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Histopathology. 2018 Jun;72(7):1128-1135. doi: 10.1111/his.13481. Epub 2018 Mar 23.

Prognostic impact of tumour-stroma ratio in early-stage oral tongue cancers.

Author information

1
Department of Pathology, University of Helsinki, Helsinki, Finland.
2
Department of Pathology, University of Turku, Turku, Finland.
3
Institute of Dentistry, University of Misurata, Misurata, Libya.
4
Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
5
Master of Biostatistics, Department of Statistics, Faculty of Sciences, Hasselt University, Hasselt, Belgium.
6
Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
7
Cancer and Translational Medicine Research Unit, Medical Research Centre Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
8
Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
9
Department of Otorhinolaryngology and Head and Neck Surgery, Kuopio University Hospital, Kuopio, Finland.
10
HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland.
11
Research Programmes Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland.
12
Department of Otorhinolaryngology and Head and Neck Surgery, Tampere University Hospital, Tampere, Finland.
13
Department of Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
14
Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Centre, São Paulo-SP, Brazil.
15
Department of Otorhinolaryngology and Head and Neck Surgery, Turku University Hospital, University of Turku, Turku, Finland.
16
Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
17
Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
18
Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil.

Abstract

AIMS:

Oral tongue squamous cell carcinoma (OTSCC) has a relatively poor outcome, and there is a need to identify better prognostic factors. Recently, tumour-stroma ratio (TSR) has been associated with prognosis in several cancers. The aim of this multi-institutional study was to evaluate the prognostic value of TSR from original haematoxylin and eosin (HE)-stained tumour-resection slides in a series of early-stage (cT1-2N0) OTSCC patients.

METHODS AND RESULTS:

A TSR cutoff value of 50% was used to divide the patients into stroma-rich (≥50%) and stroma-poor (<50%) groups. The relationships between TSR and clinicopathological characteristics of 311 early-stage OTSCC cases were analysed. The prognostic value of TSR in OTSCC was calculated separately and in combination with a previously published cancer cell budding and depth of invasion (BD) prognostic model. A total of 89 cases (28.6%) belonged to the stroma-rich group. In a multivariate analysis, the stroma-rich group had worse disease-free survival, with a hazard ratio (HR) of 1.81 [95% confidence interval (CI) 1.17-2.79, P = 0.008], and higher cancer-related mortality (HR 1.71, 95% CI 1.02-2.86, P = 0.03). The combination of the highest-risk parameter scores of TSR and the BD model showed significant correlations with recurrence rate (HR 3.42, 95% CI 1.71-6.82, P = 0.004) and cancer-related mortality (HR 11.63, 95% CI 3.83-35.31, P < 0.001).

CONCLUSIONS:

We conclude that TSR is a simple histopathological feature that is useful for prognostication of early-stage OTSCC, and suggest that TSR analyses in association with BD score could be included in routine clinical pathology reports for HE-stained slides.

KEYWORDS:

marker; oral tongue cancer; prognosis; survival; tumour-stroma ratio

PMID:
29427291
DOI:
10.1111/his.13481
[Indexed for MEDLINE]

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