Prognostic factors and long-term survival in oral squamous cell carcinoma

A cross-sectional study

Keywords: prognosis, survival analysis, medical records, mouth neoplasms, carcinoma squamous cell

Abstract

Objective: this study aimed to evaluate long-term survival and prognostic factors in patients with oral squamous cell carcinoma (OSCC) in an economically poor region of Brazil.
Methods: the data were obtained from analysis of medical and mortality records of 210 patients with OSCC treated at an oncology hospital providing services to the Brazilian Unified National Health System in a State of northeastern Brazil between January 2006 and December 2008. Sociodemographic and clinical information, treatment performed, recurrence and evolution were collected. Survival curves were estimated by the Kaplan-Meier method and the log rank and Cox regression tests were used to compare the curves.
Results: the median survival in the study period was 47.4 months (95% CI = 38.2 - 56.7). The overall survival rates at 5 and 10 years were 29% and 19.8%, respectivelly. Individuals over 60 years of age (HR = 1.70; 95% CI = 1.06 - 2.73), presence of regional metastasis (HR = 2.51; 95% CI = 1.55 - 4.08), presence of recurrence (HR = 3.18; 95% CI = 1.88 - 5.39) and no surgical treatment (HR = 2.10; 95% CI = 1.31 - 3.35) had a worse prognosis.
Conclusions: advanced age, presence of regional metastasis, tumor recurrence and non-surgical treatment predict poorer survival in patients diagnosed with OSCC.

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Author Biographies

Carlos Eduardo Moura Carvalho Rocha, Universidade Estadual do Piauí (UESPI), Teresina, PI, Brazil.

Medical student at State University of Piauí (UESPI), Teresina, PI, Brazil.

Júlio César Saraiva Santos, Universidade Estadual do Piauí (UESPI), Teresina, PI, Brazil.

Medical doctor at State University of Piauí (UESPI), Teresina, PI, Brazil.

Rafael Everton Assunção Ribeiro da Costa, Universidade Estadual do Piauí (UESPI), Teresina, PI, Brazil.

Medical student at State University of Piauí (UESPI), Teresina, PI, Brazil.

Eduardo Salmito Soares Pinto, Secretaria de Saúde do Estado do Piauí (Sesapi), Teresina, PI, Brazil.

Resident doctor at Getúlio Vargas Hospital, Teresina, PI, Brazil.

Ana Luisa Rios Barbosa de Almeida, Hospital São Marcos (HSM), Teresina, PI, Brazil; Associação Piauiense de Combate ao Câncer Alcenor Almeida, Teresina, PI, Brazil.

Specialization in Buco-Maxillo-Facial Surgery and Traumatology; specialization in Stomatology; coordinator of the Dental Service in São Marcos Hospital, Teresina, PI, Brazil.

Cacilda Castelo Branco Lima, Universidade Federal do Piauí (UFPI), Teresina, PI, Brazil.

PhD in Dentistry from the University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Professor at the Federal University of Piauí (UFPI), Teresina, PI, Brazil.

Luciana Tolstenko Nogueira, Universidade Estadual do Piauí (UESPI), Teresina, PI, Brazil.

PhD in Dental Clinics from the Faculty of Dentistry São Leopoldo Mandic (SLMANDIC), Campinas, SP, Brazil; Professor at State University of Piauí (UESPI), Teresina, PI, Brazil.

Lucielma Salmito Soares Pinto, Universidade Estadual do Piauí (UESPI), Teresina, PI, Brazil.

PhD in Stomatopathology from the University of Campinas (Unicamp), Campinas, SP, Brazil; Professor at State University of Piauí (UESPI), Teresina, PI, Brazil.

References

Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral oncol. 2009;45:4-5. https://doi.org/10.1016/j.oraloncology.2008.06.002

Brazil. Ministry of Health. National Cancer Institute José Alencar Gomes da Silva. Estimate for 2020: incidence of cancer in Brazil. [Internet]. 2019 [cited 20 Nov 2020]. Available from: https://inca.gov.br/publicacoes/livros/estimativa-2020-incidencia-de-cancer-no-brasil

Amit M, Yen TC, Liao CT, Chaturvedi P, Agarwal JP, Kowalski LP, et al. The origin of regional failure in oral cavity squamous cell carcinoma with pathologically negative neck metastases. JAMA Otolaryngol Head Neck Surg. 2014;140(12):1130-7. https://doi.org/10.1001/jamaoto.2014.1539

