Influencing factors on occurrence and prognosis of oral squamous cell carcinoma after organ transplantation

Abstract

Objectives

Patients who undergo solid organ or hematopoietic stem cell transplantation are at an increased risk of developing oral squamous cell carcinoma (OSCC) due to prolonged immunosuppression. The specific characteristics and prognostic outcomes of OSCC in these post-transplant patients are not well understood. This study aims to investigate the risk, characteristics, and prognostic outcomes of OSCC in post-transplant patients.

Methods

This study analyzed the clinical baseline characteristics of OSCC patients with pathological confirmation who had undergone organ transplantation (study group) and non-transplant OSCC patients (control group), all of whom were monitored with comprehensive follow-up. Survival outcomes, including overall survival (OS) and disease-free survival (DFS), were assessed using the Kaplan-Meier method. The Cox proportional hazards model was used to evaluate whether organ transplantation status was an independent risk factor affecting survival.

Results

A total of 103 patients were enrolled (study group, n = 17; control group, n = 86). The median age at OSCC diagnosis for study group was 53 years, with tumors primarily located on the tongue (35.3 %), buccal (17.6 %), and gingiva (11.8 %). Control group had a similar median age, with tumors mostly located on the tongue (64.0 %), buccal (16.3 %), and gingiva (8.1 %). Except for one transplant recipient who received conservative management, all patients underwent surgical resection. Cox multivariate analysis identified tumor recurrence (p = 0.002), tumor size (p = 0.016), and vascular invasion (p = 0.006) as significant adverse factors affecting survival.

Conclusion

This study emphasizes the importance of organ transplantation history in managing OSCC. Regular screening is essential for early detection and improved survival, particularly under immunosuppressive conditions, in this high-risk group.