Key clinical and demographic factors influencing head and neck tumor severity in Lagos

TL;DR

This study identifies age, tumor site, and other factors that predict malignancy in head and neck tumors in Lagos, Nigeria, and develops a predictive model to help improve patient care.

Contribution

The study introduces a predictive model for malignancy risk in head and neck tumors in a Nigerian population, where no such model previously existed.

Findings

Age, tumor site, laterality, and duration before presentation were significant predictors of malignancy.

The mandible was the most common tumor site, and squamous cell carcinoma was the most common malignancy.

The predictive model achieved an area under the curve of 0.864 and 0.883, indicating strong performance.

Abstract

Head and neck tumors pose a major health challenge in Nigeria, yet the factors that influence their severity remain poorly understood. No predictive model currently exists to assess malignancy risk in this population. This study aimed to identify key clinical and demographic predictors and to develop a model for malignancy risk in tumors diagnosed in Lagos, Nigeria.

We analyzed patient records with tumor diagnoses from 2000 to 2024, obtained from the Oral and Maxillofacial Surgery and Oral Pathology departments of the Lagos University Teaching Hospital. Surgical biopsy records and corresponding histopathology reports were reviewed. Tumor sites were grouped into five anatomical regions: mandible, midface, oral mucosa and salivary glands, extra oral, and unspecified regions. Descriptive statistics summarized patient and tumor features, while statistical analyses examined associations between demographics and tumor severity (benign/malignant). A predictive model for tumor severity was developed using data-splitting and leave-one-out cross-validation approaches.

Of the 1,068 patients, 1,062 had confirmed diagnoses. Median age was 35 years [IQR:23–52], 53.96% were male, and the mandible was the most common site (48.31%). Tumors were most frequent on the right (30.13%) and measured 6 × 4x2cm on average. Median duration of presentation was 12 months [IQR:5–36], with 50.75% benign tumors. Tumor severity was significantly associated with age (47 vs. 28 years), site, laterality, duration (p < 0.001), and sex (p = 0.024), with males more susceptible to malignancy. Age inversely correlated with presentation duration (p = 0.00067), and tumor site was not associated with sex (p = 0.054). Conventional ameloblastoma was the most common benign tumor, while squamous cell carcinoma was the most common malignancy. Multivariate analysis showed malignancy was associated with age (OR = 1.61; p < 0.001), tumor site (midface (OR = 3.88), oral mucosa and salivary glands (OR = 23.8), and extraoral sites (OR = 108.01) compared to the mandible [all p < 0.001]), length (OR = 1.93; p < 0.001), and shorter duration (OR = 0.68; p < 0.001). Central (OR = 0.2), left (OR = 0.46), or right laterality (OR = 0.32) lowered malignancy odds versus unspecified (all p < 0.04). Our predictive model approaches achieved area under the curve of 0.864 and 0.883.

We identified age, site, laterality, and duration before presentation, as key malignancy predictors. This will aid comprehensive care plans for optimal clinical outcomes.

The online version contains supplementary material available at 10.1186/s12903-025-07235-0.

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