Mode of invasion and outcome in squamous cell carcinoma of the oral tongue

Abstract

Background: Histologic parameters concerning the tumor-host relation of squamous cell carcinoma (SCC) are supposed to be important for prediction of future metastases to regional lymph nodes and prognosis. The mode of invasion of squamous cell carcinoma is graded into the following groups: grade 1—well-defined borderline; grade 2—less-marked borderline; grade 3—no distinct borderline; grade 4C—diffuse growth cord-like type; and grade 4D—diffuse type. Objectives: To investigate retrospectively the relationship between the mode of invasion of squamous cell carcinoma of the oral tongue and the occurrence of regional lymph node metastasis and outcome of the patients. Patients and methods: Twenty-two surgical specimens of histologically proven squamous cell carcinoma of the oral tongue were retrospectively studied from 1994 to 2000. All of them underwent partial glossectomy. Patients ranged from 52 to 78 years old with median of 62. There were 18 males and four females. The factors investigated in relation to the mode of invasion were pathological neck metastasis (pN) and survival rates. The pathological neck status was achieved in the medical records. The follow-up varied from 24 to 62 months after the surgical treatment. Fischer Exact Test was applied. Results: There were 10 specimens classified as grades 1 and 2, and 12 classified as grades 3, 4C and 4D. There were no metastasis in grades 1 and 2 (0/10), while the frequency of metastasis was high in grades 3, 4C and 4D (7/12) (p=0.005). All the 10 patients classified as grades 1 and 2 were alive without disease. From the 12 patients classified as grades 3, 4C and 4D, five died. Conclusions: The more invasive the tumor (grades 3, 4C and 4D), the more frequent regional metastasis are and the poorer the prognosis is. The mode of invasion of squamous cell carcinoma of the oral tongue has prognostic value.