Improving the poor prognosis of oral squamous cell carcinoma

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6930.669 (Published 12 March 1994) Cite this as: BMJ 1994;308:669
  1. I. L. Hutchison

    In Britain, oral squamous cell carcinoma kills at least 1400 people each year; nearly two thirds of patients with this cancer will die of their disease.1 But this gloomy proportion does not convey the full picture. Early disease, where the tumour measures less than 2 cm (T1) and there is no metastatic disease, responds to simple, cheap, non- debilitating treatment and has an expected five year survival of 80%.2 The poor prognosis for oral cancer in Britain reflects the large proportion of patients who have advanced disease by the time they are referred for specialist treatment.3

    Oral cancer commonly presents as an indolent ulcer.4 These malignant ulcers fail to heal, distinguishing them from the very common traumatic and aphthous ulcers that heal spontaneously within two weeks. The commonest sites of the disease, the mobile tongue, floor of the mouth, and inside of the cheek, are all readily visible. Most cases occur in people over 50 (and in men more frequently than women).1 Tobacco in all its forms is an important risk factor5; excess alcohol intake6, and chewing of betel quid7 have also been implicated.

    The cancer is locally invasive and metastasises …

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