A hospital-based study of survival in oral cancer patients of Tata Memorial Hospital, Mumbai.

ABSTRACT

Introduction: Oral cancer represents a significant global public health concern, with the death rate for lip and oral cavity malignancies experiencing a 1.40-fold increase worldwide in the past three decades. This retrospective study aimed to comprehensively understand overall survival (OS) and the influence of sociodemographic and clinical factors on patients diagnosed with oral cavity cancer. Materials and methods: The study focused on oral cancer patients enrolled in 2016 and treated at Tata Memorial Hospital, Mumbai, with a follow-up period extending to 5 years until 2021. Utilising the Kaplan-Meier technique and log-rank test, we examined OS and variations based on sociodemographic factors, while the Cox proportional hazard model allowed us to investigate the simultaneous impact of multiple factors on OS. Results: A total of 1,895 eligible participants were included. The overall 5-year survival rate was 65%. After adjusting for age, gender, education, primary site, tumour grade, TNM staging, treatment intention, status and modality, we found in our study oral cancer patients aged more than 60 years (HR = 1.37, 95% CI 1.01-1.85, p-value 0.03), patients who had poorly differentiated carcinoma (HR = 2.44, 95% CI 1.56-3.81, p-value < 0.001), belonged to stage IV as per TNM staging (HR = 2.44, 95% CI 1.65-3.61, p-value < 0.001), patient who have received partial treatment (HR = 2.44, 95% CI 1.65-3.61, p-value < 0.001) and only chemotherapy (HR = 3.56, 95% CI 2.43-5.23, p-value < 0.001) found to have a higher hazard of dying while literate (HR = 0.73, 95% CI 0.56-0.95, p-value 0.02) are protective. Limitations: The retrospective nature of the study posed constraints in exploring additional variable associations. Implication Overall early detection, appropriate treatment, and regular follow-up are critical for improving the survival rate of patients with oral cavity cancer. Conclusion: This research proposes that improving the socioeconomic status and promoting proactive treatment-seeking behaviour is crucial for enhancing the survival of oral cancer patients. Cancer hospitals, in collaboration with the wider public healthcare system in India, which includes clinicians and policymakers, should consider these suggestions to enhance cancer treatment and control in low-middle-income countries.