Stroma AReactive invasion Front Areas (SARIFA) in early-stage oral tongue squamous cell carcinoma

: Almangush, Alhadi; Faisal, Muhammad; Haglund, Caj; Kowalski, Luiz Paulo; Hagström, Jaana; Coletta, Ricardo D.; Mäkitie, Antti A.; Salo, Tuula; Leivo, Ilmo

: 2026

Oral Oncology

: 107936

: 176

: 1368-8375

: 1879-0593

DOI: https://doi.org/10.1016/j.oraloncology.2026.107936

: https://doi.org/10.1016/j.oraloncology.2026.107936

: https://research.utu.fi/converis/portal/detail/Publication/516251971

Background

Stroma AReactive Invasion Front Areas (SARIFA) has recently been introduced as a prognostic indicator. The prognostic value of SARIFA has not been studied in early-stage oral tongue squamous cell carcinoma (OTSCC).

Material and methods

A total of 287 cases of early-stage OTSCC were included in this multicenter study. SARIFA was defined as direct contact between tumor cells and the adipose tissue, and was assessed in hematoxylin and eosin (HE)-stained sections.

Results

In early-stage OTSCC, SARIFA-positive tumors were associated with worse disease-specific survival with a hazard ratio (HR) of 1.86 (95% CI 1.06–3.28, P = 0.032), overall survival (HR 1.52, 95% CI 1.06–2.19, P = 0.023) and disease-free survival (HR 1.79, 95% CI 1.09–2.93, P = 0.021).

Conclusions

SARIFA is a histomorphology-based prognosticator, that can identify cases with early-stage OTSCC who might benefit from a multimodality treatment protocol.

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This research has been funded by The Finnish Cancer Society, Turku University Hospital Fund, Finska Läkaresällskapet, Maritza and Reino Salonen Foundation and the Sigrid Jusélius Foundation.