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Mastronikolis NS, Delides A, Kyrodimos E, Piperigkou Z, Spyropoulou D, Giotakis E, Tsiambas E, Karamanos NK. Insights into metastatic roadmap of head and neck cancer squamous cell carcinoma based on clinical, histopathological and molecular profiles. Mol Biol Rep 2024; 51:597. [PMID: 38683372 PMCID: PMC11058607 DOI: 10.1007/s11033-024-09476-8] [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: 12/21/2023] [Accepted: 03/25/2024] [Indexed: 05/01/2024]
Abstract
The incidence of head and neck cancer (HNC), constituting approximately one in ten cancer cases worldwide, affects approximately 644,000 individuals annually. Managing this complex disease involves various treatment modalities such as systemic therapy, radiation, and surgery, particularly for patients with locally advanced disease. HNC treatment necessitates a multidisciplinary approach due to alterations in patients' genomes affecting their functionality. Predominantly, squamous cell carcinomas (SCCs), the majority of HNCs, arise from the upper aerodigestive tract epithelium. The epidemiology, staging, diagnosis, and management techniques of head and neck squamous cell carcinoma (HNSCC), encompassing clinical, image-based, histopathological and molecular profiling, have been extensively reviewed. Lymph node metastasis (LNM) is a well-known predictive factor for HNSCC that initiates metastasis and significantly impacts HNSCC prognosis. Distant metastasis (DM) in HNSCC has been correlated to aberrant expression of cancer cell-derived cytokines and growth factors triggering abnormal activation of several signaling pathways that boost cancer cell aggressiveness. Recent advances in genetic profiling, understanding tumor microenvironment, oligometastatic disease, and immunotherapy have revolutionized treatment strategies and disease control. Future research may leverage genomics and proteomics to identify biomarkers aiding individualized HNSCC treatment. Understanding the molecular basis, genetic landscape, atypical signaling pathways, and tumor microenvironment have enhanced the comprehension of HNSCC molecular etiology. This critical review sheds light on regional and distant metastases in HNSCC, presenting major clinical and laboratory features, predictive biomarkers, and available therapeutic approaches.
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Affiliation(s)
- Nicholas S Mastronikolis
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, University of Patras, Patras, 26504, Greece.
| | - Alexander Delides
- 2nd Otolaryngology Department, School of Medicine, National & Kapodistrian University of Athens, 'Attikon' University Hospital, Rimini 1, Athens, 12462, Greece
| | - Efthymios Kyrodimos
- 1st Otolaryngology Department, School of Medicine, National & Kapodistrian University of Athens, 'Ippokrateion' General Hospital, Athens, Greece
| | - Zoi Piperigkou
- Biochemistry, Biochemical Analysis & Matrix Pathobiology Research Group, Laboratory of Biochemistry, Department of Chemistry, University of Patras, Patras, 26504, Greece
| | - Despoina Spyropoulou
- Department of Radiation Oncology, Medical School, University of Patras, Patras, 26504, Greece
| | - Evangelos Giotakis
- 1st Otolaryngology Department, School of Medicine, National & Kapodistrian University of Athens, 'Ippokrateion' General Hospital, Athens, Greece
| | | | - Nikos K Karamanos
- Biochemistry, Biochemical Analysis & Matrix Pathobiology Research Group, Laboratory of Biochemistry, Department of Chemistry, University of Patras, Patras, 26504, Greece
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Mohtasham N, Zarepoor M, Shooshtari Z, Hesari KK, Mohajertehran F. Genes involved in metastasis in oral squamous cell carcinoma: A systematic review. Health Sci Rep 2024; 7:e1977. [PMID: 38665153 PMCID: PMC11043498 DOI: 10.1002/hsr2.1977] [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: 05/23/2023] [Revised: 02/10/2024] [Accepted: 02/27/2024] [Indexed: 04/28/2024] Open
Abstract
Background and Aims Oral squamous cell carcinoma is the most prevalent malignancy in the oral cavity, with a significant mortality rate. In oral squamous cell carcinoma patients, the survival rate could decrease because of delayed diagnosis. Thus, prevention, early diagnosis, and appropriate treatment can effectively increase the survival rate in patients. In this systematic review, we discussed the role of different genes in oral squamous cell carcinoma metastasis. Herein, we aimed to summarize clinical results, regarding the potential genes that promote oral squamous cell carcinoma metastasis. Methods This systematic review was carried out under the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. An electronic search for all relevant articles published in English between January 2018 and April 2022 was performed using Scopus, PubMed, and Google Scholar search engines. All original studies published in English were included, and we excluded studies that were in a non-English language. Results A total of 4682 articles were found, of which 14 were relevant and detected significant genes in oral squamous cell carcinoma progression. These findings investigated the overexpression of interferon-induced proteins with tetratricopeptide repeats 1 and 3 (IFIT1, IFT3), high-mobility group A2 (HMGA2), transformed growth factor-beta-induced, lectin galactoside-binding soluble 3 binding protein (LGALS3BP), bromodomain containing 4, COP9 signaling complex 6, heterogeneous nuclear ribonucleoproteins A2B1 (HNRNPA2B1), 5'-3' exoribonuclease 2 (XRN2), cystatin-A (CSTA), fibroblast growth factors 8 (FGF8), forkhead box P3, cadherin-3, also known as P-cadherin and Wnt family member 5A, ubiquitin-specific-processing protease 7, and retinoic acid receptor responder protein 2 genes lead to promote metastasis in oral squamous cell carcinoma. Overexpression of some genes (IFIT1, 3, LGALS3BP, HMGA2, HNRNPA2B1, XRN2, CSTA, and FGF8) was proven to be correlated with poor survival rates in oral squamous cell carcinoma patients. Conclusion Studies suggest that metastatic genes indicate a poor prognosis for oral squamous cell carcinoma patients. Detecting these metastatic genes in oral squamous cell carcinoma patients may be of predictive value and can also facilitate assessing oral squamous cell carcinoma development and its response to treatment.
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Affiliation(s)
- Nooshin Mohtasham
- Dental Research CenterFaculty of Dentistry of Mashhad University of Medical SciencesMashhadIran
- Department of Oral and Maxillofacial PathologySchool of Dentistry, Mashhad University of Medical SciencesMashhadIran
- Oral and Maxillofacial Diseases Research CenterFaculty of Dentistry of Mashhad University of Medical SciencesMashhadIran
| | - Marzieh Zarepoor
- Dental Research CenterFaculty of Dentistry of Mashhad University of Medical SciencesMashhadIran
| | - Zahra Shooshtari
- Dental Research CenterFaculty of Dentistry of Mashhad University of Medical SciencesMashhadIran
| | - Kiana Kamyab Hesari
- Doctor of Veterinary Medicine StudentSciences and Research UniversityTehranIran
| | - Farnaz Mohajertehran
- Dental Research CenterFaculty of Dentistry of Mashhad University of Medical SciencesMashhadIran
- Department of Oral and Maxillofacial PathologySchool of Dentistry, Mashhad University of Medical SciencesMashhadIran
- Oral and Maxillofacial Diseases Research CenterFaculty of Dentistry of Mashhad University of Medical SciencesMashhadIran
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Sultania M, Das Majumdar SK, Raghuram K, Ganapathy A. A rare case of cavernous sinus thrombosis following oral squamous cell carcinoma - The etiology and management dilemma. Oral Oncol 2023; 142:106421. [PMID: 37216834 DOI: 10.1016/j.oraloncology.2023.106421] [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: 05/01/2023] [Accepted: 05/06/2023] [Indexed: 05/24/2023]
Abstract
Intracranial cavernous sinus metastases of oral squamous cell carcinoma (OSCC) are rare, with a reported incidence of 0.4 %. Due to their extremely infrequent presentation the etiology and management modalities of such complications are not clearly represented in the literature. Here we present a case of a 58-year-old male diagnosed with OSCC of Right Lower Alveolus with underlying bone invasion, cT4aN1M0, Stage IV. He underwent Right Hemi-mandibulectomy with Modified Neck Dissection, Pectoralis Major Myocutaneous Flap, and 60 Gy/30# adjuvant radiotherapy. Six months later, the patient was diagnosed with recurrence involving the right infratemporal fossa with associated right cavernous sinus thrombosis. Immunohistochemistry block review showed PDL1 - Positive. The patient was subjected to Cisplatin and Pembrolizumab immunotherapy. After receiving 35 cycles of Pembrolizumab over a period of 2 years the patient is doing well with no recurrence.
