scholarly journals Prediction Model of Distant Metastasis in Oral Cavity Squamous Cell Carcinoma With or Without Regional Lymphatic Metastasis

2022 ◽  
Vol 11 ◽  
Author(s):  
Hsueh-Ju Lu ◽  
Yu-Wei Chiu ◽  
Wen-San Lan ◽  
Chih-Yu Peng ◽  
Hsien-Chun Tseng ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Distant Metastasis ◽  
Locoregional Recurrence ◽  
Prediction Models ◽  
Surgical Margin ◽  
Scoring Systems ◽  
Lymphocyte To Monocyte Ratio

Patients with oral cavity squamous cell carcinoma (OCSCC) who develop distant metastasis (DM) face poor outcomes, and effective prediction models of DM are rare. A total of 595 patients with OCSCC were retrospectively enrolled in this study. Because pathological N staging significantly influences the development and mechanisms of DM, the patients were divided into nodal-negative (pN−) and -positive (pN+) groups. Clinical outcomes, prognoses, and prediction models were analyzed separately for both groups. Overall, 8.9% (53/595) of these patients developed DM. Among the DM cases, 84.9% (45/53) of them developed DM within the first 3 years. The median overall survival, locoregional recurrence-free survival, time until DM development, and postmetastatic survival were 19.8, 12.7, 14.6, and 4.1 months, respectively. Distinguishing patients who only developed locoregional recurrence from those with DM according to locoregional conditions was difficult. Age, surgical margin, and early locoregional recurrence were predictors of DM that were independent of time until DM in the pN− group; the lymphocyte-to-monocyte ratio, presence of lymphovascular invasion, and early locoregional recurrence in the pN+ group were determined. If one point was scored for each factor, then two scoring systems were used to classify the patients into low- (score = 0), intermittent- (score = 1), or high- (score = 2 or 3) risk for the pN− and pN+ groups. According to this scoring system, the 3-year DM rates for the low, intermittent, and high risk subgroups were 0.0%, 5.9%, and 17.8% for the pN− group and 7.1%, 44.9%, and 82.5% for the pN+ group, respectively. These systems also effectively predicted DM, and the areas under the curve predicted DM occurring within the first 3 years were 0.744 and 0.820 for the pN− and pN+ groups, respectively. In conclusion, effective scoring models were established for predicting DM.

Predictive scoring systems for distant metastases in oral cavity squamous cell carcinoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18536-e18536
Author(s):  
Hsueh Ju LU ◽  
Kuan-Ming Lai ◽  
Chih-Yu Peng ◽  
Hsien-Chun Tseng ◽  
Chung-Han Hsin ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locoregional Recurrence ◽  
Surgical Margin ◽  
Scoring Systems ◽  
Distant Metastases ◽  
Initial Diagnosis ◽  
University Hospital

e18536 Background: At least 10% of patients with oral cavity squamous cell carcinoma (OCSCC) would progress to distant metastases (DM). Median overall survival (OS) after distant metastases is only one year and rare biomarkers are available to predict distant metastatic events. Methods: A total of 595 OCSCC patients who underwent curative surgical resection at Chung Shan Medical University Hospital were enrolled from Jan 2010 to Dec 2016. The clinical–pathological variables were compared using the χ2 test. Cox proportional-hazards analyses were performed for distant metastatic free survival (DMFS), defined from the date of initial diagnosis to the date of distant metastasis. Two scoring systems for predicting distant metastases were established for patients with pathologic regional lymph node –positive (pN+) or –negative (pN–), separately. Results: Nearly 10% (8.9%, 53/595) of patients with OCSCC would progress to DM during follow-up [20.6% (28/136) and 5.4% (25/459) for patients with pN+ and pN–, respectively]. Most of the distant metastatic lesions developed within 3 years after initial diagnosis (overall, 84.9%, 45/53; patients with pN+, 92.9%, 26/28; patients with pN–, 76.0%, 19/25). For patients with pN+, rapidly locoregional recurrence (≦6 months), lymphovascular invasion, and lymphocyte-monocyte ratio(<2.5) were the independent factors for DMFS. In addition, rapidly locoregional recurrence, elderly (age > 65), and close surgical margin(≦5mm) were independent for those with pN–. If each of the independent factors was scored one point to predict DM occurring within 3 years after the initial diagnosis, two scoring systems were established for the corresponding patients with pN+ or pN–, separately. The area under the curves of these two scoring systems for the corresponding patients with pN+ and pN– were 0.737 and 0.825, respectively (Table). Conclusions: The established scoring systems effectively predict distant metastases for OCSCC patients. [Table: see text]

The Length of Peri-Neural Spreading in Clinically Mandibular Invaded Oral Cavity Squamous Cell Carcinoma

