scholarly journals Assessment of Tumor-infiltrating Lymphocytes Predicts the Behavior of Early-stage Oral Tongue Cancer

2019 ◽  
Vol 43 (10) ◽  
pp. 1392-1396 ◽  
Author(s):  
Ilkka Heikkinen ◽  
Ibrahim O. Bello ◽  
Awais Wahab ◽  
Jaana Hagström ◽  
Caj Haglund ◽  
...  
Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3235
Author(s):  
Alhadi Almangush ◽  
Ibrahim O. Bello ◽  
Ilkka Heikkinen ◽  
Jaana Hagström ◽  
Caj Haglund ◽  
...  

Although patients with early-stage oral tongue squamous cell carcinoma (OTSCC) show better survival than those with advanced disease, there is still a number of early-stage cases who will suffer from recurrence, cancer-related mortality and worse overall survival. Incorporation of an immune descriptive factor in the staging system can aid in improving risk assessment of early OTSCC. A total of 290 cases of early-stage OTSCC re-classified according to the American Joint Committee on Cancer (AJCC 8) staging were included in this study. Scores of tumor-infiltrating lymphocytes (TILs) were divided as low or high and incorporated in TNM AJCC 8 to form our proposed TNM-Immune system. Using AJCC 8, there were no significant differences in survival between T1 and T2 tumors (p > 0.05). Our proposed TNM-Immune staging system allowed for significant discrimination in risk between tumors of T1N0M0-Immune vs. T2N0M0-Immune. The latter associated with a worse overall survival with hazard ratio (HR) of 2.87 (95% CI 1.92–4.28; p < 0.001); HR of 2.41 (95% CI 1.26–4.60; p = 0.008) for disease-specific survival; and HR of 1.97 (95% CI 1.13–3.43; p = 0.017) for disease-free survival. The TNM-Immune staging system showed a powerful ability to identify cases with worse survival. The immune response is an important player which can be assessed by evaluating TILs, and it can be implemented in the staging criteria of early OTSCC. TNM-Immune staging forms a step towards a more personalized classification of early OTSCC.


2020 ◽  
Author(s):  
Alhadi Almangush ◽  
Ibrahim O. Bello ◽  
Ilkka Heikkinen ◽  
Jaana Hagström ◽  
Caj Haglund ◽  
...  

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.


Head & Neck ◽  
2013 ◽  
Vol 36 (6) ◽  
pp. 811-818 ◽  
Author(s):  
Alhadi Almangush ◽  
Ibrahim O. Bello ◽  
Harri Keski–Säntti ◽  
Laura K. Mäkinen ◽  
Joonas H. Kauppila ◽  
...  

Oral Oncology ◽  
2014 ◽  
Vol 50 (3) ◽  
pp. 213-220 ◽  
Author(s):  
Pablo H. Montero ◽  
Frank L. Palmer ◽  
Andrew G. Shuman ◽  
Purvi D. Patel ◽  
Jay O. Boyle ◽  
...  

2015 ◽  
Vol 44 (2) ◽  
pp. 143-150 ◽  
Author(s):  
A. Almangush ◽  
R.D. Coletta ◽  
I.O. Bello ◽  
C. Bitu ◽  
H. Keski-Säntti ◽  
...  

2011 ◽  
Vol 38 (6Part24) ◽  
pp. 3695-3696
Author(s):  
J Fan ◽  
E Fourka ◽  
S Hayes ◽  
L Jin ◽  
L Wang ◽  
...  

2019 ◽  
Vol 49 (4) ◽  
pp. 297-305 ◽  
Author(s):  
Nobuhiro Hanai ◽  
Takahiro Asakage ◽  
Naomi Kiyota ◽  
Akihiro Homma ◽  
Ryuichi Hayashi

Abstract The standard local treatment for early-stage tongue cancer with no clinical lymph node metastases is partial glossectomy. The frequency of occult lymph node metastasis is ~20–30%. Thus, whether prophylactic neck dissection with glossectomy or glossectomy alone should be performed has been a controversial issue since the 1980s. Both treatments have advantages and disadvantages; however, especially in cases involving prophylactic neck dissection, surgical invasion and complications including the cosmetic disadvantage caused by neck skin incision, accessory nerve paralysis or facial nerve (mandibular marginal branch) paralysis, stiffness of the shoulder or neck and a feeling of neck tightness have been considered issues that could be solved by providing less-invasive treatment to the 70–80% of patients without occult lymph node metastasis. A more accurate preoperative diagnosis and strict follow-up are required to provide minimally invasive treatment while ensuring the therapeutic effect. It is also necessary to narrow down the target based on the risk–benefit balance. The depth of invasion should be considered in cases involving oral cavity malignancies. This was also taken into account in recent revisions of eighth edition of the TNM Classification of Malignant Tumors and it is an important factor for N0 neck management. This review article summarizes previous and recent reports on neck management, focusing on the risk–benefit and future perspectives of the diagnosis and treatment of early-stage oral tongue cancer. This effort is an attempt to establish treatment from the patient’s point of view, with the patient’s quality of life taken into account.


2019 ◽  
Vol 77 (2) ◽  
pp. 426-432
Author(s):  
Lei Wang ◽  
Mei Zhang ◽  
Yuntao Zhu ◽  
Xin Zhang ◽  
Yongmei Yang ◽  
...  

Author(s):  
Alhadi Almangush ◽  
Ricardo D. Coletta ◽  
Ibrahim O. Bello ◽  
Carolina Bitu ◽  
Laura K. Mäkinen ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document