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British Journal of Cancer logoLink to British Journal of Cancer
. 2000 Aug 16;83(5):614–619. doi: 10.1054/bjoc.2000.1323

Prognostic factors in tongue cancer – relative importance of demographic, clinical and histopathological factors

S Kantola 1, M Parikka 2, K Jokinen 3, K Hyrynkangs 3, Y Soini 4, O-P Alho 3,1, T Salo 2,4,1
PMCID: PMC2363505  PMID: 10944601

Abstract

The incidence of and mortality from squamous cell carcinoma (SCC) of the tongue have increased during the recent decades in the Western world. Much effort has been made to predict tumour behaviour, but we still lack specific prognostic indicators. The aim of our study was to evaluate the relative importance of the known demographic, clinical and histological factors in a homogeneous population-based group of patients with SCC of the mobile tongue. The demographic and clinical factors were reviewed retrospectively from primary and tertiary care patient files. Histological prognostic factors were determined from pre-treatment biopsies. The TNM stage was found to be the most important prognostic factor. In particular, local spread outside the tongue rather than spread to regional lymph nodes was related to poor prognosis. Several demographic and histopathological factors were closely related to TNM stage. When the cases were divided into stage I–II carcinomas and stage III–IV carcinomas, it appeared that the patient’s older age (> 65 years), a high malignancy score and an absence of overexpressed p53 protein were associated with a poorer prognosis in stage I–II carcinomas. Such cases may require more aggressive treatment. Among patients with stage III–IV carcinomas, heavy use of alcohol was significantly associated with a poor disease-specific survival time. © 2000 Cancer Research Campaign

