Tertiary lymphoid structures associate with improved survival in early oral tongue cancer
Alhadi Almangush1,2,3,4, Ibrahim O Bello5,6, Amr Elseragy7,8
1Department of Pathology, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, Helsinki, N00014, Finland. alhadi.almangush@helsinki.fi.
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.
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