Role of Worst Pattern of Invation-5 as a Prognostic Tool in Patients With Oral Cavity Squamous Cell Carcinoma

Introduction: Oral cavity squamous cell carcinoma (OCSCC) is the most common type of head and neck cancer, often associated with poor outcomes. This study aims to evaluate the prognostic significance of WPOI-5 in OCSCC and its correlation with various pathological factors, such as lymphovascular and perineural involvement, tumor and nodal staging, and histologic grade.

Methods: A retrospective study of 80 OCSCC patients from January 2017 to January 2020 at Albany Medical Center assessed survival and recurrence from January 2017 to January 2020. Utilizing WPOI grading from pathology reports, patient data including age, gender, and tumor characteristics, were analyzed. Associations between variables and pathology grade were examined using Welch’s t-test for continuous variables and Pearson’s chi-square test for categorical variables. Kaplan-Meier survival curves were plotted, and statistical significance between path grades was assessed with the log-rank test. Analysis was performed using SPSS and Minitab, with significance set at p < 0.05.

Results: Analysis revealed a significant correlation between WPOI-5 and lymphovascular and neurovascular invasion, as well as tumor staging. However, no statistically significant correlation was found between receiving a WPOI-5 designation and gender, histologic tumor grade, or nodal staging. Patients diagnosed with WPOI-5 pathology exhibited shorter times to death and recurrence, indicating poorer outcomes compared to those with WPOI grades 1-4 pathology.

Conclusions: Our study revealed a significant disparity in survival and recurrence rates between patients with WPOI grades 1-4 and WPOI-5. Those diagnosed with WPOI-5 demonstrated notably poorer survival rates, increased recurrence risks, and higher rates of lymphovascular and/or neurovascular invasion, as well as advanced tumor staging. These findings highlight the importance of WPOI-5 as a robust prognostic marker, and the need for its mandatory inclusion in all pathology reports involving oral squamous cell carcinoma in order to improve disease characterization and treatment planning.