Oral Squamous Cell Carcinoma: Epidemiology, Clinical Presentation and Treatment

TLDR

Squamous cell carcinoma accounts for 90 % of oral cancers, most commonly involving the tongue and floor of the mouth, and arises from pre‑existing potentially malignant lesions or de novo within precancerized epithelium, with risk factors including tobacco, betel quid, heavy alcohol use, and a diet low in fresh fruits and vegetables, while poor prognosis is linked to large tumor size, nodal metastases, and deep invasion. Treatment typically involves surgery, radiation, and chemotherapy, alone or in combination.

Abstract

Squamous cell carcinoma accounts for 90% of all oral cancers. It may affect any anatomical site in the mouth, but most commonly the tongue and the floor of the mouth. It usually arises from a pre-existing potentially malignant lesion, and occasionally de novo; but in either case from within a field of precancerized epithelium. The use of tobacco and betel quid, heavy drinking of alcoholic beverages and a diet low in fresh fruits and vegetables are well known risk factors for oral squamous cell carcinoma. Important risk factors related to the carcinoma itself that are associated with a poor prognosis include large size of the tumour at the time of diagnosis, the presence of metastases in regional lymphnodes, and a deep invasive front of the tumour. Squamous cell carcinoma is managed by surgery, radiation, and chemotherapy singularly or in combination; but regardless of the treatment modality, the five-year survival rate is poor at about 50%. This can be attributed to the fact that about two-thirds of persons with oral squamous cell carcinoma already have a large lesion at the time of diagnosis.