Time to recurrence and patient survival in recurrent oral squamous cell carcinoma. (July 2019)

• Record Type: Journal Article
• Authors: Weckx, Annelies; Riekert, Maximilian; Grandoch, Andrea; Schick, Volker; Zöller, Joachim E.; Kreppel, Matthias
• Is Part Of: Oral oncology. Volume 94(2019)
• Page Start: 8
• Page End: 13
• Publication Date: 2019-07
• Subjects: Oral Cancer -- Squamous cell carcinoma -- Recurrence -- Risk factor -- Survival -- Prognosis; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2019.05.002
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: A shorter time to recurrence (TTR) indicates a worse patient's prognosis. The primary's grading, margins and lymph node ratio significantly influence TTR. Independent predictors for overall survival in recurrent OSCC were identified. This allows for individualised follow-up programs and earlier diagnosis of relapse. Abstract: Objectives: Tumour relapse remains one of the major problems in managing oral squamous cell carcinoma (OSCC) with mortality rates of up to 92%. Early recurrences have a worse prognosis than late relapses. However, few has been written about the influence of clinicopathological parameters on the timing of recurrence and the patient survival. Materials and methods: Retrospective chart review of 159 patients with an OSCC recurrent disease. Exclusion criteria were neoadjuvant chemoradiotherapy, follow-up <6 weeks, perioperative death, second primaries and inadequate information on clinicopathological parameters. Statistical analysis was performed using univariate and multivariate analysis. Results: A significant correlation was found in the χ2-analysis between the timing of recurrence and the margin status (p = 0.020), lymph node ratio (p = 0.030) and grading (p = 0.003) of the primary tumour. In the multivariate survival analysis, the timing of recurrence (p < 0.001), margin status of the primary tumour (p = 0.023), presence of extracapsular spread in the primary tumour (p = 0.003) and performance of a salvage treatment (p < 0.001) were shown to be independent risk factors for overall survival. Conclusion: For patients with a recurrent OSCC, the time to recurrence, margin status, extracapsular spread and the performance of a salvage treatment are independent prognostic factors for overall survival. Furthermore, a significant association exists between the moment of recurrence and the lymph node ratio, the margin status and grading of the primary tumour. This knowledge can allow for the development of individualised surveillance programs and like this, an earlier diagnosis and better second treatment chance in the case of a recurrence.