A retrospective analysis to determine factors contributing to the survival of patients with oral squamous cell carcinoma (original) (raw)
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Cancers of the Head & Neck
Background: Despite improvements in diagnosis and patient management, survival and prognostic factors of patients with oral squamous cell carcinoma (OSCC) remains largely unknown in most of Sub Saharan Africa. Objective: To establish survival and associated factors among patients with oral squamous cell carcinoma treated at Mulago Hospital Complex, Kampala. Methods: We conducted a retrospective cohort study among histologically confirmed oral squamous cell carcinoma (OSCC) patients seen at our centre from January 1st 2002 to December 31st 2011. Survival was analysed using Kaplan-Meier method and comparison between associated variables made using Log rank-test. Cox proportional hazards model was used to determine independent predictors of survival. P-values of less than 0.05 were considered statistically significant. Results: A total of 384 patients (229 males and 155 females) were included in this analysis. The overall mean age was 55.2 (SD 4.1) years. The 384 patients studied contributed a total of 399.17 person-years of follow-up. 111 deaths were observed, giving an overall death rate of 27.81 per 100 person-years [95% CI; 22.97-32.65]. The two-year and five-year survival rates were 43.6% (135/384) and 20.7% (50/384), respectively. Tumours arising from the lip had the best five-year survival rate (100%), while tumours arising from the floor of the mouth, alveolus and the gingiva had the worst prognosis with five-year survival rates of 0%, 0% and 15.9%, respectively. Independent predictors of survival were clinical stage (p = 0.001), poorly differentiated histo-pathological grade (p < 0.001), male gender (p = 0.001), age > 55 years at time of diagnosis (p = 0.02) and moderately differentiated histo-pathological grade (p = 0.027). However, tobacco & alcohol consumption, tumour location and treatment group were not associated with survival (p > 0.05). Conclusions: The five-year survival rate of OSCC was poor at 20.7%. Male gender, late clinical stage at presentation, poor histo-pathological types and advanced age were independent prognostic factors of survival. Early detection through screening and prompt treatment could improve survival.
Parameters and outcomes in 525 patients operated on for oral squamous cell carcinoma
Journal of Cranio-Maxillofacial Surgery, 2016
This report analyzed the outcomes of patients undergoing surgery fororal squamous cell carcinoma (OSCC) to identify the value ofprognostic factors. Material and methods A total of 525 patients were studied who had undergone surgery for oral squamous cell carcinoma (OSCC) between 2000 and 2011, of whom 222 had received postoperative radiation-therapy (PORT) and or chemoradiation-therapy (PORTC). For each patient, personal data, histological findings, treatment and outcome were recorded and analyzed statistically. Survival curves were calculated using the Kaplan-Meier algorithm, and the difference in survival among subgroups was examined. Results The overall survival (OS) and disease-specific survival (DSS) 5-year survival rate in the 525 patients were respectively 71.38% and 73.18%. The differences in the overall survival and diseasespecific 5-year survival were significant (p < 0.05) for age < 40 years, site of origin, N status, staging, grading, osseous medullar infiltration, and perineural invasion. In patients undergoing radiation therapy, only perineural invasion negatively influenced the survival prognosis. In 150 pT1 cases of tongue and floor-of-mouth cancer, an infiltration depth (ID) > 4 mm was statistically correlated with poorer prognosis. Conclusions The results demonstrate an improvement in the 5-year OS and DSS rates during the past decade compared with the previous decade.Univariate analysis revealed that age, tumor staging, and lymph node involvement, extracapsular spread, grading, perineurial invasion, infiltration depth, and osseus medullary invasion were associated significantly with overall survival and disease-specific survival.
Clinicopathological parameters and outcome of 245 patients operated for oral squamous cell carcinoma
Journal of Cranio-maxillofacial Surgery, 2006
Introduction: This report analysed the outcome of patients undergoing surgery for oral squamous cell carcinoma in order to identify the prognostic value of several factors. Patients: A total of 245 patients were studied who had undergone surgery for oral squamous cell carcinoma between 1989 and 2002, of whom 109 had received postoperative radiation therapy. Methods: For each patient, personal data, alcohol and tobacco consumption, symptoms, histological findings, treatment, and outcome were recorded and analysed statistically. Survival curves were calculated using the Kaplan-Meier algorithm, and the difference in survival among subgroups was examined. Results: The overall 5-year survival rate in the 245 patients was 63% (72.5% at 3 years). The differences in the 5-year survival were significant (po0:05) for the site of origin, N and pN status, TNM stage, grading, status of the resection margins, osseous infiltration, and perineural invasion. Vascular involvement as a discriminator was not statistically significant. In patients undergoing radiation therapy, only perineural invasion negatively influenced the 5-year survival prognosis (po0:01). Conclusion: The overall survival rate was within the (previously) reported range. The prognostic value of many parameters is widely recognized; the combined evaluation of 'composite factors' is promising. r 2006 European Association for Cranio-Maxillofacial Surgery
BMC Oral Health, 2016
Background: The main objective of this study was to describe selected clinico-pathological characteristics of Oral Squamous Cell Carcinoma (OSCC) in Sri-Lanka. Materials & methods: The study sample comprised of eight hundred and ninety six biopsies diagnosed as OSCC. The clinical and histopathological features were analyzed using the Chi-square test. Results: Of the 896 biopsies, 801 were primary OSCCs, while 95 were recurrent OSCCs. Majority of the patients (78 %) were in the 5 th to 7 th decades of life and showed a male predilection. The buccal mucosa was the commonest site of primary OSCC comprising of 43 % of the sample. Of the primary OSCCs, with known TNM stage, 86 % were in stage 3&4 and majority (59 %) of stage 4 tumours showed tumour at one or more excision margins. Of the recurrent OSCC, 46 % developed their recurrences within one year of the excision of the primary tumour. Conclusion: In Sri-Lanka, OSCC is a major problem. Only half the patients had completely excised tumours (with clearance of >5 mm at all excision margins) at operation, and recurrences appeared early. This data should be considered in the future management policy of OSCC in Sri-Lanka.
