Influence of Clinical and Pathological Characteristics of OSCC on Disease Free and Overall Survival - A Single Institute Study

Objective of our study: To find out the significance of clinical and pathological characteristics on the survival rate and recurrence in the patients treated at our hospital. Materials and methods: Retrospective analysis of post-operative histopathology reports of patients operated in our college from 2015-2017 were analysed and all the data related to margins and other necessary clinical and pathological data were noted. We classified margins classified into clear (≥5 mm), mildly dysplastic, moderately dysplastic, severely dysplastic and inadequate margins/positive margins by the pathologist as per previous available literature. All patients were operated on with the primary objective of achieving a macroscopic clearance of 1 cm. Postoperative radiotherapy was advised in indicated cases. Known clinical and pathological prognostic indicators, in addition to the condition of surgical margins, were analysed to find out if they were predictive of overall survival and disease-free survival using the chi- square test. The survival time was calculated using Kaplan-Meier survival curve. The log rank test was used to detect the differences for survival time. We compared this data with the previously available literature. Results: Overall median survival was 34.96 months and median disease-free survival is 24.83 months. Histological grade and stage at diagnosis was identified as having a statistically significant effect on survival (p value = 0.001 and 0.033) respectively. All the other associations between age, gender, subsite, histological variant of disease, adjuvant therapy administration, status of surgical margins and disease free and overall survival was not found to be significant. Outcome and Conclusion: Histological grade of the disease and stage at presentation seem to be important factors in determining disease free and overall survival stressing the importance of early detection and treatment of oral cancer to improve a patient's chance of success in terms of long term quality of life without recurrence.