RECURRENCE OF SQUAMOUS CELL CARCINOMA IN ORAL CAVITY TUMORS

Abstract

Background: Oral squamous cell carcinoma (OSCC) is a prevalent malignancy of the head and neck, particularly in South Asia, with a high tendency for recurrence despite definitive treatment. Identifying clinicopathological factors associated with recurrence is essential for optimizing patient outcomes.

Objective: This study aimed to evaluate the recurrence rate, recurrence pattern, and key histopathological and clinical predictors of OSCC recurrence following curative-intent surgery. Methodology: A prospective cohort study was conducted at Pakistan Navy Station Shifa Hospital, Karachi, from October 2023 to September 2024. A total of 152 histologically confirmed OSCC patients undergoing surgical treatment with or without adjuvant therapy were enrolled. Data on tumor subsite, stage, grade, surgical margins, perineural invasion (PNI), lymphovascular invasion (LVI), and nodal status were collected. Kaplan-Meier analysis assessed recurrence-free survival (RFS), and Cox proportional hazards regression identified independent predictors of recurrence.

Results: The mean patient age was 55.8 ± 11.7 years, with a male predominance (73.7%). The recurrence rate was 27.0%, with local, regional, and distant recurrence in 11.8%, 8.6%, and 6.6% of cases, respectively. Median time to recurrence was 6.3 ± 2.4 months. Positive surgical margins (HR 3.24; p = 0.001), PNI (HR 2.45; p = 0.017), and nodal involvement (HR 1.98; p = 0.045) were independently associated with recurrence.

Conclusion: Recurrence of OSCC remains a significant clinical challenge, with margin status, PNI, and nodal involvement emerging as key predictive factors. Early identification of high-risk features may guide surveillance and adjuvant therapy decisions to improve patient prognosis.