Clinical correlation and survival analysis of hepatitis B virus infection in oral squamous cell carcinoma: a retrospective study of 1373 patients

Abstract Background Chronic hepatitis B virus (HBV) infection poses a significant global public health challenge and is found closely related to extrahepatic cancers, including head and neck cancer. Oral squamous cell carcinoma (OSCC) is the major category of head and neck cancer. This retrospective...

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Main Authors: Rukeng Tan, Yiyao Zhu, Zengyu Chen, Xinkai Feng, Yujie Liang, Sien Zhang, Nuerbiya Abuduxiku, Guiqing Liao, Le Yang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14188-8
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author Rukeng Tan
Yiyao Zhu
Zengyu Chen
Xinkai Feng
Yujie Liang
Sien Zhang
Nuerbiya Abuduxiku
Guiqing Liao
Le Yang
author_facet Rukeng Tan
Yiyao Zhu
Zengyu Chen
Xinkai Feng
Yujie Liang
Sien Zhang
Nuerbiya Abuduxiku
Guiqing Liao
Le Yang
author_sort Rukeng Tan
collection DOAJ
description Abstract Background Chronic hepatitis B virus (HBV) infection poses a significant global public health challenge and is found closely related to extrahepatic cancers, including head and neck cancer. Oral squamous cell carcinoma (OSCC) is the major category of head and neck cancer. This retrospective study was conducted to explore the clinical correlation and survival analysis of OSCC patients with HBV. Methods The study involved 1,373 patients with OSCC treated at the Hospital of Stomatology, Sun Yat-sen University from 2012 to 2022. Propensity score matching was used to analyze the clinical correlations and survival outcomes, specifically overall survival (OS) and disease-free survival (DFS), in patients with or without hepatitis B surface antigen (HBsAg) seropositivity. Subgroup analyses were conducted for both the early and advanced stages of OSCC. The benefits of neck dissection in OSCC patients with HBV infection were further investigated. Results The prevalence of HBV infection in our cohort was 12.0%. The HBsAg (+) group had a higher percentage of individuals under 60 (73.3% versus 63.7%, p = 0.016). Post-matching for age, sex, pathological T category, pathological N category, and neck dissection, the OSCC patients with HBsAg (+) had lower 5-year OS and DFS rates rather than HBsAg (−) patients, especially those with advanced stage and cervical lymph node metastasis. HBsAg (−) was confirmed as an independent protective prognostic indicator for both OS (hazard ratio [HR] = 0.52; 95% confidence interval [CI] = 0.34–0.79; p = 0.002) and DFS (HR = 0.69, 95% CI = 0.50–0.96; p = 0.027). Notably, elective neck dissection was recognized as an independent protective factor influencing 5-year OS and DFS. While DOI and pathological N category were both confirmed as the risk factors for prognosis. Conclusions HBsAg is a potential prognostic marker for OSCC. It is essential to screen for HBV infection prior to initiating tumor treatment. Additionally, serological testing, antiviral prophylaxis and therapy play crucial roles in preventing HBV reactivation during the course of tumor treatment. In cases of early OSCC associated with HBV infection, elective neck dissection has been shown to reduce the rates of recurrence and metastasis significantly.
