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Esophageal Cancer Research and Treatment / Head and Neck Cancer Studies · Journal article
Reports of Practical Oncology & Radiotherapy · September 4, 2026
Encouraging direction, but not yet definitive.
This single-institution prospective cohort of 134 patients with stage III/IV oral cavity squamous cell carcinoma identifies pN stage, perineural invasion, extranodal extension, and tobacco chewing as independent prognostic factors associated with worse disease-free survival. Locoregional failure (35–40%) was the predominant failure pattern. The study uses uniform treatment protocols and provides clinically relevant failure pattern data, but lacks external validation and a control arm, limiting generalizability.
Single-institution prospective cohort study. 134 consecutive patients with resectable stage III/IV oral cavity squamous cell carcinoma treated with multimodality therapy; 88% men, median age 58 years (range 32–86).. Intervention: Multimodality therapy (specific modalities not detailed in abstract). n = 134. Single institution (not named in abstract).
53 of 134 patients (39.5%) experienced recurrence: 20 (37.7%) in-field, 15 (28.3%) distant, 5 (9.4%) combined, 12 (22.6%) out-of-field second primaries; no marginal failures 3-year disease-free survival 68%; 5-year disease-free survival 56% Multivariate analysis: increasing pN stage, pan/gutka/tobacco chewing, perineural invasion, and extranodal extension significantly associated with worse DFS
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should use pN stage, perineural invasion, extranodal extension, and tobacco chewing history as prognostic markers when counselling patients on recurrence risk. The predominance of locoregional failure (35–40%) reinforces the importance of adequate local/regional control in multimodality treatment planning.
Single-institution prospective cohort with uniform treatment identifying prognostic factors for disease-free survival in oral cavity cancer, but lacks a comparator group and generalizability is limited to one centre.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should use pN stage, perineural invasion, extranodal extension, and tobacco chewing history as prognostic markers when counselling patients on recurrence risk. The predominance of locoregional failure (35–40%) reinforces the importance of adequate local/regional control in multimodality treatment planning.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background: Multimodality treatment is key to the management of oral cavity squamous cell carcinoma (OCSCC), but even then, 15–50% of patients experience recurrence, highlighting the critical need for new research focused on innovative strategies. Materials and methods: In this single-institution cohort study, we prospectively collected and analysed the clinical and radiological data of 134 consecutive patients with oral cavity cancer treated with multimodality therapy between January 2015 and December 2017 and analysed the failure patterns. This study aimed to evaluate recurrence patterns and identify prognostic factors influencing disease-free survival (DFS) in resectable OCSCC. Results: A total of 134 patients [16/134 (12%) women and 118/134 (88%) men; median (range) age, 58 (32–86) years] with stage III/IV OCSCC were treated with multimodality therapy. The median follow-up was 54 months (range, 2–114 months). In total, 53/134 (39.5%) failures were observed; most of them, i.e. 20/53 (37.7%), occurred in-field, 15/53 (28.3%) at distant sites, 5/53 (9.4%) both in-field and at distant sites, whereas 12/53 (22.6%) were out-of-field second primaries in the head and neck region. Notably, no marginal failure was observed. The 3- and 5-year DFS rates were 68% and 56%, respectively. Multivariate analysis showed that increasing pN stage, pan/gutka/tobacco chewing, the presence of perineural invasion (PNI), and the presence of extranodal extension (ENE) were significantly associated with worse DFS. Conclusions: Locoregional failure (35–40%) was the predominant cause of treatment failure in resectable OCSCC. Pathological N stage, PNI, ENE, and a history of tobacco chewing were identified as strong prognostic factors. This single-institution study, with uniform treatment protocols, highlights the biological aggressiveness of the disease.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.