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Abstract
Aim. To retrospectively analyze the oncologic outcomes of transoral surgery for oral cavity squamous cell carcinoma based on primary tumor depth of invasion (DOI).
Materials and Methods. We analyzed 122 patients (30-80 years; mean age 57.8 ± 10.2 years) with tongue and floor of mouth squamous cell carcinoma (DOI ≤20 mm). Patients were stratified by DOI: Group 1 (1-5 mm, n=35), Group 2 (6-10 mm, n=55), and Group 3 (11-20 mm, n=32). Outcomes were assessed through local/regional recurrence rates, locoregional control, distant metastasis incidence, second primary tumors, and Kaplan-Meier overall survival. Statistical analysis utilized log-rank tests for survival comparisons and Fisher's exact test for categorical variables.
Results. Median follow-up was 39.5 months (range: 4-134). Local/regional recurrence rates were: Group 1 (6%/6%), Group 2 (7%/16%), Group 3 (19%/19%). Locoregional control rates were 89%, 84%, and 69% respectively. Distant metastasis rates were 3%, 9%, and 12% (all non-significant). Second primary tumors developed in 14 patients (11.4%), predominantly oral (6 cases, 4.9%). Five-year overall survival was 80.8%, 65.9%, and 37.1% (p=0.031). Group 3 demonstrated more advanced disease and higher adjuvant radiotherapy utilization.
Conclusion. Transoral surgery demonstrates excellent oncologic safety for lesions with DOI ≤10 mm. While outcomes deteriorate with increasing DOI beyond this threshold, the specific relationship between surgical approach and recurrence requires further investigation.
References
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