Comprehensive Analysis of Oral Squamous Cell Carcinomas: Clinical, Epidemiological, and Histopathological Insights With a Focus on Prognostic Factors and Survival Time

Abstract

Background and objectives: Oral squamous cell carcinoma (OSCC) is one of the most common malignancies in the head and neck region. Particularly, high incidence rates are observed in South and Southeast Asia, attributed to the widespread use of the carcinogenic areca nut. This study aimed to investigate the clinical, epidemiological, and histopathological features of OSCC, identify prognostic factors impacting disease-free survival, and determine a post-diagnosis disease-free survival time of OSCC patients.

Methodology: Employing a descriptive cross-sectional design, the study conducted a thorough examination of the clinical, epidemiological, and histopathological aspects of OSCC among patients seeking care at a tertiary healthcare facility. Participants were personally interviewed if available, while information for unreachable or deceased individuals was extracted from archival patient records in the Oral and Maxillofacial Surgery Department, Bakhtawar Amin Medical and Dental College, Multan, Pakistan. Data analysis was performed with a significance level set at p ≤ 0.05.

Results: The mean age of the patients was 54.16 ± 11.1, with a notable concentration in the 41 years and above age group, indicating a significant prevalence of OSCC in this population. The data revealed a gender bias toward males, and a substantial proportion of patients, particularly those aged 41 years and above, had unfortunately passed away. Statistical analysis using the Fisher exact test showed a significant association between age groups and patients' current living status (p-value < 0.05).

Conclusion: Histopathologically, moderately differentiated OSCC was the most frequently encountered grade, and surgery emerged as the predominant treatment modality. The majority of patients studied had a survival period of three years or less, emphasizing the need for further exploration of factors influencing prognosis and treatment outcomes in OSCC.

Keywords: histological grading; hnscc; opscc; oscc; survival time.

Figure 1. Histogram showing age-wise distribution of the study population

Figure 2. Clinical and radiographic presentation of OSCC. (A) A chronic paan (betel quid) chewer with an ulcerated mass involving the posterior-lateral border, base of the tongue, and floor of the mouth. (B) A large exophytic mass involving the mandibular edentulous ridge with surface ulceration. (C) A hard buccal mucosal and alveolar ridge mass, clinically visible as extra-oral swelling. (D) An OPG (orthopantomogram) of the same patient showing radiolucency and erosion of alveolar bone at the extracted socket area.