Prognostic significance of bone invasion for oral cavity squamous cell carcinoma considered T1/T2 by American joint committee on cancer size criteria

Fried, David; Mullins, Brandon T.; Weissler, Mark C.; Shores, Carol G.; Zanation, Adam M.; Hackman, Trevor; Shockley, W.; Hayes, Nancy S.; Chera, Bhishamjit S.

doi:10.1002/hed.23367

Cited by 34 publications

(36 citation statements)

References 7 publications

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“…Ebrahimi et al [9]. in their study of 498 patients with oral SCC and Fried et al [10]. in a study of 254 patients observed that medullary bone invasion adversely reaffected outcomes, and recommended that tumors should first be classified as T1-T3 based on size and then upstaged by one T stage in the presence of Tumor 2 cm or less in greatest dimension and no medullary bone invasion T2…”

Section: Discussionmentioning

confidence: 99%

“…This new proposal was followed by Fried et al. in a study of 254 patients with oral SCC. The prevalence of medullary bone invasion was <13% in these studies, because they were conducted in patients with SCC of the oral cavity.…”

Section: Introductionmentioning

confidence: 99%

“…recommended a revision of the T staging system, in which tumors of the oral cavity were first classified as T1-T3 based on size and then upstaged by one T stage in the presence of medullary bone invasion, based on a study of 498 patients with oral squamous cell carcinoma (SCC). This new proposal was followed by Fried et al [10] in a study of 254 patients with oral SCC. The prevalence of medullary bone invasion was <13% in these studies, because they were conducted in patients with SCC of the oral cavity.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic and staging implications of mandibular canal invasion in lower gingival squamous cell carcinoma

et al. 2016

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A multi‐institutional study was undertaken to determine whether mandibular canal (MC) invasion and mandibular medullary bone invasion are independent factors in lower gingival squamous cell carcinoma (SCC). A total of 345 patients with lower gingival SCC were retrospectively reviewed. Mandibular bone invasion was categorized into three types; no bone invasion; invasion through cortical bone (medullary); and MC invasion. The overall survival rate and factors affecting local, regional, and distant failures were assessed by Cox proportional hazards regression analysis and Kaplan–Meier estimates. Bone invasion was present in 201 (58%) patients, of whom 107 (31%) had medullary invasion and 94 (27%) had MC invasion. Using the International Union Against Cancer (UICC) staging system and American Joint Committee on Cancer (AJCC) system, 171 (50%) patients were classified as T4a. When the bone invasion criteria were excluded from the UICC/AJCC system definition, 152 T4a tumors were downstaged and reclassified to T1 in 12 (3%), to T2 in 98 (28%), and to T3 in 42 (12%). In Cox multivariate analysis, MC invasion was an independent predictor of overall survival but medullary bone invasion was not. Medullary bone invasion was an independent variable for distant control. The current T staging system has restricted prognostic utility. The authors recommend a modified T staging system, whereby tumors with MC invasion instead of medullary bone invasion are classified as T4a, and tumors are first classified as T1 to T3 based on size and then upstaged by one T classification in the presence of medullary invasion.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic and staging implications of mandibular canal invasion in lower gingival squamous cell carcinoma

et al. 2016

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“…There is some evidence to suggest that the prognosis of T4 tumors with bone invasion varies substantially according to tumor size, and small primary tumors with bone invasion are associated with a relatively favorable prognosis that does not warrant T4 classification. 32,33 Further study is required to confirm whether incorporation of DOI data is necessary for tumors in these subsites, particularly after reclassification of tumors with bone invasion based on consideration of tumor size. This study has several limitations.…”

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confidence: 98%

Primary Tumor Staging for Oral Cancer and a Proposed Modification Incorporating Depth of Invasion

Ebrahimi

Gil

Amit

et al. 2014

JAMA Otolaryngol Head Neck Surg

250

165

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“…According to the American Joint Committee on Cancer Classification, mandibular invasion is the most advanced primary stage (T4) and overall stage (IV) for these tumors. The treatment outcomes of these lesions are typically poor, with nearly 70% of cases recurring at the primary lesion site and ultimately leading to death [6].…”

Section: Introductionmentioning

confidence: 99%

NF‐κB acts as a multifunctional modulator in bone invasion by oral squamous cell carcinoma

Jimi¹,

Kokabu²,

Matsubara³

et al. 2015

Oral Science International

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a b s t r a c tOral squamous cell carcinoma (OSCC) is the most common malignant tumor in the oral cavity and the head and neck region. Gingival squamous cell carcinomas (SCCs) frequently invade the maxilla or the mandibular bone and are associated with poor prognosis. Recent findings suggest that osteoclasts, rather than OSCC cells, mediate invasion to the bone. Nuclear factor-B (NF-B) is constitutively activated in OSCCs and is involved in promoting the invasive characteristics of OSCC. NF-B activation is also important for receptor activator of NF-B ligand (RANKL)-induced osteoclastogenesis. NF-B inhibitors suppress proliferation and stimulate apoptosis of OSCC cells in vitro and in vivo, as well as inhibit matrix metalloproteinase (MMP) production in OSCC. Furthermore, NF-B inhibitors have been shown to suppress osteoclastogenesis by reducing RANKL expression in animal models. Thus, inhibition of NF-B activity may constitute a promising therapeutic approach to treat bone-invasive OSCC. In this review, we discuss recent findings, which suggest that bone invasion in OSCC is mediated via NF-B signaling and may be successfully prevented by NF-B inhibition.

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Prognostic significance of bone invasion for oral cavity squamous cell carcinoma considered T1/T2 by American joint committee on cancer size criteria

Abstract: Bone invasion does not seem to significantly influence outcomes in patients with small primary tumors treated with surgery/radiation. Medullary bone invasion seems to result in reduced rates of control and survival.

Cited by 34 publications

References 7 publications

Prognostic and staging implications of mandibular canal invasion in lower gingival squamous cell carcinoma

Prognostic and staging implications of mandibular canal invasion in lower gingival squamous cell carcinoma

Primary Tumor Staging for Oral Cancer and a Proposed Modification Incorporating Depth of Invasion

NF‐κB acts as a multifunctional modulator in bone invasion by oral squamous cell carcinoma

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