What factors are associated with regional recurrence following operative treatment of oral squamous cell carcinoma?

Publication date: Available online 19 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Matthias Troeltzsch, Selgai Haidari, Sophie Boser, Markus Troeltzsch, Florian A. Probst, Michael Ehrenfeld, Sven Otto

Abstract

Purpose

A considerable proportion of OSCC recurrences involve the neck which has a significant impact on prognosis and is poorly understood. The purpose of this study was to analyze clinical and pathological characteristics of regional recurrence of OSCC and to identify possible risk factors.

Materials and Methods

A single – center retrospective cohort study was designed to address the study purpose. All the patients who were treated surgically for primary OSCC with or without adjuvant therapy between 2010 and 2015 were considered for the inclusion with respect to predefined criteria and demographical, clinical and pathological variables were collected. The lymph node status after primary OSCC treatment ("pN") was defined as the predictor variable and the occurrence regional recurrence served as the primary outcome variable. Further variables of special interest were the histologic differentiation (G – status) of the primary OSCC and the values lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS). Descriptive, inferential and appropriate time – dependent (Kaplan – Meier analysis, cox regression model) statistics were computed. The level of statistical significance was set at p ≤ 0.05.

Results

The study sample was composed of 171 patients (female: 70; male: 101; average age 62.4 years). Neck failure occurred in 18 patients (11%) either in combination with local recurrence (15 patients) or in isolation (3 patients). Poor histologic differentiation of the primary tumor was identified as an independent risk factor for regional recurrence. The majority of neck recurrences manifested in previously unaddressed levels (IV and V).

Conclusion

Regional recurrence of OSCC might be associated with specific clinicopathological parameters of the primary tumor. Their importance for OSCC prognosis assessment and recurrence prediction should be elucidated in further studies.

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