Oral Squamous Cell Carcinoma Associated with Precursor Lesions

Area of Science:

• Oncology
• Oral Pathology
• Cancer Epidemiology

Background:

• Oral squamous cell carcinoma (OSCC) is a significant cause of morbidity and mortality.
• Oral potentially malignant disorders (OPMD) are precursor lesions to OSCC, but their impact on OSCC detection and outcomes is understudied.
• Early detection of OSCC is crucial for improving patient survival rates.

Purpose of the Study:

• To determine the proportion of OSCC cases associated with preceding OPMD.
• To compare the clinical outcomes of OSCC with and without a diagnosed precursor lesion.
• To investigate the influence of OPMD diagnosis on the stage at diagnosis and survival rates of OSCC.

Main Methods:

• A retrospective review of oral and oropharyngeal carcinoma cases diagnosed between 2005 and 2015 from the Ontario Cancer Registry.
• Matching cancer records with OPMD records from oral pathology diagnostic services and hospital databases (2001-2015).
• Statistical analysis to compare the prevalence of precursor lesions, stage at diagnosis, and mortality rates between OSCC with and without OPMD.

Main Results:

• Out of 10,987 cancer cases, 3.44% (378) had a preceding OPMD.
• Oral cancers were more frequently linked to a precursor (6.26%) compared to oropharyngeal cancers (0.57%).
• OSCC with precursor lesions were predominantly diagnosed at stage I (49.30%), versus stage IV for those without (41.28%).
• Patients with precursor-associated OSCC had significantly lower mortality rates (22.33%) compared to those without (33.31%).

Conclusions:

• OSCC associated with preceding OPMD demonstrates a significantly better prognosis.
• The improved outcome is attributed to a higher proportion of early-stage (stage I) diagnoses in precursor-associated OSCC.
• Early clinical recognition and diagnosis of OPMD can lead to improved outcomes for oral cancer patients.