Surgical Management of Oral Cancer
Oral cancer represents a heterogeneous and complex group of tumours, variable in their behaviour and potentially lethal. In a historical cohort of 700 patients from the population-based cancer registry of the province of Manitoba, the 5-year disease-specific survival was 63 %. Survival was 74 % for stage I, 59 % for stage II, 52 % for stage III and 29 % for stage IV disease (p = 0.0000). A number of factors interacted to determine the outcome in this patient population. Major prognostic factors, as determined by multivariate analysis, included (i) gender, (ii) age, (iii) site in the oral cavity, (iv) clinical stage, and (v) initial treatment modality. Results were consistently superior with surgery. Radiotherapy as a single treatment modality was associated with an adverse outcome (HR 2.0; 95 % CI 1.8–2.7; p = 0.000). In 311 patients treated with surgery alone and 148 patients treated with surgery and adjunctive radiotherapy, involved surgical margins had a significant impact on survival after controlling for age and stage of disease (HR 2.0; 95 % CI 1.3–3.0; p = 0.0022) [1, 2].
KeywordsSurgical Margin Oral Cancer Historical Cohort Close Margin Oral Cancer Patient
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