Squamous cell carcinoma of the lips in a northern Greek population. Evaluation of prognostic factors on 5-year survival rate--I

Revisão dos fatores de risco para o câncer de boca e faringe

O presente artigo realizou breve análise de perfil epidemiológico de tumores de boca e faringe no Brasil e no mundo, bem como uma revisão da literatura pertinente a seus fatores de risco. Sua incidência, geralmente, varia entre 2% a 30% do total dos novos casos de câncer no mundo, e é fortemente influenciada pela localização geográfica. No Brasil, é a sexta localização anatômica mais comum nos Registros de Base Populacional entre os homens, sendo que a localização envolvendo a língua corresponde a 40% do total de casos. Os principais fatores de risco são o tabaco, o álcool e a interação entre ambos, que exibem forte efeito multiplicativo sobre o risco. A quantidade consumida e o tempo de exposição a estes dois fatores exibem, comumente, gradiente crescente de risco para o câncer. Elementos da dieta são considerados fatores de proteção, especialmente oβ-caroteno, enquanto estados de carência nutricional são comumente percebidos entre os casos. Condições de precária saúde bucal são achados comuns entre os casos de câncer de boca e faringe. As recentes linhas de pesquisa em patogênese e prevenção do câncer de boca e faringe têm estudado a contribuição viral e genética. O comprometimento de grupos etários mais jovens e de mulheres provavelmente deve-se à universalização dos fatores de risco, levando a esta modificação do perfil epidemiológico.

Assessment of Relationship of ABO Blood Groups in Oral Cancer Patients - A Retrospective Study

Introduction:

India is a high-risk region for oropharyngeal cancer (OC) due to high prevalence of tobacco, betel nut, and alcohol and accounts for 30% of all new cases of oral cancer annually.

Materials and Methods:

Records of all 73 diagnosed cases of different types of OC and oropharynx patients were analyzed who reported in “Tobacco cessation center”’ of the Institute between January 2017 and December 2019. The patients’ demographic details, blood groups, oral habits, and clinicohistological records were obtained from the medical records available in the hospital.

Results:

OC incidence was 3.75 cases/year with male-to-female ratio 3.29:1. Mean age was 51.25 ± 13.6 years. The most common site of tumour presentation was mandibular alveolar ridge. Combined use of tobacco/betal nut/alcohol constituted the major cause for the development of oral squamous cell carcinoma (OSCC). Majority patients were presented in Stage II (43.8%). Histopathological reports were suggestive of maximally well-differentiated (52.1%) OSCC. People with blood group A+ve had 3.22 times higher risk of developing OSCC compared to people of other blood groups.

Discussion:

Male: female ratio was reported higher than in most of other studies. Mandibular alveolus was the most frequent site because most of the patients tend to keep the tobacco quid in the buccal vestibule with close proximity to alveolus. The relative downregulation of glycosyl transferase that is involved in the biosynthesis of A and B antigens as seen in association with tumour development could be the reason for increased OC reported in blood group A subjects.

Actinic cheilitis and lip squamous cell carcinoma: Literature review and new data from Brazil

Background

To investigate the prevalence of malignant and potentially malignant lesions of the lip in an oral pathology service and to compare these data with a literature review.

Material and Methods

A total of 3173 biopsy reports and histopathological records were analyzed. Cases with a histological diagnosis of actinic cheilitis (AC) with or without epithelial dysplasia, in situ carcinoma, or lip squamous cell carcinoma (LSCC) were included. A comprehensive literature review was conducted to investigate the prevalence of AC and/or LSCC.

Results

124 cases (3.91%) were included, 75 (60.5%) had some degree of epithelial dysplasia and 31 (25.0%) were LSCC. Clinically, most of the lesions were diagnosed as AC (50.8%); however, eight cases clinically reported as AC were histologically diagnosed as LSCC. Regarding clinical characteristics, most individuals were fair-skinned male, with mean age of 54.3±12.3 years, and with a history of long-term solar exposure. Furthermore, 18 articles were selected from the literature, showing that the lower lip was predominantly affected and that most individuals were males, fair-skinned, and older than 40 years.

