Chatterjee D, Bansal V, Malik V, et al. - Researchers conducted this retrospective study to assess the role of histological parameters including worst pattern of invasion (WPOI) and tumor budding [defined as a single cell or a cluster of < 5 tumor cells present in the stroma at the invasive tumor front] to determine the risk of lymph node (LN) metastasis in cases of oral squamous cell carcinoma (OSCC), as well as to determine the recurrence risk and death in early-stage OSCC in north Indian patients. They reviewed all cases of buccal mucosa and tongue SCC which underwent excision over 4 and half years for histological parameters including histologic grade, WPOI, tumor budding, lymphovascular emboli (LVE), perineural invasion (PNI), depth of invasion (DOI), host lymphocyte response, and stromal response and compared with LN metastasis. It included a total of 126 OSCC cases, 48 of which showed LN metastasis. Histological grade, WPOI, tumor budding (≥ 3/×40 field), LVE, and PNI were significantly linked to LN metastasis risk. According to findings, WPOI and tumor budding are significant risk factors for anticipating LN metastasis in all OSCC stages and related to poorer early-stage tumors outcome. These are predictive factors that are easy and reliable and should be included in the guidelines for histopathological reports.