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Recurrence of Oral Cancer Found to Signal Poor Outcome
Date:12/22/2010

WEDNESDAY, Dec. 22 (HealthDay News) -- How people fare when oral cancer recurs depends on where and when the cancer returns, a new study has found.

The research included 77 people in Australia who'd had oral squamous cell carcinoma, a cancer that occurs in the thin, flat cells that line the lips and mouth. The cancer was treated with surgery, radiation or both. However, the cancer came back, and they all subsequently had what's called salvage surgery, which is a procedure to remove cancer after an initial treatment fails.

The researchers found that people whose cancer recurred at the same site as the initial cancer tended to do worse if the disease returned within six months, whereas those with recurrence at a different site did worse if their cancer came back after six months or more.

The overall five-year survival rate after salvage surgery was 50 percent. People who had initially had both surgery and radiation were 1.3 times as likely to die, the investigators found.

The median, or midpoint, in time to recurrence was 7.5 months after treatment, and 86 percent of the recurrences occurred within 24 months, the study found. Recurrence occurred at the initial site in 39 people, in the neck on the same side as their initial cancer in 27 people and in the neck on the opposite side in 11 people.

"Presumably, the poor outcome reflects a combination of more advanced disease at initial presentation, resistant tumor biology and limited salvage options," wrote Michael D. Kernohan and his colleagues from the Royal Prince Alfred Hospital in Camperdown, Australia. "These findings suggest that patients whose disease fails maximal combination therapy have a low likelihood of successful salvage; we recommend that such patients be counseled accordingly."

The study is published in the December issue of Archives of Otolaryngology -- Head & Neck Surgery.

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