Abstract
Background: Head and neck squamous cell carcinoma (HNSCC) shows wide variation in clinical behavior and outcome, and regional risk factors contribute to that variation. Local clinicopathological data are therefore needed before management strategies can be matched to the population being served. Aims: To analyze tumor characteristics, staging patterns, treatment modalities, and survival outcomes in a cohort of HNSCC patients from Baghdad, Iraq. Methods: We conducted a retrospective analysis of 40 HNSCC patients diagnosed between 2018-2022. Comprehensive data collection included demographics, tumor characteristics, TNM staging (AJCC 8th ed.), histopathological features, treatment modalities, and survival outcomes. Statistical analysis was performed using Kaplan-Meier survival curves, logistic regression, and correlation analysis. Results: The mean patient age was 62.98 years (range: 43-85), with a male predominance (80%). Laryngeal tumors were most prevalent (42.5%). Patients typically presented with large tumors (mean size: 6.94 cm) and aggressive histopathological features, including high rates of lymphovascular invasion (77.5%) and perineural invasion (47.5%). Advanced disease (Stage IV) was present in 50% of cases at diagnosis. Combined multimodal therapy was the most common treatment approach (57.1%). Survival showed a strong negative correlation with tumor stage (p < 0.0001), with Stage IV patients having a median survival of 0.67 years compared to over 4 years for early-stage disease. Conclusion: HNSCC in this Baghdad-based series was usually diagnosed late and showed biologically aggressive features, with correspondingly poor survival. Stage at diagnosis was the dominant prognostic factor. Earlier detection and locally relevant public-health measures targeting the risk profile of the region are needed.