Title : T1 & T2 squamous cell carcinoma of the oral cavity- A detailed study
Abstract:
Introduction: Squamous cell carcinoma is the most common oral cancer, representing up to 84- 97% of all malignant neoplasms of the oral cavity. The GLOBOCAN 2020, documented 377,713 new cancer cases and 177,757 deaths worldwide. Surgical therapy is the prime treatment option for squamous cell carcinoma, while radiotherapy and chemotherapy are adjuvant therapy depending upon the stage and histopathological characteristics. The purpose of this study was to evaluate the neck node status, patterns of neck metastasis, distribution of patients according to T (T1 & T2) stage and its management.
Methodology: 55 histopathologically proven cases of oral squamous cell carcinoma were included in our study. T1 and T2 lesions of oral squamous cell carcinoma cases were considered. Recurrent cases and prior treatment of oral cancer by chemotherapy and radiotherapy were excluded. All the patients involved in the study underwent tumor resection with neck dissection.
Results: A total of 55 patients were staged as per TNM criteria (AJCC 8th edition). The most common oral squamous cell carcinoma site was the tongue (n=26) followed by the buccal mucosa (n=21) and 2 patients each in lower alveolus, palate, lip and RMT region. Thirty two (58.18%) patients were pathologically node-negative (pN0) and twenty three (41.82%) patients were pathologically node-positive (pN+). Three (05.45%) patients were pathologically node-positive with extranodal extension (pN+/ENE+). In pathologically node-positive patients N1 category was the highest followed by N2 category and N3 category. The percentage of T1 and T2 lesions were 21.82% and 78.18% respectively. The lymph node positivity was highest in T2 followed by T1. Final histopathological stage grouping revealed early stage disease in 32 patients and advanced stage disease in 23 patients. 25, 27 and 03 patients were treated by surgery alone, surgery with postoperative radiotherapy and surgery with postoperative CTRT respectively.
Conclusion: This study concluded that 41.82% of the patients were pathologically node-positive (pN+) and nearly 06% of the patients were pathologically node-positive with extranodal extension (pN+/ENE+). Histopathology reports demonstrated the most of the patients had well-differentiated squamous cell carcinoma. Early stage patients were treated primarily by surgery alone and stage III and IV (advanced stage) patients were treated with combination therapy.
