Abstract
Background
Cervical nodal metastasis critically influences prognosis in oral squamous cell carcinoma (OSCC), yet current staging does not quantify the degree of metastatic replacement within lymph nodes. This study evaluated morphometric index Node Deposit Size Index (NDSI) to assess their association with pathological aggressiveness and survival.
Methods
An ambispective cohort of 104 surgically treated, node-positive OSCC patients was analysed. Maximum metastatic deposit diameter and lymph node diameter were measured on routine H&E slides. NDSI correlated with clinicopathological variables, extranodal extension (ENE), lymph node density (LND), and survival using non-parametric tests, Spearman correlation, Kaplan–Meier analysis, and ROC curves.
Results
ENE-positive nodes demonstrated higher NDSI than ENE-negative nodes (86.9%
vs
43.8%;
p
p
p
vs
45.4%;
p
vs
50.7%;
p
= 0.024). NDSI correlated with LND (Spearman ρ=0.43,
p
Conclusion
NDSI correlate with adverse pathology and early mortality. However, the association between NDSI and ENE is not fully independent of pathological N-stage, and reproducibility, independent prognostic value, and cutoff stability require external validation before clinical use.