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Impact of Changes in Treatment Paradigms on Survival in Oral Squamous Carcinoma—a Population-Level Study

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Abstract

There have been notable improvements in the treatment of oral cancers. The objective of this study was to see whether these improvements have translated into survival benefits at the population level from the SEER database. This is a retrospective study using the SEER 19 Custom database which included patients diagnosed with oral cancer between January 1, 1995, and December 31, 2015. The overall stage, age, sex, and treatment modalities were the covariates. For analysis, the patients were divided into four cohorts as per their year of diagnosis—cohort I included patients who were diagnosed between 1995 and 2000 (n = 3873), cohort II between 2001 and 2005 (n = 5881), cohort III between 2006 and 2010 (n = 6233), and cohort IV between 2011 and 2015 (n = 12567). Patients undergoing surgery with adjuvant therapy have increased significantly across cohorts and there is a significant fall in patients undergoing non-surgical treatment. Pairwise comparison by the Mantel-Cox test showed that cohort IV had significantly improved median overall survival (OS) and disease-specific survival (DSS) as compared to other cohorts and there was a significant impact of treatment modality on OS and DSS, especially in cohorts III and IV (p<0.001). Though geographical variations in the presentation and habits limit the generalization of these results, this study demonstrates that the changes and improvements in treatment paradigms incorporating level I evidence and surgical techniques have translated into improved survival outcomes at the population level. We recommend further studies on the local population to lend further credence to our observation.

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Acknowledgements

Dr. Atanu Bhattacharjee, Statistician.

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Authors and Affiliations

  1. Department of Head and Neck Oncology, Christian Medical College, Vellore, India

    Natarajan Ramalingam

  2. Department of Head and Neck Oncology, Kovai Medical Centre & Hospital, Coimbatore, India

    Nithyanand Chidambaranathan

  3. Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India

    Shivakumar Thiagarajan, Arjun Singh & Pankaj Chaturvedi

  4. Department of Head and Neck Oncology, Max Nanavati Hospital, Mumbai, India

    Devendra Chaukar

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  1. Natarajan Ramalingam
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  2. Nithyanand Chidambaranathan
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  3. Shivakumar Thiagarajan
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  4. Arjun Singh
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  6. Pankaj Chaturvedi
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Correspondence to Shivakumar Thiagarajan.

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All the details necessary for analysis were collected from the SEER database. The data was accessed after an agreement with SEER regarding its usage [17]. There is no direct contact between the researcher and participants. All details regarding the patients are kept confidential. No details which can be used to identify the patient are published.

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Ramalingam, N., Chidambaranathan, N., Thiagarajan, S. et al. Impact of Changes in Treatment Paradigms on Survival in Oral Squamous Carcinoma—a Population-Level Study. Indian J Surg Oncol 14, 843–849 (2023). https://doi.org/10.1007/s13193-023-01790-0

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