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Yüce I, Oflaz Çapar A, Çetinaslan V, Deniz K, Vural A, Çağlı S, Doğan S, Gündoğ M. The Depth of Invasion and Level IV Cervical Node Metastasis in Patients with Clinically N0 Tongue Cancer. Head Neck Pathol 2024; 18:41. [PMID: 38727801 PMCID: PMC11087439 DOI: 10.1007/s12105-024-01647-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND The accurate indication for level IV dissection is crucial for preventing complications such as phrenic nerve damage and chylous fistulas in clinically N0 tongue cancer. Although the depth of invasion is an established independent risk factor for occult lymph node metastasis in tongue cancer, its relationship with level IV metastasis has not been evaluated. This study investigated the relationship between the depth of invasion and level IV nodal metastasis in clinically N0 tongue cancer. METHODS We retrospectively investigated clinical N0 patients who underwent glossectomy and level I-IV neck dissection. We examined lymph node metastasis, risk factors, and the relationship between depth of invasion and metastasis. RESULTS Our study included 58 patients, and no patient had isolated level IV metastasis. Additionally, there was no level IV metastasis in well-differentiated tumors. Tumor size, depth of invasion, differentiation, and perineural invasion were significantly associated with level IV neck metastasis. We found a critical tumor size of 2.5 cm and depth of invasion of 8 mm for level IV neck metastasis. CONCLUSION Based on our findings, we recommend that level IV dissection should be considered for poorly differentiated tumors, tumors greater than 2.5 cm in size, and those deeper than 8 mm. This study highlights the importance of depth of invasion as a prognostic factor for predicting level IV metastasis and suggests that our findings can be used to prevent unnecessary level IV dissections that may lead to complications in tongue cancer surgery.
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Affiliation(s)
- Imdat Yüce
- Department of Otorhinolaryngology Head and Neck Surgery, Erciyes University, Kayseri, Turkey
| | - Aslıhan Oflaz Çapar
- Department of Otorhinolaryngology Head and Neck Surgery, Erciyes University, Kayseri, Turkey.
| | - Veli Çetinaslan
- Department of Otorhinolaryngology Head and Neck Surgery, Erciyes University, Kayseri, Turkey
- Department of Otorhinolaryngology, Medicana Bahçelievler Hospital, Istanbul, Turkey
| | - Kemal Deniz
- Department of Pathology, Erciyes University, Kayseri, Turkey
| | - Alperen Vural
- Department of Otorhinolaryngology Head and Neck, Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Sedat Çağlı
- Department of Otorhinolaryngology Head and Neck Surgery, Erciyes University, Kayseri, Turkey
| | - Serap Doğan
- Department of Radiodiagnostics, Erciyes University, Kayseri, Turkey
| | - Mete Gündoğ
- Department of Radiation Oncology, Erciyes University, Kayseri, Turkey
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Yosefof E, Tsur N, Zavdy O, Kurman N, Dudkiewicz D, Yehuda M, Bachar G, Shpitzer T, Mizrachi A, Tzelnick S. Prognostic Significance of Regional Disease in Young Patients with Oral Cancer: A Comparative Study. Laryngoscope 2024; 134:2212-2220. [PMID: 37965942 DOI: 10.1002/lary.31187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Regional metastases are considered the most important prognostic factor in OSCC patients. We aimed to investigate the impact of regional disease among different age groups with OSCC. METHODS A retrospective comparison between patients 40 years old or younger, 41-69 years old, and 70 years or older treated for OSCC between 2000 and 2020 in a tertiary-care center. RESULTS 279 patients were included. The mean age was 65 ± 17.7 and 133 were male (47.7%). Thirty-six (12.9%) were 40 years old or younger, 101 (36.2%) were 41-69 years and 142 (50.9%) were 70 years or older. Five-year overall survival and disease-specific survival (DSS) were significantly better among patients younger than 40 compared to the mid-age group and patients 70 years or older (76.7% vs. 69.4% vs.48.2%, Log-rank p < 0.001, and 76.7% vs. 75.3% vs. 46.5%, Log-rank p < 0.001, respectively). While an association between regional spread and overall survival and DSS was demonstrated among all age groups, the odds ratio (OR) for death of any cause and death of disease regarding cervical metastasis was much higher among patients younger than 40 compared with the 41-69 and 70+ age groups (death of any cause-OR = 23, p-value = 0.008, OR = 2.6, p-value = 0.026, OR = 2.4, p-value = 0.13, respectively. Death of disease-OR = 23, p-value = 0.008, OR = 2.3, p-value = 0.082, OR = 4.1, p-value = 0.001, respectively). In univariate analysis, regional metastasis was associated with disease-free survival only among patients younger than 40 (p-value = 0.04). CONCLUSIONS Regional metastases correspond with worse prognosis in young patients compared to older patients. These patients may benefit from a comprehensive treatment approach with close post-treatment follow-up. LEVEL OF EVIDENCE 3 Laryngoscope, 134:2212-2220, 2024.
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Affiliation(s)
- Eyal Yosefof
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nir Tsur
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofir Zavdy
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noga Kurman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel
| | - Dean Dudkiewicz
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Yehuda
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gideon Bachar
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Thomas Shpitzer
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviram Mizrachi
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Tzelnick
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Min F, Qiu P, Zhu X, Zhou B, Lin Z, Pan C, Wang Y. Modified submandibular mandibulotomy approach versus lip-splitting approach in tongue cancer surgery: a retrospective paired-cohort study. Clin Oral Investig 2023; 28:32. [PMID: 38147089 DOI: 10.1007/s00784-023-05395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/05/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES The surgical approach for resection and reconstruction of tongue cancer (TSCC) with or without the lip-splitting incision is controversial. This study introduced a modified approach without lip-splitting and the clinical results were assessed. METHODS Sixty-eight TSCC patients underwent surgery using the modified submandibular mandibulotomy (MSMM) approach without lip-splitting, and another matched 68 patients using lip-splitting mandibulotomy (LSM) approach were enrolled in this study. The clinical results including intraoperative relevance and surgical morbidities, survival status, facial appearance and scar scores, function of lower lip, and quality of life (QOL) were evaluated. RESULTS The primary tumors were en bloc resected through the MSMM approach with excellent tumor exposure and R0 resection margins as LSM approach. The survival status and complications were similar in both groups. The function of lower lip was better in patients of MSMM group at 1 month after surgery. The MSMM approach was associated with significantly better facial appearance and recreation compared to LSM approach by scar scores and QOL assessment. CONCLUSION The MSMM approach without lip-splitting achieves similar tumor control, better aesthetic results, and QOL compared to LSM approach. It is a safe and effective surgical approach for patients with TSCC. CLINICAL RELEVANCE The MSMM approach without lip-splitting is oncological safety in tongue cancer surgery and is scrutinized as one part of the treatment concept for better aesthetic results.
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Affiliation(s)
- Fu Min
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Rd, Guangzhou City, 510120, China
- The Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou City, China
| | - Pingping Qiu
- Dpartment of Anesthesiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou City, China
| | - Xianbei Zhu
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Rd, Guangzhou City, 510120, China
- The Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou City, China
| | - Bin Zhou
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Rd, Guangzhou City, 510120, China
- The Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou City, China
| | - Zhaoyu Lin
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Rd, Guangzhou City, 510120, China
- The Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou City, China
| | - Chaobin Pan
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Rd, Guangzhou City, 510120, China
| | - Youyuan Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Rd, Guangzhou City, 510120, China.
- The Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou City, China.
- Craniomaxillofacial Surgery Center, Sun Yat-Sen University, Guangzhou City, China.
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Li CX, Wang ZY, Tong QY, Li MQ, Wei W, Gong ZC. Effect of Prognostic Factors of Postoperative Radiotherapy in Oral Squamous Cell Carcinoma: A SEER-Based Study. EAR, NOSE & THROAT JOURNAL 2023:1455613231210388. [PMID: 37994533 DOI: 10.1177/01455613231210388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Abstract
Objective: The treatment of oral squamous cell carcinoma (OSCC) is dominated by surgery and radiochemotherapy, but its prognosis is still unsatisfactory, with around five tenths of 5-year survival. This study aimed to assess the prognosis of OSCC patients treated with surgery with and without postoperative radiotherapy. Study Design: Retrospective study. Methods: The clinicopathological information and follow-up datasets on patients with OSCC (T1-4 and/or N+) registered from 2010 to 2015 were downloaded from the Surveillance, Epidemiology, and End Results database. Totally 7231 enrolled subjects were divided into a case group (surgery alone, n = 4167) and a control group (surgery combined with postoperative radiotherapy, n = 3064). One-to-one matching was performed by propensity score matching to make the baseline data comparable between the 2 subgroups. Multivariate Cox regression analysis was used to calculate hazard ratios (HR) of various clinicopathological features. The Kaplan-Meier method and log-rank test were used to plot the survival curves. Results: The majority of patients in case group were tumor stage I (n = 2569, 61.7%), whereas most patients in control group were stages III to IV (n = 2360, 77.1%). In the case group, the 1-, 3-, and 5-year overall survival (OS; 76%, 59.5%, 53.7%) were significantly lower than those of the control group (85.1%, 64.1%, 55.8%; P < .0001). Similarly, the 1-, 3-, and 5-year cancer-specific survival (CSS) of the case group (80.2%, 66.6%, 63.3%) were significantly lower than those of the control group (87.2%, 69.3%, 63.9%, respectively; P < .0001). Cox multivariate analysis indicated that age, differentiation, clinical stage, and tumor-node-metastasis stage affected the prognosis of OSCC patients, while postoperative radiotherapy was a protective factor (OS: HR = 0.649, P < .001; CSS: HR = 0.702, P < .001). Conclusions: Postoperative radiation was an independent protective factor, hence, the combination of surgery plus radiotherapy is more beneficial for the survival of patients with OSCC, particularly for advanced cases.
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Affiliation(s)
- Chen-Xi Li
- Department of Oral and Maxillofacial Oncology & Surgery, School / Hospital of Stomatology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zheng-Ye Wang
- Department of Preventive Medicine, College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Qiao-Ying Tong
- Department of Oral and Maxillofacial Oncology & Surgery, School / Hospital of Stomatology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Mu-Qiu Li
- Department of Oral and Maxillofacial Oncology & Surgery, School / Hospital of Stomatology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Wei Wei
- Department of Oral and Maxillofacial Oncology & Surgery, School / Hospital of Stomatology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Zhong-Cheng Gong
- Department of Oral and Maxillofacial Oncology & Surgery, School / Hospital of Stomatology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, China
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Qin Z, Hu Z, Huang B, Wang F, Pan H, He X, Yin L. Construction and application of dynamic online nomogram for prognosis prediction of patients with advanced (Stage III/IV) tongue squamous cell carcinoma. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101477. [PMID: 37080357 DOI: 10.1016/j.jormas.2023.101477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES The prognosis of patients with advanced tongue squamous cell carcinoma (ATSCC) is poor, and their overall survival (OS) is relatively short. Currently, the TNM stage system is often used clinically to assess the prognosis of patients, but the evaluation index of the TNM stage system is relatively single and does not specifically demonstrate relevant prognostic data. Therefore, the purpose of this study was to construct a dynamic online nomogram for predicting the prognosis of patients with ATSCC and to provide some reference for personalized clinical treatment of patients. METHODS Clinical and prognostic information on patients with pathologically confirmed ATSCC from 2000 to 2018 was extracted from the SEER database and randomly divided into a training cohort and a validation cohort in a 7:3 ratio. Multifactorial and univariate Cox regression analyses were used to identify prognostic risk factors. Dynamic online nomogram were constructed using R software. Area under the curve (AUC), C-index, calibration curve, and decision curve analysis (DCA) with time-dependent ROC curves were used to assess the clinical utility of the nomogram. Kaplan-Meier survival curves were used to compare the prognosis of different patient categories. RESULTS A total of 3828 patients with ATSCC were screened in the SEER database.Age,race, primary site, AJCC T,N and M stage, lymph nodes surgery, radiotherapy, chemotherapy and marital status were independent influences on OS(P < 0.05). In the training cohort, the C-index of the OS-related line plot was 0.733 and the AUC for predicting 3-year OS was 0.867. In the validation cohort, the C-index was 0.738 and the AUC for 3-year OS was 0.899. Calibration plots and DCA curves showed good predictive performance of the model in both the training and validation cohorts. Kaplan-Meier survival curves showed that chemotherapy, lymph nodes surgery,married,primary site(tongue base) and radiotherapy had better OS than the non-chemotherapy, non-surgery, single, primary site(tongue anterior), and non-radiotherapy groups, respectively (all P < 0.05). CONCLUSION The established dynamic online nomogram has good predictive performance, which helps to personalize and combine the actual clinical patients to comprehensively predict the prognosis of ATSCC patients and may have better clinical application than the TNM stage system.
