Abstract
The aim of this study was to evaluate the prognostic significance of dysplasia in
patients undergoing primary surgery with curative intent in the treatment of oral
squamous cell carcinoma (OSCC). This study specifically aimed to demonstrate the effect
of dysplasia on local recurrence, disease specific survival (DSS) and overall survival
(OS). Data collection for 833 patients with OSCC undergoing treatment for curative
intent was undertaken retrospectively for the period of February 2006 to May 2020.
Analysis of any association between known clinicopathological prognostic categorical
variables with respect to dysplasia was undertaken using the chi squared test. A Kaplan-Meier
analysis was performed to demonstrate the impact of dysplasia on DSS and OS, and Cox’s
proportional-hazards model deployed to obtain hazard ratios associated with dysplasia
and the outcomes of interest. Dysplasia was statistically significant in predicting
disease specific and overall survival in patients undergoing primary surgery for OSCC
(DSS p<0.001, HR 0.577; 95%CI 0.428 to 0.777), OS p<0.001 HR 0.691; 95%CI 0.562 to
0.850) with the absence of dysplasia predicting poorer outcomes. The absence of dysplasia
correlated with pathological higher T and N stage, increased categorised depth of
tumour invasion, non-cohesive invasive front, lymphovascular invasion, perineural
invasion, extranodal extension and increased modified Glasgow Prognostic Score. No
significant prognostic relationship was attributable to the presence of dysplasia
at a surgical margin. The absence of dysplasia appeared to be a significant independent
prognostic indicator for patients with OSCC. The presence or absence of dysplasia
may provide a heuristic means of stratifying OSCC primary lesions in terms of disease
hostility.
Keywords
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Article info
Publication history
Published online: October 03, 2022
Accepted:
September 22,
2022
Identification
Copyright
Crown Copyright © 2022 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. All rights reserved.