Neck Dissection in Patients with Oral Squamous Cell Carcinoma in Dharmais Hospital, Jakarta
KnE Life Sciences, 2018
Oral squamous cell carcinoma (OSCC) is one of the rarest cancers worldwide. In Indonesia, the incidence is less than five thousands per year, and the mortality rate is almost 50%. More than 50% patients with OSCC have lymph node metastasis; the proportion of occult metastasis is 24-42%. Those with lymph node metastatis have the worst possibility of survival. This study aimed to estimate the survival of OSCC patients with neck dissections. We conducted a retrospective cohort study of 78 patients with OSCC who were treated in Dharmais National Cancer Hospital between 1 January 2003 and 31 January 2013. The three years survival rate post diagnosis, post neck dissection was calculated using Kaplan-Meier survival curves and statistically tested using a log-rank test. Cox proportional hazard models were applied to assess the prognostic significance of neck dissections. Of the total patients in this study (n=78), 53.8% of patients had surgery. Of patients who underwent surgery, 71.4% had a neck dissection surgery. These patients were in either early or advanced stages of cancer. Overall survival showed that patients who received neck dissections had better survival rates (58.2%) than patients who did not receive neck dissection (32.2%). Stratification at every stage of cancer (I, II, III, and IV) showed better survival in patients with neck dissections. The risk of patients without neck dissections is higher than patient with neck dissection to die, Hazard Ration(HR)=2.19 (CI95% 1.04-4.62, p=0.028). Adequate neck dissection surgery increases chances of survival in patients with OSCC.
Survival in squamous cell carcinoma of the oral cavity
Cancer, 2007
BACKGROUND. According to the American Joint Commission on Cancer (AJCC, 5 th edition) classification system, pT4 N0 oral cavity squamous cell carcinoma (OSCC) qualifies for stage IVA status, with its implied poor prognosis. However, preliminary observations suggested that patients with pT4 N0 OSCC might have better survival than other stage IVA categories. The authors sought to identify accurate prognosticators in patients with stage III/IVA OSCC.
Ten-Year Outcome of Different Treatment Modalities for Squamous Cell Carcinoma of Oral Cavity
PubMed, 2017
Objective: This study reports outcomes of squamous cell carcinoma of oral cavity (SCCOC) patients with different treatment modalities. Materials and Methods: We evaluated the treatment outcomes of 775 newly diagnosed SCCOC patients treated in our hospital between 2001 and 2010. Outcome data were obtained from the medical records. Survival rates were estimated by the Kaplan-Meyer method. Cox-proportional-hazard regression models were used to compare the risk of death among all risk factors. Results: The patients were divided into group 1) surgery ± adjuvant radiotherapy (RT) (n = 323) or group 2) RT ± chemotherapy (CT) for curative intent (n = 315) or group 3) RT/CT for palliative intent (n = 137). The overall 10-year survival rate was 17%. Statistically significant difference was noted in 10-year overall survival when SCCOC was managed surgically as compared to curative RT and palliative RT/CT with 25.3 %, 12.9%, 4.7%, respectively. The hazard ratio of cancer death in group 1 was 2.0 (95% CI 1.7-2.4) as compared to group 2. Conclusion: This study suggested that surgery must be the mainstay of treatment in locally advanced stage SCCOC. Palliative RT/CT still offered long term survival in some SCCOC patients.
Oral cancer is one of the most common cancer in India. The aim of this study was to analyze retrospectively the demographic, histopathological and clinical profile of oral squamous cell carcinoma patients who attended a tertiary level care referral hospital in Jharkhand. A total of 324 biopsy proven cases of OSCC were studied. The data was collected for a period of June 2015 to December 2017. The cases were analyzed in terms of age,gender,duration of symptoms,habits(tobacco and alcohol consumption),site of primary tumour and stage at presentation and the results were formulated to chart the trends. Male to female ratio was 2.48:1. Most of the patients of OSCC belonged to the age group of 51-60 years(26.54%). Buccal mucosa was found to be the most common primary site of involvement. Majority of the patients presented in stage IVA (40.12%). Well differentiated SCC (56.79%)was the most predominant histological variant in this study. This study hence showed that OSCC is very widespread in this region and majority of cases presented at advanced stages due to lack of awareness. Early detection and intervention is required to decrease the morbidity and mortality associated with oral squamous cell carcinoma.