Impact of Changes in Treatment Paradigms on Survival in Oral Squamous Carcinoma-a Population-Level Study

Natarajan Ramalingam; Nithyanand Chidambaranathan; Shivakumar Thiagarajan; Arjun Singh; Devendra Chaukar; Pankaj Chaturvedi

doi:10.1007/s13193-023-01790-0

Impact of Changes in Treatment Paradigms on Survival in Oral Squamous Carcinoma-a Population-Level Study

Indian J Surg Oncol. 2023 Dec;14(4):843-849. doi: 10.1007/s13193-023-01790-0. Epub 2023 Jul 1.

Authors

Natarajan Ramalingam¹, Nithyanand Chidambaranathan², Shivakumar Thiagarajan³, Arjun Singh³, Devendra Chaukar⁴, Pankaj Chaturvedi³

Affiliations

¹ Department of Head and Neck Oncology, Christian Medical College, Vellore, India.
² Department of Head and Neck Oncology, Kovai Medical Centre & Hospital, Coimbatore, India.
³ Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India.
⁴ Department of Head and Neck Oncology, Max Nanavati Hospital, Mumbai, India.

PMID: 38187831
PMCID: PMC10766574 (available on 2024-12-01)
DOI: 10.1007/s13193-023-01790-0

Abstract

There have been notable improvements in the treatment of oral cancers. The objective of this study was to see whether these improvements have translated into survival benefits at the population level from the SEER database. This is a retrospective study using the SEER 19 Custom database which included patients diagnosed with oral cancer between January 1, 1995, and December 31, 2015. The overall stage, age, sex, and treatment modalities were the covariates. For analysis, the patients were divided into four cohorts as per their year of diagnosis-cohort I included patients who were diagnosed between 1995 and 2000 (n = 3873), cohort II between 2001 and 2005 (n = 5881), cohort III between 2006 and 2010 (n = 6233), and cohort IV between 2011 and 2015 (n = 12567). Patients undergoing surgery with adjuvant therapy have increased significantly across cohorts and there is a significant fall in patients undergoing non-surgical treatment. Pairwise comparison by the Mantel-Cox test showed that cohort IV had significantly improved median overall survival (OS) and disease-specific survival (DSS) as compared to other cohorts and there was a significant impact of treatment modality on OS and DSS, especially in cohorts III and IV (p<0.001). Though geographical variations in the presentation and habits limit the generalization of these results, this study demonstrates that the changes and improvements in treatment paradigms incorporating level I evidence and surgical techniques have translated into improved survival outcomes at the population level. We recommend further studies on the local population to lend further credence to our observation.

Supplementary information: The online version contains supplementary material available at 10.1007/s13193-023-01790-0.

Keywords: Oral cancer; Paradigms; SEER data; Survival; Treatment.

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