Prognostic factors of survival rate in oral squamous cell carcinoma: clinical, histologic, genetic and molecular concepts.

Oral squamous cell carcinoma (OSCC) represents 95% of all forms of head and neck cancers. The five-year survival rate of OSCC patients has been reported approximately 50%, which is not satisfactory despite new treatment modalities. The aim of the current review is to present factors (histologic, clinical, genetic and molecular biomarkers) correlated with survival rate in OSCC patients. A web-based search for all types of articles published was initiated using MEDLINE/PubMed. The search was restricted to articles focusing on relevant clinical, histologic, genetic and molecular factors of survival rate in OSCC and presenting new concepts in this field. Mode of invasion, presence of lymph node metastasis, extra-capsular spread, surgical margins and invasive tumor front grade are clinical and histologic parameters, which are strongly associated with survival rate. Focusing on selected proteins, wide range of molecular markers and gene alterations involving in cell cycle regulation, apoptosis, cell migration, cell adhesion and tumor microenvironment have been documented. Among well-known molecular markers, cyclin dependent kinase, survivin, CD44, BUBR1, and heat shock proteins (27,70) can be considered as independent prognostic factors of survival rate. The identified prognostic factors imply a relatively comprehensive understanding of factors related to survival rate in OSCC patients, and provide an additional tool for selecting patients who need more aggressive treatment design.