Prognostic Role of Histological Scoring of Oral Squamous Cell Carcinoma

Abstract

Introduction: Diagnosis of oral squamous cell carcinomas require assessment of parameters like histologic grade, tumour depth of invasion, lymphovascular invasion, perineural invasion, margin status, worst pattern of Invasion, But for treatment purpose only Tumour, Nodes and Metastases (TNM) staging is given importance. Aim: To develop a scoring system based on different histopathological tumour characteristics and to know its prognostic role in oral squamous cell carcinomas. Materials and Methods: This retrospective study was conducted in Department of Pathology at Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh, India, from September 2011 to August 2016 and data was followed-up for 5 years, upto August 2021. Resection of primary oral lesions with cervical lymph nodal dissection were included in the study, while cases of non squamous cell carcinomas, variants of squamous cell carcinoma, post radiotherapy cases, defaulted cases, patients who lost for follow-up were excluded. The Histoscore (H score) was obtained by the scores of all histopathological tumour characteristics and it ranged from 2 to 11.This H score was divided into three groups and mean survival period of these three Histoscore Groups (HS groups) were calculated for their prognostic use (Group 1 has score 2 to 5, Group 2 has score 6 to 8, Group 3 has score 9 to 11). Medians and ranges were used to summarize continuous data, while frequency counts and percentages were used for categorical data. Kaplan-Meier’s analysis was used for evaluating 5 years survival. The p-value <0.05 was considered as statistically significant. Results: A total of 90 cases were studied. Mean survival period was compared to HS groups, Group 1 had 64±7.59 months, Group 2 had 40.8±11.88 months, Group 3 had 26.06±12.25 months with a p-value <0.001, indicating it as a statistically significant parameter. Based on TNM staging, majority were in T2 (N=41,45.55%), N1(N=34,37.77%) and Mx (N=87,96.66%). Conclusion: Histoscore groups of the oral squamous cell carcinomas have significant differences in the mean survival period among themselves. Hence, this histoscore groups can be an additive to the TNM classification, which provide more prognostic information to the oncologists.