Five-year survival and prognostic factors among oral cavity squamous cell carcinoma patients: Analyses of data from the Cancer Institute of Iran
-
Mahtab Molashahi
,
Maryam Hadji
,
Sanambar Sadighi
,
Mohammad Shirkhoda
,
Maedeh Dastmardi
,
Iraj Harirchi
,
Kazem Zendehdel
Abstract
Background: We conducted a historical cohort study and studied the survival rate and prognostic factors of oral cavity squamous cell carcinoma among patients admitted at the Cancer Institute of Iran. Methods: We recruited 352 patients who were referred to the Cancer Institute hospital in 2004-2011. Patients were newly diagnosed and pathologically confirmed as oral cavity squamous cell carcinoma. We abstracted data from the archived medical records and followed up with the patients until their death or end of follow-up in January 2015. Results: A total number of 347 patients (212 males and 135 females) were analyzed in this study. Surgery, alone or in combination with other modalities, was performed in 308 (88.8%) patients. The median time of follow-up was 18.7 months. The 1, 3, and 5-year survival were 84%, 53%, and 41%, respectively. The risk of death was significantly higher in patients older than 70 years of age (HR: 2.0, 95% CI: 1.1-3.7), moderately differentiated tumors (HR: 3.6, 95% CI: 1.3-9.7), “surgery with adjuvant treatment” group (HR: 2.6, 95% CI: 1.6-4.2), and the “surgery with neoadjuvant treatment” group (HR: 3.1, 95% CI: 1.4-7.0). Patients diagnosed with a higher TNM staging also experienced a higher probability of death. An increase in the number of involved lymph nodes was another independent indicator of outcome. Conclusion: the 5-year survival rate of oral cancer was 41% among patients admitted to the Cancer Institute of Iran. A higher survival rate in early-stage oral cancer patients indicates the importance of early detection among these patients.
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3. Simard EP, Torre LA, Jemal A. International trends in head and neck cancer incidence rates: differences by country, sex and anatomic site. Vol. 50, Oral Oncol. 2014. 387–403 p.
4. Howlader N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, et al. SEER Cancer Statistics Review, 1975-2010.[Based on the November 2012 SEER data submission, posted to the SEER web site, April 2013.]. Bethesda, MD: National Cancer Institute. 2013.
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6. Datema FR, Ferrier MB, van der Schroeff MP, Baatenburg de Jong RJ. Impact of comorbidity on short-term mortality and overall survival of head and neck cancer patients. Vol. 32, Head Neck. 2010. 728–736 p.
7. Forastiere A, Koch W, Trotti A, Sidransky D. Head and neck cancer. Vol. 345, N Engl J Med. 2001. 1890–1900 p.
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9. Y G, I AE. [GLOBAL INCIDENCE AND RISK FACTORS OF ORAL CANCER]. Harefuah. 2017 Oct 1;156(10):645–9.
10. 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 Mar 26;(6):486–99.
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12. Wise-Draper TM, Draper DJ, Gutkind JS, Molinolo AA, Wikenheiser-Brokamp KA, Wells SI. Future Directions and Treatment Strategies for Head and Neck Squamous Cell Carcinomas [Internet]. Vol. 160, Translational research : the journal of laboratory and clinical medicine. 2012. 167–177 p. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423575/
13. Leemans CR, Braakhuis BJ, Brakenhoff RH. The molecular biology of head and neck cancer. Vol. 11, Nat Rev Cancer. 2011. 9–22 p.
14. Sano D, Myers JN. Xenograft models of head and neck cancers [Internet]. Vol. 1, Head & Neck Oncology. BioMed Central; 2009. 32 p. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2737672/
15. Rodriguez CP, Adelstein DJ. Survival trends in head and neck cancer: opportunities for improving outcomes. The oncologist. 2010/08/26 ed. 2010;15(9):921–3.
16. González-García R, Naval-Gías L, Román-Romero L, Sastre-Pérez J, Rodríguez-Campo FJ. Local recurrences and second primary tumors from squamous cell carcinoma of the oral cavity: a retrospective analytic study of 500 patients. Head Neck J Sci Spec Head Neck. 2009;31(9):1168–80.
