Association of worst pattern of invasion and depth of invasion in oral squamous cell carcinoma with clinicopathological parameters

Abstract Context: Head and neck carcinomas are one of the most common malignancies worldwide and account for 30% of all cancers in India. Amongst it, oral cavity carcinomas alone comprised 30% and 90% of these are squamous cell carcinoma. Evaluation of various patterns of invasion (POI) is a simple, inexpensive procedure which can be incorporated into routine reporting as advised in cancer protocol templates (CAP). Aim: To evaluate the association of worst pattern of invasion (WPOI) in oral squamous cell carcinoma (SCC) with clinicopathological factors. Settings and Design: Retrospective hospital-based study. Methods and Materials: Histopathological sections were reviewed for a duration of three years. All the relevant clinical and demographic data were obtained from the medical records. Cases were also analysed for all histopathological variables and results documented. Statistical Analysis Used: Data were analysed using SPSS software, and appropriate statistical tests were used for analysis. Results: The association between WPOI and clinicopathological parameters was evaluated using the Fischer’s exact/Chi-square test. Out of 52 patients, 38.5% ( n = 20) and 61.6% ( n = 32) had WPOI I–III and IV–V, respectively. There is significant association between WPOI score and N Stage, grade of tumour, perineural and depth of invasion. However, no association was observed with T stage, lymphovascular emboli, margin status, tumour, and lymph node size. Conclusions: The pattern of invasion is an easily recognizable histopathological variable which must be included in the reporting of oral SCCs. WPOI IV and V had a worse clinical outcome and are associated with PNI, DOI, and high-grade tumour.