Background: Despite improvements in diagnosis and patient management, survival and prognostic factors of
patients with oral squamous cell carcinoma (OSCC) remains largely unknown in most of Sub Saharan Africa.
Objective: To establish survival and associated factors among patients with oral squamous cell carcinoma treated
at Mulago Hospital Complex, Kampala.
Methods: We conducted a retrospective cohort study among histologically confirmed oral squamous cell
carcinoma (OSCC) patients seen at our centre from January 1st 2002 to December 31st 2011. Survival was
analysed using Kaplan-Meier method and comparison between associated variables made using Log rank-test.
Cox proportional hazards model was used to determine independent predictors of survival. P-values of less
than 0.05 were considered statistically significant.
Results: A total of 384 patients (229 males and 155 females) were included in this analysis. The overall mean age
was 55.2 (SD 4.1) years. The 384 patients studied contributed a total of 399.17 person-years of follow-up. 111 deaths
were observed, giving an overall death rate of 27.81 per 100 person-years [95% CI; 22.97–32.65]. The two-year and
five-year survival rates were 43.6% (135/384) and 20.7% (50/384), respectively. Tumours arising from the lip had the
best five-year survival rate (100%), while tumours arising from the floor of the mouth, alveolus and the gingiva had
the worst prognosis with five-year survival rates of 0%, 0% and 15.9%, respectively. Independent predictors of
survival were clinical stage (p = 0.001), poorly differentiated histo-pathological grade (p < 0.001), male gender
(p = 0.001), age > 55 years at time of diagnosis (p = 0.02) and moderately differentiated histo-pathological grade
(p = 0.027). However, tobacco & alcohol consumption, tumour location and treatment group were not associated
with survival (p > 0.05).
Conclusions: The five-year survival rate of OSCC was poor at 20.7%. Male gender, late clinical stage at presentation,
poor histo-pathological types and advanced age were independent prognostic factors of survival. Early detection
through screening and prompt treatment could improve survival.
Keywords: Oral squamous cell carcinoma, Uganda, Survival, Clinical-pathological presentation||en_US