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Affiliation(s)
- Mahesh Sultania
- Department of Surgical Oncology, All India Institute of Medical Sciences, Bhubaneswar, India
| | | | - K Raghuram
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Arthi Ganapathy
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India.
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4
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Kurioka K, Rin S, Otsuru M, Naruse T, Hasegawa T, Yamakawa N, Yamada SI, Hirai E, Yamamoto K, Ueda M, Kirita T, Akashi M, Kurita H, Ohiro Y, Okura M. The Impact of Pretreatment Low Body Mass Index on Cause-Specific Mortality in Patients with Squamous Cell Carcinoma of the Oral Cavity. Nutr Cancer 2023; 75:520-531. [PMID: 36223283 DOI: 10.1080/01635581.2022.2125989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The association between the pretreatment body mass index (BMI) and oral squamous cell carcinoma (SCC) outcomes is controversial. We aimed to examine the association between BMI and cause-specific mortality due to cancer of the oral cavity and patterns of failure that correlate with increased mortality. We enrolled 2,023 East Asian patients in this multicenter cohort study. We used the cumulative incidence competing risks method and the Fine-Gray model to analyze factors associated with cause-specific mortality, local recurrence, regional metastasis, and distant metastasis as first events. The median follow-up period was 62 mo. The 5-year cause-specific mortality for patients with underweight was 25.7%, which was significantly higher than that for patients with normal weight (12.7%, P < 0.0001). The multivariate model revealed that underweight was an independent risk factor for cause-specific mortality and regional metastasis (P < 0.05). Moreover, patients with underweight displayed a 51% and 55% increased risk of cause-specific mortality and regional metastasis, respectively, compared with their normal weight counterparts. Local recurrence was not associated with the BMI categories; however, the incidence of distant metastasis inversely decreased with BMI value. In summary, being underweight at diagnosis should be considered a high-risk mortality factor for oral SCC.
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Affiliation(s)
- Kyoko Kurioka
- The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Shin Rin
- Department of Clinical Oral Oncology, Hokkaido Cancer Center, Sapporo, Japan
| | - Mitsunobu Otsuru
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Tomohumi Naruse
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobuhiro Yamakawa
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Nara, Japan
| | - Shin-Ichi Yamada
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Eiji Hirai
- Oral and Maxillofacial Surgery, Oita Red Cross Hospital, Oita, Japan
| | - Kozo Yamamoto
- Oral and Maxillofacial Surgery, Oita Red Cross Hospital, Oita, Japan
| | - Michihiro Ueda
- Department of Clinical Oral Oncology, Hokkaido Cancer Center, Sapporo, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Nara, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoichi Ohiro
- Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Masaya Okura
- The First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan.,Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, Matsusaka, Japan
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5
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Hasegawa T, Kobayashi E, Amano R, Saito I, Takeda D, Kakei Y, Kimoto A, Sakakibara A, Akashi M. Time to Recurrence Associated With Poor Prognosis in Japanese Oral Squamous Cell Carcinoma Patients. J Maxillofac Oral Surg 2022; 21:856-864. [PMID: 36274898 PMCID: PMC9474988 DOI: 10.1007/s12663-021-01527-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/03/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose Recurrence in oral squamous cell carcinoma (OSCC) is not rare. Due to lack of studies assessing characteristics of recurrent OSCC, including time to recurrence and outcomes, we sought to investigate its characteristics, time to recurrence, and outcomes in Japanese OSCC patients. Methods This study was a nonrandomized retrospective cohort study in a tertiary referral centre. It included 208 (117 men and 91 women) patients with recurrent oral cancer who underwent major curative surgery in the Department of Oral and Maxillofacial Surgery at Kobe University Hospital between January 1999 and April 2017. The outcomes were disease-specific survival (DSS) and overall survival (OS). Results In multivariable Cox proportional hazards analysis, the time to recurrence (hazard ratio [HR] 3.55, 95% confidence interval [CI] 1.69-6.63; P = 0.001), extranodal extension (ENE, HR 2.72, 95% CI 1.51-4.89; P = 0.001), and high T stage (HR 2.00, 95% CI 1.01-3.97; P = 0.046) were independent predictors of DSS. The time to recurrence (HR 3.29, 95% CI 1.82-5.96; P < 0.001) and ENE (HR 2.64, 95% CI 1.52-4.56; P = 0.001) were independent predictors of OS. Conclusion Time to recurrence, extranodal extension, and higher T stage were independent prognosis predictors in OSCC.
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Affiliation(s)
- Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Erina Kobayashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Rika Amano
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Izumi Saito
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Daisuke Takeda
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Akira Kimoto
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Akiko Sakakibara
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
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Survival rate and prognostic factors of oral squamous cell carcinoma in Indonesia: A single-center retrospective study. FORUM OF CLINICAL ONCOLOGY 2022. [DOI: 10.2478/fco-2021-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
Abstract
Background
Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy in Asia. Most patients in Cipto Mangunkusumo Hospital have been diagnosed with an advanced stage. There had not been any survival study for OSCC in Indonesia. This study aimed to investigate the survival rate and prognostic factors of OSCC in Cipto Mangunkusumo Hospital.
Methods
A retrospective cohort study was conducted on OSCC patients diagnosed and treated in Cipto Mangunkusumo Hospital from 2014 to 2018. Data regarding age, gender, site of the primary lesion, clinical stage of the disease, tumor differentiation, invasion, and surgical margins were collected. The main outcomes measured were overall survival (OS) and disease-specific survival (DSS). The predictors of survival were then determined.
Result
169 patients were included. The majority of patients were male (51.5%) and above 50 years old (55.6%). The most prevalent tumor site was the tongue (72.8%) followed by buccal mucosa (13%). The majority (82.2%) of patients had advanced (clinical stage IV) disease at diagnosis. A smaller majority of patients had a well-differentiated tumor (60.4%) and a low-grade tumor (53.8%). The worst one-year and two-year overall survival rates were found in the stage IV group (53.5% and 37.5%, respectively). The disease-specific survival rate was 66.9%.
Conclusion
The one-year and two-year overall survival rates of OSCC in Cipto Mangunkusumo Hospital were 58.6% and 43.1%. Moreover, clinical stage, tumor size, and lymph node involvement were the most significant prognostic factors for OSCC.
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7
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Lu CC, Tsai HC, Yang DY, Wang SW, Tsai MH, Hua CH, Chen KJ, Chen MYC, Lien MY, Tang CH. The Chemokine CCL4 Stimulates Angiopoietin-2 Expression and Angiogenesis via the MEK/ERK/STAT3 Pathway in Oral Squamous Cell Carcinoma. Biomedicines 2022; 10:biomedicines10071612. [PMID: 35884919 PMCID: PMC9313364 DOI: 10.3390/biomedicines10071612] [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: 04/26/2022] [Revised: 06/24/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is a common malignant tumor with a poor prognosis and is a major public health burden in Taiwan. Angiogenesis, the formation of new blood vessels, promotes tumor proliferation, maintenance, and metastasis. Angiopoietin 2 (Angpt2), a mitogen with a strong angiogenic effect, is highly specific to endothelial cells and a key player in angiogenesis. The inflammatory chemokine (C-C motif) ligand 4 (CCL4) is also important in the pathogenesis and progression of cancer. In this study, an analysis of records from The Cancer Genome Atlas (TCGA) database found higher CCL4 expression in oral cancer tissue than in normal healthy tissue. CCL4 treatment of oral cancer cells upregulated Angpt2 expression and stimulated mitogen-activated protein kinase kinase (MEK), extracellular signal-regulated kinase 1/2 (ERK), and signal transducer and activator of transcription 3 (STAT3) phosphorylation. Transfection of oral cancer cells with MEK, ERK, and STAT3 inhibitors and their small interfering RNAs inhibited CCL4-induced promotion of Angpt2 expression and angiogenesis. In a mouse model of OSCC, CCL4-treated cells promoted neovascularization in implanted Matrigel plugs, whereas inhibiting CCL4 expression suppressed Angpt2 expression and angiogenesis. CCL4 shows promise as a new molecular therapeutic target for inhibiting angiogenesis and metastasis in OSCC.
