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Tran Q, Maddineni S, Arnaud EH, Divi V, Megwalu UC, Topf MC, Sunwoo JB. Oral cavity cancer in young, non-smoking, and non-drinking patients: A contemporary review. Crit Rev Oncol Hematol 2023; 190:104112. [PMID: 37633348 PMCID: PMC10530437 DOI: 10.1016/j.critrevonc.2023.104112] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/11/2023] [Accepted: 08/23/2023] [Indexed: 08/28/2023] Open
Abstract
Oral squamous cell carcinoma (OSCC) in non-smoking and non-drinking (NSND) individuals appears to be distinct from the traditional head and neck squamous cell carcinoma (HNSCC). The incidence of this subset is increasing, as are the number of studies examining its characteristics. NSND OSCC individuals tend to be younger (<45 years) compared to traditional HNSCC patients. The proportion of females in the NSND OSCC cohort is also higher. The tongue is the predominantly affected subsite. Studies have revealed several gene mutations and unique epigenomic profiles but no definitive genetic etiology. Transcriptomic analysis has not found any causative viral agents. Other proposed etiologies include chronic dental trauma, microbiome abnormalities, marijuana consumption, and genetic disorders. There are international efforts to determine the relative prognostic outcome of this unique cohort, but no consensus has been reached. Here, we review the incidence, demographics, subsite, possible etiologies, prognosis, and therapy implications of the NSND OSCC cohort.
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Affiliation(s)
- Quan Tran
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Sainiteesh Maddineni
- Department of Otolaryngology - Head and Neck Surgery, Stanford University, Palo Alto, CA, USA
| | - Ethan Hunter Arnaud
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Vasu Divi
- Department of Otolaryngology - Head and Neck Surgery, Stanford University, Palo Alto, CA, USA
| | - Uchechukwu C Megwalu
- Department of Otolaryngology - Head and Neck Surgery, Stanford University, Palo Alto, CA, USA
| | - Michael C Topf
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - John B Sunwoo
- Department of Otolaryngology - Head and Neck Surgery, Stanford University, Palo Alto, CA, USA.
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2
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Soopanit T, Laokulrath N, Chayopasakul V, Pongsapich W. Prognostic value and clinicopathological status of PD-L1 expression and CD8+ TILs in oral squamous cell cancer patients with or without traditional risk factors. Head Neck 2023; 45:1017-1025. [PMID: 36811208 DOI: 10.1002/hed.27330] [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: 09/15/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Non-smokers, non-drinkers, and non-betel quid chewers (NSNDNBs) with oral squamous cell carcinoma (OSCC) have poor survival outcomes. Tumor microenvironment based on PD-L1/CD8+ T cell infiltrated lymphocyte (TIL) proportion is proposed as a prognostic indicator. METHODS Immunohistochemistry staining was performed on OSCC samples from 64 patients. The PD-L1/CD8+ TILs were scored and stratified into four groups. Disease-free survival (DFS) was analyzed using a Cox regression model. RESULTS OSCC in NSNDNB patients was associated with female sex, T1-2 classification, and PD-L1 positivity. Low CD8+ TILs correlated with perineural invasion. High CD8+ TILs correlated with improved DFS. PD-L1 positivity was not correlated with DFS. Type IV tumor microenvironment yielded the highest DFS (85%). CONCLUSION NSNDNB status relates to PD-L1 expression regardless of CD8+ TILs infiltration. Type IV tumor microenvironment was associated with the best DFS. High CD8+ TILs resulted in better survival, while PD-L1 positivity alone was not correlated to DFS.
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Affiliation(s)
- Thanion Soopanit
- Department of Otorhinolaryngology, Chulabhorn Hospital, Bangkok, Thailand
| | - Natthawadee Laokulrath
- Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Veeruth Chayopasakul
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Warut Pongsapich
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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3
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Yan EZ, Wahle BM, Nakken ER, Chidambaram S, Getz K, Thorstad WL, Zevallos JP, Mazul AL. No survival benefit in never-smoker never-drinker patients with oral cavity cancer. Head Neck 2023; 45:567-577. [PMID: 36524736 PMCID: PMC9898183 DOI: 10.1002/hed.27266] [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: 07/17/2022] [Revised: 11/01/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Although strongly associated with tobacco and alcohol use, many oral cavity squamous cell carcinoma (OCSCC) cases occur in patients without exposure to either, known as "never-smoker, never-drinkers" (NSND). We aimed to compare clinical outcomes between NSND and tobacco/alcohol-exposed populations and to define demographic characteristics of NSND. METHODS We performed a retrospective, single-institution cohort study of 672 OCSCC patients. Cox models were used to estimate differences in overall survival (OS) and recurrence-free survival (RFS) between NSND and tobacco/alcohol-exposed patients while adjusting for confounders. RESULTS NSND represented 25.6% of our cohort and were older, more female, and more economically advantaged. Among NSND, oral tongue tumors dominated in younger patients, while alveolar ridge tumors dominated in elderly patients. Multivariate survival analysis revealed no differences in OS or RFS between NSND and tobacco/alcohol-exposed patients. CONCLUSION When adjusted for independent biologic features, clinical outcomes in OCSCC are similar between NSND and tobacco/alcohol-exposed patients.
