DOI QR코드

DOI QR Code

Predicting recurrence in oral cavity cancers: a review of 116 patients with buccal mucosa carcinoma in northwestern India

  • Received : 2023.06.16
  • Accepted : 2023.09.11
  • Published : 2023.10.20

Abstract

Background: Oral cavity cancers, the second most common type in India, are responsible for 10% of the overall cancer burden. With a recurrence rate of 30% to 40% and a 5-year survival rate of 50%, these malignancies account for substantial morbidity and mortality. Despite advances in treatment modalities, survival rates following treatment completion have not improved significantly. The present study aimed to establish specific epidemiological and pathological factors responsible for recurrence after treatment completion in buccal mucosa cancers. Methods: A retrospective analysis of the data of 116 patients treated for biopsy-proven cancers of the buccal mucosa was undertaken 1 year after treatment completion. Factors such as age, sex, education, lymphovascular invasion, extranodal extension (ENE), perineural invasion, depth of invasion, and pathological margin status were compared between patients who presented with recurrence and those who did not. Statistical significance was set at p< 0.05. Results: Of the 116 patients, 40 (34.5%) developed a recurrent disease within 1 year. The mean age of the study population was 43.3 years, and males constituted 91.4% of the included patients. Ipsilateral buccal mucosa was the commonest site of disease recurrence. Neck node metastasis, ENE, and margins of resection < 5 mm were significantly related to the recurrence of disease. However, surprisingly, lymphovascular invasion, perineural invasion, and depth of invasion > 10 mm did not show statistically significant associations. Conclusion: Neck node metastasis, ENE, and margins of resection < 5 mm were the histopathological factors associated with recurrence in cancers of the buccal mucosa.

