The stage of the cancer at diagnosis is very important in prognosis of oral cavity and pharyngeal cancers. In general, the more advanced the local disease, the worse the prognosis even in the absence of regional metastasis. The survival rate declines dramatically from local disease to distant disease. The survival rate for patients diagnosed with regional stage disease is only half the survival rate for those diagnosed with local disease.

Site also affects prognosis; oral cavity cancer offers better prognosis than pharyngeal cancers, for example. In the above graph, localized disease is that which is confined to primary sites such as the tongue or tonsil. Regional disease is that which has spread to the cervical lymphatics, and distant disease refers to distant metastases. Clearly, an early diagnosis markedly improves a patient’s probability for survival. Especially alarming, however, are the consistent discrepancies between races; survival rates of African-Americans are lower than those of Caucasian patients. The causes of such discrepancies are most likely multifactorial, including lack of early detection and culture-related habits. In addition to the obvious discrepancy between races, overall survival has not improved significantly for any racial population over the past 20 years.