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New malignancy grading is a better prognostic indicator than Broders' grading in oral squamous cell carcinomas.

The prognostic value of histopathologic grading of oral squamous cell carcinomas (SCC) has varied from not any to highly significant. We have retrospectively studied all (130) SCCs registered in Norway 1963-72 in the buccal and maxillary alveolar mucosa. From 68 of these cases biopsy specimens of acceptable quality were obtained. Broders' method of grading was compared with a modification of a recent malignancy grading system recommended by Anneroth et al. which was performed only within the histologically most invasive areas of the tumors. Cox's multivariate survival analyses showed that this grading in the invasive sites had highly significant prognostic value. Broders grade had no prognostic value. The stage of tumor had also prognostic value. These highly significant results indicate that the histologically invasive areas may be primarily responsible for the clinical behavior of the tumor, and this may be of importance for the choice of therapy for oral SCC.