Abstract
T4b oral cancer is a broad umbrella term for all advanced oral cancers, the prognosis
of which varies drastically for disease of the same stage, according to the extent
of the masticator space involvement. This was a retrospective observational study
including all consecutive T4b oral squamous cell carcinoma patients treated surgically
between January 2015 and January 2016 and followed up until January 2020. The disease
was classified as upper disease or lower disease based on the anatomical location
in relation to an imaginary plane passing through the base of the retromolar trigone.
The prime objective was to evaluate overall survival and prognostic factors affecting
overall survival. The projected 5-year overall and disease-free survival rates were
40.7% and 35.6%, respectively. The assessment of prognostic factors revealed that
lower disease (lower anatomical subsites), bone invasion, and lymph nodal spread significantly
affected survival. Patients with disease in an upper anatomical location without bone
and nodal involvement can achieve fairly good survival (projected 5-year overall survival
of 64.2%) when compared to the other subsets of patients. We propose a re-evaluation
of the current staging system based on the prognostic features, so that all patients
are not considered under a single stage, since their survival differs significantly.
Keywords
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Article info
Publication history
Published online: May 21, 2022
Accepted:
April 28,
2022
Identification
Copyright
© 2022 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.