Histologic and systemic prognosticators for local control and survival in margin-negative transoral laser microsurgery treated oral cavity squamous cell carcinoma.

Abstract

BACKGROUND:

Appreciable local recurrence rates observed in patients with margin-negative, transoral laser microsurgery (TLM)-treated oral cavity squamous cell carcinoma (SCC) necessitate identification of new prognosticators for local control and survival. A histopathologic index (Brandwein-Gensler score [BGS]) and intrinsic/iatrogenic/chronic conditions causing immune compromise are investigated.

METHODS:

From a prospectively assembled database of TLM-treated oral cavity SCC, specimens for 60 patients with a minimum of 2-years follow-up could undergo BGS assignment. Local control, disease-specific survival (DSS), and overall survival (OS) were study endpoints.

RESULTS:

"Low-BGS" was recorded in 28 patients (47%) and "high-BGS" in 32 patients (53%), whereas immune compromise was observed in 18%. In multivariate analyses, immune compromise was the only predictor for local control. T classification and immune compromise were prognostic for DSS and OS. "High-BGS" was prognostic only for OS.

CONCLUSION:

"High-BGS" was associated with recurrences but immune compromise was the most significant predictor of local control and survival in margin-negative, TLM-treated oral cavity SCC. Strategies that maintain/restore tumor-specific immune responses in immune compromised oral cavity SCC hosts need to be developed.

• Authors: Parul Sinha, Mitra Mehrad, Rebecca D Chernock, James S Lewis Jr, Samir K El-Mofty, Ningying Wu, Brian Nussenbaum, Bruce H Haughey
• Journal: Head & neck (Head Neck) Vol. 37 Issue 1 Pg. 52-63 (Jan 2015) ISSN: 1097-0347 [Electronic] United States
• PMID: 24430914 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 Wiley Periodicals, Inc.

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Squamous Cell (mortality, pathology, surgery)
• Cohort Studies
• Disease-Free Survival
• Female
• Humans
• Laser Therapy
• Male
• Microsurgery
• Middle Aged
• Mouth Neoplasms (mortality, pathology, surgery)
• Neoplasm Recurrence, Local (epidemiology, pathology)
• Risk Factors
• Survival Rate
• Treatment Outcome
• Young Adult