Nasway Use as an Independent Adverse Prognostic Factor in Oral Squamous Cell Carcinoma: A Retrospective Cohort Study from Uzbekistan
DOI:
https://doi.org/10.66838/J.Carcinog.25.1.671-679Keywords:
Oral squamous cell carcinoma; Naswar; Smokeless tobacco; Prognosis; Survival; Cetuximab; Head and neck cancer.Abstract
Background: Smokeless tobacco products are established carcinogens associated with oral squamous cell carcinoma (OSCC). However, evidence regarding the prognostic significance of naswar—the most widely used smokeless tobacco product in Central Asia—remains limited.
Objective: To evaluate the impact of naswar use on clinicopathological characteristics, treatment outcomes, recurrence, and survival in patients with oral squamous cell carcinoma.
Methods: This retrospective cohort study included 131 patients with morphologically confirmed stage III–IV OSCC treated at the Department of Head and Neck Tumors Surgery of RSSPMCOR between 2018 and 2025. Patients were stratified based on naswar use status. Kaplan–Meier analysis, Cox proportional hazards regression, and multivariable logistic regression were performed.
Results: Naswar users exhibited a significantly higher frequency of leukoplakia, poorly differentiated tumors, cervical lymph node metastasis, and disease recurrence. Multivariable analyses confirmed naswar use as an independent adverse prognostic factor. Patients receiving cetuximab-based comprehensive therapy demonstrated better treatment responses; however, this benefit was attenuated in naswar users.
Conclusions: Naswar use is independently associated with aggressive tumor biology, poor treatment response, and worse long-term survival in OSCC patients. Routine assessment of naswar use should be incorporated into risk stratification models.
