{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T05:17:20Z","timestamp":1778044640642,"version":"3.51.4"},"reference-count":31,"publisher":"Societatea Romana de Morfologie","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rom J Morphol Embryol"],"published-print":{"date-parts":[[2025,12,12]]},"abstract":"<jats:p>Background and Objective: The survival of patients with oral squamous cell carcinoma (OSCC) is influenced not only by tumor characteristics but also by treatment strategies, follow-up, and patient-related factors. This study aimed to determine the overall five-year survival rate in a Romanian cohort and evaluate the impact of key prognostic factors. Patients, Materials and Methods: Seventy-two patients diagnosed with OSCC and treated surgically at the Department of Oral and Maxillofacial Surgery, Emergency County Clinical Hospital, Cluj-Napoca, Romania, between January 2016 and December 2019 were retrospectively analyzed. Prognostic factors included tumor stage, primary site, histological parameters, lymph node involvement, treatment modalities, and demographic variables. Results: Patients were stratified into four groups: five-year survivors (n=26), disease-specific mortality (n=21), mortality from non-oncological causes (n=5), and lost to follow-up (n=20). Overall, 36.1% of patients achieved five-year recurrence-free survival, corresponding to 50% among those with complete follow-up. Survivors were more often diagnosed at early or intermediate stages, had fewer tongue tumors, better differentiation, clear surgical margins, and consistent adjuvant therapy. Notably, 27.8% of patients were lost to follow-up despite favorable pathological features, suggesting systemic gaps in long-term surveillance. Conclusions: The five-year survival rate of 50% reflects both aggressive tumor biology and systemic barriers to care. Clinical stage remains the strongest prognostic factor, but tumor site and histological features, including perineural and lymphatic invasion, significantly influence outcomes even in early disease. Improved long-term survival requires earlier diagnosis, refined prognostic assessment, and multimodal therapy tailored to tumor behavior, alongside better patient follow-up strategies.<\/jats:p>","DOI":"10.47162\/rjme.66.3.15","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T10:41:45Z","timestamp":1768819305000},"page":"581-586","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic factors of oral squamous cell carcinoma: a five-year retrospective study in Cluj-Napoca, Romania"],"prefix":"10.47162","volume":"66","author":[{"name":"Department of Oro-Maxillo-Facial Surgery and Implantology, Faculty of Dental Medicine, Iuliu Ha\u0163ieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u0103d\u0103lina-Anca","family":"Moldovan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina Maria","family":"Neghin\u0103","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Oral and Maxillofacial Surgery, Emergency County Clinical Hospital, Cluj-Napoca, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdan Andrei","family":"Bumbu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru Iosif","family":"Precup","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u0103zvan Marius","family":"Vica\u015f","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Morphological Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Drago\u015f Alexandru","family":"\u0162ermure","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Oro-Maxillo-Facial Surgery and Implantology, Faculty of Dental Medicine, Iuliu Ha\u0163ieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Oral and Maxillofacial Surgery, Emergency County Clinical Hospital, Cluj-Napoca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u0103lin Rare\u015f","family":"Roman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Oro-Maxillo-Facial