Hinerman RW, Mendenhall WM, Morris CG, Amdur RJ, Werning JW, Villaret DB. Postoperative irradiation for squamous cell carcinoma of the oral cavity: 35-year experience. Head Neck. 2004;26(11):984-94. https://doi.org/10.1002/hed.20091

Amit M, Yen TC, Liao CT, Chaturvedi P, Agarwal JP, Kowalski LP, et al. Improvement in survival of patients with oral cavity squamous cell carcinoma: An international collaborative study. Cancer. 2013;119(24):4242-8. https://doi.org/10.1002/cncr.28357

Kowalski LP, Oliveira MM, Lopez RVM, Silva DRME, Ikeda MK, Curado MP. Survival trends of patients with oral and oropharyngeal cancer treated at a cancer center in São Paulo, Brazil. Clinics (Sao Paulo). 2020;75:e1507. https://doi.org/10.6061/clinics/2020/e1507

Carvalho AL, Ikeda MK, Magrin J, Kowalski LP. Trends of oral and oropharyngeal cancer survival over five decades in 3267 patients treated in a single institution. Oral Oncol. 2004;40(1):71-6. https://doi.org/10.1016/s1368-8375(03)00138-6

Boing AF, Antunes JLF. Socioeconomic conditions and head and neck cancer: a systematic literature review. Ciênc Saú de Colet. 2011;16:615-22. https://doi.org/10.1590/s1413-81232011000200025

Da Cunha AR, Prass TS, Hugo FN. Mortality from oral and oropharyngeal cancer in Brazil: impact of the National Oral Health Policy. Cad Saúde Pública. 2019;35(12):e00014319. https://doi.org/10.1590/0102-311X00014319

Abrahão R, Perdomo S, Pinto LFR, Nascimento de Carvalho F, Dias FL, de Podestá JRV, et al. Predictors of survival after Head and neck squamous cell carcinoma in South America: The InterCHANGE study. JCO Glob Oncol. 2020;6:486-99. https://doi.org/10.1200/GO.20.00014

Borba Ribeiro KR, Lira Júnior C, Marinho SA, De Carvalho SHG, Agripino GG, Sarmento DJS. Epidemiological profile of young patients with squamous cell carcinoma in northeast Brazil. J Investig Clin Dent. 2019;10(4):e12436. https://doi.org/10.1111/jicd.12436

Boing AF, Peres MA. Mortality from oral and pharyngeal cancer in Brazil: trends and regional patterns, 1979-2002. Rev Panam Salud Pú blica. 2006;20:1-8. https://doi.org/10.1590/s1020-49892006000700001

Perea LME, Peres MA, Boing AF, Antunes JLF. Trend of oral and pharyngeal cancer mortality in Brazil in the period of 2002 to 2013. Rev Saúde Pública. 2018;52:10. https://doi.org/10.11606/S1518-8787.2018052000251

Ong TK, Murphy C, Smith AB, Kanatas AN, Mitchell DA. Survival after surgery for oral cancer: a 30-year experience. Br J Oral Maxillofac Surg. 2017;55(9):911-6. https://doi.org/10.1016/j.bjoms.2017.08.362

Chitapanarux I, Traisathit P, Komolmalai N, Chuachamsai S, Sittitrai P, Pattarasakulchai T, et al. Ten-year outcome of different treatment modalities for squamous cell carcinoma of oral cavity. Asian Pac J Cancer Prev. 2017;18(7):1919-24. https://doi.org/10.22034/APJCP.2017.18.7.1919

Zanoni DK, Montero PH, Migliacci JC, Shah JP, Wong RJ, Ganly I, et al. Survival outcomes after treatment of cancer of the oral cavity (1985-2015). Oral Oncol. 2019;90:115-21. https://doi.org/10.1016/j.oraloncology.2019.02.001

Chen SW, Zhang Q, Guo ZM, Chen WK, Liu WW, Chen YF, et al. Trends in clinical features and survival of oral cavity cancer: fifty years of experience with 3,362 consecutive cases from a single institution. Cancer Manag Res. 2018;10:4523-35. https://doi.org/10.2147/CMAR.S171251

