Profile of Oral Squamous Cell Cancer in a Tertiary Level Medical College Hospital: a 10 Yr Study

To know the clinical and epidemiological characteristics & management strategies for the patients who underwent surgery for oral Squamous Cell Cancer (SCC) in a medical college hospital. Data pertaining to clinico-epidemiological factors & surgical management for oral cancer were analyzed in patients admitted to a tertiary level medical college hospital. Records of 139 patients admitted over a period of 10 years (January 1998 to December 2007) were used for data analysis. Only patients with complete records were included in the analysis. M: F ratio was 2.2:1 with average age of patients being 50.4 years. Tobacco chewing & smoking were major predisposing factors identified. Oral ulcer was the most common symptom while buccal mucosa, tongue & lower alveolus were three most common primary tumor sites. Majority of tumors were stage IV at presentation (52 %). Wide excision of tumor was done in 46 % of cases while in 54 % cases commando procedure was done. Reconstruction after either commando or wide excision was done in half of the patients. Pectoralis major myocutaneous (PMMC) flap was used in majority of cases for reconstruction. Neck dissection was done in 67 % patients. Majority (85 %) of these were radical neck dissection (RND). Per operative blood transfusions were required in 64 % patients while 19 % patients needed post operative transfusion. Post operative complications were noted in 34 % of the patients. Of these majority were related to wound infection & orocutaneous fistula formation. Hospital stay varied from 7 to 105 days with the mean duration of 30 days. Two year follow up revealed a recurrence rate of 36 %. Majority of the patients presented at an advanced stage due to self as well as professional delay in diagnosis. This leads to difficulty in resection of the primary tumor as well as reconstruction of the defect. A higher rate of recurrence after surgery is also seen. Post operative complications increase the morbidity which is reflected by an increase in the hospital stay (19 days Vs 46 days).