Oral squamous cell carcinoma in the background of oral submucous fibrosis is a distinct clinicopathological entity with better prognosis

J Oral Pathol Med. 2017 Jul;46(6):448-453. doi: 10.1111/jop.12553. Epub 2017 Feb 28.

Abstract

Background: The aim of this study was to compare the clinicopathological features of oral squamous cell carcinoma in the background of oral submucous fibrosis (OSCC-OSMF) and oral squamous cell carcinoma (OSCC).

Methods: A total of 217 cases of OSCC were retrieved from achieves for the analysis. OSCC-OSMF cases were segregated on the basis of history and clinicopathological parameters.

Results: The study included 217 patients of which 112 had OSCC and 105 OSCC-OSMF. OSCC-OSMFs were younger compared with OSCC. Overall oral cancer was noted predominantly in males compared to females. The number of OSCC-OSMF was more in clinical TNM stage I and stage II as compared to OSCC, whereas the number of OSCC was more in stage III and stage IV compared to OSCC-OSMF. Histological presentation of well-differentiated squamous cell carcinoma was significantly more in OSCC-OSMF compared to OSCC, whereas moderately differentiated squamous cell carcinoma was significantly more in OSCC compared to OSCC-OSMF. Regional lymph node metastasis was significantly higher in OSCC compared to OSCC-OSMF. Three-year disease-free survival rate was significantly higher in OSCC-OSMF compared to OSCC.

Conclusion: The OSCC-OSMF was found to be a clinicopathologically distinct entity with a better grade of tumor differentiation, less incidence of nodal metastases, and early detection (early clinical TNM stage) compared to OSCC. All these factors probably contribute to a better prognosis and increased 3-year disease-free survival in OSCC-OSMF patients.

Keywords: areca nut; oral submucous fibrosis; squamous cell carcinoma; tobacco.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Areca / adverse effects
  • Carcinoma, Squamous Cell / pathology*
  • Female
  • Humans
  • India
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Mouth Mucosa / pathology
  • Mouth Neoplasms / pathology*
  • Neoplasm Staging
  • Oral Submucous Fibrosis / pathology*
  • Precancerous Conditions / pathology*
  • Prognosis
  • Sex Factors
  • Survival Rate