Time Trends and Survival of Patients with Oral and Pharyngeal Malignancies | ||
| Journal of High Institute of Public Health | ||
| Article 8, Volume 36, Issue 4, October 2006, Pages 991-1008 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/jhiph.2006.153330 | ||
| Authors | ||
| Waguih M. Abouzeid* 1; Samiha A. Mokhtar2; Nehad H. Mahdy2; Mohamed S. Ahmed3; Fayek S. El Kwsky4 | ||
| 1Research Department, Alexandria Dental Research Center, Ministry of Health, Alexandria, Egypt | ||
| 2Bio-Statistics, High Institute of Public Health, Alexandria University, Egypt | ||
| 3Oncology, Faculty of Medicine, Alexandria University, Egypt | ||
| 4Bio-Statistic, Medical Research Institute, Alexandria University, Egypt | ||
| Abstract | ||
| An accurate assessment of oral and pharyngeal malignancies in cancer treatment trends, and survival of the diseased was missing in Egypt. Accordingly, all new cases treated in Alexandria and El-Behira Governorates during the last decade were studied retrospectively. Data were collected through all accessible archives using a special data collection sheet. The total populations of different governorates were obtained from the “Central Administration of Census and Statistics” reports, by gender and residential selective distributions. The personal history, socio-demography, staging, site of the tumor, treatment, complications of treatment, response, as well as survival were explored. The mean age of 1254 investigated subjects was 52.02±16.13 years, where 15% were educated. Pharyngeal cases represented 41.5%, while the oral were 58.5%. Those of stage I recorded 5.2%, while stage lV was 47.7%. Surgery followed by irradiation was the line of treatment for 54.3% of cases. The estimated population for non-censal years was determined as the average value of both the “Arithmetic Progression” and the “Geometric Progression” techniques estimates. The annual incidence rates through the period of study were plotted and analyzed using the relevant regression line to test their significance.1, 2 Tracing trends revealed a decreasing incidence in all situations, except in females of El-Behira Governorate, which resulted in an increasing trend of El-Behira as a whole, as all trends were not statistically significant. The 5-year survival was computed using the actuarial method, and presented graphically using the Kaplain Meier curve.3 The overall 5-year survival probability was 0.54%. Survival for stage I was 74.5%, while it was 46.38% for stage IV. Smoking showed an apparent adverse effect on survival. Stepwise logistic regression revealed that the best predictor for overall survival was gender as males have 1.74 times the risk compared to females, followed by stage, as stage IV was the worst. Results of the present study suggest that the database coded cases were quite important for treatment and follow up. Smoking should be prohibited in a decisive manner. Care is to be given for raising the socioeconomic status, especially for categories living under potentially higher stress. Early referral of cases to oncologists is highly mandatory, and whenever surgery is indicated, safety margin combined with alleviating complications is of great effect on survival. | ||
| Keywords | ||
| Oral; Pharyngeal; Cancer; Incidence; Survival; Quality of life | ||
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