Sex differences in prognostic factors and genomic variations in oral squamous cell carcinoma: A 5-year retrospective study

Background/purpose: This study examined the prognostic factors and genomic variations in oral squamous cell carcinoma (OSCC) among male and female patients, focusing on the rising incidence of OSCC in women. Materials and methods: Using data from 98 OSCC cases treated at National Taiwan University Hospital between 2013 and 2018, the study analyzed the patient cohort, clinical characteristics, and genomic profiles. Results: The Female patients had a higher incidence of tongue cancer, while the male patients were prone to have buccal cancer. Key prognostic factors included age over 55 years, tongue cancer, alcohol use in female patients as well as the buccal cancer, betel chewing, and smoking in male patients. Notably, women with tongue OSCC or without oral habits had poorer 5-year survival rates. Genomic analysis revealed the males with high-risk habits had elevated antigen-processing and reactive oxygen gene sets, whereas the low-risk females showed dysregulation in metabolic pathways. Immunologically, the female patients had fewer naïve B cells and higher suppressive M2 macrophages. Conclusion: Our findings highlight distinct sex-related OSCC prognosis differences and suggest that personalized treatments targeting specific risk factors and genomic characteristics may improve the clinical outcomes, particularly for the female OSCC patients.