Impact of the combination of the histopathological grading system with tumor budding, tumor-stroma ratio and tumor-infiltrating lymphocytes in the prognosis of early-stage oral squamous cell carcinomas.
Even in early clinical stages, a considerable fraction of the oral squamous cell carcinomas (OSCC) may present an aggressive behavior, with an increased tendency for local invasion, regional metastasis and recurrence after treatment. However, there are no parameters to differentiate patients that may present these tumors with a more aggressive behavior, who would benefit from a specific therapeutic approach, from those who present more indolent tumors. The WHO histological grading system is known to have a low predictive value for patients with OSCC, however, recent studies have shown that histopathological features, including tumor budding, tumor-stroma ratio (TSR) and tumor-infiltrating lymphocytes (TILs), are associated with an unfavorable prognosis for patients with OSCC. In this project, we intend to test the hypothesis that the incorporation of these histological parameters into the WHO histological grading system can help predict the prognosis of early-stage OSCC. The sample will consist of 115 cases of OSCC in the early clinical stage (T1N0M0 or T2N0M0). The samples, originally classified with the 7th edition of the TNM system, will be initially reclassified based on the 8th edition, taking into account the depth of invasion and extranodal extension. Cases reclassified at advanced stage will be excluded. Then, tumors will be classified according to the presence of tumor budding, TSRand TILs. All assessments will be carried out jointly by the student and the supervisor.Statistical tests will be applied to verify the association of the histological parameters,individually or in combination with the WHO histological grading system, with specificsurvival (death due to tumor) and disease-free survival (recurrence) of patients. It is expected that study improve the prognostic value of the histological parameters for OSCC in early stages, which may reflect future advances in the treatment of the disease.
News published in Agência FAPESP Newsletter about the scholarship: