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Iron and oxidative stress biomarkers linked to oral cancer recurrence after surgeryIron levels and oxidative stress linked to cancer return in oral squamous cell carcinoma patients

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Key Takeaway
Note that iron and oxidative stress biomarkers are associated with higher recurrence risk in oral cancer surgery patients.

This retrospective cohort study analyzed 240 patients with oral squamous cell carcinoma (OSCC) who underwent radical surgery. The study investigated associations between serum iron metabolism biomarkers, oxidative stress markers, and clinicopathological factors with the primary outcome of recurrence or metastasis.

The main result was a recurrence/metastasis rate of 36.7% (88 of 240 patients). In the recurrence/metastasis group, proportions of T3-T4 stage, N+ status, poor differentiation, perineural invasion, and lymphovascular invasion were higher (all P values reported as significant, though exact values are not provided).

Safety and tolerability data were not reported for the biomarker assessments. The study did not report follow-up duration, comparator groups, or funding sources.

Key limitations include the retrospective design, which cannot establish causality, and the lack of reported p-values or confidence intervals for the main results. The findings suggest that iron metabolism and oxidative stress biomarkers may be associated with worse outcomes in OSCC patients after surgery, but clinical application requires prospective validation.

For people with oral squamous cell carcinoma, surgery is often the first step toward healing. But for some, the disease returns or spreads later. A look at 240 patients who had radical surgery shows a worrying pattern. Those whose cancer recurred or metastasized had higher levels of iron and oxidative stress markers in their blood. These include serum iron, ferritin, transferrin, total iron-binding capacity, transferrin saturation, malondialdehyde, reactive oxygen species, superoxide dismutase, glutathione peroxidase, and total antioxidant capacity. The study also found that these patients were more likely to have advanced tumor stages, positive lymph nodes, poor differentiation, and invasion through nerves or blood vessels. These biological factors were present in the group that faced a return of the disease. The findings suggest that how the body handles iron and manages oxidative stress might play a role in whether cancer comes back. While this is a retrospective look at past data, it highlights specific biological signals that doctors might consider when assessing risk. Understanding these markers could one day help identify who needs closer watch after surgery.

What this means for you:
Higher iron and oxidative stress markers were found in patients whose oral cancer returned after surgery.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
ObjectiveTo investigate the impact of iron metabolism and oxidative stress on recurrence and metastasis in oral squamous cell carcinoma (OSCC) and to develop an integrated predictive model.MethodsA retrospective study was conducted on 240 OSCC patients who underwent radical surgery. Preoperative iron metabolism indicators [serum iron (Fe), ferritin, transferrin (TF), total iron-binding capacity (TIBC), transferrin saturation (TSAT)] and oxidative stress indicators [malondialdehyde (MDA), reactive oxygen species (ROS), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), total antioxidant capacity (T-AOC)] were collected alongside clinicopathological data. Multivariable Cox regression was used to identify predictors, and a nomogram was constructed. Model performance was assessed via C-index, time-dependent ROC curves, and calibration plots.ResultsThe recurrence/metastasis rate was 36.7% (88/240). The recurrence/metastasis group showed higher proportions of T3-T4 stage, N+ status, poor differentiation, perineural invasion, and lymphovascular invasion (all P
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