The predictive role of tumor infiltrating lymphocytes and pathohistological parameters for the occurrence of metastases in the clinical N0 neck of early-stage oral squamous cell carcinoma

Abstract

Introduction/Objective With 337,173 registered cases worldwide in 2020, oral squamous cell carcinoma is the most common malignant tumor of the head and neck region. The status of lymph nodes in the neck is the most important isolated prognostic factor for the five-year survival of patients. This study aimed to determine the pathohistological predictors of the occurrence of occult neck metastases in early-stage oral squamous cell carcinoma.

Methods The study included 40 patients (mean age 62.8 ± 10.7) with early-stage oral squamous cell carcinoma and clinical N0 findings in the neck. All patients underwent radical transoral tumor ablation and elective neck lymphadenectomy. Based on pathohistological findings, the patients were divided into two groups: a group with occult metastases present and a group without occult metastases.

Results Occult metastases were present in 13 patients (32.5%). The results indicate a significant difference in the desmoplastic reaction of the stroma (p < 0.001), depth of invasion (p < 0.001), lymphocytic infiltration (p < 0.001), and lymphovascular invasion in univariate (OR 24, p = 0.004) and multivariate (OR 32.713, p = 0.017) logistic regression analyses in the group with occult metastases compared to the group without metastases.

Conclusion The values of the analyzed pathohistological predictors indicate a high degree of correlation with the occurrence of occult metastases in the neck. Their predictive significance strongly supports including these parameters as part of the standard pathohistological examination of oral squamous cell carcinoma.

Keywords: oral squamous cell carcinoma; occult metastases; pathohistological analysis; surgical treatment; observation