Management of oral cancer in a tertiary care hospital

Oral cancer is the 3rd most common cause of malignancy in Saudi Arabia after lymphoma and leukemia. The high incidence of oral cancer in this region is attributed to frequent use of tobacco (Shamma). In this report we have reviewed the mode of treatment and subsequent outcome of 228 oral cancer patients at the Oral Maxillofacial Surgery Unit of the Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia.

In this retrospective study the case notes of 228 oral cancer patients treated at the Armed Forces Hospital, Riyadh were reviewed. Age, sex, presenting symptoms, location of cancer in oral cavity, habit of tobacco chewing, mode of treament and complications as a result of treatment were recorded.

Out of 228 patients 149 were males and 79 were females with age ranging from 23 to 82 years. The majority of patients (58%) had tobacco chewing habit. Most of the patients received radiation therapy (98%), some times with adjuvant chemotherapy. Seventy-three percent of patients underwent surgery followed by radiotherapy, whereas 2% had surgery alone. Recurrence of the disease was observed in 56% of the patients over a period of 5 years following initial treatment.

A close association between tobacco chewing and oral cancer was observed. It is concluded that post surgery radiotherapy is a highly successful method of treatment in patients with oral cancer. Cases with a history of shamma usage did not show deep invasion even when the tumor was large. They also showed good prognosis after excision but more resistant to radiotherapy comparing with those cases with no history of shamma usage. This point needs further investigation.