Oral squamous cell carcinoma arising from oral epithelial dysplasia shows high postoperative recurrence despite favorable histopathology.

Yiming Hu, Xiaoxian Zhao, Miao Wang, Zhiyuan Zhang, Shufang Jin, Hailong Ma

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Article in Clinical oral investigations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Yiming HuDepartment of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Xiaoxian ZhaoDepartment of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Miao WangDepartment of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Zhiyuan ZhangDepartment of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Shufang JinDepartment of Second Dental Center, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 72300120147@shsmu.edu.cn.

Hailong MaDepartment of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China. mahl21@sjtu.edu.cn.ORCID https://orcid.org/0000-0003-4110-1417

Funding

National Natural Science Foundation of China 82172897National Natural Science Foundation of China 82272983

6 · The paper itself

Abstract

objectivesWe sought to determine whether oral epithelial dysplasia (OED)-derived oral squamous cell carcinoma (OSCC) represents a clinically and pathologically distinct subtype, given that a substantial subset of OSCC is known to arise from OED. MATERIALS AND

methodsThis retrospective study analyzed 335 patients with OSCC treated at our institution. OED-OSCC was defined as OSCC in patients with a documented history of biopsy-proven oral epithelial dysplasia, irrespective of the specific clinical lesion.

resultsOED-derived OSCC (OED-OSCC), defined by pathologically confirmed dysplasia rather than clinical presentation, comprised 195 (58.2%) patients in the cohort. Compared with non-OED-OSCC, it demonstrated less aggressive tumor-centric features including shallower DOI, lower PNI, earlier T stage, and fewer nodal metastases, yet paradoxically greater cumulative surgical burden with more patients undergoing multiple resections. Recurrence in OED-OSCC was significantly associated with margin dysplasia, which was more frequent than in non-OED-OSCC (74.00% vs. 48.97%). Moreover, recurrence rates increased with margin dysplasia severity (mild: 60%; moderate: 73.08%; severe: 100%), underscoring that field cancerization at the primary site may contribute to the distinct clinical behavior of OED-OSCC. The clinical value of dysplasia-free margins warrants prospective evaluation, as even mild dysplasia was associated with a 60% recurrence rate.

conclusionsOED-OSCC represents a pathologically anchored subgroup in which margin dysplasia severity was associated with high recurrence despite favorable tumor-centric features. These findings support prospective evaluation of mucosal margin status in risk stratification. CLINICAL RELEVANCE: By anchoring OSCC classification to histopathologically confirmed dysplasia, OED-OSCC identifies patients with a dysplastic background and elevated observed recurrence risk who may merit enhanced surveillance.

Indexed as

Carcinoma, Squamous CellMouth NeoplasmsNeoplasm Recurrence, LocalPrecancerous ConditionsAdultAgedAged, 80 and overBiopsyFemaleHumansMaleMiddle AgedNeoplasm StagingRetrospective StudiesOral epithelial dysplasiaOral squamous cell carcinomaRecurrenceSurgical margin

Identifiers

PMID42803846

DOI10.7150/jca.14214

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