Analysis of Histopathologic Parameters and Patterns of Invasion in Oral Squamous Cell Carcinoma and Their Correlation With Patient Survival

INTRODUCTION: Oral squamous cell carcinoma is the most prevalent malignant neoplasm in the head and neck region, and its prognosis is influenced by various histopathological and clinical factors. pTNM tumor staging and invasion patterns are fundamental for predicting therapeutic response and patient survival. METHODS: A retrospective study analyzing 283 cases of oral squamous cell carcinoma treated at Haroldo Juaçaba Hospital. Histopathological and clinical information was collected, including tumor grade, pTNM, invasion pattern, and response to therapy. Statistical analyses were carried out in SPSS software using Fisher's tests, Pearson's chi-squared, log-rank Mantel-Cox, and Cox regression. RESULTS: The presence of pN2/pN3 nodal metastases, compromised margins, and a history of smoking were associated with a worse prognosis. Adjuvant radiotherapy alone showed longer disease-free survival. Perineural invasion and a low stromal infiltrating lymphocyte score were significant negative prognostic factors. Multivariate analysis showed that patients with lymph node involvement (HR = 1.84; 95% CI: 1.02-3.31; p = 0.042) and stromal infiltrating lymphocytes (HR = 0.44; 95% CI: 0.21-0.089; p = 0.022) had an increased risk of recurrence. CONCLUSION: Lymph node involvement and low lymphocyte infiltration are determining factors for tumor recurrence, as are the presence of comorbidities, alcohol, and smoking, reinforcing the need for continuous monitoring and personalized therapies.