Improvement in survival of patients with oral cavity squamous cell carcinoma: An international collaborative study

• Published in: Cancer Vol. 119; no. 24; pp. 4242 - 4248
• Main Authors: Amit, Moran, Yen, Tzu‐Chen, Liao, Chun‐Ta, Chaturvedi, Pankaj, Agarwal, Jai Prakash, Kowalski, Luiz P., Ebrahimi, Ardalan, Clark, Jonathan R., Kreppel, Matthias, Zöller, Joachim, Fridman, Eran, Bolzoni, Villaret A., Shah, Jatin P., Binenbaum, Yoav, Patel, Snehal G., Gil, Ziv
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley-Blackwell 15.12.2013
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Cooperative Behavior; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - radiotherapy; Head and Neck Neoplasms - surgery; Humans; International Cooperation; Longitudinal Studies; margins; Medical sciences; Middle Aged; Mouth - diagnostic imaging; Mouth - surgery; Mouth Neoplasms - mortality; Mouth Neoplasms - pathology; Mouth Neoplasms - radiotherapy; Mouth Neoplasms - surgery; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); oral cavity; Otorhinolaryngology. Stomatology; Outcome Assessment (Health Care); Prognosis; Radiography; Radionuclide Imaging; Radiotherapy, Adjuvant - methods; Retrospective Studies; squamous; Squamous Cell Carcinoma of Head and Neck; survival; time; trends; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Young Adult; Human; margins; Stomatology; Malignant tumor; Oral squamous cell carcinoma; Survival; Oral cavity; squamous; Cancerology; Oral cavity disease; time; trends; Cancer; International; oral cavity; survival
• DOI: 10.1002/cncr.28357
• ISSN: 0008-543X; 1097-0142

BACKGROUND An association between the survival of patients with oral cavity squamous cell carcinoma (OCSCC) and advancements in diagnosis and therapy has not been established. METHODS This was a retrospective, longitudinal, international, population‐based study of 2738 patients who underwent resection of OCSCC during 2 different decades. Characteristics of patients from 7 international cancer centers who received treatment between 1990 and 2000 (group A; n = 735) were compared with patients who received treatment between 2001 and 2011 (group B; n = 2003). RESULTS Patients in group B had more advanced tumors and tended to develop distant metastases more frequently than patients in group A (P = .005). More group B patients underwent selective neck dissection and received adjuvant radiotherapy (P < .001). Outcome analysis revealed a significant improvement in 5‐year overall survival, from 59% for group A to 70% for group B (P < .001). There was also a significant improvement in disease‐specific survival associated with operations performed before and after 2000 (from 69% to 81%, respectively; P < .001). Surgery after 2000, negative margins, adjuvant treatment, and early stage disease were independent predictors of a better outcome in multivariate analysis. The decade of treatment was an independent prognostic factor for cancer‐specific mortality (hazard ratio, 0.42; 95% confidence interval, 0.3‐0.6). CONCLUSIONS The survival rate of patients with OCSCC improved significantly during the past 2 decades despite older age, more advanced disease stage, and a higher rate of distant metastases. The current results suggest that the prognosis for patients with OCSCC has improved over time, presumably because of advances in imaging and therapy. Cancer 2013;119:4242–4248. © 2013 American Cancer Society. The survival rate of patients with oral cavity cancer has improved significantly during the past 2 decades despite higher stage disease, and a higher rate of distant metastases. The decade of treatment is identified as an independent prognostic factor for outcome with a hazard ratio of 0.42 for cancer‐specific mortality.