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| |  Floor of the Mouth Cancer Requires More Aggressive Treatment to Prevent Metastases: Presented at IAOO By Louise Gagnon TORONTO -- July 21, 2009 -- More aggressive management of squamous cell carcinoma (SCC) of the floor of the mouth has decreased the number of failures in local, regional, and distant metastases, according to a retrospective chart review presented here at the 2nd World Congress of the International Academy of Oral Oncology (IAOO). In the study, a total of 142 treatment-naïve patients with newly diagnosed floor of mouth cancer received treatment with curative intent from 1994 through 2004 at the Princess Margaret Hospital in Toronto, Ontario. About a third of patients received postoperative radiation, explained lead author Jane Lea, MD, Department of Otolaryngology-Head and Neck Surgery at the University of Toronto/Princess Margaret Hospital. The researches wanted to review outcomes and assess any predictive information of survival in patients, noted Dr. Lea. "We wanted to determine clinical and pathological prognosticators of survival," Dr. Lea told attendees at an oral abstract session on July 9. The primary mode of treatment was surgery, with the majority (91%) of those undergoing surgery undergoing neck dissections, noted Dr. Lea. Overall 5-year survival was 68%, and 5-year cause-specific survival was 80%. Mortality due to floor of mouth disease was 14%, and failures were reported in 24 patients. Researchers compared the outcome of this chart review to previously published reviews on the management of SCC of the floor of mouth and found more aggressive management, characterised by increased rates of neck dissections, in their practice compared with management of the condition in the 1970s and 1980s. The more aggressive approach had resulted in decreased rates of regional, local, and distant failure: the Princess Margaret Hospital chart review showed a regional failure of 12%, local failure of 9%, and distance failure of 2%. Regional, local, and distance failure rates were significantly greater in previously published reviews, noted Dr. Lea. The investigators found that being male, having advanced pathologic stage, extracapsular spread, and thickness of a tumour exceeding 5 mm were predictive of decreased 5-year survival in a statistically significant fashion. Dr. Lea cautioned that one of the shortcomings of the study was that the follow-up period was not extensive. "One of the limitations of our study is that the follow-up period was 4.2 years," she said. [Presentation title: Squamous Cell Carcinoma of the Floor of Mouth: Outcomes and Prognostic Indicators. Abstract 053]
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