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Almangush, A., Bello, I.O., Heikkinen, I. et al. Stromal categorization in early oral tongue cancer. Virchows Arch (2020). https://doi.org/10.1007/s00428-020-02930-5

Stromal categorization in early oral tongue cancer

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Author: Almangush, Alhadi1,2,3,4,5; Bello, Ibrahim O.1,6; Heikkinen, Ilkka1,3;
Organizations: 1Department of Pathology, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, FIN-00014, Helsinki, Finland
2Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
3Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
4Institute of Biomedicine, Pathology, University of Turku, Turku, Finland
5Faculty of Dentistry, University of Misurata, Misurata, Libya
6Department of Oral Medicine and Diagnostic Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia
7Research Programs Unit, Translational Cancer Medicine, University of Helsinki, Helsinki, Finland
8Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
9Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
10Department of Head and Neck Surgery, University of Sao Paulo Medical School, São Paulo, SP, Brazil
11Medical Informatics and Data Analysis Research Group, University of Oulu, Oulu, Finland
12Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
13Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
14Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
15Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
16Institute of Biomedicine, Pathology, University of Turku and Turku University Hospital, Turku, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.3 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe20201214100645
Language: English
Published: Springer Nature, 2020
Publish Date: 2020-12-14
Description:

Abstract

Stromal categorization has been used to classify many epithelial cancer types. We assessed the desmoplastic reaction and compared its significance with other stromal characteristics in early (cT1-2N0) oral tongue squamous cell carcinoma (OTSCC). In this multi-institutional study, we included 308 cases treated for early OTSCC at five Finnish university hospitals or at the A.C. Camargo Cancer Center in São Paulo, Brazil. The desmoplastic reaction was classified as immature, intermediate, or mature based on the amount of hyalinized keloid-like collagen and myxoid stroma. We compared the prognostic value of the desmoplastic reaction with a stromal grading system based on tumor-stroma ratio and stromal tumor-infiltrating lymphocytes. We found that a high amount of stroma with a weak infiltration of lymphocytes was associated statistically significantly with a worse disease-free survival with a hazard ratio (HR) of 2.68 (95% CI 1.26–5.69), worse overall survival (HR 2.95, 95% CI 1.69–5.15), and poor disease-specific survival (HR 2.66, 95% CI 1.11–6.33). Tumors having a high amount of stroma with a weak infiltration of lymphocytes were also significantly associated with a high rate of local recurrence (HR 4.13, 95% CI 1.67–10.24), but no significant association was found with lymph node metastasis (HR 1.27, 95% CI 0.37–4.35). Categorization of the stroma based on desmoplastic reaction (immature, intermediate, mature) showed a low prognostic value for early OTSCC in all survival analyses (P > 0.05). In conclusion, categorization of the stroma based on the amount of stroma and its infiltrating lymphocytes shows clinical relevance in early OTSCC superior to categorization based on the maturity of stroma.

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Series: Virchows Archiv. European journal of pathology
ISSN: 0945-6317
ISSN-E: 1432-2307
ISSN-L: 0945-6317
Issue: Online first
DOI: 10.1007/s00428-020-02930-5
OADOI: https://oadoi.org/10.1007/s00428-020-02930-5
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Subjects:
Article
Funding: Open access funding provided by University of Helsinki including Helsinki University Central Hospital. The authors acknowledge the funders of this study: Turku University Hospital Research Fund, Helsinki University Hospital Research Fund, the Finnish Cancer Society, Finnish Dental Society (Apollonia), Finska Läkaresällskapet, and the Maritza and Reino Salonen Foundation.
Copyright information: © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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