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A combined prognostic factor for improved risk stratification of patients with oral cancer

 K-Y Kim  ;  X Zhang  ;  S-M Kim  ;  B-D Lee  ;  I-H Cha 
 ORAL DISEASES, Vol.23(1) : 91-96, 2017 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/diagnosis* ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/surgery ; Female ; Humans ; Male ; Middle Aged ; Mouth Neoplasms/diagnosis* ; Mouth Neoplasms/mortality ; Mouth Neoplasms/pathology ; Mouth Neoplasms/surgery ; Neoplasm Staging ; Principal Component Analysis ; Prognosis ; Retrospective Studies ; Risk Assessment/methods ; Survival Analysis ; Young Adult
clinical diagnosis ; combined prognostic factor ; lymph node ratio ; oral cancer ; risk stratification
PURPOSE: We aimed to identify a combined prognostic factor for predicting better performance in risk stratification.

MATERIALS AND METHODS: We reviewed the clinical and pathological variables of 316 patients with oral squamous cell carcinoma (OSCC) who underwent surgery. To identify a combined predictor, principal component analysis (PCA) was performed.

RESULTS: Univariate analysis showed that the independent prognostic variables for overall survival (OS) were pathologic T stage (T1 vs T4, HR = 1.99, 95% CI: = 1.083-3.675, P = 0.026) and pathologic N stage (N0 vs N2, HR=1.90, 95% CI: = 1.17-3.08, P = 0.008). In the multivariate analysis, only pathologic T stage was significant (P = 0.006 and P = 0.007); however, the multivariate model was not significant (P = 0.191). The multivariate model became significant by including lymph node ratio (LNR) instead of pathologic N stage (P = 0.0025 in numeric LNR, P = 0.0007 in categorized LNR). Also, the performance of prediction model was improved by a combined prognostic factor (P = 0.0002).

CONCLUSIONS: The newly identified combined prognostic factor included resection margin, differentiation, and LNR, and they were insignificant factors independently except for LNR. This combined prognostic factor showed a good performance although it did not include molecular markers; therefore, it may be used conveniently for risk stratification of patients with OSCC by combining only clinical information.
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Appears in Collections:
2. College of Dentistry (치과대학) > Research Institute (부설연구소) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Others (기타) > 1. Journal Papers
Yonsei Authors
Kim, Ki Yeol(김기열) ORCID logo https://orcid.org/0000-0001-5357-1067
Zhang, Xiang Lan(장향란)
Cha, In Ho(차인호) ORCID logo https://orcid.org/0000-0001-8259-2190
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