Original article / research
Year : 2025 Month : July Volume : 14 Issue : 3 Page : PO01 - PO04 Full Version

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
KR Anila, MS Bhuvitha, Shaji Thomas, Cessal T Kainickal, Aleyamma Mathew
1. Associate Professor, Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India. 2. Fellow in Oncopathology, Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India. 3. Additional Professor, Department of Surgical Services, Regional Cancer Centre, Thiruvananthapuram, Kerala, India. 4. Additional Professor, Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India. 5. Professor, Division of Cancer Epidemiology and Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
 
Correspondence Address :
Dr. KR Anila,
Associate Professor, Regional Cancer Centre, Thiruvananthapuram, Kerala-695011, India.
E-mail: anilavenu98@gmail.com
 
ABSTRACT
: 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.
Keywords : Local recurrence, Lymphocyte host response, Perineural invasion
DOI and Others : DOI: 10.7860/NJLM/2025/79537.2917 Date of Submission: Mar 25, 2025 Date of Peer Review: Apr 17, 2025 Date of Acceptance: May 02, 2025 Date of Publishing: Jul 01, 2025 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was Ethics Committee Approval obtained for this study? Yes • Was informed consent obtained from the subjects involved in the study? No • For any images presented appropriate consent has been obtained from the subjects. NA PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Mar 31, 2025 • Manual Googling: Apr 28, 2025 • iThenticate Software: May 30, 2025 (13%) ETYMOLOGY: Author Origin EMENDATIONS: 5
 
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