Oral cancer natural history, complications and prognosis: Difference between revisions
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The thicker the tumor, the poorer the prognosis. | The thicker the tumor, the poorer the prognosis. | ||
=== | ===Vascular invasion=== | ||
The prognosis is poor if the cancer has spread to the blood vessels, which may result in rapid and widespread [[metastases]]. | The prognosis is poor if the cancer has spread to the [[blood vessels]], which may result in rapid and widespread [[metastases]]. | ||
==References== | ==References== | ||
Revision as of 15:38, 10 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. The 5-year survival rate for oral cancer diagnosed early is 75% compared to 20% for oral cancer diagnosed late.
Natural History
Complications
Prognosis
The prognosis (chance of recovery) depends on the following:
- The stage of the cancer.
- The number and size of lymph nodes with cancer.
- Whether the patient has HPV infection of the oropharynx.
- Whether the patient has a history of smoking for more than ten pack years.
People with oral cavity cancer may have questions about their prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a person’s medical history, type of cancer, stage, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis. A prognosis is the doctor’s best estimate of how cancer will affect a person, and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis.
Early detection is important. The 5-year survival rate for oral cancer diagnosed early is 75% compared to 20% for oral cancer diagnosed late.[1]Approximately half of people with oral cancer will live more than 5 years after they are diagnosed and treated. If the cancer is found early, before it has spread to other tissues, the cure rate is nearly 90%. More than half of oral cancers have spread when the cancer is detected. Most have spread to the throat or neck.[2]With early detection and timely treatment, deaths from oral cancer could be dramatically reduced. The 5-year survival rate for those with localized disease at diagnosis is 83 percent compared with only 32 percent for those whose cancer has spread to other parts of the body.
The following are prognostic factors for squamous cell carcinoma. Grading is not a very useful prognostic factor as it does not indicate treatment response or survival.[3]
Stage
The size of the tumor and extent to which the cancer has spread to the lymph nodes are the main prognostic factors. Larger and more extensive late-stage tumors have a poor prognosis.
Site
The prognosis also depends on whether the primary tumor is on the lips, tongue, gums or the lining of the mouth.
Resection margin
If the cancer extends to the outer margin of the tissue removed during surgery, it is called a positive resection margin. A negative resection margin indicates a good prognosis.
Tumor thickness
The thicker the tumor, the poorer the prognosis.
Vascular invasion
The prognosis is poor if the cancer has spread to the blood vessels, which may result in rapid and widespread metastases.