Keywords

References

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209-49.  https://doi.org/10.3322/caac.21660
  2. Chinn SB, Myers JN. Oral cavity carcinoma: current management, controversies, and future directions. J Clin Oncol 2015;33:3269-76.  https://doi.org/10.1200/JCO.2015.61.2929
  3. Safi AF, Kauke M, Grandoch A, Nickenig HJ, Zoller JE, Kreppel M. Analysis of clinicopathological risk factors for locoregional recurrence of oral squamous cell carcinoma: retrospective analysis of 517 patients. J Craniomaxillofac Surg 2017;45:1749-53.  https://doi.org/10.1016/j.jcms.2017.07.012
  4. Vikram B, Strong EW, Shah JP, Spiro R. Failure at the primary site following multimodality treatment in advanced head and neck cancer. Head Neck Surg 1984;6:720-3.  https://doi.org/10.1002/hed.2890060303
  5. Brandwein-Gensler M, Teixeira MS, Lewis CM, Lee B, Rolnitzky L, Hille JJ, et al. Oral squamous cell carcinoma: histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. Am J Surg Pathol 2005;29:167-78.  https://doi.org/10.1097/01.pas.0000149687.90710.21
  6. Safi AF, Grandoch A, Nickenig HJ, Zoller JE, Kreppel M. The importance of lymph node ratio for locoregional recurrence of squamous cell carcinoma of the tongue. J Craniomaxillofac Surg 2017;45:1058-61.  https://doi.org/10.1016/j.jcms.2017.04.008
  7. Thakur R, Thakar A, Malhotra RK, Sharma A, Kakkar A. Tumor-host interface in oral squamous cell carcinoma: impact on nodal metastasis and prognosis. Eur Arch Otorhinolaryngol 2021;278:5029-39.  https://doi.org/10.1007/s00405-021-06756-y
  8. Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, et al. The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin 2017;67:93-9.  https://doi.org/10.3322/caac.21388
  9. Sharma RG, Bang B, Verma H, Mehta JM. Profile of oral squamous cell cancer in a tertiary level medical college hospital: a 10 yr study. Indian J Surg Oncol 2012;3:250-4.  https://doi.org/10.1007/s13193-012-0165-z
  10. Aggarwal VP, Rao DCL, Mathur A, Batra M, Makkar DK. Prevalence of head and neck and oral cancer in rajasthan: an infirmary based retrospective study. Clin Cancer Investig J 2015;4:339-43.  https://doi.org/10.4103/2278-0513.154537
  11. Abbas SA, Saeed J, Tariq MU, Baksh AR, Hashmi S. Clinicopathological prognostic factors of oral squamous cell carcinoma: an experience of a tertiary care hospital. J Pak Med Assoc 2018;68:1115-9. 
  12. Sundermann BV, Uhlmann L, Hoffmann J, Freier K, Thiele OC. The localization and risk factors of squamous cell carcinoma in the oral cavity: a retrospective study of 1501 cases. J Craniomaxillofac Surg 2018;46:177-82.  https://doi.org/10.1016/j.jcms.2017.10.019
  13. Marinelli LM, Chatzopoulos K, Marinelli JP, Chen TY, Collins AR, Sotiriou S, et al. Clinicopathologic predictors of survival in buccal squamous cell carcinoma. J Oral Pathol Med 2020;49:857-64.  https://doi.org/10.1111/jop.13046
  14. Taghavi N, Yazdi I. Prognostic factors of survival rate in oral squamous cell carcinoma: clinical, histologic, genetic and molecular concepts. Arch Iran Med 2015;18:314-9. 
  15. Kartini D, Kurnia A, Putri SR, Thaher TC, Handjari DR, Khoe LC, et al. Survival rate and prognostic factors of oral squamous cell carcinoma in Indonesia: a single-center retrospective study. Forum Clin Oncol 2022;13:15-22.  https://doi.org/10.2478/fco-2021-0013
  16. Grover S, Anand T, Kishore J, Tripathy JP, Sinha DN. Tobacco use among the youth in India: evidence from global adult tobacco survey-2 (2016-2017). Tob Use Insights 2020;13:1179173X20927397. 
  17. Lo WL, Kao SY, Chi LY, Wong YK, Chang RC. Outcomes of oral squamous cell carcinoma in Taiwan after surgical therapy: factors affecting survival. J Oral Maxillofac Surg 2003;61:751-8.  https://doi.org/10.1016/S0278-2391(03)00149-6
  18. Anderson CR, Sisson K, Moncrieff M. A meta-analysis of margin size and local recurrence in oral squamous cell carcinoma. Oral Oncol 2015;51:464-9.  https://doi.org/10.1016/j.oraloncology.2015.01.015
  19. Carrillo JF, Carrillo LC, Cano A, Ramirez-Ortega MC, Chanona JG, Aviles A, et al. Retrospective cohort study of prognostic factors in patients with oral cavity and oropharyngeal squamous cell carcinoma. Head Neck 2016;38:536-41.  https://doi.org/10.1002/hed.23914
  20. Marzouki HZ, Bukhari AF, Al-Ghamdi DA, Abdullah RM, Al-Hajeili M, Khayyat S, et al. Worst pattern of invasion and other histopathological features in oral cancer as determinants of prognosis and survival rate: a retrospective cohort analysis. Oncol Lett 2023;25:75. 
  21. Liao CT, Chang JT, Wang HM, Ng SH, Hsueh C, Lee LY, et al. Analysis of risk factors of predictive local tumor control in oral cavity cancer. Ann Surg Oncol 2008;15:915-22.  https://doi.org/10.1245/s10434-007-9761-5
  22. Dolens ED, Dourado MR, Almangush A, Salo TA, Gurgel Rocha CA, da Silva SD, et al. The impact of histopathological features on the prognosis of oral squamous cell carcinoma: a comprehensive review and meta-analysis. Front Oncol 2021;11:784924. 
  23. Shaw RJ, Lowe D, Woolgar JA, Brown JS, Vaughan ED, Evans C, et al. Extracapsular spread in oral squamous cell carcinoma. Head Neck 2010;32:714-22.  https://doi.org/10.1002/hed.21244
  24. Wreesmann VB, Katabi N, Palmer FL, Montero PH, Migliacci JC, Gonen M, et al. Influence of extracapsular nodal spread extent on prognosis of oral squamous cell carcinoma. Head Neck 2016;38 Suppl 1:E1192-9.  https://doi.org/10.1002/hed.24190
  25. Kwon M, Roh JL, Lee J, Cho KJ, Choi SH, Nam SY, et al. Extranodal extension and thickness of metastatic lymph node as a significant prognostic marker of recurrence and survival in head and neck squamous cell carcinoma. J Craniomaxillofac Surg 2015;43:769-78.  https://doi.org/10.1016/j.jcms.2015.04.021
  26. Fan KH, Lin CY, Kang CJ, Lee LY, Huang SF, Liao CT, et al. Postoperative concomitant chemoradiotherapy improved treatment outcomes of patients with oral cavity cancer with multiple-node metastases but no other major risk factors. PLoS One 2014;9:e86922. 
  27. Troeltzsch M, Haidari S, Boser S, Troeltzsch M, Probst FA, Ehrenfeld M, et al. What factors are associated with regional recurrence after operative treatment of oral squamous cell carcinoma? J Oral Maxillofac Surg 2018;76:2650-9. https://doi.org/10.1016/j.joms.2018.07.005