Abstract
This study was aimed to identify key clinicopathological variables that predict recurrence
in those undergoing curative resection of oral squamous cell carcinoma (OSCC) with
emphasis on initial treatment failure patterns. Between February 2006 to May 2020,
clinicopathological data on 833 patients who underwent curative resection of OSCC
were gathered. Outcomes of interest included local, regional, distant, and overall
recurrence. Univariate analysis was performed to identify significant clinicopathological
variables for each recurrence type, and a multivariate regression analysis was utilised
to generate predictive models. A total of 187 patients (22.4%) developed recurrent
disease; 79 local, 63 regional, and 46 distant. For local recurrence: tumour depth
of invasion (DOI) >5-–10 mm, tumour DOI >10 mm and modified Glasgow Prognostic Score
(mGPS) 2 were independently predictive (c-index 0.708). For regional recurrence: primary
OSCC of hard palate/maxilla, pN1, pN3b, and non-cohesive invasive front were independently
predictive (c-index 0.738). For distant recurrence: pN1 pN2a, pN2b, pN2c, pN3b, and
tumour DOI >10 mm were independently predictive (c-index 0.809). For recurrence at
any site; pN1, pN2a, pN2b, pN2c, pN3b, tumour DOI >5–10 mm, tumour DOI >10 mm, mGPS
2, and involved surgical margins were independently predictive (c-index 0.750). Recurrence
events after curative treatment for OSCC are relatively predictable on the basis of
available clinicopathological characteristics. It seems likely that trials of adjuvant
systemic therapy in high-risk OSCC will continue to be designed with emerging therapeutic
agents. Trials should focus on those of highest risk of relapse and this study adds
clarity to the selection of the correct target population.
Keywords
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Article info
Publication history
Published online: September 03, 2022
Accepted:
July 26,
2022
Received in revised form:
July 19,
2022
Received:
May 31,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
