Correlation of Depth of Invasion in Early Stage Oral Cavity Squamous Cell Carcinoma

Document Type

Conference Proceeding

Publication Date

7-1-2025

Publication Title

Int J Oral Maxillofac Surg

Keywords

adult, aged, cell differentiation, cervical lymph node, cohort analysis, conference abstract, depth of invasion, distant metastasis, female, follow up, human, lymph node metastasis, lymph vessel metastasis, major clinical study, male, mouth squamous cell carcinoma, neck dissection, perineural invasion, retrospective study, surgery, tumor volume

Abstract

Lymph node metastasis is one of the most important prognostic factors in oral squamous cell carcinoma. The rate of occult neck node metastasis is reported to range from 20% to 40%, which reduces the likelihood of survival by 50%. In this study, we aimed to identify the occult neck node metastasis rate in early oral squamous cell carcinoma and correlate it with the depth of invasion. A retrospective cohort study was conducted at the Henry Ford Health St John Michigan. Patients surgically treated for pT1/pT2 oral squamous cell carcinoma between 2013 and 2023 were included. For all cases, the depth of invasion was measured according to the 8th edition of the American Joint Committee on Cancer guideline. Patient characteristics, tumor characteristics (pTN, differentiation grade, perineural invasion, and lymphovascular invasion), treatment modality (END or watchful waiting), and follow-up (local recurrence, regional recurrence, and distant metastasis) were obtained from patient files. A univariant logistic regression analysis showed DOI to be a significant predictor for occult lymph node metastasis. DOI of 4 mm or greater is associated with a higher rate of cervical lymph node involvement. Thus, tumors having DOI ≥ 4 mm have higher chances of occult metastasis and also an increased probability of other prognostic factors like perineural invasion and lymphovascular infiltration. This suggests that patients with tumors with a DOI of ≥ 4 mm, irrespective of tumor size and site, should receive an elective neck dissection.

Volume

54

First Page

137

Last Page

138

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