Clinical and pathological prognostic factors in patients with stage III–IVA-B oral squamous cell carcinoma
DOI:
https://doi.org/10.32471/exp-oncology.2312-8852.vol-41-no-2.13081Keywords:
clinical and pathological prognostic factors, oral squamous cell carcinomaAbstract
Summary. 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 patients 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.
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