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Affiliation(s)
- Chien-Chi Lu
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung 404327, Taiwan; (C.-C.L.); (M.-H.T.); (C.-H.H.)
| | - Hsiao-Chi Tsai
- School of Medicine, China Medical University, Taichung 404328, Taiwan;
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung 404327, Taiwan
| | - Dong-Ying Yang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung 404328, Taiwan;
| | - Shih-Wei Wang
- Institute of Biomedical Science, Mackay Medical College, New Taipei City 252005, Taiwan;
- Department of Medicine, Mackay Medical College, New Taipei City 252005, Taiwan
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Ming-Hsui Tsai
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung 404327, Taiwan; (C.-C.L.); (M.-H.T.); (C.-H.H.)
| | - Chun-Hung Hua
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung 404327, Taiwan; (C.-C.L.); (M.-H.T.); (C.-H.H.)
| | - Kwei-Jing Chen
- School of Dentistry, China Medical University, Taichung 404328, Taiwan; (K.-J.C.); (M.Y.-C.C.)
- Department of Dentistry, China Medical University Hospital, Taichung 404327, Taiwan
| | - Michael Yuan-Chien Chen
- School of Dentistry, China Medical University, Taichung 404328, Taiwan; (K.-J.C.); (M.Y.-C.C.)
- Department of Dentistry, China Medical University Hospital, Taichung 404327, Taiwan
| | - Ming-Yu Lien
- School of Medicine, China Medical University, Taichung 404328, Taiwan;
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung 404327, Taiwan
- Correspondence: (M.-Y.L.); (C.-H.T.); Tel.: +886-2205-2121 (ext. 1513) (M.-Y.L.); +886-2205-2121 (ext. 7726) (C.-H.T.)
| | - Chih-Hsin Tang
- School of Medicine, China Medical University, Taichung 404328, Taiwan;
- Graduate Institute of Basic Medical Science, China Medical University, Taichung 404328, Taiwan;
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404328, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung 404333, Taiwan
- Department of Biotechnology, College of Health Science, Asia University, Taichung 413305, Taiwan
- Correspondence: (M.-Y.L.); (C.-H.T.); Tel.: +886-2205-2121 (ext. 1513) (M.-Y.L.); +886-2205-2121 (ext. 7726) (C.-H.T.)
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Ooms M, Ponke L, Puladi B, Winnand P, Heitzer M, Katz MS, Hölzle F, Modabber A. Impact of secondary tumor-free resection margins in soft tissue on local, regional, and distant recurrence in R0-resected oral squamous cell carcinoma. Head Neck 2022; 44:1172-1181. [PMID: 35188299 DOI: 10.1002/hed.27014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The impact of additional soft tissue resection on recurrence of oral squamous cell carcinoma (OSCC) remains controversial. The study aim was to compare recurrence between patients with secondary tumor-free resection margins after intraoperative additional resection (STF-RM) and patients with primary tumor-free resection margins without additional resection (PTF-RM). METHODS Forty-five patients with STF-RM were matched with patients with PTF-RM according to Union for International Cancer Control stage, tumor location, and treatment modality and compared for local, regional, and distant recurrence. RESULTS Patients with STF-RM showed lower local and distant control rates compared to patients with PTF-RM (66.2% vs. 82.8%; p = 0.045 and 86.3% vs. 100.0%; p = 0.021). STF-RM was the only predictor of local recurrence accounting for tumor (T) status, nodal (N) status, tumor grade, margin distance, and extracapsular extension (hazard ratio 4.21 [95% confidence interval 1.26-14.04]; p = 0.019). CONCLUSIONS STF-RM have an adverse impact on local and distant recurrence of OSCC.
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Affiliation(s)
- Mark Ooms
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Lisa Ponke
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Behrus Puladi
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Philipp Winnand
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Marius Heitzer
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Marie Sophie Katz
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
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9
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Zanoni DK, Mayor CV, McGill MR, Montero PH, Shah JP, Wong RJ, Ganly I, Patel SG. Distant metastasis in oral squamous cell carcinoma: Does the neutrophil-to-lymphocyte ratio act as a surrogate of the host immune status? Oral Oncol 2022; 124:105641. [PMID: 34864297 PMCID: PMC9377276 DOI: 10.1016/j.oraloncology.2021.105641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/15/2021] [Accepted: 11/21/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Distant metastasis (DM) is an important prognostic factor for oral squamous cell carcinoma (OSCC). The aim of this study is to evaluate the influence of host and tumor factors in development of DM. MATERIALS AND METHODS After IRB approval, 1369 patients with OSCC undergoing primary surgery were eligible for the study. The primary endpoint was the development of distant metastasis (DM). Patients were pathologically staged according to the American Joint Committee on Cancer, 8th Edition. Pre-operative peripheral blood counts were used to calculate neutrophil-to-lymphocyte ratio (NLR). RESULTS Median follow-up was 39 months (range 1-221). DM were identified in 126 patients during follow-up. When analyzed as a time-dependent covariate, neck recurrence (NR) was a significant predictor of DM (HR 16.35, 95% CI: 11.39-23.47, p < 0.001). NLR, margin status, vascular invasion, perineural invasion (PNI), grade, pT, number of metastatic lymph nodes, level IV involvement, and extra nodal-extension (ENE) were also significant. In multivariable analysis, NLR, margins, PNI, number of metastatic lymph nodes, and ENE maintained independent predictive capacity. Patients with NLR ≥ 5.7 were 3 times more likely to develop DM compared to NLR ≤ 2.9 (95% CI: 1.74-5.59, p < 0.001), patients with ≥ 5 metastatic lymph nodes were 2 times more likely to develop DM (95% CI: 1.18-3.60, p = 0.011), and those with ENE were 4 times more likely (95% CI: 2.67-8.20, p < 0.001) when compared to pNx/pN0 patients. CONCLUSIONS NLR, number of metastatic lymph nodes, and ENE were the strongest independent predictors of DM in OSCC treated with primary surgery and appropriate adjuvant therapy.
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10
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Yamada I, Yohino N, Yokokawa M, Oikawa Y, Harada H, Hikishima K, Kurabayashi T, Saida Y, Tateishi U, Ohata Y. Diffusion tensor imaging of oral carcinoma: Clinical evaluation and comparison with histopathological findings. Magn Reson Imaging 2020; 77:99-108. [PMID: 33373694 DOI: 10.1016/j.mri.2020.12.016] [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: 11/28/2019] [Revised: 11/15/2020] [Accepted: 12/20/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aims to assess the usefulness of diffusion tensor imaging (DTI) as a noninvasive method for the evaluation of histological grade and lymph node metastasis in patients with oral carcinoma (OC). MATERIALS AND METHODS Thirty-six consecutive patients with histologically confirmed OC underwent examination by 3-T MRI. DTI was performed using a single-shot echo-planar imaging sequence with b values of 0 and 1000 s/mm2 and motion-probing gradients in 12 noncollinear directions. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) maps were compared with histopathological findings. The DTI parameters were correlated with the histological grade of the OCs based on the World Health Organization grading criteria and the presence or absence of lymph node metastasis. RESULTS The FA values (0.275 ± 0.058) of OC were significantly lower than those of normal tongue, muscle, and parotid glands (P < 0.001 for all), and the MD, AD, and RD values (1.220 ± 0.149, 1.434 ± 0.172, and 1.019 ± 0.165 × 10-3 mm2/s, respectively) were significantly higher than their respective normal values (P < 0.001 for all). Significant inverse correlations with histological grades were shown for FA, MD, AD, and RD values in OC patients (r = -0.862, r = -0.797, r = -0.747, and r = -0.844, respectively; P < 0.001 for all). In addition, there was a significant difference in the FA values of metastatic and nonmetastatic lymph nodes (0.186 vs. 0.276), MD (0.923 vs. 1.242 × 10-3 mm2/s), AD (1.246 vs. 1.621 × 10-3 mm2/s), and RD (0.792 vs. 1.100 × 10-3 mm2/s; P < 0.001 for all). CONCLUSIONS DTI may be clinically useful for the noninvasive evaluation of histological grade and lymph node metastasis in OC patients.
