: Introductionmentioning

confidence: 99%

“…In particular, its local recurrence is strongly related to a poor prognosis (4)(5)(6). Even when the surgical margins are diagnosed as tumor free by histopathological examination, the local recurrence rate is still 6.9-22.0% (4,5,7,8). There are two explanations for the mechanism of local recurrence (9).…”

Section: Introductionmentioning

confidence: 99%

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Yanamoto

Yamada

Takahashi

et al. 2014

International Journal of Oncology

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“…3,5 Surgery is the most well established mode of initial definitive treatment for the majority of OSCC. [5][6][7] Locoregional recurrence in patients with OSCC remains a problem and can affect survival. 2,6,7 In particular, local recurrence of OSCC after primary surgery has been considered to be a bad prognostic entity in terms of survival rate.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] Locoregional recurrence in patients with OSCC remains a problem and can affect survival. 2,6,7 In particular, local recurrence of OSCC after primary surgery has been considered to be a bad prognostic entity in terms of survival rate. [2][3][4][5][6][7][8] Several parameters may play a crucial role in determining therapeutic strategies; however, very few studies have focused on clinicopathological factors that may predict local recurrence in OSCC.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological risk factors for local recurrence in oral squamous cell carcinoma

Yanamoto

Yamada

Takahashi

et al. 2012

International Journal of Oral and Maxillofacial Surgery

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Abstract. Local recurrence of oral squamous cell carcinoma (OSCC) after primary surgery has been considered to be a poor prognostic entity in terms of survival rate. The purpose of this study is to evaluate the incidence of local recurrence and to identify significant risk factors for the local recurrence in OSCC. We retrospectively reviewed records for 187 patients who underwent radical surgery for OSCC. The local recurrence rate was 16.0% (30/187 patients) in this study. The survival rate of patients with local recurrence was 33.3%, which was significantly lower than that (94.3%) of patients without local recurrence. Pattern of invasion (POI), neoadjuvant chemotherapy (NAC), and the status of the surgical margin were identified as factors influencing local recurrence. In particular, NAC and the status of the surgical margin were independent risk factors by multivariate analysis. The deep margin was resected at a close site in many NAC-treated patients, suggesting that NAC may lead to local recurrence and poor outcomes. No efficacy of NAC was observed, suggesting that the standard treatment of oral cancers is surgery alone.3

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“…These cases reflect the limitations of our FS method in assisting with determining a reliable tumor resection range, in addition to the difficulties involved in imaging diagnosis of tumors located in regions with a complex anatomical structure, such as advanced upper and lower gingival cancers containing hard as well as soft tissues. The prognosis for cases with recurrence is very poor (23,24). To determine the resection range for the primary lesion in such cases, further improvements are required in the imaging evaluation of jaw bone infiltration, tumor invasion pattern and infiltration into the surrounding soft tissues in consideration of the direction of tumor advancement (25).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative frozen section histological analysis of resection samples is useful for the control of primary lesions in patients with oral squamous cell carcinoma

Miyawaki

Hara

Ishida

et al. 2014

Molecular and Clinical Oncology

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Abstract. To ensure reliable surgical margins, intraoperative frozen section histological analysis (FS) has been performed since October, 2005 as follows: i) the orientation at the anatomical position and extent of the tumor are shared between oral pathologists and oral surgeons using imaging evaluations and pathological pictures and the planned site of sampling for intraoperative FS is confirmed; ii) a tumor team is organized and the team marks the tumor area and sets the resection range to correct the setting errors of the resection range among operators; iii) vital Lugol staining is applied to the lesion prior to tumor resection, the surgical margin is set based on the non-stained region and the extent of the tumor is macroscopically confirmed in the maximum cross-sectional surface of the resected specimen; and iv) FS is performed using samples from resected specimens to confirm the mucoepithelium and safety margin of the deep stump. The aim of this study was to evaluate the usefulness of our FS method. The treatment outcomes of oral squamous cell carcinoma were retrospectively investigated in patients treated prior to (Group 1) and after (Group 2) the introduction of our FS method. The recurrence rate of the primary lesions was high (17.3%) in Group 1, but decreased significantly in Group 2 (6.9%). Regarding clinicopathological factors, the condition of the surgical margins was associated with recurrence of the primary lesion in Group 1, but not in Group 2. In conclusion, our FS method appears to be useful for resecting tumors with reliable safety margins.

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Predicting the Prognosis of Oral Squamous Cell Carcinoma After First Recurrence

Cited by 81 publications

References 14 publications

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Clinicopathological risk factors for local recurrence in oral squamous cell carcinoma

Intraoperative frozen section histological analysis of resection samples is useful for the control of primary lesions in patients with oral squamous cell carcinoma

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