Prognostic Factors in Oral Squamous Cell Carcinoma: Systematic Review and Meta-Analysis
Isabel González-Ruiz1, Pablo Ramos-García2, Noor Mjouel-Boutaleb2
1Pius de Valls Hospital, Tarragona, España.
Oral Diseases
|April 25, 2025
Summary
Prognostic factors for oral squamous cell carcinoma (OSCC) indicate that lymph node involvement, tumor size, and distant metastases significantly increase the risk of death and recurrence. Early diagnosis is crucial for improving patient outcomes in OSCC.
Area of Science:
- Oncology
- Cancer Research
- Head and Neck Surgery
Background:
- Oral squamous cell carcinoma (OSCC) is a significant global health concern.
- Accurate prognostic factors are essential for effective patient management and treatment planning.
Purpose of the Study:
- To conduct a comprehensive meta-analysis evaluating current evidence on prognostic factors in OSCC.
- To synthesize data from 255 primary studies involving 63,114 patients.
Main Methods:
- Systematic literature search of MEDLINE, Embase, Web of Science, and Scopus databases up to January 2024.
- Risk of bias assessment using the Quality in Prognosis Studies tool.
- Meta-analysis of prognostic factors including lymph node status, tumor invasion depth, and distant metastasis.
Main Results:
- Lymph node involvement (cN, pN) and extracapsular spread significantly correlate with poorer overall survival, disease-specific survival, and disease-free survival.
- Tumor invasion depth exceeding 5mm is a strong predictor of increased mortality.
- Distant metastasis (cM, pM) emerged as the most potent negative prognostic factor, despite limited primary study data.
Conclusions:
- The presence of affected neck nodes, larger tumor size, and distant metastases are critical indicators of increased mortality and recurrence risk in OSCC.
- There is an urgent need to implement strategies that enhance early OSCC diagnosis to mitigate diagnostic delays and improve patient survival rates.
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