Oral tongue squamous cell carcinoma: recurrent disease is associated with histopathologic risk score and young age.

PURPOSE: To apply the Brandwein-Gensler et al.'s histopathologic risk score (RS) system and to evaluate its impact on locoregional recurrence and overall survival in a series of cases of oral tongue cancer, along with variables of patient age and margin status.

METHODS

Sections of the resection specimens (N = 50) were submitted to a RS assignment of three components: the worst pattern of invasion, lymphocytic infiltration and perineural invasion. Risk scores of 0-2 were classified as low-to-intermediate and RSs > or = 3 were classified as high with respect to recurrence and survival. Margins were considered as "clean" if the tumor was > or = 5 mm away from them, otherwise they were defined as "positive". Patients < or = 60 years were considered "young" and those >60 years "old". Kaplan-Meier survival analysis with univariate and Cox multivariate regression model with stepwise forward selection tests were used.

RESULTS

Univariate analysis showed that locoregional recurrence was negatively influenced by high RSs (P = 0.011), "young" age (P = 0.027) and positive margins (P = 0.027). Multivariate analysis revealed that the risk of recurrence was increased by high RSs (hazard ratio 11.14; P = 0.022) and "young" age (hazard ratio 3.41; P = 0.022). "Young" patients with high RSs had a higher frequency of recurrence rate compared to "young" patients with low-to-intermediate scores (P = 0.008) and "old" patients with low-to-intermediate and high RSs (P = 0.012 and P = 0.011, respectively).

CONCLUSIONS

The histopathologic RS can serve to identify a subgroup of patients <60 years who have a high recurrence rate of oral tongue cancer, irrespective of the margin status.