Clinico‑pathological profile of oral squamous cell carcinoma: a five‑year analysis of 150 cases at Alexandria University.

Abstract

Oral Squamous Cell Carcinoma exhibits variable clinicopathological behavior and prognosis across different geographic populations. Limited data are available regarding the clinicopathological characteristics and prognostic factors of this disease in Middle Eastern populations, particularly in Egypt, where late presentation and advanced disease stages remain common challenges. To evaluate the clinicopathological characteristics of Oral squamous cell carcinoma and assess the prognostic significance of American Joint Committee on Cancer 8th edition staging, histopathological parameters, and combined risk patterns on survival and recurrence in an Egyptian cohort. This retrospective study included 150 Oral squamous cell carcinoma patients treated at Alexandria University between 2018 and 2022. Tumors were re-staged according to American Joint Committee on Cancer 8th edition criteria. Clinical, histopathological, and follow-up data were analyzed, including tumor differentiation, surgical margin status, perineural invasion, lymphovascular invasion, depth of invasion, and extranodal extension. Recurrence and survival outcomes were correlated with clinicopathological and combined histopathological risk factors. Mean age of patients was approximately 56 years, with tongue being the commonest tumor site. Re-staging according to American Joint Committee on Cancer 8th edition resulted in significant stage migration toward advanced disease stages, particularly stage IVb. Moderately differentiated tumors represented the commonest histopathological grade. Advanced AJCC stages, depth of invasion > 10 mm, positive surgical margins, higher histological grades, positive extranodal extension, and perineural and lymphovascular positivity were significantly associated with poorer survival and higher recurrence rates. Smoking and positive family history were also significantly associated with adverse outcomes. In contrast, traditional TNM staging showed no significant association with recurrence or survival outcomes. American Joint Committee on Cancer 8th edition staging demonstrated improved risk stratification and stronger associations with recurrence and survival outcomes compared to traditional TNM staging in Oral Squamous Cell Carcinoma patients. Depth of invasion, extranodal extension, and the combined histopathological risk pattern were strongly associated with aggressive tumor behavior and poorer outcomes. These findings provide valuable data from an Egyptian and Middle Eastern population and support the integration of updated staging systems with histopathological risk assessment in Oral Squamous Cell Carcinoma management.