Shilpa Busnur J and Rajeshwari K. / American Journal of Oral Medicine and Radiology. 2016;3(4):146-149.
e - ISSN - XXXX-XXXX
ISSN - 2394-7721
American Journal of Oral Medicine and
Radiology
Journal homepage: www.mcmed.us/journal/ajomr
A STUDY ON PROFILE OF PATIENTS WITH ORAL CANCER
Shilpa Busnur Jayadevappa1* and Rajeshwari K2
1
Reader, Department of Oral medicine and Radiology, SJM Dental College and Hospital, Chitradurga, Karnataka, India.
2
Prosthodontist, Department of Prosthodontics, KLE Dental College, Bangalore, Karnataka, India.
Article Info ABSTRACT
Received 23/07/2016 The majority of tongue cancers occur in the middle third of the lateral margins extending in
Revised 16/08/2016 the course of disease on to the ventral aspect and floor of mouth. Often the growth is
Accepted 19/08/2016 exophytic with areas of ulceration Detailed history was recorded in a proforma, regarding
age, sex, presenting complaints, habits of chewing tobacco, pan and gutkha, habit of
Key words:- Oral smoking and consumption of alcohol. Thorough examination of oral cavity was done and
cancer, habits, Tongue site of growth was noted. Majority of patients had squamous cell carcinoma (97%) and
cancer. only 3 patients had a variety of adenoid cystic carcinoma (3%). No difference is observed
in gender suffering with oral cavity cancer.
INTRODUCTION
The oral cavity extends from the vermillion underlying muscle. Excessive salivation, Foetor oris,
border of the lip to the hard palate/soft palate junction Ankyloglossia are the other symptoms. Pain is a late
superiorly, to circumvallate papillae inferiorly and to the symptom due to involvement of lingual nerve. Lymph
anterior tonsillar pillars laterally. The slit like space node metastasis is common and present as lump in the
between the lips and cheeks and teeth/gingivae is the neck [3].
vestibule of the mouth. The space inside the teeth and Biopsy plays a main diagnostic tool in oral
gums is the oral cavity proper. The floor is formed by the malignancies. It is always done on any doubtful or obvious
mylohyoid muscle and the roof is formed by the hard malignant lesions of the oral cavity. Positive biopsy
palate [1]. confirms malignancy but a negative malignancy does not
Oral cancers generally refer to squamous cell exclude malignancy [3].
carcinoma of oral mucosal origin. More than 90% of
cancers of oral cavity are squamous cell carcinomas. METHODOLOGY
Squamous cell carcinomas are described as either This is a descriptive study conducted at for
exophytic or ulcerative or a mixture of both ie, eighteen months and a total of 100 patients having
ulceroproliferative [2]. malignant neoplasm of lip, cheek, alveolus, tongue, floor
The majority of tongue cancers occur in the of mouth and hard palate were included using purposive
middle third of the lateral margins extending in the course sampling technique.
of disease on to the ventral aspect and floor of mouth. No specific criteria were used among the oral
Often the growth is exophytic with areas of ulceration. It cancers. Detailed history was recorded in a proforma,
may occur as an ulcer in the depths of a fissure or as an regarding age, sex, presenting complaints, habits of
area of superficial ulceration with infiltration into the chewing tobacco, pan and gutkha, habit of smoking and
consumption of alcohol. Thorough examination of oral
Corresponding Author cavity was done and site of growth was noted. A through
clinical examination of the neck and other parts of the
Shilpa Busnur Jayadevappa body was also done and staged in TNM staging.
Email: -
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Shilpa Busnur J and Rajeshwari K. / American Journal of Oral Medicine and Radiology. 2016;3(4):146-149.
All patients underwent routine baseline subjected to wedge biopsy of the lesion and
investigations like urine for albumin and sugar, complete histopathology examination of the specimen was carried
hemogram, blood for urea and sugar, serum for creatinine out to assess the native and histological grading of the
and bilirubin, chest x ray and ECG. All the patients were tumour.
Fig 1. Habits Fig 2. Size of Lesion
Considering the largest diameter of oral cavity lesion, 27%
of patients had a size of 2 cms lesion, 26% had a lesion of
History of substance abuse revealed that 94% of patients size 5 cms, 13% of patient had a lesion of 4 cms, and 6% of
were using smokeless tobacco, 52% were using betel nut, patients had a lesion of 8 cms. Only two patients had lesion
22% were smokers and 15% were alcoholics of size 10 cms.
