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A higher number of natural teeth at the start of treatment emerges as a powerful, accessible prognostic marker that predicts better survival outcomes in patients with locally advanced nasopharyngeal cancer.
A new study by Erkan Topkan et al. has found that the number of natural teeth a patient has before chemoradiotherapy can forecast survival outcomes in locally advanced nasopharyngeal carcinoma (NPC).
NPC remains a clinically challenging head and neck malignancy, and researchers continue to explore simple, real-world predictors that could enhance individualized treatment strategies. Growing evidence suggests that oral health—particularly the integrity of natural dentition—plays a meaningful role in cancer prognosis, yet its relevance in advanced NPC is not fully understood.
Building on these scientific trends, the study aimed to evaluate whether the pretreatment number of natural teeth can serve as a prognostic indicator of progression-free survival (PFS) and overall survival (OS) in patients with locally advanced NPC treated with concurrent chemoradiotherapy. The researchers conducted a retrospective observational analysis of 248 patients diagnosed with locally advanced NPC who received intensity-modulated radiotherapy–based concurrent chemoradiotherapy followed by adjuvant chemotherapy.
Prior to the initiation of chemoradiotherapy, the number of natural teeth for each patient was recorded as part of their pretreatment evaluation. Using receiver operating characteristic (ROC) curve analysis, the optimal threshold of natural teeth predictive of OS and PFS was determined. Based on this cutoff value, patients were stratified into two groups for comparative survival assessment. The team further conducted multivariate analyses to verify whether dentition count independently predicted clinical outcomes after adjusting for confounding variables.
The ROC analysis identified 19.5 teeth as the optimal prognostic cutoff, with an area under the curve (AUC) of 70.6%.
The study showed that patients with fewer than 20 natural teeth before starting chemoradiotherapy faced poorer survival outcomes, positioning natural dentition count as a practical and impactful prognostic biomarker in locally advanced NPC. This accessible indicator offered clinicians an additional layer of risk stratification and highlighted the important interplay between oral health and oncologic prognosis in head and neck cancer care.
Journal of International Medical Research
Prechemoradiotherapy number of natural teeth as a prognostic factor in patients with locally advanced nasopharyngeal cancer: A retrospective observational study
Erkan Topkan et al.
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