Conclusions

Since most of the cases diagnosed clinically as AC presented some degree of epithelial dysplasia, it is important to emphasize the value of biopsy and the histological evaluation of this lesion.

Key words:Actinic cheilitis, Precancerous conditions, In situ carcinoma, Oral diagnosis, Mouth neoplasms.

The prevalence of squamous cell carcinoma in different sites of oral cavity at our Rural Health Care Centre in Loni, Maharashtra - a retrospective 10-year study

AIM OF THE STUDY

Oral cancer ranks in the top three of all cancers in India and is quickly becoming a global health priority. More than 90% of oral and oropharyngeal cancers are squamous cell carcinoma. The purpose of this study was to document its incidence depending upon the involvement of different sites of oral cavity, and its variation with age and gender.

MATERIAL AND METHODS

Histopathologically proven oral squamous cell carcinoma cases were collected from the department of oral and maxillofacial surgery RDC, PIMS. The cases were systematically grouped under three headings: anatomical sub-site of oral cavity, age group, and gender, which were analysed to calculate the prevalence of oral cancer. The study was undertaken after obtaining approval from the institutional Ethical Committee board.

RESULTS

Among the different sites of oral cavity, the highest incidence (31.47%) of oral squamous cell carcinoma was seen for buccal mucosa in our study. The most affected age group (39.50%) were patients above 50 years old, predominantly involving males.

CONCLUSIONS

The population in this study were mostly from remote areas, among which a high rate of occurrence of oral cancer was encountered because the people were of low socio-economic class, had a casual attitude towards their health, high rate of tobacco consumption, and limited health care facilities. This study provides valuable data of the prevalence of oral cancer among the rural population.

An epidemiological survey in hospital setup in Lucknow district: A cross-sectional study

Introduction:

Oral cancer is the sixth most common form of cancer reported globally which includes lip, tongue, mouth, and throat. Developing countries face several challenges to identify and remove potential risk factors. Chewing tobacco/pan masala is considered to be the most potential risk factor for oral precancerous lesions and oral cancer.

Objective:

To study the clinical-epidemiological profile of oral cancer cases and potential risk factor associated with it.

Materials and Methods:

This is cross-sectional study which includes all major tertiary hospital in Lucknow district. Five hundred and eight cases of oral cancer reported in all major tertiary hospitals in Lucknow district during 2013–2016.

Study Variable:

Clinicoepidemiological characteristics of oral cancer cases.

Statistical Analysis:

percentages, proportions.

Results:

Out of 508 cases, majority of the subjects included in the study belonged to 18–75 years age group. Reported cases of oral cancer in males were higher as compared to females. Most of the subjects belonged to lower middle and upper lower socioeconomic group. It was found that 199 (39.2%) subjects consumed smokeless tobacco. Buccal mucosa was the common site of oral cancer being present in 50.4% of the subjects. Histopathologically, 256 cases of buccal mucosa, 17 cases of lip, 33 cases of alveolar region, 16 cases of mandible region, 156 cases of tongue region, 7 cases of gingival buccal sulcus region, and 23 cases of palate were diagnosed as oral squamous cell carcinoma.

Conclusion:

In the present study, the most affected site was buccal mucosa (50.4%), tongue (30.7%), and other diagnosis was <10%.

One Year Audit of In Patient Department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital

BACKGROUND

The world wide pattern of oral and maxillofacial surgical conditions has rarely been reported despite its significance in ensuring quality of care. A large number of patients are managed surgically in Oral and Maxillofacial Surgery department of Dhaka Dental College Hospital but there has been no surgical audit to identify the potential problems in patient care.

OBJECTIVES

The aim of this study was to identify the pattern of oral and maxillofacial conditions in patients of maxillofacial surgery of Dhaka Dental College Hospital, which would provide valuable information to build up the focus of attention, to develop a future strategy plan, to improve its clinical care and extend the academic and research field.

