Analysis of epidemiological and clinicopathological risk factors for locoregional recurrence of oral cavity squamous cell carcinoma: retrospective analysis of 150 patients with buccal mucosal carcinoma in a tertiary care centre

Authors

  • Gopu Govindasamy Department of Surgical Oncology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
  • Selvakumar Ganesan Department of Surgical Oncology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20242700

Keywords:

Buccal mucosa, Squamous cell carcinoma, Recurrece, Extra nodal extension, Depth of invasion

Abstract

Background: Oral cavity cancers, the second most common type in India, are responsible for 10% of the overall cancer burden. With a recurrence rate of 30% to 40% and a 5-year survival rate of 50%, these malignancies account for substantial morbidity and mortality. Despite advances in treatment modalities, survival rates following treatment completion have not improved significantly. The present study aimed to establish specific epidemiological and pathological factors which are responsible for recurrence after treatment completion in buccal mucosa cancers.

Methods: A retrospective analysis of the data of 150 patients treated for biopsy-proven cancers of the buccal mucosa was undertaken 2 years after treatment completion. Factors such as age, sex, education, lymphovascular invasion, extranodal extension (ENE), perineural invasion, depth of invasion, and pathological margin status were compared between patients who presented with recurrence and those who did not. Statistical significance was set at p<0.05.  

Results: Of the 150 patients, 52 (34.6%) developed a recurrent disease within 2 years. The mean age of the study population was 45.6 years, and males constituted 84% of the included patients. Ipsilateral buccal mucosa was the commonest site of disease recurrence. Neck node metastasis, ENE, and margins of resection <5 mm, lymphovascular invasion, perineural invasion, and depth of invasion >10 mm, tobacco consumption, smoking were significantly related to the recurrence of disease.

Conclusions: Neck node metastasis, ENE, and margins of resection <5 mm, lymphovascular invasion, perineural invasion, depth of invasion >10 mm were the histopathological factors associated with recurrence in cancers of the buccal mucosa.

References

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209-49.

Chinn SB, Myers JN. Oral cavity carcinoma: current management, controversies, and future directions. J Clin Oncol. 2015;33:3269-76.

Safi AF, Kauke M, Grandoch A, Nickenig HJ, Zoller JE, Kreppel M. Analysis of clinicopathological risk factors for locoregional recurrence of oral squamous cell carcinoma: retrospective analysis of 517 patients. J Craniomaxillofac Surg. 2017;45:1749-53.

Vikram B, Strong EW, Shah JP, Spiro R. Failure at the primary site following multimodality treatment in advanced head and neck cancer. Head Neck Surg. 1984;6:720-3.

Brandwein-Gensler M, Teixeira MS, Lewis CM, Lee B, Rolnitzky L, Hille JJ, et al. Oral squamous cell carcinoma: histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. Am J Surg Pathol. 2005;29:167-78.

Safi AF, Grandoch A, Nickenig HJ, Zoller JE, Kreppel M. The importance of lymph node ratio for locoregional recurrence of squamous cell carcinoma of the tongue. J Craniomaxillofac Surg. 2017;45:1058-61.

Thakur R, Thakar A, Malhotra RK, Sharma A, Kakkar A. Tumor-host interface in oral squamous cell carcinoma: impact on nodal metastasis and prognosis. Eur Arch Otorhinolaryngol. 2021;278:5029-39.

Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, et al. The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin. 2017;67:93-9.

Sharma RG, Bang B, Verma H, Mehta JM. Profile of oral squamous cell cancer in a tertiary level medical college hospital: a 10 yr study. Indian J Surg Oncol. 2012;3:250-4.

Aggarwal VP, Rao DCL, Mathur A, Batra M, Makkar DK. Prevalence of head and neck and oral cancer in rajasthan: an infirmary based retrospective study. Clin Cancer Investig J. 2015;4:339-43.

Abbas SA, Saeed J, Tariq MU, Baksh AR, Hashmi S. Clinicopathological prognostic factors of oral squamous cell carcinoma: an experience of a tertiary care hospital. J Pak Med Assoc. 2018;68:1115-9.

Sundermann BV, Uhlmann L, Hoffmann J, Freier K, Thiele OC. The localization and risk factors of squamous cell carcinoma in the oral cavity: a retrospective study of 1501 cases. J Craniomaxillofac Surg. 2018;46:177-82.

