Oral Cancer in the Indian Subcontinent-Survival Outcomes and Risk Factors with Primary Surgery.
Academic Medical Centers
/ statistics & numerical data
Adult
Aged
Aged, 80 and over
Chemoradiotherapy, Adjuvant
Disease-Free Survival
Female
Follow-Up Studies
Humans
India
/ epidemiology
Male
Middle Aged
Mouth
/ pathology
Mouth Neoplasms
/ diagnosis
Neoplasm Recurrence, Local
/ epidemiology
Neoplasm Staging
Oral Surgical Procedures
/ statistics & numerical data
Prognosis
Retrospective Studies
Risk Factors
Squamous Cell Carcinoma of Head and Neck
/ diagnosis
Tertiary Care Centers
/ statistics & numerical data
Young Adult
Oral cancer
age
disease free survival
neck nodal metastasis
overall survival
skin involvement
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
19
02
2021
received:
04
01
2021
accepted:
14
03
2021
pubmed:
3
4
2021
medline:
7
10
2021
entrez:
2
4
2021
Statut:
ppublish
Résumé
To assess the oncological outcome and prognostic factors for primary Oral Squamous Cell Cancer (OSCC) staged as per AJCC 8th pTNM, and treated by the contemporary standard of primary surgery and pathology directed adjuvant radiation-chemoradiation. A single institution cohort from a tertiary care academic institution in North India. Case inclusion 2013 to 2016; n = 218, median follow-up 35 months. All patients were restaged as per the AJCC 8th pTNM classification. Analysis for Overall Survival (OS), Disease-free Survival(DFS), and factors impacting outcome (Cox proportionate model Multivariate analysis). AJCC pTNM 7th to 8th edition conversion led to upstaging in 16.5%. Stage-II demonstrated greatest stage migration and apparent improvement in OS and DFS (P < .09). Discordance was noted between the presurgical (clinico-radiologic) and postsurgical (pathological) nodal status in 40.3% (88/218; 54 pathologically upstaged;34 downstaged). Pathological downstaging was particularly significant with advanced stage Gingivo-Buccal Cancers (25/73-34.7%). Stage-I-II early cancers had 3 years. OS-86.7% and DFS-78.8%; Stage-III-IV advanced cancers had 3 years. OS-56.7% and DFS-46.6%. Multivariate analysis identified poorer OS and DFS for age < 40 years (HR-1.8; 2.0), skin involvement (HR-2.1; 2.6) and pN+ status (HR-2.4; 3.5). Bone involvement did not compromise survival in this surgically treated set of patients. Age < 45 is newly identified as significantly compromising DFS and OS in Oral Cancer. Established factors of skin involvement and pN+ are confirmed as impacting DFS-OS. An apparent improvement in survival in Stage II Cancers is noted as consequent to adoption of AJCC 8th edition staging. 2 (OCEBM 2011-Inception Cohort Study for Prognosis) Laryngoscope, 131:2254-2261, 2021.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2254-2261Informations de copyright
© 2021 The American Laryngological, Rhinological and Otological Society, Inc.
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