Archives of Head and Neck Surgery
Archives of Head and Neck Surgery
Original Article Tumors of lip and oral cavity

Evaluation of oncological outcomes in patients with oral cavity cancer treated in a lowvolume hospital

Sara de Souza Bettioli, Agnaldo José Graciano, Ana Lavratti Borga, Carlos Augusto Fischer

Downloads: 0
Views: 87


Introduction: Oral cavity cancer (OCC) is one of the 10 most common types of tumors in the world. Surgical resection is the most indicated initial treatment, followed by adjuvant therapy, depending on tumor stage. A few studies have suggested that patients treated in high-volume hospitals present better oncologic outcomes; however, particularly in continental countries, some patients are treated in regional hospitals. Objective: To evaluate the results of OCC patients treated in low-volume regional hospitals. Methods: This is a retrospective longitudinal study conducted with patients diagnosed with OCC and operated on in a low-volume hospital between January 2003 and December 2018. Results: 174 patients with OCC were treated at the institution - an average of 11 patients/year. The most common tumor location was the tongue (48.2%), followed by the lip (18.2%). Squamous cell carcinomas were the most frequent (94.7% of patients). Adjuvant radiotherapy and chemotherapy were performed in 46.7 and 31.9% of patients, respectively. Almost 21% of patients had some postoperative complication. Specific survival of 62.6% and global survival of 58.2% after 3 years were similar to the results reported in high-volume centers. Disease-free survival was 45.8% in the same period. Conclusion: Low-volume hospitals qualified for oncological treatments can present outcomes similar to those of high-volume centers, and are thus a regional option for patients with OCC.


oral cavity; tongue; floor of mouth e lower lip; malignant neoplasm


1. Neville BW, Day TA. Oral cancer and precancerous lesions. CA Cancer J Clin. 2002;52(4):195-215. PMid:12139232.

2. Cervenka B, Pipkorn P, Fagan J, Zafereo M, Aswani J, Macharia C, Kundiona I, Mashamba V, Zender C, Moore M. Oral cavity cancer management guidelines for low-resource regions. Head Neck. 2019;41(3):799-812. hed.25423. PMid:30666743.

3. Genden EM, Ferlito A, Silver CE, Takes RP, Suárez C, Owen RP, Haigentz M Jr, Stoeckli SJ, Shaha AR, Rapidis AD, Rodrigo JP, Rinaldo A. Contemporary management of cancer of the oral cavity. Eur Arch Otorhinolaryngol. 2010;267(7):1001-17. http:// PMid:20155361.

4. Ernani V, Saba NF. Oral cavity cancer: risk factors, pathology, and management. Oncology. 2015;89(4):187-95. PMid:26088938.

5. Ministério da Saúde. Estimativa 2020: incidência de câncer no Brasil [Internet]. Rio de Janeiro: Instituto Nacional de Câncer José Alencar Gomes da Silva; 2020 [cited 2022 Jan 9]. 122 p. Available from: inca.local/files/media/document/estimativa-2020-incidencia-de-cancer-no-brasil. pdf.

6. Ettinger KS, Ganry L, Fernandes RP. Oral cavity cancer. Oral Maxillofac Surg Clin North Am. 2019;31(1):13-29. PMid:30454788.

7. Kim D, Li R. Contemporary treatment of locally advanced oral cancer. Curr Treat Options Oncol. 2019;20(4):32. PMid:30874958.

8. Gigliotti J, Madathil S, Makhoul N. Delays in oral cavity cancer. Int J Oral Maxillofac Surg. 2019;48(9):1131-7. PMid:30878273

9. Agarwal P, Agrawal RR, Jones EA, Devaiah AK. Social determinants of health and oral cavity cancer treatment and survival: a competing risk analysis. Laryngoscope. 2020;130(9):2160-5.

10. Mummudi N, Agarwal JP, Chatterjee S, Mallick I, Ghosh-Laskar S. Oral cavity cancer in the Indian subcontinent – challenges and opportunities. Clin Oncol. 2019;31(8):520-8. PMid:31174947.

11. Montoro JRMC, Hicz HA, Souza LD, Livingstone D, Melo DH, Tiveron RC, Mamede RCM. Fatores prognósticos do carcinoma espinocelular de cavidade oral. Rev Bras Otorrinolaringol. 2008;74(6):861-6. S0034-72992008000600008.

12. Koyama S, Tabuchi T, Okawa S, Morishima T, Ishimoto S, Ishibashi M, Miyashiro I. Oral cavity cancer incidence rates in Osaka, Japan between 2000 and 2014. Oral Oncol. 2020;105:104653. PMid:32272382.

13. Farhood Z, Simpson M, Ward GM, Walker RJ, Osazuwa-Peters N, Does anatomic subsite influence oral cavity cancer mortality? A SEER database analysis. Laryngoscope. 2019;129(6):1400-6.

14. Cheraghlou S, Schettino A, Zogg CK, Judson BL. Changing prognosis of oral cancer: an analysis of survival and treatment between 1973 and 2014. Laryngoscope. 2018;128(12):2762-9. PMid:30194691.

15. Garrocho AA, Aguiar MCF. Perfil do paciente portador de carcinoma epidermóide da cavidade bucal, em tratamento no Hospital Mário Penna em Belo Horizonte. Rev Bras Cancerol. 2002;3(48):357-62.

16. Ramos GHA, Crivelaro ALS, Oliveira BVD, Pedruzzi PAG, Freitas RRD. Fístulas orocutâneas após cirurgia de câncer da cavidade oral: fatores de risco. Rev Col Bras Cir. 2010;37(2):86-91.

17. Lee C-C, Ho H-C, Chou P. Multivariate analyses to assess the effect of surgeon volume on survival rate in oral cancer: a nationwide population-based study in Taiwan. Oral Oncol. 2010;46(4):271-5. oraloncology.2010.01.006. PMid:20138566.

18. Lin C-C, Lin H-C. Effects of surgeon and hospital volume on 5-year survival rates following oral cancer resections: the experience of an Asian country. Surgery. 2008;143(3):343-51. PMid:18291255.

19. Koyama S, Tabuchi T, Okawa S, Taniyama Y, Nakata K, Morishima T, Miyashiro I. Hospital volume and 5-year survival in head and neck cancer patients in Osaka, Japan. Jpn J Clin Oncol. 2021;51(10):1515-22. jjco/hyab132. PMid:34392346.

20. Gomes VMS, Saraiva WB, Silva PFN, Leite RA. Mortalidade brasileira por câncer de cavidade oral. Rev Soc Bras Clin Med. 2018;3(16):164-6.

Submitted date:

Accepted date:

63849c42a953953b1b220353 archives Articles
Links & Downloads

Arch. Head Neck Surg.

Share this page
Page Sections