Worst Pattern of Invasion in Oral Squamous Cell Carcinoma - An Independent Prognostic Predictor

Authors

  •   K. Praveen Department of Pathology, Tirunelveli Medical College and Hospital, Tirunelveli - 627001, Tamil Nadu
  •   Mahalakshmi Department of Pathology, Tirunelveli Medical College and Hospital, Tirunelveli - 627001, Tamil Nadu
  •   Arasi Rajesh Department of Pathology, Tirunelveli Medical College and Hospital, Tirunelveli - 627001, Tamil Nadu

DOI:

https://doi.org/10.65129/health.v1i3.92

Keywords:

Depth of invasion, Oral squamous cell carcinoma, Prognostic predictor, Perineural invasion, Worst pattern of invasion

Abstract

Introduction: Oral Cavity Squamous Cell Carcinoma (OCSCC) shows an increasing trend in their incidence and some of them are aggressive and present with recurrence. Identification of pathologic prognosticators in early-stage OCSCC is prudent to aid selection of patients who may benefit from adjuvant chemotherapy. The objective of this study was to evaluate the prognostic ability of Worst Pattern of Invasion I-V (WPOI I-V) in early stage OCSCC. Many studies have reported WPOI I-V as an adverse prognostic factor associated with poor prognosis. However, these factors are not considered while planning for treatment protocols and disease-free survival rates. Case Details: 30 patients with early stage OCSCC who underwent treatment, from January 2024 – June 2024 was analysed. Materials and Methods: This is a prospective study of 30 patients. Clinicodemographic and histopathological details was extracted from the records. Univariate and multivariate analysis was done for the parameters. WPOI I-V was correlated with all histopathological prognostic factors. Results: We analyzed the results. WPOI I-V showed a significant association with T-stage (p = 0.025), N-stage (p = 0.002), Depth of Invasion (DOI) (p = 0.004), Perineural Invasion (PNI) (p=0.002), LymphoVascular Invasion (LVI) (P= 0.000), Tumor Grade (p = 0.001), Margin (p=0.013) and Lymphocyte Host Response (LHR) (p=0.000). Discussion and Conclusion: Presence of invasive WPOI is associated with advanced T stage, poor differentiation, PNI, greater DOI, and higher chances of nodal metastasis. Adjuvant chemotherapy in early-stage disease with WPOI type IV and V may improve survival rate and prevent recurrence.

Downloads

Download data is not yet available.

Downloads

Published

2025-09-29

How to Cite

K. Praveen, Mahalakshmi, & Rajesh, A. (2025). Worst Pattern of Invasion in Oral Squamous Cell Carcinoma - An Independent Prognostic Predictor. Journal of Health and Technology, 1(3), 175–182. https://doi.org/10.65129/health.v1i3.92

Issue

Volume 1, Issue 3, September 2025

Section

Research Article

License

Copyright (c) 2026 Journal of Health and Technology

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Crossref
Scopus
Google Scholar
Europe PMC

References

1. Barsouk A, Aluru JS, Rawla P, Saginala K, Barsouk A. Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma. Med Sci (Basel). 2023; 13;11(2):42. https://doi.org/10.3390/medsci11020042 PMid: 37367741 PMCid: PMC10304137.

2. Kulkarni MR, Ionna F, Bossi P, Guida A, Alberti A, Muto P, Salzano G, Ottaiano A, Maglitto F, Leopardo D, De Felice M, Longo F, Tafuto S, Scarpati GDV, Perri F. Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A big and intriguing challenge which may be resolved by integrated treatments combining locoregional and systemic therapies. Cancers (Basel). 2021; 14; 13(10):2371. https://doi.org/10.3390/cancers13102371 PMid:34069092 PMCid: PMC8155962.

3. B D Chaurasia’s Human anatomy Volume 3 Head - Neck Brain, 6th ed.

4. Histology for pathologists, Stacey E. Mills, 5th ed.

5. Robbins and Cotran Pathologic Basis of Disease, 10th ed.

6. WHO classification of Head and Neck Tumors, 4th ed.

7. College of American Pathologists, Protocol for the Examination of Specimens from Patients with Cancers of Oral Cavity, version 4.2.0.0; 2023.

8. Mishra A, Das A, Dhal I, Shankar R, Bhavya BM, Singh N, Tripathi P, Daga D, Rai A, Gupta M, Sahu GC,Worst pattern of invasion in oral squamous cell carcinoma is an independent prognostic factor, J Oral Biol Craniofac Res. 2022; 12(6):771-776. https://doi.org/10.1016/j.jobcr.2022.08.027 PMid:36159069 PMCid: PMC9489719.

9. Yin M, Ma W, An L. Cortactin in cancer cell migration and invasion. Oncotarget. 2017; 8: 88232-88243. https://doi.org/10.18632/oncotarget.21088 PMid:29152154 PMCid: PMC5675706.