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Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1995 Sep;77(5):325–331.

Survival, metastasis and recurrence of oral cancer in relation to pathological features.

J A Woolgar 1, J Scott 1, E D Vaughan 1, J S Brown 1, C R West 1, S Rogers 1
PMCID: PMC2502417  PMID: 7486755

Abstract

The outcome of 123 patients with squamous cell carcinoma of the oral/oropharyngeal mucosa treated by primary radical surgery and simultaneous neck dissection and followed up for a maximum of 5 years is reported and related to the pathological features of the tumour. Actuarial survival analysis showed the overall 1-year survival probability was 84%, falling to 69% at 2 years, and 65% at 5 years. For patients without lymph node metastasis, the corresponding survival probabilities were 95%, 86% and 86%, respectively; and for patients with metastasis, 71%, 52% and 44%, respectively. In all, 30 patients (24%) died of their oral cancer; 16 (13%) of local recurrence, 10 (8%) of regional recurrence and 4 (3%) of systemic metastases. In addition to lymph node metastasis, survival was related to the site and stage of the primary tumour, histological pattern of invasion, status of the resection margins and, for patients with metastasis, the number and anatomical level of positive nodes and the presence and extent of extracapsular spread. These pathological features are important indicators of tumour behaviour and should be incorporated into protocols for assessment of prognosis.