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Affiliation(s)
- Zishun Qin
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China; School/Hospital of Stomatology, Lanzhou university, Lanzhou 730000, China
| | - Zonghao Hu
- School/Hospital of Stomatology, Lanzhou university, Lanzhou 730000, China
| | - Benheng Huang
- School/Hospital of Stomatology, Lanzhou university, Lanzhou 730000, China
| | - Feng Wang
- School/Hospital of Stomatology, Lanzhou university, Lanzhou 730000, China
| | - Hongwei Pan
- School/Hospital of Stomatology, Lanzhou university, Lanzhou 730000, China
| | - Xuxia He
- School/Hospital of Stomatology, Lanzhou university, Lanzhou 730000, China; The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
| | - Lihua Yin
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China; School/Hospital of Stomatology, Lanzhou university, Lanzhou 730000, China.
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Jonasson K, Sjövall J, Holmberg E, Beran M, Niklasson M, Kristiánsson S, Sandström K, Wennerberg J. Squamous cell carcinoma of the mobile tongue in young adults: A Swedish head & neck cancer register (SweHNCR) population-based analysis of prognosis in relation to age and stage. Oral Oncol 2023; 144:106485. [PMID: 37451141 DOI: 10.1016/j.oraloncology.2023.106485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
Increased incidence of squamous cell carcinoma (SCC) of the tongue has been reported in young adults (YA) in several countries since the 1980s and confirmed in later studies. The etiology is unclear, the prognosis has been debated, and conflicting results have been published. Some studies show better survival in young adults than in older patients, some worse, and others no difference. Most studies are based on selected series or include other sites in the oral cavity. The definition of "YA" is arbitrary and varies between studies. It is thus difficult to use in general conclusions. This work uses data from the population-based Swedish Head and Neck Cancer register (SweHNCR), which has > 98% coverage. SweHNCR data includes age, gender, TNM, treatment intention, treatment given, lead times, performance status, and to a lesser degree, smoking habits. The current Swedish population is around 10 million. We analyzed outcomes for 1416 patients diagnosed with SCC of the oral tongue from 2008 to 2017 using 18-39 years to define YA age because it is the range most commonly used. We found no significant difference in relative survival (a proxy for diagnosis-specific survival) between age groups of patients treated with curative intent for SCC of the oral tongue. The stage at time of diagnosis was equally distributed among the age groups. Excess mortality rate correlated mainly with stage, subsite of the tongue, performance status, and lead time to treatment.
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Affiliation(s)
| | - Johanna Sjövall
- Dept of Otolaryngology/H&N Surgery, Department of Clinical Sciences, Lund, Lund University and Skåne University Hospital, Lund, Sweden.
| | - Erik Holmberg
- Regional Cancer Centre West, Western Sweden Healthcare Region, Gothenburg, Sweden; The Swedish Head and Neck Cancer Register (SweHNCR), Sweden
| | - Martin Beran
- The Swedish Head and Neck Cancer Register (SweHNCR), Sweden; Department of ENT and Maxillofacial Surgery, NAL Medical Center Hospital, Trollhättan, Sweden
| | - Magnus Niklasson
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stefan Kristiánsson
- Department of Otorhinolaryngology, Head and Neck Surgery, Örebro University Hospital, Örebro, Sweden
| | - Karl Sandström
- Otolaryngology, Department of Surgical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
| | - Johan Wennerberg
- Dept of Otolaryngology/H&N Surgery, Department of Clinical Sciences, Lund, Lund University and Skåne University Hospital, Lund, Sweden
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Abed H. Dental considerations for head and neck cancer: A clinical review. Saudi Dent J 2023; 35:476-486. [PMID: 37520601 PMCID: PMC10373080 DOI: 10.1016/j.sdentj.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/10/2023] [Accepted: 05/14/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Radiotherapy is one of the treatment modalities for the treatment of head and neck cancer (HNC). However, it leads to the development of chronic and acute side effects. These side effects impact negatively on the patient's quality of life and oral functioning. This clinical review aims to provide basic information about HNC, understand the impact of radiotherapy on oral health, and explain the role of dental care providers for HNC patients during the pre-and post-radiotherapy time. Materials and Methods Electronic databases (i.e., PubMed, Scopus, and Google Scholar) were searched using defined keywords. The main inclusion criteria were any studies describing "dental management of patients with head and neck cancer" and "dental management of patients treated with radiotherapy." Results Thematic analysis was used to summaries the findings of the included studies (n = 102) into main headings and subheadings. All studies were published between 1970 and 2023. Conclusion The number of HNC patients is increasing. This necessitates the need for raising the awareness of dental care providers to the side-effects of HNC therapy which includes treatment with radiotherapy, chemotherapy, and/or surgery. Dental care providers should understand the common side-effects and their treatments besides their role in the pre- (i.e., dental extraction of teeth with poor prognosis and maintaining good oral hygiene) and post- (i.e., oral rehabilitation and post-HNC dental care) radiotherapy dental care.
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Alexidis P, Kolias P, Mentesidou V, Topalidou M, Kamperis E, Giannouzakos V, Efthymiadis K, Bangeas P, Timotheadou E. Investigating Predictive Factors of Dysphagia and Treatment Prolongation in Patients with Oral Cavity or Oropharyngeal Cancer Receiving Radiation Therapy Concurrently with Chemotherapy. Curr Oncol 2023; 30:5168-5178. [PMID: 37232849 DOI: 10.3390/curroncol30050391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/20/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
Radiation therapy (RT) treatment for head and neck cancer has been associated with dysphagia manifestation leading to worse outcomes and decrease in life quality. In this study, we investigated factors leading to dysphagia and treatment prolongation in patients with primaries arising from oral cavity or oropharynx that were submitted to radiation therapy concurrently with chemotherapy. The records of patients with oral cavity or oropharyngeal cancer that received RT treatment to the primary and bilateral neck lymph nodes concurrently with chemotherapy were retrospectively reviewed. Logistic regression models were used to analyze the potential correlation between explanatory variables and the primary (dysphagia ≥ 2) and secondary (prolongation of total treatment duration ≥ 7 days) outcomes of interest. The Toxicity Criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) were used to evaluate dysphagia. A total of 160 patients were included in the study. Age mean was 63.31 (SD = 8.24). Dysphagia grade ≥ 2 was observed in 76 (47.5%) patients, while 32 (20%) experienced treatment prolongation ≥ 7 days. The logistic regression analysis showed that the volume in the primary site of disease that received dose ≥ 60 Gy (≥118.75 cc, p < 0.001, (OR = 8.43, 95% CI [3.51-20.26]) and mean dose to the pharyngeal constrictor muscles > 40.6 Gy (p < 0.001, OR = 11.58, 95% CI [4.84-27.71]) were significantly associated with dysphagia grade ≥ 2. Treatment prolongation ≥ 7 days was predicted by higher age (p = 0.007, OR = 1.079, 95% CI [1.021-1.140]) and development of grade ≥ 2 dysphagia (p = 0.005, OR = 4.02, 95% CI [1.53-10.53]). In patients with oral cavity or oropharyngeal cancer that receive bilateral neck irradiation concurrently with chemotherapy, constrictors mean dose and the volume in the primary site receiving ≥ 60 Gy should be kept below 40.6 Gy and 118.75 cc, respectively, whenever possible. Elderly patients or those that are considered at high risk for dysphagia manifestation are more likely to experience treatment prolongation ≥ 7 days and they should be closely monitored during treatment course for nutritional support and pain management.
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Affiliation(s)
- Petros Alexidis
- Radiation Oncologist, Department of Radiation Oncology, Papageorgiou Hospital, 56429 Thessaloniki, Greece
| | - Pavlos Kolias
- Section of Statistics and Operational Research, Department of Mathematics, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
| | - Vaia Mentesidou
- Medical Oncology Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece
| | - Maria Topalidou
- Radiation Oncologist, Department of Radiation Oncology, Papageorgiou Hospital, 56429 Thessaloniki, Greece
| | - Efstathios Kamperis
- Radiation Oncologist, Department of Radiation Oncology, Papageorgiou Hospital, 56429 Thessaloniki, Greece
| | - Vasileios Giannouzakos
- Radiation Oncologist, Department of Radiation Oncology, Papageorgiou Hospital, 56429 Thessaloniki, Greece
| | - Konstantinos Efthymiadis
- Medical Oncology Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece
| | - Petros Bangeas
- 1st University Surgery Department, Nanomedicine and Nanotechnology Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece
| | - Eleni Timotheadou
- Medical Oncologist, Medical Oncology Clinic Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece
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Zulijani A, Milardović A, Kovač Z, Perić B, Jakovac H. Megalin Expression in Primary Oral Squamous Cell Carcinoma Is Associated with the Presence of Lymph Node Metastases, Vascular Invasion, and Lower Overall Survival. Curr Issues Mol Biol 2023; 45:2757-2766. [PMID: 37185704 PMCID: PMC10136934 DOI: 10.3390/cimb45040180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Megalin (LRP2) is a rapidly recycling multiligand endocytic receptor primarily expressed in polarized epithelial cells. Although megalin might be involved in tumor growth and invasiveness through several mechanisms, its role has been understudied in the field of molecular oncology so far. The present study aimed to evaluate the impact of megalin expression in oral squamous cell carcinoma (OSCC) on disease progression. Megalin expression was evaluated immunohistochemically in 63 OSCC specimens. Data obtained were retrospectively compared with patient clinicopathological features and their survival. The proportion of megalin-expressing cells in the primary OSCC tissue was significantly associated with metastatic spreading to lymph nodes, vascular invasion and lower overall survival rate. Results obtained by the study suggest that megalin can be considered as a novel molecule involved in OSCC pathogenesis, but also useful as a potential biomarker for cancer progression.
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10
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Piyarathne NS, Weerasekera MM, Fonseka PFD, Karunatilleke AHTS, Liyanage RLPR, Jayasinghe RD, De Silva K, Yasawardene S, Gupta E, Jayasinghe JAP, Abu-Eid R. Salivary Interleukin Levels in Oral Squamous Cell Carcinoma and Oral Epithelial Dysplasia: Findings from a Sri Lankan Study. Cancers (Basel) 2023; 15:cancers15051510. [PMID: 36900301 PMCID: PMC10001283 DOI: 10.3390/cancers15051510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
The incidence of oral squamous cell carcinoma (OSCC), and its precursor, oral epithelial dysplasia (OED), is on the rise, especially in South Asia. OSCC is the leading cancer in males in Sri Lanka, with >80% diagnosed at advanced clinical stages. Early detection is paramount to improve patient outcome, and saliva testing is a promising non-invasive tool. The aim of this study was to assess salivary interleukins (lL1β, IL6, and IL8) in OSCC, OED and disease-free controls in a Sri Lankan study cohort. A case-control study with OSCC (n = 37), OED (n = 30) patients and disease-free controls (n = 30) was conducted. Salivary lL1β, IL6, and IL8 were quantified using enzyme-linked immuno-sorbent assay. Comparisons between different diagnostic groups and potential correlations to risk factors were assessed. Salivary levels for the three tested interleukins increased from disease-free controls through OED, and were highest in OSCC samples. Furthermore, the levels of IL1β, IL6, and IL8 increased progressively with OED grade. The discrimination between patients (OSCC and OED) and controls, as assessed by AUC of receiver operating characteristic curves, was 0.9 for IL8 (p = 0.0001) and 0.8 for IL6 (p = 0.0001), while IL1β differentiated OSCC from controls (AUC 0.7, p = 0.006). No significant associations were found between salivary interleukin levels and smoking, alcohol, and betel quid risk factors. Our findings suggest that salivary IL1β, IL6, and IL8 are associated with disease severity of OED, and are potential biomarkers for predicting disease progression in OED, and the screening of OSCC.
