A correlation of depth of tumour invasion and pattern of cervical metastasis in Oral Squamous Cell Carcinoma (OSCC) in the background of Oral Submucous fibrosis (OSMF)

The aim of this study to determine the depth of tumor invasion and pattern of cervical metastasis in patients of OSCC with OSMF. Methods: The authors prospectively investigated 40 patients of OSCC with OSMF who underwent surgery for OSCC with curative intent over a 2 year period. OSCC with OSMF was more commonly seen in males (87.5%) compared to females (12.5%). Buccal mucosa was the most frequently involved site, accounting for 40% cases. Broader‟s grading showed 65% moderately differentiated, the overall incidence of cervical lymph node metastasis was found to be 37.5% (n=15) out of 40 cases level Ib node was found to be frequently involved (23.26%). Mean depth of tumour invasion was 4.46mm. A cut-off predictive value of ≥ 4mm of depth of tumour invasion (DTI) was found to be reliable indicator of cervical node metastasis. Relationship of histopathological depth of tumor invasion and cervical metastasis was found to be statistically significant (p = 0.006). The correlation between tumor size and cervical lymph node metastasis was found to be insignificant. Conclusion: OSCC with OSMF affects younger population showing better grade of tumor differentiation, predominantly involving buccal mucosa, GB sulcus and tongue with lesser DTI, superficial and more predictable nodal metastases, most commonly involving level I lymph nodes. These factors together may act as guide line to form a strategy for management of OSCC with OSMF which could be more conservative than the established protocol.