Correlation between Tumor Pathological Characteristics and Nodal Metastasis in Primary Tumors in Oral Cavity Cancers

Abstract Introduction: Head and neck squamous cell carcinoma is a significant public health concern globally, particularly when it affects the oral cavity. The prognosis and management of this type of carcinoma largely depend on the extent of nodal metastasis, which indicates how far the cancer has spread to lymph nodes. This study aimed to identify primary tumor characteristics that can effectively predict nodal metastasis in patients who have undergone surgical treatment for carcinoma of the oral cavity. Understanding these characteristics can aid in better treatment planning and improving patient outcomes. Methodology: A retrospective and prospective cohort study was undertaken at a tertiary care hospital, focusing on 100 patients with surgically treated oral cavity carcinoma. The analysis considered several variables: T-stage, tumor site, tumor thickness, differentiation, perineural invasion (PNI), and lymph vascular emboli (LVE). These factors were statistically evaluated using SPSS software, providing insights into the characteristics and outcomes of the patients’ treatments. The study’s dual approach allowed for a comprehensive understanding of both past and future trends in managing oral cavity carcinoma, contributing to improved patient care and research in the field. Results: Higher T-stages were significantly associated with increased nodal positivity ( P = 0.007). Moderately differentiated tumors had a higher nodal positivity rate (37.8%) compared to well-differentiated tumors (27.0%). Tumor thickness >10 mm was linked to increased nodal metastasis. PNI and LVE were also significantly associated with nodal metastasis, with P < 0.001. Multivariate analysis identified LVE and T-stage as the most significant predictors of nodal metastasis. Conclusion: The study identified higher T-stages, moderate differentiation, increased tumor thickness, PNI, and LVE as significant predictors of nodal metastasis in patients with surgically treated carcinoma of the oral cavity. These findings highlight the importance of comprehensive clinical and pathological assessments in managing oral cavity cancer and suggest the need for rigorous monitoring and potentially aggressive treatment for high-risk patients. Future research should focus on validating these predictors in larger, more diverse populations.