Keywords: squamous cell carcinoma, survival, immunohistochemistry

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Selected References

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  1. Bryne M., Koppang H. S., Lilleng R., Kjaerheim A. Malignancy grading of the deep invasive margins of oral squamous cell carcinomas has high prognostic value. J Pathol. 1992 Apr;166(4):375–381. doi: 10.1002/path.1711660409. [DOI] [PubMed] [Google Scholar]
  2. Bundgaard T., Bentzen S. M., Wildt J., Sørensen F. B., Søgaard H., Nielsen J. E. Histopathologic, stereologic, epidemiologic, and clinical parameters in the prognostic evaluation of squamous cell carcinoma of the oral cavity. Head Neck. 1996 Mar-Apr;18(2):142–152. doi: 10.1002/(SICI)1097-0347(199603/04)18:2<142::AID-HED6>3.0.CO;2-1. [DOI] [PubMed] [Google Scholar]
  3. Davis S., Severson R. K. Increasing incidence of cancer of the tongue in the United States among young adults. Lancet. 1987 Oct 17;2(8564):910–911. doi: 10.1016/s0140-6736(87)91393-6. [DOI] [PubMed] [Google Scholar]
  4. Depue R. H. Rising mortality from cancer of the tongue in young white males. N Engl J Med. 1986 Sep 4;315(10):647–647. doi: 10.1056/NEJM198609043151013. [DOI] [PubMed] [Google Scholar]
  5. Friedlander P. L., Schantz S. P., Shaha A. R., Yu G., Shah J. P. Squamous cell carcinoma of the tongue in young patients: a matched-pair analysis. Head Neck. 1998 Aug;20(5):363–368. doi: 10.1002/(sici)1097-0347(199808)20:5<363::aid-hed1>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  6. Gasparini G., Weidner N., Maluta S., Pozza F., Boracchi P., Mezzetti M., Testolin A., Bevilacqua P. Intratumoral microvessel density and p53 protein: correlation with metastasis in head-and-neck squamous-cell carcinoma. Int J Cancer. 1993 Nov 11;55(5):739–744. doi: 10.1002/ijc.2910550507. [DOI] [PubMed] [Google Scholar]
  7. Ghouri A. F., Zamora R. L., Harvey J. E., Spitznagel E. L., Jr, Sessions D. G. Epidermoid carcinoma of the oral cavity and oropharynx: validity of the current AJCC staging system and new statistical tools for the prediction of subclinical neck disease. Otolaryngol Head Neck Surg. 1993 Mar;108(3):225–232. doi: 10.1177/019459989310800304. [DOI] [PubMed] [Google Scholar]
  8. Gleich L. L., Biddinger P. W., Duperier F. D., Gluckman J. L. Tumor angiogenesis as a prognostic indicator in T2-T4 oral cavity squamous cell carcinoma: a clinical-pathologic correlation. Head Neck. 1997 Jul;19(4):276–280. doi: 10.1002/(sici)1097-0347(199707)19:4<276::aid-hed5>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  9. Gluckman J. L., Pavelic Z. P., Welkoborsky H. J., Mann W., Stambrook P., Gleich L., Wilson K., Righi P., Portugal L. G., McDonald J. Prognostic indicators for squamous cell carcinoma of the oral cavity: a clinicopathologic correlation. Laryngoscope. 1997 Sep;107(9):1239–1244. doi: 10.1097/00005537-199709000-00015. [DOI] [PubMed] [Google Scholar]
  10. Högmo A., Kuylenstierna R., Lindholm J., Munck-Wikland E. Predictive value of malignancy grading systems, DNA content, p53, and angiogenesis for stage I tongue carcinomas. J Clin Pathol. 1999 Jan;52(1):35–40. doi: 10.1136/jcp.52.1.35. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Janot F., Klijanienko J., Russo A., Mamet J. P., de Braud F., El-Naggar A. K., Pignon J. P., Luboinski B., Cvitkovic E. Prognostic value of clinicopathological parameters in head and neck squamous cell carcinoma: a prospective analysis. Br J Cancer. 1996 Feb;73(4):531–538. doi: 10.1038/bjc.1996.92. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Leedy D. A., Trune D. R., Kronz J. D., Weidner N., Cohen J. I. Tumor angiogenesis, the p53 antigen, and cervical metastasis in squamous carcinoma of the tongue. Otolaryngol Head Neck Surg. 1994 Oct;111(4):417–422. doi: 10.1177/019459989411100405. [DOI] [PubMed] [Google Scholar]
  13. Macfarlane G. J., Sharp L., Porter S., Franceschi S. Trends in survival from cancers of the oral cavity and pharynx in Scotland: a clue as to why the disease is becoming more common? Br J Cancer. 1996 Mar;73(6):805–808. doi: 10.1038/bjc.1996.141. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Matzow T., Boysen M., Kalantari M., Johansson B., Hagmar B. Low detection rate of HPV in oral and laryngeal carcinomas. Acta Oncol. 1998;37(1):73–76. doi: 10.1080/028418698423203. [DOI] [PubMed] [Google Scholar]
  15. Piffkò J., Bànkfalvi A., Ofner D., Bryne M., Rasch D., Joos U., Böcker W., Schmid K. W. Prognostic value of histobiological factors (malignancy grading and AgNOR content) assessed at the invasive tumour front of oral squamous cell carcinomas. Br J Cancer. 1997;75(10):1543–1546. doi: 10.1038/bjc.1997.263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Pintos J., Franco E. L., Black M. J., Bergeron J., Arella M. Human papillomavirus and prognoses of patients with cancers of the upper aerodigestive tract. Cancer. 1999 May 1;85(9):1903–1909. doi: 10.1002/(sici)1097-0142(19990501)85:9<1903::aid-cncr4>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  17. Ponte P., Ng S. Y., Engel J., Gunning P., Kedes L. Evolutionary conservation in the untranslated regions of actin mRNAs: DNA sequence of a human beta-actin cDNA. Nucleic Acids Res. 1984 Feb 10;12(3):1687–1696. doi: 10.1093/nar/12.3.1687. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Saunders M. E., MacKenzie R., Shipman R., Fransen E., Gilbert R., Jordan R. C. Patterns of p53 gene mutations in head and neck cancer: full-length gene sequencing and results of primary radiotherapy. Clin Cancer Res. 1999 Sep;5(9):2455–2463. [PubMed] [Google Scholar]
  19. Shpitzer T., Chaimoff M., Gal R., Stern Y., Feinmesser R., Segal K. Tumor angiogenesis as a prognostic factor in early oral tongue cancer. Arch Otolaryngol Head Neck Surg. 1996 Aug;122(8):865–868. doi: 10.1001/archotol.1996.01890200055012. [DOI] [PubMed] [Google Scholar]
  20. Soini Y., Nuorva K., Kamel D., Pöllänen R., Vähäkangas K., Lehto V. P., Päkkö P. Presence of human papillomavirus DNA and abnormal p53 protein accumulation in lung carcinoma. Thorax. 1996 Sep;51(9):887–893. doi: 10.1136/thx.51.9.887. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Soini Y., Paakko P. Extent of apoptosis in relation to p53 and bcl-2 expression in germ cell tumors. Hum Pathol. 1996 Nov;27(11):1221–1226. doi: 10.1016/s0046-8177(96)90318-4. [DOI] [PubMed] [Google Scholar]
  22. Soussi T., Legros Y., Lubin R., Ory K., Schlichtholz B. Multifactorial analysis of p53 alteration in human cancer: a review. Int J Cancer. 1994 Apr 1;57(1):1–9. doi: 10.1002/ijc.2910570102. [DOI] [PubMed] [Google Scholar]
  23. Zeuss M. S., Miller C. S., White D. K. In situ hybridization analysis of human papillomavirus DNA in oral mucosal lesions. Oral Surg Oral Med Oral Pathol. 1991 Jun;71(6):714–720. doi: 10.1016/0030-4220(91)90280-p. [DOI] [PubMed] [Google Scholar]

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