Rafiq, Khalid (2019) Development of a risk model for oral squamous cell carcinoma - a preliminary study / Rafiq Khalid. Masters thesis, Universiti Malaya.
Abstract
Introduction: Oral squamous cell carcinoma (OSCC) is a disease that has a global presence. According to the latest Global cancer incidence, mortality and prevalence (GLOBOCAN) data from 2018; there were 354,864 new cases of cancers of the lip and oral cavity with 177,384 deaths in the same year. The prognostic factors for OSCC include a variety of socio-demographic, clinical, and histopathological related factors. Over the years, there have been several risk models developed utilizing these various prognostic factors. However, previous studies have shown that these existing risks models are limited in their prognostic determination of patients with OSCC. Aim: To identify the socio-demographic, clinical and histopathological characteristics that may be utilized for the development of a preliminary risk model in OSCC. Materials and Methods: This study was conducted in a retrospective manner on patients who have been diagnosed with OSCC within the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). A total of 73 patients that met the inclusion criteria were utilized in this study. Socio-demographic and clinical data of the OSCC cases were obtained from the MOCDTBS. Histopathological data was retrieved from the archived hematoxylin and eosin stained slides from the MOCDTBS. Histopathological scoring was also calculated based on previous risk models. A univariate and multivariate analysis were then utilized to determine the association of these various sociodemographic, clinical, and histopathological characteristics with lymph node metastasis, local recurrence and overall survival. Characteristics that showed statistical significance (p<0.05); indicating prognostic potential, were identified. Results: Characteristics with prognostic potential in OSCC included extracapsular spread (ECS), depth of tumour iv invasion (DOI), tumour budding, sarcolemmal spread, bone invasion, and tumour associated tissue eosinophilia (TATE). These factors were then included in a preliminary risk model for OSCC. Conclusion: There are significant associations between ECS, DOI, tumour budding, sarcolemmal spread, bone invasion and TATE with patient outcomes in OSCC, which when integrated within a preliminary risk model would potentially aid in the prognostic determination of these patients. However, it is recommended to use a larger sample size for further validation of these results. Keywords: Oral squamous cell carcinoma, risk model, overall survival, lymph node metastasis, local recurrence.
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