Postoperative Adjuvant Therapy in Resectable Advanced Oral Squamous Cell Carcinoma With Intermediate Risk Factors

Area of Science:

• Oncology
• Surgical Pathology
• Cancer Treatment

Background:

• Oral cancer treatment relies on pathological risk stratification for postoperative adjuvant therapy.
• Efficacy of adjuvant therapy for intermediate-risk oral cancer factors (e.g., close margins, advanced T/N stage, invasion) remains unclear.
• Lack of standardized guidelines necessitates research into risk factors and adjuvant therapy impact.

Purpose of the Study:

• To retrospectively analyze clinical significance of pathological recurrence risk factors in advanced oral cancer.
• To evaluate the impact of postoperative adjuvant therapy on patient prognosis, particularly for those with specific invasion types.

Main Methods:

• Retrospective study of 130 advanced oral squamous cell carcinoma (OSCC) patients undergoing radical surgery.
• Identified risk factors: ENE, positive/close margins, pT3-T4, pN2-N3, lymph node metastasis (level IV-V), perineural, vascular, and lymphatic invasion.
• Analyzed relationships between risk factors, adjuvant therapy (RT/CRT), recurrence/metastasis, and disease-free survival (DFS).

Main Results:

• Lymphatic invasion significantly correlated with lower survival rates (66.7% vs. 82.8%, p<0.05).
• Perineural invasion-positive patients showed significantly higher recurrence and metastasis rates (51.9% vs. 23.6%, p<0.05).
• Multivariate analysis confirmed perineural invasion as an independent prognostic factor (HR=4.496, p=0.019).

Conclusions:

• Perineural invasion is a significant risk factor for oral cancer recurrence.
• Lymphatic invasion is a poor prognostic indicator in oral cancer.
• Postoperative adjuvant therapy is beneficial for patients with perineural or lymphatic invasion, reducing recurrence and prolonging survival.