# A Comprehensive Retrospective Institutional Study for Decoding Oral Squamous Cell Carcinoma

## TL;DR

This study analyzes oral cancer cases to identify risk factors and outcomes, finding that men and older adults are most affected.

## Contribution

The study provides a detailed retrospective analysis of OSCC cases in a specific region, highlighting demographic and clinical trends.

## Key findings

- Males accounted for 78.35% of OSCC cases, with most patients aged between their fifth and seventh decades.
- The buccal mucosa was the most affected region, and T4a staging was most common.
- Perineural and lymphovascular invasions were found to significantly impact treatment and quality of life.

## Abstract

Background

Oral cancer is found to be the thirteenth most common cancer as stated by the WHO (World Health Organization 2023). Oral squamous cell carcinoma (OSCC) is associated with deleterious oral habits such as smoking, chewing tobacco and betel quid, alcohol consumption, low socioeconomic status, sharp teeth, and various causative factors.

Materials and methods

A three-year retrospective analysis (March 2020-September 2023) was carried out with the available patient records in the Dental Information Archival Software (DIAS) used in a private dental college in Chennai. The demographic data such as age, gender, and habit duration and clinicopathological data such as the anatomical site; tumor, node, and metastasis (TNM) staging; perineural invasion (PNI); lymphovascular invasion (LVI); and oral health-related quality of life were retrieved. Statistical analysis was done using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States).

Results

Males (78.35%) more commonly reported OSCC than females (21.62%), and the majority of them were in the age category of fifth to seventh decades of life. The most affected region was the buccal mucosa with 33.3%, followed by the lower alveolus with 30.63%. The duration of harmful habits varied from one year to more than 40 years, and the majority of the patients had T4a staging (40.54%), followed by T2 staging (29.73%) with a habit duration of more than five years. Approximately 22.52% and 0.9% had PNI and LVI, respectively. The correlation between the two variables was evaluated using the Pearson correlation test and was found to be statistically significant (p < 0.05), i.e., habit to gender and staging with gender were p = 0.027 and p = 0.028, respectively.

Conclusion

The majority of cases reported were found to be at T4a tumor staging with a habitual duration of more than five years, and more than half of the study population had severe compromise in their quality of life. The presence of perineural invasion and lymphovascular invasion has an impact on nodal metastasis, treatment choices, recurrence, and oral health-related quality of life. To address this challenge, oral health programs can implement comprehensive antitobacco counseling strategies, oral cancer public awareness programs to tackle the rising incidence of OSCC, and early oral precancer screening measures to enhance the prevention and overall quality of life of individuals with oral cancer.