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 cervical
lymph node metastasis is an important determinant of prognosis and treatment planning. Several clinicopathological
characteristics may influence the likelihood of nodal involvement, making their identification important for individualized
management. The study aimed to evaluate the association of selected clinicopathological factors with cervical lymph node
metastasis in patients with oral cavity squamous cell carcinoma and to identify factors that could help predict nodal
involvement. Materials and Methods: This hospital-based observational study included 120 patients with
histopathologically confirmed OSCC treated at the Department of Radiation Oncology, American International Institute of
Medical Sciences, Udaipur, between January 2025 and March 2026. Demographic, clinical and histopathological variables
were assessed in relation to cervical lymph node status. Categorical variables were compared using appropriate statistical
tests, 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 with
nodal metastasis (p=0.178), nor was sex (p=0.812) or primary tumour site (p=0.923). Nodal involvement increased
significantly 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 was
associated with metastasis in 34/44 (77.3%) patients (p<0.001). Lymphovascular invasion and perineural invasion were also
significantly 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 node
metastasis in OSCC. These factors may assist in identifying patients at increased nodal risk and support individualized
treatment planning.