Assessment of Histopathological Prognosticators in Oral Squamous Cell Carcinoma Prognosis: A Systematic Review and Meta-Analysis

Abstract Aim: Oral squamous cell carcinomas (OSCC) are aggressive tumors, and many factors were proposed in the literature for estimating its prognosis. Here, we aim to assess the impact of histopathologic prognostic factors in OSCC based on survival rates. Materials and: Methods In this retrospective study, Pub Med and Google Scholar were searched for relevant articles published between the years 2003 and 2021. A total of 35 articles were selected for this review based on PRISMA guidelines. The risk of bias was evaluated using the Quality in Prognosis Studies tool. Meta-analysis was conducted using Jamovi 2.2.5 software, and the prognostic factor was analyzed with a 95% confidence interval. Results: Factors such as lymph node ratio, pT4 (pathologic tumor), pN 3 (pathologic lymph nodes), surgical margin status, extranodal extension (ENE), depth of invasion (DOI), and stage of tumor were found to be encompassing a survival rate of less than 50%, suggesting its association with poor prognosis. Our review also found that factors such as DOI, worst pattern of invasion, and tumor budding can be evaluated through preoperative biopsy for detecting prognosis at an early stage of the disease. The meta-analysis estimated the overall survival and disease-specific survival of histopathological factor ENE-positive OSCC patients to be about 38% and 28%, respectively. Conclusion: The set of proposed prognosticators that have an association with lesser survival rates may play a vital role in predicting the prognosis and outcomes of OSCC patients. Those factors should be evaluated and analyzed in histopathological reports.