Oral cancer natural history, complications and prognosis
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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.
Prognosis
- The prognosis (chance of recovery) depends on the following:
- Stage of the cancer.
- Number and size of lymph nodes with cancer.
- HPV infection of the oropharynx.
- smoking history more than ten pack years.
- 5-year survival rate for oral cancer:
- Diagnosed early is 75%
- Diagnosed late is 20%
- Cure rate :
- 90% - If cancer is found early and before it has spread to other tissues.
- More than half of oral cancers have spread when the cancer is detected. Most have spread to the throat or neck.[1] 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.[2]
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.