• Cheng-Ping Wang, Li-Jen Liao, Chun-Ju Chiang, Wan-Lun Hsu, Chung-Jan Kang, Chen-Chi Wang, Peir-Rong Chen, Tseng-Cheng Chen, Wen-Wei Huang, and Chih-Yen Chien.
• Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan.
• J Formos Med Assoc. 2020 Jan 1; 119 (1 Pt 3): 392-398.

BackgroundThere are still oral cancer patients without surgery. To improve the survival, it is necessary to know the causes of the oral cancer patients without surgery.Methods23,217 patients with a newly-diagnosed oral cancer in Taiwan Cancer Registry (TCR) database between 2011 and 2015 were enrolled. Data from TCR database named "Reason for No Surgery of Primary Site" were extracted for analysis of the causes of those without surgery. Overall survival plots were presented using the Kaplan-Meier method with log-rank test.Results3263 (14%) patients did not received surgery. Among them, there were 720 patients (group 3) without surgery although surgery was advised, 154 patients (group 2) because of poor condition or death before surgery, and 2389 patients (group 1) because of other causes. Twenty-four percent of the patients with surgery were treated one month and more after diagnosis. The 5-year overall survival rates were 68.7%, 25.2%, 9.1% and 17.3% for surgery group, group 3, 2 and 1, respectively (p < 0.001). The mean age of the patients with and without surgery were 54.8 and 59.3, respectively (p < 0.01). Female patients were commoner in group 3 (p < 0.01). The patients without surgery was commoner in the middle (15.7%) and southern (14.8%) than in Northern Taiwan (12.1%). All groups without surgery had more advanced stage and lower BMI (p < 0.01).ConclusionOne-sevenths of patients were not treated surgically because of refusal, poor condition, older age, low BMI, and advanced stage. It is necessary to encourage the patients to undergo surgery with shortening the diagnosis-to-treatment interval.Copyright © 2019 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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