Conclusion

In conclusion, in this study 67 of 308 patients surgically treated for recurred OSCC, recurrences and/or metastases were found in 22.7% of patients, mostly at the primary site within 1.8 years after the initial treatment.

Although half of patients were Stage IV, recurrence rate was relatively lower than previous reports.

It implies that serial surgical procedures such as wide excision, neck dissection and reconstruction with free flap for treating advanced OSCC has benefit in removing malignant lesions clearly.

Pathologic features are more important than population based features in locoregional recurrence of OSCC.

Among clinical features, only TNM stage and primary tumor sites show a little possibility in recurrence of OSCC.

Node status is an important risk factor in predicting prognosis both clinically and pathologically.

LVI, PNI, Histologic grade and resection margin status are critical risk factors while almost of them are biologically related with cellular invasion and migration, so called epithelial mesenchymal transition (EMT).

Missing values in several pathologic features still remain further study and close communication between surgeon and pathologist.

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ABSTRACT (IN KOREAN)

였다. 재발이 나타나는 중위 기간은 최초 치료 이후 1.8 년 이었으며 남성과 고령 환자에서 더 많이 재발하는 것으로 관찰되었다. 림프절 전이, 안전 절제연 확보, 신경침범 및 림프혈관 침범은 구강편평세포 재발에 유의미한 영향을 주는 요소로 분석되었다. 이상의 결과를 토대로 구강편평세포암의 재발은 선택적 혹은 근치적 경부 곽청술을 포함한 광범위 절제술과 유리피판을 이용한 재건, 적절한 술후 방사선 및 화학치료, 주의 깊은 술후 감시에 의해 예방되어 질 수 있을 것으로 사료된다.

핵심어 : 구강암, 구강편평세포암, 구강편평세포암 재발, 두경부암, 구인두