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Affiliation(s)
- Ichiro Yamada
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Norio Yohino
- Department of Oral and Maxillofacial Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Misaki Yokokawa
- Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Oikawa
- Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keigo Hikishima
- Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
| | - Tohru Kurabayashi
- Department of Oral and Maxillofacial Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukihisa Saida
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yae Ohata
- Department of Oral Pathology, Tokyo Medical and Dental University, Tokyo, Japan
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11
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Wu X, Yao Y, Li Z, Ge H, Wang D, Wang Y. Identification of a Transcriptional Prognostic Signature From Five Metabolic Pathways in Oral Squamous Cell Carcinoma. Front Oncol 2020; 10:572919. [PMID: 33425725 PMCID: PMC7793793 DOI: 10.3389/fonc.2020.572919] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/02/2020] [Indexed: 12/18/2022] Open
Abstract
Dysregulated metabolic pathways have been appreciated to be intimately associated with tumorigenesis and patient prognosis. Here, we sought to develop a novel prognostic signature based on metabolic pathways in patients with primary oral squamous cell carcinoma (OSCC). The original RNA-seq data of OSCC from The Cancer Genome Atlas (TCGA) project and Gene Expression Omnibus (GEO) database were transformed into a metabolic pathway enrichment score matrix by single-sample gene set enrichment analysis (ssGSEA). A novel prognostic signature based on metabolic pathways was constructed by LASSO and stepwise Cox regression analysis in the training cohort and validated in both testing and validation cohorts. The optimal cut-off value was obtained using the Youden index by receiver operating characteristic (ROC) curve. The overall survival curves were plotted by the Kaplan-Meier method. A time-dependent ROC curve analysis with 1, 3, 5 years as the defining point was performed to evaluate the predictive value of this prognostic signature. A 5-metabolic pathways prognostic signature (5MPS) for OSCC was constructed which stratified patients into subgroups with favorable or inferior survival. It served as an independent prognostic factor for patient survival and had a satisfactory predictive performance for OSCC. Our results developed a novel prognostic signature based on dysregulated metabolic pathways in OSCC and provided support for aberrant metabolism underlying OSCC tumorigenesis.
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Affiliation(s)
- Xiang Wu
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Yuan Yao
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Zhongwu Li
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Han Ge
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Dongmiao Wang
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Yanling Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
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12
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Faisal M, Dhanani R, Ullah S, Bakar MA, Irfan N, Malik KI, Loya A, Boban EM, Hussain R, Jamshed A. Prognostic outcomes of treatment naïve oral tongue squamous cell carcinoma (OTSCC): a comprehensive analysis of 14 years. Eur Arch Otorhinolaryngol 2020; 278:3045-3053. [PMID: 33236214 DOI: 10.1007/s00405-020-06482-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/07/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To analyze the factors predicting survival outcomes in treatment naïve oral tongue squamous cell carcinoma (OTSCC). MATERIALS AND METHODS A comprehensive review of 531 oral tongue carcinoma patients treated with upfront surgery followed by adjuvant radiotherapy or chemoradiotherapy was conducted from 2004-2018. RESULTS The mean age of presentation was 53 years (11-86) with a male to female ratio of 1.3:1. The associated risk factors were smoking (21%), betel nut (16%), naswar (9%) and alcohol (1%). Most of the cases were either well (45.1%) or moderately (46.2%) differentiated. Surgery was performed in 164 patients alone while 368 were treated with surgery in combination with adjuvant modalities. Overall (OS) and disease free survival (DFS) were 66 and 71%, respectively, with a median follow up of 2.5 years. Cox regression analysis showed nodal positivity, increased depth of invasion (DOI) and higher lymph node ratio (LNR) as significant prognosticators impacting OS and DSS. CONCLUSION Nodal volume, DOI and LNR are the most consistent predictors of poor outcome in OTSCC. Nodal positivity, depth of invasion > 5 mm and lymph node ratio > 0.04 adversely affect OS and DSS.
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Affiliation(s)
- Muhammad Faisal
- Department of Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
| | - Rahim Dhanani
- Department of Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Sami Ullah
- Department of Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Muhammad Abu Bakar
- Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Nabia Irfan
- Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Kashif Iqbal Malik
- Department of Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Asif Loya
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Erovic M Boban
- Department of Head and Neck Surgery, Evangelisches Krankenhaus, Vienna, Austria
| | - Raza Hussain
- Department of Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Arif Jamshed
- Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
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13
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Zeng S, Fu L, Zhou P, Ling H. Identifying risk factors for the prognosis of head and neck cutaneous squamous cell carcinoma: A systematic review and meta-analysis. PLoS One 2020; 15:e0239586. [PMID: 32991600 PMCID: PMC7523977 DOI: 10.1371/journal.pone.0239586] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/10/2020] [Indexed: 01/22/2023] Open
Abstract
In this study, we sought to identify the potential impacts of disease characteristics on the prognosis of cutaneous squamous cell carcinoma (cSCC). We searched the PubMed, EmBase, and Cochrane Library databases from their inception until February 2020 to identify studies that investigated the prognosis of cSCC. The pooled effect estimates were applied using odds ratios (OR) and 95% confidence intervals (CI) and were calculated using the random-effects model. Forty-three studies including a total of 21,530 patients and reporting 28,627 cases of cSCC were selected for the final meta-analysis. Poor differentiation (OR, 3.54; 95% CI, 2.30–5.46; P < 0.001), perineural invasion (OR, 3.27; 95% CI, 1.60–6.67; P = 0.001), Breslow greater than 2 mm (OR, 5.47; 95% CI, 2.63–11.37; P < 0.001), diameter greater than 20 mm (OR, 4.62; 95% CI, 2.95–7.23; P < 0.001), and location on temple (OR, 3.20; 95% CI, 1.12–9.15; P = 0.030) were associated with an increased risk of recurrence, whereas immunosuppression status and location on cheek, ear, or lip were not associated with the risk of recurrence. Poor differentiation (OR, 6.82; 95% CI, 4.66–9.99; P < 0.001); perineural invasion (OR, 7.15; 95% CI, 4.73–10.83; P < 0.001); Breslow greater than 2 mm (OR, 6.11; 95% CI, 4.05–9.21; P < 0.001); diameter greater than 20 mm (OR, 5.01; 95% CI, 2.56–9.80; P < 0.001); and location on ear (OR, 2.38; 95% CI, 1.39–4.09; P = 0.002), lip (OR, 2.15; 95% CI, 1.26–3.68; P = 0.005), and temple (OR, 2.77; 95% CI, 1.20–6.40; P = 0.017) were associated with an increased risk of metastasis, whereas immunosuppression status and location on cheek did not affect the risk of metastasis. Finally, poor differentiation (OR, 5.97; 95% CI, 1.82–19.62; P = 0.003), perineural invasion (OR, 6.64; 95% CI, 3.63–12.12; P < 0.001), and Breslow greater than 2 mm (OR, 3.42; 95% CI, 1.76–6.66; P < 0.001) were associated with an increased risk of disease-specific death, whereas diameter; immunosuppression status; and location on ear, lip, and temple did not affect the risk of disease-specific death. We found that differentiation, perineural invasion, depth, diameter, and location could affect the prognosis of cSCC. The potential role of other patient characteristics on the prognosis of cSCC should be identified in further large-scale prospective studies.