Mosleh-Shirazi MS, Mohammadianpanah M, Mosleh-Shirazi MA. Squamous cell carcinoma of the oral tongue: a 25-year, single institution experience. J Laryngol Otol. 2009;123(1):114-20. https://doi.org/10.1017/S0022215108003186

Carvalho AL, Singh B, Spiro RH, Kowalski LP, Shah JP. Cancer of the oral cavity: a comparison between institutions in a developing and a developed nation. Head Neck. 2004;26(1):31-8. https://doi.org/10.1002/hed.10354

Oliveira LL, Bergmann A, Melo AC, Thuler LC. Prognostic factors associated with overall survival in patients with oral cavity squamous cell carcinoma. Med Oral Patol Oral Cir Bucal. 2020;25(4):e523-31. https://doi.org/10.4317/medoral.23558

Moro JS, Maroneze MC, Ardenghi TM, Barin LM, Danesi CC. Oral and oropharyngeal cancer: epidemiology and survival analysis. Einstein (São Paulo). 2018;16(2):1-5. https://doi.org/10.1590/S1679-45082018AO4248

Schneider IJC, Flores ME, Nickel DA, Martins LGT, Traebert J. Survival rates of patients with cancer of the lip, mouth and pharynx: a cohort study of 10 years. Rev Bras Epidemiol. 2014;17(3):680-91. https://doi.org/10.1590/1809-4503201400030009

Le Campion ACOV, Ribeiro CMB, Luiz RR, da Silva Júnior FF, Barros HCS, Dos Santos KCB, et al. Low survival rates of oral and oropharyngeal squamous cell carcinoma. Int J Dent. 2017;2017:5815493. https://doi.org/10.1155/2017/5815493

Ferreira AK, Carvalho SH, Granville-Garcia AF, Sarmento DJ, Agripino GG, Abreu MH, et al. Survival and prognostic factors in patients with oral squamous cell carcinoma. Med Oral Patol Oral Cir Bucal. 2020;26(3):e387-92. https://doi.org/10.4317/medoral.24242

Nóbrega TD, Queiroz SI, Santos EM, Costa AL, Pereira-Pinto L, De Souza LB. Clinicopathological evaluation and survival of patients with squamous cell carcinoma of the tongue. Med Oral Patol Oral Cir Bucal. 2018;23(5):e579-87. https://doi.org/10.4317/medoral.22421

Barros-Silva PG, Fontes-Borges MM, Costa-Dias C, Mota-Lemos JV, Socorro-Saldanha-Cunha MD, Fernandes-Souza E, et al. Clinical-pathological and sociodemographic factors associated with the distant metastasis and overall survival of oral cavity and oropharynx squamous cell carcinoma. Med Oral Patol Oral Cir Bucal. 2020;25(3):e375-82. https://doi.org/10.4317/medoral.23410

Bonfante GMS, Machado CJ, Souza PEA, Andrade EIG, Acurcio FA, Cherchiglia ML. Specific 5-year oral cancer survival and associated factors in cancer outpatients in the Brazilian Unified National Health System. Cad Saúde Pública. 2014;30(5):983-97. https://doi.org/10.1590/0102-311x00182712

Agra IM, Carvalho AL, Ulbrich FS, De Campos OD, Martins EP, Magrin J, et al. Prognostic factors in salvage surgery for recurrent oral and oropharyngeal cancer. Head Neck. 2006;28(2):107-13. https://doi.org/10.1002/hed.20309

Kowalski LP, Carvalho AL. Influence of time delay and clinical upstaging in the prognosis of head and neck cancer. Oral Oncol. 2001;37(1):94-8. https://doi.org/10.1016/s1368-8375(00)00066-x

Agra IM, Filho JG, Martins EP, Kowalski LP. Second salvage surgery for re-recurrent oral cavity and oropharynx carcinoma. Head Neck. 2010;32(8):997-1002. https://doi.org/10.1002/hed.21298

Published
2021-10-29
How to Cite
Rocha, C. E. M. C., Santos, J. C. S., Costa, R. E. A. R. da, Pinto, E. S. S., Almeida, A. L. R. B. de, Lima, C. C. B., Nogueira, L. T., & Pinto, L. S. S. (2021). Prognostic factors and long-term survival in oral squamous cell carcinoma: A cross-sectional study. Scientia Medica, 31(1), e41124. https://doi.org/10.15448/1980-6108.2021.1.41124