Survival following primary surgery for oral cancer.



Rogers, Simon N ORCID: 0000-0002-5989-6142, Brown, James S, Woolgar, Julia A, Lowe, Derek, Magennis, Patrick, Shaw, Richard J ORCID: 0000-0002-5157-4042, Sutton, David, Errington, Douglas and Vaughan, David
(2009) Survival following primary surgery for oral cancer. Oral oncology, 45 (3). 201 - 211.

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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
Uncontrolled Keywords: Humans, Carcinoma, Squamous Cell, Mouth Neoplasms, Neoplasm Recurrence, Local, Prognosis, Treatment Outcome, Risk Factors, Survival Analysis, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, England, Female, Male, Young Adult
Subjects: ?? RK ??
Divisions: Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences > School of Dentistry
Depositing User: Symplectic Admin
Date Deposited: 29 Apr 2009 11:51
Last Modified: 30 Oct 2021 12:04
DOI: 10.1016/j.oraloncology.2008.05.008
URI: https://livrepository.liverpool.ac.uk/id/eprint/733