Prognostic factors in patients with buccal squamous cell carcinoma: 10-year experience.

PURPOSE: Squamous cell carcinoma (SCC) of the buccal mucosa accounts for 23% to 37% of all intraoral cancer cases in Taiwan. Because of the high recurrence rate and invasive tumor behavior, the prognosis is generally poor. The aim of this study was to evaluate the prognostic significance of clinicopathologic factors on survival rates for patients with buccal SCC in a medical center in central Taiwan. MATERIALS AND METHODS: Between March 1995 and December 2002, patients admitted to hospital and diagnosed as having buccal SCC were enrolled in the study. There were 415 patients (406 men and 9 women) 25 to 84 years old (mean age, 51.1 ± 11.4 years). The chart records were retrospectively reviewed. Relevant clinical features in each patient, such as primary tumor size, tumor stage, initial treatment modalities, surgical margin status, cervical nodal metastasis status, and histopathologic grade, were compared for survival analysis. RESULTS: Three hundred ninety-four patients received surgical intervention. Univariate analysis of relevant prognostic factors showed that positive surgical margin, positive cervical nodal metastasis, positive extracapsular spread, larger tumor, and advanced tumor stage were associated with poor prognosis. Multivariate analysis identified the factors that independently influenced the survival rate as advanced stage disease (stage III: relative risk [RR], 3.09; P = .006; stage IV: RR, 4.64; P < .001), positive surgical margin (RR, 2.02; P = .001), and extracapsular spread of cervical lymph node metastasis (RR, 6.89; P < .001). CONCLUSIONS: This study represents the largest series in the literature and highlights the importance of tumor stage, surgical margin status, and extracapsular spread of cervical nodal metastasis as the most important prognostic factors in patients with buccal SCC.

Risk factors for wound infection after surgery in primary oral cavity cancer patients.

OBJECTIVES: Few studies have discussed the predictive factors of surgical wound infection (WI) in primary oral cavity cancer patients. Therefore, we aimed to determine the relevant factors associated with postoperative WI in a large group of patients with oral cavity cancers. STUDY DESIGN: Retrospective chart review. METHODS: We retrospectively reviewed 1,693 chart records of oral cavity cancer patients. Twenty variables were obtained from chart review. Statistical methods included descriptive statistics, bivariate analyses, and a multiple logistic regression model for investigating the predictive factors for WI. RESULTS: Postoperative WI rate was 19.8%. Diabetes mellitus (odds ratio [OR]: 2.511, 95% confidence interval [CI]: 1.409-4.475), perioperative blood transfusion (OR: 4.293, 95% CI: 2.448-7.529), reconstruction with free flap or pectoris major myocutaneous flap (OR: 3.682, 95% CI: 1.909-7.102), and postoperative serum albumin level less than 2.8 g/dL (OR: 2.853, 95% CI: 1.928-4.221) were all independent factors associated with postoperative WI. CONCLUSIONS: Recognition of relevant factors can help surgeons to identify those at high risk of WI after surgery for primary oral cavity cancer and can enable better management of such cases.

Impact of recurrence interval on survival of oral cavity squamous cell carcinoma patients after local relapse.

OBJECTIVE: The aim of this study was to investigate whether the recurrence interval influenced the survival of oral cavity squamous cell carcinoma patients after relapse. STUDY DESIGN AND SETTING: Retrospective charts were reviewed at a medical center. METHODS: We retrospectively reviewed 1687 chart records of oral cancer patients. Statistical methods included descriptive statistics, bivariate analyses, Kaplan-Meier survival analyses, and Cox proportional hazard models for investigating the relationship between the recurrence interval and survival of oral cancer patients after relapse. RESULTS: Local recurrence rate was 31.3 percent. Kaplan-Meier survival analyses showed the 5-year overall survival after recurrence was 31.56 percent. Cox proportional hazard model revealed that those with recurrence interval less than 18 months tended to have a higher probability of death than those with recurrence interval greater than or equal to 18 months (relative risk, 1.743; 95% confidence interval, 1.298-2.358). CONCLUSION: The interval from initial treatment to recurrence is an independent prognostic factor for oral squamous cell carcinoma patients. Those with a shorter disease-free interval tend to have a less favorable outcome.

Nutritional factors and survival of patients with oral cancer.

BACKGROUND: Our objective was to determine the survival rate of patients with oral cancer who were treated at a medical center in central Taiwan. Furthermore, we attempted to investigate whether nutritional factors influence the survival. METHODS: We carried out a retrospective review of 1010 chart records of patients with oral cancer. We used the Kaplan-Meier method for survival analysis and the Cox proportional hazard models to investigate the prognosticators. RESULTS: Kaplan-Meier survival analysis showed an overall 5-year survival rate of 63.24%. The Cox proportional hazard model revealed that those with a preoperative body mass index (BMI) of <22.8 kg/m(2) tended to have a higher probability of death (relative risk [RR] = 1.292, p = .022). In addition, those with a preoperative serum albumin level of <4.15 g/dL were generally associated with a poorer prognosis (RR = 1.313, p = .016). CONCLUSIONS: Apart from clinical features, nutritional factors also had a significant influence on the survival of patients with oral cancer. Therefore, good nutritional status is crucial for patients with oral cancer in improving their survival.

Socio-demographic factors in the prognosis of oral cancer patients.

The aim of this study was to determine the survival rate of oral cancer patients treated in a medical center in central Taiwan and to investigate whether socio-demographic factors influence their survival. We retrospectively reviewed 1010 chart records of oral cancer patients. Survival was analyzed by the Kaplan-Meier method and Cox proportional hazard model was used for investigating the relationship between socio-demographic factors and survival. The overall 5-year survival rate was 63.24%. Multivariate analysis revealed that those without religious belief tended to have higher probability of death than those who had religious belief (relative risk (RR): 2.057, p<0.001). In addition, those who were single, widow/widower or divorced/separated had a poorer prognosis than those who were married (RR: 1.528, p=0.008). Apart from clinical features, socio-demographic factors also significantly influenced the survival of oral cancer patients. Therefore, care providers should take socio-demographic issues into consideration aside from ordinary clinical health care.