Tongue tumor and prognostic factors: Could a diagnostic procedure influence patient outcomes?

OBJECTIVES: Diagnosis of tongue tumors is often performed in primary care centers with an incisional biopsy using stitches in the lesion at the end of the procedure. We hypothesize that stitches placed in tumor tissue could potentially increase local inflammation and significantly affect the tumor microenvironment, influencing the cancer spread and local relapses. MATERIALS AND METHODS: We conducted a retrospective study involving a consecutive series of 299 patients with Oral Tongue Squamous Cell Carcinoma (OTSCC). The study population was divided into two groups: Group 1 consisting of patients who did not receive stitches during the biopsy and, Group 2 composed by patients who had stitches placed in the tumor at the time of diagnosis. All data collected were statistically analyzed. RESULTS: The use of stitches during biopsy was associated with a negative prognostic role in Disease Free Survival (DFS), Disease Specific Survival (DSS) and a worsening trend in cause specific overall survival (cs-OS) for early stages (I-II) OTSCC. This negative prognostic impact was confirmed in the cumulative multivariable analyses of the DFS and DSS curves for stages I-II. The negative prognostic impact was not observed for patients with advanced-stage carcinoma and for OS. CONCLUSION: Our analysis suggested that the placement of stitches during biopsy in patients with early OTSCC may worsen outcomes in terms of DFS and DSS. We recommend evaluating whether stitches are truly necessary during biopsy or if they could be avoided altogether by using less invasive biopsy techniques.