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Affiliation(s)
- Nadisha S. Piyarathne
- Institute of Dentistry, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZR, UK
- Center for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Manjula M. Weerasekera
- Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
- Sri Lanka Institute of Biotechnology, Pitipana, Homagama 10206, Sri Lanka
| | | | | | | | - Ruwan Duminda Jayasinghe
- Center for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | | | - Surangi Yasawardene
- Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
| | - Ekta Gupta
- Institute of Dentistry, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZR, UK
| | | | - Rasha Abu-Eid
- Institute of Dentistry, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZR, UK
- Aberdeen Cancer Centre, University of Aberdeen, Aberdeen AB25 2ZR, UK
- Correspondence:
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11
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A Novel Tongue Squamous Cell Carcinoma Cell Line Escapes from Immune Recognition due to Genetic Alterations in HLA Class I Complex. Cells 2022; 12:cells12010035. [PMID: 36611830 PMCID: PMC9818362 DOI: 10.3390/cells12010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Immune checkpoint inhibitors (ICI) have made progress in the field of anticancer treatment, but a certain number of PD-L1 negative OSCC patients still have limited benefits from ICI immuno-therapy because of primary immune evasion due to immunodeficiency. However, in existing human OSCC cell lines, cell models that can be used to study immunodeficiency have not been reported. The objective of this study was to establish a PD-L1 negative OSCC cell line, profile whether the presence of mutated genes is associated with immune deficiency, and explore its influence on the immune recognition of CD8+ T cells in vitro. Here, we established a novel tongue SCC cell line (WU-TSC-1), which escapes from immune recognition by antigen presentation defects. This cell line was from a female patient who lacked typical causative factors. The expression of PD-L1 was negative in the WU-TSC-1 primary tumor, transplanted tumor, cultured cells and lipopolysaccharide stimulation. Whole exome sequencing (WES) revealed that WU-TSC-1 harbored missense mutations, loss of copy number and structural variations in human leukocyte antigen (HLA) class I/II genes. The tumor mutation burden (TMB) score was high at 292.28. In addition, loss of heterozygosity at beta-2-microglobulin (B2M)-a component of all HLA class I complex allotypes-was detected. Compared with the commonly used OSCC cell lines, genetic alterations in HLA class I and B2M impeded the proteins' translation and inhibited the activation and killing effect of CD8+ T cells. In all, the WU-TSC-1 cell line is characterized by genetic variations and functional defects of the HLA class I complex, leading to escape from recognition by CD8+ T cells.
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12
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Qiu L, Tao A, Liu F, Ge X, Li C. Potential prognostic value of a eight ferroptosis-related lncRNAs model and the correlative immune activity in oral squamous cell carcinoma. BMC Genom Data 2022; 23:80. [PMID: 36384476 PMCID: PMC9667687 DOI: 10.1186/s12863-022-01097-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022] Open
Abstract
Background To investigate the prognostic value of ferroptosis-related long noncoding RNAs (lncRNAs) in oral squamous cell carcinoma (OSCC) and to construct a prognostic risk and immune activity model. Methods We obtained clinical and RNA-seq information on OSCC patient data in The Cancer Genome Atlas (TCGA) Genome Data Sharing (GDC) portal. Through a combination of a differential analysis, Pearson correlation analysis and Cox regression analysis, ferroptosis-related lncRNAs were identified, and a prognostic model was established based on these ferroptosis-related lncRNAs. The accuracy of the model was evaluated via analyses based on survival curves, receiver operating characteristic (ROC) curves, and clinical decision curve analysis (DCA). Univariate Cox and multivariate Cox regression analyses were performed to evaluate independent prognostic factors. Then, the infiltration and functional enrichment of immune cells in high- and low-risk groups were compared. Finally, certain small-molecule drugs that potentially target OSCC were predicted via use of the L1000FWD database. Results The prognostic model included 8 ferroptosis-related lncRNAs (FIRRE, LINC01305, AC099850.3, AL512274.1, AC090246.1, MIAT, AC079921.2 and LINC00524). The area under the ROC curve (AUC) was 0.726. The DCA revealed that the risk score based on the prognostic model was a better prognostic indicator than other clinical indicators. The multivariate Cox regression analysis showed that the risk score was an independent prognostic factor for OSCC. There were differences in immune cell infiltration, immune functions, m6A-related gene expression levels, and signal pathway enrichment between the high- and low-risk groups. Subsequently, several small-molecule drugs were predicted for use against differentially expressed ferroptosis-related genes in OSCC. Conclusions We constructed a new prognostic model of OSCC based on ferroptosis-related lncRNAs. The model is valuable for prognostic prediction and immune evaluation, laying a foundation for the study of ferroptosis-related lncRNAs in OSCC. Supplementary Information The online version contains supplementary material available at 10.1186/s12863-022-01097-z.
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13
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Batistella EÂ, Gondak R, Rivero ERC, Warnakulasuriya S, Guerra E, Porporatti AL, De Luca Canto G. Comparison of tobacco and alcohol consumption in young and older patients with oral squamous cell carcinoma: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:6855-6869. [PMID: 36131100 DOI: 10.1007/s00784-022-04719-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the proportion of young (up to 45 years of age) and older (over 45 years of age) oral squamous cell carcinoma (OSCC) patients who report tobacco and alcohol consumption. METHODS Observational studies reporting tobacco and alcohol consumption among young and older OSCC patients were selected in a two-phase process. Search strategies were conducted on five main electronic databases and complemented by grey literature. The risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data. Synthesis of results was calculated with the software R Statistics version 4.0.2 (The R Foundation). RESULTS From 6675 records identified, 38 studies met the eligibility criteria and were selected for qualitative synthesis and meta-analysis, encompassing 2439 young and 13,393 older patients. Tobacco smoking was reported by 39.5% (confidence interval (CI) = 31.7% to 47.9%, I2 = 78%) of the young patients and 48.4% (CI = 37.8% to 59.2%, I2 = 94%) of the older patients. Alcohol consumption was reported by 30.9% (CI = 22.7% to 40.5%, I2 = 83%) of the young and 45.8% (CI = 35.6% to 56.5%, I2 = 95%) of the older patients (P < 0.05). CONCLUSION The comparison in the proportion of individuals reporting tobacco and alcohol consumption demonstrated that these habits were more prevalent in the older group (48.4% and 45.8% respectively) than in the young group (39.5% and 30.9%, respectively). CLINICAL RELEVANCE As a significant proportion of patients with OSCC reported no habits, novel risk factors for OSCC need to be investigated in further research.
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Affiliation(s)
- Elis Ângela Batistella
- Health Sciences Center, Federal University of Santa Catarina, Rector David Ferreira Lima Campus, Trindade, Florianopolis, SC, 88037150, Brazil.
| | - Rogério Gondak
- Department of Pathology, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Elena Riet Correa Rivero
- Department of Pathology, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Saman Warnakulasuriya
- Department of Oral Medicine and Experimental Oral Pathology, King's College Dental Institute, Bessemer Road, London, SE5 9RS, UK.,WHO Collaborating Centre for Oral Cancer and Precancer in the United Kingdom, Denmark Hill Campus, London, SE5 9RS, UK
| | - Eliete Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia (UnB), Brasilia, DF, Brazil
| | - André Luís Porporatti
- Laboratoire de Neurobiologie OroFaciale, Université de Paris, France and GHPS Assitance Publique Hopitaux de Paris, Paris, France
| | - Graziela De Luca Canto
- Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianopolis, SC, Brazil
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14
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Bojaxhiu B, Sinovcic D, Elicin O, Templeton AJ, Shelan M, Wartenberg J, Alberts I, Rominger A, Aebersold DM, Zaugg K. Correlation between hematological parameters and PET/CT metabolic parameters in patients with head and neck cancer. Radiat Oncol 2022; 17:141. [PMID: 35964056 PMCID: PMC9375277 DOI: 10.1186/s13014-022-02112-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022] Open
Abstract
Background Systemic inflammation is predictive of the overall survival in cancer patients and is related to the density of immune cells in the tumor microenvironment of cancer, which in turn correlates with 18F -fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) metabolic parameters (MPs). The density of tumor-infiltrating lymphocytes (TILs) in the microenvironment has the potential to be a biomarker that can be used clinically to optimize patient selection in oropharyngeal head and neck squamous cell carcinoma (HNSCC). There is little to no data regarding the association of systemic inflammation with PET/CT-MPs, especially in HNSCC. This study aimed to evaluate the correlation between markers of host inflammation, namely blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), with the PET/CT-MPs standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor, derived from FDG-PET/CT in patients with nonmetastatic (cM0) HNSCC before treatment. We hypothesized that NLR and PLR at baseline are positively correlated with PET/CT-MPs. Methods A retrospective review of consecutive patients with HNSCC with a pretreatment PET/CT was performed. NLR and PLR were computed using complete blood counts measured within 10 days before the start of any treatment. The correlation between NLR and PLR with PET/CT-MPs was evaluated with Spearman's rho test. Results Seventy-one patients were analyzed. Overall survival (OS) at 1, 2, and 3 years was 86%, 76%, and 68%. PLR was found to be correlated with MTV (rho = 0.26, P = .03) and TLG (rho = 0.28, P = .02) but not with maximum SUV or mean SUV. There was no correlation between NLR and the analyzed PET/CT-MPs. TLG was associated with worse survival in uni- and multivariable analysis, but no other PET/CT-MPs were associated with either OS or disease-specific survival (DSS). NLR and PLR were associated with OS and DSS on uni- and multivariable analysis. Conclusions In patients with HNSCC before any treatment such as definitive radio (chemo)therapy or oncologic surgery followed by adjuvant RT, baseline PLR correlated with MTV and TLG but not with SUV. NLR was not correlated with any PET/CT-MPs analyzed in our study. Confirmatory studies are needed, and a potential interaction between tumor microenvironment, host inflammation, and FDG-PET/CT measures warrants further investigation. Supplementary Information The online version contains supplementary material available at 10.1186/s13014-022-02112-4.
