Association of worst pattern of invasion in oral squamous cell carcinoma with clinicopathological parameters

Abstract

There is a paucity of literature regarding the association of various clinicopathological parameters with the different patterns of invasion including the worst pattern of invasion (WPOI). The current study aimed to evaluate the association of WPOI in oral squamous cell carcinoma (SCC) with clinicopathological factors. This was a retrospective study conducted on all newly diagnosed cases of oral SCC patients, who underwent resection surgery. The cases were evaluated for the WPOI, tumor budding, extra-nodal extension, perineural invasion (PNI), lympho-vascular emboli (LVE), depth of invasion (DOI), nodal metastasis, closest surgical margin and histological grade. The association between WPOI and clinicopathological parameters was evaluated using the Fischer exact/Chi-square test. Out of 71 patients, 61.9% (n = 44) and 38.1% (n = 27) had WPOI I-III and IV-V respectively. A significant association was seen between WPOI and tumor stage, nodal involvement, histological grade, LVE, PNI, DOI and tumor budding. However, no association was observed with extra-nodal extension and margin status. The patients with WPOI IV and V had nodal metastasis, a higher histological grade, a high tumor budding and lympho-vascular invasion. The pattern of invasion is an easily recognizable histopathological variable which must be included in routine reporting of oral SCCs. An infiltrative pattern has a worse clinical outcome and is associated with nodal metastasis, PNI and LVE.