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Abstract：
BACKGROUND: There is an ongoing need to identify pathologic prognosticators in early-stage oral cavity squamous cell carcinoma (OCSCC) to aid selection of patients who may benefit from adjuvant treatment. The objective of this study was to evaluate the prognostic ability of worst pattern of invasion-5 (WPOI-5) defined by the presence of satellite nodules, extratumoural perineural invasion (PNI) and/or extratumoural lymphovascular space invasion (LVI) in low-stage, node negative OCSCC.
METHODS: This was a retrospective study of 160 patients with T1/T2N0 tumours staged using TNM7 treated surgically. Histology of the primary tumour was re-reviewed as appropriate to assess for the presence of WPOI-5 parameters. Univariate and multivariate analysis assessing impact of pathological features on survival outcomes was performed.
RESULTS: On univariate analysis, WPOI-5 and its 3 constituent components of satellite nodules, extratumoural PNI and extratumoural LVI were all significantly associated with disease-specific survival (DSS) and overall survival (OS). On multivariate analysis, satellite nodules (odds ratio 6.61, 95% CI 2.83-15.44, p < 0.0001) and extratumoural LVI (odds ratio 9.97, 95% CI 2.19-45.35, p = 0.003) were independently associated with OS. Postoperative radiotherapy (odds ratio 0.40, 95% CI 0.19-0.87, p = 0.02) and non-tongue subsite (odds ratio 3.03, 95% CI 1.70-5.39, p = 0.0002) were also significantly associated with OS on multivariate analysis.
CONCLUSIONS: Satellite nodules and extratumoural LVI correlated significantly with survival outcomes in our early-stage OSCC cohort. Further study is required to investigate the benefit of adjuvant treatment in these cases and to ascertain if WPOI-5 parameters including satellite nodules should be mandatory reporting data elements.
METHODS: This was a retrospective study of 160 patients with T1/T2N0 tumours staged using TNM7 treated surgically. Histology of the primary tumour was re-reviewed as appropriate to assess for the presence of WPOI-5 parameters. Univariate and multivariate analysis assessing impact of pathological features on survival outcomes was performed.
RESULTS: On univariate analysis, WPOI-5 and its 3 constituent components of satellite nodules, extratumoural PNI and extratumoural LVI were all significantly associated with disease-specific survival (DSS) and overall survival (OS). On multivariate analysis, satellite nodules (odds ratio 6.61, 95% CI 2.83-15.44, p < 0.0001) and extratumoural LVI (odds ratio 9.97, 95% CI 2.19-45.35, p = 0.003) were independently associated with OS. Postoperative radiotherapy (odds ratio 0.40, 95% CI 0.19-0.87, p = 0.02) and non-tongue subsite (odds ratio 3.03, 95% CI 1.70-5.39, p = 0.0002) were also significantly associated with OS on multivariate analysis.
CONCLUSIONS: Satellite nodules and extratumoural LVI correlated significantly with survival outcomes in our early-stage OSCC cohort. Further study is required to investigate the benefit of adjuvant treatment in these cases and to ascertain if WPOI-5 parameters including satellite nodules should be mandatory reporting data elements.
摘要：
背景：需要确定早期口腔鳞状细胞癌（OCSCC）的病理预后指标，以帮助选择可能受益于辅助治疗的患者。这项研究的目的是评估由卫星结节的存在定义的最差侵袭模式5（WPOI-5）的预后能力，肿瘤外神经周侵犯（PNI）和/或肿瘤外淋巴血管间隙侵犯（LVI）在低阶段，节点负OCSCC。
方法：这是一项对160例T1/T2N0肿瘤患者进行手术治疗的回顾性研究。适当地重新审查原发性肿瘤的组织学以评估WPOI-5参数的存在。进行单变量和多变量分析，评估病理特征对生存结果的影响。
结果：关于单变量分析，WPOI-5及其卫星结核的3个组成部分，肿瘤外PNI和肿瘤外LVI均与疾病特异性生存期(DSS)和总生存期(OS)显著相关.在多变量分析中，卫星结节(比值比6.61,95%CI2.83-15.44,p<0.0001)和肿瘤外LVI(比值比9.97,95%CI2.19-45.35,p=0.003)与OS独立相关.在多变量分析中，术后放疗（比值比0.40，95％CI0.19-0.87，p=0.02）和非舌亚位点（比值比3.03，95％CI1.70-5.39，p=0.0002）也与OS显着相关。
结论：在早期OSCC队列中，卫星结节和肿瘤外LVI与生存结果显著相关。需要进一步研究，以调查在这些情况下辅助治疗的益处，并确定包括卫星结节在内的WPOI-5参数是否应为强制性报告数据要素。
方法：这是一项对160例T1/T2N0肿瘤患者进行手术治疗的回顾性研究。适当地重新审查原发性肿瘤的组织学以评估WPOI-5参数的存在。进行单变量和多变量分析，评估病理特征对生存结果的影响。
结果：关于单变量分析，WPOI-5及其卫星结核的3个组成部分，肿瘤外PNI和肿瘤外LVI均与疾病特异性生存期(DSS)和总生存期(OS)显著相关.在多变量分析中，卫星结节(比值比6.61,95%CI2.83-15.44,p<0.0001)和肿瘤外LVI(比值比9.97,95%CI2.19-45.35,p=0.003)与OS独立相关.在多变量分析中，术后放疗（比值比0.40，95％CI0.19-0.87，p=0.02）和非舌亚位点（比值比3.03，95％CI1.70-5.39，p=0.0002）也与OS显着相关。
结论：在早期OSCC队列中，卫星结节和肿瘤外LVI与生存结果显著相关。需要进一步研究，以调查在这些情况下辅助治疗的益处，并确定包括卫星结节在内的WPOI-5参数是否应为强制性报告数据要素。
