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Risk factors of cancer occurrence after surgery of oral intraepithelial neoplasia: A long‐term retrospective study
Author(s) -
Régloix Stanislas,
Badois Nathalie,
Bernardeschi Celine,
Jouffroy Thomas,
Hofmann Caroline
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27214
Subject(s) - medicine , hazard ratio , confidence interval , cancer , intraepithelial neoplasia , retrospective cohort study , surgery , risk factor , gastroenterology , prostate
Objective Oral intraepithelial neoplasia (OIN) is a premalignant lesion of oral mucosa graded I through III according to the importance of atypic cells and the thickness of the dysplastic layers. The aim of this study was to evaluate the long‐term clinical course of OIN lesions and identify predictive factors of outcomes. Methods The clinical, surgical, and follow‐up data of the patients consecutively treated for OIN by primary surgical removal in a referral anti‐cancer center from November 1998 to March 2009 were retrospectively analyzed. The main outcome parameters were the 10‐year disease‐free survival (DFS), cancer‐free survival (CFS), overall survival (OS), and disease‐specific survival (DSS) rates (Kaplan‐Meier). Results Thirty‐one patients were included. Patients with positive or close margins (n = 15) had a significantly lower 10‐year CFS rate (46.7% vs. 92.38%; P = .004) than patients with negative margins. This predictive factor remained significant in multivariate analysis (hazard ratio, 9.157; 95% confidence interval, 1.4–60.6). There was no significant difference in the 10‐year DFS (33.3% vs. 48.7%; P = .2), DSS (92.8% vs. 100%; P = .1), and OS (92.8% vs. 69.6%; P = .2) rates between these two groups. Neither the initial OIN grade nor other clinical or surgical parameters were found to be significant predictors of outcomes. Conclusion In this long‐term follow‐up study on histologically proven OIN treated by primary surgery, positive or close margins status was the only independent predictive factor of progression to cancer. Therefore, we warmly recommand performing re‐resection rather than surveillance in cases with positive margins. Oral intraepithelial neoplasia grading or lesion size were not significant predictors of outcomes. Level of Evidence 4. Laryngoscope , 2546–2551, 2018