Microcytic anaemia independent predictor of regional metastases in early oral squamous cell carcinoma

The findings, published in the International Journal of Oral and Maxillofacial Surgery, pave the way for prospective studies to determine the effect of iron supplementation or presurgical blood transfusion on the outcomes in this population.

"The occurrence of regional metastases of early-stage OSCC within three years after primary surgical treatment was significantly more common among patients with presurgical microcytic anaemia, with an adjusted odds ratio of 2.99," the researchers reported. "Alcohol consumption was independently associated with a higher frequency of a second primary tumour, with an adjusted odds ratio of 2.97."

The study was conducted by I. Luksic, Department of Maxillofacial Surgery, Dubrava University Hospital, Zagreb, Croatia, and colleagues to evaluate the effect of preoperative anaemia on the risk of occurrence of regional metastases and second primary tumours in patients with early-stage (cT1–T2N0M0) oral squamous cell carcinoma after primary surgical treatment.

The study included consecutive patients with OSCC who met the following criteria: adult> 18 years of age; verified cT1–T2N0M0 stage; available data on clinical and laboratory work-up allowing the assessment of demographics, anaemia, lifestyle/habits, and comorbidities. The inclusion time frame allowed a minimum censored observation of 5 years and a maximum potential censored observation of 15 years.

Key findings of the study are as follows:

• Microcytic anaemia was significantly associated with a higher risk of regional metastases (60% vs 40%), with an odds ratio of 3.65.
• Alcohol consumption was independently associated with an increased risk of a second primary tumour, with an odds ratio of 2.79.

"Although the treatment of early-stage OSCC is relatively successful, patients with anaemia are at a higher risk of metastases owing to hypoxia-induced angiogenesis, whereas second primary tumour occurrence appears to be related to the field cancerisation of the preconditioned mucosa," the researchers wrote.

"These results pave the way for prospective studies to determine the impact of iron supplementation or presurgical blood transfusion on the outcomes in this population," they concluded.

Reference:

Gllareva E, Prekazi F, Salihu S, Luksic I. Prognostic significance of preoperative anaemia on occurrence of regional metastases and second primary tumours in patients with early-stage oral squamous cell carcinoma. Int J Oral Maxillofac Surg. 2023 Oct;52(10):1017-1024. doi: 10.1016/j.ijom.2023.03.006. Epub 2023 Apr 3. PMID: 37019735.