Prognostic Analysis of Patients of Oral Squamous Cell Carcinoma in Seoul National University Hospital Using Computer-Aided Individual Prognosis (CIP)

Choi, Keum Kang; Kim, Myung Jin

Abstract

TNM system has been generally used for the clinical classification and the estimation of the prognosis of malignant tumors but it has been criticized for its accuracy in the field of oral and maxillofacial malignant tumors. This is because the prognoses of tumors are affected by so many factors, which have been not fully understood yet. For oral squamous cell carcinoma, "Treatment-dependent prognosis Index(TPI)" was developed from the retrospective DOSAK(German-Austrian-Swiss Association for Head and Neck Tumors) study from 1952 to 1985 for the purpose of more accurate and more objective estimations of prognoses. Considering the additional factors, DOSAK developed TPI into "Computer-Aided Individual Prognosis (CIP)" from the prospective study in 1992. We yielded and compared the estimated survival rates and the real survival rates in 145 patients who can be traced their survival out of 241 oral squamous cell carcinoma patents in Seoul National University Hospital during a decade from 1986 to 1995 using Computer-Aided Individual Prognosis (CIP). The patients were divided into group of overall, groups of nonevidence of disease and evidence of disease, groups divided by stage, groups divided by T classifications and by N classifications. The results are as follows. 1. Overall five-year survival rates are 53.6% in real survival rate and 25.4% in estimated survival rate. Generally the real survival rates are higher than the estimated survival rates in the standard of 5 year survival rates. 2. The differences of survival rates are up to maximum 43.3% in stage 2 and minimum 17.1% in N2. 3. Among 15 groups, 11 groups have statistical meaningful correlations (p<0.01) except stage2, stage 3, N1 and N3 The prognoses of Korean oral squamous patients were able to be estimated indirectly by CIP. For the more accurate estimation of the prognoses of Korean oral squamous patients, it is necessary to develop our own CIP program through the systemic epidemic studies.