Management of and risk factors for regional recurrence in upper lip squamous cell carcinoma

Adjuvant radiotherapy may not significantly change outcomes in high-risk cutaneous squamous cell carcinomas with clear surgical margins: A systematic review and meta-analysis

BACKGROUND

The role of adjuvant radiotherapy for high-risk cutaneous squamous cell carcinomas (cSCC) after surgery with negative margins is unclear.

OBJECTIVE

To conduct a systematic review and meta-analysis examining the risk of poor outcomes for those treated with surgery vs. surgery and adjuvant radiotherapy.

METHODS

A comprehensive search of articles was executed in PubMed, Embase, and Cochrane Database. Random-effected meta-analyses were conducted.

RESULTS

Thirty-three studies comprised of 3,867 high-risk cSCC were included. There were no statistically significant differences in poor outcomes between the surgery vs. surgery and adjuvant radiotherapy groups. Estimates for local recurrence were 15.2% (95% confidence interval [CI]: 6.3%-27%) vs. 8.8% (CI: 1.6%-20.9%), regional metastases were 11.5% (CI: 7.2%-16.7%) vs. 4.4% (CI: 0%-18%), distant metastases were 2.6% (CI: 0.6%-6%) vs. 1.7% (CI: 0.2%-4.5%) and disease-specific deaths were 8.2% (CI: 1.2%-20.6%) vs. 19.7% (CI: 3.8%-43.7%) for the surgery group vs. surgery and adjuvant radiotherapy group respectively.

LIMITATIONS

Retrospective nature of most studies with a lack of sufficient patient-specific data.

CONCLUSIONS

For patients with high risk cSCC treated with margin-negative resection, there were no differences in poor outcomes between the surgery vs. surgery and adjuvant radiotherapy groups. Randomized-controlled trials are necessary to define the benefit of adjuvant radiotherapy in this setting.

Distant metastasis from oral cavity-correlation between histopathology results and primary site

OBJECTIVES

Oral cancer is the eighth most common type of cancer worldwide and a significant contributor to the global burden caused by this disease. The principal parameters considered to influence prognosis, and thus treatment selection, are size and location of the primary tumor, as well as assessment of the presence and extent of lymph node and distant metastasis (DM). However, no known report regarding the relationship between the primary site and DM has been presented. For effective treatment selection and good prognosis, the correlation of DM with anatomic site and histopathology results of the primary malignancy is important. In the present study, we performed a systematic review of published reports in an effort to determine the relationship between the anatomic site of various types of oral cavity cancer and DM.

METHODS

A systematic review of articles published until the end of 2018 was performed using PubMed/MEDLINE.

RESULTS

A total of 150 studies were selected for this review. The percentage of all cases reported with DM was 6.3%, ranging from 0.6% to 33.1% in the individual studies. The rate of incidence of tongue occurrence was 9.3%. A frequent DM site was the lungs, with adenoid cystic carcinoma the most commonly involved histopathological factor. Malignant melanoma was most frequent (43.4%) in all histopathology findings, whereas there were no cases with an acinic cell carcinoma or cystadenocarcinoma.

CONCLUSIONS

We found that the occurrence of DM from the primary site as well as rate of incidence was dependent on histopathological factors.