The US population is at risk for OSCC with a rate of approximately 1.75 per 100,000. In this population, the use of tobacco and alcohol are the main risk factors for OSCC. These data should help establish the optimum screening and prevention strategies in the United States.
Oral cancers can occur on the cheeks, gums, tongue and floor of the mouth. Patients with early oral cancers, people who have or have had oral squamous cell carcinoma and patients with gingival cancer should be followed up frequently. In addition, oral squamous cell carcinomas are often difficult to detect and there are many unknown risk factors for early detection.\n
A cure for oral cancer does not exist. The risk of long-term survival for a patient will depend primarily on the stage in which the cancer is diagnosed. The risk is also affected by factors such as the individual's psychological stability, oral and general health, and the treatment received. Good dental care can help reduce the incidence of oral cancer and therefore the risk to the patient and the patient's family.
Results from a recent clinical trial suggests that the risk of OSCC associated with smoking may be related to alterations in both local stomatal density and stomatal conductance. The high prevalence of smoking and OSCC suggests that local stomatal factors may act as carcinogens. The use and duration of alcohol consumption is also associated with an increased risk of OSCC.
Common treatments for OSCC include radiotherapy, chemotherapy, and surgery. Laryngeal/uvula cancer can typically be managed by surgery, while tongue/oropharyngeal cancer tends to be managed through radiation. If metastasis to the liver has occurred, surgery is often the preferred treatment, because it can provide pain relief and increase survival time for the patients and their families.
Lesions may present as oral ulceration and erythematous changes in the gums, or as a mass of the floor of the mouth or cheeks. The most common site of tumors is the tongue (30%). Lesions in the gums and floor of the mouth are more likely to be squamous cell carcinoma than benign lesions. It is not uncommon for oral cancers to be present before lesions become detectable. Screening the oral cavity is considered essential for early detection of oral cancers. Cancerous lesions on the hard palate may be a good candidate to implement early oral cancer screening.
There are no conclusive studies that can be used to support the use of radiotherapy for treating oral cancer. Although chemotherapy has significant efficacy in treating oral squamous cell carcinoma, there are still some cases where relapse and cancer death occurred in the oral cavity.
[Pit and fissure lesions] had an overall 5-year survival of 71%-82%.[Slightly raised lesions, erythroplasty, and T4 lesions had an overall 5-year survival of 69%-72%; while erythroplasty, T4 and poorly differentiated lesions had an overall 5-year survival of 56%-64%.[Small ulcers or inverted papilloma] had an overall 5-year survival of 79-82%; while inverted papilloma and well differentiated lesions had an overall 5-year survival of 69%-82%.
Adjuvant hypofractionation in oropharyngeal and non‐oropharyngeal cancer patients with localized disease and a 3-grade tumor with good histologic margins should be offered before radiation therapy without delay as part of a multidisciplinary management approach to patients willing to receive radical radiation therapy after surgery. There is no clear evidence that hypofractionation can prolong survival.
The present study revealed that adjuvant radiation treatment with fractionated-dose was associated with a non-significant decrease in physical and mental functioning. The treatment-related deterioration of psychosocial parameters, such as body image, was noted. In a recent study, findings imply that quality of life is adversely influenced by adjuvant radiation treatment for OSCC.
The risk of developing OSCC was higher in males than females. This difference may be attributed to a lower smoking and drinking rates in females and also be associated with a lower diet intake. Larger and longer duration studies are required to fully understand the aetiology and risk factors associated with OSCC. A better dietary questionnaire should be developed to assess dietary habits.
Overall 5-year survival for patients with all stages is 65.7%. For T1, T2, T3N0, and T3N1 patients, it is 86.3%, 57.1%, 47.6%, and 43.9% respectively. In summary, the overall 5-year survival rate is similar to other cancers (65.7%), however, the 5-year survival is high for patients with all stages compared to OSCC and for patients with early-stage OSCC compared to those who have lymph node involvement.