Comparison of Worst Pattern of Invasion with Other Histopathological Prognostic Indicators in Oral Cavity Squamous Cell Carcinoma: A Cohort Study from Regional Cancer Centre, Thiruvananthapuram, Kerala, India
Introduction: Oral Cavity Squamous Cell Carcinoma (OCSCC) is one of the most common cancers worldwide and a leading cause of morbidity and mortality in certain parts of the world like South-Central Asia. In the year 2005, the histologic risk assessment model was introduced by Brandwein Gensler for O...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2025-07-01
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| Series: | National Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | https://njlm.net/article_FULLTEXT.aspx?issn=0973-709x&year=2025&month=July&volume=14&issue=3&page=PO01%20-%20PO04&id=2917 |
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| Summary: | Introduction: Oral Cavity Squamous Cell Carcinoma (OCSCC) is one of the most common cancers worldwide and a leading cause of morbidity and mortality in certain parts of the world like South-Central Asia. In the year 2005, the histologic risk assessment model was introduced by Brandwein Gensler for OCSCC to predict disease outcome and included risk factors like Perineural Invasion (PNI), Worst Pattern Of Invasion (WPOI), and Lymphocyte Host Response (LHR), which have a strong association with Local Recurrence (LR), Disease-Free Survival (DFS) and Overall Survival (OS).
Aim: To evaluate WPOI in OCSCC and analyse its association with other histopathological prognostic indicators in patients who have undergone primary surgery.
Materials and Methods: This cohort study was conducted in Department of Pathology at Regional Cancer Centre, Thiruvananthapuram, Kerala, India, from January 2023 to December 2023. A total of 100 cases of OCSCC diagnosed and treated between January 2018 and December 2021 were reviewed and clinical, histopathological and treatment data were analysed. The histopathological features analysed included grade, Lymphovascular Invasion (LVI), PNI, WPOI, LHR, tumour size, Depth of Invasion (DOI), margin status, bone invasion and lymph node status. The follow-up details of patients with respect to recurrences or terminal event was recorded from the medical records as of December 2023. Statistical Package for the Social Sciences (SPSS) version 28.0 was used for analysis. Chi-square tests and Fisher’s exact test were used to analyse association between WPOI in OCSCC and other histopathologic prognostic indicators. A p-value of <0.05 was considered significant.
Results: Most common pattern of invasion was WPOI 4, comprising 61 patients. WPOI 3 was present in 38 patients and only one case with WPOI 5. A statistical significance between WPOI 4 and the presence of PNI and LVI, with p-values of 0.017 and 0.012, was observed. There was no statistical significance between cancer stage and POI (p-value=0.885), LHR and POI (p-value=0.686), or tumour differentiation/grade and POI (p-value=0.298). The OS for POI 3 was 97.1%, while OS for POI 4 was only 86%.
Conclusion: This outcome demonstrates that the existence of WPOI 4 may be a predictive factor of the presence of LVI and PNI, which are established risk factors of aggressive tumour behaviour and poor prognosis in OCSCC. |
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| ISSN: | 2277-8551 2455-6882 |