Prognostic factor and disease-free survival analysis of patients with oral tongue cancer in Bihar, India: A hospital-based prospective study

ABSTRACT Background: Tongue is the most common subsite of oral cavity carcinoma in Bihar, and disease-free survival (DFS) depends upon multiple clinical and treatment-related factors. Objectives: The primary objective was to estimate the 3-year DFS of patients with oral tongue cancer from Bihar, India. The secondary objective was to identify prognostic factors associated with DFS and to assess whether surgical excision improves DFS. Materials and Methods: We conducted a cohort study of 515 newly diagnosed, biopsy-proven tongue cancer cases from Bihar who received treatment at Mahavir Cancer Sansthan and Research Center, Patna, between January 2020 and December 2020. Patients were clinically examined at 3-month intervals for 3 years. Results: Among 515 patients, 269 experienced disease recurrence during the study period. The overall median DFS was 13.6 months. DFS varied across stages and treatment groups, with lower survival in the non-surgical group and advanced stages. Recurrence was found to be significantly associated with treatment modality ( P < 0.001), treatment default ( P < 0.001), and clinical stage ( P < 0.001). Conclusion: Surgical excision was associated with a lower risk of disease recurrence and improved DFS across all stages. Given that nearly half of the patients presented with advanced disease, effective awareness and early detection initiatives are needed to improve prognosis.