Introduction: Indian subcontinent has a unique problem of oral submucous fibrosis (OSMF), which is related to areca nut chewing usually along with smokeless tobacco. Our astute observation indicated that the oral squamous cell carcinomas (OSCC) arising in the background of OSMF are clinically different from those without OSMF.

Methodology: Consecutive 371 diagnosed OSCC patients undergoing surgery, from June 2010 to April 2011 were included. The diagnosis of OSMF was based on the established clinical criteria. All underwent standard surgery as per their disease status. We analyzed their histopathology reports for certain known prognostic parameters. The data was analyzed by the SPSS software.

Results: One hundred and twelve patients (30.2%) had OSCC arising in the background of OSMF (OC-SMF) and 220 oral cancer patients (69.8%) did not have OSMF (OC). The male female ratio for OC-SMF was 1:10 while for OC it was 1: 3 ( p = 0.001). OC-SMF patients were in younger age ( p = 0.003) and early stages (T1 and T2) ( p = 0.001). Incidences of nodal metastasis and extra-capsular spread were significantly less ( p = 0.0001) and ( p = 0.0002) in OC-SMF group. The mean tumor thickness was significantly low ( p = 0.0001) and tumors were less likely poorly differentiated ( p = 0.001) with primary site as tongue in OC-SMF group ( p = 0.003) (odd’s ratio 2.06).

Discussion: Based on our results we propose that oral cancer patients with SMF are clinico-pathologically different from those without SMF. Since the study is of short duration, we cannot comment on the differential oncologic outcomes of these 2 groups of patients following treatment

Conflict of interest: None declared.