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KMID : 0351619720130020131
Kyungpook Medical Journal
1972 Volume.13 No. 2 p.131 ~ p.145
Snuff Dipping in Relation to Cancer of Oral Cavity


Abstract
Three hundred and ninety four cases of or~il cancer, treated at the Winship Clinic, Emory University Hospital during 1937-1952, were si:-udied. Epidermoid carcinomas arising from anterior tonsillar pillar anteriorly, soft and hard palate, tongue_, floor of mouth,.-buccal mucosa,upper and lower alveolar ridge were included and cancers arising from the lip were excluded. Those who had experienced previous treatment before admission (78 cases), no _histological diagn~sis (15 cases), and histology other than epidermoid cancer (4 cases) were net included in this .study but those 9 lost to follow up be-fore 5 years were included in this 394 study group.
Male patients were 231 cases (59%) and female were 163 cases (41%). Snuff users were _ 78 cases (19%) out of 394 cases. Snuff dipping vas more common among female ;patients (female 44 % vs. male 2.6%). Anatomical locations of oral cancer were so divided. as to point out the direct contact of the snuff to the mucous membrane of the oral cavity.
Tumors were graded histologically by Broders¢¥" classification. Stages of disease were classified into four stages. Survival rate vas calculated by life table method.
The principle of surgery was that the primary lesion was widely excised. The radical neck dissection was performed only when the neck lymphnodes were palpable and movable.
Roentgen radiation was given internally and /or externally. For some indicated cases, radium needles and radon seeds were implanted 1oc111y.
In summary intraoral cancer associated with snuff dipping had the following characteristics.
1. Intraoral cancer associated with snuff dip-ping occurred predominantly in female patients.
2. This cancer showed histologically low gr~.-de tumor.
3. This cancer was associated with increased incidence of leukoplakia and of intraoral ne~v primary but with decreased incidence of regional metastasis.
4. This cancer revealed increased 5 year survival rate.
5. Those patients treated by surgery appeared to have higher survivals than those treated by radiation. Hc~vever it .must be remembered that this was a retrospective s~udy and the reasons surgery or radiation was chosen could not determined from the charts reviewed. Therefore direct comparison of survival data of the two groups might be questioned. However it could be said that the difference in survival Suss not due to selection by the stage of disease.
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