Surgery and Implantology, Faculty of Dental Medicine, Iuliu Ha\u0163ieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Oral and Maxillofacial Surgery, Emergency County Clinical Hospital, Cluj-Napoca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian Niky","family":"Cump\u0103t\u0103","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Titu Maiorescu University, Bucharest, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"26736","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"\"[1] Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, La Vecchia C. Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980. Ann Oncol, 2013, 24(10):2657-2671. https:\/\/doi.org\/10.1093\/annonc\/mdt301","DOI":"10.1093\/annonc\/mdt301"},{"key":"ref1","unstructured":"[2] World Health Organization (WHO). Global health estimates: leading causes of death. Global Health Estimates, Life Expectancy and Leading Causes of Death and Disability, Geneva, Switzerland, 2024 Dec 18."},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"[3] Ghanem AS, Memon HA, Nagy AC. Evolving trends in oral cancer burden in Europe: a systematic review. Front Oncol, 2024, 14:1444326. https:\/\/doi.org\/10.3389\/fonc.2024.1444326","DOI":"10.3389\/fonc.2024.1444326"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"[4] Tan Y, Wang Z, Xu M, Li B, Huang Z, Qin S, Nice EC, Tang J, Huang C. Oral squamous cell carcinomas: state of the field and emerging directions. Int J Oral Sci, 2023, 15(1):44. https:\/\/doi.org\/10.1038\/s41368-023-00249-w","DOI":"10.1038\/s41368-023-00249-w"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"[5] Fl\u00fcgge T, Gaudin R, Sabatakakis A, Tr\u00f6ltzsch D, Heiland M, van Nistelrooij N, Vinayahalingam S. Detection of oral squamous cell carcinoma in clinical photographs using a vision transformer. Sci Rep, 2023, 13(1):2296. https:\/\/doi.org\/10.1038\/s41598-023-29204-9","DOI":"10.1038\/s41598-023-29204-9"},{"key":"ref5","unstructured":"[6] World Health Organization (WHO). Global Cancer Observatory. International Agency for Research on Cancer (IARC), Lyon, France, 2024 Dec 18."},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"[7] Ragin CCR, Modugno F, Gollin SM. The epidemiology and risk factors of head and neck cancer: a focus on human papillomavirus. J Dent Res, 2007, 86(2):104-114. https:\/\/doi.org\/10.1177\/154405910708600202","DOI":"10.1177\/154405910708600202"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"[8] Chinn SB, Myers JN. Oral cavity carcinoma: current management, controversies, and future directions. J Clin Oncol, 2015, 33(29):3269-3276. https:\/\/doi.org\/10.1200\/JCO.2015.61.2929","DOI":"10.1200\/JCO.2015.61.2929"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"[9] Davaatsend O, Altannamar M, Batbayar B, Jagdagsuren U. Factors influencing the 5-year survival rate of oral cancer patients in the Mongolian population: a retrospective cohort study. Front Oral Health, 2023, 4:1292720. https:\/\/doi.org\/10.3389\/froh.2023.1292720","DOI":"10.3389\/froh.2023.1292720"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"[10] Zanoni DK, Montero PH, Migliacci JC, Shah JP, Wong RJ, Ganly I, Patel SG. Survival outcomes after treatment of cancer of the oral cavity (1985-2015). Oral Oncol, 2019, 90:115-121. https:\/\/doi.org\/10.1016\/j.oraloncology.2019.02.001","DOI":"10.1016\/j.oraloncology.2019.02.001"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"[11] Ashwini R, Narayan M, Rajkumar K. Diagnostic and prognostic markers of oral squamous cell carcinoma - a detailed review. Oral Oncol Rep, 2024, 10:100321. https:\/\/doi.org\/10.1016\/j.oor.2024.100321","DOI":"10.1016\/j.oor.2024.100321"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"[12] Dolens EDS, Dourado MR, Almangush A, Salo TA, Gurgel Rocha CA, da Silva SD, Brennan PA, Coletta RD. The impact