2020 ◽  
pp. 459-464
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Lymphovascular Invasion ◽  
Perineural Invasion ◽  
Inferior Alveolar Nerve ◽  
Surgical Margin ◽  
Neural Invasion ◽  
Resected Margin

Background: The objective of surgical management of oral squamous cell carcinoma (OSCC) is adequate resection with a clear margin. However, there is still a debate as to the optimal length for a mandibular resected margin. Objective: To examine the length of peri-neural spreading in T4 mandibular invaded oral cavity squamous cell carcinoma. Materials and Methods: Twenty-eight T4 pathological OSCC specimens that involved mandible and serial slices were studied and the length of tumor spreading along the inferior alveolar nerve (IAN) was determined. Tumor characteristics, risk factors, and survival were analyzed. Results: The incidence of peri-neural invasion was 11.11%, and IAN invasion was found in 14.29% of the tumor-invaded mandibular marrow. The length of tumor spreading along IAN was 3 to 12 mm. Poor prognostic factors of T4 OSCC were it being located on the tongue (HR 14.16), was pathological N2-3 (HR 31.05), and had high-risk features such as peri-neural invasion, lymphovascular invasion, and extra-nodal extension. Conclusion: A mandibular resected margin of at least 18 mm is recommended as a clear surgical margin in cases of T4 mandibular invasion OSCC. Keywords: Oral cancer, Perineural invasion, Inferior alveolar nerve, Squamous cell carcinoma, Mandibulectomy

Risk factors of distant metastasis in patients with squamous cell carcinoma of the oral cavity

2016 ◽  
Vol 121 (5) ◽  
pp. 474-480 ◽  
Author(s):  
Yuki Sakamoto ◽  
Yuki Matsushita ◽  
Shin-ichi Yamada ◽  
Souich Yanamoto ◽  
Takeshi Shiraishi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Distant Metastasis

Human Papillomavirus-16 E7 Viral Load Predicts Distant Metastasis in Oral Cavity Squamous Cell Carcinoma

2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P169-P169
Author(s):  
Chung-Guei Huang ◽  
Li-Ang Lee ◽  
Kuo-Chien Tsao ◽  
Chun-Ta Liao ◽  
Shin-Ru Shih ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
Viral Load ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Distant Metastasis ◽  
Human Papillomavirus 16

scholarly journals Molecular and Cellular Mechanisms of Perineural Invasion in Oral Squamous Cell Carcinoma: Potential Targets for Therapeutic Intervention

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6011
Author(s):  
Carly I. Misztal ◽  
Carlos Green ◽  
Christine Mei ◽  
Rita Bhatia ◽  
Jaylou M. Velez Torres ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Schwann Cells ◽  
Squamous Cell ◽  
Therapeutic Intervention ◽  
Locoregional Recurrence ◽  
Perineural Invasion ◽  
Cellular Mechanisms ◽  
Cancer Migration

The most common oral cavity cancer is squamous cell carcinoma (SCC), of which perineural invasion (PNI) is a significant prognostic factor associated with decreased survival and an increased rate of locoregional recurrence. In the classical theory of PNI, cancer was believed to invade nerves directly through the path of least resistance in the perineural space; however, more recent evidence suggests that PNI requires reciprocal signaling interactions between tumor cells and nerve components, particularly Schwann cells. Specifically, head and neck SCC can express neurotrophins and neurotrophin receptors that may contribute to cancer migration towards nerves, PNI, and neuritogenesis towards cancer. Through reciprocal signaling, recent studies also suggest that Schwann cells may play an important role in promoting PNI by migrating toward cancer cells, intercalating, and dispersing cancer, and facilitating cancer migration toward nerves. The interactions of neurotrophins with their high affinity receptors is a new area of interest in the development of pharmaceutical therapies for many types of cancer. In this comprehensive review, we discuss diagnosis and treatment of oral cavity SCC, how PNI affects locoregional recurrence and survival, and the impact of adjuvant therapies on tumors with PNI. We also describe the molecular and cellular mechanisms associated with PNI, including the expression of neurotrophins and their receptors, and highlight potential targets for therapeutic intervention for PNI in oral SCC.

scholarly journals Correlation of gene methylation in surgical margin imprints with locoregional recurrence in head and neck squamous cell carcinoma

Cancer ◽  
2015 ◽  
Vol 121 (12) ◽  
pp. 1957-1965 ◽  
Author(s):  
Masamichi Hayashi ◽  
Gaosong Wu ◽  
Jong-Lyel Roh ◽  
Xiaofei Chang ◽  
Xiufeng Li ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Locoregional Recurrence ◽  
Surgical Margin ◽  
Neck Squamous Cell Carcinoma ◽  
Gene Methylation
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