The Correlation between Histopathological Parameters of Oral Squamous Cell Carcinoma and Nodular Metastasis and Consequent Neck Dissection Decision Making

Objectives: The aim of this study was to evaluate neck nodular metastasis and related clinic opathological parameters of primary oral squamous cell carcinoma (OSCC) patients who underwent neck dissections. Materials and Methods: A descriptive cross-sectional study was conducted compromising 571 records of patients treated at the Oral and Maxillofacial Unit, National Hospital, Galle, Sri Lanka, from 2001 to 2020. Data was analyzed using SPSS-26 statistical software package. Results: The occurrence of neck positivity was 54.1 %. Stages III and IV cancers (OR = 1.79: 95% CI 1.22- 2.63 (P = 0.003), compared with stages 1 and II and types 3 &4 invasive fronts (OR = 1.8: 95% CI 1.1-2.9) (P = 0.030) compared with types 1 & 2 were significantly associated with neck node metastasis. Depth of invasion types 2, 3, 4 (> 5 mm) vs. type 1 (OR = 7.6, 95% CI = 2.5- 13.7) (P = 0.0001) and grade 3 differentiation compared to grade 1 or 2 had significant neck-node metastasis (OR= 2.8, 95% CI, 1.2-6.4) (p=0.0001). Palatal (OR = 2.91, 95% CI: 1.40-6.04) (P = 0.004) and tongue lesions (OR=1.50, 95% CI: 1.03- 2.19) (P = 0.034) demonstrated higher neck mode metastasis compared to other primary sites. Conclusions: The results confirm that clinicopathological parameters of primary OSCC could assist rational neck dissection decision. As advanced staged tumors with aggressive biology were more likely to have nodal involvement and radical neck dissections, early detection and prompt treatment of OSCC become important for countries like Sri Lanka. Keywords: Oral squamous cell carcinoma, Metastasis, Neck dissection, Clinicalpathological parameters.