Survival of Oral Cancer Patients in Malaysia- A Multi-Centre Audit

Objectives: No prior oral cancer survival data exists among Malaysians. The objective of this study was to audit 1 year survival status. Methods: Multicentre data were collected for 156 oral cancer patients and was analyzed for its relation with disease stage, nodal status, tumor size and treatment modalities. Comparison was made between early and late stage presentation, positive versus negative nodes, tumor size and types of treatment modalities. Results: Mean age was 60.7±12.8 years old with 7.7% patients below the age of 40. Majority are females (59.6%) and of Indian ethnic origin (46.2%) followed by Indigenous (21.2%), Chinese (17.9%) and Malays (14.7%). Most common risk habit practiced was betel quid chewing (59.9%), smoking (36.1%) and alcohol consumption (35.2%). The most common site was buccal mucosa (36.2%), followed by tongue (33.8%), gingiva (21.5%), palate (4.6%) and floor of mouth (3.8%). Most patients came at stage IV (62.3%) followed by stage III and II (15.8%) and stage I (6.1%). Among those who presented at late stage, 41.6% survived 1 year after diagnosis while survival for those at early stage was 80% (p=0.001). Lower survival was found for those with positive node (43.3%) compared to those without node involvement (66.7%) (p=0.022). Lower survival was also found for those with tumor size >2cm (47.2%) compared to those with tumor size °Ü2cm (100%) (p=0.007). Most common treatment used was surgery with post-operative radiotherapy (43.5%), followed by radiotherapy alone (20.9%) and surgery alone (17.4%). Among those who had surgery with post-operative radiotherapy, survival was only 54.1% for those who came at late stage compared to 75% for those who came at an early stage (p>0.05). Conclusions: Disease stage, nodal status and tumor size are independent predictors of 1 year survival for oral cancer patients in Malaysia. Grant: MOSTI, Malaysia, IRPA RMK8 Project no 06-02-03-0174 PR 0054/05-05