Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Sep:168:107566.
doi: 10.1016/j.oraloncology.2025.107566. Epub 2025 Aug 5.

Predictors of recurrence, and the impact of adjuvant radiation therapy on survival in early stage (pT1-2, N0) oral cavity squamous cell carcinoma: A matched pair analysis

Rachit Sood  1 , Chirom Amit Singh  2 , Smriti Panda  2 , Aanchal Kakkar  3 , Alok Thakar  2 , Kapil Sikka  2 , Rajeev Kumar  2 , Anup Singh  2 , Suman Bhasker  4 , Ahitagni Biswas  4 , Kavneet Kaur  3 , Anjali V Ramdulari  4
Affiliations
Observational Study

Predictors of recurrence, and the impact of adjuvant radiation therapy on survival in early stage (pT1-2, N0) oral cavity squamous cell carcinoma: A matched pair analysis

Rachit Sood et al. Oral Oncol. 2025 Sep.

Abstract

Background: Early stage constitutes around 40 % of all oral cavity squamous cell carcinoma (OSCC). While the role of adjuvant therapy in advanced cases is well established, its role in early-stage disease remains controversial and is institutional based. Despite treatment advances, the 5-year Disease Free Survival (DFS) falls short of 80 %.

Methods: An ambispective observational study was conducted on all early stage (pT1-2, N0) OSCC who underwent curative surgery of the primary and neck from 2019 to 2024 at a tertiary oncology care centre. Patients with a history of radiation, recurrence, neoadjuvant chemotherapy or positive margins were excluded. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Secondary outcomes were factors associated with recurrence, radiation-induced toxicity, and quality of life.

Results: 1260 OSCC were operated during the study period. 357(28 %) were early stage, and 274 were eligible for analysis. 52(18.9 %) patients had recurrence. 3-year-OS was 92 % and 3-year-DFS was 74 %. Tongue subsite (p = 0.034), depth of invasion (DOI) > 5 mm (p = 0.012), and peri-neural Invasion (PNI) (p = 0.036) were significant predictors of recurrence on multi-variate analysis. On matched-pair analysis patients who received adjuvant radiotherapy had lower rates of recurrence (16.9 % vs 24.6 %, p = 0.2815). Odds of recurrence increased from low to intermediate to high Brandwein-Gensler score (OR - 0.54 vs 0.89 vs 1.54, p = 0.4332).

Conclusion: Tongue/FOM subsite, DOI > 5 mm, and PNI are aggressive features in early-stage OSCC. Adjuvant therapy can help to achieve improved disease control. There is a pressing need to establish definitive indications for adjuvant therapy in pT1-2, N0 OSCC.

Keywords: Adjuvant radiation; Brandwein gensler score; Depth of invasion; Early oral cancer; Matched pair analysis; Oral cavity squamous cell carcinoma; Perineural invasion; Prognosis; Quality of life; Recurrence.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Publication types