PATIENTS AND METHODS

A retrospective survey of oral and maxillofacial surgical cases managed at the inpatient Department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital. All admitted patients from 1st January, 2012 to 31st December, 2012 were included in this study. The patients' data were retrieved from the wards registers and patient records. The data were recorded as age, sex, occupation, geographic distribution, diagnosis, treatment done and operation name. These were studied to assess the prevalence of age, sex, diseases and the name of the treatment offered. Analysis of major groups of diagnosis on the basis of age and sex was also studied. Mortality was also recorded.

RESULTS

Between 1st January, 2012 and 31st December, 2012 a total of 768 patients were treated. Among them 494 patients were male while 274 were female, male female ratio was 1.80:1. The majority of the patients were from Dhaka division. The mean age of the patients was 33.20 years; peak age group was 15-30 years. The most common diagnosis was maxillofacial injuries (35 %), followed by oral squamous cell carcinoma (22 %) and odontogenic tumours and hamartomas (11 %). Maxillo-mandibular fixation or wiring was the main modality of treatment. The mortality rate was 0.26 % of total patients.

CONCLUSIONS

The department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital is a busy centre for specialized maxillofacial services in Bangladesh. A good number of patients with a wide range of oral and maxillofacial surgical conditions are managed here. Maxillofacial injury and oral cancer are the two most common conditions encountered here.

A clinical study on survival rate of patients with squamous cell carcinoma of the lower lip in Kosovo

OBJECTIVE

The aim of this study is to find out the survival rate of patients with squamous cell carcinoma of the lower lip in Kosovo and to see the effect of stage of disease on the success of surgical treatment.

PATIENTS AND METHODS

789 patients with SCCLL who were referred to the Department of Maxillofacial Surgery, University Clinical Centre of Kosovo, were examined during a period of 20 years (between 1993 and 2013). 614 (77.82%) of these patients received treatment and have regularly visited the department once every 3 months for post-operative controls. Data have been collected from these 614 patients for 10 years; thus the follow-up period lasts for 10 years for every patient under control. The collected data were analysed using Chi square test. Patients were classified by sex, aetiology, stage of the disease, location of the disease, the treatment patients received, metastasis rate and survival rate.

RESULTS

The most susceptible patients were those at ages between 50 and 70. The youngest patient was 8 years old whereas the oldest was 92. The male-female ratio was 5:1. 57% of the patients had been working outdoors and had been exposed to sunlight. Ten years survival rate for the Stages I, II, III and IV was 91.7%, 83.7%, 28% and 11.4% respectively.

CONCLUSION

It was found that the success of the surgery was closely related with the stage of disease and early diagnosis. Training the relevant parties (i.e., the people, family doctors etc.) on early diagnosis would improve the survival rate.

Two-piece customized mold technique for high-dose-rate brachytherapy on cancers of the buccal mucosa and lip

OBJECTIVE

High-dose-rate (HDR) brachytherapy using a customized mold is a minimally invasive treatment for oral cancer; however, it is difficult to use this technique for buccal and lip cancers involving the commissura labiorum, owing to its anatomic form. The purpose of this study was to introduce an improved customized mold consisting of 2 pieces to allow the fixation of molds to these sites.

STUDY DESIGN

Five patients with buccal carcinoma and 1 patient with lip carcinoma were treated with this technique after external beam radiotherapy. One patient with neck metastasis underwent both neck dissection and partial tumor resection before HDR brachytherapy.

RESULTS

At the end of the follow-up period, 5 patients had no tumor recurrence, and 1 patient had suffered local recurrence.

CONCLUSIONS

Our technique is a viable therapeutic option for patients with buccal and lip carcinomas for whom the therapeutic modalities are limited by age, performance status, and other factors.

Actinic cheilitis adjacent to squamous carcinoma of the lips as an indicator of prognosis

Many studies have shown an association between actinic cheilitis and squamous carcinoma of the lips.

