Background: A number of improvements in the management of oral cavity cancer, from the use of multimodal adjuvant therapies to novel operative approaches to improved diagnostic imaging, are reported to have improved survival for these patients in the last several decades. We aim to outline the extent to which these improvements have altered the trajectory of oral cavity cancer treatment and prognosis over time on a national scale using a nationally representative sample.
Methods: A retrospective study of 18658 adult oral cavity cancer diagnosed from 1973-2014 in the Surveillance, Epidemiology, and End Results dataset was conducted. Patients were stratified into early- and late-stage groups. Demographic, facility, tumor, and survival variables were included in the analyses. Multivariate Cox survival regressions as well as univariate Kaplan-Meier analyses were conducted.
Results: Among both early-stage (A) and late-stage (B) patients, the prognosis of oral cavity cancer has significantly improved over time. Among early-stage patients, 3-year survival ranged from 80.0% (SE: 1.1) for patients diagnosed from 1973-1980 to 93.6% (SE: 0.9) for patients diagnosed from 2010-2014. Among late-stage patients, 3-year survival ranged from 54.7% (SE: 1.4) for patients diagnosed from 1973-1980 to 71.4% (SE: 1.8) for patients diagnosed from 2010-2014. For late-stage patients, these improvements occurred in tandem with the rising utilization of chemotherapy in adjuvant therapies.
Conclusion: The prognosis of oral cavity cancer has improved significantly between 1973 and 2014 for both early- and late-stage patients. For late-stage patients, these improvements may be influenced by increased utilization of multimodal adjuvant therapy.