Prognosis and survival for oral cancer

Last medical review:

A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors.

The doctor will look at certain aspects of the cancer as well as characteristics of the person. These are called prognostic factors. The doctor will also look at predictive factors, which influence how a cancer will respond to a certain treatment and how likely it is that the cancer will come back after treatment.

Prognostic and predictive factors are often discussed together. They both play a part in deciding on a prognosis and a treatment plan just for you. 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 and chances of survival.

The following are prognostic and predictive factors for oral cancer.

Stage

The lower the stage of oral cancer, the better the prognosis.

Depth of invasion

Depth of invasion is how deep the tumour has grown into the tissue of the mouth. A tumour with a larger depth of invasion has a poorer prognosis.

Surgical margins

The margin is the area of healthy tissue around a tumour that is removed along with the tumour during surgery. If there are cancer cells in the margin, it is called a positive surgical margin. If there are no cancer cells in the margin, it is called a negative margin. Tumours with negative surgical margins have a better prognosis than tumours with a positive surgical margin.

If the cancer has spread

Cancer can spread from the place where it started to nearby areas. Oral cancer that has grown into or around a nerve (called perineural invasion), the blood vessels (called vascular invasion), or the lymph nodes has a poorer prognosis than cancer that has not spread into these nearby areas.

Expert review and references

  • Mark Taylor, MD, FRCSC
  • American Cancer Society. Oral Cavity (Mouth) and Oropharyngeal (Throat) Cancer. 2021. https://www.cancer.org/.
  • Dziegielewski PT, Mendenhall WM, Dunn LA. Cancer of the Oral Cavity. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, [chapter 27], https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.
  • Hashibe M, Strugis EM, Ferlay J, Winn DM. Oral Cavity, Oropharynx, Lip, and Salivary Glands. Thun MJ, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D, eds.. Schottenfeld and Fraumeni Cancer Epidemiology and Prevention . 4th ed. New York, NY: Oxford University Press; 2018: Kindle version, [chapter 29] https://read.amazon.ca/?asin=B0777JYQQC&language=en-CA.
  • Machiels JP, Leemans CR, Golusinski W, Grau C, Licitra L, Gregoire V. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS–ESMO–ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2020: 31(11):1462–1475.
  • Ridge JA, Lydiatt WM, Patel SG, Glastonbury CM, Brandwein-Weber M, Ghossein RA, Shah JP. Oral Cavity. Amin, MB (ed.). AJCC Cancer Staging Manual . 8th ed. Chicago, IL: American College of Surgeons; 2017: Kindle version, [chapter 7], https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.
  • Statistics Canada. Table 13-10-0160-01 Age-standardized five-year net survival estimates for primary sites of cancer, by sex, three years combined. https://www.statcan.gc.ca/en/start.

Survival statistics for oral cancer

Survival statistics for oral cancer are very general estimates. Survival is different for each stage and location of tumour.

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