[Study of survival factors of oral squamous cell carcinoma]

Objective: To explore the survival factors for oral squamous cell carcinoma(OSCC). Methods: A total of 492 patients with OSCC were recruited from the First Affiliated Hospital of Fujian Medical University from June 2003 to December 2014. Then, 456 cases were included in the present study according to inclusion and exclusion criteria. Clinical and follow-up data were collected to evaluate survival factors of OSCC. Survival rates were calculated using the Kaplan-Meier method and compared using the Log-rank test. The Cox proportional hazards regression model was used to estimate the hazard ratio(HR)and 95% confidence intervals(CI)of survival factors. We also stratified by TNM Classification of Malignant Tumours stage and BMI to assess the association between treatments and OSCC outcomes. Results: The age of the recruited patients was(57.89±11.61)years, and the proportions in TNM stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ were 14.0%(64), 23.7%(108), 16.1%(73)and 42.5%(194), respectively. The multivariate Cox regression indicated that the HR(95% CI)of the increase to mortality risk associated with stage T₂-T₃, T₄(T₁ as reference), stage N₂-N₃(N₀ as reference), poormoderate differentiation, BMI<18.5 kg/m²(compared with BMI 18.5-23.9 kg/m²), alcohol consumption ≥20 g/d(compared with no alcohol)before treatment were 2.69(1.21-5.95), 3.40(1.54-7.53), 2.65(1.17-6.00), 2.56(1.39-4.71), 2.00(1.15-3.50), 2.09(1.11-3.93), and 1.68(1.03-2.73), respectively. The stratification analysis demonstrated that, compared with surgery alone, surgery combined with radiotherapy reduced the mortality risk of stage Ⅲ-Ⅳ, HR(95% CI)0.33(0.12-0.93). Surgery combined with chemoradiotherapy reduced the mortality risk of OSCC with normal BMI, HR(95% CI)were 0.39(0.17-0.87). Conclusions: Clinical stage and histological grade are survival factors for patients with OSCC.