Low dental health-related quality of life (HRQoL) at the time of head and neck cancer diagnosis may be associated with worse survival outcomes. This research was published in mid-November in BMC Oral Health.
Additionally, alveolar bone loss (ABL) associated with periodontitis may predict decreased long-term survival in head and neck squamous cell carcinoma (HNSCC) patients, the authors wrote.
"Alveolar bone loss, together with low patient reported dental HRQoL, uniquely predicted decreased long-term survival,” wrote the authors, led by Mirna Farran of Haukeland University Hospital and the University of Bergen in Norway (BMC Oral Health, November 19, 2024, Vol. 24, 1406).
Periodontal disease and oral HRQoL scores are known survival predictors in oral cancer, though the mechanisms remain unclear. This study aimed to evaluate five-year and long-term survival in an HNSCC cohort, focusing on periodontal pathology from orthopantomogram (OPG) and HRQoL scores at diagnosis, they wrote.
The study included 79 Haukeland University Hospital patients from a cohort of 106 diagnosed with HNSCC from November 2002 to June 2005. Patient-reported HRQoL and OPG-measured ABL were assessed. A reduced ABL of ≥4 mm on at least two molars or premolars indicated periodontal disease.
HRQoL was evaluated using the validated Norwegian EORTC QLQ H&N-35 through structured interviews. The QLQ H&N-35 assesses seven functional areas and six symptoms related to head and neck cancer. Survival rates were presented as percentage survival or relative risk (RR) with 95% confidence intervals (CI).
In univariate analysis, ABL significantly increased mortality (RR = 2.28; CI, 1.22-4.28; p = 0.01) and showed a strong trend in multivariate analysis adjusted for clinical factors (RR = 1.95; CI, 0.98-3.87; p = 0.056). Lower dental HRQoL scores predicted reduced long-term survival in both univariate (RR = 3.58; CI, 1.99-6.45; p < 0.001) and multivariate analyses (RR = 2.17; CI, 1.17-4.01; p = 0.014), they wrote.
Furthermore, a Cox regression analysis confirmed dental HRQoL (p = 0.007) and ABL (p = 0.034) as significant predictors of long-term survival when adjusted for clinical variables. Additionally, non-HNSCC disease-specific long-term survival was predicted when both factors were analyzed together and adjusted for standard clinical information.
However, further research in formal phase II/III studies is needed to clarify the relationship between head and neck cancer, dental HRQoL, and periodontitis, they added.
"The degree of alveolar bone loss, as determined by OPG, and dental HRQoL both obtained at the time of HNSCC diagnosis, predicted long-term survival," Farran et al wrote.