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Affiliation(s)
- Beat Bojaxhiu
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, 3010, Bern, Switzerland. .,Department of Radiation Oncology, Stadtspital Triemli, Zurich, Switzerland.
| | - Dubravko Sinovcic
- Department of Radiation Oncology, Stadtspital Triemli, Zurich, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Arnoud J Templeton
- Department of Medical Oncology, St. Claraspital Basel and Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Mohamed Shelan
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Jan Wartenberg
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel M Aebersold
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Kathrin Zaugg
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.,Department of Radiation Oncology, Stadtspital Triemli, Zurich, Switzerland
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15
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Jones BM, Villavisanis DF, Lehrer EJ, Dickstein DR, Sindhu KK, Misiukiewicz KJ, Posner M, Liu JT, Gupta V, Sharma S, Roof SA, Teng M, Genden EM, Bakst RL. High Failure Rates in Young Nonsmoker Nondrinkers With Squamous Cell Carcinoma of the Oral Tongue. Laryngoscope 2022; 133:1110-1121. [PMID: 35716359 DOI: 10.1002/lary.30253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/17/2022] [Accepted: 05/21/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE(S) There has been a disproportionate increase in the incidence of young patients with squamous cell carcinoma of the oral tongue (SCCOT). The purpose of this study was to compare young patients to older patients with SCCOT without prior drinking or smoking history as this population is poorly characterized in the literature. METHODS A retrospective review of patients presenting to our institution with SCCOT was performed. The clinical and pathologic characteristics, as well as, outcomes were compared between younger patients (age ≤45) and older patients (age >45). Outcome analysis was performed using Kaplan Meier method. Multivariable Cox proportional hazard models were performed for age and stage. RESULTS Eighty-two patients (38 young, 44 old) were included in this study. Median follow-up was 29.4 months. When compared to the older cohort (age >45), the younger cohort (age ≤45) demonstrated lower rates of 5-year locoregional control (LC) (79.6% vs. 52.5%, p = 0.043) and distant metastasis-free survival (88.1% vs. 61.8%, p = 0.006). Both cohorts demonstrated similar overall survival rates (55.5% vs. 58.1%) and disease-specific survival (66.2% vs. 58.1%). Of patients experiencing locoregional failure with available radiation therapy plans and PET scans in younger cohorts (n = 7), 100% demonstrated in-field failures. Multivariable Cox proportional hazards demonstrated age was an independent predictor of DMFS (p = 0.004) and the advanced stage was a predictor of DSS (p = 0.03). CONCLUSIONS Young, nondrinker, nonsmokers with SCCOT demonstrate high rates of locoregional recurrence, distant metastasis, and in-field failures. Future studies are warranted to determine underlying mechanisms driving pathogenesis in this unique cohort. LEVEL OF EVIDENCE 3 Laryngoscope, 2022.
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Affiliation(s)
- Brianna M Jones
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dillan F Villavisanis
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eric J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kunal K Sindhu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Krzysztof J Misiukiewicz
- Department of Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marshall Posner
- Department of Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jerry T Liu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vishal Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sonam Sharma
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Scott A Roof
- Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marita Teng
- Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eric M Genden
- Department of Otolaryngology - Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Richard L Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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16
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Matsuda Y, Jayasinghe RD, Zhong H, Arakawa S, Kanno T. Oral Health Management and Rehabilitation for Patients with Oral Cancer: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10050960. [PMID: 35628095 PMCID: PMC9140416 DOI: 10.3390/healthcare10050960] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/29/2022] [Accepted: 05/20/2022] [Indexed: 12/10/2022] Open
Abstract
Surgery is the current first choice for oral cancer treatment. Intensity-modulated radiation therapy, molecular targeted drugs, and immune checkpoint inhibitors are still used as adjuvant therapy for advanced cancer. In addition, postoperative rehabilitation and multidisciplinary treatment have also been developed in recent years. Multidisciplinary team approaches and supportive care in oral cancer treatment reportedly shorten the time to treatment and improve outcomes. Although there is enough evidence confirming the role of oral and maxillofacial surgeons, dentists, and dental hygienists in supportive care in oral cancer treatment, there are very few systematic studies. In particular, oral health management is a concept that encompasses oral function management, oral hygiene management, and oral care during oral cancer treatment. We provide a narrative review focusing on oral health management from a multidisciplinary and supportive care perspective, applicable in oral cancer treatment.
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Affiliation(s)
- Yuhei Matsuda
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8501, Japan; (H.Z.); (S.A.)
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
- Correspondence: ; Tel.: +81-3-5803-4649
| | - Ruwan D. Jayasinghe
- Center for Research in Oral Cancer, Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Getambe 20400, Sri Lanka;
| | - Hui Zhong
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8501, Japan; (H.Z.); (S.A.)
| | - Shinichi Arakawa
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8501, Japan; (H.Z.); (S.A.)
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
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17
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Kaminagakura E, Tango RN, Cruz-Perez D, Bonan R, Yamamoto de Almeida L, de Almeida Lança ML, Bonan P, Martins H, Takahama A, Ito FA, Coutinho-Camillo CM, Lourenço SV, Caneppele T, Sikora AG, Kowalski LP, Young S. Oral squamous cell carcinoma outcome in adolescent/young adult: Systematic review and meta-analysis. Head Neck 2021; 44:548-561. [PMID: 34808012 DOI: 10.1002/hed.26940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 12/24/2022] Open
Abstract
To perform a systematic review focusing on the prognosis of oral cavity squamous cell carcinoma (OSCC) in young patients (≤40 years old) compared to older (>40 years old). Four databases were used in our search strategy. First, all titles were systematically organized using the Covidence platform online. In the second phase, 118 full texts of potentially eligible studies were analyzed by reviewers independently and in pairs. Twelve studies were considered eligible for data extraction. The relapse was higher in the young than in controls (pooled relative risk (RR) = 1.31; 95% CI [1.10-1.56]). The 5-year disease-free survival (DFS) was worse in young group (pooled hazard ratio (HR) = 0.73; 95% CI [0.63-0.85]) but the 5-year overall survival (OS) estimate was similar between the groups (pooled HR = 0.84; 95% CI [0.70-1.00]). While the 5-year OS was similar between groups, the number of relapses and 5-year DFS were worse in patients with OSCC ≤40 years old.
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Affiliation(s)
- Estela Kaminagakura
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil.,Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Rubens Nisie Tango
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Danyel Cruz-Perez
- Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Roberta Bonan
- Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Luciana Yamamoto de Almeida
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (Unesp), Araraquara, Brazil
| | - Maria Letícia de Almeida Lança
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Paulo Bonan
- Department of Clinical and Social Dentistry, School of Dentistry, Federal University of Paraíba, João Pessoa, Brazil
| | - Hélder Martins
- Department of Oral Pathology, School of Dentistry, University Federal do Rio Grande do Norte, Natal, Brazil
| | - Ademar Takahama
- Department of Oral Medicine and Pediatric Dentistry, State University of Londrina, Londrina, Brazil
| | - Fábio Augusto Ito
- Department of Oral Medicine and Pediatric Dentistry, State University of Londrina, Londrina, Brazil
| | | | | | - Taciana Caneppele
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Andrew G Sikora
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil.,Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Centre, São Paulo, Brazil
| | - Simon Young
- Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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18
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Mohideen K, Krithika C, Jeddy N, Balakrishnan T, Bharathi R, Sankari SL. A Meta-analysis of Oral Squamous Cell Carcinoma in Young Adults with a Comparison to the Older Group Patients (2014-2019). Contemp Clin Dent 2021; 12:213-221. [PMID: 34759676 PMCID: PMC8525813 DOI: 10.4103/ccd.ccd_466_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/22/2020] [Accepted: 08/13/2020] [Indexed: 12/24/2022] Open
Abstract
Background: The oral squamous cell carcinoma (OSCC) often affects elderly aged adults, who had long-term tobacco exposure. In the recent past decade, there is an increasing incidence of OSCC in younger individuals, who had less tobacco association. Aim: The aim of this study is to examine the risk factors and to assess and compare the clinicopathological features and prognosis of OSCC in young patients with the older group patients. Materials and Methods: We included studies that addressed the OSCC involving young patients during the period between 2014 and 2019. Initially, we found 679 articles; after refined evaluation, 92 works had their titles matching to the present work. After extraction of case reports, reviews, and studies with un-matched objectives or inadequate data, we have chosen only 24 presentations matching to the abstract. The statistical analysis performed by Chi-square tests using SPSS 20.0 version for windows. Results: Of the total OSCC, 10% of patients belonged to the younger age group, and 90% were the older aged group. Both the groups showed male gender predominance and tongue as the predominant site of involvement. The younger patients tend to have significantly reduced tobacco exposure. The highly reported tumors were advanced staged and moderately differentiated tumors in both groups. There was a statistically evident high recurrence reported in the younger group. The overall survival seems to be similar for both groups. Conclusion: The identification of the potential risk factors, along with unique molecular mechanisms, and biological behavior of the disease is mandatory to control the incidence of OSCC in young adults.
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Affiliation(s)
- Khadijah Mohideen
- Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India
| | - C Krithika
- Department of Oral Medicine and Radiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Nadeem Jeddy
- Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Thayumanavan Balakrishnan
- Department of Oral Pathology and Microbiology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - R Bharathi
- Department of Oral Pathology and Microbiology, The Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - S Leena Sankari
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
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19
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Sambasivan K, Sassoon I, Thavaraj S, Kennedy R, Doss G, Michaelidou A, Odell E, Sandison A, Hall G, Morgan P, Collins LHC, Lyons A, Cascarini L, Fry A, Oakley R, Simo R, Jeannon JP, Petkar I, Reis Ferreira M, Kong A, Lei M, Guerrero Urbano T. TNM 8 staging is a better prognosticator than TNM 7 for patients with locally advanced oral cavity squamous cell carcinoma treated with surgery and post-operative radiotherapy. Radiother Oncol 2021; 160:54-60. [PMID: 33845044 DOI: 10.1016/j.radonc.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/20/2021] [Accepted: 04/02/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess TNM 8 staging in discriminating overall survival (OS) amongst patients with locally advanced oral cavity squamous cell carcinoma (OCSCC) treated with surgery and post-operative radiotherapy (PORT), compared to TNM 7. MATERIAL AND METHODS Data from OCSCC patients treated with surgery and PORT between January 2010 and December 2018 were reviewed. Demographics, tumour characteristics and treatment response data were collected, and patients staged according to both TNM 7 and TNM 8. OS and disease free survival (DFS) were estimated using the Kaplan Meier method. Univariate and multivariable analyses were conducted for factors affecting OS, DFS and early disease recurrence within 12 months. RESULTS Overall 172 patients were analyzed. Median follow up was 32 months for all patients and 48 months for surviving patients. TNM 8 staging demonstrated significant stratification of OS and DFS amongst the entire cohort, whereas TNM 7 staging did not. On multivariable analysis, TNM 8 stage, performance status (PS) and a positive surgical margin were prognostic for OS. Looking at disease recurrence within 12 months, TNM 8 stage IVB, presence of lymphovascular invasion (LVSI), younger age and lesser smoking history were predictive factors on multivariable analysis. CONCLUSION TNM 8 is a good development of its predecessor in terms of predicting survival for patients with locally advanced OCSCC. We have also identified younger age (<60 years) and a smoking history of <10 pack years as risk factors for early disease recurrence, potentially representing a separate biological cohort within OCSCC patients.
