J Korean Assoc Oral Maxillofac Surg.  2016 Feb;42(1):31-37. 10.5125/jkaoms.2016.42.1.31.

Changes in the management and survival rates of patients with oral cancer: a 30-year single-institution study

• Seo BY
• Lee CO
• Kim JW

• KMID: 2189408
• DOI: http://doi.org/10.5125/jkaoms.2016.42.1.31

Abstract

OBJECTIVES
The aim of the present study was to evaluate changes in the management and 5-year survival rates of patients with oral cancer in our department over a 30-year period.
MATERIALS AND METHODS
We investigated the patient distributions, treatment methods, method of neck dissection according to cancer stage, and 5-year survival rates for 700 oral cancer patients over the periods of 1982-1996 (256 patients), 1999-2006 (248 patients), and 2007-2011 (196 patients).
RESULTS
Stage IV patients were the largest group in all of the time periods evaluated. Although surgery and radiotherapy were the most common methods in all periods (over 50%), the prevalence of patients who underwent concomitant chemoradiotherapy increased from 7.0% to 16.2%. The use of radical neck dissection decreased from 43.0% to 5.3%, while conservative surgical methods increased from 24.1% to 76.3%. Lastly, the overall 5-year survival rate increased from 31.6% to 63.5% during the study period.
CONCLUSION
Although the 5-year survival rate reached the same level as that of other developed countries during the course of our study, most patients continue to come to the hospital with stage IV disease. In order to increase the 5-year survival rate of oral carcinoma, it may be necessary to improve public education and social efforts relevant to early diagnosis.

Keyword

Oral carcinoma; 5-year survival rate; Neck dissection; TNM staging

MeSH Terms

Chemoradiotherapy
Developed Countries
Early Diagnosis
Education
Humans
Mouth Neoplasms*
Neck Dissection
Neoplasm Staging
Prevalence
Radiotherapy
Survival Rate*

Figure

• 

  Fig. 1 Patient distribution according to the stage of oral cancer.

• 

  Fig. 2 The 5-year survival rate during 2007–2011 (Kaplan-Meier survival curve). A. Total 5-year survival rates. B. Stratified by tumor stage.

Reference

1. Strouhal E. Ancient Egyptian case of carcinoma. Bull N Y Acad Med. 1978; 54:290–302. PMID: 343851.

2. Archer WH, William TG. Morton, dentist, who first publicly demonstrated ether anesthesia; a short biography. J Am Dent Assoc. 1946; 33:1528–1532. PMID: 20273724.

3. Kaplan HS. Historic milestones in radiobiology and radiation therapy. Semin Oncol. 1979; 6:479–489. PMID: 119321.

4. Buschke F. Radiation therapy. Historical perspectives. Radiol Clin Biol. 1971; 40:217–220. PMID: 4938754.

5. Cade S. The radium treatment of cancer of the tongue. Can Med Assoc J. 1930; 23:771–774. PMID: 20318081.

6. Goodman LS, Wintrobe MM, Dameshek W, Goodman MJ, Gilman A, McLennan MT. Nitrogen mustard therapy; use of methyl-bis (beta-chloroethyl) amine hydrochloride and tris (beta-chloroethyl) amine hydrochloride for Hodgkin's disease, lymphosarcoma, leukemia and certain allied and miscellaneous disorders. J Am Med Assoc. 1946; 132:126–132. PMID: 20997191.

7. Crile G. Excision of cancer of the head and neck: with special reference to the plan of dissection based on one hundred and thirtytwo operations. JAMA. 1906; 47:1780–1786.

8. Butlin HT. An address on the results of operations for carcinoma of the tongue, with an analysis of 197 cases: delivered before the International Surgical Society in Brussels, September, 1908. Br Med J. 1909; 1:1.b2–1.b6. PMID: 20764214.

9. Shah JP, Gil Z. Current concepts in management of oral cancer: surgery. Oral Oncol. 2009; 45:394–401. PMID: 18674952.

10. Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin. 2002; 52:23–47. PMID: 11814064.

11. SEER Data, 1973-2012 [Internet]. Bethesda (MD): NIH National Cancer Institute; Surveillance, Epidemiology, an End Results Program;cited 2011 Aug 1. Available from: http://seer.cancer.gov/data/.

12. Cancer survival: England and Wales, less common cancers by age group [Internet]. London: Office for National Statistics (ONS);2005. 3. 02. cited 2011 Aug 1. Available from: http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=tcm%3A77-252716.

13. Cho JH, Kim CS. Clinical and statistical analysis of the oral cancer patients: a statistical analysis of 256 cases. J Korean Assoc Maxillofac Plast Reconstr Surg. 1998; 20:33–44.

14. Kim MY, Kim CS, Lee SH, Kim JW, Jang HJ. A clinicostatistical analysis of oral cancer patients for recent 8 years. J Korean Assoc Oral Maxillofac Surg. 2007; 33:660–668.

15. Cho YS. A clinical study on squamous cell carcinoma of the oral cavity of Korean. J Korean Assoc Oral Maxillofac Surg. 1992; 18:40–52.

16. Hoffman HT, Karnell LH, Funk GF, Robinson RA, Menck HR. The National Cancer Data Base report on cancer of the head and neck. Arch Otolaryngol Head Neck Surg. 1998; 124:951–962. PMID: 9738803.

17. Lingen MW, Kalmar JR, Karrison T, Speight PM. Critical evaluation of diagnostic aids for the detection of oral cancer. Oral Oncol. 2008; 44:10–22. PMID: 17825602.

18. Noonan B. Understanding the reasons why patients delay seeking treatment for oral cancer symptoms from a primary health care professional: an integrative literature review. Eur J Oncol Nurs. 2014; 18:118–124. PMID: 24012186.

19. Shah JP, Lydiatt W. Treatment of cancer of the head and neck. CA Cancer J Clin. 1995; 45:352–368. PMID: 7583907.

20. Martin H, Del Valle B, Ehrlich H, Cahan WG. Neck dissection. Cancer. 1951; 4:441–499. PMID: 14839606.

21. Nahum AM, Mullally W, Marmor L. A syndrome resulting from radical neck dissection. Arch Otolaryngol. 1961; 74:424–428. PMID: 14477989.

22. Fitz-Hugh GS, Robins RB, Craddock WD. Increased intracranial pressure complicating unilateral neck dissection. Laryngoscope. 1966; 76:893–906. PMID: 5949296.

23. Medina JE, Byers RM. Supraomohyoid neck dissection: rationale, indications, and surgical technique. Head Neck. 1989; 11:111–122. PMID: 2722487.

24. Byers RM. Modified neck dissection: a study of 967 cases from 1970 to 1980. Am J Surg. 1985; 150:414–421. PMID: 4051103.

25. Byers RM, Wolf PF, Ballantyne AJ. Rationale for elective modified neck dissection. Head Neck Surg. 1988; 10:160–167. PMID: 3235344.

26. Lister J. On the antiseptic principle in the practice of surgery. Br Med J. 1867; 2:246–248.

27. Pulte D, Brenner H. Changes in survival in head and neck cancers in the late 20th and early 21st century: a period analysis. Oncologist. 2010; 15:994–1001. PMID: 20798198.