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- Title
Worst pattern of invasion in oral squamous cell carcinomas: Assessing the prognosis of malignancy from its invasive front.
- Authors
Jadhav, Toyaja M.; Malik, Ajay; Shelly, Divya; Kashif, Ahmed Waheed; Sahu, Rajesh; Gupta, Samir; Tyagi, Arvind K.
- Abstract
Background: Oral squamous cell carcinoma (OSCC) is one of the commonest malignancies worldwide and in India. Its prognosis can be determined by various clinicopathological parameters, an important one being the worst pattern of invasion (WPOI). The present study was undertaken to assess the prognostic value of WPOI and its correlation with other prognostic parameters in determining the outcome of OSCC, correlation of these parameters with the clinical outcome, and to verify the histological risk assessment score (HRS) proposed by Brandwein-Gensler et al. in 2005. Methods and Material: In this retrospective descriptive study, 194 cases of OSCC were evaluated with at least two years of follow-up data, histopathologically for their WPOI, depth of invasion (DOI), perineural invasion (PNI), lymphovascular invasion (LVI), and lymph node metastasis with extranodal extension along with clinical outcome in the form of locoregional recurrence (LRR) and disease-specific survival (DSS). Cases were also categorized as high risk, intermediate risk, and low risk based on their WPOI and the HRS. These features were statistically correlated with WPOI and compared with the patient clinical outcome. Results: Statistically significant association was noted between WPOI and sex, histological grade, tumor and nodal stage, DOI and site of recurrence. Although no statistically significant correlation was seen between WPOI and the clinical outcomes, WPOI showed a statistically significant correlation with HRS. Also, HRS showed a significant correlation with DSS. Conclusions: WPOI, histological grade, DOI, LHR, PNI, LVI and tumor and nodal stage can be entrusted to assess the prognosis of OSCC. Of these, WPOI is the single most reliable marker for assessing the HRS-based risk status of OSCC. This study validates the HRS proposed by Brandwein-Gensler et al.
- Subjects
DISEASE risk factors; SQUAMOUS cell carcinoma; TREATMENT effectiveness; PROGNOSIS; LYMPHATIC metastasis
- Publication
Indian Journal of Cancer, 2024, Vol 61, Issue 3, p595
- ISSN
0019-509X
- Publication type
Academic Journal
- DOI
10.4103/ijc.ijc_846_21