p53-positive expression in dysplastic surgical margins is a predictor of tumor recurrence in patients with early oral squamous cell carcinoma

Purpose: This was a retrospective analysis of the impact of the expression of p53 in the dysplastic surgical margins of early oral squamous cell carcinoma (OSCC) (pT1-2, N0). Patients and methods: Seventy-two patients with early oral squamous cell carcinoma (OSCC) were recruited. Margin characteristics were abstracted from the pathology report. Expression of p53 in dysplastic surgical margins was examined with the immunohistochemical method and was correlated with clinicopathological parameters and clinical outcomes. Results: Patients with moderate/severe dysplasia had poor local relapse-free survival (RFS) compared to those with mild dysplasia. Thirty-two (44.4%) had at least one p53-positive margin, and there was a significant association between the expression of p53 and tumor recurrence (P< 0.001). p53-positive expression was correlated with RFS in patients with dysplastic margins, and its expression in moderate/severe dysplastic groups had a worse RFS than mild dysplastic groups. We also found that the grade of the dysplasia margin was not correlated with RFS in p53-negative groups. Multivariable analysis validated p53 expression in dysplastic surgical margins as an independent risk factor for recurrence. Conclusion: Our results validated that p53 expression was an independent risk factor for early OSCC with dysplastic surgical margins. Additional therapy and close follow-up are needed for these patients.