of histopathological features on the prognosis of oral squamous cell carcinoma: a comprehensive review and meta-analysis. Front Oncol, 2021, 11:784924. https:\/\/doi.org\/10.3389\/fonc.2021.784924","DOI":"10.3389\/fonc.2021.784924"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"[13] Rogers SN, Brown JS, Woolgar JA, Lowe D, Magennis P, Shaw RJ, Sutton D, Errington D, Vaughan D. Survival following primary surgery for oral cancer. Oral Oncol, 2009, 45(3):201-211. https:\/\/doi.org\/10.1016\/j.oraloncology.2008.05.008","DOI":"10.1016\/j.oraloncology.2008.05.008"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"[14] Garzino-Demo P, Zavattero E, Franco P, Fasolis M, Tanteri G, Mettus A, Tosco P, Chiusa L, Airoldi M, Ostellino O, Schena M, Rampino M, Ricardi U, Evangelista A, Merletti F, Berrone S, Ramieri G. Parameters and outcomes in 525 patients operated on for oral squamous cell carcinoma. J Craniomaxillofac Surg, 2016, 44(9):1414-1421. https:\/\/doi.org\/10.1016\/j.jcms.2016.06.007","DOI":"10.1016\/j.jcms.2016.06.007"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"[15] Kademani D, Bell RB, Bagheri S, Holmgren E, Dierks E, Potter B, Homer L. Prognostic factors in intraoral squamous cell carcinoma: the influence of histologic grade. J Oral Maxillofac Surg, 2005, 63(11):1599-1605. https:\/\/doi.org\/10.1016\/j.joms.2005.07.011","DOI":"10.1016\/j.joms.2005.07.011"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"[16] Kim MJ, Ahn KM. Prognostic factors of oral squamous cell carcinoma: the importance of recurrence and pTNM stage. Maxillofac Plast Reconstr Surg, 2024, 46(1):8. https:\/\/doi.org\/10.1186\/s40902-024-00410-3","DOI":"10.1186\/s40902-024-00410-3"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"[17] Chow JCH, Cheuk W, Cho WCS, Wong CF, Au DWY, Tam AHP, Wong RCW, Chan JCH, Law SCC, Ngan RKC, Wong KH, Cheung KM. Comparison of clinical outcomes, pathologic characteristics, and immune-related features of postradiation vs sporadic oral cavity squamous cell carcinoma. JAMA Netw Open, 2023, 6(7):e2323890. https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.23890","DOI":"10.1001\/jamanetworkopen.2023.23890"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"[18] Ajmani GS, Nocon CC, Wang CH, Bhayani MK. Assessment of adjuvant therapy in resected head and neck cancer with high-risk features. Oral Oncol, 2017, 74:15-20. https:\/\/doi.org\/10.1016\/j.oraloncology.2017.09.005","DOI":"10.1016\/j.oraloncology.2017.09.005"},{"key":"ref18","unstructured":"[19] Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, Sullivan DC, Jessup JM, Brierley JD, Gaspar LE, Schilsky RL, Balch CM, Winchester DP, Asare EA, Madera M, Gress DM, Meyer LR (eds). AJCC Cancer Staging Manual. American College of Surgeons, Springer, New York, NY, USA, 2017, 1032."},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"[20] Jones HB, Sykes A, Bayman N, Sloan P, Swindell R, Patel M, Musgrove B. The impact of lymphovascular invasion on survival in oral carcinoma. Oral Oncol, 2009, 45(1):10-15. https:\/\/doi.org\/10.1016\/j.oraloncology.2008.03.009","DOI":"10.1016\/j.oraloncology.2008.03.009"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"[21] Sunkara PR, Graff JT, Cramer JD. Association of surgical margin distance with survival in patients with resected head and neck squamous cell carcinoma: a secondary analysis of a randomized clinical trial. JAMA Otolaryngol Head Neck Surg, 2023, 149(4):317-326. https:\/\/doi.org\/10.1001\/jamaoto.2022.5186","DOI":"10.1001\/jamaoto.2022.5186"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"[22] Chatzistefanou I, Lubek J, Markou K, Ord RA. The role of perineural invasion in treatment decisions for oral cancer patients: a review of the literature. J Craniomaxillofacial Surg, 2017, 