Fig 3. Type of cancer
Majority of patients had squamous cell carcinoma (97%) and only 3 patients had a variety of adenoid cystic carcinoma(3%)
RESULTS
Table 1. Age sex wise distribution of study subjects
Gender
Age group Total
Male Female
20 – 29 years 03 (06.1%) 03 (05.9%) 06 (06%)
30 – 39 years 05 (10.2%) 09 (17.6%) 14 (14%)
40 – 49 years 18 (36.7%) 18 (35.3%) 36 (36%)
50 – 59 years 23 (46.9%) 08 (15.7%) 31 (31%)
60 – 69 years 00 10 (19.6%) 10 (10%)
70 – 79 years 00 03 (05.9%) 03 (03%)
Total 49 (100%) 51 (100%) 100 (100%)
Chi square value – 21.3 df- 5 p value-0.001
Among males, higher proportion of patients were in the age group of 50 – 59 years (46.9%)followed by 40 – 49
years(36.7%), 30 – 39 years(10.2%) and 20 – 29 years(06.1%) whereas among females, higher proportion of patients were in
the age group of 40 – 49 years (35.3%)followed by 60 – 69 years(19.6%), 30 – 39 years(17.6%) and 50 – 59 years(15.7%) and
20 – 29 years (5.9%)
The relation between age and gender is found to be statistically significant.
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Table 2. Distribution based on duration of oral cancer at presentation
Duration Frequency Percentage
Up to 6 months 80 80%
7 – 12 months 13 13%
13 – 18 months 03 03%
19 – 24 months 04 04%
Total 100 100%
Majority of patients had a history of duration of cancer of 6 months i.e 80% and 20% of patients had a history of duration of
cancer between 7 – 24 months at presentation.
DISCUSSION
In this study, oral cavity lesion was more al [8], in their study reported that 68.3% of patients were
commonly found in the age group of 40 – 49 years (36%), males. . In a hospital based study by Khandekar SP et
followed by 50 – 59 years (31%), 30 – 39 years (14%), 60 al[12] 61.3% of patients were males. Durazzo MD et
- 69 years (10%) and 70 – 79 years (3%). It was observed al[13] from Brazil reported 31.8% cases were females.
that age group 40 – 59 years comprised of 67% of total Dias et al[9] from Portugal reported a male: female ratio
cases. Similar to this, a study by Patel MM et al[4,5] of 4:1. Brandizzi D et al [10] from Argentina reported
reported 12.9% of oral and oropharyngeal malignancies 55% oral malignancies in males.
below 35 years age, 23.8% between 35 and 45, and 63.3% The delay in diagnosis of oral squamous cell
cases over 45 years of age. carcinoma could be correlated to patient delay (in looking
In a study by Mehrotra Ravi et al [6], the for professional care), professional delay (in reading a
maximum incidence was in 50-59 years age range Iype diagnosis), or both and presumably has some bearing on
EM et al [7] found 2.8% of oral cancer in young patients the size of the tumor presented. The time interval between
below 35 years of age. Dhar PK et al [8] reported the onset of symptoms and the start of treatment depends
maximum incidence ( 35.7%) in the age range of 51-60 on various factors such as patient behavior, clinical course
years. of the illness and the quality of the health services.A study
According to Dias et al [9], the average age of in Cordoba, Argentina, reported that, both patients and
diagnosis of oral malignancy was 62 years, with a standard professionals were responsible for the delay in diagnosis.
deviation of 12 years. Brandizzi D et al[10] reported the The study indicated that the professional delay was the
mean age of oral malignancy to be 62 years, with a range most associated variable to the stage of tumor [14]. In our
of 19 to 95 years. study maximum number, i.e., 80 patients (80%) presented
According to Wahid A et al[11] in Pakistan, the within 6 months of onset of symptoms. This can be
commonest age group affected in oral cavity squamous attributed to the fact that because of poverty, illiteracy,
cell carcinoma was 41-50 years (38%), followed by 51-60 and possibly resorting to home remedies, all leading to
years (34%). delay by the patients[15]. Most of the patients have to earn
This study comprised both males and females their living by daily wages and the loss of working day’s
almost in equal proportion i.e Males were 49% and means a loss of wages. Hence, these patients refer late as
females were 51% of total study subjects. But compared to western data [16].
contradicting to this, other studies have difference in
gender with oral cancer. CONCLUSION
In a study by Patel MM et al [5] 75% of patients Oral cavity cancer more commonly affects age more
were males. Mehrotra Ravi et al[6] from Allahabad, India than forty years but younger age group are not completely
reported a male: female ratio of 3.27:1. Iype EM et al[7] spared
from Trivendrum, Kerala found a higher preponderance in The relation between age and gender is found to be
males (70%) compared to females (30%). Dhar PK et statistically significant
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