ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2025
The impact of worst patterns of invasion on survival outcomes in oral cavity cancer: implications for adjuvant therapy and prognostic stratification.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Prognostic Role of Worst Pattern of Invasion in Oral Squamous Cell Carcinoma.Journal of clinical medicine · 2026Review
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6 authors.
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Abstract
purposeTo examine the impact of the worst patterns of invasion (WPOI) on survival outcomes and possible implications for adjuvant treatment decisions in squamous cell oral cavity cancer patients.
methodsThe loco-regional progression-free survival (LRPFS) and the distant metastasis-free survival (DMFS) were calculated for 162 patients. Univariate and multivariate analyses were done according to prognostic predictors of stage (early/T1-2 or N0; locally advanced /T3-4 or N +), grade, depth of invasion, WPOI, perineural (PNI), and lymphovascular (LVI) invasion and margin status. WPOI-V, PNI, and LVI were also analyzed for their positive status.
resultsThe median follow-up was 46 months (3-77 months). A total of 32 events, as loco-regional (n = 16), systemic progression (n = 14), and second primary lung cancer (n = 2) were observed. The presence of locally advanced disease, PNI or LVI, and WPOI-V were significantly worse prognostic factors for LRFS and DMFS. The 5-year LRPFS (74% vs. 92.8%, p = 0.001) and DMFS (74% vs. 94%, p < 0.0001) were significantly worse in patients with WPOI-V present. In multivariate analysis, WPOI-V patients had a worse prognosis for loco-regional relapse (p = 0.037) in early-stage cancer. There were no triple-positive patients in the early-stage group. LRRFS (90.4% vs. 59.7%, p < 0.0001) and DMFS (97% vs. 42.9%, p = 0.013) were significantly better in triple-negative patients compared to triple-positive patients.
conclusionWPOI-V indicates a poor prognosis for locoregional progression and distant metastasis. Survival outcomes are significantly worse in triple-positive patients. These results need further evidence for adjuvant radiotherapy for early and systemic therapy for triple-positive locally advanced-stage patients.
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