Abstract
IntroductionThe most important factor determining survival in patients with head and neck squamous cell carcinoma (HNSCC) is a disease recurrence. A high rate of recurrence was noted in previous studies conducted in Pakistan; however, these studies did not consider margin status as inadequate margin clearance leads to disease recurrence. In this study, we determined cancer recurrence in patients with HNSCC after nullifying this factor.MethodsThis cross-sectional observational study was conducted in Liaquat National Hospital (LNH) for a duration of three years. Data collection period was from January 2015 to December 2017. A total of 150 patients that underwent surgery at LNH for HNSCC with margin-free frozen sections were included in the study. Pathological tumor characteristics such as tumor type, size, depth of invasion and nodal status were determined.ResultsThe mean age of the patients was 50.31±12.90 with mean tumor size of 3.38±1.76. Nodal metastases were present in 45.3% cases with 17.3% showing extranodal extension. Recurrence was observed in 66% of cases with median disease-free survival of 12 months and perineural invasion was noted in 12% cases. We found a significant association of disease recurrence with larger tumor size, depth of invasion and extranodal extension. Moreover, younger age (<30 years) and older age (>50 years) groups showed higher rates of recurrence than the middle age group (30-50 years). Similarly, univariate and multivariate analyses revealed that tumors with ≥1 cm depth of invasion and the presence of extranodal extension were more likely to have disease recurrence than tumors with <1 cm depth of invasion and without extranodal extension. Survival analysis using the Kaplan-Meier method for HNSCC revealed a significant difference in disease-free survival in patients with more than 2 cm tumor size and ≥1 cm depth of invasion than cases with ≤ 2cm tumor size and <1 cm depth of invasion.ConclusionA high rate of disease recurrence for HNSSC was noted in our study, despite margin-free primary tumor resection. Apart from tumor size and depth of invasion, extranodal extension was significantly associated with disease recurrence in HNSCC. This signifies a need for margin evaluation of neck dissection specimen in cases with extranodal extension.
Highlights
The most important factor determining survival in patients with head and neck squamous cell carcinoma (HNSCC) is a disease recurrence
A high rate of recurrence was noted in previous studies conducted in Pakistan; these studies did not consider margin status as inadequate margin clearance leads to disease recurrence
Recurrence was observed in 66% of cases with median disease-free survival of 12 months and perineural invasion was noted in 12% cases
Summary
A total of 150 patients that underwent surgery at LNH for HNSCC with margin-free frozen sections were included in the study Pathological tumor characteristics such as tumor type, size, depth of invasion and nodal status were determined. This cross-sectional observational study was conducted in Liaquat National Hospital (LNH) for a duration of three years. All the cases included in the study had the diagnosis of squamous cell carcinoma on incisional biopsy before definitive surgical resection All these patients presented in the Otorhinology clinics of LNH with head and neck mass or ulcerated lesions. Frozen section reports were assessed along with final histopathology reports of all patients Pathological tumor characteristics such as tumor type, size, depth of invasion and nodal status were noted. The disease-free survival was determined by reviewing the oncological records
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.