Correlation of clinical presentation with prognosis in oral squamous cell carcinoma associated with oral submucous fibrosis.

Abstract

Background: Oral squamous cell carcinoma (OSCC) associated with oral submucous fibrosis (OSMF) constitutes a clinicopathologically distinct entity in context to younger age of presentation, better histological grade of tumor differentiation, and lower risk of nodal metastasis. This study is intended to provide the basis of clinical presentation of OSCC associated with OSMF to consider a clinicopathologically unique entity compared to OSCC without OSMF.

Methods: The cohort of 320 OSCC patients was divided into two groups based on the association of OSMF. Group one, OSCC without OSMF (n = 166), whereas Group two, OSCC associated with OSMF (n = 154). The varied clinical presentation were categorized as, erythroplakic, erythro-leukoplakic, ulcerative/endophytic, ulcero-proliferative, and proliferative/exophytic. The variations in clinical presentation between the OSCC without OSMF and OSCC associated with OSMF groups were assessed using one-way ANOVA and the Tukey's HSD test.

Results: Group one cohort presented with, significantly high number of cases clinically as ulcerative/endophytic 72 (43.4%) followed by ulcero-proliferative 53 (31.9%), erythro-leukoplakic 30 (18.1%), proliferative/exophytic 8 (4.8%) and erythroplakic 3 (1.8%). Whereas in Group two, significantly high number of cases clinically presented as nearly equal number of ulcero-proliferative 55 (35.7%) and proliferative/exophytic 50 (32.5%) followed by ulcerative/endophytic 25 (16.2%), erythro-leukoplakic 18 (11.7%) and erythroplakic 6 (3.9%) (p < 0.001).

Conclusion: Significantly high number of cases of OSCC associated with OSMF clinically presented as ulcero-proliferative and proliferative/exophytic. This characteristic clinical presentation may contribute in early detection and diagnosis by providing considerable period for recognition and treatment planning and thus better prognosis in OSCC associated with OSMF cases.