Prognosis and survival for oral cancer
If you have oral cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person (such as whether they smoke) that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic factors for oral cancer.
The stage of oral cancer is an important prognostic factor. The lower the stage, the better the prognosis.
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Tumour thickness is also an important prognostic factor. A thin tumour has a better prognosis. A thicker tumour has a higher risk of coming back (recurring) in the same place (local recurrence). Thicker tumours are also more likely to have spread to the lymph nodes.
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The margin is the area of healthy tissue around a tumour that is removed along with the tumour during surgery. If cancer cells are found in the margin, it is called a positive surgical margin. If cancer cells are not found in the margin, it is called a negative margin. Tumours with negative surgical margins have a better prognosis.
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When oral cancer has grown into, around or along a nerve (called perineural invasion) the prognosis may be poorer.
Spread to blood vessels @(Model.HeadingTag)>
When oral cancer has spread to blood vessels (called vascular invasion) it may increase the risk of spread throughout the body. Cancer that has spread throughout the body has a poorer prognosis.
Spread to lymph nodes @(Model.HeadingTag)>
Oral cancer that has spread to the lymph nodes has a poorer prognosis. The more lymph nodes the cancer reaches, the higher the risk of distant spread or metastasis. If cancer grows beyond the wall of a lymph node (called extracapsular extension), the prognosis is also poorer.
Prognosis can also depend on the location of the oral cancer.
Expert review and references
Oral cavity and oropharyngealCancer. American Cancer Society. Oral Cavity Cancer. Atlanta, GA: American Cancer Society; 2011: https://www.cancer.org/.
Barnes L, Eveson JW, Reichart P, Sidransky D . Pathology and genetics of head and neck tumours. World Health Organization Classification of Tumours. International Agency for Research on Cancer (IARC); 2005.
Kim S, Smith BD and Haffty BG . Prognostic factors in patients with head and neck cancer. Harrison LB, Sessions RB, Kies MS (eds.). Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 3: 87-111.
National Cancer Institute. Lip and Oral Cavity Cancer Treatment (PDQ®). 2016.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers (Version 1.2015). 2015.