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Selected References

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  1. Anneroth G., Batsakis J., Luna M. Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas. Scand J Dent Res. 1987 Jun;95(3):229–249. doi: 10.1111/j.1600-0722.1987.tb01836.x. [DOI] [PubMed] [Google Scholar]
  2. Barnes L., Johnson J. T. Pathologic and clinical considerations in the evaluation of major head and neck specimens resected for cancer. Part I. Pathol Annu. 1986;21(Pt 1):173–250. [PubMed] [Google Scholar]
  3. Boyle P., Macfarlane G. J., Maisonneuve P., Zheng T., Scully C., Tedesco B. Epidemiology of mouth cancer in 1989: a review. J R Soc Med. 1990 Nov;83(11):724–730. doi: 10.1177/014107689008301116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bryne M., Koppang H. S., Lilleng R., Kjaerheim A. Malignancy grading of the deep invasive margins of oral squamous cell carcinomas has high prognostic value. J Pathol. 1992 Apr;166(4):375–381. doi: 10.1002/path.1711660409. [DOI] [PubMed] [Google Scholar]
  5. Carr R. J., Langdon J. D. Multiple primaries in mouth cancer--the price of success. Br J Oral Maxillofac Surg. 1989 Oct;27(5):394–399. doi: 10.1016/0266-4356(89)90079-x. [DOI] [PubMed] [Google Scholar]
  6. Foote R. L., Olsen K. D., Davis D. L., Buskirk S. J., Stanley R. J., Kunselman S. J., Schaid D. J., DeSanto L. W. Base of tongue carcinoma: patterns of failure and predictors of recurrence after surgery alone. Head Neck. 1993 Jul-Aug;15(4):300–307. doi: 10.1002/hed.2880150406. [DOI] [PubMed] [Google Scholar]
  7. Hindle I., Nally F. Oral cancer: a comparative study between 1962-67 and 1980-84 in England and Wales. Br Dent J. 1991 Jan 5;170(1):15–20. doi: 10.1038/sj.bdj.4807395. [DOI] [PubMed] [Google Scholar]
  8. Johnson J. T., Barnes E. L., Myers E. N., Schramm V. L., Jr, Borochovitz D., Sigler B. A. The extracapsular spread of tumors in cervical node metastasis. Arch Otolaryngol. 1981 Dec;107(12):725–729. doi: 10.1001/archotol.1981.00790480001001. [DOI] [PubMed] [Google Scholar]
  9. Kotwall C., Sako K., Razack M. S., Rao U., Bakamjian V., Shedd D. P. Metastatic patterns in squamous cell cancer of the head and neck. Am J Surg. 1987 Oct;154(4):439–442. doi: 10.1016/0002-9610(89)90020-2. [DOI] [PubMed] [Google Scholar]
  10. Langdon J. D., Harvey P. W., Rapidis A. D., Patel M. F., Johnson N. W., Hopps R. Oral cancer: the behaviour and response to treatment of 194 cases. J Maxillofac Surg. 1977 Nov;5(4):221–237. doi: 10.1016/s0301-0503(77)80115-x. [DOI] [PubMed] [Google Scholar]
  11. Leemans C. R., Tiwari R., Nauta J. J., van der Waal I., Snow G. B. Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma. Cancer. 1993 Jan 15;71(2):452–456. doi: 10.1002/1097-0142(19930115)71:2<452::aid-cncr2820710228>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  12. Leemans C. R., Tiwari R., van der Waal I., Karim A. B., Nauta J. J., Snow G. B. The efficacy of comprehensive neck dissection with or without postoperative radiotherapy in nodal metastases of squamous cell carcinoma of the upper respiratory and digestive tracts. Laryngoscope. 1990 Nov;100(11):1194–1198. doi: 10.1288/00005537-199011000-00012. [DOI] [PubMed] [Google Scholar]
  13. Scully C. The immunology of cancer of the head and neck with particular reference to oral cancer. Oral Surg Oral Med Oral Pathol. 1982 Feb;53(2):157–169. doi: 10.1016/0030-4220(82)90282-1. [DOI] [PubMed] [Google Scholar]
  14. Slootweg P. J., Müller H. Mandibular invasion by oral squamous cell carcinoma. J Craniomaxillofac Surg. 1989 Feb;17(2):69–74. doi: 10.1016/s1010-5182(89)80048-4. [DOI] [PubMed] [Google Scholar]
  15. Vaughan E. D., Bainton R., Martin I. C. Improvements in morbidity of mouth cancer using microvascular free flap reconstructions. J Craniomaxillofac Surg. 1992 Apr;20(3):132–134. doi: 10.1016/s1010-5182(05)80095-2. [DOI] [PubMed] [Google Scholar]
  16. Vikram B., Strong E. W., Shah J. P., Spiro R. Failure at distant sites following multimodality treatment for advanced head and neck cancer. Head Neck Surg. 1984 Jan-Feb;6(3):730–733. doi: 10.1002/hed.2890060305. [DOI] [PubMed] [Google Scholar]
  17. Vikram B., Strong E. W., Shah J. P., Spiro R. Failure at the primary site following multimodality treatment in advanced head and neck cancer. Head Neck Surg. 1984 Jan-Feb;6(3):720–723. doi: 10.1002/hed.2890060303. [DOI] [PubMed] [Google Scholar]
  18. Vikram B., Strong E. W., Shah J. P., Spiro R. Failure in the neck following multimodality treatment for advanced head and neck cancer. Head Neck Surg. 1984 Jan-Feb;6(3):724–729. doi: 10.1002/hed.2890060304. [DOI] [PubMed] [Google Scholar]
  19. Vikram B., Strong E. W., Shah J. P., Spiro R. Second malignant neoplasms in patients successfully treated with multimodality treatment for advanced head and neck cancer. Head Neck Surg. 1984 Jan-Feb;6(3):734–737. doi: 10.1002/hed.2890060306. [DOI] [PubMed] [Google Scholar]
  20. Wang M. B., Lichtenstein A., Mickel R. A. Hierarchical immunosuppression of regional lymph nodes in patients with head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg. 1991 Oct;105(4):517–527. doi: 10.1177/019459989110500403. [DOI] [PubMed] [Google Scholar]
  21. van den Brekel M. W., Stel H. V., van der Valk P., van der Waal I., Meyer C. J., Snow G. B. Micrometastases from squamous cell carcinoma in neck dissection specimens. Eur Arch Otorhinolaryngol. 1992;249(6):349–353. doi: 10.1007/BF00179388. [DOI] [PubMed] [Google Scholar]

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