Liu, Yingci
(2018)
CLINICOPATHOLOGIC FACTORS FOR DISEASE-FREE SURVIVAL IN EARLY STAGE ORAL SQUAMOUS CELL CARCINOMA.
Master's Thesis, University of Pittsburgh.
(Unpublished)
Abstract
OBJECTIVE: Oral squamous cell carcinoma (OSCC) is a life-threatening disease that can cause significant morbidity and mortality. OSCC recurrence occurs frequently with the rates varying between 15% and 40% depending on the extent of the tumor. Our aim was to determine association between select clinicopathologic factors and the risk of local recurrence in early stage (T1N0) OSCC.
METHODS: After approval by the University of Pittsburgh IRB (PRO17100554), 65 cases of T1N0 stage OSCC over a period of 12 years (2000-2012) were retrieved. Cancer originating from non-mucosal epithelium such as lip, cases with positive surgical margins, and HPV-related tumors were omitted from our study. Relevant clinicopathologic data collected included sex, age, oral site, history of dysplasia, histologic grade, depth of invasion, and surgical treatment modality.
RESULTS: 33.8% (22/65) cases experienced locoregional recurrence with the median time to recurrence of 31 months (range: 4-119). The majority 56.9% (37/65) of the T1N0 lesions were classified as moderately-differentiated tumors; the average depth of invasion was 1.7 mm. The tongue was the most prevalent site (49.2%, 32/65) followed by the mandibular gingiva (9/65, 13.8%) and floor of mouth (8/65, 12.3%). A higher risk of recurrence was found to be associated with a previous history of dysplasia (OR 12.0, 95% CI 3.1, 45.6, P <0.001) and “low risk” oral site (P <0.05) when clustered into high and low risk sites for OSCC development. Age, sex, histologic grade, depth of invasion, and treatment modality were not found to have statistically significant associations with locoregional recurrence.
CONCLUSION: Our findings suggest that patients with a history of dysplasia and with OSCC development at traditionally lower risk areas have a higher risk of locoregional recurrence. Surprisingly, higher histologic grade, larger depth of invasion, and elective neck dissections did not appear to decrease risk of locoregional recurrence in early stage (T1N0) cancers. Understanding of the clinicopathological risk factors associated with disease-free survival will aid in improving post-treatment follow-up protocols for oral cancer patients. Dental professionals hold a unique position in their proficiency in the diagnosis of oral lesions and their ability to follow up with patients at frequent intervals.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
10 December 2018 |
| Date Type: |
Publication |
| Defense Date: |
30 November 2018 |
| Approval Date: |
10 December 2018 |
| Submission Date: |
3 December 2018 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
56 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Dental Medicine > Dental Science |
| Degree: |
MS - Master of Science |
| Thesis Type: |
Master's Thesis |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
oral cancer, recurrence, oral squamous cell carcinoma, prognosis |
| Date Deposited: |
10 Dec 2018 19:03 |
| Last Modified: |
11 Dec 2018 20:16 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/35688 |
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