Matthias Troeltzsch1, Selgai Haidari2, Sophie Boser3, Markus Troeltzsch4, Florian A Probst5, Michael Ehrenfeld6, Sven Otto7. 1. Fellow, Department of Oral and Maxillofacial Surgery, Ludwig Maximilian University of Munich, Munich, Germany. Electronic address: matthias_troeltzsch@hotmail.com. 2. Resident, Department of Oral and Maxillofacial Surgery, Ludwig Maximilian University of Munich, Munich, Germany. 3. Doctoral Student, Department of Oral and Maxillofacial Surgery, Ludwig Maximilian University of Munich, Munich, Germany. 4. Attending Physician, Department of Oral and Maxillofacial Surgery, Ansbach General Hospital, and Private Practice, Ansbach, Germany. 5. Fellow, Department of Oral and Maxillofacial Surgery, Ludwig Maximilian University of Munich, Munich, Germany. 6. Professor and Department Chair, Department of Oral and Maxillofacial Surgery, Ludwig Maximilian University of Munich, Munich, Germany. 7. Associate Professor, Department of Oral and Maxillofacial Surgery, Ludwig Maximilian University of Munich, Munich, Germany.
Abstract
PURPOSE: A considerable proportion of oral squamous cell carcinoma (OSCC) recurrences involve the neck, which has a substantial impact on prognosis and is poorly understood. The purpose of this study was to analyze clinical and pathologic characteristics of regional recurrence of OSCC and identify possible risk factors. MATERIALS AND METHODS: A single-center retrospective cohort study was designed to address the study purpose. All patients who were treated surgically for primary OSCC with or without adjuvant therapy between 2010 and 2015 were considered for inclusion with respect to predefined criteria, and demographic, clinical, and pathologic variables were collected. The lymph node status after primary OSCC treatment (pN) was defined as the predictor variable, and the occurrence of regional recurrence served as the primary outcome variable. Further variables of special interest were the histologic differentiation (G status) of the primary OSCC and the values of the lymph node ratio and log odds of positive lymph nodes. Descriptive, inferential, and appropriate time-dependent (Kaplan-Meier analysis, Cox regression model) statistics were computed. The level of statistical significance was set at P ≤ .05. RESULTS: The study sample was composed of 171 patients (70 women and 101 men; average age, 62.4 years). Neck failure occurred in 18 patients (11%) either in combination with local recurrence (15 patients) or in isolation (3 patients). Poor histologic differentiation of the primary tumor was identified as an independent risk factor for regional recurrence. Most neck recurrences manifested in previously unaddressed levels (IV and V). CONCLUSIONS: Regional recurrence of OSCC might be associated with specific clinicopathologic parameters of the primary tumor. The importance of these parameters for OSCC prognosis assessment and recurrence prediction should be elucidated in further studies.
PURPOSE: A considerable proportion of oral squamous cell carcinoma (OSCC) recurrences involve the neck, which has a substantial impact on prognosis and is poorly understood. The purpose of this study was to analyze clinical and pathologic characteristics of regional recurrence of OSCC and identify possible risk factors. MATERIALS AND METHODS: A single-center retrospective cohort study was designed to address the study purpose. All patients who were treated surgically for primary OSCC with or without adjuvant therapy between 2010 and 2015 were considered for inclusion with respect to predefined criteria, and demographic, clinical, and pathologic variables were collected. The lymph node status after primary OSCC treatment (pN) was defined as the predictor variable, and the occurrence of regional recurrence served as the primary outcome variable. Further variables of special interest were the histologic differentiation (G status) of the primary OSCC and the values of the lymph node ratio and log odds of positive lymph nodes. Descriptive, inferential, and appropriate time-dependent (Kaplan-Meier analysis, Cox regression model) statistics were computed. The level of statistical significance was set at P ≤ .05. RESULTS: The study sample was composed of 171 patients (70 women and 101 men; average age, 62.4 years). Neck failure occurred in 18 patients (11%) either in combination with local recurrence (15 patients) or in isolation (3 patients). Poor histologic differentiation of the primary tumor was identified as an independent risk factor for regional recurrence. Most neck recurrences manifested in previously unaddressed levels (IV and V). CONCLUSIONS: Regional recurrence of OSCC might be associated with specific clinicopathologic parameters of the primary tumor. The importance of these parameters for OSCC prognosis assessment and recurrence prediction should be elucidated in further studies.