RESUMO
We assessed oral cancer mortality data in São Paulo to study trends of the disease and its distribution by areas of the city. We standardized death rates by gender and age group, and also supplied complementary information regarding oral cancer incidence. Oral cancer mortality remained stationary at high levels during the study period. Site-specific death rates revealed high figures for two categories of site: tongue and unspecified parts of mouth. Gum cancer death rates--the most easily diagnosed site-specific oral cancer at a routine dental examination--fell sharply, possibly as a consequence of the recent expansion in community dental health services in the city. In spite of this observation, the increase of death rates related to unspecified parts of the mouth points to the deficiencies of health services in detecting most of oral cancer cases early. Spatial data analysis enabled indication of areas and socio-economic factors associated with poorer profile in oral cancer mortality, important information for the targeting of health resources directed to the screening, prevention and education in oral cancer.
Assuntos
Carcinoma de Células Escamosas/mortalidade , Neoplasias Bucais/mortalidade , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Análise por Conglomerados , Feminino , Humanos , Incidência , Análise dos Mínimos Quadrados , Masculino , Pessoa de Meia-Idade , Soalho Bucal , Neoplasias Palatinas/mortalidade , Neoplasias das Glândulas Salivares/mortalidade , Distribuição por Sexo , Fatores Socioeconômicos , Estatísticas não Paramétricas , Neoplasias da Língua/mortalidadeRESUMO
BACKGROUND: Minor salivary gland carcinomas are uncommon tumors of the oral cavity. The decision regarding treatment remains controversial. The main objective of this paper is to report on the survival results of 128 patients treated in a single institution. METHODS: Tumor sites were: hard palate (62 cases), tongue (16 cases), buccal mucosa (13 cases), soft palate (12 cases), and other sites (25 cases). The most common histology was mucoepidermoid carcinoma (76 cases). Clinically metastatic lymph nodes were palpable in 21 patients. Cox regression technique was used to construct the mathematical-statistical models, aiming to predict the risks of recurrence and of death as functions of the different variables under study. RESULTS: The 5-year overall survival rates were, respectively, 85.9% and 87.7% in the groups of patients treated by surgery or combined therapy. There were significant differences in survival rates according to N stage, bone involvement, tumor histology, sex, and type of surgery. CONCLUSIONS: Most of the recurrences were at the site of primary tumor; neck metastases were rare at presentation and after initial treatment. Prognosis involves several factors related to stage, histology, and treatment.