Advertisement

Pattern of recurrence amongst patients undergoing resection of oral squamous cell carcinoma with curative intent

Published:September 03, 2022DOI:https://doi.org/10.1016/j.bjoms.2022.07.015

      Abstract

      Background

      This study aims to identify key clinicopathological variables which predict recurrence in those undergoing curative resection of oral squamous cell carcinoma (OSCC) with emphasis on initial treatment failure patterns.

      Methods

      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, where a multivariate regression analysis was utilised to generate predictive models.

      Results

      187 patients (22.4%) developed recurrent disease; 79 local, 63 regional and 46 distant. For local recurrence: tumour depth of invasion (DOI) >5-10mm, tumour DOI >10mm 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 >10mm were independently predictive (c-index 0.809). For recurrence at any site; pN1, pN2a, pN2b, pN2c, pN3b, tumour DOI >5-10mm, tumour DOI >10mm, mGPS 2 and involved surgical margins were independently predictive (c-index 0.750).

      Conclusions

      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

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to British Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Jerjes W.
        • Upile T.
        • Petrie A.
        • et al.
        Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1–T2 oral squamous cell carcinoma patients.
        Head and Neck Oncology. 2010; 2: 9
        • Wang B.
        • Zhang S.
        • Yue K.
        • Wang X.D.
        The recurrence and survival of oral squamous cell carcinoma: a report of 275 cases.
        Chinese Journal of Cancer. 2013; 32: 614-618
        • Camisasca D.R.
        • Silami M.A.N.C.
        • Honorato J.
        • Dias F.L.D.
        • Faria P.A.S.
        • Lourenço S.Q.C.
        Oral squamous cell carcinoma: clinicopathological features in patients with and without recurrence.
        ORL – Journal for Otorhinolaryngology and its related specialties. 2011; 73: 170-176
        • Ebrahimi A.
        • Clark J.R.
        • Zhang W.J.
        • Elliott M.S.
        • Gao K.
        • Milross C.G.
        • Shannon K.F.
        Lymph node ratio as an independent prognostic factor in oral squamous cell carcinoma.
        Head & Neck. 2011; 33: 1245-1251
        • Zubair F.
        • McMahon J.
        • Kryklyas G.
        • Wicks C.
        The systemic inflammatory response in predicting outcomes of patients undergoing curative resection for oral squamous cell carcinoma.
        British Journal of Oral and Maxillofacial Surgery. 2021;
        • Mantovani A.
        • Ponzetta A.
        • Inforzato A.
        • Jaillon S.
        Innate Immunity, Inflammation and Tumour Progression: Double Edged Swords.
        Journal of Internal Medicine. 2019 May; 285: 524-532
        • Greten F.R.
        • Grivennikov S.I.
        Inflammation and Cancer: Triggers, Mechanisms and Consequences.
        Immunity. 2019 July; 51: 27-41
        • Troeltzsch M.
        • Haidari S.
        • Boser S.
        • Troeltzsch M.
        • Probst F.A.
        • Ehrenfeld M.
        • Otto S.
        What Factors Are Associated With Regional Recurrence After Operative Treatment of Oral Squamous Cell Carcinoma?.
        Journal of Oral and Maxillofacial Surgery. 2018; 76: 2650-2659
        • Myres J.N.
        • Greenberg J.S.
        • Mo V.
        • Roberts D.
        Extracapsular spread. A significant predictor of treatment failure in patients with squamous cell carcinoma of the tongue.
        Cancer. 2001; 92: 3030-3036
        • Yamamoto E.
        • Miyakawa A.
        • Kohama G.
        Mode of invasion and lymph node metastasis in squamous cell carcinoma of the oral cavity.
        Head and Neck Surgery. 1984; 6: 938-947
        • Hsieh R.W.
        • Borson S.
        • Tsagianni Z.DP.
        Immunotherapy in Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck. Frontiers.
        Oncology. 2021; : 11:705614
        • Stafford M.
        • Kaczmar J.
        The neoadjuvant paradigm reinvigorated: a review of pre-surgical immunotherapy in HNSCC. Cancers of the.
        Head & Neck. 2020; 5
        • Saidak Z.
        • Lailler C.
        • Clatot F.
        • Galmiche A.
        Perineural invasion in head and neck squamous cell carcinoma: background, mechanisms, and prognostic implications.
        Curr Opin Otolaryngol Head Neck Surg. 2020; 28: 90-95