Analytical Study of Oral Cancer Staging at Presentation and Its Relationship to Survival in South East Nigeria

Late-stage presentation is the primary determinant of poor oral cancer survival in Nigeria, and analytical characterisation of staging patterns and their survival correlates in South East Nigeria provides evidence for early detection investment. This study analysed oral cancer staging at presentation and its relationship to 2-year survival among patients diagnosed with oral squamous cell carcinoma at three teaching hospitals in Enugu, Imo, and Anambra States from 2018 to 2023. A retrospective cohort study was conducted using hospital oncology and pathology records. TNM staging at diagnosis was determined from diagnostic reports. Treatment received, time from symptom onset to diagnosis, and 2-year survival status were extracted. A total of 127 confirmed OSCC cases were analysed. Late-stage presentation (Stage III or IV) was present in 74.0 percent. Time from first symptom to diagnosis averaged 8.4 months. Two-year overall survival was 31.5 percent. Patients presenting at Stage I or II showed significantly better 2-year survival (68.4 percent) versus Stage III-IV (21.3 percent, log-rank p < 0.001). Stage IV patients had a 6.8 times higher mortality hazard than Stage I-II patients (HR = 6.82, 95% CI: 2.94 to 15.84). Traditional healer consultation before hospital referral was documented in 42.5 percent and significantly delayed diagnosis. The study confirms late-stage presentation as the primary barrier to improved survival outcomes and recommends community oral cancer awareness campaigns, mandatory visual inspection at PHC level, and fast-track biopsy pathways at state hospitals. Keywords: oral squamous cell carcinoma, staging, survival, South East Nigeria, early detection