HISTOLOGICAL GRADING IN THE DEEP INVASIVE FRONT OF T1 AND T2 GLOTTIC SQUAMOUS-CELL CARCINOMAS HAS HIGH PROGNOSTIC VALUE

The characteristics of the deep invasive front area of squamous cell c arcinomas may reflect tumour prognosis better than other parts of the tumour. Consequently, the authors have recently developed a simple mal ignancy grading system based solely on the characteristics of the deep invasive front area of oral squamous cell carcinomas, which has great prognostic value. Our previous materials were somewhat heterogeneous, and the prognostic value of our system needed to be confirmed in homo geneous patient material. In the present study of 95 T1-2/NO glottic c arcinomas all treated by radiation, the high prognostic value for inva sive front grading of biopsy specimens is confirmed. The grading signi ficantly predicted local recurrence, i.e. treatment failure (P=0.001). Histological characteristics of the deep invasive front proved to be a better indicator of prognosis than the T-category (size of tumour), and our findings may be of value in the selection of treatment. Of the individual variables in the grading system (pattern of invasion, degr ee of keratinization, nuclear poly morphism and host response), patter n of invasion and degree of keratinization were the strongest prognost icators in the multivariate analyses. Invasive front characteristics m ay also prove to be of prognostic value in other cancers.