Role of extended histological examination in the assessment of local recurrence of the oral cancer.

INTRODUCTION: Oral cancer is the second most prevalent head and neck malignancy in Poland. The incidence of these types of cancer is constantly growing. A reason for a treatment failure of the oral cancer is local recurrence. AIM OF THE STUDY: To find out why the rate of recurrence of the oral cancer is so high despite radical surgical treatment combined with radiochemotherapy. MATERIALS AND METHODS: The study comprised a group of 160 oral cancer patients. 30 patients who showed local recurrence were given an extended histopathological examination in keeping to the guidelines of the Royal College of Pathologists. RESULTS: In 9 patients, primary tumours were found to be histologically aggressive as indicated by the proliferation of the vessels, nerves and muscles. In next 9 cases, the cancer infiltrated both the vessels and nerves or the vessels and muscles, and in the 8 other cases, just one of those structures. The tumours which were found to penetrate the vessels, nerves and muscles were also characterised with peri- and intraneural infiltration. The aggressiveness of invasion measured by the extent of damage done to the muscles, vessels and nerves correlated with the depth of invasion from the mucous membrane, the occurrence of embolisms in blood vessels, and a high (score 4) risk assessment as proposed by Margaret Brandwein-Gensler. CONCLUSION: The progression of cancer depends strongly on histopathological features. The incidence of penetration of the vessels, nerves and muscles correlates with aggressiveness of the front of tumour and few other histological features.