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Affiliation(s)
- Shihua Zeng
- Department of Dermatology, Chengdu Second People’s Hospital, Chengdu, China
- * E-mail:
| | - Lixin Fu
- Department of Dermatology, Chengdu Second People’s Hospital, Chengdu, China
| | - Peimei Zhou
- Department of Dermatology, Chengdu Second People’s Hospital, Chengdu, China
| | - Hua Ling
- Department of Anesthesiology, Chengdu Second People’s Hospital, Chengdu, China
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14
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Adeoye J, Thomson P, Choi S. Prognostic significance of multi‐positive invasive histopathology in oral cancer. J Oral Pathol Med 2020; 49:1004-1010. [DOI: 10.1111/jop.13086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/20/2020] [Indexed: 12/15/2022]
Affiliation(s)
- John Adeoye
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Peter Thomson
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Siu‐Wai Choi
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
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15
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Bostel T, Rühle A, Rackwitz T, Mayer A, Klodt T, Oebel L, Förster R, Schlampp I, Wollschläger D, Rief H, Sprave T, Debus J, Grosu AL, Schmidberger H, Akbaba S, Nicolay NH. The Role of Palliative Radiotherapy in the Treatment of Spinal Bone Metastases from Head and Neck Tumors-A Multicenter Analysis of a Rare Event. Cancers (Basel) 2020; 12:cancers12071950. [PMID: 32708389 PMCID: PMC7409283 DOI: 10.3390/cancers12071950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/08/2020] [Accepted: 07/15/2020] [Indexed: 01/04/2023] Open
Abstract
This retrospective multi-center analysis aimed to assess the clinical response and stabilizing effects of palliative radiotherapy (RT) for spinal bone metastases (SBM) in head and neck cancer (HNC), and to establish potential predictive factors for stability and overall survival (OS). Patients included in this analysis were treated at the University Hospitals of Mainz, Freiburg, and Heidelberg between 2001 and 2019. Clinical information was taken from the medical records. The stability of affected vertebral bodies was assessed according to the validated spine instability neoplastic score (SINS) based on CT-imaging before RT, as well as 3 and 6 months after RT. OS was quantified as the time between the start of palliative RT and death from any cause or last follow-up. Potential predictive factors for stability and OS were analyzed using generalized estimating equations and Cox regression for time-varying covariates to take into account multiple observations per patient. The mean follow-up time of 66 included patients after the first palliative RT was 8.1 months (range 0.3–85.0 months). The majority of patients (70%; n = 46) had squamous cell carcinomas (SCC) originating from the pharynx, larynx and oral cavity, while most of the remaining patients (26%; n = 17) suffered from salivary glands tumors. A total of 95 target volumes including 178 SBM were evaluated that received a total of 81 irradiation series. In patients with more than one metastasis per irradiated region, only the most critical bone metastasis was analyzed according to the SINS system. Prior to RT, pain and neurologic deficits were present in 76% (n = 72) and 22% (n = 21) of irradiated lesions, respectively, and 68% of the irradiated lesions (n = 65) were assessed as unstable or potentially unstable prior to RT. SBM-related pain symptoms and neurologic deficits responded to RT in 63% and 47% of the treated lesions, respectively. Among patients still alive at 3 and 6 months after RT with potentially unstable or unstable SBM, a shift to a better stability class according to the SINS was observed in 20% and 33% of the irradiated SBM, respectively. Pathological fractures of SBM were frequently detected before the start of irradiation (43%; n = 41), but after RT, new fractures or increasing vertebral body sintering within the irradiated region occurred rarely (8%; n = 8). A pathological fracture before RT was negatively associated with stabilization 6 months after RT (OR 0.1, 95% CI 0.02–0.49, p = 0.004), while a Karnofsky performance score (KPS) ≥ 70% was associated positively with a stabilization effect through irradiation (OR 6.09, 95% CI 1.68–22.05, p = 0.006). Mean OS following first palliative RT was 10.7 months, and the KPS (≥70% vs. <70%) was shown to be a strong predictive factor for OS after RT (HR 0.197, 95% CI 0.11–0.35, p < 0.001). There was no significant difference in OS between patients with SCC and non-SCC. Palliative RT in symptomatic SBM of HNC provides sufficient symptom relief in the majority of patients, while only about one third of initially unstable SBM show re-stabilization after RT. Since patients in our multi-center cohort exhibited very limited OS, fractionation schemes should be determined depending on the patients’ performance status.
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Affiliation(s)
- Tilman Bostel
- Department of Radiation Oncology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (A.M.); (T.K.); (L.O.); (H.S.); (S.A.)
- Correspondence: (T.B.); (A.R.)
| | - Alexander Rühle
- Department of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Strasse 3, 79106 Freiburg, Germany; (T.S.); (A.-L.G.); (N.H.N.)
- Correspondence: (T.B.); (A.R.)
| | - Tilmann Rackwitz
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (T.R.); (I.S.); (J.D.)
| | - Arnulf Mayer
- Department of Radiation Oncology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (A.M.); (T.K.); (L.O.); (H.S.); (S.A.)
| | - Tristan Klodt
- Department of Radiation Oncology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (A.M.); (T.K.); (L.O.); (H.S.); (S.A.)
| | - Laura Oebel
- Department of Radiation Oncology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (A.M.); (T.K.); (L.O.); (H.S.); (S.A.)
| | - Robert Förster
- Institute of Radiation Oncology, Cantonal Hospital Winterthur, University of Zurich, Brauerstrasse 15, 8401 Winterthur, Switzerland;
| | - Ingmar Schlampp
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (T.R.); (I.S.); (J.D.)
| | - Daniel Wollschläger
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, 55131 Mainz, Germany;
| | - Harald Rief
- Radiotherapy Bonn-Rhein-Sieg, 53115 Bonn, Germany;
| | - Tanja Sprave
- Department of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Strasse 3, 79106 Freiburg, Germany; (T.S.); (A.-L.G.); (N.H.N.)
| | - Jürgen Debus
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (T.R.); (I.S.); (J.D.)
| | - Anca-Ligia Grosu
- Department of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Strasse 3, 79106 Freiburg, Germany; (T.S.); (A.-L.G.); (N.H.N.)
| | - Heinz Schmidberger
- Department of Radiation Oncology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (A.M.); (T.K.); (L.O.); (H.S.); (S.A.)
| | - Sati Akbaba
- Department of Radiation Oncology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (A.M.); (T.K.); (L.O.); (H.S.); (S.A.)
| | - Nils Henrik Nicolay
- Department of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Strasse 3, 79106 Freiburg, Germany; (T.S.); (A.-L.G.); (N.H.N.)
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16
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Uchiyama Y, Sasai T, Nakatani A, Shimamoto H, Tsujimoto T, Kreiborg S, Murakami S. Distant metastasis from oral cavity-correlation between histopathology results and primary site. Oral Radiol 2020; 37:167-179. [PMID: 32468449 DOI: 10.1007/s11282-020-00440-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 04/19/2020] [Indexed: 12/16/2022]
Abstract
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.
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Affiliation(s)
- Yuka Uchiyama
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Tadashi Sasai
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Atsutoshi Nakatani
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hiroaki Shimamoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tomomi Tsujimoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Sven Kreiborg
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.,3D Craniofacial Image Research Laboratory, University of Copenhagen, Copenhagen, Denmark
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.,3D Craniofacial Image Research Laboratory, University of Copenhagen, Copenhagen, Denmark
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17
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Cai X, Huang J. Distant metastases in newly diagnosed tongue squamous cell carcinoma. Oral Dis 2019; 25:1822-1828. [PMID: 31206925 DOI: 10.1111/odi.13147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/05/2019] [Accepted: 06/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To characterize the incidence and survivals of patients with distant metastases in newly diagnosed tongue squamous cell carcinoma. MATERIALS AND METHODS Patients with distant metastases in newly diagnosed tongue squamous cell carcinoma were collected from the Surveillance, Epidemiology, and End Results database. Data were classified by sex, age, race, insurance status, T stage, N stage and grade. Multivariable logistic and Cox regression were used to demonstrate risk factors of the presence of distant metastases and hazards related to mortality, respectively. RESULTS We found 92 patients with distant metastases in newly diagnosed tongue squamous cell carcinoma, including lung, bone, liver, and brain, representing 1.08% of the entire cohort. 69 were male and 23 were female. Median survival among patients with distant metastases was 4.0 months. CONCLUSION The study describes the incidence and prognosis of patients with distant metastases in newly diagnosed tongue squamous cell carcinoma based on population estimates. The findings lend support to closely monitor the development of distant metastases among patients with predictors at the time of diagnosis of tongue squamous cell carcinoma.
