Dilemmas in Managing Oral Cavity Carcinoma: A Single Institution Experience with Illustration of Four Cases

Dilemmas in Managing Oral Cavity Carcinoma – A Single Institution Experience with Illustration of Four Cases

Introduction: Oral cavity carcinoma is a common tumor of head and neck with tongue carcinoma is the main site of involvement in South East Asia region. Majority of patients present late and prognosis is dismal despite optimal treatment.

Methodology: A retrospective study of oral cavity malignancy at Hospital Universiti Sains Malaysia located in East Coast of Peninsular Malaysia was carried out from January 2011 to October 2013. Only four cases of oral cavity carcinoma were identified. Details of clinical presentation, imaging finding, histopathological diagnosis and treatment outcomes were reviewed.

Clinical presentation and Result: The age of patients ranges from 35 to 43 years old with a Chinese and three Malays. Two patients were male and two were female. All cases are oral tongue carcinoma subsites. Three patients had glossectomy and neck dissections with adjuvant chemoradiation. The other male patient adamantly refused any form of surge and went for complementary and alternative medicines. All patients had minimal response to chemoradiation and two patients succumbed to diseases.

Discussion: The survival of oral cavity carcinoma patient is reducing in South East Asia in contrast to an increasing survival trend seen in Western World. Multiple factors contribute to this phenomenon and numerous local issues are taken into consideration in highlighting the true spectrum of this diseases and its progression locally. Most patients deteriorate despite multimodality treatment.

Conclusion: OCSCC is an important entity in the armamentarium of head and neck cancer management. Despite multimodality treatment, the outcome remains poor. Thus it is imperative to refine treatment strategies and expertise locally in order to ensure a finesse cancer patients care in near future.