New malignancy grading is a better prognostic indicator than Broders' grading in oral squamous cell carcinomas

TLDR

The prognostic significance of histopathologic grading in oral squamous cell carcinoma has been inconsistent, ranging from negligible to highly predictive. We retrospectively examined 130 oral SCCs from Norway (1963‑72), obtained biopsy specimens from 68 cases, and compared Broders’ grading with a modified malignancy grading system applied only to the most invasive tumor areas. Cox multivariate analysis revealed that grading within invasive sites was a highly significant prognostic factor, whereas Broders’ grade and tumor stage also showed prognostic value, indicating that invasive areas largely determine clinical behavior.

Abstract

The prognostic value of histopathologic grading of oral squamous cell carcinomas (SCC) has varied from not any to highly significant. We have retrospectively studied all (130) SCCs registered in Norway 1963‐72 in the buccal and maxillary alveolar mucosa. From 68 of these cases biopsy specimens of accetable quality were obtained. B roders ’method of grading was compared with a modification of a recent malignancy grading system recommended by A nneroth et al. which was performed only within the histologically most invasive areas of the tumors. Cox's multivariate survival analyses showed that this grading in the invasive sites had highly significant prognostic value. B roders grade had no prognostic value. The stage of tumor had also prognostic value. These highly significant results indicate that the histologically invasive areas may be primarily responsible for the clinical behavior of the tumor, and this may be of importance for the choice of therapy for oral SCC.