Tertiary lymphoid structures associate with improved survival in early oral tongue cancer
Alhadi Almangush,
Ibrahim O. Bello,
Amr Elseragy,
Jaana Hagström,
Caj Haglund,
Luiz Paulo Kowalski,
Pentti Nieminen,
Ricardo D. Coletta,
Antti A. Mäkitie,
Tuula Salo,
Ilmo Leivo
Affiliations
Alhadi Almangush
Department of Pathology, University of Helsinki
Ibrahim O. Bello
Department of Pathology, University of Helsinki
Amr Elseragy
Cancer and Translational Medicine Research Unit, University of Oulu
Jaana Hagström
Department of Pathology, University of Helsinki
Caj Haglund
Research Programs Unit, Translational Cancer Medicine, University of Helsinki
Luiz Paulo Kowalski
Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, and University of Sao Paulo Medical School, Department of Head and Neck Surgery
Pentti Nieminen
Medical Informatics and Data Analysis Research Group, University of Oulu
Ricardo D. Coletta
Department of Oral Diagnosis and Graduate Program in Oral Biology, School of Dentistry, University of Campinas
Antti A. Mäkitie
Faculty of Medicine, Research Program in Systems Oncology, University of Helsinki
Tuula Salo
Department of Pathology, University of Helsinki
Ilmo Leivo
Institute of Biomedicine, Pathology, University of Turku
Abstract Background The clinical significance of tertiary lymphoid structures (TLSs) is not well-documented in early oral tongue squamous cell carcinoma (OTSCC). Methods A total of 310 cases of early (cT1-2N0) OTSCC were included in this multicenter study. Assessment of TLSs was conducted on hematoxylin and eosin-stained sections. TLSs were assessed both in the central part of the tumor and at the invasive front area. Results The presence of TLSs associated with improved survival of early OTSCC as presented by Kaplan–Meier survival analyses for disease-specific survival (P = 0.01) and overall survival (P = 0.006). In multivariable analyses, which included conventional prognostic factors, the absence of TLSs associated with worse disease-specific survival with a hazard ratio (HR) of 1.96 (95% CI 1.09–3.54; P = 0.025) and poor overall survival (HR 1.66, 95% CI 1.11–2.48; P = 0.014). Conclusion Histological evaluation of TLSs predicts survival in early OTSCC. TLSs showed superior prognostic power independent of routine WHO grading and TNM staging system.
