The Impact of Histopathological Features on the Prognosis of Oral Squamous Cell Carcinoma: A Comprehensive Review and Meta-Analysis

Author(s)

Dolens, Eder da Silva ^{[1, 2]} ; Dourado, Mauricio Rocha ^[3] ; Almangush, Alhadi ^{[4, 5]} ; Salo, Tuula A. ^{[6, 4, 5, 7]} ; Gurgel Rocha, Clarissa Araujo ^{[8, 9]} ; da Silva, Sabrina Daniela ^{[10, 11, 12]} ; Brennan, Peter A. ^[13] ; Coletta, Ricardo D. ^{[3, 1]}

Affiliation:Show less -

^[1] Univ Estadual Campinas, Sch Dent, Grad Program Oral Biol, Piracicaba - Brazil

^[2] Univ Western Sao Paulo UNOESTE, Presidente Prudente - Brazil

^[3] Univ Estadual Campinas, Sch Dent, Dept Oral Diag, Piracicaba - Brazil

^[4] Univ Helsinki, Dept Oral & Maxillofacial Dis, Helsinki - Finland

^[5] Univ Helsinki, Dept Pathol, Helsinki - Finland

^[6] Oulu Univ Hosp, Oulu - Finland

^[7] Univ Oulu, Med Res Ctr Oulu, Canc & Translat Med Res Unit, Oulu - Finland

^[8] Fundacao Oswaldo Cruz, Goncalo Moniz Inst, Salvador, BA - Brazil

^[9] Univ Fed Bahia, Sch Dent, Dept Propaedeut, Salvador, BA - Brazil

^[10] McGill Univ, Sir Mortimer B Davis Jewish Gen Hosp, Dept Otolaryngol Head & Neck Surg, Fac Med, Montreal, PQ - Canada

^[11] McGill Univ, Sir Mortimer B Davis Jewish Gen Hosp, Dept Expt Med, Segal Canc Ctr, Fac Med, Montreal, PQ - Canada

^[12] McGill Univ, Sir Mortimer B Davis Jewish Gen Hosp, Dept Expt Med, Lady Davis Inst Med Res, Fac Med, Montreal, PQ - Canada

^[13] Queen Alexandra Hosp, Dept Oral & Maxillofacial Surg, Portsmouth, Hants - England

• Document type: Review article
• Source: FRONTIERS IN ONCOLOGY; v. 11, NOV 10 2021.
• Web of Science Citations: 0

Abstract

ObjectiveOver many decades, studies on histopathological features have not only presented high-level evidence of contribution for treatment directions and prognosis of oral squamous cell carcinoma (OSCC) but also provided inconsistencies, making clinical application difficult. The 8th TNM staging system of OSCC has acknowledged the importance of some histopathological features, by incorporating depth of invasion (DOI) to T category and extranodal extension (ENE) to N category. The aim of this systematic review with meta-analysis is to determine the most clinically relevant histopathological features for risk assessment and treatment planning of OSCC and to elucidate gaps in the literature. MethodsA systematic review was conducted using PRISMA guidelines, and the eligibility criteria were based on population, exposure, comparison, outcome, and study type (PECOS). PubMed, Cochrane, Scopus, and Web of Science were searched for articles exploring the impact of histopathological features on OSCC outcomes with Cox multivariate analysis. Pooled data were subjected to an inverse variance method with random effects or fixed effect model, and the risk of bias was evaluated using quality in prognosis studies (QUIPS). Quality of evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. ResultsThe study included 172 articles published from 1999 to 2021. Meta-analyses confirmed the prognostic potential of DOI, ENE, perineural invasion, lymphovascular invasion, and involvement of the surgical margins and brought promising results for the association of bone invasion, tumor thickness, and pattern of invasion with increased risk for poor survival. Although with a small number of studies, the results also revealed a clinical significance of tumor budding and tumor-stroma ratio on predicted survival of patients with OSCC. Most of the studies were considered with low or moderate risk of bias, and the certainty in evidence varied from very low to high. ConclusionOur results confirm the potential prognostic usefulness of many histopathological features and highlight the promising results of others; however, further studies are advised to apply consistent designs, filling in the literature gaps to the pertinence of histopathological markers for OSCC prognosis. Systematic Review RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO), identifier CRD42020219630. (AU)

• FAPESP's process: 18/16077-6 - The prognostic value and biological role of overexpressed proteins in oral squamous cell carcinoma identified by mass spectrometry-based proteomic
• Grantee: Ricardo Della Coletta
• Support Opportunities: Regular Research Grants
• FAPESP's process: 17/26764-8 - The prognostic value and biological role of overexpressed proteins in oral squamous cell carcinoma identified by mass spectrometry-based proteomic
• Grantee: Mauricio da Rocha Dourado
• Support Opportunities: Scholarships in Brazil - Post-Doctoral