Univariate and multivariate analysis of prognostic significance of betel quid chewing in squamous cell carcinoma of buccal mucosa in Taiwan.
OBJECTIVE
While betel quid (BQ) chewing is clearly the most avoidable risk factor of squamous cell carcinoma of buccal mucosa (BMSCC), little is known about the influence of this habit on the prognosis of BMSCC.


METHODS
We surveyed 280 patients with BMSCC who were treated during an 8-year period in a cohort study to assess the independent predictive value of pretreatment BQ chewing habit on the prognosis by univariate and multivariate analysis.


RESULTS
We found by univariate analysis that sex, age, clinical stage, smoking, and BQ chewing significantly affected the patients' prognosis and only age, clinical stage, and BQ chewing had significant influence on prognosis by multivariate analysis (P < 0.05). Further analysis revealed that the prognostic effect of BQ chewing changed in a dose- and time-dependent manner. The risk of death was 31.4-fold higher in heavy user (duration >30 years, daily consumption >30 quids, age of start <20 years old) when compared to those who chewed BQ to a milder degree (duration <10 years, daily consumption <15 quids, age of start > or =20 years old ) (P < 0.001).


CONCLUSIONS
Pretreatment BQ chewing habit worsens the prognosis of BMSCC in Taiwan. BQ chewing is a prognostic indicator that can be used in conjunction with clinical staging to help plan the treatment for the patients.
Lee
Jang-Jaer
JJ
School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan.
Jeng
Jiiang-Huei
JH
Wang
Hsiao-Mei
HM
Chang
Hao-Hueng
HH
Chiang
Chun-Pin
CP
Kuo
Ying-Shiung
YS
Lan
Wan-Hong
WH
Kok
Sang-Heng
SH
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001114:Areca; D002294:Carcinoma, Squamous Cell / Q000209:etiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication; D008875:Middle Aged; D009061:Mouth Mucosa; D009062:Mouth Neoplasms / Q000209:etiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking; D015996:Survival Rate