Oral squamous cell carcinoma: early detection and improved 5-year survival in 102 patients

The 5-year survival rate for oral cancer remains poor, as a significant number of patients present with advanced disease at the time of diagnosis. The need remains for early detection within the context of routine oral examinations and evaluation of any noted clinical abnormalities. This retrospective study analyzed patient demographics, lesion characteristics, and 5-year survival rates associated with oral squamous cell carcinoma (OSCC) that was initially assessed using computer-assisted, 3-dimensional analysis of a transepithelial oral brush biopsy. Patients with oral lesions were initially assessed by community-based dentists and physicians using an oral brush biopsy. In 102 patients, OSCC was subsequently confirmed by incisional biopsy and histopathologic analysis. The majority of patients were without traditional risk factors. Almost half of the cancers presented as white lesions, and one-third presented as lesions smaller than 5 mm. In about three-fourths of all cases, OSCC initially presented without pain or bleeding. The overall 5-year survival rate for all patients was approximately 94%. Despite barriers to early detection, identification of early, asymptomatic OSCC with innocuous-appearing clinical features is achievable. This earlier detection can be expected to lead to a marked improvement in overall survival patterns.