Patterns of recurrence amongst patients undergoing resection of oral squamous cell carcinoma with curative intent

Zubair, Farhan; Farooq, Salman; Wright, Sylvia; Schipani, Stefano; McMahon, Jeremy

doi:10.1016/j.bjoms.2022.07.015

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…For example, Zubair et al evaluated 187 patients with recurrent disease, 46 of whom developed distant recurrence. The main risk factors were nodal disease (HR = 23.04 for pN2c) and depth of invasion (HR = 14.03 for >10 mm) [30]. Zanoni et al found that the neutrophile-to-lymphocyte (NLR) ratio-which we did not evaluate in our study-and nodal disease (>5 metastatic nodes) were the strongest risk factors (HR = 3.1 and HR = 2.06, respectively) for distant recurrence [31].…”

Section: Discussionmentioning

confidence: 99%

A Matter of Margins in Oral Cancer—How Close Is Enough?

Szewczyk,

Pazdrowski,

Pieńkowski

et al. 2024

Cancers

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In patients with oral cancer, the risk factors for local, regional, and distant recurrence according to margin status have not been well established. We aimed to determine the risk factors for recurrence by margin status and to identify a margin cut-off point for improved survival in patients with close margins. We retrospectively reviewed adult patients treated at our centre from 2009 to 2021 for primary oral cancer. Margins were classified as positive (<1 mm), close (1 to 4.9 mm), or clear (>5 mm). Univariate and multivariate analyses were performed. A total of 326 patients (210 men) were included. The mean age was 59.1 years. Margin status was close (n = 168, 51.5%), clear (n = 83, 25.4%), or positive (n = 75, 23.0%). In the univariate analysis, positive surgical margins (HR = 7.53) had the greatest impact on distant failure. Positive surgical margins—without nodal involvement—had the greatest impact on the risk of distant failure. In the close margin group, the optimal cut-off for disease-free survival (AUC = 0.58) and overall survival (AUC = 0.63) was a deep margin > 3 mm, with survival outcomes that were comparable to the clear margin group. These finding suggest that margins < 5 mm may be sufficient in certain well-defined cases. Prospective studies are warranted to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

A Matter of Margins in Oral Cancer—How Close Is Enough?

Szewczyk,

Pazdrowski,

Pieńkowski

et al. 2024

Cancers

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“…In contrast, the results of other authors indicate an increased risk of LR with increasing DOI. Farhan Zubair et al state that DOI > 10mm is predictive of an increased risk of LR (45). This fact shows how unpredictable OSCC is as a neoplasm, which makes it very difficult to develop gold standards for therapeutic approaches.…”

Section: Discussionmentioning

confidence: 99%

Oral squamous cell carcinoma – do we always need elective neck dissection? evaluation of clinicopathological factors of greatest prognostic significance: a cross-sectional observational study

Michcik,

Polcyn,

Sikora

et al. 2023

Front. Oncol.

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The aim of the study was to find clinical and pathological factors with the greatest prognostic significance in patients with OSCC. The analysis included 125 patients grouped according to the tumor primary site (TPS): the floor of the mouth (FOM), tongue (TC) and retromolar triangle (RMT). Grading (G), tumor size (pT), nodal metastases (NM), local recurrence (LR), nodal recurrence (NR), perineural invasion (PNI), lymphovascular invasion (LVI), extranodal extension (pENE), and nodal yield (NY) were evaluated in each group.ResultsWith regard to TPS, FOM appeared to be the most metastatic. However, the recurrence rate was similar to TC tumors, which were characterized by higher G than those in other locations. When analyzing G, the highest percentage of LR (40.5%) and NM (34.5%) was observed among patients with G2. As G increased, so did the number of pENE G1 – 7.4%; G2 – 31%; G3 – 35.7%; LVI: G1 – 25.9%; G2 – 50%; G3 – 57.1%; PNI: G1 – 29.6%; G2 – 47.6%; G3 – 92.9%; NR G1 – 14.8%; G2 – 32.1%; G3 – 21.4%. Grading did not affect the type of growth and did not directly affect the occurrence of NR. pT and DOI increased the frequency of NM but we did not observe any effect of pT and DOI on LR, PNI, and LVI. NY in the study group did not increase the risk of NR.ConclusionTumor primary sites within the FOM, TC, and pT classification are the factors that increase the risk of NM and LR. However, apart from the primary site predisposing to the occurrence of NM, the histological structure of the tumor turned out to be the most important feature affecting the patient’s prognosis. The number of cases of pENE+, LVI+, PNI+, NM+, and NR+ increased with the increase in G. Although the pT, DOI increased the frequency of NM, we did not observe the effect of the pT and DOI on LR, PNI and LVI. Thus, even in the case of a small tumor of the FOM and TC with at least G2, elective neck dissection should be performed each time.

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Letter to the Editor regarding Patterns of recurrence amongst patients undergoing resection of squamous cell carcinoma with curative intent

McGurk¹,

Sassoon²

2023

British Journal of Oral and Maxillofacial Surgery

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Patterns of recurrence amongst patients undergoing resection of oral squamous cell carcinoma with curative intent

Cited by 4 publications

References 13 publications

A Matter of Margins in Oral Cancer—How Close Is Enough?

A Matter of Margins in Oral Cancer—How Close Is Enough?

Oral squamous cell carcinoma – do we always need elective neck dissection? evaluation of clinicopathological factors of greatest prognostic significance: a cross-sectional observational study

Letter to the Editor regarding Patterns of recurrence amongst patients undergoing resection of squamous cell carcinoma with curative intent

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