PROLIFERATIVE ACTIVITY AND DIAGNOSTIC DELAY IN ORAL CANCER

Background. Tumor stage may relate to the chronology of neoplasm growth and has been used as an outcome variable when studying diagnostic delay in oral cancer. However, tumor growth rate may act as a confounding factor. Methods. We reviewed a total of 63 incident cases of oral cancer. The variables considered for the study included age, sex, smoking history, tumor site, TNM stage, Ki-67 score, and diagnostic delay. Results. Significant differences between survivors and exitus were found in terms of tumor stage at diagnosis (I-II vs III-IV), sex, and Ki-67 scores. When the analysis was adjusted for tumor stage at diagnosis (I-II vs III-IV), proliferative activity resulted to be an independent prognostic factor for survival, whereas diagnostic delay did not influence survival. Conclusion. These results seem to suggest that survival from oral cancer is affected more by the biology of the cancer (rapid tumor growth) than by diagnostic delay. (C) 2010 Wiley Periodicals, Inc. Head Neck 32: 1377-1384, 2010