Analysis of the outcome of treatment for squamous cell carcinoma of the oral cavity: Retrospective study of 180 patients.

Abstract

e16019 Background: To assess the results of curative treatment of patients with squamous cell carcinoma of the oral cavity and to evaluate the factors predictive for recurrence and survival. Methods: This is a retrospective analysis of 180 patients with primary squamous cell carcinomas of the oral cavity seen between 1984 and 2005 in Kuwait cancer centre. All patients treated with curative intent with surgery +_ postoperative radiotherapy. (Analysis, March 2010). Results: At a minimum follow-up period of 5 years the local control rate was 61.1% and disease-free survival was 85% for the whole series. The LCR by treatment modality was 74% for local resection, 63% for composite resection and 81.2% for surgery plus radiotherapy. The actuarial control rate according to the stage of the disease was 83.8% and 49.1% for early and advanced stage respectively. The actuarial control rate for patients with positive and/or close and negative margins who received postoperative radiotherapy was 75% and 95% respectively. This difference is statistically significant. Extracapsular nodal extension was reported in patients 20.7%, twenty of them received post operative RT, with LCR of 60% for patients treated with surgery plus postoperative radiotherapy vs 3/10 (30%) for who did not receive postoperative radiotherapy. The actuarial LCR was 82.5% for patients with well and moderately differentiated carcinoma and 50% for high grade tumors. Conclusions: We conclude that prognosis ultimately depends on the stage of disease at presentation, margin status and extracapsular nodal extension. Patients positive margin of resection and/or extracapsular nodal extension treated by postoperative radiotherapy have significantly longer disease-free survival in comparison to patients treated by surgery alone. Concomitant chemotherapy and hyperfractionation for patients with advanced stage significantly improved locoregional control rates and consequently DFS but the toxicity rates were high. Future strategies must be directed at further improving these results.