Primary diagnosis of oral squamous cell carcinoma. A retrospective study of patient data from 1990 to 2002

Abstract

In this retrospective study, charts were analyzed of 94 patients who presented with oral squamous cell carcinoma (OSCC) at the Department of Oral Surgery and Stomatology at the University of Bern from 1990 to 2002. Critical points in the evaluation included presence and type of potential noxious agents, tumor size and palpable lymph nodes at the first oral cancer examination, and the delay (patient and professional delay) from the appearance of the first clinical signs to the definitive diagnosis. Of the patients included, 56 patients were smokers, 48 patients reported regular consumption of alcoholic beverages, and 41 patients had a combination of smoking and drinking habits. Invasion of neighbouring tissues by the OSCCs (= cT4), mainly into alveolar bone, was found in 25 cases, and 35 patients already had clinically suspicious lymph nodes upon examination (cN1-cN3). The total delay until the definitive diagnosis "OSCC" was between two (median) and five months (mean). These results suggest that further efforts in primary and secondary OSCC prevention programs, such as smoking cessation and screening of patients at risk, are necessary to optimize the longterm prognosis and to minimize morbidity of patients suffering from OSCC.