Regular clinical follow-up of oral potentially malignant disorders results in improved survival for patients who develop oral cancer

Fredrik Jäwert; Jennie Nyman; Emma Olsson; Claudia Adok; Madeleine Helmersson; Jenny Öhman

doi:10.1016/j.oraloncology.2021.105469

Regular clinical follow-up of oral potentially malignant disorders results in improved survival for patients who develop oral cancer

Oral Oncol. 2021 Oct:121:105469. doi: 10.1016/j.oraloncology.2021.105469. Epub 2021 Aug 6.

Authors

Fredrik Jäwert¹, Jennie Nyman², Emma Olsson², Claudia Adok³, Madeleine Helmersson³, Jenny Öhman²

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Otorhinolaryngology, Oral and Maxillofacial Surgery, NU Hospital Group, Trollhättan, Sweden. Electronic address: fredrik.jawert@gu.se.
² Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³ Regional Cancer Center West, Western Sweden Health Care Region, Gothenburg, Sweden.

PMID: 34371451
DOI: 10.1016/j.oraloncology.2021.105469

Abstract

Objectives: To evaluate whether clinical follow-up programs of oral potentially malignant disorders (OPMD) result in earlier detection and improved survival rates if malignant transformation occurs, as compared to OPMD patients without follow-up and other patients with oral squamous cell carcinoma (OSCC).

Materials and methods: Three OSCC groups were retrospectively studied for disease stage at diagnosis and survival rates (N = 739): Group A, patients with OSCC with regular follow-up of preceding OPMD (N = 94); Group B, patients with OSCC with preceding OPMD but no follow-up (N = 68); Group C, patients with OSCC without previously known OPMD diagnosis (N = 577).

Results: The patients with OPMD with follow-up (Group A) was diagnosed at a significantly earlier stage and have significantly higher survival rates compared to Group B (p < 0.001 and p = 0.022, respectively) and Group C (p < 0.001 and p < 0.001, respectively). There was no significant difference between Group B and Group C in terms of survival rate (p = 0.143) or stage at diagnosis (p = 0.475). Patients with OPMD and follow-up (Group A) had a 5-year net survival rate of 90.0% (95%CI 80.3-100.8%), as compared to 68.3% percent (95% CI 54.5-85.7) for Group B and 56.1% (95% CI 51.4-61.3) for Group C.

Conclusion: The results of this study indicate that regular follow-up of patients with OPMD results in earlier detection of OSCC (if malignant transformation occurs) and improved survival.

Keywords: Early diagnosis; Mouth neoplasms; Oral leukoplakia; Prognosis; Squamous cell carcinoma of head and neck; Survival.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Head and Neck Neoplasms* / diagnosis
Humans
Mouth Diseases* / diagnosis
Mouth Neoplasms* / diagnosis
Precancerous Conditions* / diagnosis
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck* / diagnosis
Survival Rate