Incorporation of adverse features in advanced oral cancer improves precision in staging and patient prognostication

• Published in: Head & neck 2022-04, Vol.44 (4), p.964-974
• Main Authors: Singh, Manraj, Thankappan, Krishnakumar, Balasubramanian, Deepak, Pillai, Vijay, Shetty, Vivek, Rangappa, Vidyabhushan, Chandrasekhar, Naveen Hedne, Kekatpure, Vikram, Kuriakose, Moni Abraham, Krishnamurthy, Arvind, Mitra, Arun, Pattatheyil, Arun, Jain, Prateek, Iyer, Subramania, Iyer, Narayanan Gopalakrishna, Subramaniam, Narayana
• Format: Article
• Language: English
• Subjects: Carcinoma, Squamous Cell - pathology; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - pathology; Humans; Mouth Neoplasms - pathology; Neoplasm Invasiveness - pathology; Neoplasm Staging; Oral cancer; Oral carcinoma; Oral squamous cell carcinoma; Patients; Prognosis; Retrospective Studies; Risk factors
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.26990

Background Despite revised staging criteria, stratification of patients with advanced oral squamous cell carcinoma (OSCC) remains difficult. Well‐established features like perineural invasion (PNI), differentiation, and lymphovascular‐invasion (LVI) are controversial, and hence omitted from staging. We endeavor to better stratify this cohort by identifying predictors of survival in advanced OSCC (T3‐4). Methods Seven hundred and forty‐two patients with T3‐4 OSCC underwent surgery from 2006 to 2013. Cox regression was performed to determine predictors of overall survival (OS). Results OS was adversely impacted by PNI (p = 0.046), LVI (p = 0.038), moderate/poor differentiation (p = 0.001), close/involved surgical margins (p = 0.002), pT (p = 0.034), and pN (p