CORRELATION OF HISTOLOGICAL RISK ASSESSMENT/ SCORING SYSTEM WITH LYMPH NODE METASTASIS AND RECURRENCE/PROGRESSION OF DISEASE IN ORAL SQUAMOUS CELL CARCINOMA

Histological Risk Assessment in OSS

Abstract

Objective: To correlate the scoring system using histopathologic parameters; worst pattern of invasion (WPOI), lymphocytic host response (LHR) and peri-neural invasion (PNI), with disease recurrence, overall survival and cervical lymph node metastasis in OSCC patients.

Study Design: Cross sectional.

Place and Duration of Study: Department of Histopathology, Shaukat Khanam Memorial Cancer and Research Hospital, Lahore in collaboration with Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi. Study completed in 2 years.

Material and Methods: A “Risk Scoring system” was applied to 50 cases of OSCC with 2 years follow-up data, based on histopathologic parameters WPOI, LHR and PNI. The cases were divided into High risk and Non-High risk categories according to the specified parameters and then correlated with disease recurrence, overall survival and cervical lymph node metastasis.

Results: There were 7 low risk, 17 intermediate risk and 26 high risk cases. No correlation was seen between the risk groups and disease recurrence, overall survival or cervical lymph node metastasis. However, when assessing the individual parameters, significant correlation was observed between PNI with disease recurrence (p = 0.03), and between WPOI and overall survival (p = 0.02) and cervical lymph node metastasis  (p = 0.005).

Conclusion: The individual parameters, peri-neural invasion and worst pattern of invasion are observed to be significant prognostic indicators in OSCC patients. A study with a larger number of cases is required to truly assess the value of the scoring system in Pakistani patients.