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Affiliation(s)
| | - Isabel Sassoon
- Department of Computer Science, Brunel University London, UK
| | - Selvam Thavaraj
- Faculty of Dentistry, Clinical and Orofacial Sciences, King's College London, UK; Head and Neck Pathology, Guy's and St Thomas, NHS Foundation Trust, UK
| | - Robert Kennedy
- Faculty of Dentistry, Clinical and Orofacial Sciences, King's College London, UK
| | - Gowardhanan Doss
- Department of Clinical Oncology, Guy's and St Thomas, NHS Trust London, UK
| | | | - Edward Odell
- King's College London, UK; Head and Neck Pathology, Guy's and St Thomas, NHS Foundation Trust, UK
| | - Ann Sandison
- Head and Neck Pathology, Guy's and St Thomas, NHS Foundation Trust, UK
| | - Gillian Hall
- King's College London, UK; Head and Neck Pathology, Guy's and St Thomas, NHS Foundation Trust, UK
| | - Peter Morgan
- King's College London, UK; Head and Neck Pathology, Guy's and St Thomas, NHS Foundation Trust, UK
| | | | - Andrew Lyons
- Head and Neck Surgery Unit, Guy's and St Thomas' NHS Trust, London, UK
| | - Luke Cascarini
- Head and Neck Surgery Unit, Guy's and St Thomas' NHS Trust, London, UK
| | - Alastair Fry
- Head and Neck Surgery Unit, Guy's and St Thomas' NHS Trust, London, UK
| | - Richard Oakley
- Head and Neck Surgery Unit, Guy's and St Thomas' NHS Trust, London, UK
| | - Ricard Simo
- Head and Neck Surgery Unit, Guy's and St Thomas' NHS Trust, London, UK
| | | | - Imran Petkar
- Department of Clinical Oncology, Guy's and St Thomas, NHS Trust London, UK
| | - Miguel Reis Ferreira
- Department of Clinical Oncology, Guy's and St Thomas, NHS Trust London, UK; King's College London, UK
| | - Anthony Kong
- Department of Clinical Oncology, Guy's and St Thomas, NHS Trust London, UK; King's College London, UK
| | - Mary Lei
- Department of Clinical Oncology, Guy's and St Thomas, NHS Trust London, UK
| | - Teresa Guerrero Urbano
- Department of Clinical Oncology, Guy's and St Thomas, NHS Trust London, UK; King's College London, UK
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20
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Deneuve S, Guerlain J, Dupret-Bories A, Majoufre C, Philouze P, Ceruse P, Perreard M, Sigaud N, Barry B, Ransy P, Schultz P, Malard O, Morinière S, Chatellier A, De Monès E, Folia M, Virard F, Fervers B. Oral tongue squamous cell carcinomas in young patients according to their smoking status: a GETTEC study. Eur Arch Otorhinolaryngol 2021; 279:415-424. [PMID: 33877432 DOI: 10.1007/s00405-021-06793-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/31/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Incidence of oral tongue squamous cell carcinoma (OTSCC) is increasing, especially in young adults, despite decreasing tobacco and alcohol consumption. METHODS This multicentric retrospective study of 185 young adults with OTSCC (median follow-up 43 months), investigated risk factors, tumour characteristics and oncological outcomes according to the smoking status. RESULTS Overall, 38% of patients were smokers (S). Non-smokers (NS) were significantly younger than S. Sex ratios were 1.1 for N and 1.8 for S. NS patients were less frequently cannabis or alcohol users than S, but were more likely to have a history of leukoplakia. Second primaries were observed in NS (4.4%) and in S (12.7%). Despite more frequent local relapse in NS (p = 0.018), there was no difference in diagnostic stage and overall survival between groups. CONCLUSION OTSCC affects differently young S and NS patients suggesting the existence of a specific clinical entity of OTSCC in non-smoking young adults.
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Affiliation(s)
- Sophie Deneuve
- Surgical Oncology Department, Léon Bérard Comprehensive Cancer Center, 28 rue Laennec, 69008, Lyon, France. .,INSERM UA8, Radiation: Défense, Santé , Environnement, Lyon, France.
| | - Joanne Guerlain
- Head and Neck Department, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - Agnès Dupret-Bories
- Head and Neck Department, Toulouse University Cancer Institute, Toulouse, France
| | - Claire Majoufre
- Maxillofacial Surgery, CHU Bordeaux Pellegrin, Bordeaux, France
| | | | | | | | - Nicolas Sigaud
- Maxillofacial Surgery, CHU Lyon Sud, Pierre-Bénite, France
| | | | | | | | | | | | | | | | | | - François Virard
- INSERM U1052-CNRS UMR5286, Cancer Research Center, centre Léon Berard, Lyon 1 University, Lyon, France.,Université de Lyon, Faculté d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Béatrice Fervers
- INSERM UA8, Radiation: Défense, Santé , Environnement, Lyon, France.,Cancer and Environnement Department, Léon Bérard Comprehensive Cancer Center, Lyon, France
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21
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Tagliabue M, Belloni P, De Berardinis R, Gandini S, Chu F, Zorzi S, Fumagalli C, Santoro L, Chiocca S, Ansarin M. A systematic review and meta-analysis of the prognostic role of age in oral tongue cancer. Cancer Med 2021; 10:2566-2578. [PMID: 33760398 PMCID: PMC8026930 DOI: 10.1002/cam4.3795] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 12/18/2022] Open
Abstract
While evidence suggests an increasing incidence of tongue cancer in young adults, published findings regarding the prognostic role of age at diagnosis are inconsistent. We performed a meta-analysis of the literature to highlight key points that might help in understanding the association between age of oral tongue cancer patients at diagnosis and their prognosis. According to age at diagnosis, a systematic literature review of all published cohort studies assessing the recurrence risks and mortality associated with tongue cancer was conducted. We compared the risk estimates between patients aged >45 years and those aged <45 years at diagnosis. Random-effects models were used to calculate summary relative risk estimates (SRRs) according to different clinical outcomes and sources of between-study heterogeneity (I2 ) and bias. We included 31 independent cohort studies published between 1989 and 2019; these studies included a total of 28,288 patients. When risk estimations were not adjusted for confounders, no significant association was found between age at diagnosis and overall survival (OS). Conversely, after adjustment for confounders, older age at diagnosis was associated with a significantly increased risk of mortality. The difference between SRRs for adjusted and unadjusted estimates was significant (p < 0.01). Younger patients had a significantly higher risk of local recurrence. Younger patients with oral tongue cancer have better OS but a greater risk of recurrence than older patients. These findings should be validated in a large prospective cohort study which considers all confounders and prognostic factors.
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Affiliation(s)
- Marta Tagliabue
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Pietro Belloni
- Department of Experimental OncologyIEOEuropean Institute of Oncology IRCCSMilanItaly
- Department of Statistical SciencesUniversity of PaduaPaduaItaly
| | - Rita De Berardinis
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Sara Gandini
- Department of Experimental OncologyIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Francesco Chu
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Stefano Zorzi
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
| | | | | | - Susanna Chiocca
- Department of Experimental OncologyIEOEuropean Institute of Oncology IRCCSMilanItaly
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck SurgeryIEOEuropean Institute of Oncology IRCCSMilanItaly
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22
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Al-Jamaei AAH, van Dijk BAC, Helder MN, Forouzanfar T, Leemans CR, de Visscher JGAM. A population-based study of the epidemiology of oral squamous cell carcinoma in the Netherlands 1989-2018, with emphasis on young adults. Int J Oral Maxillofac Surg 2021; 51:18-26. [PMID: 33773877 DOI: 10.1016/j.ijom.2021.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/28/2021] [Accepted: 03/09/2021] [Indexed: 12/24/2022]
Abstract
There has been an increasing trend in oral squamous cell carcinoma (OSCC) in patients under 45 years of age. The aim of this study was to evaluate the burden of OSCC in the Netherlands between 1989 and 2018 among young adults (age 20-34 years) when compared to adults (age 35-44 years), and to describe the burden in older groups as well, utilizing cancer registry data to characterize incidence patterns by age, sex, and risk factors. A total of 18,963 cases of OSCC were reported. The overall incidence rate, as measured by annual percentage change (APC), increased significantly from 1989 to 2010 by 1.3% per year (95% confidence interval (CI) 0.9-1.7%) but decreased thereafter by -0.9% (95% CI -2.5% to 0.7%). Annual incidence increased significantly by 2.4% (95% CI 1.1-3.8%) for patients aged 20-34 years, while it decreased for those aged 35-44 years by -0.9% (95% CI -1.7% to 0.0%). In patients older than 60 years, incidence rates increased overall (60-74 years: APC 1.8%, 95% CI 1.5-2.1%; ≥75 years: APC 1.5%, 95% CI 1.2-1.9%). Overall, 66.5% of patients were smokers and 65.3% were alcohol consumers. The marked differences in incidence within the young age subgroups warrants further investigation to elucidate any likely disparity in biological process and clinical outcomes in these populations.
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Affiliation(s)
- A A H Al-Jamaei
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - B A C van Dijk
- Netherlands Comprehensive Cancer Organization (IKNL), Department of Research and Development, Utrecht, The Netherlands; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M N Helder
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - C R Leemans
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC-location VUMC, Amsterdam, The Netherlands
| | - J G A M de Visscher
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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23
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Bera RN, Tiwari P. Do medial sural artery perforator flaps have better clinical outcomes compared to the rectus abdominis perforator (DIEAP) flap in reconstruction of glossectomy defects? A Prisma guided meta-analysis. Ann Maxillofac Surg 2021; 11:121-128. [PMID: 34522666 PMCID: PMC8407617 DOI: 10.4103/ams.ams_339_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 02/16/2021] [Accepted: 02/24/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND There is an increasing evidence for the use of thin flaps based on vascular perforators for reconstructive surgeries. The medial sural and deep inferior epigastric artery flaps offer versatility for the reconstruction of major defects of the head and neck. OBJECTIVES "Whether medial sural artery perforator (MSAP) flap or rectus abdominis perforator flap is better for the reconstruction of glossectomy defects in terms of functional outcome?" DATA SOURCES PubMed, Cochrane Library, clinicaltrials.gov and hand searches. PARTICIPANTS AND INTERVENTIONS Patients who underwent tongue reconstruction with either MSAP flap or deep inferior epigastric artery perforator (DIEAP) flap. STUDY APPRAISAL AND SYNTHESIS METHODS Based on defined study criteria 6 studies were selected according to Prisma Guidelines. The overall estimated effect was categorized as significant where P < 0.05. RESULTS There was no significant difference between both flaps in terms of receptor site complications (P = 0.223). Overall odds ratio (OR) for complications was 1.35 (95% confidence interval [CI]: 0.412-0.736) and the test for overall effect t value was 2.836, P < 0.05. Overall OR was 6.01 (95% CI 0.5-7.45) and the test for overall effect t value was 1.41, P < 0.05 indicating there was a statistical difference in the intelligibility of speech. LIMITATIONS Anatomical variations, under-reporting of studies and lack of universal tool for speech intelligibility. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Both the flaps are comparable in terms of functional outcome. Medium-sized defects can be reconstructed with MSAP and composite larger defects would benefit from DIEAP. In females, anterolateral thigh flap still remains the choice for composite reconstructions.
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Affiliation(s)
- Rathindra Nath Bera
- Unit of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences Trauma Centre BHU, Varanasi, Uttar Pradesh, India
| | - Preeti Tiwari
- Unit of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences Trauma Centre BHU, Varanasi, Uttar Pradesh, India
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24
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Lee DS, Ramirez RJ, Lee JJ, Valenzuela CV, Zevallos JP, Mazul AL, Puram SV, Doering MM, Pipkorn P, Jackson RS. Survival of Young Versus Old Patients With Oral Cavity Squamous Cell Carcinoma: A Meta-Analysis. Laryngoscope 2020; 131:1310-1319. [PMID: 33264444 DOI: 10.1002/lary.29260] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE/HYPOTHESIS To assess whether young patients with oral cavity squamous cell carcinoma (OCSCC) demonstrate worse oncologic outcomes than older patients after definitive therapy. STUDY DESIGN Systematic review and meta-analysis. METHODS A medical librarian composed a search strategy to identify relevant studies in Medline, Embase, Scopus, and other major databases (Prospero registration number CRD42019127974). Inclusion criteria were adults with histologically diagnosed OCSCC that underwent treatment, comparator groups with an age cutoff of 40 years old, and reported survival outcomes. Articles were excluded if they contained patients with oropharyngeal squamous cell carcinoma or patients treated for palliative intent. Overall survival hazard ratios were analyzed with a meta-analysis. RESULTS There were 23,382 patients with OCSCC that were treated with definitive therapy from 22 included studies. The pooled cohort contained 2,238 (10%) patients ≤40 years of age. Oral tongue was the most common subsite in both the younger (n = 1,961, 91%) and older (n = 18,047, 88%) cohorts. The majority of OCSCCs were either T1 or T2, representing 859 (80%) malignancies in younger patients and 8,126 (77%) malignancies in older patients. A meta-analysis of nine studies demonstrated that younger patients did not experience worse survival outcomes than older patients (hazard ratio = 0.97, 95% confidence interval = 0.66-1.41). CONCLUSIONS Young adults with OCSCC experienced similar oncologic outcomes as older patients with OCSCC after definitive treatment. Until compelling evidence demonstrates clinically relevant differences between these two cohorts, their approach to management should be similar. Future studies should consider comorbidities and using age 40 as a standard age cutoff to provide more uniform data moving forward. Laryngoscope, 131:1310-1319, 2021.
