Factors affecting prognosis in locoregional recurrence of oral squamous cell carcinoma

Research output: Contribution to journalArticle

Authors

  • Daniele Borsetto
  • James A Higginson
  • Adil Aslam
  • Laith Al-Qamachi
  • Jagtar Dhanda
  • Gino Marioni
  • Sebastiano Franchella
  • Annachiara Frigo
  • Prav Praveen
  • Tim Martin
  • Sat Parmar

Colleges, School and Institutes

External organisations

  • Institute for Global Innovation and Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK.
  • Oral and Maxillofacial Department, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
  • Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy.
  • Unit of Biostatistics, Epidemiology and Public Health, University Hospital of Padova, Padova, Italy.

Abstract

BACKGROUND: Recurrence of oral squamous cell carcinoma (rOSCC) after primary treatment is associated with poor survival outcomes. Salvage treatment with further surgery, radiotherapy and chemotherapy has high morbidity, making patient selection crucial. However, in the recurrence setting, reliable stratification data are scarce. Decision-making in this context is consequently complex. We investigated factors influencing overall survival after rOSCC.

METHODS: Retrospective cohort study of patients with rOSCC (n = 83) at the Queen Elizabeth Hospital Birmingham, UK between 2006 and 2016. Associations with overall survival were analysed using univariate and multivariate analyses to identify important clinical prognostic indicators.

RESULTS: Overall survival at 1 year was 32.5% and at 5 years was 18.1% after a median follow-up of 7.4 months. Multivariate analysis identified four independent predictors of overall survival following rOSCC: size of primary tumour (HR 2.077; 95% CI 1.034-4.172), extent of recurrent disease (HR 3.286; 95% CI 1.545-6.991), history of moderate alcohol consumption (HR 0.351; 95% CI 0.162-0.763), and close or positive margins at primary resection (HR 1.955; 95% CI 1.063-3.595).

CONCLUSIONS: We identified four key factors that help prognostication and risk stratification of rOSCC. Given the high morbidity associated with salvage treatment, we recommend that the multidisciplinary team (MDT) and the patient weigh these factors carefully when considering further treatment. Further investigation of the biology underlying these oncophenotypes may contribute to better patient stratification.

Bibliographic note

Borsetto D, Higginson JA, Aslam A, et al. Factors affecting prognosis in locoregional recurrence of oral squamous cell carcinoma. J Oral Pathol Med. 2019;00:1–8. https://doi.org/10.1111/jop.12815

Details

Original languageEnglish
Pages (from-to)206-213
Number of pages8
JournalJournal of Oral Pathology and Medicine
Volume48
Issue number3
Early online date21 Dec 2018
Publication statusPublished - Mar 2019

Keywords

  • alcohol, head and neck cancer, oral cancer, radiotherapy, tobacco