Citation Information :
Kharkwal S, Sarkar S, Boban AT, Kaur O, Verma AK. Clinical Profile and Management of Oral Cancer; Is Tobacco Ban the Need of the Hour? An ESIC Tertiary Care Hospital Experience. Int J Head Neck Surg 2023; 14 (1):1-5.
Background: Oral cancer is the commonest cancer of males in India, and tobacco use is its most common modifiable risk factor. The study was conducted to provide the demographic profile and management outcomes of oral cancer in an exclusive labor-class population in an Employees, State Insurance Corporation (ESIC) Hospital, catering specifically to labor-class insured patients of low-income groups.
Materials and methods: Data of patients presenting to the Surgical Oncology outpatient department (OPD), ESIC Basaidarapur, from the period January 2019 to May 2022 with cancer of the oral cavity were maintained prospectively in our computer database, and a retrospective analysis was done.
Results: A total of 40 patients who presented in Surgical Oncology OPD with cancer of the oral cavity were included in the study. The most common age group affected was the 5th decade, and 52.4% of the patients belonged to the age group of 31–50 years of age. Gender preponderance stands at 5:1, in favor of males. Around 85.7% of the patients had a history of tobacco use. The most common subsite involved was the buccal mucosa (38.1%), followed by the tongue (26.2%), and lip (14.3%). About 76.2% of patients underwent upfront surgery, while 23.8% of patients received induction chemotherapy (ICT) before surgery. There were no postoperative (post-op) complications in 85.7% of the cases. Surgical site infection developed in 9.5% of the cases, while parotid fistula was seen in 4.5% of the cases. None of the cases showed submandibular gland involvement. The median lymph node harvest was 27 nodes. Lymphovascular invasion was seen in 46.1% of the cases. Perineural invasion was seen in 19.2% of the cases. Bone was involved in two out of the 40 cases (5%). As per the final histopathological examination (HPE) report, eight cases belonged to pT1 stage (20%), 17 cases to pT2 stage (42.5%), five cases to pT3 stage (12.5%), and five cases belonged to pT4 stage (12.5%). No residual tumor was found in three cases (7.5%). In 35% of cases, lymph nodes were found to be involved in the final HPE report. A positive margin was identified in only one out of the 40 cases. During follow-up, six out of the 40 cases presented with locoregional recurrence.
Conclusion: Despite having a well-streamlined healthcare system for our insured patients, most presented with locally advanced stages, emphasizing the need for screening and awareness programs. Tobacco use was the single most modifiable risk factor in our study, highlighting the need for tobacco cessation programs and serious thinking for tobacco ban.
https://gco.iarc.fr ˃ data ˃ 356-india-fact-sheets.
Coelho KR. Challenges of the oral cancer burden in India. J Cancer Epidemiol 2012;2012:701932. DOI: 10.1155/2012/701932
Tandon A, Bordoloi B, Jaiswal R, et al. Demographic and clinicopathological profile of oral squamous cell carcinoma patients of North India: a retrospective institutional study. SRM J Res Dent Sci 2018;9(3):114–118. DOI: 10.4103/srmjrds.srmjrds_21_18
Aruna DS, Prasad KV, Shavi GR, et al. Retrospective study on risk habits among oral cancer patients in Karnataka cancer therapy and research institute, Hubli, India. Asian Pac J Cancer Prev 2011;12(6):1561–1566.
Krishna Rao SV, Mejia G, Roberts-Thomson K, et al. Epidemiology of oral cancer in Asia in the past decade–an update (2000-2012). Asian Pac J Cancer Prev 2013;14((10):5567–5577. DOI: 10.7314/apjcp.2013.14.10.5567
Madani AH, dikshit M, Bhaduri D. Risk for oral cancer associated to smoking, smokeless and oral dip products. Indian J of Public Health 2012;56(1):57–60. DOI: 10.4103/0019-557X.96977
Sharma P, Saxena S, Aggarwal P. Trends in the epidemiology of oral squamous cell carcinoma in western UP: an institutional study. Indian J Dent Res 2010;21(3):316–319. DOI: 10.4103/0970-9290.70782
Shenoi R, Devrukhkar V, Chaudhuri, et al. Demographic and clinical profile of oral squamous cell carcinoma patients: a retrospective study. Indian J Cancer2012;49(1):21–26. DOI: 10.4103/0019-509X.98910
Sharma P, Deb T, Ray JG, et al. Oral squamous cell carcinoma profile in North-Eastern regions of India from habits to histopathology: a hospital-based study. Natl J Maxillofac Surg 2018;9(1):56–60. DOI: 10.4103/njms.NJMS_59_15
Kiran G, Shyam NDVN, Rao J, et al. Demographics and histopathological patterns of oral squamous cell carcinoma at a tertiary level referral hospital in Hyderabad, India: a 5-year retrospective study. J Orofac Res 2012;2(4):198–201.
Agrawal KH, Rajderkar SS. Clinico-epidemiological profile of oral cancer: a hospital based study. Indian J community Health 2012;24(2):80–85.
Khandekar SP, Bagdey PS, Tiwari RR. Oral cancer and some epidemiological factors: a hospital based study. Indian J Community Med 2006;31(3):157.
Bhurgri Y. Cancer of the oral cavity - Trends in Karachi South (1995-2002). Asian Pac J Cancer Prev 2005;6(1):22–26.
Shukla NK, Deo SVS, Jakhetiya A, et al. Clinical spectrum, treatment and relapse patterns in 353 patients with squamous cell carcinoma of the alveobuccal complex treated with a curative intent: a retrospective study. ;J Maxillofac Oral Surg201817(1):24–31. DOI: 10.1007/s12663-016-0970-y
Deo SV, Purkayastha J, Das DK, et al. Reconstruction of complex oral defects using bi-paddle pectoralis major flap - technical modifications and outcome in 54 cancer patients. Indian J Otolaryngol Head Neck Surg 2003;55(1);5–9. DOI: 10.1007/BF02968744
Niu LX, Feng Z, Li JN, et al. Prognostic factors of squamous cell carcinoma of the buccal mucosa: a retrospective study of 168 cases in North China. J Oral Maxillofac Surg 2014;72(11):2344–2350. DOI: 10.1016/j.joms.2014.05.021
Pandey M, Shukla M, Nithya CS. Pattern of lymphatic spread from carcinoma of the buccal mucosa and its implication for less than radical surgery. J Oral Maxillofac Surg 2011;69(2):340–345. DOI: 10.1016/j.joms.2010.02.031
Panda NK, Patro SK, Bakshi J, et al. Metastasis to submandibular glands in oral cavity cancers: can we preserve the gland safely? Auris Nasus Larynx 2015;42(4):322–325. DOI: 10.1016/j.anl.2015.02.006
Agarwal G, Nagpure PS, Chavan SS. Questionable necessity for removing submandibular gland in neck dissection in squamous cell carcinoma of oral cavity. Indian J Otolaryngol Head Neck Surg 2016;68(3):314–316. DOI: 10.1007/s12070-016-0966-4
Yang S, Wang X, Su JZ, et al. Rate of submandibular gland involvement in oral squamous cell carcinoma. J Oral Maxillofac Surg 2019;77(5):1000–1008. DOI: 10.1016/j.joms.2018.12.011