A Predictive Model to Determine the Pattern of Nodal Metastasis in Oral Squamous Cell Carcinoma

Abstract

Background Developing histological prediction models that estimate the probability of developing metastatic deposit will help clinicians to identify individuals who need either radical or prophylactic neck dissection, which leads to better prognosis. Identification of accurate predictive models in oral cancer is important to overcome extensive prophylactic surgical management for neck nodes. Therefore, accurate prediction of metastasis in oral cancer would have an immediate clinical impact, especially to avoid unnecessary radical treatment of patients who are at a low risk of metastasis. Methods Histologically confirmed OSCC cases with neck dissection were used. Interrelation of demographic, clinical, and histological data was done using univariate and multivariate analysis. Results 465 cases were used and presence of metastasis and extracapsular invasion were statistically well correlated with level of differentiation (p < 0.001) and pattern of invasion (p < 0.001). Multivariate analysis showed level of differentiation, pattern of invasion, and stage as predictors of metastasis. Conclusions The proposed predictive model may provide some guidance for maxillofacial surgeons to decide the appropriate treatment plan for OSCC, especially in developing countries. This model appears to be reliable and simple and may guide surgeons in planning surgical management of neck nodes.

Development of clinico-histopathological predictive model for the assessment of metastatic risk of oral squamous cell carcinoma

“…[ 14 18 ] Many individual predictive models have been developed in the past that can assess the metastatic risk or survival of OSCC patients. [ 2 ] However, there are meager studies that have employed combined clinical and histopathological variables to assess the metastatic risk of OSCC. Hence, there is a need to identify the risk factors involved in metastasis for the development of therapeutic strategies to improve prognosis and survival in OSCC patients.…”

“…However, due to its multifactorial etiology, it is difficult to recognize a single etiological factor for oral cancer metastasis. [ 2 ]…”

“…Therefore, an attempt has been made to develop a model using clinical and histopathologic parameters that may help the clinician in customizing the treatment plan for each case. [ 2 ]…”

Impact of Histological and Molecular Parameters on Prognosis of Oral Squamous Cell Carcinoma: Analysis of 290 Cases

“…Therefore, we focused on some of the patient- and tumour-related factors, such as demographic data, anatomic site, tumour stage, lymph node metastasis, POI, histological grading, and expression of selected molecular markers. Although many studies have attempted to analyse various combinations of these factors, a model with reliable practical implications for the management of OSCC is yet to be developed [ 25 – 27 ].…”

Pathoradiological association between depth of invasion and neck node metastasis in oral cavity tumours

“…3,4 Cervical lymph node metastasis has remained the most important prognostic factor. 1,2,[4][5][6][7][8] However, many previous studies have studied different predictive factors for cervical nodal metastasis in oral carcinoma among which depth of tumour invasion (DOI) is the most important. 2,[4][5][6][8][9][10][11][12] Hence, we conducted the study to know whether the increase in the depth of invasion in oral cavity carcinoma assessed histopathologically and radiologically co-relates with neck node metastasis and to accurately co-relate radiological thickness at which neck dissection is required.…”