Long-term immunosuppressive therapy for leads to poor outcomes in patients with oral squamous cell carcinoma

Objectives: The number of patients with connective tissue disorders or organ transplants, who are on glucocorticoids and/or immunosuppressive drugs, is increasing. A diagnosis of cancer in these patients is problematic, as the number of available treatment options is limited. This is because of an increased potential for the proliferation of cancer cells and metastasis due to depressed immune function. In this study, we investigated clinical outcomes in patients on immunosuppressive therapy, who subsequently developed oral squamous cell carcinoma (OSCC). Methods: We retrospectively reviewed the medical records of 12 patients identified to be on long-term glucocorticoid and/or immunosuppressive agents, who had undergone surgery for OSCC between January 2008 and March 2017. Controls were reviewed the patients not on long-term glucocorticoid and/or immunosuppressive agents in the same periods. Results: Immunosuppressive therapy was an independent risk factor for distant metastasis (odds ratio, 7.654; P < 0.05). The 5-year overall survival rate was lower in patients who were on immunosuppressive therapy than in those who were not; neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and platelet-to-lymphocyte ratios were also significantly worse in patients on immunosuppressive therapy (all P < 0.05). Conclusion: Patients on long-term immunosuppressive therapy have a relatively poor survival and are at a high risk of distant metastasis.