Abstract：
This study aimed to reveal the underlying mechanisms linking advanced oral squamous cell carcinoma (OSCC) with its comorbidities. Data extracted from the POROMS database included 448 advanced OSCC patients in stage III or IV (AJCC 8th) with primary tumors between August 2015 and August 2021. Time to diagnosis delay increased from 4.5, 5.3-6.5 months when the Adult Comorbidity Evaluation-27 (ACE-27) worsened from none, mild (RR: 1.155, 1.043-1.279; P = 0.006) to moderate-severe (RR: 1.431, 1.251-1.636; P < 0.001). With the number of comorbidities increased from 0, 1-2 (RR: 1.188, 1.078-1.310; P = 0.001) to 3 (RR: 1.563, 1.296-1.885; P < 0.001), the time to diagnosis delay increased from 4.5, 5.4-7.1 months. As the level and number of comorbidities increased, the likelihood of treatment completion gradually declined, especially in those older than 65 years (P = 0.003). The presence of comorbidity was an independent prognostic factor for disease-free survival (HR: 1.431, 1.022-2.005; P = 0.037). Comorbidities may lead to poorer prognosis by directly causing delays in diagnosis, limiting treatment options, and increasing the risk of death in advanced OSCC patients.
摘要：
这项研究旨在揭示晚期口腔鳞状细胞癌（OSCC）与其合并症之间的潜在机制。从POROMS数据库中提取的数据包括2015年8月至2021年8月期间患有原发性肿瘤的448例III期或IV期（AJCC第8期）晚期OSCC患者。当成人合并症评估-27（ACE-27）从无恶化时，诊断延迟的时间从4.5，5.3-6.5个月增加，轻度（RR：1.155，1.043-1.279；P=0.006）至中度-重度（RR：1.431，1.251-1.636；P<0.001）。随着合并症的数量从0，1-2（RR：1.188，1.078-1.310；P=0.001）增加到3（RR：1.563，1.296-1.885；P<0.001），诊断延迟时间从4.5,5.4-7.1个月增加.随着合并症的水平和数量的增加，治疗完成的可能性逐渐下降，尤其是65岁以上的人群（P=0.003）。合并症的存在是无病生存的独立预后因素(HR:1.431,1.022-2.005;P=0.037)。合并症可能会直接导致诊断延迟，从而导致预后较差。限制治疗选择，并增加晚期OSCC患者的死亡风险。
