Date of Award

12-31-2022

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Farhan

Second Advisor

Raza Khan

Third Advisor

Dr. Shahid Pervez

Department

Community Health Sciences

Abstract

Background: Amongst all head and neck tumours, oral cavity carcinoma is the most common and has distinctive survival outcomes. The dorsum of tongue is the area of the oral cavity where cancer occurs most frequently. Oral squamous cell carcinomas (OSCC) that accounts for 90% of oral cancer cases, can be aggressive and fatal. TNM classification is used to guide the treatment but tumours within the same TNM class can act differently in terms of aggression, . When the cancer is considered resectable, surgery is the preferred treatment method, mostly with an additional surgery of neck-dissection to remove cervical lymph nodes chain Radiation therapy (RT) is another mode of treatment that can be done along with the surgery. Chemotherapy may be administered with post[1]surgical fort in cases where cancer has already spread to distant places... When no lymph node metastases are present, currently there are no established histopathological or molecular markers to distinguish between those who will benefit from additional neck-dissection or RT. Such indicators could support the TNM categorization, frequently used to guide treatment decisions.
Objective: This study aimed to collect clinical and histological data especially the depth of Invasion (DOI) for OSCC patients managed between 2020 and 2022 to evaluate prognostic and survival factors.
Methods: This study has two phases; in first phase a retrospective charts review of medical records was done to identify patients with known OSCC. We identified 120 patients of which 82 were OSCC survivors and rest were deceased. In second phase, a cross-sectional study was done to clinically examine the OSCC survivors. We examined 74 out of 82 survivors who are on regular follow-up. Odds ratio, Chi square test and regression analysis was done to identify the factors that are associated with OC survival and explored the role of Depth of Invasion (DOI) on the outcome.
Results: We found DOI as a significant prognostic indicator. There was a substantial delay in health seeking mostly due to lack of knowledge amongst the patients. All the patients had surgical procedure done with the advanced stage tumours managed with combination of chemotherapy or/and radiation. Poor oral hygiene was observed amongst the survivors as well as scarce knowledge of importance of oral hygiene. Most survivors had limited mouth opening, however, those with tongue cancer had a better mouth opening and oral hygiene.

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