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Evaluating Treatment Strategies for p53 Mutant Oral Cancer and Oral Cancer Precursors
Sponsor: University of British Columbia
Summary
The goal of this clinical trial is to optimize treatment strategies for patients with p53-mutant oral epithelial dysplasia (OED) and early-stage oral squamous cell carcinoma (SCC). The main question it aims to answer is what the most optimal treatment is at each diagnostic stage. It is hypothesized that lesions with p53-abnormal low-grade dysplasia without surgical intervention will progress to high-grade dysplasia or SCC in 4 years. It is also predicted that a clear p53 and severe/CIS excision margins in patients with p53-abnormal HGD will reduce the progression to invasive SCC, compared to clear severe/CIS margins, within 4 years. Finally, it is thought that patients with p53-abnormal cT1N0 and DOI\<3mm receiving an END will have improved disease free and overall survival. This research will elucidate whether or not these hypotheses are correct. Participants in each diagnostic cohort will be assigned to one of two different treatment options, listed below: Cohort 1: A) No intervention, observation only B) Surgical excision with clear margins Cohort 2: A) Surgical excision with clear severe/CIS margins B) Surgical excision with clear severe/CIS and p53 margins Cohort 3: A) Surgical excision and elective neck dissection (END) B) Surgical excision and close follow-up, only END if development of nodal disease
Official title: Evaluating Treatment Strategies for p53 Mutant Oral Epithelial Dysplasia and SCC Study
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
171
Start Date
2026-03-12
Completion Date
2032-09
Last Updated
2026-02-17
Healthy Volunteers
No
Interventions
Cohort 1 Intervention group
Clear margin excision of the lesion under local anesthetic, with re-excision for p53-positive margins.
Cohort 2 severe/CIS margins clear
Clear margin excision of the lesion under local anesthetic, with re-excision until severe/CIS margins are clear
Cohort 2 p53 and severe/CIS margins clear
Excision of the lesion ensuring final negative p53 and severe/CIS margins
Cohort 3 Excision and END
Excision of primary lesions with 5+mm margins and immediate elective neck dissection
Cohort 3 Excision and Close follow up
Excision of primary lesion with 5+mm margins and close follow up with salvage elective neck dissection if development of nodal disease
Locations (1)
Vancouver General Hospital
Vancouver, British Columbia, Canada