17. Iseli TA, Lin MJ, Tsui A, Guiney A, Wiesenfeld D, Iseli CE. Are wider surgical margins needed for early oral tongue cancer? J Laryngol Otol. 2012 Mar;126(3):289–94.
18. Sutton DN, Brown JS, Rogers SN, Vaughan ED, Woolgar JA. The prognostic implications of the surgical margin in oral squamous cell carcinoma. Int J Oral Maxillofac Surg. 2003;32(1):30–4.
19. Sessions DG, Spector GJ, Lenox J, Haughey B, Chao C, Marks J. Analysis of treatment results for oral tongue cancer. The Laryngoscope. 2002;112(4):616–25.
20. Pulte D, Brenner H. Changes in Survival in Head and Neck Cancers in the Late 20th and Early 21st Century: A Period Analysis [Internet]. Vol. 15, The Oncologist. 2010. 994–1001 p. Available from: http://theoncologist.alphamedpress.org/content/15/9/994.abstract
21. Beaudoin PL, Anchouche S, Gaffar R, Guadagno E, Ayad T, Poenaru D. Barriers in Access to Care for Patients With Head and Neck Cancer in Resource-Limited Settings: A Systematic Review. JAMA Otolaryngol-- Head Neck Surg. 2020 Mar 1;146(3):291–7.
22. Wei WI. Commentary: head and neck carcinomas in the developing world. British Medical Journal. 2002.
23. Sargeran K, Murtomaa H, Safavi SMR, Vehkalahti MM, Teronen O. Survival after diagnosis of cancer of the oral cavity. Br J Oral Maxillofac Surg. 2008;46(3):187–91.
24. Esmaelbeigi F, Hadji M, Harirchi I, Omranipour R, VAND RM, Zendehdel K. Factors affecting professional delay in diagnosis and treatment of oral cancer in Iran. 2014;
25. World Health Organization. International classification of diseases for oncology (ICD-O) – 3rd edition, 1st revision [Internet]. 3rd ed. ICD-O. Geneva; 2013. Available from: https://apps.who.int/iris/handle/10665/96612
26. Carvalho AL, Nishimoto IN, Califano JA, Kowalski LP. Trends in incidence and prognosis for head and neck cancer in the United States: a site-specific analysis of the SEER database. Vol. 114, Int J Cancer. 2005. 806–816 p.
27. Fan Y, Zheng L, Mao MH, Huang MW, Liu SM, Zhang J, et al. Survival analysis of oral squamous cell carcinoma in a subgroup of young patients. Asian Pac J Cancer Prev. 2014;15(20):8887–91.
28. Givi B, Eskander A, Awad MI, Kong Q, Montero PH, Palmer FL, et al. Impact of elective neck dissection on the outcome of oral squamous cell carcinomas arising in the maxillary alveolus and hard palate [Internet]. Vol. 38, Head & Neck. John Wiley & Sons, Ltd; 2016 [cited 2021 Jan 5]. p. E1688–94. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/hed.24302
29. Hoffman HT, Karnell L, Funk GF, Robinson RA, Menck HR. THe national cancer data base report on cancer of the head and neck [Internet]. Vol. 124, Archives of Otolaryngology–Head & Neck Surgery. 1998. 951–962 p. Available from: http://dx.doi.org/10.1001/archotol.124.9.951
30. Woolgar JA, Rogers S, West CR, Errington RD, Brown JS, Vaughan ED. Survival and patterns of recurrence in 200 oral cancer patients treated by radical surgery and neck dissection. Oral Oncol. 1999 May;35(3):257–65.
31. Yeole BB, Ramanakumar AV, Sankaranarayanan R. Survival from oral cancer in Mumbai (Bombay), India. Cancer Causes Control CCC. 2003 Dec;14(10):945–52.
32. Sargeran K. Oral Cancer in Tehran, Iran: An approach for understanding disease burden. 2008;
33. Haas I, Hauser U, Ganzer U. The dilemma of follow-up in head and neck cancer patients. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2001 May;258(4):177–83.
34. Kowalski LP, Carvalho AL, Martins Priante AV, Magrin J. Predictive factors for distant metastasis from oral and oropharyngeal squamous cell carcinoma. Oral Oncol. 2005 May;41(5):534–41.
