Objective: To determine the association of clinical and pathological parameters on recurrence of treated stage T4squamous cell carcinoma of oral cavity patients managed with surgery followed by concomitant chemo and radiation therapy. Method: The retrospective, cohort study was conducted at Patel Hospital, Karachi, and comprised data of patients diagnosed with oral squamous cell carcinoma and admitted between January 1, 2014, and January 30, 2019. Patients of either gender aged 20-80 years who had a minimum follow-up of one year were included. Data was collected using the Head and Neck Cancer registry form and the medical record files. The subjects were also contacted by telephone when needed. The study end-points were disease-free survival and overall survival. Data was analysed using SPSS 21. Results: Out of the 83 patients, 65(78%) were male. The overall median(range) age was 46(20-80) years, and 43(52%) of them were aged 31-50 years. Overall, 15(18%) patients had positive margins and 48(58%) had proven cervical node metastasis on histopathology. Overall survival was 42.2% with the median(range) follow-up time was 14(9-21) months and 5-year disease-free survival was 45.8% with the median (range) follow-up time was 13(7-19). The factor that affected the final outcome was found to be the increasing nodal ratio (p=0.043). Conclusion: Among T4 oral squamous cell carcinoma patients treated with surgery and adjuvant therapy, the rate of disease recurrence was found to be high. Tumors with a high cervical nodal disease burden and/or margin involved were at substantially higher risk of recurrence. Key Words: Squamous cell carcinoma, Oral cancer, Recurrence, Survival.

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The aim of this study is to determine adhesion formation rate and antrostomy closure rate after the use of Mitomycin-C in patients underwent FESS. This is a prospective case control study conducted at ENT Department Lyari General Hospital, Karachi, Pakistan. Fifty one patients included with diagnosis of bilateral chronic rhinosinusitis or allergic fungal sinusitis and were the surgical candidate, underwent bilateral Functional Endoscopic Sinus Surgery (FESS). The patients were evaluated using Lund-Mackay staging system prior to surgery. At the completion of surgery Mitomycin-c (MMC) was applied in one nasal cavity the other nasal cavity served as a control. Among fifty one patients both nostrils were used hence we have 51 cases and 51 controls. The patients were followed for a minimum period of three months after surgery. Subjective improvement of symptoms were recorded as well as rigid nasoendoscpic examination was also performed regularly. The adhesion formation rate in MMC applied nasal cavities was 11.7% as compared to 64.7% of controls. The middle meatal antrostomy closure rate was 41% and 5% in controls and MMC applied group respectively. Hence mitomycin-c application has shown benefit in reducing post FESS ostial stenosis and adhesion formation between middle turbinate and lateral nasal wall. Application of Mitomycin-C has impact on reducing post FESS adhesion formation and middle meatal antrostomy closure.