Malignancy grading of invasive fronts of oral squamous cell carcinomas

Background: Clinical stage and pathology grading have consistently failed to predict survival in patients diagnosed with oral squamous cell carcinoma (OSCC). There is a need to develop a grading system that could have a predictive value in assessing the prognosis of patients with OSCC. The aim was to evaluate the prognostic significance of several parameters of the modified Bryne’s malignancy grading system. Methods: Malignancy grading of invasive fronts of 60 OSCCs from Sri Lankan subjects was undertaken using Bryne’s criteria. Results: Of the five morphological features assessed at the invasive fronts of the tumours, the range of scores derived for keratinization was low, and the host response in the stromal tissue was marked compared with reported series from European countries. There were no tumours scoring a malignancy grading under 9, regarded as tumours with a ‘good prognosis’. In logistic regression analysis among patient factors, age had a positive association on survival, and among tumour factors, the malignancy grading was significantly predictive of overall survival. Conclusions: Bryne’s malignancy grading is predictive of overall survival in patients with OSCCs.