Buccal Cancer
Determining Your Prognosis
Your prognosis is a prediction of the outcome of your disease. What is the risk of succumbing to the cancer or the risk of its coming back? These are the big questions on most people’s minds after receiving a diagnosis of oral cancer. In general, doctors know there are several characteristics of the tumor that can tell you something about your chances of being cured.
The following aspects of the cancer may affect your prognosis.
| Stage | This is the most important factor that affects your chances of being cured.19Pradhan SA, Rajpal RM. Marginal mandibulectomy in the management of squamous cancer of the oral cavity. Indian J Cancer. 1987;24;167-171. |
| Spread to Lymph Nodes | This goes along with stage, but even without other factors, if there is spread to lymph nodes in the neck, it’s a worse chance of cure, especially if there is evidence of growth of cancer outside of the lymph node.19Pradhan SA, Rajpal RM. Marginal mandibulectomy in the management of squamous cancer of the oral cavity. Indian J Cancer. 1987;24;167-171. |
| Tumor Margins | The ability to completely remove the tumor can be a very important factor that will indicate whether you will be cured or not.19, Pradhan SA, Rajpal RM. Marginal mandibulectomy in the management of squamous cancer of the oral cavity. Indian J Cancer. 1987;24;167-171.20Pentenero M, Gandolfo S, Carrozzo M. Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: a review of the literature. Head Neck. 2005 Dec;27(12):1080-91. |
| Depth of Invasion | How deep the tumor goes beyond the surface can impact the chance of cure.21, Maddox WA, Urist MM. Histopathological prognostic factors of certain primary oral cavity cancers. 1990 Dec;4(12):39-42; discussion 42, 45-6.22, Urist MM, O'Brien CJ, Soong SJ, Visscher DW, Maddox WA. Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors. Am J Surg. 1987 Oct;154(4):411-4.23Adelstein, D. J., et al. (2012). “Transoral resection of pharyngeal cancer: summary of a National Cancer Institute Head and Neck Cancer Steering Committee Clinical Trials Planning Meeting, November 6-7, 2011, Arlington, Virginia.” Head Neck 34(12): 1681-1703. |
| Spread into Local Structures | Spread into large nerves, vessels, lymphatics, or even the skin of the cheek might make your prognosis worse.20, Pentenero M, Gandolfo S, Carrozzo M. Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: a review of the literature. Head Neck. 2005 Dec;27(12):1080-91.22Urist MM, O'Brien CJ, Soong SJ, Visscher DW, Maddox WA. Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors. Am J Surg. 1987 Oct;154(4):411-4. |
It is very difficult to discuss prognosis without understanding all the details of your cancer, and this is a conversation you’re better off having in person with your doctor. To give you a percentage chance of cure is really difficult because cancer research looks at all sorts of different types of cancers and may include patients from long ago.
In general, for patients with cancer of the oral cavity, studies have shown the following17Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010.:
| Disease-Specific Survival at Five Years | Overall Survival at Ten Years | |
| Oral Cavity Cancer | Oral Cavity Cancer | |
| Stage I | 72% | 59% |
| Stage II | 58% | 47% |
| Stage III | 45% | 36% |
| Stage IV | 32% | 27% |
The disease-specific survival is higher than the overall survival because the first one tries to control for patients that probably died from something other than the cancer.
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