Periodontal status at diagnosis predicts non-disease-specific survival in a geographically defined cohort of patients with oropharynx squamous cell carcinoma

Abstract

Background: The aim of this study was to examine periodontal status with a time-efficient screening method from a cohort of newly diagnosed oropharynx squamous cell carcinoma (OPSCC) patients and to study to what extent dental disease level predicted survival.

Aims/objective: Can measuring level of dental pathology based on a blind investigation of a routine orthopantogram (OPG) obtained during diagnostic workup reveal prognostic information?

Materials and methods: We included 97 patients diagnosed between 2003 and 2010. Radiographic alveolar bone loss was measured. At least 4 mm bone loss from cement–enamel junction on at least two teeth was registered as periodontal pathology. The number of missing and filled teeth (MFT), residual roots and apical radiolucencies were noted. Clinical data were determined through hospital patient records.

Results: The horizontal bone loss discriminated between hr-HPV(+) versus hr-HPV(−) status, but secondary to age and smoking history at diagnosis. Vertical and horizontal bone loss predicted survival directly, and adjusted by gender, patient, smoking history, TN stage and hr-HPV tumor infection at diagnosis.

Conclusions: Degree of periodontal OPG pathology at the time of OPSCC diagnosis to some extent predicted hr-HPV infection, but predicted non-disease-specific long-term survival.

Significance: Degree of periodontal OPG pathology at diagnosis predicts prognosis.

Chinese abstract

背景：本研究的目的是, 用时间有效筛选方法来对一个新诊断的口咽鳞状细胞癌（opscc）患者群进行牙周状况检查, 并研究牙病状态可预测生存率的程度。

目的：通过诊断检查中获得的常规正断层图（OPG）的盲检, 测量牙科病理学水平。这是否能揭示预后信息？

材料与方法：本研究纳入2003-2010年间确诊的97例患者。测量了放射性肺泡骨损失。至少两颗牙齿的灰质-牙釉质连接处至少有4 mm的骨损失被登记为牙周病。记录了缺补牙、残根和顶端放射状的数量。通过医院患者记录确定临床数据。

结果：水平性骨损失在hr-HPV（+）和hr-HPV（−）状态之间存在差异, 但与诊断时的年龄和吸烟史相关。垂直性和水平性骨损失直接预测生存率, 并在诊断时根据性别、患者、吸烟史、TN阶段和hr-HPV肿瘤感染进行调整。

结论：OPSCC确诊时的牙周OPG的病理程度在一定程度上可预测hr-HPV感染, 但可预测非疾病特定性的长期生存率。

意义：确诊时的牙周OPG病理发展程度可预测预后。

Keywords:

• Oropharynx
• carcinoma
• HPV
• dental
• periodontitis

Disclosure statement

No potential conflict of interest was reported by the authors.