AIM

The aim of the study was to observe the relation between actinic cheilitis and the prognosis of squamous carcinoma of the lips. MATERIALS AND METHODS This is a retrospective cross-sectional cohort study of squamous carcinoma of the lips. Histological sections of squamous carcinoma tumors done at the the Department of Pathology of the Sao Paulo Federal University between 1993 and 2000 were reviewed for evidence of actinic cheilitis in the lip vermillion adjacent to the tumor. Patient reports were reviewed to find information about exposure to sun, metastases and relapses. The occurrence or absence of relapses and metastases was correlated with the presence or absence of actinic cheilitis in the lip vermillion. Data was analyzed by Fisher's Exact test.

RESULTS

Of the 31 selected patients, most were caucasian, males and with lower lip involvement. Statistical analysis demonstrated independence between the occurrence of metastases and relapse and gender, skin color and site (lower or upper lips). There was dependence between actinic cheilitis and solar elastosis, and between the absence of actinic cheilitis and the occurrence of metastases. There was no dependence between the absence of actinic cheilitis and the occurrence of relapses.

CONCLUSION

It may be concluded that tumors originating from actinic cheilitis have a better prognosis.

Queilite actínica adjacente ao carcinoma espinocelular do lábio como indicador de prognóstico

Muitos estudos demonstram associação entre queilite actínica e carcinoma espinocelular do lábio. OBJETIVO: Verificar a relação da queilite actínica com o prognóstico dessa neoplasia. MATERIAIS E MÉTODOS: Elaborou-se um estudo de coorte retrospectivo com corte transversal em carcinoma espinocelular do lábio. Cortes histológicos desse tumor, levantados entre 1993-2000, nos arquivos do Departamento de Patologia/Universidade Federal de São Paulo, foram revisados para evidenciar presença ou ausência de queilite actínica no vermelhão adjacente ao tumor. Os prontuários dos pacientes foram revisados à procura de informações sobre exposição solar, metástase e recidiva. A ocorrência ou ausência de recidiva e metástase foi correlacionada com a presença ou ausência de queilite actínica no vermelhão. Os dados obtidos foram analisados pelo teste exato de Fisher. RESULTADOS: Dos 31 pacientes selecionados predominou o sexo masculino, cor da pele branca e localização no lábio inferior. Constatou-se: independência entre a ocorrência de metástase e recidiva com sexo, cor dos pacientes e localizações no lábio superior ou inferior; dependência entre a presença de queilite actínica e elastose solar, dependência entre a ausência de queilite actínica e presença de metástase; independência entre a ausência de queilite actínica e presença de recidiva. CONCLUSÃO: Os tumores originários de queilite actínica têm melhor prognóstico.

Clinico-pathological features of squamous cell carcinoma of the oral cavity in patients <40 years of age

BACKGROUND

Considerable controversy exists in the literature regarding the clinical course of young patients with oral squamous cell carcinoma (SCC). The purpose of this study was to evaluate the clinico-pathological features of oral SCC among young people.

METHODS

From a cohort of 529 patients diagnosed with SCC, 35 (6.6%) were under the age of 40 years. This group was compared to a control group of 110 cases aged over 40 to determine if there were any differences in clinicopathological features between the two groups.

RESULTS

In the young group there were 20 males and 15 females. The site was most frequently the tongue (51.3%), followed by the floor of the mouth, the buccal mucosa, and the upper and lower alveolus and gingiva. The local and regional control rate was 64.8% which was similar to that of older patients in this series.

CONCLUSIONS

The prognosis of oral SCC in the young patients does not appear to be different from that of the older population. Univariate analysis showed that clinical stage and the mode of invasion were the most significant prognostic factors in both younger and older patients.

