Tumor budding and adjacent tissue at the invasive front correlate with delayed neck metastasis in clinical early-stage tongue squamous cell carcinoma

J Surg Oncol. 2019 Mar;119(3):370-378. doi: 10.1002/jso.25334. Epub 2018 Dec 12.

Abstract

Background and objectives: Some patients with early-stage oral cancer have a poor prognosis owing to the delayed neck metastasis (DNM). Tumor budding is reportedly a promising prognostic marker in many cancers. Moreover, the tissue surrounding a tumor is also considered to play a prognostic role. In this study, we evaluated whether tumor budding and adjacent tissue at the invasive front can be potential novel predictors of DNM in early tongue cancer.

Methods: In total, 337 patients with early-stage tongue squamous cell carcinoma were retrospectively reviewed. The patient characteristics and histopathological factors were evaluated for association with DNM. DNM rates were calculated; items which were significant in the univariate analysis were used as explanatory variables, and independent factors for DNM were identified by the multivariate analysis.

Results: The univariate analysis identified T classification, depth of invasion, tumor budding, vascular invasion, and adjacent tissue at the invasive front as significant predictors of DNM; the multivariate analysis using these factors revealed all the above variables except vascular invasion, which are independent predictors of DNM.

Conclusion: In addition to conventional predictors, high grade tumor budding and adjacent tissue at the invasive front can serve as useful predictors of DNM in early tongue cancer.

Keywords: metachronous neck metastasis; prognostic indicator; small cancer-cell clusters; tongue cancer; tumor-adjacent tissue.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / secondary*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Prognosis
  • Retrospective Studies
  • Tongue Neoplasms / pathology*
  • Tongue Neoplasms / surgery
  • Young Adult