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spelling doaj-art-6675d64a69734283ae8df37a16e4cd522025-08-20T02:55:38ZengBMCBMC Cancer1471-24072025-04-0125111310.1186/s12885-025-14188-8Clinical correlation and survival analysis of hepatitis B virus infection in oral squamous cell carcinoma: a retrospective study of 1373 patientsRukeng Tan0Yiyao Zhu1Zengyu Chen2Xinkai Feng3Yujie Liang4Sien Zhang5Nuerbiya Abuduxiku6Guiqing Liao7Le Yang8Hospital of Stomatology, Sun Yat-sen UniversityHospital of Stomatology, Sun Yat-sen UniversityHospital of Stomatology, Sun Yat-sen UniversityHospital of Stomatology, Sun Yat-sen UniversityHospital of Stomatology, Sun Yat-sen UniversityHospital of Stomatology, Sun Yat-sen UniversityThe First People’s Hospital of Kashi Area, Xinjiang Uygur Autonomous RegionHospital of Stomatology, Sun Yat-sen UniversityHospital of Stomatology, Sun Yat-sen UniversityAbstract Background Chronic hepatitis B virus (HBV) infection poses a significant global public health challenge and is found closely related to extrahepatic cancers, including head and neck cancer. Oral squamous cell carcinoma (OSCC) is the major category of head and neck cancer. This retrospective study was conducted to explore the clinical correlation and survival analysis of OSCC patients with HBV. Methods The study involved 1,373 patients with OSCC treated at the Hospital of Stomatology, Sun Yat-sen University from 2012 to 2022. Propensity score matching was used to analyze the clinical correlations and survival outcomes, specifically overall survival (OS) and disease-free survival (DFS), in patients with or without hepatitis B surface antigen (HBsAg) seropositivity. Subgroup analyses were conducted for both the early and advanced stages of OSCC. The benefits of neck dissection in OSCC patients with HBV infection were further investigated. Results The prevalence of HBV infection in our cohort was 12.0%. The HBsAg (+) group had a higher percentage of individuals under 60 (73.3% versus 63.7%, p = 0.016). Post-matching for age, sex, pathological T category, pathological N category, and neck dissection, the OSCC patients with HBsAg (+) had lower 5-year OS and DFS rates rather than HBsAg (−) patients, especially those with advanced stage and cervical lymph node metastasis. HBsAg (−) was confirmed as an independent protective prognostic indicator for both OS (hazard ratio [HR] = 0.52; 95% confidence interval [CI] = 0.34–0.79; p = 0.002) and DFS (HR = 0.69, 95% CI = 0.50–0.96; p = 0.027). Notably, elective neck dissection was recognized as an independent protective factor influencing 5-year OS and DFS. While DOI and pathological N category were both confirmed as the risk factors for prognosis. Conclusions HBsAg is a potential prognostic marker for OSCC. It is essential to screen for HBV infection prior to initiating tumor treatment. Additionally, serological testing, antiviral prophylaxis and therapy play crucial roles in preventing HBV reactivation during the course of tumor treatment. In cases of early OSCC associated with HBV infection, elective neck dissection has been shown to reduce the rates of recurrence and metastasis significantly.https://doi.org/10.1186/s12885-025-14188-8Hepatitis B virusHead and neck cancerOral squamous cell carcinomaPropensity score matchingNeck dissection
spellingShingle Rukeng Tan
Yiyao Zhu
Zengyu Chen
Xinkai Feng
Yujie Liang
Sien Zhang
Nuerbiya Abuduxiku
Guiqing Liao
Le Yang
Clinical correlation and survival analysis of hepatitis B virus infection in oral squamous cell carcinoma: a retrospective study of 1373 patients
BMC Cancer
Hepatitis B virus
Head and neck cancer
Oral squamous cell carcinoma
Propensity score matching
Neck dissection
title Clinical correlation and survival analysis of hepatitis B virus infection in oral squamous cell carcinoma: a retrospective study of 1373 patients
title_full Clinical correlation and survival analysis of hepatitis B virus infection in oral squamous cell carcinoma: a retrospective study of 1373 patients
title_fullStr Clinical correlation and survival analysis of hepatitis B virus infection in oral squamous cell carcinoma: a retrospective study of 1373 patients
title_full_unstemmed Clinical correlation and survival analysis of hepatitis B virus infection in oral squamous cell carcinoma: a retrospective study of 1373 patients
title_short Clinical correlation and survival analysis of hepatitis B virus infection in oral squamous cell carcinoma: a retrospective study of 1373 patients
title_sort clinical correlation and survival analysis of hepatitis b virus infection in oral squamous cell carcinoma a retrospective study of 1373 patients
topic Hepatitis B virus
Head and neck cancer
Oral squamous cell carcinoma
Propensity score matching
Neck dissection
url https://doi.org/10.1186/s12885-025-14188-8
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