Assessment of histological parameters indicative of occult metastasis in oral cavity cancers

Abstract

Objective: It is well established fact that in squamous cell carcinoma cases of oral cavity ,the presence of lymph node metastasis decreases the 5 year survival rate by 50%. Therefore, it is imperative to identify patients who are at greatest risk for occult cervical metastasis. This study aimed to identify various histological parameters which are predictive for occult metastasis. Design and subject: This is a retrospective study which includes all cases which are clinically cT1N0M0 and cT2N0M0 in a tenure of previous 2 years (2021 and 2020) and excludes all other cases which have clinically nodes palpable and have imaging findings suggestive of metastasis. Methods: The histological parameters of 24 cases of Oral cavity cancers (which includes tongue,buccal mucosa and hard palate cancers) with cT1N0M0 and cT2N0M0 as the stage and without prior radiotherapy and chemotherapy were considered. All radical specimens of oral cavity cancers were fixed in formalin and were subjected to processing and staining by Hematoxylin and Eosin.The sections obtained were microscopically examined by two pathologist individually. The histological parameters were recorded that includes tumor grade, invading front ,depth of invasion perineurial invasion , inflammatory response and lymph node metastasis. Results and conclusion: A total of 7 cases were found with positive occult nodal metastasis. On performing univariate analysis, the histolological parameters which were found to be significant were Perineurial invasion(p=0.001 ), Tumor inflammatory response(p=0.01 ) and Invading tumor front (p= 0.01 ). Hence histopathological assessment of the primary tumor specimen continues to provide information that is central to guide clinical management, particularly in cases of occult nodal metastasis.