Cancer Recurrence in Operated Primary Oral Squamous Cell Carcinoma Patients Seems to Be Independent of the Currently Available Postoperative Therapeutic Approach: A Retrospective Clinical Study.

Abstract

Despite advances in treatment, recurrence rates in oral squamous cell carcinoma (OSCC) remain high. Prognostic outcomes vary in terms of local recurrence, metastasis, and overall survival. A retrospective cohort analysis was conducted on OSCC patients who underwent primary surgery at the Department of Craniomaxillofacial and Facial Plastic Surgery, University Medical Center Frankfurt, between January 2014 and December 2020. Demographic data, tumor characteristics, surgical details, intraoperative frozen section results, and recurrence patterns were first assessed for availability. Subsequently, the available data relevant to each endpoint were analyzed. A total of 169 patients were analyzed (mean age: 64 years). The tongue was the most affected site and had the highest recurrence rate, followed by the floor of the mouth. Overall, 24.3% of patients experienced recurrence, with most cases occurring within the first year. T2 tumors had the highest recurrence rates. Between patients with and without adjuvant therapy, recurrence rates were comparable. Positive surgical margins were more common in recurrence cases, but no significant correlation was found between margin status and recurrence in patients without adjuvant therapy. Based on the analyzed data, achieving recurrence-free survival in OSCC does not solely depend on surgical technique or adjuvant therapy. Instead, early recognition of individual tumor characteristics and even tumor biology should guide personalized treatment planning. Notably, tumors of the tongue and floor of the mouth exhibited high recurrence rates regardless of disease stage, raising the question of whether primary chemoradiotherapy (CRT) could achieve better outcomes than surgery. Further studies are needed to evaluate the role of CRT as a first-line treatment for OSCC in these locations.