Carcinoma espinocelular do lábio: avaliação de fatores prognósticos

Dentre os cânceres do lábio de 90% a 95% dos casos afetam o lábio inferior, sendo o carcinoma espinocelular o mais freqüente. A classificação TNM sintetiza as características clínicas do tumor, permitindo realizar um prognóstico e possibilitando comparações dos resultados. Relaciona três parâmetros: tamanho do tumor (T), propagação aos gânglios linfáticos regionais (N) e metástases à distância (M), mas estabelece padrões a partir de 2cm. Para o carcinoma espinocelular do lábio lesões com 2cm são extremamente grandes. OBJETIVO: O objetivo deste estudo é verificar a relação entre as características epidemiológicas, clínicas, evolutivas e histopatológicas do carcinoma espinocelular do lábio tendo como parâmetro lesões de tamanhos a partir de 0,5cm. CASUÍSTICA E MÉTODO: Foi elaborado um estudo retrospectivo transversal em pacientes com carcinoma espinocelular do lábio, no período 1993-2000, em São Paulo, Brasil. Estudou-se prontuários, laudos originais dos exames histopatológicos e lâminas de tumores de pacientes com carcinoma espinocelular do lábio. Os tumores foram classificados de 0.5 em 0.5cm, sendo verificado o tipo, o grau de diferenciação histológica, a presença de desmoplasia, as invasões muscular, neural e vascular, e o tipo de infiltrado inflamatório. RESULTADOS: A análise estatística mostrou que metástases e recidivas não dependem da cor de pele ou do sexo dos pacientes e que há independência entre a localização do tumor, no lábio superior ou inferior, e a incidência de metástases e recidiva. Houve correlação entre o tamanho da lesão a partir de 0,5cm e a ocorrência de metástases e recidiva. Verificou-se que o tamanho da lesão determina a invasão em outros tecidos. O infiltrado inflamatório verificado em todas as lesões era linfoplasmocitário e, em algumas, associado com eosinófilos sem relação com o tamanho do tumor. CONCLUSÃO: Tumores menores que 2cm podem apresentar comportamentos evolutivos distintos, sob o ponto de vista clínico e histopatológico. O tipo mais prevalente de lesão é o ulcerativo e o que mais metastatiza e recidiva é o úlcero-vegetante. Os tipos úlcero-vegetante e vegetante estão ligados a lesões de maior tamanho. O tamanho do tumor se relaciona, de forma semelhante, com os graus II e III, nos quais ocorrem os maiores índices de metástases e recidivas. O tumor invade em ordem decrescente de freqüência músculos, nervos e vasos sanguíneos, e esta pode ser prevista pelo tamanho da lesão. É necessária a invasão dos músculos para a ocorrência de metástases, sendo que os vasos sanguíneos somente podem estar implicados quando há invasão concomitante dos nervos. A desmoplasia está diretamente relacionada ao tamanho da lesão e à ocorrência de metástases.

Important prognostic factors of long-term oropharyngeal carcinoma survivors in Taiwan

In Taiwan, a clear gender difference emerges for rates of oropharyngeal carcinoma incidence. The purpose of this study was to identify the gender differences and clinical factors associated with oropharyngeal carcinoma survival rates in Taiwan. We analyzed the 5-year survival rates of 8114 subjects diagnosed with oropharyngeal carcinoma between 1987 and 1994. The Cox proportional-hazards model identified clinical characteristics for gender according to oropharyngeal carcinoma death and all-cause death outcomes. The 5-year survival rates were significantly lower for males than females (p < 0.0001). The adjusted hazard ratio of males versus females was 1.54 (95% CI: 1.36-1.74) for oropharyngeal carcinoma death and 1.44 (95% CI: 1.31-1.58) for all-cause death. Gender and other clinical characteristics (i.e. diagnostic age, anatomic site, morphologic type, and treatment modality) play important roles in oropharyngeal carcinoma survival. We suggested that Taiwanese males have high proportion of betel quid chewing and that this is associated with the gender differences.

Oral cancer examinations among adults at high risk: findings from the 1998 National Health Interview Survey

OBJECTIVES

Cigarette smoking and alcohol use are risk factors for oral and pharyngeal cancer. Recommendations for periodic oral cancer examinations highlight the importance of examining high-risk smokers and alcohol users. This investigation assessed whether cigarette smoking and alcohol use were associated with receipt of an oral cancer examination.

METHODS

The cross-sectional 1998 National Health Interview Survey was used. Covariates included age, sex, race/ethnicity, poverty status, and geographic region. Weighted bivariate and multivariate analyses were stratified by dentition status and limited to adults aged > or = 40 years.

