Oral Squamous Cell Carcinoma: A 6-Month Clinico-Histopathologic Audit in a Kenyan Population

Abstract

Objective: To determine the clinico-histopathologic variations and etiological factors associated with oral squamous cell carcinoma (OSCC). Methods: A descriptive cross-sectional hospital based study was conducted at the University of Nairobi Dental Hospital (UNDH) and Kenyatta National Hospital (KNH) between September 2008 and February 2009. Eighty-two (82) patients presenting with lesions confirmed as OSCC were evaluated for habits identified as risk factors such as tobacco use, alcohol use and betel quid chewing. Demographic features including age and gender as well as clinical parameters such as site of the primary lesion, tumour size and nodal involvement were documented. Incisional biopsies were performed for all patients to confirm the diagnosis and histopathological features noted. Results: The mean age of the patients was 58.49 (range = 14 to 90 years), with a male to female ratio of 1.6:1. Remarkably, 13.4% of the patients were aged 40 years and below. The peak incidence was found to have been in the 6 th-7 th decades. Tobacco use was the main associated etiological factor (73.2%) followed by alcohol use (57.3%). Notably, 25.6% of the cases had no identifiable risk factor. The tongue was the most common site (35%) followed by the palate (22%) (p = 0.03). The least commonly affected site was the floor of the mouth (10%). The most common stage at presentation was stage IV (52.4%) and; the poorly differentiated OSCC was the most common histopathologic variant (48.8%) followed by the well differentiated (30.5%) and moderately differentiated OSCC (20.7%). Conclusion: In the present investigation it is evident that OSCC has a male predilection with a peak incidence in the 6 th-7 th decades and most commonly manifests in the tongue at stage IV with the poorly differentiated subtype being the most common. Of the cases diagnosed 13.4% were aged 40 years and below.

A Study of 89 Cases of Oral Squamous Cell Carcinoma Presenting at Teaching Hospitals of Lahore, Pakistan

“…This finding was consistent with other observations. 24 In the present study, the mean duration of the lesions at presentation was 5 ± 3.68 months which is somewhat similar to the study conducted in Kenya 25 reporting a mean duration of 7.2 months.Consistent with the findings of Shenoiet al 26 ,68.5% of patients reported within 6 months of onset of the lesions. Delayed presentation can be attributed to lack of awareness about the symptoms and misinterpretation of oral symptoms as minor oral conditions.…”

Orofacial squamous cell carcinoma: Analysis of histopathological reports of 465 patients in Tanzania

“…[1] Most worldwide studies about OfSCC have reported that males are affected more than females, with male to female ratio ranging between 1:3:1 and 20.3:1. [2,12,[14][15][16][17] Similarly, in the current study a slight male predominance was observed. It is widely recognized that there is a strong association between orofacial cancer and risky behaviors like smoking and alcohol consumption, which males tend to display more.…”

“…Malignant conditions in the orofacial region constitute an important group of human diseases with an estimated prevalence of about 5-8% of all malignancies worldwide, and squamous cell carcinoma accounts for up to 90% of all these lesions in the head and neck region. [1][2][3] Orofacial squamous cell carcinoma (OfSCC) originates from the mucosal epithelium in the aerodigestive tract (oral cavity, pharynx, and sinuses) [4] and keratinocytes in the spinous layer of the epidermis (skin). [5] Generally, OfSCC tends to affect more males than females by twofold to fourfold, with the median age of diagnosis being around 60 years, though, the incidence of OfSCC in persons under the age of 45 years is increasing.…”

Epidemiological profile of oral cancers in Benin

“…3 According to Muange et al in Kenya, language was the most frequent site (35%) followed by palate (22%) and the least affected site was the oral floor (10%). 29 The main locations of cancer in the oral cavity in Zimbabwe in 2005 were the mandibular gingiva (21.1%), tongue (20.5%) and oral floor (18.5%). 30 In Benin, the oral floor was poorly affected (1.7%) and cancers mainly concerned the palate (32.2%) and the tongue (25.4%).…”