Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas

TLDR

The study reviews histologic grading systems for head and neck squamous cell carcinoma and outlines requirements for correlating grade with recurrence and survival. The review examines grading systems, discusses sources of variability and errors, and identifies key methodological factors such as patient selection, staging, follow-up, treatment modalities, margin status, and metastatic spread.

Abstract

A review of histologic classification systems for grading of malignancy in squamous cell carcinomas of the head and neck region is presented. Reasons behind the varying results obtained in studies using histomorphologic grading schemes are presented and potential errors involved in this type of clinical research are discussed. Requirements for the study of correlations between malignancy grade scoring, and recurrence and survival rates are presented. These include factors as patient selection, clinical staging, and follow-up principles. Special attention must be given to treatment modalities, establishment of negative surgical margins and occurrence of regional lymph node and/or distant metastases.