Inter-Correlations Between Various High-Risk Pathological Factors in Resected Buccal Mucosal Squamous Cell Carcinoma

Abstract

<h3>Purpose/Objective(s)</h3> While exploring histopathological high-risk factors for squamous cell oral cancer most studies have included oral tongue as major subsite in their patient population. Buccal mucosal squamous cell carcinoma (BMSCC) being rare in developed countries is a less studied site in this regard. Hence most of the knowledge we have about high-risk factors of BMSCC is extrapolated from oral tongue carcinoma. The objective of this study was to explore inter-correlations between various pathological high-risk factors found in resected specimen of BMSCC. <h3>Materials/Methods</h3> It was a retrospective analysis in which we reviewed the final histopathology of surgical specimen of 150 patients with BMSCC who had undergone upfront surgical resection followed by adjuvant therapy. Various high-risk factors studied were pT Stage, pN Stage, depth of invasion (DOI), grade, perineural invasion (PNI), lymphovascular invasion (LVI), tumor thickness (TT), worst pattern of invasion (WPOI), and extranodal extension (ENE). Inter-correlations were performed between various pathological factors using Spearman's correlation test. <h3>Results</h3> Inter-correlation between various factors were found and shown in Table. <h3>Conclusion</h3> pT stage showed significant positive correlation with pN stage, TT, DOI, PNI, nodal deposit size and with ENE. pN stage showed significant positive correlation with pT stage, PNI, LVI, WPOI and ENE. PNI showed significant positive correlation with pT stage, pN stage, nodal deposit size, ENE, LVI, DOI, TT, WPOI. LVI showed significant positive correlation with PNI, WPOI, pN stage, nodal deposit size and ENE. DOI showed significant positive correlation with pT stage, PNI, TT. TT showed significant positive correlation with pT stage, PNI and DOI. WPOI showed significant positive correlation with pN stage, frozen section margin, PNI, LVI and ENE. ENE showed significant positive correlation with pT stage, pN stage, PNI, LVI and WPOI. Grade, configuration and margin status of the tumor showed no significant association with any of the histopathologic variable. Many of these correlations are not shown in oral tongue cancer in most studies. Hence, it is appropriate that intercorrelation between these factors in BMSCC should be dealt differently than in oral tongue cancer. BMSCC may have different biology than oral tongue cancer.