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

Marilena Vered*, Dan Dayan, Alex Dobriyan, Ran Yahalom, Bruria Shalmon, Iris Barshack, Lev Bedrin, Yoav P. Talmi, Shlomo Taicher

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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 ≥3 were classified as high with respect to recurrence and survival. Margins were considered as "clean" if the tumor was ≥5 mm away from them, otherwise they were defined as "positive". Patients ≥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.

Original languageEnglish
Pages (from-to)1039-1048
Number of pages10
JournalJournal of Cancer Research and Clinical Oncology
Issue number7
StatePublished - Jul 2010


  • Age
  • Histopathologic risk score
  • Margin status
  • Recurrence
  • Tongue cancer


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