Clinicopathological features, management and outcome of patients with poorly-differentiated oral and oropharyngeal squamous cell carcinoma

Publication date: Available online 4 July 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Zhien Feng, Qiao Shi Xu, Chong Wang, Bo Li, Jin Zhong Li, Ming Hui Mao, Hua Li, Li Zheng Qin, Zhengxue Han
BackgroundThe purpose of this study was to explore the clinicopathological features, risk factors, and management of poorly differentiated oral and oropharyngeal squamous cell carcinoma (OOSCC) patients in the northern Chinese population.MethodA total of 118 poorly differentiated OOSCC patients from 2236 consecutive cases were retrospectively enrolled in this study.ResultsCox regression analysis showed that site (hazard ratio (HR): 2.561, 95% confidence interval (CI): 1.064–6.164, p = 0.036) and lymph node ratio (LNR) (HR: 3.915, 95% CI: 1.797–8.530, p = 0.001) were independent predictive factors for 5-year disease-specific survival (DSS). LNR > 0.036, oropharynx site, and advanced clinical stage formulate a model of risk stratification. The patients with a risk score of ≥2 were identified as the high-risk population, and patients with a risk score of 0 or 1 were identified as the low-risk population. Patients in the high-risk population who underwent surgery plus concurrent chemoradiotherapy (CCRT) had markedly better 5-year DSS than those who only underwent surgery (60.0% vs. 20.0%, p = 0.016). However, patients in the low-risk population who underwent surgery alone exhibited a similar 5-year DSS (68.2%) compared with those who received surgery plus radiotherapy (RT) (68.2%) or surgery plus CCRT (50.0%) (p = 0.907).ConclusionsHigh LNR, oropharynx site and advanced clinical stage constitute a model of risk stratification for patients with poorly differentiated OOSCC. If two or more risk factors are present, surgery and adjuvant chemoradiotherapy can give the best prognosis.



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