title: Predictors for tumor recurrence after primary definitive surgery for oral cancer.
abstract: OBJECTIVE
  The purpose of this study was to identify significant predictors for oral squamous cell carcinoma recurrence.
  
  
  METHODS
  This Ambispective cohort study was performed in consecutive metastasis-free patients treated for oral squamous cell carcinoma with curative intent from 1998 through 2003. Variables included gender, age, tumor site, macroscopic pattern of the lesion, coexisting disorders (diabetes, hepatic and heart disorders, other tumors/diseases), degree of differentiation, and pathologic TNM stage. Tumor recurrence was considered the dependent variable (outcome). The distribution of recurrences was assessed with χ(2) test. Survival times were estimated by Kaplan-Meier curves and differences were examined with log-rank test. Multiple Cox regression study was also performed. The significance level chosen for all tests was P < .05.
  
  
  RESULTS
  One hundred eighteen patients entered the study. Tumor recurrence was 44.9% during the follow-up period (10% local, 29.7% regional, and 5% distant). The mean period that had elapsed before recurrence was 15 months (1.5 to 81.8), with most recurrences (66%) during the first year after treatment (84.9% before 2 years). Multivariate Cox regression analysis indicated the presence of a coexisting disorder (P = .022) as the most relevant prognostic factor for relapse, because patients with associated diseases had a 2.43-fold risk of recurrence. Tumor stage (P = .037), degree of differentiation (P = .042), and macroscopic pattern of the lesion (P = .022) were also identified as prognostic factors for relapse.
  
  
  CONCLUSIONS
  The risk profile for oral cancer recurrence includes patients younger than 60 years with coexisting diseases whose primary tumor occurred as an ulcerated lesion, and diagnosed at an advanced stage with a poorly differentiated tumor.
authors.affiliation: Service of Maxillofacial Surgery, A Coruña University Hospital, A Coruña, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: Vázquez-Mahía
authors.forename: Juan
authors.initials: J
authors.lastname: Seoane
authors.forename: Pablo
authors.initials: P
authors.lastname: Varela-Centelles
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Tomás
authors.forename: Augusto
authors.initials: A
authors.lastname: Álvarez García
authors.forename: José Luis
authors.initials: JL
authors.lastname: López Cedrún
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002908:Chronic Disease; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D019226:Oral Ulcer / Q000473:pathology; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate