Prognostic factors of oral squamous cell carcinoma: a five-year retrospective study in Cluj-Napoca, Romania

The survival of patients with oral squamous cell carcinoma (OSCC) is influenced not only by tumor characteristics but also by treatment strategies, follow-up, and patient-related factors. This study aimed to determine the overall five-year survival rate in a Romanian cohort and evaluate the impact of key prognostic factors.

Seventy-two patients diagnosed with OSCC and treated surgically at the Department of Oral and Maxillofacial Surgery, Emergency County Clinical Hospital, Cluj-Napoca, Romania, between January 2016 and December 2019 were retrospectively analyzed. Prognostic factors included tumor stage, primary site, histological parameters, lymph node involvement, treatment modalities, and demographic variables.

Patients were stratified into four groups: five-year survivors (n=26), disease-specific mortality (n=21), mortality from non-oncological causes (n=5), and lost to follow-up (n=20). Overall, 36.1% of patients achieved five-year recurrence-free survival, corresponding to 50% among those with complete follow-up. Survivors were more often diagnosed at early or intermediate stages, had fewer tongue tumors, better differentiation, clear surgical margins, and consistent adjuvant therapy. Notably, 27.8% of patients were lost to follow-up despite favorable pathological features, suggesting systemic gaps in long-term surveillance.

The five-year survival rate of 50% reflects both aggressive tumor biology and systemic barriers to care. Clinical stage remains the strongest prognostic factor, but tumor site and histological features, including perineural and lymphatic invasion, significantly influence outcomes even in early disease. Improved long-term survival requires earlier diagnosis, refined prognostic assessment, and multimodal therapy tailored to tumor behavior, alongside better patient follow-up strategies.