Treatment effects in patients with squamous cell carcinoma of the oral cavity.
A total of 221 patients (155 males, 66 females; stage I, n = 55: stage II, n = 58; stage III, n = 57; stage IV, n = 51) with squamous cell carcinoma of the oral cavity were studied. Tumor localization was as follows: cancer of the tongue, n = 161; cancer of the oral floor, n = 28; cancer of the hard palate, n = 12; cancer of the buccal mucosa, n = 11; and cancer of the gingiva, n = 9. In order to compare the effect of different treatments, three major treatment groups were defined, namely a surgery group, a radiotherapy group and a combination treatment group. Five-year cumulative survival rates showed significant differences between stage classifications (stage I = 91%, stage II = 73%, stage III = 63%, stage IV = 47%; p < 0.01) but not between tumor sites. The 5-year cumulative survival rate was highest for oral floor cancer (80%). In the early-cancer group, the 5-year cumulative survival rate for the surgery group (92%) was significantly higher (p < 0.05) than those for both the radiation (69%) and combination (71%) groups. In the advanced-cancer group, the 5-year cumulative survival rate for the surgery group (74%) was significantly higher (p < 0.05) than those for both the radiation (37%) and combination (51%) groups. No significant difference in regional control rates was observed between the treatment groups. Five-year regional control rates were 86% for cervical untreated patients with T1N0 tumors and 60% for cervical untreated patients with T2N0 tumors. Fourteen N0 cases were treated with neck dissection. Cervical metastasis was found pathologically in 2/14 (14%) of these cases. The 5-year survival rate for patients with cervical recurrences after primary tumor resection was 70% (n = 15). In contrast, the 5-year survival rate for patients with both primary tumor resection and neck dissection was 74% (n = 14) but no significant difference was observed between these 2 groups.
Inagi
Katsuhide
K
Department of Otolaryngology, Kitasato Institute Medical Center Hospital, Saitama, Japan. inagi-k@kitasato.or.jp
Takahashi
Hiroomi
H
Okamoto
Makito
M
Nakayama
Meijin
M
Makoshi
Tomohiro
T
Nagai
Hiromi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D024221:Antineoplastic Protocols; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000187:drug effects* / Q000528:radiation effects* / Q000601:surgery; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate