E-poster Presentation 2014 World Cancer Congress

Distant metastasis in squamous cell cancer of the oral cavity (#913)

Arun Chaturvedi 1 , Vivekanand Singh 2
  1. Department of Surgical Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, U.P., India
  2. Department of Surgical Oncology, Sahara India Medical Institute Ltd., Lucknow, U.P., India

Background: Squamous cell cancers (SCC) of the oral cavity are common in India. Majority of patients present with advanced disease. Despite aggressive multimodality management, loco-regional failure is common. Distant metastatic disease, though uncommon, is also a threat to survival and may occur even in the absence of loco-regional relapse.

Aim: Descriptive analysis of a cohort of oral SCC patients developing distant metastasis.

Methods: A retrospective descriptive analysis of records to identify patients of oral SCC treated by us at Sahara Hospital, Lucknow (India) during the period October 2011 to February 2014, who developed distant metastasis.

Results: During the study period we managed 170 patients of oral SCC. Loco-regional failure occurred in 40 (23.5%) patients. Distant metastatic disease appeared in 18 (10.6%) patients. No loco-regional relapse occurred in 12 (66.7%) of these patients. Most patients with metastasis were males (77.8%) and below 50 years of age (94.4%). Median time to relapse was 6 months (range 2 - 9 months). Metastatic disease sites were lung (8), bone (7), subcutaneous abdomen (3), axilla (2), mediastinal nodes (2) and brain (1). Multiple sites were involved in 4 patients. The most common oral primary sites were buccal mucosa (50%) and tongue (38.9%). Most patients (88.9%) had advanced (T4 or N2) disease and 83.3% had well or moderately differentiated cancers. Surgical margins were close in 5 (27.8%) patients. Median survival (Kaplan Meier, SPSS-20) was 3 months and 10 of the 18 (55.5%) patients have died.

Conclusions: In this small retrospective study metastatic disease appeared mostly in males below 50 years treated for advanced (T4 or N2) oral SCC. Such patients may probably benefit from additional preoperative metastatic workup (CT Thorax, Bone scan or PET) before loco-regional treatment. Distant metastatic disease, not addressed by even the current very aggressive loco-regional treatment, remains a major threat to survival.