Oral Squamous Cell Carcinoma in the Annals of the Department of Dentistry in Hradec Králové

Abstract

Introduction: The incidence of head and neck cancer in Czech Republic is rising. Despite the recent advances in treatment which improve the quality of life of these patients, no significant drop in fatality of the disease has been noted in the last decades. Aim: The aim of the study was to describe the clinical and demographic characteristics and analyze the survival of a series of patients treated at the Department of Dentistry, Charles University Faculty of Medicine and University Teaching Hospital in Hradec Králové for oral squamous cell carcinoma in the period 1988-2008 and to compare the results to those of similar studies published in the Czech literature in the past. Methods: Two-hundred patients with oral squamous cell carcinoma diagnosed and treated at the Department of Dentistry were included in the study. Information about sex, age, site of the tumour, histologic findings, stage of disease, primary treatment method and cause of death were analyzed. The Kaplan-Meier method was used for survival analysis. Results: The median of follow up was 28 months (range 1-242 months). The male to female ratio was 2.1:1. The mean age of the patients was 62 ± 12 years. The most common areas affected by carcinoma were floor of mouth (51 cases, 26%) and lower lip (47 cases, 24%). One-hundred-and-one patients were diagnosed in the late stage of the disease (TNM stages III, IV). Most patients (87, 44%) were treated surgically. Seventy-seven patients (39%) experienced a locoregional recurrence. During the time of observation, 106 patients (53%) died, out of which 74 patients died of the primary malignant disease (37%). The 5-year overall survival was 45%, the 5-year disease-specific survival was 58%. The survival depended mostly on the site of the tumour (98% and 46% 5-year disease-specific survival for lip and intraoral carcinoma, respectively, p < 0.001) and on the stage of the disease. 5-year disease-specific survival was 91% for stage I, 73% for stage II, 46% for stage III, and 25% for stage IV disease (p < 0.001). Conclusion: One of the most important prognostic factors for oral squamous cell carcinoma is the stage of the disease, therefore, early diagnostics is essential. Examination of the oral cavity aimed at early detection of potentially malignant and malignant changes should be a part of every dental check up.

Keywords

• mouth neoplasms
• head and neck cancer
• squamous cell carcinoma
• survival