HISTOPATHOLOGICAL EVALUATION OF ORAL SQUAMOUS CELL CARCINOMA IN PAKISTANI POPULATION: A RETROSPECTIVE STUDY OF CLINICOPATHOLOGICAL FEATURES AND PROGNOSTIC FACTORS

Abstract

Introduction: The most prevalent oral malignancy, oral squamous cell carcinoma (OSCC), is becoming more prevalent in Pakistan. Late-stage diagnosis and aggressive tumor behavior contribute to poor prognosis. This study evaluates the histopathological features, clinicopathological characteristics, and prognostic factors of OSCC in the Pakistani population.
Methodology: A total of 93 OSCC cases were analyzed. Data were collected on patient demographics, tumor location, histopathological grading, tumor size, lymph node involvement, perineural invasion, lymphovascular invasion, and distant metastasis. Chi-square tests, independent t-tests, Kaplan-Meier survival analysis, and Cox regression models were used to assess the prognostic significance of clinicopathological features.
Results: OSCC was more prevalent in males (62.4%) than females (37.6%). The most affected site was the buccal mucosa (39.8%), followed by the tongue (26.9%). Moderate differentiation (44.1%) was the most common histopathological grade. The mean tumor size was 3.8 cm (SD ± 1.2 cm), with lymph node involvement in 52.7% of cases. Perineural invasion (29.0%) and lymphovascular invasion (23.7%) correlated with poorer prognosis. Kaplan-Meier analysis showed median survival of 18.4 months for poorly differentiated tumors and 22.7 months for well-differentiated tumors (p < 0.05). Cox regression identified lymph node involvement, perineural invasion, and high histological grade as poor prognostic factors.
Conclusion: OSCC in Pakistan presents aggressively, with late-stage diagnosis and poor survival rates. Early detection and improved screening are essential for better outcomes. Prospective studies are needed to explore molecular markers and targeted therapies.