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

Acta Otolaryngol. 2019 Mar;139(3):309-315. doi: 10.1080/00016489.2019.1571224. Epub 2019 Feb 26.

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.

Keywords: HPV; Oropharynx; carcinoma; dental; periodontitis.

MeSH terms

  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / mortality*
  • Female
  • Humans
  • Male
  • Norway / epidemiology
  • Oropharyngeal Neoplasms / complications
  • Oropharyngeal Neoplasms / mortality*
  • Periodontal Diseases / complications
  • Periodontal Diseases / diagnostic imaging
  • Periodontal Diseases / mortality*
  • Radiography, Panoramic
  • Retrospective Studies