Abstract:
Background: The presence of nodal metastasis from OSCC is the single most important prognostic feature. Extranodal extension further decreases survival by approximately half. Clinical evaluation of the nodal basin has been found to correlate poorly with pathological nodal status.
Methods: Ninety-one consecutive cases of oral squamous cell carcinoma were retrospectively studied and the clinical (cN) and pathological (pN) TNM nodal staging compared using the 8th edition of the AJCC/UICC TNM staging system. Extranodal extension was determined in the total number of patients with OSCC, as well as in the subgroup with clinically nodal negative (cN0) disease. The socio-demographical information was described.
Results: There was poor correlation between clinical and pathological nodal staging using the 8th edition TNM staging. The cN and pN were congruent in 41.7% (n=38/91), upstaged in 35.2% (n=32/91), and downstaged in 23.1% (n=21/91) of cases. Twenty-one patients (23.1%) had pathological evidence of ENE. The cN0 subgroup consisted of 49 patients, 9 of which has pathologically evident ENE. Males constituted 67% of the study sample, and females 33%. The average age at the time of diagnosis of 57.3 years (range 5-85 years). A smoking history was present in 73.6%, absent in 14.3%, and unknown in 12.1% of patients. The tongue (38.4%) and floor of mouth (29.7%) were the most common anatomical sub sites for primary tumours. Most tumours were conventional squamous cell carcinomas with poorly differentiated grade (62.6%)
Conclusion: There is poor correlation between clinical and pathological nodal status when the 8th TNM staging is used. ENE at the time of diagnosis is common among patients with OSCC.
