Early oral cavity cancer: The prognostic factors and impact of adjuvant radiation on survival

Abstract

Background Early oral cavity cancer has good prognosis but recurrence in them is still not uncommon. There is no general consensus on the prognostic factors and adjuvant therapy that would have a significant impact on survival. Methods A retrospective analysis of early oral cavity cancer patients during the time period 2009‐2017. The data regarding demographics, histopathological features, and recurrence patterns were collected and analyzed. Results Depth of invasion (DOI) was the most important prognostic factor among all the factors analyzed. Further analysis showed that addition of adjuvant radiotherapy for patients with DOI >5 mm did not show survival benefits (P = .73). Another subset analysis of patients with DOI >10 mm also did not show any survival advantage with adjuvant therapy P = .24. Conclusion There is no benefit of adding adjuvant RT in patients with DOI > 5 mm or in patients who were upstaged to T3 based only on DOI.

Postoperative Radiotherapy Improved Survival in pT1-2N1 Oral and Oropharyngeal Cancer Without Adequate Neck Dissection ​

“…Several studies have demonstrated that pN1 may itself be an indication for postoperative radiotherapy after resection of oral cavity primary tumors. 4,16 Chen et al reported an association of postoperative radiotherapy with improved OS for 1,467 patients from the National Cancer Database with oral (HR, 0.76; 95% CI, 0.63-0.92) and oropharyngeal cancer (HR, 0.62; 95% CI, 0.41-0.92) with pN1 disease without adverse feature, especially in those younger than 70 years or those with pT2 disease. Shrime et al, in an analysis of 1,539 patients with T-21N1 oral cancer, found that 78.6% had postoperative radiotherapy, which was associated with better 5-year OS (54.2% vs 41.4%, P < 0.001).…”

Efficacy of Computed Tomography and Magnetic Resonance Imaging in the Assessment of Depth of Invasion in Oral Squamous Cell Carcinoma: Analysis of 125 Clinical Cases

“…Approximately 40% of patients with OSCC at the time of diagnosis already present with metastatic lymph nodes [2], which are known to significantly reduce a patient's prognosis [3]. In addition to evaluating the cervical lymphatic system, it is crucial to accurately assess the tumor's features, especially the depth of invasion (DOI), which is a prognostically significant factor [4,5]. A classification published in the eighth edition of the American Joint Committee on Cancer's (AJCC) manual included depth of invasion due to the strong association of the DOI with nodal metastasis [6].…”

Knowledge, attitude, and practice in oral cancer: A national survey on 150 dental hygienists

“…Various prognostic factors have been studied to evaluate their role in OC prognosis: patient factors (age at diagnosis, gender, and risk factors), tumor factors (tumor size, lymph node involvement, stage, and grade at diagnosis), and molecular biomarkers (Geleijnse et al, 2020; Saka‐Herrán et al, 2021). Among these, especially depth of invasion, lymph vascular invasion, perineural invasion, margin status, and histologic grade were predictive of poor survival (Ghani et al, 2019; Rajappa et al, 2019). Therefore, the advanced stage at diagnosis, in particular, the pathologic lymph node stage, is the most consistent predictor of survival in OC patients (Zanoni et al, 2019).…”