CORRELATION OF SYSTEMIC IMMUNE INFLAMMATORY INDEX WITH DEPTH OF INVASION AND LYMPH NODE METASTASIS IN ORAL CANCERS

Abstract

BACKGROUND: Oral squamous cell carcinoma is a leading cause of mortality in India. It is observed that 30% of all malignancies are involving head and neck, out of which 20 per 1 lakh individuals are affected by oral cancer. The main etiology of addiction to tobacco quid chewing females in our region have a high prevalence of oral squamous cell cancer. Majority of these individuals present with locally advanced illness which will definitely need extensive surgery and adjuvant therapy. SII has observed to play a significant role in the prognosis and outcome of the surgery. This index involving the blood parameters like neutrophils, lymphocytes and platelets counts obtained preoperatively. In this study we intend to find out whether there is a correlation between systemic immune inflammatory index and depth of invasion and lymph node metastasis in oral cancers and its reliability in preoperatively predicting the outcome of surgery and treatment. OBJECTIVES: 1. To document the systemic immune inflammatory index in patients planned for curative treatment comprising composite resection and adjuvant therapy in oral cancers staged T2 – T3. 2. To document the depth of invasion and lymph node metastasis on histopathological examination of the respected specimen in the above mentioned patients. 3. To correlate the systemic immune inflammatory index with depth of invasion and lymph node metastasis. xvii MATERIAL & METHODS: A prospective observational study, involving 41 patients with biopsy proven OSCC staged T2-T3, was carried out at Sri Devaraj Urs Medical College, R.L. Jalappa Hospital & Research Centre, Kolar from July 2022 to May 2024. A full blood count (CBC) was performed, and SII was approximated prior to surgery. Following surgery (primary excision of tumour with neck dissection and reconstruction), the resected specimen was histopathologically evaluated to determine the size, depth of invasion, and number of metastatic lymph nodes. The cut-off limit for SII was 484.5. RESULTS This prospective observational study conducted in Kolar included 58.5% female patients, with the majority of patients being over the age of 60. SII was found to be statistically significant for depth of invasion, lymph node metastases, complications, TNM stage, adjuvant treatment, hospital stay, and disease-free survival. CONCLUSION From the discussion it showed that SII can be used as a prognostic marker for survival for patients treated for OSCC. Mainly the features of easy access, cheaper and easy calculation has helped to prognosticate these patients. However, we still need larger prospective and well-structured studies to confirm the conclusion in the future.