Survival following primary surgery for oral cancer

Rogers, S., Brown, J., Woolgar, J., Lowe, D., Magennis, P., Shaw, R., Sutton, D., Errington, D. and Vaughan, D. (2009) Survival following primary surgery for oral cancer. Oral Oncology, 45 (3). pp. 201-211. ISSN 1368-8375 DOI https://doi.org/10.1016/j.oraloncology.2008.05.008

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Abstract

The main aims of this article are to report the overall and disease-specific survival of a consecutive series of patients presenting with oral cancer from 1992 to 2002 and to relate survival to clinical and pathological factors. The article uses population-based age-sex mortality rates in the North-West of England to highlight differences in overall and disease-specific survival. 541 patients with oral squamous cell carcinoma presented to the Regional Maxillofacial Unit from 1992 to 2002. Curative treatment favoured radical primary surgery, 10% (52) received primary radiotherapy. These patients were on average 8 years older with more advanced tumours and overall poorer survival at 5 years, 23% (SE 7%). The remainder of the results refer to 489 patients who had primary curative surgery, 40% (194) of whom received adjuvant radiotherapy. The overall survival (OS) was 56% (SE 2%) and the disease-specific survival (DSS) was 74% (SE 2%). There was a local recurrence rate of 10% (50) and the loco-regional recurrence rate was 21% (103). The second primary rate was 7% (35). Survival figures had improved over the 10-year period from 63% DSS for the first 4 years of the study (1992–1995) compared to 81% for the last 3 years (2000–2002). In stepwise Cox regression the two predictors selected for disease-specific survival were pN status and margins (both p < 0.001). Age-sex mortality rates for the North-West indicate that 15.0% of the 489 primary surgery patients might have been expected to die within 5 years if they were typical of the general population and the observed difference between all causes and oral-cancer specific survival was 18.3%. These data emphasise the value of disease-specific survival as an indicator of successful treatment in a cohort that tends to be elderly, from social deprived backgrounds, with life styles and comorbidity that influence overall survival.

Item Type: Article
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RK Dentistry
Divisions: Nursing and Midwifery
Date Deposited: 01 Mar 2011 13:51
URI: http://repository.edgehill.ac.uk/id/eprint/2679

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