Abstract

An accurate assessment of oral and pharyngeal malignancies in cancer treatment trends, and survival of the disease was missing in Egypt. Accordingly, all new cases treated in Alexandria and El Behira governorates during the last decade were studied retrospectively. Data were collected through all accessible archives using a special data collection sheet. The total populations of different governorates were obtained from the “Central Administration of Census and Statistics” reports, by gender, and residential selective distributions. The personal history, socio-demography, staging and site of the tumor, treatment and complications of treatment, response, as well as survival were explored. The mean age of 1254 investigated subjects was 52.02 ± 16.13 years, where 15% were educated. Pharyngeal cases represented 41.5%, while the oral were 58.5%. Those of stage 1 recorded 52%, while stage 4 was 47.7%. Surgery followed by irradiation was the line of treatment for 54.3% of cases. The estimated population for non-censal years was determined as the average value of both the “Arithmetic Progression” and the “Geometric Progression” technique estimates. The annual incidence rates through the period of study were plotted and analyzed using the relevant regression line to test significance (Di Bonito, 1983; Saunders and Trapp, 1990). Tracing trends revealed a decreasing incidence in all situations, except in females of El Behira governorate, which resulted in an increasing trend of El Behira as a whole, as all trends were not statistically significant. The 5-year survival was computed using the actuarial method, and presented graphically using the Kaplain Meier curve (Ederer and Cutler, 1958). The overall 5-year survival probability was 0.54%. Survival for stage 1 was 74.5%, while it was 46.38% for stage 4. Smoking showed an apparent adverse effect on survival. Stepwise logistic regression revealed that, the best predictor for overall survival was gender, as males have 1.74 times the risk compared to females, followed by stage, as stage 4 was the worst. Results of the present study suggest that, the database coded cases were quite important for treatment and follow up. Smoking should be prohibited in a decisive manner. Care is to be given for raising the socioeconomic status, especially for categories living under potentially higher stress. Early referral of cases to oncologists is highly mandatory, and whenever surgery is indicated; safety margin combined with alleviating complications is of great effect on survival.

Key words: Oral, pharyngeal, cancer, incidence, survival, quality of life.