Difference in Clinical Presentation and Their Significance in Oral Squamous Cell Carcinoma – a Retrospective Analysis

Abstract

Oral squamous cell carcinoma(OSCC) involving tongue and buccoalveolar complex(BAC) behaves differently. Clinical features of the two subsites and their influence on pathological factors remain least analysed. Patients are divided into two groups i.e, tongue cancer and BAC cancer group, and various clinical parameters were compared. Among 474 patients 232 had tongue cancer and 242 had BAC cancer. 30% of patients with OSCC were asymptomatic at presentation except for the ulcer. Compared to tongue cancers, lesions confined to BAC presents at an advanced stage(p=0.006). Multivariate analysis showed that dysphagia in tongue cancer(p=0.020) and external swelling or lesion in BAC cancers(p=0.002) were significant predictors of an advanced stage of disease. On histopathology perineural invasion was significantly associated tongue(p=0.008) and BAC cancers(P=0.015). Among tongue cancers, those with pain and referred otalgia had a statistically significantly high depth of invasion(DOI), compared to those without pain (DOI – no pain 6.9mm, pain 9.9mm and referred otalgia 11.4mm). There is a delay in clinical presentation of OSCC. Among tongue cancers, clinical history of pain was significantly associated with depth of invasion and perineural invasion, the significance of which needs to be prospectively analysed. Clinical history in OSCC can be used as predicting factors for various pathological characters, which is subsite specific.