Study of clinicopathological factors related to recurrence, metastasis, and prognosis in lower gingival squamous cell carcinoma

Abstract

Lower gingival squamous cell carcinoma (LGSCC) poses a unique challenge in oncology due to its frequent early bone invasion, a characteristic stemming from its anatomical location. This often results in an overrepresentation of T4 staging within the traditional TNM system, which primarily relies on tumor size and extent. Consequently, the TNM staging may not accurately reflect the true biological behavior and prognosis of LGSCC, as it neglects other critical factors influencing disease progression. This study aimed to address this discrepancy by investigating the limitations of the current TNM system in predicting LGSCC outcomes and identifying additional prognostic factors that could contribute to a more comprehensive and accurate risk assessment. To investigate the limitations of the standard TNM staging system in lower gingival squamous cell carcinoma (LGSCC), a retrospective analysis was performed on 104 patients treated at Hokkaido University Hospital. This study expanded beyond traditional TNM staging by incorporating detailed histopathological evaluations, including YK classification for bone invasion, worst pattern of invasion (WPOI), grade of differentiation, and depth of invasion (DOI). Utilizing Kaplan-Meier survival analysis and chi-squared tests, the study aimed to identify additional prognostic factors that could refine risk assessment, demonstrating that DOI, patient age, and WPOI, in conjunction with traditional T staging, significantly influence disease outcomes, emphasizing the necessity of incorporating histopathological features for more accurate LGSCC prognostication.