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Survival following primary surgery for oral cancer

Rogers, Simon N.; Brown, James S.; Woolgar, Julia A.; Lowe, Derek; Magennis, Patrick; Shaw, Richard J.; Sutton, David; Errington, Douglas and Vaughan, David (2009) Survival following primary surgery for oral cancer. Oral Oncology, 45 (3). pp. 201-211. ISSN 1368-8375 (Submitted)

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Cited 51 times in WoS

Abstract

The main aims of this article are to report the overall and disease-specific survival of a consecutive series of patients presenting with oral cancer from 1992 to 2002 and relate survival to clinical and pathological factors. The article uses population-based age-sex mortality rates in the North-West of England to highlight differences in overall and disease-specific survival. 541 patients with oral squamous cell carcinoma presented to the Regional Maxillofacial Unit from 1992 to 2002. Curative treatment favoured radical primary surgery, 10% (52) received primary radiotherapy. These patients were on average 8 years older with more advanced tumours and overall poorer survival at 5 years, 23% (SE 7%). The remainder of the results refer to 489 patients who had primary curative surgery, 40% (194) of whom received adjuvant radiotherapy. The overall survival (OS) was 56% (SE 2%) and the disease-specific survival (DSS) was 74% (SE 2%). There was local recurrence rate of 10% (50) and the loco-regional recurrence rate was 21% (103). The second primary rate was 7% (35). Survival figures had improved over the 10-year period from 63% DSS for the first 4 years of the study (1992-1995) compared to 81% for the last 3 years (2000-2002). In stepwise Cox regression the two predictors selected for disease specific survival were pN status and margins (both p<0.001). Age-sex mortality rates for the North-West indicate that 15.0% of the 489 primary surgery patients might have been expected to die within 5 years if they were typical of the general population and the observed difference between all causes and oral-cancer specific survival was 18.3%. These data emphasise the value of disease-specific survival as an indicator of successful treatment in a cohort that tends to be elderly, from social deprived backgrounds, with life styles and comorbidity that influence overall survival.

Item Type:Article
Additional Information:Available online 31 July 2008.
Uncontrolled Keywords:oral cancer; surgery; survival
Subjects:R Medicine > RK Dentistry
Departments, Research Centres and Related Units:Academic Faculties, Institutes and Research Centres > Faculty of Medicine > School of Dental Sciences
DOI:10.1016/j.oraloncology.2008.05.008
Refereed:Yes
Status:Submitted
ID Code:733
Deposited On:29 Apr 2009 12:51
Last Modified:28 Feb 2012 09:22

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