Abstract
Postoperative prognostic stratification using the Union for International Cancer Control
(UICC) TNM 8th edition staging rules (UICC 8) may identify additional groups of patients
who could benefit from adjuvant radiotherapy. Currently, selection for such treatment
is not based on all known prognostic factors, and their relative importance may vary
depending on the overall risk category. The objective of this study therefore was
to evaluate these possibilities. We retrospectively studied 644 patients who had surgery
with curative intent for oral squamous cell carcinoma (OSCC) between March 2006 and
February 2017. The outcomes of interest were disease-specific survival (DSS) and locoregional
recurrence (LRR). Patients were re-staged according to the UICC 8 staging rules. Putative
clinical and pathological prognostic variables were evaluated and hazard ratios estimated.
Regression analysis was done to identify independent prognostic factors, and iterative
analyses identified clinically-relevant risk categories with a minimum of residual
prognostic variables. The significance of recognised pathological prognostic factors
differed according to the overall risk category. An intermediate risk group comprising
patients with pN1 disease as well those with pT3 disease solely on the basis of a
depth of invasion (DOI) of more than 10 mm, was identified. A trial to evaluate the
benefit or otherwise of adjuvant radiotherapy in this group is now required. Individual
prognostic risk factors should be considered within the context of the overall risk
category in patients with OSCC.
Keywords
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Article info
Publication history
Published online: March 25, 2020
Accepted:
February 24,
2020
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
