Prognostic factors for survival in patients with N1-3 oral squamous carcinoma. Multivariate analysis using Cox's hazards model.:MULTIVARIATE ANALYSIS USING COX'S HAZARDS MODEL

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A multivariate analysis was carried out in 113 patients with N1-3 oral squamous carcinoma to determine the influence of clinical and pathological factors on survival. Tumors were located in the tongue of 44 patients; gums, 37 patietns; floor of the mouth, 20 patietns; and buccal mucosa, 12 patients. According to the UICC classification (1987), there were 48 (42%) patients with stage III and 65 (58%) patients with stage IV. Neck dissection was carried out in all the patients. Survival distributions were estimated by the Kaplan-Meier method and were compared using the log rank test. Prognostic factors were evaluated simultaneously in multivariate analyses by Cox's proportional hazards model. Significant variables obtained from univariate analyses were entered into the Cox regression equation in a stepwise fashion. Four independent variables were found to significantly influence survival in the following order: 1. pN stage; 2. N stage; 3. T stage; and 4. histological grade. Five-year cumulative survival rates according to pN stage, variable were 89% for 40 patients with pN 0 and 36% for 73 patients with pN 1-3; a conspicicuous difference between both groups was found, as expected. Therefore, a multivariate analysis was carried out only in 73 patients with pN 1-3 to determine independent variables for survival. Independent variables identified by this method were presence or absence of extracapsular spread and T stage.
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