Background: Despite advances in treatment, oral squamous cell carcinoma (OSCC) remains associated with high recurrence and mortality rates. Traditional TNM staging, while foundational, may not fully capture tumor aggressiveness. This study aimed to identify clinical and histopathological predictors of survival to enhance risk stratification and guide treatment planning in OSCC patients.Methods: A retrospective study of 100 patients with confirmed OSCC treated surgically with curative intent between January 2019 and January 2024 was analyzed. Clinicopathologic variables—including tumor volume, angioinvasion, perineural invasion, lymphatic invasion, and nodal status—were evaluated. Disease-specific survival (DSS) was assessed using Kaplan–Meier estimates, Cox regression, and logistic regression models.Results: The cohort had a mean age of 62.1 years, with a 46% OS rate and 43% DSS at study end. Perineural invasion (44%) and lymphatic invasion (42%) were the most common invasive features. Kaplan–Meier analysis revealed significantly reduced DSS in patients with angioinvasion, perineural invasion, and pN+ status. Multivariate logistic regression identified perineural invasion (OR = 3.93,p= 0.0023) and pN+ status (OR = 2.74,p= 0.0284) as independent predictors of cancer-specific mortality. Tumor volume was significantly associated with lymphatic invasion but not directly with DSS.Conclusions: Perineural invasion, angioinvasion, lymph node involvement, and tumor volume are important prognostic markers in OSCC, offering critical information beyond TNM staging. Incorporating these features into risk assessment models could improve prognostic accuracy and inform more individualized treatment strategies for high-risk OSCC patients.
背景：尽管治疗手段不断进步，口腔鳞状细胞癌（OSCC）仍具有较高的复发率和死亡率。传统的TNM分期虽为基础，但可能无法全面反映肿瘤的侵袭性。本研究旨在识别影响生存的临床与组织病理学预测因子，以优化OSCC患者的风险分层并指导治疗决策。 方法：回顾性分析了2019年1月至2024年1月期间接受根治性手术治疗的100例确诊OSCC患者。评估了包括肿瘤体积、血管侵犯、神经周围侵犯、淋巴管侵犯及淋巴结状态在内的临床病理学变量。采用Kaplan-Meier估计、Cox回归和逻辑回归模型评估疾病特异性生存率（DSS）。 结果：队列平均年龄为62.1岁，研究结束时总生存率为46%，疾病特异性生存率为43%。神经周围侵犯（44%）和淋巴管侵犯（42%）是最常见的侵袭性特征。Kaplan-Meier分析显示，存在血管侵犯、神经周围侵犯及pN+状态的患者DSS显著降低。多变量逻辑回归分析确定神经周围侵犯（OR = 3.93，p = 0.0023）和pN+状态（OR = 2.74，p = 0.0284）是癌症特异性死亡的独立预测因子。肿瘤体积与淋巴管侵犯显著相关，但与DSS无直接关联。 结论：神经周围侵犯、血管侵犯、淋巴结受累及肿瘤体积是OSCC的重要预后标志物，提供了超越TNM分期的关键信息。将这些特征纳入风险评估模型，可提高预后判断的准确性，并为高危OSCC患者制定更个体化的治疗策略提供依据。
Clinicopathologic Predictors of Survival Following Oral Cancer Surgery: A Retrospective Cohort Study
肿瘤(癌症)患者之家