Prognostic Risk Factors of Oral Squamous Cell Carcinoma: A Retrospective Case-Control Study at a Tertiary Hospital in Riyadh, Saudi Arabia.

Background Oral squamous cell carcinoma (OSCC) is the most prevalent malignant tumor in the oral cavity, often associated with poor prognosis, particularly in advanced stages. While smoking, alcohol consumption, and areca nut use are recognized risk factors globally, shamma (Arabian snuff) stands out as a significant risk factor specific to Saudi Arabia. This study aims to evaluate the clinical and demographic factors that influence outcomes in patients diagnosed with OSCC. Methodology This retrospective case-control study was performed at Prince Sultan Military Medical City in Riyadh, Saudi Arabia, from January 2010 to December 2022. It included all cases diagnosed with OSCC that received treatment and follow-up at our institution. Clinical and demographic data were collected from electronic medical records and pathology requests. Statistical analysis, including descriptive statistics, frequency distribution, survival analysis with the Kaplan-Meier method, and regression analysis with the Cox proportional-hazards regression method, was performed using SPSS version 24 (IBM Corp., Armonk, NY). Results Eighty-eight cases were included in the study, with 52 (59.1%) occurring in males. The most common tumor site was the lateral tongue, accounting for 55 cases (62.5%), followed by the buccal and alveolar mucosa, each with 8 cases (9.1%). Shamma was the most frequently reported risk factor, present in 21 cases (23.9%), followed by tobacco smoking in 14 cases (15.9%). Death was reported in 33 patients at the end of the study period (37.5%), with a five-year overall survival rate was 59.9%, and the total overall survival rate was 38.7%, with a mean survival time of 95 months (95% confidence interval (CI) 79.5-110). Older age (more than 40 years), high stage, and presence of lymph node metastasis were significantly associated with the worst overall survival, while negative margin was significantly related to an improved overall survival. Conclusions OSCC is a highly aggressive malignancy with poor outcomes. Factors such as older age, advanced stage, and lymph node metastasis are linked to worse overall survival.