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Affiliation(s)
- David S Lee
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Ricardo J Ramirez
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Jake J Lee
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Carla V Valenzuela
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Jose P Zevallos
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Angela L Mazul
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.,Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Sidharth V Puram
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.,Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Michelle M Doering
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Patrik Pipkorn
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Ryan S Jackson
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
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25
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Mizuno K, Takeuchi M, Kikuchi M, Omori K, Kawakami K. Outcomes in patients diagnosed with tongue cancer before and after the age of 45 years. Oral Oncol 2020; 110:105010. [PMID: 32950892 DOI: 10.1016/j.oraloncology.2020.105010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/21/2020] [Accepted: 09/09/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Whether the prognosis of tongue cancer differs between young patients and elderly patients remains controversial. We aimed to compare the clinical characteristics and prognoses of patients with young-onset and old-onset tongue cancer. MATERIALS AND METHODS The retrospective cohort study utilized data from the Diagnosis Procedure Combination database maintained in Japan. Data derived from patients age ≥ 20 years diagnosed with tongue cancer between April 2008 and January 2019 were extracted from the database. Patients were divided into two groups based on age at tongue cancer diagnosis, a < 45 years group and a ≥ 45 years group. The primary outcomes were overall survival and disease-free survival, adjusted for age, sex, tumor classification, nodal metastasis, distant metastasis, smoking history, Charlson Comorbidity Index score, and tongue cancer treatment. RESULTS A total of 2315 patients diagnosed with tongue cancer were included in the study, of whom 1412 patients diagnosed based on the seventh edition of the Union for International Cancer Control in the multivariable Cox proportional hazards modeling. The adjusted hazard ratio for overall survival was 1.22 (95% confidence interval 0.66-2.24, p = 0.54) and that for disease-free survival was 1.14 (95% confidence interval 0.80-1.61, p = 0.47), and neither differed significantly between the two age groups. CONCLUSIONS The results of the present study suggest that younger age at the time of tongue cancer diagnosis may not be associated with a poorer prognosis. Young patients with tongue cancer should be treated in accordance with general guidelines.
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Affiliation(s)
- Kayoko Mizuno
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Syogoin-Kawahara-cho, Sakyo-ku, Kyoto 650-8507, Japan; Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 650-8501, Japan
| | - Masato Takeuchi
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 650-8501, Japan
| | - Masahiro Kikuchi
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Syogoin-Kawahara-cho, Sakyo-ku, Kyoto 650-8507, Japan
| | - Koichi Omori
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Syogoin-Kawahara-cho, Sakyo-ku, Kyoto 650-8507, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 650-8501, Japan.
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26
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Moreira DGL, Morais EFD, Santos HBDP, Freitas RDA. Immunohistochemical expression of DNA repair proteins in oral tongue and lower lip squamous cell carcinoma. Braz Oral Res 2020; 34:e101. [PMID: 32901726 DOI: 10.1590/1807-3107bor-2020.vol34.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 06/15/2020] [Indexed: 05/30/2023] Open
Abstract
The DNA repair system involves genes and proteins that are essential for the maintenance of genome integrity and the consequent control of various cellular processes. Alterations in these genes and proteins play a role in tumor development and progression and might be associated with prognosis. The aims of this study were to analyze the immunoexpression of two DNA repair proteins, XPF and XRCC1, in lower lip squamous cell carcinoma (LLSCC) and oral tongue squamous cell carcinoma (OTSCC), and to investigate possible associations with clinical and histopathological parameters. The immunohistochemical expression of XPF and XRCC1 was analyzed semi-quantitatively in 40 cases each of LLSCC and OTSCC. The chi-squared test or Fisher's exact test, when appropriate, was used to investigate the association between expression of the proteins and clinicopathological characteristics. The cytoplasmic immunoexpression of XPF was high in OTSCC (95% of the cases analyzed) but low in LLSCC (52.5%). Among the clinicopathological parameters evaluated, a statistically significant association was observed between high nuclear expression of XRCC1 and the absence of regional lymph node metastasis in patients diagnosed with OTSCC (p=0.006). The high protein expression of XPF and XRCC1 in OTSCC and LLSCC suggests an important role in the development and progression of these tumors. Our study found an association between high nuclear expression of XRCC1 and the absence of loco-regional metastasis in cases diagnosed as OTSCC, suggesting a role of this protein in tumor progression.
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Affiliation(s)
- Deborah Gondim Lambert Moreira
- Universidade Federal do Rio Grande do Norte - UFRN, Centro de Ciênicas da Saúde, Department of Oral Pathology, Natal, RN, Brazil
| | - Everton Freitas de Morais
- Universidade Federal do Rio Grande do Norte - UFRN, Centro de Ciênicas da Saúde, Department of Oral Pathology, Natal, RN, Brazil
| | - Hellen Bandeira de Pontes Santos
- Universidade Federal do Rio Grande do Norte - UFRN, Centro de Ciênicas da Saúde, Department of Oral Pathology, Natal, RN, Brazil
| | - Roseana de Almeida Freitas
- Universidade Federal do Rio Grande do Norte - UFRN, Centro de Ciênicas da Saúde, Department of Oral Pathology, Natal, RN, Brazil
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27
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Lee SU, Moon SH, Choi SW, Cho KH, Park JY, Jung YS, Ryu J, Ryu CH, Yun T, Kim TH, Youn SH, Oh ES. Prognostic significance of smoking and alcohol history in young age oral cavity cancer. Oral Dis 2020; 26:1440-1448. [PMID: 32430951 DOI: 10.1111/odi.13432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/01/2020] [Accepted: 05/11/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To assess prognostic factors of patients with operable oral cavity squamous cell carcinoma (OSCC), focusing on the associations with smoking/alcohol exposure and age. MATERIALS AND METHODS A total of 247 patients with OSCC who received curative surgery ± adjuvant radiotherapy were analyzed. The patient subgroups were divided according to pretreatment smoking/alcohol exposure. Individuals aged 45 years or less were classified as younger patients. RESULTS The median follow-up was 52.2 months. The 5-year locoregional progression-free survival (LRFFS), distant metastasis-free survival (DMFS), overall survival (OS), and cancer-specific survival (CSS) rates were 85.2%, 88.3%, 78.1%, and 83.5%, respectively. An advanced stage, differentiation, and lympho-vascular space invasion were significantly associated with lower OS and CSS. In a subgroup analysis of younger patients (n = 49), more smoking/alcohol exposure was significantly associated with better OS (hazard ratio [HR]: 0.21, 95% confidence interval [CI]: 0.05-0.95, p = .043). With increasing age, the HR for smoking/alcohol exposure with respect to OS increased up to 11.59 (95% CI: 1.49-89.84, p = .019) in older patients. CONCLUSION Younger OSCC patients with non- or less smoking/alcohol exposure showed unfavorable outcomes. The prognostic significance of pretreatment smoking/alcohol exposure changed from favorable to detrimental with increasing age in operable OSCC.
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Affiliation(s)
- Sung Uk Lee
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Sung Ho Moon
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Center for Specific Organs Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Sung Weon Choi
- Center for Specific Organs Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Kwan Ho Cho
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Center for Specific Organs Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Joo Yong Park
- Center for Specific Organs Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Yuh-Seok Jung
- Center for Specific Organs Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Junsun Ryu
- Center for Specific Organs Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Chang Hwan Ryu
- Center for Specific Organs Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Tak Yun
- Center for Specific Organs Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Tae Hyun Kim
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Sang Hee Youn
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Eun Sang Oh
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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Tomo S, Neto SC, Collado FU, Sundefeld ML, Bernabé DG, Biasoli ÉR, Miyahara GI. Head and neck squamous cell carcinoma in young patients: a 26-year clinicopathologic retrospective study in a Brazilian specialized center. Med Oral Patol Oral Cir Bucal 2020; 25:e416-e424. [PMID: 32134900 PMCID: PMC7211379 DOI: 10.4317/medoral.23461] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/20/2020] [Indexed: 12/18/2022] Open
Abstract
Background To describe the clinicopathologic profile of young patients with head and neck squamous cell carcinoma (HNSCC) and compare to middle-aged and elderly adults.
Material and Methods Patients’ individual records were reviewed for clinicopathologic data. Eighty-nine patients with age 18-45 years old met the inclusion criteria of the study. Two additional groups of middle-aged (n=89) and old (n=89) adults were set to comparative analysis.
Results Young patients represented 11.9% of all patients diagnosed with HNSCC. Women were more affected by HNSCC in the young and elder groups (p= 0.04), and young patients were more prone to be non-smokers (p= 0.01) and have lymph node metastasis at the time of diagnosis (p=0.04). In the young group, patients diagnosed with the disease in advanced stages were more prone to have a positive familial history of cancer (p= 0.04), a positive status of alcohol consumption (p= 0.03), and to be heavy drinkers (p= 0.01). Survival was not different for the young group in comparison to the other groups.
Conclusions HNSCC in young patients had a different profile when compared to older patients, especially regarding sex and exposure to the classic risk factors for this disease. The survival of the young group is similar to the older groups and advanced clinical stage is predictor of worse survival. Key words:Mouth neoplasms, young adult, epidemiology.
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Affiliation(s)
- S Tomo
- Oral Oncology Center, Araçatuba Dental School São Paulo State University - UNESP José Bonifácio Street, 1193, Araçatuba São Paulo, 16015-050, Brazil
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Kuan FC, Lee KD, Huang SF, Chen PT, Huang CE, Wang TY, Chen MC. Radiotherapy Is Associated with an Accelerated Risk of Ischemic Stroke in Oral Cavity Cancer Survivors after Primary Surgery. Cancers (Basel) 2020; 12:cancers12030616. [PMID: 32155918 PMCID: PMC7139411 DOI: 10.3390/cancers12030616] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/26/2020] [Accepted: 03/03/2020] [Indexed: 01/17/2023] Open
Abstract
The number of oral cavity carcinoma (OCC) survivors continues to increase due to advances in definitive surgery and radiation therapy (RT), however the risk of ischemic stroke is unclear in long-term survivors. In this study, survivors are defined as those who survived for >5 years after a diagnosis of OCC. They were matched at a 1:5 ratio with normal controls. Those who received surgery alone versus surgery+RT were also matched at a 1:1 ratio. From 2000 to 2005, 5172 OCC survivors who received surgery alone (n = 3205) or surgery+RT (n = 1967), and 25,860 matched normal controls were analyzed using stratified Cox regression models. Adjusted HRs (aHR) revealed that the surgery+RT group (aHR = 1.68, p < 0.001) had an elevated risk of stroke, but this was not seen in the surgery alone group (aHR = 0.99, p = 0.953). Furthermore, the age at stroke onset was at least 10 years earlier in the surgery+RT group than in the controls. In conclusion, radiotherapy increased the risk of ischemic stroke by 68% and also accelerated the onset of stroke in long-term OCC survivors after primary surgery compared with matched normal controls. Secondary prevention should include stroke as a late complication in OCC survivorship programs.
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Affiliation(s)
- Feng-Che Kuan
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Chiayi 613, Taiwan; (F.-C.K.); (P.-T.C.); (C.-E.H.); (T.-Y.W.)
| | - Kuan-Der Lee
- Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, and School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
| | - Shiang-Fu Huang
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Department of Public Health, Biostatistics Consulting Center, College of Medicine, Chang Gung University, Guishan, Taoyuan 333, Taiwan
| | - Ping-Tsung Chen
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Chiayi 613, Taiwan; (F.-C.K.); (P.-T.C.); (C.-E.H.); (T.-Y.W.)
| | - Cih-En Huang
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Chiayi 613, Taiwan; (F.-C.K.); (P.-T.C.); (C.-E.H.); (T.-Y.W.)
| | - Ting-Yao Wang
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Chiayi 613, Taiwan; (F.-C.K.); (P.-T.C.); (C.-E.H.); (T.-Y.W.)
| | - Min-Chi Chen
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Chiayi 613, Taiwan; (F.-C.K.); (P.-T.C.); (C.-E.H.); (T.-Y.W.)
