Primary Orofacial Squamous Cell Carcinoma: A Multicenter Nigerian Study

Abstract

BACKGROUND: Previous Nigerian reports of primary orofacial squamous cell carcinoma have focused on individual center experiences; hence we decided to undertake a review of cases in order to give a fairly national overview. METHODS: Multicenter retrospective study of 149 histologically diagnosed cases of primary orofacial squamous cell carcinoma seen between 1992-2001 in 3 Nigerian Teaching Hospitals RESULTS: The patients' (85 males (57%) and 64 (43%) females.) whose ages ranged from 11-91years (mean ± SD; 54 ± 15.5 years, median 52.5 years) constituted 78.7% of all orofacial malignancies seen within the study period. Lesions were of 8-67 weeks duration (mean ± SD 28.6± 15.1 weeks, median 24 weeks). Overall, the maxillary antrum (20.3%) was the most commonest site, while intraorally; the alveolus (29.6%) and palate (12.4%) predominated. Most lesions (65.8%) were welldifferentiated and only 35.6% showed individual cell keratinization. Patients with well-differentiated lesions had a comparatively higher mean age than their counterparts with other histological varieties and this was statistically significant (P < 0.05). About 45.6% presented with stages III and IV disease, and significant difference was found between duration of the lesions and clinical staging of disease (P < 0.05). Surgery in conjunction with radiotherapy was undertaken for 36.9% of the cases, followed by surgery alone in 14.4%. Close to a quarter (24.2%) either declined or failed to turn-up for treatment. Whereas treatment was found to be successful in 13.4% of the cases, failure to attend follow-up appointment was observed in 62.4%. CONCLUSIONS: The pattern of orofacial squamous cell carcinoma differs from that of industrialized countries and since the majority of the lesions were well differentiated, there is need for intensive oral health awareness to encourage early presentation, as this will further enhance prognosis.