CLINICAL STAGE OF ORAL CANCER PATIENTS AT THE TIME OF INITIAL DIAGNOSIS

Irfan Shah, Omer Sefvan, Uzair Luqman, Waseem Ibrahim, Sana Mehmood, Wajiha Alamgir

Abstract


Background: Squamous cell carcinoma is the most common oral cancer. Early diagnosis ensures
better prognosis. Late diagnosis is however common around the world and contributes to the high
morbidity and mortality related to oral cancer. The objective of this study was to determine the
clinical stage of oral cancer patients at the time of diagnosis. Methods: This retrospective study was
carried out on 334 oral cancer patients who presented to the outdoor departments of Armed Forces
Institute of Dentistry, and Armed Forces Institute of Pathology, Rawalpindi from July 2008 to
December 2009. The records that were reviewed included history and clinical examination findings,
OPG and CT scans of the head and neck region, chest X-rays, abdominal ultrasounds and liver
function tests. Size of the primary tumour, the size, number and laterality of the involved cervical
lymph nodes and the presence/absence of distant metastases were documented and statistically
analysed using SPSS-17. Results: Out of the 334 patients, 203 (60.8%) were males and 131
(39.2%) females. The age range was from 21 to 88 years. Buccal mucosa was the most commonly
involved site (32 %). The primary tumour was 4 Cm or more in size, (T3/T4) 71.25% of the cases.
Cervical lymph nodes were involved in 211 patients (63.2%) and distant metastases were present in
39 patients (11.7%). Overall, clinical stage IV was the most common (57.18%) followed by stage III
(24.55%), stage II (13.77%) and stage I (4.49%). Conclusion: Oral cancers are diagnosed late (Stage
III and IV) in Pakistan and need immediate public and professional attention.
Keywords: Oral Cancer, Clinical Staging, TNM Staging

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