Atención al paciente oncológico en el Servicio de Cirugía Oral y Maxilofacial del Hospital de Basurto

Abstract

Epidermoid carcinomas involving the oral cavity account for one of the most frequent instances of head and neck cancer. Over 90% of the tumours found in the mouth and oropharynx are squamous cell or epidermoid carcinomas. The oral cavity includes the mucosa lining the internal surface of the lips and cheeks; the gums, the two anterior thirds of the tongue, the bed of the mouth under the tongue, the hard palate and the retromolar trigone. The epidemiology of cancer involving the oral cavity changed in the past decade: the WHO reported an increased global prevalence and an unprecedented growth in frequency in individuals under 35 who are neither smokers nor drink alcohol; the meta analysis also associated the disease with the socioeconomic status of the different countries; those most affected by the disease are people with lower levels of income; the socioeconomic status of an individual is a key factor in terms of the onset of cancer involving the oral cavity, even when other known risk factors are corrected (7, 10, 11). In the United States, the rate of survival reported one year after diagnosis is approximately 82% and 59% at five years for all stages and sites combined (7). When relapses occur, the figure for 5-year survival drops to 31% and the amount of time elapsed until the onset of the recurrence significantly influences survival (13). If a local relapse appears 12 months after treatment, salvage surgery is considered to be an option with good outcomes, 81% at 2 years in the case of single treatments (surgery or radiotherapy) and 62% with a combined approach; three-month recurrences, however, are associated with poorer 2-year survival outcomes of 18% (14). In the case of regional relapses, the rate of success at 2 years is much lower and stands at 18%.