Marinelli LM, Chatzopoulos K, Marinelli JP, Chen TY, Collins AR, Sotiriou S, et al. Clinicopathologic predictors of survival in buccal squamous cell carcinoma. J Oral Pathol Med. 2020;49:857-64.

Taghavi N, Yazdi I. Prognostic factors of survival rate in oral squamous cell carcinoma: clinical, histologic, genetic and molecular concepts. Arch Iran Med. 2015;18:314-9.

Kartini D, Kurnia A, Putri SR, Thaher TC, Handjari DR, Khoe LC, et al. Survival rate and prognostic factors of oral squamous cell carcinoma in Indonesia: a single-center retrospective study. Forum Clin Oncol. 2022;13:15-22.

Grover S, Anand T, Kishore J, Tripathy JP, Sinha DN. Tobacco use among the youth in India: evidence from global adult tobacco survey-2 (2016-2017) Tob Use Insights. 2020;13:117917-3.

Lo WL, Kao SY, Chi LY, Wong YK, Chang RC. Outcomes of oral squamous cell carcinoma in Taiwan after surgical therapy: factors affecting survival. J Oral Maxillofac Surg. 2003;61:751-8.

Anderson CR, Sisson K, Moncrieff M. A meta-analysis of margin size and local recurrence in oral squamous cell carcinoma. Oral Oncol. 2015;51:464-9.

Carrillo JF, Carrillo LC, Cano A, Ramirez-Ortega MC, Chanona JG, Aviles A, et al. Retrospective cohort study of prognostic factors in patients with oral cavity and oropharyngeal squamous cell carcinoma. Head Neck. 2016;38:536-41.

Marzouki HZ, Bukhari AF, Al-Ghamdi DA, Abdullah RM, Al-Hajeili M, Khayyat S, et al. Worst pattern of invasion and other histopathological features in oral cancer as determinants of prognosis and survival rate: a retrospective cohort analysis. Oncol Lett. 2023;25:75.

Liao CT, Chang JT, Wang HM, Ng SH, Hsueh C, Lee LY, et al. Analysis of risk factors of predictive local tumor control in oral cavity cancer. Ann Surg Oncol. 2008;15:915-22.

Dolens ED, Dourado MR, Almangush A, Salo TA, Gurgel Rocha CA, da Silva SD, et al. The impact of histopathological features on the prognosis of oral squamous cell carcinoma: a comprehensive review and meta-analysis. Front Oncol. 2021;11:784924.

Shaw RJ, Lowe D, Woolgar JA, Brown JS, Vaughan ED, Evans C, et al. Extracapsular spread in oral squamous cell carcinoma. Head Neck. 2010;32:714-22.

Wreesmann VB, Katabi N, Palmer FL, Montero PH, Migliacci JC, Gonen M, et al. Influence of extracapsular nodal spread extent on prognosis of oral squamous cell carcinoma. Head Neck. 2016;38 Suppl 1:E1192-9.

Kwon M, Roh JL, Lee J, Cho KJ, Choi SH, Nam SY, et al. Extranodal extension and thickness of metastatic lymph node as a significant prognostic marker of recurrence and survival in head and neck squamous cell carcinoma. J Craniomaxillofac Surg. 2015;43:769-78.

Fan KH, Lin CY, Kang CJ, Lee LY, Huang SF, Liao CT, et al. Postoperative concomitant chemoradiotherapy improved treatment outcomes of patients with oral cavity cancer with multiple-node metastases but no other major risk factors. PLoS One. 2014;9:e86922.

Troeltzsch M, Haidari S, Boser S, Troeltzsch M, Probst FA, Ehrenfeld M, et al. What factors are associated with regional recurrence after operative treatment of oral squamous cell carcinoma? J Oral Maxillofac Surg. 2018;76:2650-9.

Vázquez-Mahía I, Seoane J, Varela-Centelles P, Tomás I, Álvarez García A, López Cedrún JL. Predictors for tumor recurrence after primary definitive surgery for oral cancer. J Oral Maxillofac Surg. 2012;70(7):1724-32.

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Published

2024-09-25

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Original Research Articles