Pattern of Recurrence in Carcinoma Oral Cavity: Prospective Longitudinal Study

The aim of this prospective longitudinal study was to assess the pattern of recurrence in operated oral squamous cell carcinoma with clinical stage T1-T4a, N1-2, M0 who completed their adjuvant treatment as per standard guidelines.

This prospective longitudinal study was performed from August 2016-December 2018 to analyze the recurrence pattern and factors affecting it in 100 patients operated in time period of August 2016-December 2018 who developed recurrence in a defined time period till December 2018. All patients were followed post-surgery every three month in OPD, recurrences were detected by history, physical examination, imaging and were confirmed by tissue biopsy/FNAC.

A total 840 patients of SCC oral cavity operated in time period of August 2016-December 2018. These patients were regularly followed up till December 2018 in head and neck unit, total 100 patients who developed recurrence in the defined time period were included in the study. 82 patients were male and 18 female (M: F = 4.5:1), 40-60 year being most common age group. Most common site of primary tumor was Buccal mucosa in 40% of cases followed by oral tongue in 24% of cases in the present study, local recurrence was most common pattern of failure in 65% of patient, while 29% patients fails regionally and 6% patients developed distant failure.

This study indicates that more than half of patients presented mostly in the advanced stage. Most recurrences were local. Close margins was the most common factor predisposing both the total and local recurrence. Perineural spread was more in patients with local recurrence but the p value was not significant. Lymphovascular invasion and extra capsular spread contributes to nodal recurrences. Operated patients of carcinoma buccal mucosa need intensive surveillance, since most recurrences occur within 12 months.