Risk factors associated with local recurrence in oral squamous cell carcinoma (OSCC) patients / Navenithamaria Eirutharajan

Navenithamaria , Eirutharajan (2024) Risk factors associated with local recurrence in oral squamous cell carcinoma (OSCC) patients / Navenithamaria Eirutharajan. Masters thesis, Universiti Malaya.

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Abstract

Background: Oral squamous cell carcinoma (OSCC) which is the most common histological subset of oral cancer remains a significant global health concern. The overall reported survival rate of OSCC is still poor and one of the main contributing factors for poor survival is local recurrence (LR) of the disease. Various clinicopathological factors are known to influence the LR of the OSCC. Objective: To identify the sociodemographic, clinicopathological characteristics and type of surgical interventions that influence the LR of OSCC. Methods: The socio-demographic, clinicopathological, and follow-up data of all the surgically treated OSCC cases from the year 2005 till September 2023 was obtained from the Diagnostic Oral Pathology Unit (DOPU) archive, which includes histopathological reports and H&E slides. Results: Out of 181 OSCC patients, 12 (6.6%) had LR. Of these, 8 were male and 4 females, with a mean age of 58. Malays had the highest LR percentage at 14.3%, followed by Chinese at 10% and Indians at 2.9%. Among 123 patients with risk habits, 9 (7.3%) had LR compared to 3 (5.2%) without habits. Primary tumours were mainly non-tongue regions, with 10 out of 12 LR cases present in the buccal mucosa, palate, and retromolar trigone. Among patients who underwent surgical resection only, 3 out of 40 (7.0%) developed LR. In contrast, among those who had both surgical resection and neck dissection, 9 out of 129 (6.5%) experienced LR. Bone invasion was present in 35 patients, with 6 (14.6%) experiencing LR. Multiple logistic regression identified race (p=0.024) and primary tumour site (p=0.020) as significant predictors of LR, with Malay and non-tongue tumours having a higher risk of developing LR. The model had an area under the ROC of 0.737, indicating moderate discrimination. Conclusion: Race and primary tumour site emerged as significant independent risk factors for LR. These findings highlight the need for targeted monitoring and tailored interventions to improve OSCC outcomes.

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