ArticleOdontology2026
Determination of prognostic parameters with impact on disease-free survival rate of patients treated for oral squamous cell carcinoma: a look at a few confounding variables.
Article in Odontology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Oral Squamous Cell Carcinoma (OSCC) poses a significant health concern, necessitating early prognostic studies for effective treatment planning. Traditional TNM staging has proven inadequate, prompting a need for deeper understanding of biological markers. This study evaluates the prognostic value of Hematoxylin and Eosin (H&E)-stained Depth of Invasion (DOI) compared to immunohistochemical (IHC) assessments, focusing on correlations with neck node positivity, tumor thickness, staging, perineural invasion, tumor budding, and patient survival rates. We analyzed 102 histologically confirmed OSCC cases, investigating the relationship between histological DOI, tumor budding, tumor thickness, staging, perineural invasion, recurrence, and survival. Additionally, 15 cases with borderline DOI were subjected to H&E staining and IHC to evaluate the necessity of IHC in DOI prediction. Depth of invasion (DOI) showed significant associations with tumor site (p = 0.007), tumor thickness (p = 0.000), tumor size (p = 0.000), nodal involvement (p = 0.000), perineural invasion (p = 0.001), survival (p = 0.000), and recurrence rate (p = 0.001), underscoring its role in tumor progression and prognosis. IHC demonstrated increased DOI in some cases, leading to upgraded staging and treatment changes. The association of tumor budding with various clinicopathological parameters was evaluated, showing significant correlations. Tumor budding showed significant associations with depth of invasion (p = 0.000), tumor thickness (p = 0.000), tumor size (p = 0.000), nodal involvement (p = 0.000), perineural invasion (p = 0.000), survival (p = 0.000), and recurrence rate (p = 0.003). Kaplan-Meier analysis showed lower survival rates for higher-risk patients. Histopathological analysis facilitates the classification of OSCC patients into high and low-risk groups, allowing for customized treatment strategies. Integrating histomorphologic factors with TNM staging, using H&E and IHC evaluations, can enhance OSCC prognosis accuracy, guide tailored treatments, and improve patient survival outcomes. The study was approved by the institutional review board (SRB/ SDC/ OPATH-2103/24/026).
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