Pattern of Recurrence in Carcinoma Oral Cavity: Prospective Longitudinal Study

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Cancer Research

Background:

• Oral squamous cell carcinoma (OSCC) is a significant global health concern.
• Understanding recurrence patterns is crucial for improving patient outcomes and survival rates.
• Adjuvant treatment protocols aim to minimize the risk of disease recurrence after surgery.

Purpose of the Study:

• To prospectively assess the recurrence patterns in operated OSCC patients (clinical stage T1-T4a, N1-2, M0) post-adjuvant therapy.
• To identify factors influencing the likelihood and type of recurrence (local, regional, distant).
• To guide surveillance strategies for high-risk OSCC patients.

Main Methods:

• Prospective longitudinal study conducted from August 2016 to December 2018.
• Recruitment of 100 OSCC patients who developed recurrence after surgery and adjuvant treatment.
• Regular follow-up (every three months) including clinical examination, imaging, and biopsy/FNAC for recurrence confirmation.

Main Results:

• Local recurrence was the most common pattern (65%), followed by regional (29%) and distant failure (6%).
• Close surgical margins were significantly associated with both total and local recurrence.
• Lymphovascular invasion and extranodal extension were linked to nodal recurrences.

Conclusions:

• Most OSCC recurrences are local, often occurring within 12 months post-surgery.
• Close surgical margins are a critical predictor of recurrence, highlighting the importance of meticulous surgical technique.
• Patients with carcinoma of the buccal mucosa require intensive surveillance due to a high recurrence rate.