Survival trends of patients with oral and oropharyngeal cancer treated at a cancer center in São Paulo, Brazil

Abstract

OBJECTIVE:We aimed to estimate the overall survival (OS) and conditional survival (CS) in patients diagnosed with oral and oropharyngeal squamous cell carcinoma (SCC) and to determine their survival trends. METHODS:The study included all consecutive patients treated at the A.C. Camargo Cancer Center for oral or oropharyngeal SCC between 2001 and 2012. Data were obtained from the Hospital Cancer Registry. OS and CS were analyzed using the Kaplan-Meier method to evaluate the probability of survival with Cox predictor models. RESULTS: Data of 505 oral and 380 oropharyngeal SCC patients obtained in 2001-2006 and 2007-2012 were analyzed. Most of the oral SCC (59%) and oropharyngeal SCC (90%) patients had stages III-IV SCC. The 5-year OS for patients with oral SCC was 51.7%, with no significant difference between the first and second periods. The CS rates in 2007-2012 were 65% after the first year and 86% up to the fifth year. For oropharyngeal SCC, the 5-year OS rate was 45.0% in the first period. The survival rate increased to 49.1% from 2007 to 2012, with a reduction in the risk of death (HR=0.69;0.52-09.2). The CS estimates from 2007 to 2012 were 59% after the first year and 75% up to the fifth year. CONCLUSION: Survival across the two time periods remained stable for oral SCC but showed a significant increase for oropharyngeal SCC, possibly because of improvements in the patients' response to radiotherapy, such as intensity-modulated radiation therapy, and the use of more accurate diagnostic imaging approaches.

Influence of Sociodemographic Factors, and the Coverage and Offer of Health Services on Mortality Due to Oral and Oropharyngeal Cancer in Brazil: A 20-year Analysis

“…However, some studies conducted in the Southeast and Northeast regions' capitals did not identify differences in survival between the sexes. [12,34,35] Clinical factors such as site of injury, histological type, staging of the disease, type of treatment, time between diagnosis and initiation of treatment, nutritional status, and HPV exposure, also in uence the survival of individuals with oral cancer, [4,12,14,34,36,37] which may justify the difference found in this study compared to other ndings in the literature. Another possible explanation is that the regular use of health services, speci cally by women, [8] which can enable early diagnosis, encounters barriers such as wrong diagnoses and erroneous and/or late referrals, which lead to late diagnosis, with consequent worsening of prognosis and survival.…”

Effect of socioeconomic status on survival in patients with head and neck cancer

“…The 5‐year survival rate from all types of HNC was about 61%. For each site, the 5‐year survival corresponded to and even exceeded the data of other Western countries 21–25 …”

“…For each site, the 5-year survival corresponded to and even exceeded the data of other Western countries. [21][22][23][24][25] As expected, there was a significant difference in OS between the periphery and the center in Israel for ages <65 in all types of HNC. This may indicate poor quality and/or less availability of treatment in the periphery, less awareness of risk behavior, or differences in patient's delay until a diagnosis is made.…”

Direct healthcare costs of lip, oral cavity and oropharyngeal cancer in Brazil

“…This could explain this study’s findings that this group was shown as the costliest for males and females and is also the one with highest demand for hospitalisation hours, attendants, and ICU. Also, this highest incidence regions are anatomically more complex and, considering that most cases of oral cancer that reach treatment are in advanced stages [ 29 ], the high cost of cancers in these regions may be related to a greater demand for more complex multimodal and surgical treatments, integrating multi- professional teams (vascular microsurgery, plastic surgery) and requiring professionals specialised in long-term rehabilitation [ 30 ].…”