Review
Prognosis in mouth cancer: Tumour factors

https://doi.org/10.1016/0964-1955(94)90044-2Get rights and content

Abstract

524 patients with histologically proven squamous cell carcinoma of the oral cavity who were previously untreated are studied for prognostic factors. There were various associations between T stage and site; T2 being more common in buccal cancer, T1 in tongue cancer, T4 in floor of mouth tumours and T2 in the roof of the mouth. Floor of mouth cancer tended to be more frequently associated with positive cervical lymph nodes than were other sites (45%). Well-differentiated tumours tended not to be associated with nodal disease (66%). Small tumours tended not to be associated with nodal metastases whereas large ones were. Univariate analysis of observed survival showed that well differentiated tumours had a slightly better survival than poorly-differentiated tumours (a difference of 8%). Survival fell with increasing T stage and with increasing pT stage. Positive resection margins and advanced pT stage in particular had a dismal prognosis. Survival also fell with increasing N stage and with increasing pathological N stage and extranodal rupture adversely affected prognosis. When the data were analysed by Cox's multivariate regression only two factors were found to be significant. These were T stage and N stage. Both were highly significant predictors of survival; survival falling with increasing stage.

References (43)

  • Henk et al.

    Malignant Tumours of the Oral Cavity

    (1985)
  • EC Easson et al.

    Prognostic factors in oral cancer

    Clin Oncol

    (1976)
  • WS MacComb et al.

    Cancer of the Head and Neck

    (1967)
  • PH O'Brien et al.

    Cancer of the cheek (mucosa)

    Cancer

    (1965)
  • EL Frazell et al.

    Cancer of the tongue: report of the management of 1554 patients

    Cancer

    (1962)
  • C Grandi et al.

    Prognostic significance of lymphatic spread in head and neck carcinomas: therapeutic implications

    Head Neck Surg

    (1985)
  • WM Trible et al.

    Cervical node metastases: prognosis related to level and distribution

    Arch Otolaryngol

    (1964)
  • S Warren et al.

    Multiple primary malignant tumours: a survey of the literature and statistical study

    Am J Cancer

    (1932)
  • O Kleinsasser

    Tumoren des Larynx und des Hypopharynx

  • B Vikram et al.

    Second malignant neoplasms in patients successfully treated with multimodality treatment with advanced head and neck cancer

    Head Neck Surg

    (1984)
  • AH Shikhani et al.

    Multiple primary malignancies in head and neck cancer

    Arch Otolaryngol Head Neck Surg

    (1986)
  • Cited by (69)

    • Prognostic significance of dysplasia associated with oral squamous cell carcinoma in patients undergoing surgery with curative intent

      2022, British Journal of Oral and Maxillofacial Surgery
      Citation Excerpt :

      The impact of the presence and effect of dysplasia in oral cancer resections and at margins is less well understood. Literature related to dysplasia at surgical margins suggest positive margins are more likely to be associated with decreased disease-free survival.5–7 The purpose of this study was to evaluate the prognostic implications of dysplasia, and dysplasia at margins, in a cohort of patients undergoing oral cancer resection with curative intent using local recurrence, disease specific survival (DSS) and overall survival (OS) as outcomes of interest.

    • Prognostic value of tumor mutational burden in patients with oral cavity squamous cell carcinoma treated with upfront surgery

      2021, ESMO Open
      Citation Excerpt :

      Despite advances in research and therapy, survival has not improved significantly in the last few decades.2 The well-established prognostic factors in OCSCC are mainly clinical and histological with disease stage, nodal involvement, extracapsular spread, invasion of resection margins, and perineural and lymphovascular invasion.6 Margin invasion and extracapsular spread are used for recurrence risk stratification and to guide post-operative treatment decision.7,8

    • Squamous Cell Carcinoma of the Upper Aerodigestive System

      2020, Gnepp's Diagnostic Surgical Pathology of the Head and Neck, Third Edition
    View all citing articles on Scopus
    View full text