Pattern of invasion as a factor in determining lymph node metastasis in oral squamous cell carcinoma.

CONTEXT: Lymph node metastasis (LNM) influences survival of oral squamous cell carcinoma (OSCC). Evidence supports the value of prognostic information provided by most aggressive cells that lie in the tumor invasive front. AIMS: This study evaluated the clinical and histological parameters (C and HP) that would best associate with LNM in OSCC. SETTINGS AND DESIGN: A review of records and histological examination of nonrecurrent surgically treated 182 cases. SUBJECTS AND METHODS: A review of records and histological examination according to the Bryne's invasive front grading system of nonrecurrent surgically treated 182 cases (pN- =100; pN+ =82) was undertaken. The data were subjected to suitable statistical analysis to check the agreement between observers, association of the parameters to LNM, and to identify the best among all of them. STATISTICAL ANALYSIS USED: Kappa statistics, Pearson's Chi-square, Fisher's exact test, multiple logistic regression analysis. RESULTS: None of the C and HP, with the exception of pattern of invasion (PI) (P = 0.000), modified degree of keratinization and nuclear polymorphism (P = 0.041, 0.022), and total malignancy score for survival (P = 0.013) showed a significant association with nodal status. PI was identified as the most influencing parameter of all. CONCLUSIONS: Factor that is primarily the manifestation of tumor and its microenvironment has taken the prime seat followed by the ones that are dictated by the tumor. The factors that are basically quantified were not able to show association. Site influences the nodal status alongside PI.