Clinical and pathological prognostic factors in patients with stage III–IVA-B oral squamous cell carcinoma

Abstract

The aim of the work was to study clinical and pathological factors affecting the prognosis of the disease in patients with stage III–IVA-B oral squamous cell carcinoma (OSCC). Materials and Methods: A retrospective review of medical records of 234 pa- tients with stage III–IVA-B OSCC was performed in order to study the impact of clinical and pathological factors on disease-free survival (DFS) and overall survival (OS). Results: Multivariable analysis of clinical factors revealed a statistically significant effect of stage IVA-B and the presence of surgical complications on DFS (hazard ratio (HR) = 4.9 (95% confidence interval (CI) 2.9–8.3), p < 0.001; HR = 1.6 (95% CI 1.0–2.6), p = 0.047), respectively. Stage IVA-B, the presence of surgical complications and the retromolar trigone subsite were found to have a statistically significant impact on OS (HR = 4.0 (95% CI 2.5–6.5), p < 0.001; HR = 1.8 (95% CI 1.1–2.8), p = 0.01; HR = 1.9 (95% CI 1.1–3.2), p = 0.02), respectively. Multivariable analysis of pathological factors showed a statistically significant effect of positive resection margins, the multiple lymph node involvement and high-grade tumor on DFS (HR = 3.7 (95% CI 2.0–6.6), p < 0.001; HR = 4.3 (95% CI 2.8–6.7), p < 0.001; HR = 1.6 (95% CI 1.1–2.2), p = 0.01), respectively. Besides, positive resection margins and multiple lymph node involvement were found to cause a statistically significant impact on the OS (HR = 3.6 (95% CI 2.0–6.5), p < 0.001; HR = 3.7 (95% CI 2 5–5.6), p < 0.001), respectively. A tumor grade tended to worsen OS (HR = 1.4 (95% CI 1.0–1.9), p = 0.053). Conclusion: Stage IVA, B, the presence of surgical complications, the retromolar trigone subsite, positive resection margins, multiple lymph node involvements and high-grade tumor were found to be significant clinical and pathological prognostic factors in patients with stage III–IVA-B OSCC.