Abstract
OBJECTIVES: This study was conducted for the first time in the Sudan that aimed to assess whether the tumor depth of invasion (DOI) in oral squamous cell carcinoma (OSCC) is a prognosticator for regional nodal metastasis, locoregional recurrence, survival and identify the cutoff point for metastasis. METHODS: Descriptive retrospective cross-sectional hospital based study carried out at Khartoum Teaching Dental Hospital (KTDH) and histopathology laboratory, University of Khartoum. Records of patients were retrieved from the archives of KTDH and the histopathological records were retrieved from archival specimens of Oral Pathology laboratory, University of Khartoum. Data of patients who underwent primary radical surgery for OSCC and neck dissection at KTDH were reviewed. RESULTS: A total of 127 cases, 84 were males and 43 were females.Sixty-seven were snuff dippers.Thirty-six of the total number of snuff dippers favored the lower labial vestibule. Lower gingivolabial area was the favorite site for OSCC that encountered in 52 patients. In the present study, 93 of patients presented with stage IV and the predominant grade was well differentiated squamous cell carcinoma that found in 67 patients. There is a high significant association between depth of invasion and recurrence. Among 60 patients who developed recurrence, 55 of them had DOI ≥ 4 mm. From total of 24 patients with DOI > 4 mm, six patients died, and from total of 101 patients with DOI ≥ 4 mm, 62 patients died that indicated a high significant association between depth of invasion and death with a survival period 27.05 ± 23.08 months in patients with DOI ≥ 4 mm and 44.77 ± 19.20 months in patients with DOI < 4 mm. Patients with positive surgical margins were 9.9 timed more likely to develop recurrence. CONCLUSIONS: DOI of OSCC is a reliable histological parameter to predict nodal metastasis, locoregional recurrence and survival with 4 mm cutoff point.