Concomitant Association of Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma and Incidence of Malignant Transformation of Oral Submucous Fibrosis in a Population of Central India: A Retrospective Study

Abstract

Aim To evaluate the incidence of oral squamous cell carcinoma concomitant with oral sub mucous fibrosis in central India and to correlate precipitating factors associated with oral submucous fibrosis and oral squamous cell carcinoma. This paper also aims to study the incidence of oral squamous cell carcinoma arising secondary to untreated oral submucous fibrosis. Materials and Methods Two hundred and twenty five cases of oral squamous cell carcinoma and one hundred and nineteen cases of oral submucous fibrosis of various regions in oral cavity were included in the study. All the included cases were clinically and histopathologically diagnosed and retrospective data was retrieved. Result In the present study of 119 patients of oral submucous fibrosis, 97.4 % were found to have betel nut chewing habit. Incidence of malignant transformation to oral squamous cell carcinoma in patients of untreated oral submucous fibrosis was found to be 4.2 % in the present study. The incidence of oral cancer concomitant with oral submucous fibrosis was found to be 25.77 %, which is statistically significant. Conclusion From the present study, it is evident that the malignant potential of OSF is underestimated. However, considering the small sample size and the fact that the study was carried out in a small geographical area, further study with a larger sample size and longer duration of follow up on a multicentric basis may be required to reveal the actual malignant potential of the disease.

Oral squamous cell carcinoma in the background of oral submucous fibrosis is a distinct clinicopathological entity with better prognosis

“…Primary malignancy of buccal mucosa and tongue was the most common site for OSCC‐OSMF compared to OSCC. These findings are in accordance with studies of VanWyk CW et al , Chourasia et al , and Muttagi et al . Betel quid being placed in close contact with buccal mucosa could be the reason for most common site in the OSCC‐OSMF group.…”

“…Oral squamous cell carcinoma in the background of oral submucous fibrosis (OSCC‐OSMF) is one of the most common malignancies in South and South‐East Asian countries . In this regard, Chourasia et al reported 25.77% of OSCC‐OSMF. Recently, it has been proposed that OSCC‐OSMF constitutes a clinicopathologically distinct disease, the differences of which believed to arise from differential mechanisms of areca nut carcinogenesis.…”

TFM classification and staging of oral submucous fibrosis: A new proposal

“…As OSMF malignant transformation is known to be independent of stage and site in the affected oral cavity ( Figure 1C), 23 For the first time to our knowledge, we analyzed bilateral buccal mucosa biopsies to further evaluate the uniformity of histological grade in multiple oral sites, finding grading agreement between bilateral biopsy sites was low (k = À0.478). This finding suggests there may be multiple grades of OSMF throughout the oral mucosa.…”

“…As OSMF malignant transformation is known to be independent of stage and site in the affected oral cavity (Figure C), grouping OSMF patients with malignant transformation in late stages may result in losing vital data with prognostic value. Hence, the validity of any clinicopathological classification and its usefulness in treatment planning remains questionable.…”

“…Malignant transformation in OSMF can occur anywhere in the oral cavity . Unlike oral SCC, OMFS can be diffuse and heterogeneous and be present at different anatomical mucosal surfaces and with different behaviors .…”