Estudio de supervivencia y recidiva del carcinoma epidermoide oral y de orofaringe

Abstract

world, depending on the series of published cases. Its development depends on genetic factors, the host's defense capacity and environmental factors, among which we highlight the exposure to carcinogens such as tobacco or alcohol. The objective of this thesis was to analyze the risk of recurrence and survival of patients treated in the health area of Coruña between 1995 and 2016. We analyzed the risk factors and classic modifiers focusing special attention on surgical margins, time intervals until diagnosis, the treatment and age. The overall survival in our sample was 89.5% at one year of follow-up and 57.5% at 5 years. 7.46% died a year later and 27.55% at 5 years due to oral and oropharyngeal squamous cell carcinoma. They relapsed 47.1%. This fact multiplied the risk of death by 2.19 in the overall survival study and by 11.34 in the specific survival study, significantly. Of the total 622 patients, 27 (4%) were under 41 years old. This age group did not show significant differences in terms of sex, risk factors, location, histological analysis, evolution and final status with respect to older patients. There was only one significant difference: the tumor size, smaller in the youngest (1.91 cm), compared to the largest (2.57 cm). The time intervals analyzed were the time it took for the patient to go to the specialist, the time elapsed from the diagnosis to the treatment, the time of admission and the time to recurrence. After a multivariate analysis, we only found significant data for overall and specific survival with respect to the treatment time with a Hazar ratio of 0.96 and 0.99 respectively, combined with age, sex and histological stage. The existence of tumor involvement of the resection margin multiplies by 2.59 the risk of death in the overall survival study and by 1.61 in the specific survival study. In the multivariate analysis the type of treatment loses significance. The percentage of surgical margin contraction in our subsample was approximately 50%.