Association of worst pattern of invasion with clinicopathological characteristics in oral squamous cell carcinoma: a retrospective study

Worst Pattern of Invasion

Abstract

Objective: Over the past few decades, research on a variety of prognostic histopathological indicators has been captivated by the biological aggressiveness of OSCC (Oral Squamous Cell Carcinoma). The association between the worst pattern of invasion (WPOI) with various clinicopathological characteristics is not well documented in the literature. The purpose of the present research was to assess the association of WPOI with clinicopathological factors in oral squamous cell carcinoma.

Study design: Retrospective study

Place and duration of study: Ziauddin University Hospital, Karachi, Pakistan from March 2023 to December 2024.

Patients and methods: The histological reports of forty-two OSCC patients who received primary surgery were reviewed in this retrospective study. The cases were assessed for the WPOI, perineural invasion (PNI), lympho-vascular invasion (LVI), depth of invasion (DOI), nodal status, histological grade and tumor staging. To assess the association between WPOI and clinicopathological characteristics, the Fisher's exact/Chi-square test was employed. To find significant risk factors for WPO-V, univariate logistic regression was employed. The data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 25.

Results: Of the 42 patients, 33.33% (n=14) and 66.66% (n=28) had WPOI I-IV and V respectively. There was a significant association between WPOI and site of tumor (0.005), histological grade (0.009), PNI (0.000), and tumor staging (0.000). However, there was no association seen with LVI, DOI or nodal status.

Conclusion: We have found significant association between WPOI and clinipathological characteristics in patients of OSCC. It is imperative to include the easily identifiable histological characteristic of the pattern of invasion when reporting oral SCCs. However, more detailed studies with a larger cohort are required for composing a definitive risk stratification module based on WPOI for OSCC.