35. Lee WR, Berkey B, Marcial V, Fu KK, Cooper JS, Vikram B, et al. Anemia is associated with decreased survival and increased locoregional failure in patients with locally advanced head and neck carcinoma: a secondary analysis of RTOG 85-27. Int J Radiat Oncol Biol Phys. 1998 Dec 1;42(5):1069–75.
36. 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 APJCP. 2017;18(7):1919–24.
37. Olaleye O, Ekrikpo U, Lyne O, Wiseberg J. Incidence and survival trends of lip, intra-oral cavity and tongue base cancers in south-east England. Ann R Coll Surg Engl. 2015 Apr;97(3):229–34.
38. Ozturk K, Gode S, Erdogan U, Akyildiz S, Apaydin F. Squamous cell carcinoma of the lip: survival analysis with long-term follow-up. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg. 2015 Nov;272(11):3545–50.
39. Mamelle G, Pampurik J, Luboinski B, Lancar R, Lusinchi A, Bosq J. Lymph node prognostic factors in head and neck squamous cell carcinomas. Vol. 168, The American journal of surgery. 1994. 494–498 p.
40. Razak AA, Saddki N, Naing NN, Abdullah N. Oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia, Kelantan. Asian Pac J Cancer Prev APJCP. 2010;11(1):187–91.
41. Liu SY, Lu CL, Chiou CT, Yen CY, Liaw GA, Chen YC, et al. Surgical outcomes and prognostic factors of oral cancer associated with betel quid chewing and tobacco smoking in Taiwan. Oral Oncol. 2010 Apr;46(4):276–82.
42. Neville BW, Day TA. Oral cancer and precancerous lesions. CA Cancer J Clin. 2002 Aug;52(4):195–215.
43. Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009 May;45(4–5):309–16.
44. Pignon JPP, Le Maitre A, Maillard E, Bourhis J. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Vol. 92, Radiother Oncol. 2009. 4–14 p.
45. Bonner JA, Harari PM, Giralt J, Azarnia N, Shin DM, Cohen RB, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. Vol. 354, New England Journal of Medicine. 2006. 567–578 p.
46. Bonner JA, Harari PM, Giralt J, Cohen RB, Jones CU, Sur RK, et al. Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Vol. 11, Lancet Oncol. 2010. 21–28 p.
47. Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, et al. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. Vol. 350, N Engl J Med. 2004. 1937–1944 p.
48. Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefebvre JL, Greiner RH, et al. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. Vol. 350, N Engl J Med. 2004. 1945–1952 p.
49. Charabi S, Balle V, Charabi B, Berthelsen A, Thomsen J. Squamous Cell Carcinoma of the Oral Cavity: The Results of the Surgical and Non-surgical Therapeutic Modalities in a Consecutive Series of 156 Patients Treated in Copenhagen County. Acta Otolaryngol (Stockh). 1997 Jan 1;117(sup529):226–8.
50. Worrall SF. An audit of general dental practitioners’ referral practice following the distribution of third molar guidelines [Internet]. Vol. 83, Annals of The Royal College of Surgeons of England. Royal College of Surgeons of England; 2001. 61–64 p. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503547/
51. Vigneswaran N, Williams MD. Epidemiologic trends in head and neck cancer and aids in diagnosis. Oral Maxillofac Surg Clin. 2014;26(2):123–41.
52. Buchakjian MR, Ginader T, Tasche KK, Pagedar NA, Smith BJ, Sperry SM. Independent predictors of prognosis based on oral cavity squamous cell carcinoma surgical margins. Otolaryngol Neck Surg. 2018;159(4):675–82.
53. Lo WL, Kao SY, Chi LY, Wong YK, Chang RCS. Outcomes of oral squamous cell carcinoma in Taiwan after surgical therapy: factors affecting survival. J Oral Maxillofac Surg. 2003 Jul;61(7):751–8.
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| Files | ||
| Issue | Vol 16 No 2 (2024) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/bccr.v16i2.19429 | |
| Keywords | ||
| oral cavity squamous cell carcinoma survival prognostic indicators | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Molashahi M, Hadji M, Sadighi S, Shirkhoda M, Dastmardi M, Harirchi I, Zendehdel K. Five-year survival and prognostic factors among oral cavity squamous cell carcinoma patients: Analyses of data from the Cancer Institute of Iran. Basic Clin Cancer Res. 2025;16(2):98-110.