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Affiliation(s)
- Xinjia Cai
- Department of Oral Pathology, Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Junhui Huang
- Department of Oral Pathology, Xiangya Stomatological Hospital, Central South University, Changsha, China
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18
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HMGA2 Contributes to Distant Metastasis and Poor Prognosis by Promoting Angiogenesis in Oral Squamous Cell Carcinoma. Int J Mol Sci 2019; 20:ijms20102473. [PMID: 31109142 PMCID: PMC6566167 DOI: 10.3390/ijms20102473] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 12/14/2022] Open
Abstract
The highly malignant phenotype of oral squamous cell carcinoma (OSCC), including the presence of nodal and distant metastasis, reduces patient survival. High-mobility group A protein 2 (HMGA2) is a non-histone chromatin factor that is involved in advanced malignant phenotypes and poor prognosis in several human cancers. However, its biological role in OSCC remains to be elucidated. The purpose of this study was to determine the clinical significance and role of HMGA2 in the malignant potential of OSCC. We first investigated the expression pattern of HMGA2 and its clinical relevance in 110 OSCC specimens using immunohistochemical staining. In addition, we examined the effects HMGA2 on the regulation of vascular endothelial growth factor (VEGF)-A, VEGF-C, and fibroblast growth factor (FGF)-2, which are related to angiogenesis, in vitro. High expression of HMGA2 was significantly correlated with distant metastasis and poor prognosis. Further, HMGA2 depletion in OSCC cells reduced the expression of angiogenesis genes. In OSCC tissues with high HMGA2 expression, angiogenesis genes were increased and a high proportion of blood vessels was observed. These findings suggest that HMGA2 plays a significant role in the regulation of angiogenesis and might be a potential biomarker to predict distant metastasis and prognosis in OSCC.
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Hosni A, Huang SH, Chiu K, Xu W, Su J, Lu L, Bayley A, Bratman SV, Cho J, Giuliani M, Kim J, O'Sullivan B, Ringash J, Waldron J, Spreafico A, de Almeida JR, Chepeha DB, Irish JC, Goldstein DP, Hope A. Validation of distant metastases risk-groups in oral cavity squamous cell carcinoma patients treated with postoperative intensity-modulated radiotherapy. Radiother Oncol 2019; 134:10-16. [DOI: 10.1016/j.radonc.2019.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/06/2018] [Accepted: 01/13/2019] [Indexed: 10/27/2022]
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20
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Yamada I, Yoshino N, Hikishima K, Sakamoto J, Yokokawa M, Oikawa Y, Harada H, Kurabayashi T, Saida Y, Tateishi U, Yukimori A, Izumo T, Asahina S. Oral carcinoma: Clinical evaluation using diffusion kurtosis imaging and its correlation with histopathologic findings. Magn Reson Imaging 2018; 51:69-78. [DOI: 10.1016/j.mri.2018.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 12/26/2022]
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Hasegawa T, Yanamoto S, Otsuru M, Kakei Y, Okura M, Yamakawa N, Yamada SI, Ota Y, Umeda M, Kirita T, Kurita H, Ueda M, Komori T. Multi-center retrospective study of the prognosis and treatment outcomes of Japanese oral squamous cell carcinoma patients with single lymph node metastasis and extra nodal extension. J Surg Oncol 2018; 117:1736-1743. [PMID: 29714825 DOI: 10.1002/jso.25083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/30/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) containing single lymph node metastasis (pN1) with extra nodal extension (ENE) is a rare clinical situation. Therefore, it is unclear whether pN1 with ENE is at high risk of recurrence among the OSCC population, or whether postoperative radiotherapy (RT)/concomitant chemoradiotherapy (CCRT) is effective in these cases. OBJECTIVES The purpose of this retrospective study was to investigate the prognosis and compare between no postoperative therapy and postoperative RT/CCRT in pN1 with ENE OSCC patients. METHODS Clinicopathological data and treatment modalities were investigated. The evaluated endpoints were overall survival (OS) and type of recurrence. RESULTS The 3-year cumulative OS rates for the pN1 only, multiple lymph node metastasis (MLM) only, ENE + MLM, and ENE + pN1 groups were 77.2%, 66.8%, 43.3%, and 66.6%, respectively. In the ENE + pN1 group, the most common cause of death in the surgery only group was from regional failure. The surgery + RT/CCRT group was associated with better disease-specific survival and OS rates than the surgery only groups (P < 0.05). CONCLUSIONS The prognosis of ENE + pN1 was not as poor as that of ENE + MLM, although both these groups feature ENE. Adjuvant therapy (RT/CCRT) after surgery is recommend for cases of ENE + pN1.
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Affiliation(s)
- Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Souichi Yanamoto
- Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mitsunobu Otsuru
- Department of Oral and Maxillofacial Surgery, Division of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaya Okura
- The First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Nobuhiro Yamakawa
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan
| | - Shin-Ichi Yamada
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoshihide Ota
- Department of Oral and Maxillofacial Surgery, Division of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Michihiro Ueda
- Department of Oral Surgical Oncology, Hokkaido Cancer Center, Sapporo, Japan
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22
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Bezerra NVF, Leite KLF, de Medeiros MMD, Martins ML, Cardoso AMR, Alves PM, Padilha WWN, Cavalcanti YW. Impact of the anatomical location, alcoholism and smoking on the prevalence of advanced oral cancer in Brazil. Med Oral Patol Oral Cir Bucal 2018; 23:e295-e301. [PMID: 29680854 PMCID: PMC5945237 DOI: 10.4317/medoral.22318] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 02/14/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND To evaluate the prevalence of oral cancer in Brazil according to the clinical stage, anatomical location, alcoholism and smoking. MATERIAL AND METHODS Data referring to 31,217 cases of oral cancer, from 2000 to 2010, were obtained from the Integrator Module of the Hospital Registry of Cancer. Inconsistent data ("non-classified" cases) was eliminated and 21,160 cases were analyzed. The frequency distribution according to clinical stage, anatomical location, alcoholism and smoking was analyzed descriptively and through a binary logistic regression model (α<0.05). The clinical stage (dependent variable) was dichotomized in early stage (I and II) or advanced stage (III and IV). The year of diagnosis, anatomical location and deleterious habits (alcoholism and smoking) were considered independent variables. RESULTS The most frequent characteristics were: oropharynx location (n=3856, 18.41%), clinical stage IV (n=11924, 56.09%) and combined use of alcohol and tobacco (n=19226; 61.59%). The year 2009 (p<0.01, PR = 1.162, CI-95%=1.053-1.283) and location at the base of tongue (p<0.01, PR = 2.485, CI-95% = 2.182-2.807) presented a higher prevalence ratio for advanced stage oral cancer. The combined use of alcohol and tobacco showed a higher prevalence rate for the advanced clinical stage of cancer (p<0.01, PR =1.449, CI-95%=1.382-1.520) if compared to individuals without habits, or just alcoholics. CONCLUSIONS Higher prevalence of advanced stage of oral cancer is related to the localization at the base of the tongue and to the concomitant use of alcohol and tobacco. Therefore, it can be suggested that all these characteristics lead to a worse prognosis of oral cancer.
