Prognostic significance of lymph node pattern in oral squamous cell carcinoma

Background: Assessment of lymph node reactivity pattern is an important indicator of the host response status and prognosis of oral squamous cell carcinoma (OSCC). Aim: To assess the prognostic significance of lymph node reactivity patterns in OSCC. Settings and Design: This is a cross-sectional study aimed correlating host status and prognosis of OSCC. Materials and Method: Morphological patterns of lymph nodes received from 30 histologically proven cases of oral squamous cell carcinoma were analyzed. Five different patterns of the lymph node reaction were categorized (lymphocytic predominance, germinal center predominance, sinus histiocytosis, normal lymph node and lymphocytic depleted) and compared with the prognosis of oral squamous cell carcinoma. Statistical Analysis Used: TNM, Histological grading parameters and Lymph node reactivity pattern were compared with the event of recurrence of OSCC and death of patient using Fisher's Exact test. Survival of the patients was analyzed for association with lymph node patterns using Log rank test. Results: Recurrence of the tumour was seen in association with all the patterns, with higher rates of mortality seen in patients with sinus histiocytosis of lymph node. Conclusion: Morphological pattern being an aid in predicting prognosis, cannot be used as a lone predictor. An attempt is made to identify and discuss the possible pathogenesis for the reaction patterns.