Analysis of Survival Rates Following Primary Surgery of 178 Consecutive Patients with Oral Cancer in a Large District General Hospital

Abstract

As almost half of our patients presented with advanced cancer and had discouraging survival rates, we emphasize the need for early recognition of the disease. Advanced disease signifies difficulty in obtaining clear margins which actually indicates a higher recurrence rate. 25 % of our patients died of oral cancer within 5 years of surgery which highlights the poor prognosis that recurrence carries after treatment. Effective educational campaign with purpose to raise oral cancer awareness and earlier referral may result in improvement of survival.

Diagnosis and referral delays in primary care for oral squamous cell cancer: a systematic review

“…Unfortunately, at diagnosis it is common for the disease to have reached an advanced stage (stage III or IV). 5 Clinical stage at diagnosis is recognised as an important prognostic marker; 6 the differences in 5-year mortality rates based on staging are marked, with >80% survival in those with localised disease, compared with <30% in those with advanced disease. 7 Furthermore, there is a consensus that in oral cancer the greater the diagnostic delay, the more advanced the disease will be at staging.…”

Close Resection Margins Do Not Influence Local Recurrence in Patients With Oral Squamous Cell Carcinoma: A Prospective Cohort Study

“…The institutional review board advised that ''the study is not required to be ethically reviewed under the terms of the governance arrangements for NHS Ethics committee.'' 5 The preferred method of treatment consisted of elective tracheostomy for the early postoperative period for cases in which serious edema was expected, radical resection of the primary tumor aiming for a 1-cm margin when possible, preservation of mandibular continuity by marginal mandibulectomy when suitable, and a low threshold for pull-through or lipsplit and mandibulotomy techniques for access when needed. Supraomohyoid neck dissection (levels I, II, and III) was used routinely for patients with T2N0 status.…”

“…Patients with SCC of the oral tongue and floor of the mouth underwent extended supraomohyoid neck dissection (levels I to IV). 5 The TNM classification of the Union for International Cancer Control was used for tumor staging. 11 This treatment protocol is in accordance with the head and neck cancer multidisciplinary team guidelines in the United Kingdom.…”

“…A margin of at least 5 mm was considered free of disease (clear). 5 All patients with various degrees of dysplasia at the surgical margin were excluded. Patients were offered postoperative radiotherapy dependent on the histologic outcome.…”

“…[1][2][3][4] Surgical margins involved with tumor cells not only result in a higher risk of local recurrence but also have a negative effect on survival. 5,6 Achieving cancer clearance at the primary site can often become a challenge because of anatomic restrictions and tumor biological characteristics.…”