Influence of Clinicopathological Risk Factors on the Time to Recurrence and Patient Survival in Recurrent Oral Squamous Cell Carcinoma

Objectives: Tumour relapse remains one of the major problems in managing oral squamous cell carcinoma (OSCC) and is associated with a dramatic worsening of the patient’s prognosis. Early recurrences have a worse prognosis than late relapses. Therefore, the goal of this study was to identify the clinicopathological factors that influence the moment of relapse and patient survival.

Methods: Retrospective chart review of 159 patients with an OSCC recurrent disease. Exclusion criteria were neoadjuvant radiochemotherapy, follow-up < 6 weeks, perioperative death, second primaries and inadequate information on clinicopathological parameters. Statistical analysis was performed using univariate and multivariate analysis.

Results: A significant correlation was found in the χ2-analysis between the timing of recurrence and the margin status, lymph node ratio and grading of the primary tumour. In the multivariate survival analysis, the timing of recurrence, margin status, presence of extracapsular spread in the primary tumour and performance of a salvage treatment were shown to be independent risk factors for overall survival.

Conclusion: For patients with a recurrent OSCC, the time to recurrence, margin status, extracapsular spread and the performance of a salvage treatment are independent prognostic factors for overall survival. Furthermore, the moment of recurrence significantly depends on the lymph node ratio, margin status and grading of the primary tumour. This knowledge can allow for the development of individualised surveillance programs based on risk stratification rather than a general follow-up program and like this, lead to an earlier diagnosis and realistic second treatment chance in the case of a recurrence.