Natural tooth count associated with long-term survival after pancreatic cancer surgery

Dr Kenichiro Uemura, co-author of a recent study examining the association between natural tooth count and long-term survival following pancreatic cancer surgery. (Image: Dr Kenichiro Uemura)

“Pancreatic cancer remains one of the deadliest malignancies worldwide, and even after curative resection, prognosis is often poor,” co-author Dr Kenichiro Uemura, associate professor of surgery at Hiroshima University’s Graduate School of Biomedical and Health Sciences, said in a press release. “Recently, several high-impact studies have suggested that periodontal pathogens such as Porphyromonas gingivalis may contribute to pancreatic carcinogenesis and tumour progression. However, it has remained unclear whether oral health itself influences postoperative survival outcomes in patients with pancreatic cancer.”

The retrospective study included 339 patients who underwent pancreatic resection at Hiroshima University Hospital. The analysis found that patients with fewer natural teeth had significantly shorter overall survival after surgery. The association remained significant after adjustment for established prognostic factors related to tumour characteristics and treatment.

Dr Uemura highlighted the marked survival gap, noting that patients with more natural teeth lived almost two years longer after surgery than those with fewer teeth. He added that masticatory function, assessed by posterior occlusion, was not independently linked to survival. The authors interpreted the contrast with natural tooth count as suggesting that tooth count may reflect cumulative health influences rather than oral status at a single point in time, including chronic inflammation, frailty, nutrition, lifestyle and long‑term systemic vulnerability. “The mouth may reflect the body’s long‑term resilience,” Dr Uemura said.

He explained that the team now aims to validate the findings in larger, multicentre and international studies and to explore the biological links between oral bacteria, chronic inflammation and pancreatic cancer progression. The long‑term goal, Dr Uemura said, is to integrate oral health assessment into personalised risk stratification and perioperative management for pancreatic cancer patients.

The study, titled “Independent prognostic value of natural tooth count versus posterior teeth occlusion in resected pancreatic cancer”, was published online on 23 April 2026 in the Journal of Hepato-Biliary-Pancreatic Sciences, ahead of final publication.