Oral squamous cell carcinoma has a remarkable incidence worldwide and a fairly onerous prognosis, encouraging further research on factors that might modify disease outcome. In this review article, the authors approach the factors that may exert influence on the prognosis and eventually guide the selection of patients for more aggressive therapies. Published scientific data was collected, selected, and grouped into 3 main clusters: patient-, tumor-, and treatment-related factors. Well established aspects are discussed, but also those less common or with only supposed usefulness. Disease staging, extracapsular dissemination, resection margin free of disease, and tumor thickness are factors with high influence on the prognosis. There has been an increasing interest in the study of tumor molecular factors, and some have been strongly correlated with the outcome, showing promising pathways for the future development of more effective prognosis systems and anticancer therapies.
DISCUSSION
Despite the attainments already achieved concerning OSCC diagnosis and therapy, mortality and morbidity rates are still exceedingly high, challenging the available methods of prognosis assessment and encouraging the search for new and better markers, namely, molecular markers that relate comprehensively with known alterations of tumor progression. The immense diversity found in the field of clinical oncology must be considered from 2 main perspectives: the biologic distinctiveness of each patient and the biologic distinctiveness of each malignancy. Currently, in practical terms, the factors with greater consensual influence on disease outcome include disease staging, extracapsular spread, tumor thickness, and resection margin free of disease. In the future, better results in clinical oncology appear to rely on improved understanding of tumor molecular biology.
