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Open Access Research article

Prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan

Ping-Ho Chen1, Tien-Yu Shieh23, Pei-Shan Ho4, Chi-Cheng Tsai56, Yi-Hsin Yang27, Ying-Chu Lin5, Min-Shan Ko8, Pei-Chien Tsai1, Shang-Lun Chiang9, Hung-Pin Tu10 and Ying-Chin Ko110*

Author Affiliations

1 Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Kaohsiung, Taiwan

2 Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

3 Division of Oral and Maxillofacial Surgery, Department of Dentistry, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

4 Faculty of Dental Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

5 Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

6 Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

7 Statistical Analysis Laboratory, Department of Clinical Research, Kaohsiung Medical University Chung-Ho Memorial Hospital

8 School of Medicine, University of Western Australia, Perth, Australia

9 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

10 Department of Public Health, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

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BMC Cancer 2007, 7:101  doi:10.1186/1471-2407-7-101

Published: 15 June 2007

Abstract

Background

In Taiwan, a distinct ethnic group variation in incidence and mortality rates has been suggested for most carcinomas. Our aim is to identify the role of prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan.

Methods

Taiwan Cancer Registry records of 9039 subjects diagnosed with oral and pharyngeal carcinoma were analyzed. The population was divided into three ethnic groups by residence, which were Taiwanese aborigines, Hakka and Hokkien communities. Five-year survival rates were estimated by Kaplan-Meier methods. Ethnic curves differed significantly by log-rank test; therefore separate models for Taiwanese aborigines, Hakka and Hokkien were carried out. The Cox multivariate proportional hazards model was used to examine the role of prognostic factors on ethnic survival.

Results

The five-year survival rates of oral and pharyngeal carcinoma were significantly poorer for Hokkien community (53.9%) and Taiwanese aborigines community (58.1%) compared with Hakka community (60.5%). The adjusted hazard ratio of Taiwanese aborigines versus Hakka was 1.07 (95%CI, 0.86–1.33) for oral and pharyngeal carcinoma mortality, and 1.16 (95%CI, 1.01–1.33) for Hokkien versus Hakka. Males had significantly poor prognosis than females. Subjects with tongue and/or mouth carcinoma presented the worst prognosis, whereas lip carcinoma had the best prognosis. Subjects with verrucous carcinoma had better survival than squamous cell carcinoma. Prognosis was the worst in elderly subjects, and subjects who underwent surgery had the highest survival rate.

Conclusion

Our study presented that predictive variables in oral and pharyngeal carcinoma survival have been: ethnic groups, period of diagnosis, gender, diagnostic age, anatomic site, morphologic type, and therapy.