title: A retrospective analysis to determine factors contributing to the survival of patients with oral squamous cell carcinoma.
abstract: The clinical outcome of patients with OSCC is assessed based on TNM system and currently it is the most reliable indicator on which therapeutic decisions are made. The patients with advanced disease are managed with combined treatment modalities. The aim of this retrospective study was to identify the factors which influence survival of patients with OSCC in Sri Lanka. Four hundred and thirty patients who have been managed surgically using either (1) local excision, (2) local excision+supraomohyoid neck dissection, (3) local excision+modified radical neck dissection, (4) local excision+radical neck dissection, (5) local excision+contra-lateral neck dissection depending on TNM stage, with or without post-operative radiotherapy. Patients with incompletely excised tumours showed statistically significant poor survival which improved with radiotherapy (stage II P=0.002, stage III P=0.017). With reference to TNM stage IV tumours, the patients who had received surgical option 4, showed poor survival compared to surgical options 2, 3, and 5 (P=0.001). However, within the group of patients who had received surgical option 4, those who had nodal metastasis showed poorer survival compared to patients without nodal metastasis. In addition, survival improved in patients who had been treated with surgical option 4, with radiotherapy. Furthermore, margin status was also found to significantly influence the survival of patients with TNM stage IV tumours (P=0.003). The main factors that had significant impact on the survival were TNM stage, nodal metastasis and the state of excision margins.
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
authors.forename: R M A R
authors.initials: RM
authors.lastname: Rajapakshe
authors.affiliation: Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
authors.forename: R W
authors.initials: RW
authors.lastname: Pallegama
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
authors.forename: P R
authors.initials: PR
authors.lastname: Jayasooriya
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
authors.forename: B S M S
authors.initials: BS
authors.lastname: Siriwardena
authors.affiliation: Department of Oral & Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
authors.forename: A M
authors.initials: AM
authors.lastname: Attygalla
authors.affiliation: Department of Oral & Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
authors.forename: S
authors.initials: S
authors.lastname: Hewapathirana
authors.affiliation: Department of Oral & Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
authors.forename: J U
authors.initials: JU
authors.lastname: Weerasinghe
authors.affiliation: Teaching Hospital Karapitiya, Galle, Sri Lanka.
authors.forename: D K
authors.initials: DK
authors.lastname: Dias
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. Electronic address: wmtilak@pdn.ac.lk.
authors.forename: W M
authors.initials: WM
authors.lastname: Tilakaratne
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery*; D019647:Oral Surgical Procedures; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013188:Sri Lanka / Q000453:epidemiology
keywords: Oral squamous cell carcinoma; Radiotherapy; Tumour–node–metastasis stage