A retrospective study of clinicopathological features of oral squamous cell carcinoma with and without oral submucous fibrosis

CONTEXT: Oral submucous fibrosis (OSF) is strongly associated with areca nut usage; the existence of OSF in patients with oral squamous cell carcinoma (OSCC) is an indicator of areca nut-induced carcinogenesis. As areca nut follows a discrete molecular path for oral carcinogenesis, this could be the basis why OSCC patients with OSF are different and are currently projected to constitute a distinct clinicopathologic entity. AIM: This study aims to analyze and compare the demographics, risk factors and clinicopathologic features of OSCC patients with and without OSF. MATERIALS AND METHODS: A retrospective review of OSCC cases treated in the institution from 2008 to 2013 was done. Sixty OSCC of buccal mucosa were selected, of which 30 were with concomitant OSF and 30 without OSF. Demographics, risk factors and clinicopathological features were studied. The data were analyzed by SPSS-20 software, using the Pearson Chi-square, Fisher's exact and Mann–Whitney U-tests. RESULTS: OSCC cases with OSF were younger (mean age 40.5 vs. 54 years) compared to those without OSF (P < 0.05). Risk factors and other clinicopathological parameters did not differ between the two groups. There was significant difference in the two groups with regard to tumor differentiation (P = 0.000). Tumors in OSCC with OSF were more likely to be well differentiated. CONCLUSION: Although majority of OSCC patients with OSF were young with a better grade of tumor differentiation, other clinicopathologic features having prognostic significance did not differ significantly between the two groups. Therefore, OSCC arising in background OSF as a distinct entity is uncertain.