University of Oulu

Elseragy, A., Salo, T., Coletta, R., Kowalski, L., Haglund, C., Nieminen, P., Mäkitie, A., Leivo, I., Almangush, A. (2019) A Proposal to Revise the Histopathologic Grading System of Early Oral Tongue Cancer Incorporating Tumor Budding. 43 (5), 703-709. doi:10.1097/PAS.0000000000001241

A proposal to revise the histopathologic grading system of early oral tongue cancer incorporating tumor budding

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Author: Elseragy, Amr1,2; Salo, Tuula2,1,3; Coletta, Ricardo D.4;
Organizations: 1Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
2Department of Pathology, University of Helsinki, Helsinki, Finland
3Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
4Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
5Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo-SP, Brazil
6Research Programs Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland
7Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
8Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
9Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
10Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
11Institute of Biomedicine, Pathology, University of Turku, Turku, Finland
12Institute of Dentistry, University of Misurata, Misurata, Libya
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2019061921347
Language: English
Published: Wolters Kluwer, 2019
Publish Date: 2020-05-01
Description:

Abstract

The World Health Organization (WHO) grading system has a low prognostic value for early-stage oral tongue squamous cell carcinoma (OTSCC); greater prognostic power has been shown with tumor budding analysis. In this study, we combined tumor budding analysis with histopathologic grading according to WHO 2017. In our proposal, a revised Grade I tumor is defined as a “well differentiated cohesive tumor”; revised Grade II as a “moderately differentiated and/or slightly dissociated tumor”; and revised Grade III as a “poorly differentiated and/or dissociated tumor”. We evaluated the prognostic value of this proposed grading system in a multicenter cohort of 311 cases of early OTSCC. The proposed grading system showed significant prognostic value in multivariable analysis for disease-specific survival (DSS) with a hazard ratio (HR) of 3.86 and a 95% confidence interval (CI) of 1.36 to 10.9 (P = 0.001). For disease-free survival (DFS), the proposed grading system showed good predictive power in multivariable analysis (HR 2.07, 95% CI 1.00–4.27; P = 0.009). The conventional WHO grading system showed a low prognostic value for DSS and DFS (P > 0.05). In conclusion, the prognostic power of the WHO histopathologic grading improved significantly with incorporation of tumor budding. Our proposed grading system can be easily included in pathology reports.

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Series: The American journal of surgical pathology
ISSN: 0147-5185
ISSN-E: 1532-0979
ISSN-L: 0147-5185
Volume: 43
Issue: 5
Pages: 703 - 709
DOI: 10.1097/PAS.0000000000001241
OADOI: https://oadoi.org/10.1097/PAS.0000000000001241
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Subjects:
Funding: The authors acknowledge the Rauha Ahokas Foundation, K. Albin Johanssons Foundation, Turku University Hospital Fund, Helsinki University Hospital Research Fund, the Finnish Cancer Society, the Finnish Dental Society, Finska Läkaresällskapet, and the Maritza and Reino Salonen Foundation.
Copyright information: © 2019 Wolters Kluwer Health, Inc. All rights reserved. This is the peer reviewed version of the following article: Elseragy, A., Salo, T., Coletta, R., Kowalski, L., Haglund, C., Nieminen, P., Mäkitie, A., Leivo, I., Almangush, A. (2019) A Proposal to Revise the Histopathologic Grading System of Early Oral Tongue Cancer Incorporating Tumor Budding. 43 (5), 703-709, which has been published in final form at http://dx.doi.org/10.1097/PAS.0000000000001241.