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Aims <p>To analyze the clinical, surgical, and pathological profile of oral malignancy, specifically oral cavity squamous cell carcinoma (OCSCC), over a 10-year period in a tertiary care center, and to identify prognostic indicators influencing recurrence and survival.</p> Materials and Methods <p><i>Design</i>: Retrospective observational study. <i>Setting</i>: Tertiary care hospital. <i>Subjects</i>: 270 patients with histopathologically confirmed oral malignancy treated between January 2013 and December 2022. <i>Methodology</i>: Patient records were reviewed for demographics, site distribution, risk factors, clinical stage, surgical modality, neck dissection type, reconstructive technique, histological grade, depth of invasion (DOI), worst pattern of invasion (WPOI), margin status, and margin-to-depth of invasion ratio (MTDR). Outcomes were analyzed for recurrence and recurrence-free survival. A risk score was proposed using pathological parameters.</p> Results <p>Middle-aged males (41–60 years) formed the majority, with a male-to-female ratio of 2.6:1. Buccal mucosa (41.9%) and anterior tongue (33.7%) were the most commonly affected subsites. Tobacco and alcohol use were observed in 84.8% of patients. Most tumors were diagnosed at Stage III/IV. Wide excision was the primary surgical modality, with supraomohyoid neck dissection performed in most early-stage cases. Forehead flap reconstruction was used in 14.4% of cases. Histologically, 60.4% were moderately differentiated, with 27% exhibiting WPOI 4–5. Close margins (1–5&#xa0;mm) were seen in 17.4% of resections. Recurrence occurred in 12.2% of patients, with local recurrences being most common. On univariate and multivariate analyses, depth of invasion &gt; 10&#xa0;mm, adverse Worst Pattern of Invasion (WPOI 4–5), and Margin-to-Depth Ratio (MTDR &lt; 1) were significant predictors of recurrence. At 3 years, the estimated RFS for the entire cohort was 74.8%. Kaplan–Meier analysis demonstrated lower 3-year recurrence-free survival in patients with these high-risk features, underscoring their prognostic importance. Cox proportional hazards analysis also confirmed that depth of invasion &gt; 10&#xa0;mm, WPOI 4–5, and nodal metastasis were independent predictors of reduced recurrence-free survival. The proposed recurrence risk score stratified patients into low (0–1), intermediate (2–3), and high-risk (4) groups with estimated recurrence rates of 10.4%, 55.7%, and 70–80%, respectively.</p> Conclusion <p>Oral malignancy continues to present at advanced stages with tobacco as a key driver. Pathological features such as DOI, WPOI, MTDR, and grade serve as reliable prognostic markers. The proposed risk scoring system offers a practical tool for postoperative risk stratification and individualized surveillance planning.</p>

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Oral Malignancy: A Single Institution 10 Years Experience

  • 期刊论文

  • 发表日期：

    2026年2月17日

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  • Aman Bansal,
  • Ashwin Ashok Jaiswal,
  • Bibhu Kalyan Tripathy,
  • M. Mohan Raj,
  • A. Swathi,
  • Girish Umredkar,
  • Amrish Kumar Garg,
  • Praveer Kumar Banerjee,
  • Neeta Sharma,
  • Prachi Mene,
  • Sweta Verma,
  • Anirudh Mene,
  • M. Ravindranath,
  • Manisha Kango,
  • Priya Sahu,
  • Vineeta Dwivedi,
  • Atul Srivastava,
  • Dhiraj Gupta

摘要

Aims

To analyze the clinical, surgical, and pathological profile of oral malignancy, specifically oral cavity squamous cell carcinoma (OCSCC), over a 10-year period in a tertiary care center, and to identify prognostic indicators influencing recurrence and survival.

Materials and Methods

Design: Retrospective observational study. Setting: Tertiary care hospital. Subjects: 270 patients with histopathologically confirmed oral malignancy treated between January 2013 and December 2022. Methodology: Patient records were reviewed for demographics, site distribution, risk factors, clinical stage, surgical modality, neck dissection type, reconstructive technique, histological grade, depth of invasion (DOI), worst pattern of invasion (WPOI), margin status, and margin-to-depth of invasion ratio (MTDR). Outcomes were analyzed for recurrence and recurrence-free survival. A risk score was proposed using pathological parameters.

Results

Middle-aged males (41–60 years) formed the majority, with a male-to-female ratio of 2.6:1. Buccal mucosa (41.9%) and anterior tongue (33.7%) were the most commonly affected subsites. Tobacco and alcohol use were observed in 84.8% of patients. Most tumors were diagnosed at Stage III/IV. Wide excision was the primary surgical modality, with supraomohyoid neck dissection performed in most early-stage cases. Forehead flap reconstruction was used in 14.4% of cases. Histologically, 60.4% were moderately differentiated, with 27% exhibiting WPOI 4–5. Close margins (1–5 mm) were seen in 17.4% of resections. Recurrence occurred in 12.2% of patients, with local recurrences being most common. On univariate and multivariate analyses, depth of invasion > 10 mm, adverse Worst Pattern of Invasion (WPOI 4–5), and Margin-to-Depth Ratio (MTDR < 1) were significant predictors of recurrence. At 3 years, the estimated RFS for the entire cohort was 74.8%. Kaplan–Meier analysis demonstrated lower 3-year recurrence-free survival in patients with these high-risk features, underscoring their prognostic importance. Cox proportional hazards analysis also confirmed that depth of invasion > 10 mm, WPOI 4–5, and nodal metastasis were independent predictors of reduced recurrence-free survival. The proposed recurrence risk score stratified patients into low (0–1), intermediate (2–3), and high-risk (4) groups with estimated recurrence rates of 10.4%, 55.7%, and 70–80%, respectively.

Conclusion

Oral malignancy continues to present at advanced stages with tobacco as a key driver. Pathological features such as DOI, WPOI, MTDR, and grade serve as reliable prognostic markers. The proposed risk scoring system offers a practical tool for postoperative risk stratification and individualized surveillance planning.