CLINICOPATHOLOGICAL FACTORS PREDICTING LYMPH NODE METASTASIS IN ORAL CAVITY SQUAMOUS CELL CARCINOMA

Background: Oral cavity squamous cell carcinoma (OSCC) is a common head and neck malignancy in which cervicallymph node metastasis is an important determinant of prognosis and treatment planning. Several clinicopathologicalcharacteristics may influence the likelihood of nodal involvement, making their identification important for individualizedmanagement. The study aimed to evaluate the association of selected clinicopathological factors with cervical lymph nodemetastasis in patients with oral cavity squamous cell carcinoma and to identify factors that could help predict nodalinvolvement. Materials and Methods: This hospital-based observational study included 120 patients withhistopathologically confirmed OSCC treated at the Department of Radiation Oncology, American International Institute ofMedical Sciences, Udaipur, between January 2025 and March 2026. Demographic, clinical and histopathological variableswere assessed in relation to cervical lymph node status. Categorical variables were compared using appropriate statisticaltests, with p<0.05 considered statistically significant. Results: Of the 120 patients, 48 (40.0%) had lymph node metastasis,while 72 (60.0%) were node-negative. Males constituted 98 (81.7%) patients. Age was not significantly associated withnodal metastasis (p=0.178), nor was sex (p=0.812) or primary tumour site (p=0.923). Nodal involvement increasedsignificantly with T stage, occurring in 2/34 (5.9%) T1, 10/37 (27.0%) T2, 24/34 (70.6%) T3, and 12/15 (80.0%) T4 tumours(p<0.001). Histological grade was significantly associated with nodal disease (p=0.003). Depth of invasion >10 mm wasassociated with metastasis in 34/44 (77.3%) patients (p<0.001). Lymphovascular invasion and perineural invasion were alsosignificantly associated with nodal metastasis (p<0.001 for both). Conclusion: Advanced T stage, greater depth of invasion,poor differentiation, lymphovascular invasion and perineural invasion were important predictors of cervical lymph nodemetastasis in OSCC. These factors may assist in identifying patients at increased nodal risk and support individualizedtreatment planning.