CLINICAL STAGE OF ORAL CANCER PATIENTS AT INITIAL DIAGNOSIS: A PREDICTOR OF TREATMENT SUCCESS AND POST TREATMENT QUALITY OF LIFE

Abstract

Background: Oral cancer remains a major public health issue in Pakistan, with most patients presenting at advanced stages due to delayed diagnosis, limited screening, and high exposure to risk factors such as tobacco and HPV. Objective: To evaluate the clinical stage of oral cancer at initial diagnosis and assess correlations with treatment outcomes, risk factors, survival, and post-treatment quality of life (QoL). Methodology: This retrospective cohort study included 115 patients treated at KRL Hospital, Islamabad (Oct 2023–Dec 2024). TNM staging, demographic data, tobacco use, HPV status, treatment modalities, and QoL were analyzed. Statistical analysis included chisquare and Kaplan-Meier survival tests. Results: Mean patient age was 60.2 ± 9.6 years; 61% were male. Late-stage diagnosis (Stage III & IV) was observed in 81% of cases, with Stage IV comprising 52%. Tobacco use and HPV infection were strongly associated with advanced disease. Screening absence (95%) and rural residency (90%) contributed to delays. Treatment success and QoL were significantly better in early-stage cases. Conclusion: Late-stage diagnosis remains a key challenge in oral cancer management. Strengthening early detection through screening, awareness campaigns, and integration of AI-based diagnostics is crucial to improving outcomes, particularly in resource-limited settings like Pakistan.