Analysis Of Prognostic Factors Of 389 Patients With Oral Squamous Cell Carcinoma

Objective Aimed at improving therapeutic effect in OSCC patients,raising survival rate and decreasing recurrence rate at the same time,the clinicopathologic factors which may influence survival and recurrence in patients with oral squamous cell carcinoma were explored and the associatedNomograms were designed so as to make a more scientific and more reasonable prediction of OSCC patients' survival and recurrence regularities and make more positive and more effective prevention and treatment strategies.Methods The clinicopathologic data and follow-up data of 389 OSCC patients who were firstly diagnosed and treated in Tianjin medical university cancer hospital in January2005-December 2012 were collected and analysed.The statistical analysis was conducted by SPSS 20.0 software.The Kaplan-Meier method was used for univariate survival analysis.The Proportional Hazard Assumption(PH Assumption)test was performed with STATA software.The Cox regression mode was used for multivariate survival analysis.TheNomogram was used to visualize the prediction effect of Cox regression model.At the same time,a prognostic evaluation model of OSCC was constructed based on the Cox regression model to evaluate the prognosis.The study subjects were randomly divided into modeling population(67%)and validation population(33%).The area under the ROC curve(AUC)was used to evaluate the prediction effect of the model.The multigroup AUC test was used to make a further verification.The relationships between clinicopathologic factors for OSCC and recurrence were analyzed using Chi-square test,and P<0.05 was considered as the significant difference criterion.Results The 3-year OSR and 3-year DFSR of OSCC patients were 74.3% and 73.5%,respectively.The 5-year OSR and 5-year DFSR of OSCC patients were 52.7% and44.5%,respectively.153 patients were dead,including 145 patients caused by tumor deterioration and 8 patients caused by respiratory and cardiovascular diseases(death caused by respiratory and cardiovascular diseases was defined as the event of interest).Among 200 clinical LNM-negative(cN0 stage)patients treated by operation,44 patients had LNM confirmed by postoperative diagnosis(pN+ stage),and the rate of occult lymphatic metastasis(OLM)was 22.0%.155 patients underwent recurrence,and the recurrence rate was 39.8%.There were 71 patients with local recurrence,54 patients with regional lymph node recurrence,30 patients with the above.24 patients diagnosed with distant metastasis,and distant metastasis rate was 6.2%.The metastasis areas included lung,liver,bone and brain.Conclusions1.OSCC patients had a relatively low 5-year OSR and 5-year DFSR and high recurrence rate.2.The cN stage,clinical stage,pN stage,ENE,and differentiated degree were related to the prognosis of OSCC patients.The clinical stage and ENE directly affected the prognosis of OSCC patients.Through physical examination and imaging examination in patients with OSCC,cN stage and clinical stage can be confirmed,combined with pathological factors such as pN stage,differentiated degree and ENE,a predication towards the prognosis condition could be made.3.TheNomograms for survival prediction of patients with oral squamous cell carcinoma were built,thus the prognosis of patients can be predicted individually.4.ENE was obvious in advanced OSCC patients,which seriously affected the prognosis.Early detection and treatment could reduce the recurrence rate of OSCC,thus improving the survival rate of OSCC patients.