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Affiliation(s)
- N-V-F Bezerra
- Clinical and Social Dentistry Department, Health Sciences Center, Federal University of Paraiba, Campus I, Cidade Universitária. João Pessoa-PB, ZIP code: 58051-900,
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Naruse T, Tokuhisa M, Yanamoto S, Sakamoto Y, Okuyama K, Tsuchihashi H, Umeda M. Lower gingival squamous cell carcinoma with brain metastasis during long-term cetuximab treatment: A case report. Oncol Lett 2018; 15:7158-7162. [PMID: 29725438 PMCID: PMC5920247 DOI: 10.3892/ol.2018.8261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 02/16/2018] [Indexed: 01/11/2023] Open
Abstract
Long-term cetuximab treatment can lead to acquired resistance, and tumor progression and/or new lesions often occur. The present report describes a case of lower gingival squamous cell carcinoma with brain metastasis during long-term cetuximab treatment in a 60-year-old man, including findings of an immunohistochemical study. The resected primary tumors, biopsy of the lung metastasis before administration of cetuximab, and brain metastasis specimens mediated by cetuximab were immunohistochemically examined. Histologically, the metastatic brain lesion showed hyperkeratinizing tumor cells with deeply stained irregular nuclei with necrotizing tumor cells, and a decrease in cell density was exhibited in part of the tumor nest. Moreover, the brain lesion was less malignant compared with the primary tumor and metastatic lung lesions. Immunohistochemically, the metastatic brain lesions showed low expression of epidermal growth factor receptor (EGFR) and high expression of N-cadherin compared with the primary tumor and metastatic lung lesions. These results suggest that acquired resistance to cetuximab may be associated with low EGFR expression and increased epithelial-to-mesenchymal transition potential.
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Affiliation(s)
- Tomofumi Naruse
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Mitsuko Tokuhisa
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Souichi Yanamoto
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Yuki Sakamoto
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Kohei Okuyama
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Hiroki Tsuchihashi
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
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24
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Multicenter retrospective study of cetuximab plus platinum-based chemotherapy for recurrent or metastatic oral squamous cell carcinoma. Cancer Chemother Pharmacol 2018; 81:549-554. [DOI: 10.1007/s00280-018-3531-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/26/2018] [Indexed: 10/18/2022]
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25
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Aires FT, Lin CS, Matos LL, Kulcsar MAV, Cernea CR. Risk Factors for Distant Metastasis in Patients with Oral Cavity Squamous Cell Carcinoma Undergoing Surgical Treatment. ORL J Otorhinolaryngol Relat Spec 2018; 79:347-355. [PMID: 29393250 DOI: 10.1159/000485627] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/20/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study is to investigate the clinical and pathological factors related to distant metastasis in patients with oral cavity squamous cell carcinoma (OCSCC) undergoing surgery. STUDY DESIGN A retrospective data review was conducted on patients who underwent primary surgery for OCSCC at the Instituto do Cancer do Estado de São Paulo (ICESP) between 2009 and 2015. Distant metastasis rates were calculated and predictive factors were determined by the Cox proportional-hazards model. RESULTS There was a total of 274 patients, including 210 (76.6%) men and 64 (23.4%) women, with a mean age of 59.9 ± 10.9 years. The incidence of distant metastasis was 9.6%, with the lung being the most common site. The mean time interval between surgical treatment and the diagnosis of distant metastasis was 12 months (range 2-40 months). In the multivariate analysis, angiolymphatic invasion (HR = 2,87; p = 0.023), contralateral cervical metastasis (HR = 3.3; p = 0,007), tumor thickness >25 mm (HR = 3.50; p = 0.009), and locoregional recurrence (HR = 6.59; p < 0.0001) were the only independent risk factors for distant metastasis. CONCLUSION Patients with OCSCC who have contralateral lymph node metastasis, tumors with a thickness >25 mm, angiolymphatic invasion, or locoregional recurrence after surgical treatment have a greater risk of developing distant metastasis.
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Affiliation(s)
- Felipe Toyama Aires
- Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Chin Shien Lin
- Department of Head and Neck Surgery, Instituto do Cancer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Leandro Luongo Matos
- Department of Head and Neck Surgery, Instituto do Cancer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | | | - Claudio Roberto Cernea
- Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
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26
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Advanced-stage tongue and mouth floor cancer is related to tobacco and alcohol abuse. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-017-0859-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Pathological features and their prognostic impacts on oral cavity cancer patients among different subsites - A singe institute's experience in Taiwan. Sci Rep 2017; 7:7451. [PMID: 28785002 PMCID: PMC5547072 DOI: 10.1038/s41598-017-08022-w] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/05/2017] [Indexed: 12/17/2022] Open
Abstract
We investigated the relationship of different primary subsites together with their pathological features on the survival of oral cavity squamous cell carcinoma (OCSCC) patients. We retrospectively reviewed OCSCC patients and documented their demographic data, pathological features and clinical outcome. The Cox proportional hazard model was used to examine the influence of various pathological features on the prognosis in different subsites of oral cavity. There were totally 1,383 OCSCC patients enrolled for final analysis. Perineural invasion had a poor prognosis at the early stage of OCSCC patients especially those with primary at the tongue. In addition, lymphovascular invasion was associated with poor survival at the late stage especially those with primary at the buccal mucosa and the tongue. The impact of pathological features on the survival of OCSCC patients varied in different subsites. Further investigation is warranted to validate our finding in a multicenter study. Grouping the different markers to establish a prognostic scoring system may provide more accurate evaluation of the prognosis in OCSCC patients.
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28
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Han N, Ong H, Liu Z, Ruan M, Yang W, Zhang C. Lymph node involvement predicts poor prognosis in primary tongue adenoid cystic carcinoma: A preliminary study of 54 cases. J Craniomaxillofac Surg 2017; 45:589-594. [DOI: 10.1016/j.jcms.2017.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/13/2016] [Accepted: 01/17/2017] [Indexed: 01/20/2023] Open
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29
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Naruse T, Yanamoto S, Matsushita Y, Sakamoto Y, Morishita K, Ohba S, Shiraishi T, Yamada SI, Asahina I, Umeda M. Cetuximab for the treatment of locally advanced and recurrent/metastatic oral cancer: An investigation of distant metastasis. Mol Clin Oncol 2016; 5:246-252. [PMID: 27446558 PMCID: PMC4950138 DOI: 10.3892/mco.2016.928] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 03/21/2016] [Indexed: 11/10/2022] Open
Abstract
The aim of this retrospective study was to assess the efficacy and safety of cetuximab therapy for patients with locally advanced (LA) and recurrent/metastatic (R/M) oral squamous cell carcinoma (OSCC), with a specific focus on distant metastases (DMs). Data from 21 patients with unresectable LA and R/M OSCC treated with cetuximab therapy in our department between December, 2012 and July, 2015 were reviewed. The endpoint was the time-to-progression and the assessments made were tumor response rate, progression-free survival (PFS), overall survival (OS) and safety. The overall response rate was 57.1%, with a complete response (CR) rate of 33.3%. The overall median PFS and OS were 5.5 and 8.0 months, respectively. For patients with DMs, the overall response rate was 60.0%, with a CR rate of 40.0%. The median PFS and OS were 3.8 and 5.8 months, respectively. In addition, improved 1-year OS was observed following approval of cetuximab, although the differences between the group of patients treated after that time and historical controls were not statistically significantly (P=0.246). Grade 3–4 adverse events included infusion reaction (4 cases), neutropenia, hypophosphatemia, upper gastrointestinal hemorrhage, liver toxicity and mucositis (1 case each). There was one cetuximab-related death due to interstitial pneumonia. An acne-like rash was observed in all cases, but no grade 3 or 4 rash was reported. Hypomagnesemia was observed in 10 cases. Our results suggest that cetuximab may display significant therapeutic efficacy in patients with unresectable LA and R/M OSCC, including those with DMs.