45(6):821-825. https:\/\/doi.org\/10.1016\/j.jcms.2017.02.022","DOI":"10.1016\/j.jcms.2017.02.022"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"[23] Binmadi N, Alsharif M, Almazrooa S, Aljohani S, Akeel S, Osailan S, Shahzad M, Elias W, Mair Y. Perineural invasion is a significant prognostic factor in oral squamous cell carcinoma: a systematic review and meta-analysis. Diagnostics (Basel), 2023, 13(21):3339. https:\/\/doi.org\/10.3390\/diagnostics13213339","DOI":"10.3390\/diagnostics13213339"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"[24] Mello FW, Melo G, Pasetto JJ, Silva CAB, Warnakulasuriya S, Rivero ERC. The synergistic effect of tobacco and alcohol consumption on oral squamous cell carcinoma: a systematic review and meta-analysis. Clin Oral Investig, 2019, 23(7):2849-2859. https:\/\/doi.org\/10.1007\/s00784-019-02958-1","DOI":"10.1007\/s00784-019-02958-1"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"[25] Wolfer S, Kunzler A, Foos T, Ernst C, Leha A, Schultze\u2010Mosgau S. Gender and risk\u2010taking behaviors influence the clinical presentation of oral squamous cell carcinoma. Clin Exp Dent Res, 2022, 8(1):141-151. https:\/\/doi.org\/10.1002\/cre2.523","DOI":"10.1002\/cre2.523"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"[26] Santos HBP, dos Santos TKG, Paz AR, Cavalcanti YW, Nonaka CFW, Godoy GP, Alves PM. Clinical findings and risk factors to oral squamous cell carcinoma in young patients: a 12-year retrospective analysis. Med Oral Patol Oral Cir Bucal, 2016, 21(2):e151-e156. https:\/\/doi.org\/10.4317\/medoral.20770","DOI":"10.4317\/medoral.20770"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"[27] Jariod-Ferrer \u00daM, Arbones-Mainar JM, Gavin-Clavero MA, Sim\u00f3n-Sanz MV, Moral-Saez I, Cisneros-Gimeno AI, Martinez-Trufero J. Are comorbidities associated with overall survival in patients with oral squamous cell carcinoma? J Oral Maxillofac Surg, 2019, 77(9):1906-1914. https:\/\/doi.org\/10.1016\/j.joms.2019.03.007","DOI":"10.1016\/j.joms.2019.03.007"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"[28] Cheraghlou S, Kuo P, Mehra S, Yarbrough WG, Judson BL. Untreated oral cavity cancer: long\u2010term survival and factors associated with treatment refusal. Laryngoscope, 2018, 128(3):664-669. https:\/\/doi.org\/10.1002\/lary.26809","DOI":"10.1002\/lary.26809"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"[29] Wang S, Yang M, Li R, Bai J. Current advances in noninvasive methods for the diagnosis of oral squamous cell carcinoma: a review. Eur J Med Res, 2023, 28(1):53. https:\/\/doi.org\/10.1186\/s40001-022-00916-4","DOI":"10.1186\/s40001-022-00916-4"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"[30] Jones KR, Lodge-Rigal RD, Reddick RL, Tudor GE, Shockley WW. Prognostic factors in the recurrence of stage I and II squamous cell cancer of the oral cavity. Arch Otolaryngol Head Neck Surg, 1992, 118(5):483-485. https:\/\/doi.org\/10.1001\/archotol.1992.01880050029006","DOI":"10.1001\/archotol.1992.01880050029006"},{"key":"ref30","unstructured":"[31] Ghaderi H, Roshan-Zamir M, Jafarinia M, Kruger E. Oral squamous cell carcinoma: focus on biomarkers for screening. J Dent (Shiraz), 2024, 25(1):1-16. https:\/\/doi.org\/10.30476\/dentjods.2023.96159.1924\""}],"container-title":["Romanian Journal of Morphology and Embryology"],"original-title":[],"link":[{"URL":"https:\/\/rjme.ro\/RJME\/resources\/files\/660325581586.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T10:48:39Z","timestamp":1768819719000},"score":1,"resource":{"primary":{"URL":"https:\/\/rjme.ro\/archive\/66\/3\/15\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,12,12]]},"published-print":{"date-parts":[[2025,12,12]]}},"URL":"https:\/\/doi.org\/10.47162\/rjme.66.3.15","relation":{},"ISSN":["1220-0522","2066-8279"],"issn-type":[{"value":"1220-0522","type":"print"},{"value":"2066-8279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]}}}