J Korean Assoc Oral Maxillofac Surg.  2019 Apr;45(2):83-90. 10.5125/jkaoms.2019.45.2.83.

Overall and disease-specific survival outcomes following primary surgery for oral squamous cell carcinoma: analysis of consecutive 67 patients

• Sim YC
• Hwang JH
• Ahn KM

• KMID: 2467151
• DOI: http://doi.org/10.5125/jkaoms.2019.45.2.83

Abstract

OBJECTIVES
This study evaluated the predictive factors for survival of patients with oral squamous cell carcinoma (OSCC) and investigated the overall and disease-specific survival (DSS) outcomes.
MATERIALS AND METHODS
A total of 67 consecutive patients who underwent surgery for OSCC from January 2006 to November 2014 were included in this study. Patients were classified according to age, sex, pTNM stages, primary sites, smoking and alcohol drinking habits, depth of invasion, perineural and lymphovascular invasion, cell differentiation and postoperative radiotherapy. Kaplan-Meier methods were used to estimate the survival categorized by patient groups. Cox regression methods were used to investigate the main independent predictors of survival.
RESULTS
Nineteen patients died of OSCC during follow-up periods. Another five patients died of other diseases including lung adenocarcinoma (n=1), cerebral infarction (n=1), general weakness (n=2), and pneumonia (n=1). The tongue (n=16) was the most common site for primary origin, followed by buccal mucosa (n=15), mandibular gingiva (n=15), maxillary gingiva (n=9), floor of mouth (n=9), retromolar trigone (n=2), and palate (n=1). Eleven patients had pTNM stage I disease, followed by stage II (n=22) and stage IV (n=34). No patients had pTNM stage III disease in this study. The overall survival of all patients was 64.2% and the DSS was 71.6%. DSS of patients with stage I and II disease was 100%. Stepwise Cox regression showed the two predictors for DSS were pTNM stage (P<0.0001, odds ratio=19.633) and presence of metastatic lymph nodes (P=0.0004, odds ratio=0.1039).
CONCLUSION
OSCC has been associated with poor prognosis; however, there were improved survival outcomes compared with past studies. Advanced-stage disease and presence of metastatic lymph nodes were associated with poorer survival compared with early-stage OSCC and absence of neck node metastasis. Stage I and II OSCC were associated with excellent survival results in this study.

Keyword

Head and neck neoplasm; Survival; Lymphatic metastasis; Neoplasm staging

MeSH Terms

Adenocarcinoma
Alcohol Drinking
Carcinoma, Squamous Cell*
Cell Differentiation
Cerebral Infarction
Epithelial Cells*
Follow-Up Studies
Gingiva
Humans
Lung
Lymph Nodes
Lymphatic Metastasis
Mouth Floor
Mouth Mucosa
Neck
Neoplasm Metastasis
Neoplasm Staging
Palate
Pneumonia
Prognosis
Radiotherapy
Smoke
Smoking
Tongue
Smoke

Figure

• 

  Fig. 1 Overall survival (OS) and disease-specific survival (DSS) of 67 patients with oral squamous cell carcinoma.

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  Fig. 2 Comparison of the disease-specific survival of neck node positive and negative groups.

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  Fig. 3 Disease-specific survival for 67 patients with oral squamous cell carcinoma by pTNM stage.

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