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Affiliation(s)
- Tomofumi Naruse
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8588, Japan
| | - Souichi Yanamoto
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8588, Japan
| | - Yuki Matsushita
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8588, Japan
| | - Yuki Sakamoto
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8588, Japan
| | - Kota Morishita
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8588, Japan
| | - Seigo Ohba
- Department of Regenerative Oral Surgery, Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8588, Japan
| | - Takeshi Shiraishi
- Department of Regenerative Oral Surgery, Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8588, Japan
| | - Shin-Ichi Yamada
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan
| | - Izumi Asahina
- Department of Regenerative Oral Surgery, Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8588, Japan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8588, Japan
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Adel M, Tsao CK, Wei FC, Chien HT, Lai CH, Liao CT, Wang HM, Fan KH, Kang CJ, Chang JTC, Huang SF. Preoperative SCC Antigen, CRP Serum Levels, and Lymph Node Density in Oral Squamous Cell Carcinoma. Medicine (Baltimore) 2016; 95:e3149. [PMID: 27057838 PMCID: PMC4998754 DOI: 10.1097/md.0000000000003149] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/24/2016] [Accepted: 02/24/2016] [Indexed: 01/29/2023] Open
Abstract
The prognostic significance of squamous cell carcinoma antigen (SCC-Ag) and C-reactive protein (CRP) levels and lymph node density (LND) has been individually recognized in oral squamous cell carcinoma (OSCC). We investigated the relationship between preoperative serum markers (SCC-Ag and CRP) and postoperative prognostic marker (LND) in this study. We retrospectively analyzed 277 OSCC patients who underwent primary curative resection and neck dissection with/or without adjuvant therapy between March 2008 and November 2013. Serum SCC-Ag and CRP levels were measured preoperatively. Distant metastasis, overall survival (OS), and disease-free survival (DFS) were used to evaluate the prognostic significance of preoperative SCC-Ag and CRP levels in relation to LND. LND (cutoff point ≥0.06) correlated with the pathologic tumor status, pathologic nodal metastasis, degree of differentiation, tumor stage, tumor depth (≥10 mm vs <10 mm), and perineural invasion (all P values were <0.001). LND was significantly associated with development of distant metastasis, DFS, and OS (all P values were <0.001). Preoperative elevated CRP and SCC-Ag levels were significantly associated with LND (P = 0.006), DFS (P < 0.001), and OS (P < 0.001). LND patients were further stratified into prognostic groups according to their SCC-Ag and CRP levels (DFS: P = 0.010; OS: P = 0.003). LND correlated with the incidence of DM, DFS, and OS in patients with OSCC. Concurrent elevated preoperative SCC-Ag and CRP levels are predictors for LND. In addition, SCC-Ag and CRP are markers for classifying high-risk LND patients with OSCC into subgroups.
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Affiliation(s)
- Mohamad Adel
- From the Department of Surgery (MA), Division of Surgical Oncology, Al-Azhar University Hospitals, Al-Azhar Faculty of Medicine, Cairo, Egypt, Department of Otolaryngology (MA, CTL, CJK, SFH), Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University (CKT, FCW), Department of Epidemiology (HTC, CHL), Department of Medical Oncology (HMW), and Department of Radiation Oncology (KHF, JTC), Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan, China
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31
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Precht C, Baustian S, Tribius S, Schöllchen M, Hanken H, Smeets R, Heiland M, Gröbe A. The benefit of abdominal sonography and chest X-ray for staging oral squamous cell carcinomas in stages UICC I and II. J Craniomaxillofac Surg 2015; 44:186-90. [PMID: 26712481 DOI: 10.1016/j.jcms.2015.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 10/11/2015] [Accepted: 11/09/2015] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate how often distant metastases occur in localized oral squamous cell carcinomas (OSCC). The investigators hypothesize that abdominal sonography and chest X-ray may not be necessary for initial staging of early oral squamous cell carcinoma in UICC stage I/II. MATERIAL AND METHODS The investigators implemented a retrospective study. The study collective was composed of 124 patients with OSCC, who were treated in the department of oral and maxillofacial surgery during the years 2011-2015 at the University Medical Center Hamburg Eppendorf, Germany. We focused on age, gender, date of diagnosis, tumour stage (clinical and pathological), HPV status, occurrence of metastases, recurrences, date and frequency of staging and restaging (abdominal sonography, chest X-ray, CT Abdomen/Thorax, PET CT), follow up time and date of death. Descriptive and bivariate statistics were computed (chi-square test) and the P value was set at .05. RESULTS 19 distant metastases were found in 13 out of 124 patients (10.48%). Of those 20 metastases 5 were found in the liver (26.32%), 11 in the lung (57.89%) and 4 in the bone (15.79%). Hepatic metastases co-occurred in every case with pulmonary metastases. In one case bone metastases occurred without the presence of pulmonary metastases. There was no significant correlation of metastasis rate to T stage. But distant metastases were solely found in node positive patients. This was significant for pulmonary metastases, not for liver metastases. Only one out of 11 pulmonary metastases was diagnosed by chest X-ray. CONCLUSION Abdominal sonography and chest X-ray can be omitted as a standard procedure in staging of localized node negative oral squamous cell carcinoma. A thoracic CT including the liver should be performed in patients with suspected lymph nodes metastases in the neck on CT. A skeletal scintigraphy or alternatively a PET/PET-CT should be added if there are signs and symptoms suspicious for bone metastases.
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Affiliation(s)
- Clarissa Precht
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sara Baustian
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Tribius
- Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Schöllchen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Henning Hanken
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Gröbe
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Muhanna N, Cui L, Chan H, Burgess L, Jin CS, MacDonald TD, Huynh E, Wang F, Chen J, Irish JC, Zheng G. Multimodal Image-Guided Surgical and Photodynamic Interventions in Head and Neck Cancer: From Primary Tumor to Metastatic Drainage. Clin Cancer Res 2015; 22:961-70. [PMID: 26463705 DOI: 10.1158/1078-0432.ccr-15-1235] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/24/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE The low survival rate of head and neck cancer (HNC) patients is attributable to late disease diagnosis and high recurrence rate. Current HNC staging has inadequate accuracy and low sensitivity for effective diagnosis and treatment management. The multimodal porphyrin lipoprotein-mimicking nanoparticle (PLP), intrinsically capable of positron emission tomography (PET), fluorescence imaging, and photodynamic therapy (PDT), shows great potential to enhance the accuracy of HNC staging and potentially HNC management. EXPERIMENTAL DESIGN Using a clinically relevant VX-2 buccal carcinoma rabbit model that is able to consistently develop metastasis to regional lymph nodes after tumor induction, we investigated the abilities of PLP for HNC diagnosis and management. RESULTS PLPs facilitated accurate detection of primary tumor and metastatic nodes (their PET image signal to surrounding muscle ratios were 10.0 and 7.3, respectively), and provided visualization of the lymphatic drainage from tumor to regional lymph nodes by both preoperative PET and intraoperative fluorescence imaging, allowing the identification of unknown primaries and recurrent tumors. PLP-PDT significantly enhanced cell apoptosis in mouse tumors (73.2% of PLP-PDT group vs 7.1% of PLP alone group) and demonstrated complete eradication of primary tumors and obstruction of tumor metastasis in HNC rabbit model without toxicity in normal tissues or damage to adjacent critical structures. CONCLUSIONS PLPs provide a multimodal imaging and therapy platform that could enhance HNC diagnosis by integrating PET/computed tomography and fluorescence imaging, and improve HNC therapeutic efficacy and specificity by tailoring treatment via fluorescence-guided surgery and PDT.
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Affiliation(s)
- Nidal Muhanna
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Liyang Cui
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Canada. Medical Isotopes Research Center, Peking University, Beijing, China
| | - Harley Chan
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Laura Burgess
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Cheng S Jin
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Pharmaceutical Sciences, University of Toronto, Toronto, Canada. Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Thomas D MacDonald
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Pharmaceutical Sciences, University of Toronto, Toronto, Canada
| | - Elizabeth Huynh
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Fan Wang
- Medical Isotopes Research Center, Peking University, Beijing, China
| | - Juan Chen
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada.
| | - Jonathan C Irish
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada.
| | - Gang Zheng
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Canada. Department of Pharmaceutical Sciences, University of Toronto, Toronto, Canada. Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.
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