The Prognostic Value of Worst Pattern of Invasion-5 on Low-Risk and Early-Stage Oral Tongue Cancer.

Abstract

To evaluate the prognostic value of the worst pattern of invasion-5 (WPOI-5) for patients with pathologically early-stage and low-risk oral tongue squamous cell carcinoma (OTSCC). A total of 224 patients treated between 2005 and 2016 were analyzed. WPOI-5 was defined as tumor satellites ≥ 1 mm from the main tumor or nearest satellite. Its prognostic impact on cancer-specific survival (CSS) and locoregional recurrence-free survival (LRRFS) was assessed, and a WPOI-5-based nomogram was developed. Patients with WPOI-5 had significantly worse 5-year CSS and LRRFS (both p < 0.001). In Cox analysis, WPOI-5 independently predicted poorer CSS (HR 6.908, p = 0.006) and LRRFS (HR 14.910, p < 0.001). Adding WPOI-5 improved the nomogram's 5-year LRRFS AUC from 0.789 to 0.842. WPOI-5 is an adverse prognostic factor in pathologically early-stage, low-risk OTSCC and may justify trials of adjuvant therapy in these patients.