A Study on Oral Cavity Cancers: Association of Risk Factors, Primary Radiotherapy, Primary Surgery and Salvage Surgery

John Mathew, Manipadam (2007) A Study on Oral Cavity Cancers: Association of Risk Factors, Primary Radiotherapy, Primary Surgery and Salvage Surgery. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: Oral Carcinomas are grouped under: 1. Cheek, 2. Buccoalveolar sulci Buccal Mucosa, 3. Retromolar, 4. Lip – Upper, Lower, Angle of mouth (fissure), Carcinoma Tongue anterior 2/3, Carcinoma alveolus upper, lower, Carcinoma floor of mouth, Carcinoma palate. Among the Carcinoma of oral cavity the commonest was Squomous cell Carcinoma. The majority if these are seen in very advanced stage and treatment of these conditions are very demanding with surgery and radiotherapy being the main modality of therapy. The pathetic way they come to hospital is a challenge to the surgeon, surgical team and hospital when attempts are made to solve this problem. The incidence among oral cancers, association of risk factors, role of primary radiotherapy, palliative radiotherapy, primary surgery and salvage surgery for advanced disease has been studied. AIM OF THE STUDY: 1. To find out the age group with highest incidence. 2. To find out the site of commonest presentation. 3. Association of risk factors with oral cancers. 4. To find presenting stage at the time of hospital visit. 5. To assess the response of primary radiotherapy in all stages of disease. 6. To study role of primary surgery. 7. To study the role of salvage surgery and out come in advanced oral Carcinoma. 8. To look in to various aspects of primary reconstruction for excisional defect in oral cancer. MATERIALS AND METHODS: All patients who reported at cancer department diagnosed as oral cancer at Govt. Royapettah Hospital were included in the study. The study period was eighteen months from Oct 2004 to Mar 2006. No specific selection criteria was used among oral cancers. The patients either came to department of cancer directly or were referred from other departments and other hospitals after proving the malignancy by histopathological examination. Diagnosis was confirmed by histopathological examination of specimen obtained by wedge biopsy of ulcer/growth. Detailed history regarding duration of symptoms habits like smoking / tobacco were obtained, baseline investigation done which included a complete hemogram, blood biochemistry, X-ray chest and X-ray mandible as required. A through physical examination was done to assess the size and extent of tumour, presence or absence of trismus, involvement of bone & skin. Nodal status assessed clinically. All patients assessed and stage in TNM staging. RESULTS, SUMMARY & CONCLUSIONS: 104 patients were treated for oral cavity cancer at Department of Oncology Govt. Royapettah Hospital, from Oct 2004 to Mar 2006. Highest incidence was seen at 5th & 6th decades of life and majority of them were males. Cheek is the site commonly involved (45%), next comes tongue. There is a strong association of the risk factor of Tobacco chewing with Ca cheek (95%). Majority of patients presented with advanced disease. Maximum numbers in T4 & N2 groups (T4 – 55%, N2 – 45%). 30 patients completed primary RT apy, 26 patients underwent palliative radiotherapy. 31 patients discontinued treatment at various stages. 17 patients were taken up for primary surgery. 10 patients were taken for salvage surgery. Action is required to encourage screening programmes while raising awareness of oral cancer among public and association with risk factors.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Oral Cavity Cancers ; Risk Factors ; Primary Radiotherapy ; Primary Surgery ; Salvage Surgery.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 05 Jun 2018 17:36
Last Modified: 06 Jun 2018 01:19
URI: http://repository-tnmgrmu.ac.in/id/eprint/8207

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