The Long-Term survival in Surgically-Resected Oral and Oropharyngeal Squamous Cell Carcinoma: 12-years Retrospective Study

บทคัดย่อ

The incidence of oral cavity and pharynx cancer is the 6^th most common malignancy in male and the 10^th in female. Ninty five percents are squamous cell carcinoma. It is common in older adulthood. The prognosis is poor. An aim of this study was to assess the demographic data and to investigate the prognostic factors in estimating response to treatment associated with disease-free survival (DFS) and overall survival (OS) in a cohort of surgically-resected oral squamous cell carcinoma (OC) and oropharyngeal carcinoma (OP) patients. Survival probability was calculated according to the Kaplan-Meier survival analysis and the differences between variables were assessed with a multivariable Cox proportional hazards regression and hazard ratios (HRs). Participants included 150 patients. A median of follow-up period was 44+/-36.93 months. Ninety patients were male and sixty patients were female. The median age at diagnosis was 65 years. The rate of alcohol drinking, cigarette smoking and betel nut chewing were 48%, 41.33% and 18% respectively. The OP was 16% and OC was 84%. The most common OC location was the gum; 41.54 %, follow by the tongue, the floor of mouth, the buccal mucosa, the hard palate and the lip; 23.85%, 13.85%, 13.85%, 3.84% and 3.07% respectively. The Early stage cancer was 20% and the late stage cancer was 80%. Multiple primary cancer was identified 9.3%. The DFS was 53.33%. At the end of this study, 12 years period, the OS was 50.67%. There were no differences in DFS and OS observed between variables. The OP was more likely to have worse OS than OC (aHR 1.94,95%CI:1.03-3.65, p=0.039) The DFS in young adult, <40 years, was more likely less than the older adult, >40 years, (aHR 2.78,95%CI:1.10-7.02, p=0.031).and also the DFS in betel nut chewing was more likely less than the others. Never the less, up to 38.1% of patients develop locoregional relapse. The local recurrence was 29.2% and the 78.57 percents present within 6 months. The nodal recurrence was 70.8% and the 82.4 percents were detected within a year. The local recurrence patients were more likely to have worse OS than the nodal recurrence patients (aHR 1.94,95%CI:1.03-3.65, p=0.039). In conclusion, there are no differences in DFS and OS were observed between variables in this study. Planning joint treatment for patients to recover from cancer is the ultimate goal. The surgeon requires a good understanding of cancer prognostic factors and also, good skill in the removal of tumors and cervical lymph nodes. Consider irradiation and or provide joint chemotherapy based on indications. Raising awareness of the dangers of oral cancer, Proactive oral cancer screening campaign, Self-detection of oral cancer, then bring them into the treatment system, are the main way to beat oral cancer.