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Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way

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The occurrence and impact of time to presentation for oral squamous cell carcinoma with curative surgery.

Chang Liu¹, Hao Wang¹, Kaixiong Wei¹

¹Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery

|February 23, 2025

Summary

Time to presentation (TTP) for oral squamous cell carcinoma (OSCC) does not predict survival. Tumor stage, not TTP, is the key factor influencing patient outcomes in OSCC.

Keywords:

Oral potentially malignant disorders Oral squamous cell carcinoma Prognosis Symptoms Time to presentation

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Published on: April 22, 2019

Area of Science:

Oncology
Oral Medicine
Surgical Oncology

Background:

Oral squamous cell carcinoma (OSCC) is a significant global health concern.
Understanding factors influencing OSCC prognosis is crucial for effective treatment.
Time to presentation (TTP) is a potentially modifiable factor in cancer care.

Purpose of the Study:

To investigate the occurrence and features of TTP in OSCC patients undergoing curative surgery.
To determine the prognostic impact of TTP on overall survival (OS) in OSCC.
To explore the relationship between TTP, tumor stage, and OS in OSCC.

Main Methods:

Retrospective analysis of 633 OSCC patients from the Beijing Stomatological Hospital.
Data extraction from the POROMS database for baseline characteristics.
Multivariate Cox analysis to assess TTP as an independent predictor of OS.
Mediation analysis to evaluate the indirect effect of TTP on OS through tumor stage.

Main Results:

Patients with a history of oral potentially malignant disorders, mild symptoms, or buccal mucosa carcinoma were more likely to have a longer TTP (>4.5 months).
TTP was not an independent predictor of OS in multivariate analysis.
Longer TTP was associated with earlier tumor stages (I-II) and fewer advanced stages (III-IV).
Tumor stage significantly mediated the relationship between TTP and OS, accounting for 35.2% of the total effect.

Conclusions:

Time to presentation does not directly correlate with worse overall survival in oral squamous cell carcinoma.
The prognostic impact of TTP on OS is largely indirect, mediated by tumor stage.
Disease severity and intrinsic tumor characteristics are more critical prognostic indicators than TTP in OSCC.