Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Delhi Cancer Registry, BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Eur Arch Otorhinolaryngol. 2021 Dec;278(12):5029-5039. doi: 10.1007/s00405-021-06756-y. Epub 2021 Mar 20.
To evaluate tumor-host interface in oral squamous cell carcinoma (OSCC) by the Brandwein-Gensler histological risk score (BG risk score); to assess its association with clinicopathological features and impact on survival outcomes in a contemporary cohort staged as per AJCC 8th edition pTNM classification.
This retrospective cohort study at a tertiary care centre included 178 cases of OSCC treated by primary surgical resection from 2013 to 2016. Pathological lymph node status, disease-free survival (DFS), overall survival (OS) were assessed.
BG risk score assessment categorized 25 (14%) cases as low-risk, 93 (52%) as intermediate-risk, and 60 (34%) as high-risk. BG risk score category progression from low to intermediate to high risk was associated with an incremental risk of worsening pN status, DFS, and OS. BG risk score categories significantly demarcated 2-year DFS (96% in low-risk, 51.6% in intermediate-risk, 15% in high-risk; p < 0.001) and OS (96% in low-risk, 66.7% in intermediate-risk, 31.3% in high-risk; p < 0.001). On stratified analysis, BG risk score could further demarcate prognosis in early (I/II) and late (III/IV) stage subgroups (p < 0.001). Multivariate analysis indicated the prognostic impact of BG risk score categories to be additional to, and of equal magnitude to, impact of pTNM stage.
BG risk score is a powerful prognostic tool in OSCC additional to pTNM staging. It can enable risk stratification and inform decisions regarding post-surgical adjuvant treatment. It is undertaken with routine histopathological evaluation, with no increased expense or turnaround time. A case is made for its inclusion in OSCC reporting guidelines.
通过 Brandwein-Gensler 组织学风险评分（BG 风险评分）评估口腔鳞状细胞癌（OSCC）中的肿瘤-宿主界面；评估其与临床病理特征的相关性，并根据 AJCC 第 8 版 pTNM 分类评估在当代队列中的生存结局。
本回顾性队列研究在一家三级护理中心进行，纳入了 2013 年至 2016 年期间通过原发性手术切除治疗的 178 例 OSCC 病例。评估了病理淋巴结状态、无病生存（DFS）和总生存（OS）。
BG 风险评分评估将 25 例（14%）病例归类为低风险，93 例（52%）为中风险，60 例（34%）为高风险。BG 风险评分从低到中到高的类别进展与 pN 状态恶化、DFS 和 OS 风险增加相关。BG 风险评分类别显著区分了 2 年 DFS（低风险组为 96%，中风险组为 51.6%，高风险组为 15%；p<0.001）和 OS（低风险组为 96%，中风险组为 66.7%，高风险组为 31.3%；p<0.001）。分层分析表明，BG 风险评分在早期（I/II 期）和晚期（III/IV 期）亚组中也能进一步区分预后（p<0.001）。多变量分析表明，BG 风险评分类别的预后影响与 pTNM 分期的影响同等重要，且是额外的。
BG 风险评分是 OSCC 中除 pTNM 分期之外的一种强大的预后工具。它可以进行风险分层，并为术后辅助治疗决策提供信息。该评分是在常规组织病理学评估的基础上进行的，不会增加费用或周转时间。建议将其纳入 OSCC 报告指南。
