Demographic, clinicopathological, and treatment of oral squamous cell carcinoma patients at a Johannesburg Academic Hospital, South Africa

Abstract

BACKGROUND : Oral squamous cell carcinoma (OSCC) comprises most oral malignancies worldwide and is closely associated with modifiable risk factors such as tobacco and alcohol use. Late-stage presentation is common and contributes significantly to poor treatment outcomes. This study aimed to delineate demographic, clinicopathological features, and radiation-induced toxicities among OSCC patients treated at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) between 2014 and 2019. METHODS : A retrospective, cross-sectional review of 119 histologically confirmed OSCC cases was conducted. Data included patient demographics, tumour characteristics, alcohol consumption and smoking, treatment modality, and acute radiation-related toxicities. Descriptive statistics and inferential analyses were performed using SPSS version 24.0. Associations between categorical variables were tested using chi-square and Fisher's exact tests; p-values < 0.05 were considered statistically significant. RESULTS : Among 119 patients, 71% were male (n = 84) with a mean age of 59.6 years. Black African patients constituted 67% of the cohort. The tongue (30%) and floor of mouth (25%), others were the most common tumour subsites. Most tumours were moderately differentiated (53%), and over 85% presented with stage III or IV disease. Tobacco use was reported in 94% of males and 66% of females, with alcohol use in 73% and 49%, respectively. A significant association was found between combined substance use and higher-grade tumours (p = 0.04). All patients experienced at least one radiation-induced toxicity, with mucositis (61%) and dermatitis (62%) being most frequent. Toxicities were significantly more prevalent in patients receiving concurrent chemoradiotherapy (p < 0.01). CONCLUSION : The study highlights the predominance of advanced-stage OSCC in older males with high-risk habits and underscores the urgent need for early detection strategies and public health interventions. High toxicity rates necessitate enhanced patient education and supportive care during treatment.