Adverse pathologic features in T1/2 oral squamous cell carcinoma classified by the American Joint Committee on Cancer eighth edition and implications for treatment

Objectives To assess the impact of pathologic features and chronic tobacco use on human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma (OPSCC). Study Design Case series with chart review. Setting Single tertiary care referral center. Subject and Methods A total of 301 patients were treated for OPSCC from 2008 to 2016. Clinical and pathologic T and N stage, American Joint Committee on Cancer (AJCC) stage (seventh and eighth edition staging manuals), cigarette pack years, alcohol use, and presence of extranodal extension (ENE), perineural invasion (PNI), or lymphovascular invasion (LVI) were assessed. Patients were stratified into HPV negative, HPV-positive heavy smokers (≥20 pack years), and HPV-positive nonsmokers. Five-year survival by Kaplan-Meier method was assessed. Results Of the HPV-positive patients, 97 were nonsmokers and 73 were heavy smokers. HPV-positive heavy smokers had significantly decreased survival compared to their nonsmoking counterparts ( P = .02). The presence of ENE was associated with a significantly decreased 5-year survival ( P = .02) in heavy smokers relative to nonsmokers in HPV-positive patients. Furthermore, for the AJCC eighth edition, clinically stage 1 HPV-positive heavy smokers had significantly decreased survival relative to nonsmokers ( P = .01). Conclusions This series highlights the potential need for more aggressive therapy for HPV-positive patients with extensive tobacco use under the new staging system.

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Stratification of Poor Outcomes for Cutaneous Squamous Cell Carcinoma in Immunosuppressed Patients Using the American Joint Committee on Cancer Eighth Edition and Brigham and Womenʼs Hospital Staging Systems

Dermatologic Surgery ◽

10.1097/dss.0000000000001774 ◽

2019 ◽

Vol 45 (9) ◽

pp. 1117-1124 ◽

Cited By ~ 5

Author(s):

Adam B. Blechman ◽

John A. Carucci ◽

Mary L. Stevenson

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cutaneous Squamous Cell Carcinoma ◽

American Joint Committee ◽

Staging Systems ◽

Immunosuppressed Patients ◽

Eighth Edition ◽

Poor Outcomes

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Central neck lymph node metastasis in oral squamous cell carcinoma at the floor of mouth

BMC Cancer ◽

10.1186/s12885-021-07958-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Songtao Zhang ◽

Runfang Zhang ◽

Chao Wang ◽

Wenbo Gong ◽

Miaomiao Xue ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Survival Data ◽

Mean Value ◽

Neck Lymph Node ◽

Floor Of Mouth ◽

Pathologic Features

Abstracts Background Our goal was to analyze the incidence of level VI metastasis in previously untreated oral squamous cell carcinoma (SCC) patients and their clinicopathological and prognostic characteristics. Methods Oral SCC patients with level VI metastasis were retrospectively enrolled, and their demographic and pathologic features as well as their survival data were descriptively analyzed. Results A total of 13 cases from 1875 patients were included, all patients had SCC at the floor of mouth (SCCFOM). Eight (61.5%) patients had a pT4 tumor, and all patients had a pathological N3 neck with multiple positive lymph nodes. Adverse pathologic features were present in 100% of the patients. The size of the metastatic foci in level VI ranged from 2.6 cm to 4.5 cm with a mean value of 3.2 cm, and 5 patients showed a soft tissue deposit with no lymph node component. Recurrence occurred in all patients, and 11 patients died of uncontrolled cancer within 5 years after surgery. Conclusion Level VI metastasis in primary oral SCCFOM is rare, and its prognosis is poor.

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