Clinical Study on Postoperative Treatment for Patients at High Risk of Oral Squamous Cell Carcinoma Recurrence

Surgery is the standard treatment for oral squamous cell carcinoma (OSCC), and concurrent chemoradiotherapy (CRT) is recommended in cases where extranodal extension (ENE) or positive margins are found histopathologically after surgery. However, the indications and efficacy of CRT remain controversial. In this study, we investigated the efficacy of postoperative treatment by examining risk factors for postoperative OSCC recurrence.

We investigated the postoperative treatment and prognosis of 52 patients with OSCC with high-risk factors for recurrence (28 with ENE only, 17 with positive margins only, and seven with both). ENE was classified into minor ENE (ENEmi < 2 mm) and major ENE (ENEma ≥ 2 mm).

The prognosis for ENEmi was good regardless of whether postoperative treatment was administered; however, the prognosis for ENEma was significantly poor. In the ENEma group, the prognosis of the patients who underwent radiotherapy (RT) or CRT was better than that of patients who did not undergo postoperative treatment, with no significant differences between the RT and CRT groups. In patients with positive margins, the prognosis was better in those who underwent additional resection than in those who underwent CRT.

Patients with ENEma have a poor prognosis and require additional treatment with RT or CRT. Re-resection may improve the prognosis in patients with positive margins.