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A proposal to revise the histopathologic grading system of early oral tongue cancer incorporating tumor budding

Elseragy, Amr; Salo, Tuula; Coletta, Ricardo D.; Kowalski, Luiz Paulo; Haglund, Caj; Nieminen, Pentti; Mäkitie, Antti A.; Leivo, Ilmo; Almangush, Alhadi (2019-05-01)

 
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URL:
https://doi.org/10.1097/PAS.0000000000001241

Elseragy, Amr
Salo, Tuula
Coletta, Ricardo D.
Kowalski, Luiz Paulo
Haglund, Caj
Nieminen, Pentti
Mäkitie, Antti A.
Leivo, Ilmo
Almangush, Alhadi
Wolters Kluwer
01.05.2019

Elseragy, A., Salo, T., Coletta, R., Kowalski, L., Haglund, C., Nieminen, P., Mäkitie, A., Leivo, I., Almangush, A. (2019) A Proposal to Revise the Histopathologic Grading System of Early Oral Tongue Cancer Incorporating Tumor Budding. 43 (5), 703-709. doi:10.1097/PAS.0000000000001241

https://rightsstatements.org/vocab/InC/1.0/
© 2019 Wolters Kluwer Health, Inc. All rights reserved. This is the peer reviewed version of the following article: Elseragy, A., Salo, T., Coletta, R., Kowalski, L., Haglund, C., Nieminen, P., Mäkitie, A., Leivo, I., Almangush, A. (2019) A Proposal to Revise the Histopathologic Grading System of Early Oral Tongue Cancer Incorporating Tumor Budding. 43 (5), 703-709, which has been published in final form at http://dx.doi.org/10.1097/PAS.0000000000001241.
https://rightsstatements.org/vocab/InC/1.0/
doi:https://doi.org/10.1097/PAS.0000000000001241
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi-fe2019061921347
Tiivistelmä

Abstract

The World Health Organization (WHO) grading system has a low prognostic value for early-stage oral tongue squamous cell carcinoma (OTSCC); greater prognostic power has been shown with tumor budding analysis. In this study, we combined tumor budding analysis with histopathologic grading according to WHO 2017. In our proposal, a revised Grade I tumor is defined as a “well differentiated cohesive tumor”; revised Grade II as a “moderately differentiated and/or slightly dissociated tumor”; and revised Grade III as a “poorly differentiated and/or dissociated tumor”. We evaluated the prognostic value of this proposed grading system in a multicenter cohort of 311 cases of early OTSCC. The proposed grading system showed significant prognostic value in multivariable analysis for disease-specific survival (DSS) with a hazard ratio (HR) of 3.86 and a 95% confidence interval (CI) of 1.36 to 10.9 (P = 0.001). For disease-free survival (DFS), the proposed grading system showed good predictive power in multivariable analysis (HR 2.07, 95% CI 1.00–4.27; P = 0.009). The conventional WHO grading system showed a low prognostic value for DSS and DFS (P > 0.05). In conclusion, the prognostic power of the WHO histopathologic grading improved significantly with incorporation of tumor budding. Our proposed grading system can be easily included in pathology reports.

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