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

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

Nobuhiro Yamakawa  1 , Tadaaki Kirita  1 , Masahiro Umeda  2 , Souichi Yanamoto  2 , Yoshihide Ota  3 , Mitsunobu Otsuru  3 , Masaya Okura  4 , Hiroshi Kurita  5 , Shin-Ichi Yamada  5 , Takumi Hasegawa  6 , Tomonao Aikawa  4 , Takahide Komori  6 , Michihiro Ueda  7 ; Japan Oral Oncology Group (JOOG)
Affiliations

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

Nobuhiro Yamakawa et al. J Surg Oncol. 2019 Mar.

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.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
Histopathological analysis of tumor budding at the tumor invasive front (arrow; 20× magnification) [Color figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Representative examples of histopathological parameters for adjacent tissue at the invasive front. A,B, Presence of lymphocytes and fibrous tissue. C, Presence of fibrous tissue and muscle tissue. D, Presence of muscle tissue and fatty tissue. L, lymphocytes; Fi, fibrous tissue; M, muscle tissue; Fa, fatty tissue [Color figure can be viewed at wileyonlinelibrary.com]
Figure 3
Figure 3
Kaplan‐Meier curves for delayed neck metastatic rate in all patients
Figure 4
Figure 4
(A) Kaplan‐Meier curves for delayed neck metastatic rate according to T classification, B, depth of invasion, and C, tumor budding. *P < 0.05 [Color figure can be viewed at wileyonlinelibrary.com]
Figure 5
Figure 5
Kaplan‐Meier curves for delayed neck metastatic rate according to adjacent tissue at the invasive front. A, Lymphocytes, B, fibrous tissue, C, muscle tissue, D, and fatty tissue *P < 0.05 [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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