- Department of Public Health, Biostatistics Consulting Center, College of Medicine, Chang Gung University, Guishan, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-3-2118800 (ext. 5056); Fax: +886-3-2118700
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Choi G, Song JS, Choi SH, Nam SY, Kim SY, Roh JL, Lee BK, Cho KJ. Comparison of Squamous Cell Carcinoma of the Tongue between Young and Old Patients. J Pathol Transl Med 2019; 53:369-377. [PMID: 31602967 PMCID: PMC6877439 DOI: 10.4132/jptm.2019.09.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/16/2019] [Indexed: 12/20/2022] Open
Abstract
Background The worldwide incidence of squamous cell carcinoma of the tongue (SCCOT) in young patients has been increasing. We investigated clinicopathologic features of this unique population and compared them with those of SCCOT in the elderly to delineate its pathogenesis. Methods We compared clinicopathological parameters between patients under and over 45 years old. Immunohistochemical assays of estrogen receptor, progesterone receptor, androgen receptor, p53, p16, mdm2, cyclin D1, and glutathione S-transferase P1 were also compared between them. Results Among 189 cases, 51 patients (27.0%) were under 45 years of age. A higher proportion of women was seen in the young group, but was not statistically significant. Smoking and drinking behaviors between age groups were similar. Histopathological and immunohistochemical analysis showed no significant difference by age and sex other than higher histologic grades observed in young patients. Conclusions SCCOT in young adults has similar clinicopathological features to that in the elderly, suggesting that both progress via similar pathogenetic pathways.
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Affiliation(s)
- Gyuheon Choi
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Seon Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Ho Choi
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bu-Kyu Lee
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Ja Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Zhang B, Du W, Gan K, Fang Q, Zhang X. Significance of the neutrophil-to-lymphocyte ratio in young patients with oral squamous cell carcinoma. Cancer Manag Res 2019; 11:7597-7603. [PMID: 31496814 PMCID: PMC6691951 DOI: 10.2147/cmar.s211847] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/10/2019] [Indexed: 12/16/2022] Open
Abstract
Background The main goal of this study was to evaluate the prognosis of young patients with oral squamous cell carcinoma (SCC) with a focus on the value of the pretreatment neutrophil-to-lymphocyte ratio (NLR). Materials and methods Young (≤40 years old) patients with oral SCC were retrospectively enrolled, and each young patient was matched with an old (≥60 years old) oral SCC patient. Associations between the NLR and clinicopathological variables were analyzed by the chi-square test, and the Kaplan–Meier method was used to analyze recurrence-free survival (RFS) and disease-specific survival (DSS) rates. Results A total of 103 young patients were enrolled, and compared to the old group, the young group had a significantly lower NLR value (p=0.012). In the young group, the 5-year RFS and DSS rates were 82% and 85%, respectively. In the old group, the 5-year RFS and DSS rates were 65% and 71%, respectively, and the differences between the groups were significant (both p<0.05). In the young patients with an NLR≤2.56, the 5-year DSS rate was 93%, while in the young patients with an NLR >2.56, the 5-year DSS rate was 76%. This difference was significant (p=0.020). A further Cox model analysis confirmed that the NLR was an independent prognostic factor for DSS. Conclusion Young patients with oral SCC have a better prognosis than old oral SCC patients, and the NLR is significantly associated with DSS in young patients.
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Affiliation(s)
- Baixia Zhang
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Wei Du
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province, People's Republic of China
| | - Kang Gan
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Qigen Fang
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province, People's Republic of China
| | - Xu Zhang
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province, People's Republic of China
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Tagliabue M, Gandini S, Maffini F, Navach V, Bruschini R, Giugliano G, Lombardi F, Chiocca S, Rebecchi E, Sica E, Tommasino M, Calabrese L, Ansarin M. The role of the T-N tract in advanced stage tongue cancer. Head Neck 2019; 41:2756-2767. [PMID: 30942940 DOI: 10.1002/hed.25761] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 03/11/2019] [Accepted: 03/18/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND We investigated the role of the soft tissue tract between the primary tumor and the neck lymph nodes, the "T-N tract," in patients with tongue squamous cell carcinoma at an advanced stage. METHODS We performed a compartmental tongue surgery in 233 patients. Cumulative incidence of relapses and overall survival curves were compared by T-N tract involvement. Multivariate Cox proportional hazards models were used to assess the independent role of T-N tract. RESULTS At 4 years of follow-up, patients with disease in the T-N tract experienced a significantly more distant recurrence (40%) than did patients without T-N tract involvement (22%; P = .02). Multivariate Cox models indicate a significant almost triple risk of distant metastases (hazard ratio [HR], 2.70; 95% CI, 1.01-7.19; P = .05) and double risk of death (HR, 2.09; 95%CI, 1.13-3.85; P = .02) in patients with "T-N tract involvement." CONCLUSIONS Our data show that the T-N tract plays an important role in prognosis and survival in patients with tongue cancer.
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Affiliation(s)
- Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Valeria Navach
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Bruschini
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Gioacchino Giugliano
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesca Lombardi
- Division of Data Manager, European Institute of Oncology IRCCS, Milan, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Elisabetta Rebecchi
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Eleonora Sica
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di circolo Fondazione Macchi, Varese, Italy
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Course Albert Thomas 150, Lyon, France
| | - Luca Calabrese
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
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Graizel D, Zlotogorski-Hurvitz A, Tsesis I, Rosen E, Kedem R, Vered M. Oral cancer-associated fibroblasts predict poor survival: Systematic review and meta-analysis. Oral Dis 2019; 26:733-744. [PMID: 31179584 DOI: 10.1111/odi.13140] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/10/2019] [Accepted: 06/04/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To perform systematic review and meta-analysis on correlations between cancer-associated fibroblasts (CAFs) and the risk of death for patients with oral squamous cell carcinoma. SUBJECTS AND METHODS English literature (1966-2018) was systematically analyzed for studies that immunohistochemically assessed CAF density by alpha-smooth muscle actin and presented 5 year survival rates by Kaplan-Meier plots. Mean age of patients, proportion of male/female patients, and male/female majority (>50% male/female patients) per study were also collected. Significance level for statistical models was p < 0.05. RESULTS Meta-analysis comprised 11 studies/1,040 patients. Univariate Cox regressions showed that high CAF density was a negative prognostic factor in studies with female and male majority [OR 5.329 (95% CI 3.223-8.811), p < 0.001, and OR 2.208 (95% CI 1.717-2.839), p < 0.001, respectively]. High CAF density with male majority was associated with a more favorable prognosis [OR 0.996 (95% CI 0.979-1.013), p < 0.001]. Multivariate Cox regressions showed that death risk was significantly higher among patients with high CAF density compared to low CAF [OR 2.741 (95% CI 2.220-3.384) p < 0.001]. High mean age and male proportion were significantly protective [OR 0.940 (95% CI 0.925-9.955), p < 0.001, OR 0.125 (95% CI 0.018-0.867), p = 0.035), respectively]. CONCLUSIONS CAFs increased death risk, male majority, and higher mean age were protective. A clinically validated cutoff for CAF density could serve as a reliable prognostic tool.
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Affiliation(s)
- Diana Graizel
- Department of Oral Rehabilitation, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ayelet Zlotogorski-Hurvitz
- Department of Oral Pathology, Oral Medicine and Oral and Maxillofacial Imaging, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.,The Department of Oral and Maxillofacial Surgery, Beilinson Medical Center, Rabin Campus, Petah Tikva, Israel
| | - Igor Tsesis
- Department of Endodontology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Rosen
- Department of Endodontology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Kedem
- Private Practice in Statistics, Ramat Hasharon, Israel
| | - Marilena Vered
- Department of Oral Pathology, Oral Medicine and Oral and Maxillofacial Imaging, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.,The Institute of Pathology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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Weckx A, Riekert M, Grandoch A, Schick V, Zöller JE, Kreppel M. Time to recurrence and patient survival in recurrent oral squamous cell carcinoma. Oral Oncol 2019; 94:8-13. [PMID: 31178216 DOI: 10.1016/j.oraloncology.2019.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/28/2019] [Accepted: 05/05/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Tumour relapse remains one of the major problems in managing oral squamous cell carcinoma (OSCC) with mortality rates of up to 92%. Early recurrences have a worse prognosis than late relapses. However, few has been written about the influence of clinicopathological parameters on the timing of recurrence and the patient survival. MATERIALS AND METHODS Retrospective chart review of 159 patients with an OSCC recurrent disease. Exclusion criteria were neoadjuvant chemoradiotherapy, follow-up <6 weeks, perioperative death, second primaries and inadequate information on clinicopathological parameters. Statistical analysis was performed using univariate and multivariate analysis. RESULTS A significant correlation was found in the χ2-analysis between the timing of recurrence and the margin status (p = 0.020), lymph node ratio (p = 0.030) and grading (p = 0.003) of the primary tumour. In the multivariate survival analysis, the timing of recurrence (p < 0.001), margin status of the primary tumour (p = 0.023), presence of extracapsular spread in the primary tumour (p = 0.003) and performance of a salvage treatment (p < 0.001) were shown to be independent risk factors for overall survival. CONCLUSION For patients with a recurrent OSCC, the time to recurrence, margin status, extracapsular spread and the performance of a salvage treatment are independent prognostic factors for overall survival. Furthermore, a significant association exists between the moment of recurrence and the lymph node ratio, the margin status and grading of the primary tumour. This knowledge can allow for the development of individualised surveillance programs and like this, an earlier diagnosis and better second treatment chance in the case of a recurrence.
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Affiliation(s)
- Annelies Weckx
- Department for Oral and Craniomaxillofacial Plastic Surgery, University of Cologne, Kerpenerstraβe 62, 50937 Cologne, Germany.
| | - Maximilian Riekert
- Department for Oral and Craniomaxillofacial Plastic Surgery, University of Cologne, Kerpenerstraβe 62, 50937 Cologne, Germany
| | - Andrea Grandoch
- Department for Oral and Craniomaxillofacial Plastic Surgery, University of Cologne, Kerpenerstraβe 62, 50937 Cologne, Germany
| | - Volker Schick
- Department for Anesthesiology and Intensive Care, University of Cologne, Kerpenerstraβe 62, 50937 Cologne, Germany
| | - Joachim E Zöller
- Department for Oral and Craniomaxillofacial Plastic Surgery, University of Cologne, Kerpenerstraβe 62, 50937 Cologne, Germany
| | - Matthias Kreppel
- Department for Oral and Craniomaxillofacial Plastic Surgery, University of Cologne, Kerpenerstraβe 62, 50937 Cologne, Germany
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Paderno A, Morello R, Piazza C. Tongue carcinoma in young adults: a review of the literature. ACTA ACUST UNITED AC 2019; 38:175-180. [PMID: 29984792 DOI: 10.14639/0392-100x-1932] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/09/2018] [Indexed: 12/15/2022]
Abstract
SUMMARY A recent reduction in the number of smoke-related tumours has been observed thanks to the diffusion of anti-tobacco campaigns carried out in the majority of developed countries. Nevertheless, as demonstrated by recent global epidemiologic studies, squamous cell carcinoma of the mobile tongue appears to be progressively increasing in incidence, particularly among young adults and especially in females. The driving mechanism responsible for such changes is still to be precisely defined. Several genetic studies have compared the mutational pattern of tongue squamous cell carcinoma in young adults to that of more elderly patients, without identifying significant differences that may help in better characterising this subgroup of subjects. Tongue squamous cell carcinomas in young adults have been historically considered as particularly aggressive clinical entities, with a high risk of loco-regional relapse, survival rates inferior to those of the general head and neck cancer group and need for a more aggressive therapy. However, considering the most recent studies, prognostic results in this patient group are heterogeneous and it is not possible to confirm this tendency. Thus, it is not justified to embrace different therapeutic approaches according to patient age. Eventually, an additional element to consider when examining young subjects affected by tongue cancer is the possibility of genetic predisposition. Alterations affecting pathways involved in DNA repair, surveillance of genetic stability or regulation of cellular growth may determine an increased likelihood of developing head and neck cancers.
