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. 2021 Feb;43(2):568-576.
doi: 10.1002/hed.26520. Epub 2020 Oct 23.

Cumulative suppressive index as a predictor of relapse free survival and overall survival in Human Papilloma Virus-negative oral squamous cell carcinomas with negative resection margins

Lauren Hum  1 , Daniel Bethmann  2 , Zipei Feng  3 , Shu-Ching Chang  4 , Alexander Eckert  5 , Carmen Ballesteros-Merino  6 , Claudia Keschke  2 , Matthias Kappler  5 , Carlo B Bifulco  6 , Claudia Wickenhauser  2 , Barbara Seliger  7 , Bernard A Fox  6   8 , Richard Bryan Bell  6   9
Affiliations

Cumulative suppressive index as a predictor of relapse free survival and overall survival in Human Papilloma Virus-negative oral squamous cell carcinomas with negative resection margins

Lauren Hum et al. Head Neck. 2021 Feb.

Abstract

Background: This study aimed to analyze margin status and the impact of the immune elements on recurrence in patients with oral squamous cell carcinoma (OSCC), employing a prognostic biomarker, cumulative suppressive index (CSI), which reflects FoxP3+, PD-L1+, and CD8+ cell spatial relationships in the tumor microenvironment.

Methods: Cox proportional hazards regression was used to evaluate the interactive effect of the margin by CSI discrepancy (high, 3-4 vs low, 0-2) on recurrence free survival (RFS) and overall survival (OS) in 119 patients with stage I to IVA OSCC.

Results: In cases with negative margins, multivariable analysis showed high CSI was significantly associated with worse RFS (HR = 2.59, 95% CI [1.03, 6.49], P = .04) and OS (HR = 5.49, 95% CI [1.48, 20.35], P = .01) compared to low CSI. However, high CSI was not significantly associated with recurrence in cases with positive margins.

Conclusions: Immune architecture analysis can augment our current histopathological risk assessment of margin status.

Keywords: biomarker; head and neck cancer; immunotherapy; margins; oral cancer.

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References

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