Evaluation of Factors Predicting Recurrence in Oral Squamous Cell Carcinoma.

Abstract

Oral cancer is the most common type of cancer in Indian males. Recurrent disease occurs in 17-40% of patients after primary treatment. Out of these around 20-30% recur at primary site and 10-15% at loco-regional nodal area with greater than 90% of recurrences occurring in first 2 years Survival rate is less even after advancement in management strategies. Most of the patients present at an advanced stage of the disease when the lymph node metastasis has already occurred which determines the outcome and leads to poor prognosis. Even if meticulous treatment, the risk of regional recurrence cannot be eliminated. We undertook to study and compare the factors responsible for locoregional control rate, distant control rate, disease free survival rate, recurrence free survival time and overall survival time. All patients enrolled in Department of Otorhinolaryngology, GTBH and DSCI, Delhi with surgery as integral part of treatment and upto 2 year of follow up were included and studied. Bony invasion (p = 0.001) and positive margins (p = 0.006) were found to be significant predictor of recurrence. LVI and Lymph node staging decreased RFS time (p < 0.05). LVI and ECE was associated decreased OS. 2 year overall survival rate with and without recurrence were 36% and 68% respectively. Mortality rates after recurrence was found to be 62%, RFS was 51%. Histopathologically, advanced diseases are associated with high recurrence rate, Bone involvement, margin status, LVI, ECE, advanced N-Stage being important predictors. Recurrence is always associated with poor outcome.