Primary tumor lymphangiogenesis in oral squamous cell carcinoma with N 0 neck is the key determinant of its therapeutics.

BACKGROUND: Vascular Endothelial Growth Factor-C (VEGF-C) plays a critical role in tumor growth and invasion through lymphangiogenesis and helps to identify the variability of lymphatic potential of oral squamous cell carcinoma (OSCC) cases with or without lymph node metastasis. MATERIALS AND METHODS: A total of 65 cases of OSCC were included. The clinical details were obtained from patient records. The cases were grouped as N 0 versus any N categories. All the cases were immunohistochemically evaluated for VEGF-C within the primary tumor using a standard protocol. An average of 5 lymph nodes were dissected from all neck dissection specimens and were evaluated histopathologically. The data obtained were statistically evaluated at 95% confidence interval and P </= 0.05. RESULTS: 100% cases in our study showed VEGF-C immunopositivity. The immunoreactivity increased linearly with advancing grades. A total of 31 out of 40 N 0 OSCC revealed score 2 (26%-50%) of VEGF-C immunoreactivity. Eighteen cases were false negative clinically. CONCLUSION: Recognition of locoregional spread may empower clinicians for correct therapeutic decisions in N 0 versus any N case.