University of Oulu

Almangush A, Heikkinen I, Bakhti N, Mäkinen L K, Kauppila J H, Pukkila M, Hagström J, Laranne J, Soini Y, Kowalski L P, Grénman R, Haglund C, Mäkitie A A, Coletta R D, Leivo I & Salo T (2018) Histopathology 72, 1128–1135. https://doi.org/10.1111/his.13481 Prognostic impact of tumour–stroma ratio in early‐stage oral tongue cancers

Prognostic impact of tumour–stroma ratio in early‐stage oral tongue cancers

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Author: Almangush, Alhadi1,2,3; Heikkinen, Ilkka1,4; Bakhti, Nassira5;
Organizations: 1Department of Pathology, University of Helsinki, Helsinki
2Department of Pathology, University of Turku, Turku, Finland
3Institute of Dentistry, University of Misurata, Misurata, Libya
4Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
5Master of Biostatistics, Department of Statistics, Faculty of Sciences, Hasselt University, Hasselt, Belgium
6Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki
7Cancer and Translational Medicine Research Unit, Medical Research Centre Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
8Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
9Department of Otorhinolaryngology and Head and Neck Surgery, Kuopio University Hospital, Kuopio
10HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki
11Research Programmes Unit, Translational Cancer Biology, University of Helsinki, Helsinki
12Department of Otorhinolaryngology and Head and Neck Surgery, Tampere University Hospital, Tampere
13Department of Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
14Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Centre, S~ao Paulo-SP, Brazil
15Department of Otorhinolaryngology and Head and Neck Surgery, Turku University Hospital, University of Turku, Turku
16Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
17Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
18Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, S~ao Paulo, Brazil
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2018060525307
Language: English
Published: John Wiley & Sons, 2018
Publish Date: 2019-02-10
Description:

Abstract

Aims: Oral tongue squamous cell carcinoma (OTSCC) has a relatively poor outcome, and there is a need to identify better prognostic factors. Recently, tumour–stroma ratio (TSR) has been associated with prognosis in several cancers. The aim of this multi‐institutional study was to evaluate the prognostic value of TSR from original haematoxylin and eosin (HE)‐stained tumour‐resection slides in a series of early‐stage (cT1‐2N0) OTSCC patients.

Methods and results: A TSR cutoff value of 50% was used to divide the patients into stroma‐rich (≥50%) and stroma‐poor (<50%) groups. The relationships between TSR and clinicopathological characteristics of 311 early‐stage OTSCC cases were analysed. The prognostic value of TSR in OTSCC was calculated separately and in combination with a previously published cancer cell budding and depth of invasion (BD) prognostic model. A total of 89 cases (28.6%) belonged to the stroma‐rich group. In a multivariate analysis, the stroma‐rich group had worse disease‐free survival, with a hazard ratio (HR) of 1.81 [95% confidence interval (CI) 1.17–2.79, P = 0.008], and higher cancer‐related mortality (HR 1.71, 95% CI 1.02–2.86, P = 0.03). The combination of the highest‐risk parameter scores of TSR and the BD model showed significant correlations with recurrence rate (HR 3.42, 95% CI 1.71–6.82, P = 0.004) and cancer‐related mortality (HR 11.63, 95% CI 3.83–35.31, P < 0.001).

Conclusions: We conclude that TSR is a simple histopathological feature that is useful for prognostication of early‐stage OTSCC, and suggest that TSR analyses in association with BD score could be included in routine clinical pathology reports for HE‐stained slides.

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Series: Histopathology
ISSN: 0309-0167
ISSN-E: 1365-2559
ISSN-L: 0309-0167
Volume: 72
Issue: 7
Pages: 1128 - 1135
DOI: 10.1111/his.13481
OADOI: https://oadoi.org/10.1111/his.13481
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Subjects:
Funding: The authors acknowledge the funders of this study: the Finnish Dental Society, the Finnish Cancer Society, the Jalmari and Rauha Ahokas Foundation, the K. Albin Johanssons Foundation, Finska Läkaresällskapet, the Sigrid Jusélius Foundation, the Helsinki University Hospital research funds, the Orion Research Foundation, and the Maritza and Reino Salonen Foundation.
Copyright information: © 2018 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Almangush A, Heikkinen I, Bakhti N, Mäkinen L K, Kauppila J H, Pukkila M, Hagström J, Laranne J, Soini Y, Kowalski L P, Grénman R, Haglund C, Mäkitie A A, Coletta R D, Leivo I & Salo T (2018) Histopathology 72, 1128–1135. https://doi.org/10.1111/his.13481 Prognostic impact of tumour–stroma ratio in early‐stage oral tongue cancers, which has been published in final form at https://doi.org/10.1111/his.13481. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.