RECURRENCE-FREE SURVIVAL AND PATTERNS OF RECURRENCE IN SQUAMOUS CELL CARCINOMA OF ORAL CAVITY: AN INSTITUTIONAL PERSPECTIVE

Objective: To determine the recurrence-free survival (RFS) in patients with squamous cell carcinoma of oral cavity (OSCC) Methodology: It was a longitudinal study conducted on oncology patients who were diagnosed as having squa-mous cell carcinoma of the oral cavity and treated in our tertiary care hospital in the department of medical on-cology. Patients were followed for the evaluation of disease recurrence. The Chi-square test was used to see the association between outcomes and clinicopathological features of the tumor. Results: Of 97 patients, 85(87.62%) patients had no disease, however, 12(12.37%) patients had residual/re-current disease in the first post-treatment follow-up scans performed three months after the completion of cu-rative treatment. Subsequent follow-up scans showed disease recurrence in 87(89.69%) patients, out of which 52(59.77%) had loco-regional disease recurrence while 35(40.22%) patients had combined loco-regional and systemic disease recurrence with lung(n=18) being the most common site of distant metastasis. The mean RFS was 15 months (IQR= 8, 26). Patients with lymph vascular invasion (LVI), perineural invasion (PNI), positive mar-gin, and extranodal extension(ENE) had a significantly higher risk of progressive disease after primary treatment, on follow up scans. The relationships between treatment outcomes and LVI, PNI, positive margin and ENE were statistically significant (p<0.05). Conclusion: Our study shows that there is a higher frequency of recurrence in patients with OSCC among patients with extra nodal extension, lymph vascular and perineural-invasion, and positive margins. Clinical trials are re-quired to identify other poor prognostic factors and the need of developing a prognostic model for risk-stratification of such patients.