Worst Pattern of Invasion as an Independent Predictor of Lymph node Metastasis and Prognosis in oral Cavity Squamous cell carcinoma - A Retrospective Cohort Study
© Association of Otolaryngologists of India 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law..
Although Worst pattern of invasion (WPOI) is one of the histopathological (HP) markers that has been utilized in risk stratification of oral squamous cell carcinoma (OSCC) patients, its potential as an independent predictive factor for lymph node metastasis (LNM) and prognosis is least analyzed. Aim of the study is to analyze the relationship of various HP parameters to WPOI, their propensity for lymph node metastasis and prognostic value. This retrospective study included 140 patients diagnosed with resectable OSCC who underwent definitive surgery. Multiparametric HP risk assessment was done on the postoperative specimen and patients were categorized as low-risk WPOI (Type 1-3), and high-risk group (type 4 and 5). After categorization, 36.1% patients had low-risk WPOI and 63.9% had high-risk WPOI. Significant association was noted between WPOI and patient's age (p = 0.001), nodal stage (p = 0.001), lymphovascular invasion (LVI) (p = 0.006) and neural invasion (p = 0.001). 87% patients with nodal metastasis had high risk WPOI. LVI (p = 0.014) and WPOI (p < 0.001) had significant predictive role in LNM. High-risk WPOI and bone involvement were found to be predictive factors for overall survival, and only high risk WPOI had strong correlation with disease free survival having significant poor prognosis. Analyzing WPOI is essential in reporting HP specimens in OSCC. High-risk WPOI can act as an independent predictor for LNM, early recurrence and poor prognosis. Incorporation of WPOI into TNM staging is recommended to improve clinician's ability to prognosticate and individualize treatment strategies.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:75 |
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| Enthalten in: |
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India - 75(2023), 2 vom: 12. Juni, Seite 440-449 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Anto, Ronald [VerfasserIn] |
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| Links: |
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| Themen: |
Disease free survival |
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| Anmerkungen: |
Date Revised 28.09.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1007/s12070-022-03193-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Although Worst pattern of invasion (WPOI) is one of the histopathological (HP) markers that has been utilized in risk stratification of oral squamous cell carcinoma (OSCC) patients, its potential as an independent predictive factor for lymph node metastasis (LNM) and prognosis is least analyzed. Aim of the study is to analyze the relationship of various HP parameters to WPOI, their propensity for lymph node metastasis and prognostic value. This retrospective study included 140 patients diagnosed with resectable OSCC who underwent definitive surgery. Multiparametric HP risk assessment was done on the postoperative specimen and patients were categorized as low-risk WPOI (Type 1-3), and high-risk group (type 4 and 5). After categorization, 36.1% patients had low-risk WPOI and 63.9% had high-risk WPOI. Significant association was noted between WPOI and patient's age (p = 0.001), nodal stage (p = 0.001), lymphovascular invasion (LVI) (p = 0.006) and neural invasion (p = 0.001). 87% patients with nodal metastasis had high risk WPOI. LVI (p = 0.014) and WPOI (p < 0.001) had significant predictive role in LNM. High-risk WPOI and bone involvement were found to be predictive factors for overall survival, and only high risk WPOI had strong correlation with disease free survival having significant poor prognosis. Analyzing WPOI is essential in reporting HP specimens in OSCC. High-risk WPOI can act as an independent predictor for LNM, early recurrence and poor prognosis. Incorporation of WPOI into TNM staging is recommended to improve clinician's ability to prognosticate and individualize treatment strategies | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Oral squamous cell carcinoma | |
| 650 | 4 | |a Worst Pattern of Invasion | |
| 650 | 4 | |a disease free survival | |
| 650 | 4 | |a lymph node metastasis | |
| 650 | 4 | |a overall survival | |
| 650 | 4 | |a prognosis | |
| 700 | 1 | |a Vidya, Konduru |e verfasserin |4 aut | |
| 700 | 1 | |a Thomas, Meera |e verfasserin |4 aut | |
| 700 | 1 | |a Tirkey, Amit Jiwan |e verfasserin |4 aut | |
| 700 | 1 | |a Agarwal, Mansi |e verfasserin |4 aut | |
| 700 | 1 | |a Riju, Jeyashanth |e verfasserin |4 aut | |
| 700 | 1 | |a Patil, Shruthi |e verfasserin |4 aut | |
| 700 | 1 | |a Bhandari, Subhan |e verfasserin |4 aut | |
| 700 | 1 | |a Rekha |e verfasserin |4 aut | |
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