Clinicopathological study of oral cancers

Introduction: Oral cancer is the sixth most common cancer in the world and ranks number one (12 % of all cancers) among men and number three (8% of all cancers) among women in Indi. The most common oral cancer is squamous cell carcinoma. Tobacco and alcohol are the most important risk factors associated with oral cancer. Diagnosis of oral squamous cell carcinoma is confirmed with a biopsy for histopathological examination. Aims & Objectives: To find out the topographical distribution, incidence of lymph node metastasis, type of malignancy and dietary habits of patients of oral cancers and associated predisposing factors. Material & Methods: The present study was conducted for a period of one year. Out of the patients attending/admitted in the Department of E.N.T, with suspected oral lesions, thirty histologically proved cases of oral cancer were taken for the study. After history and examination, all the patients were subjected to complete routine investigations. Biopsy (punch or excision biopsy) was taken from all the 30 patients for histopathological confirmation of diagnosis and for categorizing the type of malignancy. Results: Majority of patients (50%) were in the age group of 51-60 years with mean age of 53 ± 7. Majority of patients (93%) were males with male: female ratio of 14:1 with most common site involved being lateral border of tongue (36.6%) followed by buccal mucosa (30%). Out of the 30 patients, only 10 had palpable lymph nodes. 6 patients had N1 disease, 1 patient had N2a disease, 2 patients had N2b disease and 1 patient had N2c disease. There were no patients who had lymph node more than 6cm i.e. N3. Most common risk factor in the present study was tobacco use whether alone or in combination with alcohol i.e in twenty four (80%) cases. 80% patients in the present study were tobacco users. Majority of males (73%) had a history of tobacco consumption, where as tobacco use in females was low (6%). Among tobacco users, 70% patients were tobacco chewers and 12.5% were tobacco smokers. Majority of patients (66%) consumed fruits occasionally. The majority of patients (53%) consumed green leafy vegetables occasionally. The majority of patients (83%) were non vegetarian whereas only (16%) were vegetarians. In the present study most common clinical complaint was ulceration followed by swelling. Squamous cell carcinoma was the most common histological type found in 93% of patients in the present study. Conclusion: There is high male predominance (14:1) since in our state tobacco intake, which is most potent risk factor, is predominantly seen in males and also because of male labour migration to our state. Tobacco intake for more than five years is commonest of all risk factors. Chewing of tobacco was more prevalent risk factor (70%) as compared to smoking. Buccal mucosa is next common site (30%) as it is affected more by chronic irritation caused by tobacco and alcohol. Majority of our cases were non vegetarian, though the exact reason for this is not fully established. Regular use of fruits and green leafy vegetables is found to decrease the risk of oral cancer, may be because of more minerals and antioxidants properties in them.