A correlation of Worst Pattern of Invasion (WPOI) and Tumor budding (TB) with clinicopathological factors in oral squamous cell carcinoma (OSCC).

BACKGROUND

Squamous Cell Carcinoma (SCC) of the oral cavity is the most common malignancy of the head and neck region and is known for its aggressive behavior with a high rates of recurrence and metastasis.

MATERIALS AND

METHODS

A total of 73 patients of surgically resected cases of oral squamous cell carcinoma from January 2021 to December 2021 with or without adjuvant therapy were included. Worst Pattern of Invasion (WPOI) and Tumor budding (TB) were evaluated on routine hematoxylin and eosin-stained sections and these were correlated with clinicopathological parameters. Statistical analysis was conducted by using Chi-square test and multivariate logistic regression model. A P value < .05 considered significant.

RESULT: The mean age was 44 ± 12.57 and M: F of 6.3:1. Most of the tumors were located on buccal mucosa (47.9%) and tongue (32.8%). Lip, alveolus and floor of the mouth were the other sites involved constituting 9.5% (n = 7), 6.8% (n = 5) and 2.7% (n = 2), respectively. Both WPOI and TB in oral squamous cell carcinoma (OSCC) was found to be significantly associated with stage of the tumor and metastasis to lymph node with P value <0.5. Depth of invasion >1 cm was found in 64.3% of the cases (n = 47), which was found to be significantly associated with WPOI (P = 0.004) and TB (P = 0.04). We also found a significant association of TB with Perineural invasion (PNI) (0.003). A significant association of WPOI and TB with a P value of 0.012 was also found. On multivariate analysis the lymph node metastasis was found to be significantly associated with high WPOI (IV, V) and PNI.

CONCLUSION

Both WPOI and TB are found to be significantly associated with the clinicopathological factors like stage, Depth of invasion (DOI), and metastatic lymph nodes. They are highly reproducible and can be easily evaluated on routine H and E sections, thus proving to be cost effective in a resource poor setting. They can be used as independent prognostic markers in OSCC and thus help in deciding the treatment plan for the patients.