Einfluss klinischer und histologischer Parameter auf das Überleben von Patienten mit oralem Plattenepithelkarzinom - eine retrospektive Kohortenstudie

The oral squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral cavity. The high and rising incidence of OSCC contrasts with the almost constantly poor prognosis for the long-term survival of affected patients in recent decades. In addition to the resulting burden on the healthcare system, the often therapeutically complex and invasive procedures in the head and neck area also represent a significant burden for patients. This study investigates clinical and histological parameters concerning patients with an OSCC analyzing them in terms of survival rate. To accomplish this, data from 558 patients, who were diagnosed with OSCC and were treated at Charité – Universitätsmedizin Berlin during the years from 2005 to 2011 was collected and analyzed in this retrospective study. Patients included in the evaluation aged 27 to 98 years with a typical gender distribution of 361 males (64,7 %) and 197 females (35,3 %). The median survival in this study group was found to be 79.5 months, with a 5-year-survival rate of 55 %. The influence of a high patient age at diagnosis on the mortality risk was shown in both univariate and multivariate analyses. Furthermore, underweight (BMI < 18), clinical and pathological T-stage, extracapsular lymph node metastasis and a resection distance < 5 mm were found to be significantly associated with overall survival in multivariate analyses. In addition to factors already known to influence survival, such as nicotine abuse and advanced tumor stage, the role of the following laboratory parameters in the risk of mortality was identified: increased CRP levels, Hb values < 12 mg/dl and leukocytosis (> 12/nl). It was also shown that the tumor size was underestimated by an average of 3.9 mm in CT diagnostics. Parameters associated with advanced tumor stages such as lymph node involvement and in particular the extracapsular spread of lymph node metastases as well as patients with R1 resection status have a significantly worse survival rate, so that in conclusion the early detection of OSCC plays a key role in the question of ways to improve the prognosis. In addition to the need to conduct further studies in order to find suitable predictive parameters for the survival of OSCC patients, which could influence treatment planning as possible risk markers, the present study aims to emphasize the relevance of the earliest possible diagnosis.