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Affiliation(s)
- A Paderno
- Department of Otolaryngology, Head and Neck Surgery, University of Brescia, Italy
| | - R Morello
- Department of Otolaryngology, Head and Neck Surgery, University of Brescia, Italy
| | - C Piazza
- Department of Otolaryngology, Head and Neck Surgery, Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, University of Milan, Italy
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Campbell BR, Sanders CB, Netterville JL, Sinard RJ, Rohde SL, Langerman A, Mannion K, Kim YJ, Murphy BA, Lewis JS, Warner JL, Smith DK, Lang Kuhs KA. Early onset oral tongue squamous cell carcinoma: Associated factors and patient outcomes. Head Neck 2019; 41:1952-1960. [PMID: 30633435 DOI: 10.1002/hed.25650] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/15/2018] [Accepted: 12/21/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Incidence of oral tongue squamous cell carcinoma (OTC) is rising among those under age 50 years. The etiology is unknown. METHODS A total of 395 cases of OTC diagnosed and/or treated at Vanderbilt University Medical Center between 2000 and 2017 were identified. Of those, 113 (28.6%) were early onset (age < 50 years). Logistic regression was used to identify factors associated with early onset OTC. Cox proportional hazards models evaluated survival and recurrence. RESULTS Compared to typical onset patients, patients with early onset OTC were more likely to receive multimodality treatment (surgery and radiation; adjusted odds ratio [aOR], 2.7; 95% confidence interval [CI], 1.2-6.3) and report a history of snuff use (aOR, 5.4; 95% CI, 1.8-15.8) and were less likely to report a history of cigarette use (aOR, 0.5; 95% CI, 0.2-0.9). Early onset patients had better overall survival (adjusted hazard ratio, 0.6). CONCLUSIONS This is the largest study to evaluate factors associated with early onset OTC and the first to report an association with snuff.
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Affiliation(s)
| | | | - James L Netterville
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Robert J Sinard
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Sarah L Rohde
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Alexander Langerman
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Kyle Mannion
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Young J Kim
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Barbara A Murphy
- Vanderbilt University Medical Center, Department of Medicine, Division of Hematology and Oncology, Nashville, Tennessee, USA
| | - James S Lewis
- Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, Nashville, Tennessee, USA
| | - Jeremy L Warner
- Vanderbilt University Medical Center, Department of Medicine, Division of Hematology and Oncology, Nashville, Tennessee, USA
| | - Derek K Smith
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, Tennessee, USA
| | - Krystle A Lang Kuhs
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
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Miller C, Shay A, Tajudeen B, Sen N, Fidler M, Stenson K, Gattuso P, Al-Khudari S. Clinical features and outcomes in young adults with oral tongue cancer. Am J Otolaryngol 2019; 40:93-96. [PMID: 30472130 DOI: 10.1016/j.amjoto.2018.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 09/30/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate outcomes and survival in young patients with oral tongue cancer (OTC). METHODS Retrospective chart review of patients aged 18-40 with OTC treated between 2000 and 2016. Tumor characteristics of p16 expression, perineural invasion (PNI), and lymph-vascular invasion (LVI) were evaluated. Recurrence-free (RFS) and overall survival (OS) data were analyzed according to Kaplan-Meier method with univariate analysis. RESULTS A total of 23 patients were identified: 12 with early stage disease (ESD, stage I), and 11 with advanced stage disease (ASD, stage III or IV), (17 men and 6 women). Mean age at presentation was 34.5 years (±5 months) and mean follow-up was 46.6 months. For all patients, 5-year RFS was 62% and OS 66%. RFS for ESD was 73% and ASD 25% (log rank p = 0.011). OS for ESD was 100% and ASD 55% (log rank p = 0.012). 22% indicated tobacco use >5 pack-years and 9% heavy alcohol use. Factors associated with worse OS were neck disease (log rank p = 0.073), positive margins (log rank p = 0.001), and LVI (log rank p = 0.002). Factors associated with worse RFS were chemotherapy or radiation therapy prior to surgery (log rank p = 0.002), neck disease (log rank p = 0.047), positive margins (log rank p = 0.039), and PNI (log rank p = 0.001). Expression of p16 was observed in five cases and was not significantly associated with OS or RFS. CONCLUSION In young patients with OTC, factors associated with worse outcomes are similar to known predictors in older patients. Expression of p16 was not statistically associated with improved OS. OS in patients with ESD was excellent (100%), and significantly worse for ASD.
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Affiliation(s)
- Courtney Miller
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America
| | - Aryan Shay
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America
| | - Bobby Tajudeen
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America
| | - Neilayan Sen
- Department of Radiation Oncology, Rush University Medical Center, 1653 w congress pkwy, Chicago, IL 60612, United States of America
| | - Mary Fidler
- Department of Medicine, section of Medical Oncology, Rush University Medical Center, 1653 w congress pkwy, Chicago, IL 60612, United States of America
| | - Kerstin Stenson
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America
| | - Paolo Gattuso
- Department of Pathology, Rush University Medical Center, 1653 w congress pkwy, Chicago, IL 60612, United States of America
| | - Samer Al-Khudari
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America.
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Mukdad L, Heineman TE, Alonso J, Badran KW, Kuan EC, St. John MA. Oral tongue squamous cell carcinoma survival as stratified by age and sex: A surveillance, epidemiology, and end results analysis. Laryngoscope 2018; 129:2076-2081. [DOI: 10.1002/lary.27720] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Laith Mukdad
- Department of Head and Neck SurgeryUniversity of California Los Angeles California Los Angeles
| | - Thomas E. Heineman
- Department of Head and Neck SurgeryUniversity of California Los Angeles California Los Angeles
| | - Jose Alonso
- Department of Head and Neck SurgeryUniversity of California Los Angeles California Los Angeles
| | - Karam W. Badran
- Department of Head and Neck SurgeryUniversity of California Los Angeles California Los Angeles
| | - Edward C. Kuan
- Department of Otolaryngology–Head and Neck SurgeryUniversity of California, Irvine Medical Center Orange, California U.S.A
| | - Maie A. St. John
- Department of Head and Neck SurgeryUniversity of California Los Angeles California Los Angeles
- David Geffen School of MedicineUniversity of California Los Angeles California Los Angeles
- Head and Neck Cancer ProgramUniversity of California Los Angeles California Los Angeles
- Jonsson Comprehensive Cancer CenterUniversity of California Los Angeles Los Angeles, California
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Challapalli SD, Simpson MC, Adjei Boakye E, Pannu JS, Costa DJ, Osazuwa-Peters N. Head and Neck Squamous Cell Carcinoma in Adolescents and Young Adults: Survivorship Patterns and Disparities. J Adolesc Young Adult Oncol 2018; 7:472-479. [DOI: 10.1089/jayao.2018.0001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
| | - Matthew C. Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Eric Adjei Boakye
- Saint Louis University Center for Outcomes Research, St. Louis, Missouri
| | - Jay S. Pannu
- Saint Louis University School of Medicine, St. Louis, Missouri
| | - Dary J. Costa
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri
- Department of Pediatric Otolaryngology, Cardinal Glennon Children's Medical Center, St. Louis, Missouri
| | - Nosayaba Osazuwa-Peters
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri
- Saint Louis University Cancer Center, St. Louis, Missouri
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri
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Farquhar DR, Tanner AM, Masood MM, Patel SR, Hackman TG, Olshan AF, Mazul AL, Zevallos JP. Oral tongue carcinoma among young patients: An analysis of risk factors and survival. Oral Oncol 2018; 84:7-11. [PMID: 30115478 DOI: 10.1016/j.oraloncology.2018.06.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/14/2018] [Accepted: 06/16/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The incidence of oral tongue squamous cell carcinoma (OTSCC) in younger adults has rapidly increased over the past two decades. While tobacco and alcohol use may be less likely to cause these tumors, it remains controversial whether differences also exist in their prognosis. Our aim is to examine the risk factors for cancer among young (<45 years old) OTSCC patients at our institution, and to compare their recurrence and survival with older patients in a matched cohort. MATERIALS AND METHODS All OTSCC patients seen at our institution between 2000 and 2015 were reviewed. Patients under 45 who with sufficient treatment information were matched 1:1 on race, T-stage, and N-stage with patients 45 and older. Three-year recurrence and survival were determined in stratified and adjusted Cox regression models. RESULTS Of 397 OTSCC patients were seen at our institution, 117 (29%) were less than 45 years old. Younger patients were significantly more likely to be female, (50% vs. 39%; p = 0.04) and to abstain from tobacco (51% vs. 39%; p < 0.01). Young patients in the matched cohort were significantly more likely to have a recurrence (HR 3.9 95% CI 1.4-10.5). There was no difference in overall survival. CONCLUSION Younger OTSCC patients in a matched cohort were more likely to recur within 3 years, although there was no difference in overall mortality. Differences in risk factors and recurrence between older and younger patients suggest that some cancer among younger patients may be distinct from traditional OTSCC.
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Affiliation(s)
- Douglas R Farquhar
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States.
| | - April M Tanner
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Maheer M Masood
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Sagar R Patel
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Trevor G Hackman
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Angela L Mazul
- Department of Otolaryngology-Head and Neck Surgery, Washington University, St. Louis, MO, United States
| | - Jose P Zevallos
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Otolaryngology-Head and Neck Surgery, Washington University, St. Louis, MO, United States
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Hanna G, Woo SB, Li Y, Barletta J, Hammerman P, Lorch J. Tumor PD-L1 expression is associated with improved survival and lower recurrence risk in young women with oral cavity squamous cell carcinoma. Int J Oral Maxillofac Surg 2018; 47:568-577. [DOI: 10.1016/j.ijom.2017.09.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/25/2017] [Accepted: 09/15/2017] [Indexed: 12/12/2022]
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De Felice F, Polimeni A, Valentini V, Brugnoletti O, Cassoni A, Greco A, de Vincentiis M, Tombolini V. Radiotherapy Controversies and Prospective in Head and Neck Cancer: A Literature-Based Critical Review. Neoplasia 2018; 20:227-232. [PMID: 29448084 PMCID: PMC5849807 DOI: 10.1016/j.neo.2018.01.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/03/2018] [Indexed: 12/25/2022]
Abstract
In treating head and neck cancer (HNC), the objectives are provided for best functional results and minimal risk of serious complications. The choice of appropriate management depends primarily on specific site and stage of primary tumor at diagnosis. Radiation therapy (RT) with or without concomitant chemotherapy represents a classical treatment option. In this review, we provide an update of recent research strategies to counteract the existing damage caused by RT and highlight clinical trials currently in progress. We discuss the challenges in the evaluation of new stage system and RT-related toxicity onset. We mainly address the deficiencies and the advantages noted in the current treatment era.
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Affiliation(s)
- Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
| | - Antonella Polimeni
- Department of Oral and Maxillo Facial Sciences, Policlinico Umberto I "Sapienza" University of Rome, Italy.
| | - Valentino Valentini
- Department of Oral and Maxillo Facial Sciences, Policlinico Umberto I "Sapienza" University of Rome, Italy.
| | - Orlando Brugnoletti
- Department of Oral and Maxillo Facial Sciences, Policlinico Umberto I "Sapienza" University of Rome, Italy.
| | - Andrea Cassoni
- Department of Oral and Maxillo Facial Sciences, Policlinico Umberto I "Sapienza" University of Rome, Italy.
| | - Antonio Greco
- Department of Sense Organs, Policlinico Umberto I "Sapienza" University of Rome, Italy.
| | - Marco de Vincentiis
- Department of Oral and Maxillo Facial Sciences, Policlinico Umberto I "Sapienza" University of Rome, Italy.
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
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