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Oral Squamous Cell Carcinoma Prognostic Factors Identified

Time to recurrence, initial treatment modality predict outcome after first recurrence

TUESDAY, Dec. 28 (HealthDay News) -- Initial treatment of oral squamous cell carcinoma with more than one modality as well as shorter time to recurrence (TTR) appears to be associated with worse outcomes in those who develop locoregional recurrence, according to a study in the December issue of the Archives of Otolaryngology -- Head & Neck Surgery.

In a cohort study, Michael D. Kernohan, of the Royal Prince Alfred Hospital in Camperdown, Australia, and colleagues evaluated 77 patients who underwent salvage surgery for oral squamous cell carcinoma that had been treated initially by surgery, radiotherapy, or surgery with postoperative radiotherapy.

The investigators found that the median TTR from initial treatment was 7.5 months, with most recurrences (86 percent) occurring within the first two years. Of the 77 patients, 39 experienced recurrence at the primary site, 27 at the ipsilateral neck, and 11 at the contralateral neck. Independent prognostic variables included TTR, initial treatment modality, and site of failure. Initial combined modality treatment was associated with a worse outcome, as was shorter TTR. The effect of site of recurrence was dependent on an interaction with the TTR. Consequently, local recurrence was worse for those who experienced it less than six months after initial treatment, and nodal recurrence was worse for those who experienced it six months or more after initial treatment.

"This retrospective study provides new information regarding survival prediction for these patients and demonstrates the interaction of clinically relevant prognostic factors that reflect variation in disease biology and behavior," the authors write. "These data and unique analyses have identified the independent prognostic variables as TTR, initial treatment modality (single or combined), and site of failure (local or regional). The relationship of these variables is not fixed; the variables have a dynamic interaction."

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