Clinical Significance of Molar Count in Esophageal Squamous Cell Carcinoma: Propensity Score Matching Study

Emerging evidence suggests that oral health influences the prognosis of esophageal squamous cell carcinoma, with tooth loss linked to poorer outcomes and higher risk of postoperative pneumonia. While the number of teeth has been associated with esophageal squamous cell carcinoma risk, the prognostic role of molars, which play key roles in masticatory function, remains underexplored. Therefore, this study evaluated the prognostic significance of the number of remaining molars in patients undergoing esophagectomy for esophageal squamous cell carcinoma.

This retrospective study analyzed data from 272 patients with esophageal squamous cell carcinoma who underwent surgery and preoperative dental assessment. The patients were categorized into two groups based on the number of molars (≥7 vs. <7), and propensity score matching was applied to control for confounding variables. Survival outcomes were analyzed using Kaplan-Meier curves and Cox regression analysis.

After propensity score matching, 68 matched pairs were analyzed. The group with ≥7 molars showed significantly better overall survival (57.0% vs. 36.1%, p=0.0284) and recurrence-free survival (RFS; 52.3% vs. 32.2%, p=0.0498) compared with the group with <7 molars. Multivariate analysis identified postoperative pneumonia and advanced pathological stage as independent predictors of poor survival.

The number of remaining molars could serve as a prognostic marker in patients with esophageal squamous cell carcinoma. Maintaining molars may improve clinical outcomes, emphasizing the role of oral health in the perioperative management of esophageal cancer.