Clinical value of the worst pattern of invasion in predicting extranodal extension in oral squamous cell carcinoma.

IF 2.8 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Discover. Oncology Pub Date : 2025-07-04 DOI:10.1007/s12672-025-03058-1

Mirai Higaki, Toshinori Ando, Fumitaka Obayashi, Nanako Ito, Suguru Hirota, Atsuko Hamada, Sachiko Yamasaki, Tomoaki Shintani, Koichi Koizumi, Souichi Yanamoto

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Abstract

Objective: Extranodal extension (ENE) is one of the major influencing factors for the oncological outcomes in oral squamous cell carcinoma (OSCC). We aimed to elucidate the clinical features predictive of ENE in OSCC.

Materials and methods: We conducted a retrospective analysis of patients with OSCC who underwent neck dissection (ND) with a confirmed pN + status. Cases in which the histopathological evaluation was compromised by preoperative chemotherapy or radiotherapy were excluded. Histopathological evaluation of extent of ENE category and grading of worst pattern of invasion (WPOI) was compared for available cases.

Results: Fifty-nine patients met the inclusion criteria for the study. Of these, 32/59 (54.2%) were ENE-positive. A higher incidence of ENE was observed in cases where ND was performed at a separate time from the primary tumor resection (odds ratio [OR] = 11.0, 95% confidence interval [95%CI] 2.23-54.5, P = 0.003). Additionally, a higher grade of WPOI (WPOI 4 or 5) was significantly associated with ENE occurrence (OR = 4.53, 95%CI 1.19-20.50, P = 0.026). A positive correlation between the WPOI grade and ENE extent was also identified (ρ = 0.412, P <.001).

Conclusion: We demonstrated an association between WPOI and ENE in patients with OSCC.

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口腔鳞状细胞癌最坏浸润模式预测结外扩张的临床价值。

目的：结外延伸（ENE）是影响口腔鳞状细胞癌（OSCC）预后的主要因素之一。我们的目的是阐明在OSCC中预测ENE的临床特征。材料和方法：我们回顾性分析了经颈清扫（ND）确认为pN +状态的OSCC患者。排除术前化疗或放疗损害组织病理学评价的病例。比较现有病例的组织病理学评估ENE类型的程度和最严重侵犯模式（WPOI）的分级。结果：59例患者符合本研究的纳入标准。其中32/59（54.2%）为ene阳性。在原发肿瘤切除后单独进行ND手术的病例中，ENE的发生率更高（优势比[OR] = 11.0, 95%可信区间[95% ci] 2.23-54.5, P = 0.003）。此外，较高级别的WPOI （WPOI 4或5）与ENE的发生显著相关（or = 4.53, 95%CI 1.19-20.50, P = 0.026）。结论：我们证实了OSCC患者的WPOI和ENE之间存在相关性。

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