Association of Tumour Necrosis with Histopathological Prognostic Parameters in Oral Squamous Cell Carcinoma

Abstract

Background- Oral squamous cell carcinoma (OSCC) is the most common cancer in India but to the dismay, it has limited treatment modalities. This is a retrospective study on 50 cases of OSCC to evaluate association of tumour necrosis with histopathological parameters like tumour size, nodal involvement and depth of invasion. Methods- This was a retrospective study in which all resection specimens of OSCC operated over a one year period were included. The tumours were graded and staged according to the WHO classification. Tumour necrosis was graded semi-quantitatively as Grade 0- no necrosis, grade1- focal or <10% of total tumour area, moderate or grade 2- necrosis comprising 10-30% of the tumour area and extensive or grade 3- necrosis >30% of the tumour area. Necrosis grade was categorised into- low (Grade 0 and 1) and high (Grade 2 and 3). The association between tumour necrosis and histopathological parameters was evaluated using the Chi square test. Results- A total of 50 resection specimens were included in the study. Out of 50 cases, 14 (28%), 7 (14%), 21(42%), 8 (16%) were T4, T3, T2 and T1 respectively. 28(56%) cases showed low grade necrosis while 22(44%) cases exhibited high grade necrosis. The grade of necrosis showed significant association with depth of invasion, primary tumour size and grade of tumour. However, no association could be elicited between tumour necrosis and nodal status. Conclusions- Tumour necrosis is an easily recognizable histopathological variable which must be included in routine reporting of OSCCs. A higher grade of tumour necrosis is associated with greater tumour size, grade and depth of invasion.