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: Sargun Singh Walia M.B.B.S.[2]; Grammar Reviewer: Natalie Harpenau, B.S.[3]

Overview

If left untreated, patients with oral cancer may progress to develop a non-healing ulcer, which demonstrates growth over time. A neck mass may develop, which may cause a mass defect. Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. The 5-year survival rate for oral cancer that is diagnosed early is 75%, compared to 20% for late diagnosis. Complications of oral cancer include difficulty speaking, dysphagia, weight loss, bleeding and even death.

Natural History

  • Oral cancers usually present late, as they are usually painless and often ignored by the patient.
  • Eventually they present as a non-healing ulcer, which demonstrates growth over time.
  • Due to the extensive lymphatic drainage of the oral cavity, nodal metastases are common at the time of diagnosis.
  • neck mass may be the presenting complaint.
  • Because of the difficulties with direct visualization, they may extend into the tongue or have clinical lymph node metastases before the diagnosis is established.
  • As the tumors enlarge, they may cause a mass effect, which can lead to respiratory compromise when the patient presents late in their illness.[1]

Prognosis

  • 5-year survival rate for oral cancer:
    • Diagnosed early - 75%
    • Diagnosed late - 20%
    • Localized disease at diagnosis - 83%
    • Cancer spread to other parts of the body - 32%
  • Cure rate:
    • 90% - If cancer is found early and before it has spread to other tissues
  • More than 50% oral cancers are diagnosed when they have spread to throat and neck.

Complications

References

  1. Pauloski BR, Rademaker AW, Logemann JA, Colangelo LA (1998). "Speech and swallowing in irradiated and nonirradiated postsurgical oral cancer patients". Otolaryngol Head Neck Surg. 118 (5): 616–24. doi:10.1177/019459989811800509. PMID 9591859.
  2. Gomez DR, Zhung JE, Gomez J, Chan K, Wu AJ, Wolden SL; et al. (2009). "Intensity-modulated radiotherapy in postoperative treatment of oral cavity cancers". Int J Radiat Oncol Biol Phys. 73 (4): 1096–103. doi:10.1016/j.ijrobp.2008.05.024. PMID 18707827.
  3. Oh HK, Chambers MS, Martin JW, Lim HJ, Park HJ (2009). "Osteoradionecrosis of the mandible: treatment outcomes and factors influencing the progress of osteoradionecrosis". J Oral Maxillofac Surg. 67 (7): 1378–86. doi:10.1016/j.joms.2009.02.008. PMID 19531406.




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