RESULTS

Regardless of dentition status, current smokers were no more likely to have received an examination than were never smokers. The associations between alcohol use and receipt of an examination were mixed, and were generally more favorable among those who had a dental visit in the last year. Dentate current and former alcohol users were more likely than abstainers to have received an examination. There was no statistically significant association between alcohol use and receipt of an oral cancer examination among edentulous adults.

CONCLUSIONS

Practitioners should improve the provision rates of oral cancer examinations in accordance with published guidelines, especially among current smokers and edentulous alcohol users who have not been to the dentist in the last year. Recommendations for improvement are presented.

The epidemiology of lip cancer: a review of global incidence and aetiology

Lip cancer (140 ICD-9) is a form of oral cancer that has a distinctive global epidemiology. This review summarises global incidence rates for male and female lip cancer with the aid of cancer atlases. High male lip cancer rates are reported for regions of North America (12.7 per 100 000 per annum), Europe (12.0 per 100 000 per annum) and Oceania (13.5 per 100 000 per annum), while it is virtually unknown in parts of Asia. Factors commonly cited as important in the aetiology of lip cancer include solar radiation, tobacco smoking and viruses. An attempt is made to summarise the evidence for factors that may be important in lip carcinogenesis. While incidence rates are generally stable or falling among males worldwide, they are rising in many female populations. The aetiology of the disease is far from established and much information regarding its pathogenesis is based on anecdotal rather than case-controlled epidemiological evidence. The epidemiology of lip cancer supports the proposal that the lip should be considered as a distinct cancer site, rather than being included with other forms of intraoral cancer.

Oral cancer in the UK: to screen or not to screen

Although oral squamous cell carcinoma accounts for only a small proportion of malignant neoplasms in the UK, oral cancer incidence and mortality rates have been rising in recent years. The natural history of oral cancer is not adequately understood at present and there is very little information about the epidemiology of precancerous lesions in the UK. There are also insufficient data to provide firm evidence that the percentage of cases arising de novo is greater in the UK and the Western world as compared to the Indian subcontinent. Screening for oral cancer by visual examination is simple, inexpensive and causes little discomfort; however, there is no evidence for the effectiveness of screening for oral cancer either in reducing mortality from the disease or in reducing the incidence of invasive disease by detection and treatment of precancerous lesions. There is currently insufficient evidence to recommend population screening for oral cancer in the UK. Measures aimed at primary prevention of the disease may be a more feasible method of disease control at present.

Epidemiology of cancer of the lip in The Netherlands

Descriptive epidemiological data of new cases of squamous cell carcinoma of the vermilion border of the lip in the Netherlands from 1989-94 inclusive are presented. Lip cancer represented 0.47 and 0.09% of all new malignancies in males and females, respectively. The lower lip was the most frequently affected site. The majority of the lip cancers were diagnosed in tumour stage I. The median age at diagnosis in males was 68 years, 5 years less than in females. The overall male-to-female ratio was 5.7. Age-adjusted incidence rates in males and females were 2.2 and 0.3 per 100,000 (ESR), respectively. The cumulative lifetime risk for developing lip cancer was 0.15 for males and 0.03 for females. Mortality/incidence ratios in males and females were 0.05 and 0.07, respectively. Differences in lip cancer incidence were observed between an urban and a rural area. There was a positive association between the occurrence of lip cancer and rural residence; rate ratios were 3.3 among males and 3.5 among females.

Survival analysis in a sample of oral cancer patients at a reference hospital in Rio de Janeiro, Brazil

This article gives the results of a 5-year survival analysis of 371 oral cancer patients who received medical care at a cancer reference hospital in Rio de Janeiro between 1986 and 1987. Patient profiles based on selected risk factors for oral cancer and 5-year survival based on prognostically relevant variables are described.

Etiology of cancer of the lip. A review

A range of environmental and host factors has been identified to explain the etiopathogenesis of squamous cell carcinoma of the lip. However, the definitive pathogenic pathway remains unclear. Carcinogenesis does not seem to be limited to a single agent, but rather to a complex multistep process of interactions between putative risk factors. In this paper, the currently available data regarding risk factors, considered to be causally related to the onset of lip cancer, are reviewed.