Independent Prognostic Significance of Worst Pattern of Invasion-5 in Oral Squamous Cell Carcinoma Patients
Recommended Citation
Dang RR, Huang S. Independent Prognostic Significance of Worst Pattern of Invasion-5 in Oral Squamous Cell Carcinoma Patients. Int J Oral Maxillofac Surg 2025; 54:165.
Document Type
Conference Proceeding
Publication Date
7-1-2025
Publication Title
Int J Oral Maxillofac Surg
Keywords
biological marker, adult, cancer staging, cohort analysis, conference abstract, depth of invasion, female, human, lymph vessel metastasis, major clinical study, male, mouth squamous cell carcinoma, overall survival, perineural invasion, retrospective study, surgery
Abstract
Background/Purpose: This study evaluates the prognostic significance of Worst Pattern of Invasion-5 (WPOI-5) in oral squamous cell carcinoma (OSCC) and its potential as an independent predictor for adverse outcomes, including overall survival (OS), disease-free survival (DFS), and locoregional recurrence (LRR). Methods: We conducted a retrospective analysis of 187 OSCC patients treated at a single institution from 2017 to 2023. Variables such as pathological T-stage, N-stage, depth of invasion (DOI), lymphovascular invasion (LVI), and perineural invasion (PNI) were collected. Cox proportional hazards models were used to assess hazard ratios (HR) for OS, DFS, and LRR in relation to WPOI-5. To better isolate WPOI-5’s impact, a second multivariate model that excluded well validated adverse features including DOI, LVI, and PNI was also performed. Results: WPOI-5 was observed in 15.5% of patients and those with WPOI-5 had a mean DFS of 34.3 months versus 54.1 months for those without it. LRR was noted in a total of 23.5% (n=44) of patients. On univariate analysis, WPOI 5 associated with significantly lower DFS (HR 2.3, 95% CI, 1.2–4.4, P=0.006) and OS. After excluding DOI, LVI, and PNI, WPOI-5 remained a significant predictor for DFS (HR 2.1, 95% CI, 1.0–4.5, P=0.037). Conclusions: WPOI-5 appears to be an independent prognostic factor for DFS in OSCC, warranting consideration for treatment intensification. Our findings support further investigation of WPOI-5 as a routine pathological assessment parameter to guide treatment in OSCC.
Volume
54
First Page
165
