SquamousCell Carcinoma of the Oral Cavity (OSCC) has a strong presence in this part of
the world – with the 2012 GLOBOCAN estimates reporting the highest
age-standardized rate, with respect to the world population, in the World
Health Organization (WHO) South-East Asia region (6.0 per 100,000). OSCC is
known to carry high mortality and morbidity, with various cohorts having
described five-year Overall Survival (OS) between 36.1% to 62.5%, and
complications rates ranging from 47% to 62%. The tongue is the most common
subsite in OSCC.
Surgery
has been established as the treatment of choice in OSCC, with chemotherapy and
radiotherapy largely being used in the adjuvant setting for patients with
specific risk features, and in the palliative setting for patients with
recurrent or unresectable disease. Multidisciplinary care is imperative for
ensuring favorable outcomes. Nevertheless, some patients seek alternative
non-surgical treatment in the primary setting due to concerns of surgical
morbidity and its impact on essential functions of eating, drinking, chewing,
swallowing, and speaking.
While
it is understandable that concerns arising from potential surgical morbidity
may deter patients from accepting treatment upfront, non-surgical treatment in
the primary setting for resectable OSCC has been associated with poorer
outcomes. There is little published data on the outcomes of patients who
avoid surgery and instead undergo multiple cycles of non-surgical treatment for
OSCC.
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