Histopathological Factors in Oral Squamous Cell Carcinoma-Should a Clinician Look Beyond Clinical Staging?

PURPOSE: Several researchers have proposed and investigated the prognostic implications of various parameters, but have failed to provide concrete evidence regarding the inclusion or exclusion of histopathological features while clinically managing an oral squamous cell carcinoma (OSCC) case. The study purpose was to measure the prognostic values of a set of key histologic features and its association with its clinical outcome-5-year survival. MATERIALS AND METHODS: This is a prospective cohort study and the sample was composed of patients treated for OSCC (April 2014 - March 2015). The predictor variables included pattern of tumor invasion (POI), stromal inflammation, angiogenesis, and vascular invasion with the outcome being survival of subjects observed over this 5-year period. Sociodemographic data (age, sex, marital status, systemic disease, habits etc), clinical staging and TNM staging were also recorded. We used multivariate regression analysis for predictor analysis; Kaplan-Meier survival curves and Cox hazard modeling was also performed using the data. RESULTS: This article includes 50 subjects with a mean age of 54.94 years and 58% were male and their characteristics collected at the baseline and at a 12-, 24-, 36-, 48-, and 60-month follow-up. The overall 5-year survival was 48%. We saw a significant association between N-stage and POI (0.027), T-stage and mean vascular density (0.042), and T-stage and vascular invasion (0.046). POI, angiogenesis, and vascular invasion were found as significant predictors of overall 5-year survival (P < .001). CONCLUSIONS: This study shows that histopathological parameters such as POI are important while determining the clinical outcome of OSCC. Histopathological parameters such as angiogenesis and vascular invasion can provide valuable information about the overall survival and prognosis.

Pattern of tumor invasion, stromal inflammation, angiogenesis and vascular invasion in oral squamous cell carcinoma - A prognostic study.

INTRODUCTION: Oral cancer is one of the leading causes of mortality, and its worsening impact on the society has revealed the danger it poses in the coming future. Several researchers proposed and investigated the prognostic implications of various clinicopathologic and histopathologic parameters. AIM AND OBJECTIVES: The aim of this study--assessing significance of histopathological features like pattern of tumor invasion, stromal inflammation, angiogenesis and vascular invasion on the clinical outcome of oral squamous cell carcinoma any possible correlations between the parameters, TNM Staging and prognosis were assessed and evaluated for a 5-year period. MATERIALS AND METHODS: This study includes description of 50 diagnosed cases (mean age: 61.40, 29 males, and 21 females) of oral squamous cell carcinoma and their characteristics collected at baseline and at a 12-month follow up. The cases were grouped on the basis of their histological grade (well-differentiated, moderately differentiated, and poorly-differentiated). RESULTS: All the data collected was tabulated in a baseline descriptive table, and all the parameters were compared between the 3 different histological groups. On cross-tabulations we found statistical significant difference the parameters of stromal inflammation with recurrence, clinical stage with T-stage, T-stage with N-stage, and N-stage with clinical stage. On analysis of the follow up we found 16 patients (32%) with recurrence and 9 patients (18%) succumb to the disease. CONCLUSION: This study provides a significant insight on the importance of a combined histopathological analysis and clinical staging process to deliver an accurate prognostic opinion and also subsequently effect the treatment protocol.

A case report and short review on changing trends in the site of occurrence of adenomatoid odontogenic tumor: Unravelling the past 15 years.

Adenomatoid odontogenic tumor (AOT) is an uncommon benign odontogenic lesion, with debatable histogenesis and variable histopathology. A systematic and diverse insight into the evolution, clinical presentation, histology, and immunohistochemical findings of this lesion is reviewed and presented. We reviewed the data published from 2000 to 2014 of approximately 255 cases that revealed a significant change in the incidence of predominant site involved, in contrast to the findings published by Reichart. We have also included the chronological order of events leading to the coining of the term AOT, which shows the curiosity that has been dedicated to understanding the lesion. Immunohistochemistry is considered to be a hallmark in pathology for learning the molecular pathogenesis and giving a correct final diagnosis. Several markers have been used to investigate and understand this lesion, and a compilation of the findings has been tabulated.