Prognostic factors analysis of patients with oral cavity squamous cell carcinoma

OBJECTIVE: This study aimed to analyze prognostic factors associated with survival and recurrence in patients with Oral Cavity Squamous Cell Carcinoma (OCSCC) treated in São Paulo, Brazil. The investigation focused on evaluating the influence of clinical stage, treatment modality, age, and sex on overall and recurrence-free survival in a large cohort derived from a public cancer registry. STUDY DESIGN: Single-center retrospective observational study with a cross-sectional and quantitative design. SETTING: São Paulo, Brazil. METHODS: A retrospective analysis was conducted using data from 10,122 patients diagnosed with OCSCC between 2004 and 2014, obtained from the Oncocenter Foundation of São Paulo (FOSP) database. The primary endpoint was Overall Survival (OS), and secondary endpoints included Recurrence-Free Survival (RFS), Disease-Free Survival (DFS), and Local Recurrence-Free Survival (LRFS). Prognostic factors were assessed through univariable and multivariable Cox proportional hazards models. Kaplan-Meier curves were used to estimate survival, and comparisons were made using the log-rank test. RESULTS: The mean follow-up time was 39.37 ± 37.93 months. Age ranged from 11- to 104-years, with a mean age of 60.2 ± 12.6 years at diagnosis, and 78.3% were male. Most patients (61.97%) were diagnosed at an advanced stage (III-IV). Advanced stage and non-surgical treatment were independently associated with worse OS (HR = 4.253, 95% CI 3.883-4.659; 2.546, 95% CI 2.381-2.722, respectively). The 5-year overall survival rate was 50.3%, with a mean survival interval of 6.70 ± 0.06 years after diagnosis. Elderly patients and men had higher recurrence and mortality risks, whereas early-stage disease and surgical treatment were associated with better outcomes. CONCLUSION: Advanced clinical stage and non-surgical treatment were the strongest independent prognostic factors for decreased survival in OSCC. These findings underscore the importance of early detection and surgical management, as well as the need for public health strategies to reduce diagnostic and treatment delays in Brazil. LEVEL OF EVIDENCE: 2B.