Five-year survival rates after oral cavity and lip cancer diagnosis

Objective: To describe survival rates after diagnosis of oral cavity and lip cancer in Tehran, Iran. Method: Patients (n=174) diagnosed with invasive primary tumors of the oral cavity (ICD-10 C01-C06 and C09-C10) and lip (C00), excluding hematological tumors, in three hospitals in Tehran during the years 1996 to 2002 were followed using data from the death registry department of Iran's Ministry of Health as well as by follow-up phone call. Statistical evaluation was done by Kaplan-Maier method. Results: The mean age of the patients (64% male) at the time of diagnosis was 60.2 years (SD 15; range 16-92; median 64), which appeared higher for women (63.5) than for men (58.4) (p<0.05). The most common cancer site was the tongue (42%), buccal mucosa (29%), and lip (10%). At the time of diagnosis, 57% of oral cancers were at stages III or IV, and 43% at stage I or II, with no statistically significant differences in age or gender. The overall survival rate at five years was 31% (SE 3). Survival rates were rather similar despite differences in gender or age. The mean overall survival for those diagnosed at early stages (57 months, 95% CI 46-68) was higher than those diagnosed at advanced stages (31 months, 95% CI 24-38), and was higher for lip cancers (78 months, 95% CI 57-98) than for tongue (38 months, 95% CI 29-47) and buccal mucosa (34 months, 95% CI 26-43) cancers. Conclusions: In the majority of cases, cancer was diagnosed at advanced stages. When compared to international survival rates the clinical outcome in the studied group was significantly worse. These results highlight an urgent need for a national comprehensive program to improve diagnostic skills in order to facilitate early detection, and to promote the involvement of oral health professionals in oral cancer preventive activities in Iran.