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Affiliation(s)
- Emily Z. Yan
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Benjamin M. Wahle
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Erik R. Nakken
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Smrithi Chidambaram
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Kayla Getz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Wade L. Thorstad
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jose P. Zevallos
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Angela L. Mazul
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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4
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Mazul AL, Chidambaram S, Zevallos JP, Massa ST. Disparities in head and neck cancer incidence and trends by race/ethnicity and sex. Head Neck 2023; 45:75-84. [PMID: 36200577 PMCID: PMC9742317 DOI: 10.1002/hed.27209] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The epidemiology of head and neck cancer (HNC) sites differ substantially. This study compares HNC incidence trends by site and demographic subgroups. METHODS We used the U.S. Cancer Statistics Public Use Database to calculate HNC incidence rates per 100 000. We assessed trends with annual percent change (APC) longitudinally from 2001 to 2017. RESULTS The oropharyngeal cancer incidence APC decreased from 4.38% (95% CI: 3.6, 5.1) to 2.93% (2.5, 3.3) in 2008 among White males. Oral cavity cancer incidence rose in Other race males (APC 2.5% [1.6, 3.36]) and White females (APC: 0.96% [0.7, 1.2]). Although decreasing (APC: -1.15% [-1.48, -0.83]), laryngeal cancer incidence remained disproportionately high among Black males. CONCLUSIONS Notable incidence trends occurred in non-White groups at non-oropharyngeal sites. With parity of smoking rates by race, differing sexual behaviors, and shifting demographics by race and sex, future studies of HNC trends should consider stratifying analyses to understand health disparities.
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Affiliation(s)
- Angela L Mazul
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Smrithi Chidambaram
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Jose P Zevallos
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sean T Massa
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA
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León X, Pujals G, Sauter B, Neumann E, Pujol A, Quer M. Differential characteristics of patients with squamous cell carcinoma of the head and neck with no history of tobacco or alcohol use. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2023; 74:31-38. [PMID: 36709798 DOI: 10.1016/j.otoeng.2022.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 02/06/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The present study aims to analyse the differential characteristics of patients with head and neck squamous cell carcinoma (HNSCC) without a history of consumption of toxic substances such as tobacco and alcohol. MATERIAL AND METHODS We carried out a retrospective study of 4694 patients with HNSCC located in the oral cavity, oropharynx, hypopharynx or larynx treated in our centre during the period 1985-2019. RESULT 7.7% of the patients (n = 363) did not report a history of consumption of toxic substances. The group of patients with no toxic history was older, had a higher proportion of women, a higher frequency of cases located in the oral cavity, a higher proportion of cases diagnosed in early stages, and a lower incidence of second neoplasms. The percentage of patients with no history of consumption of toxic substances increased significantly over the study period. The overall survival of patients with no history of consumption of toxic substances was significantly higher than that of patients with toxic substances use. Specific survival for patients with tumours located in the oral cavity without a history of consumption of toxic substances was significantly lower than that of patients with toxic substances use, whereas for patients with oropharyngeal carcinomas the absence of a history of consumption of toxic substances was associated with a better prognosis. CONCLUSIONS There were differences in the epidemiological and prognostic characteristics of patients with HNSCC according to the history of consumption of toxic substances such as tobacco and alcohol.
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Affiliation(s)
- Xavier León
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain; UVIC, Universitat Central de Catalunya, Vic, Spain.
| | - Gerard Pujals
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Blanca Sauter
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eduard Neumann
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Albert Pujol
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Quer
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
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Relationship between Menopausal Hormone Therapy and Oral Cancer: A Cohort Study Based on the Health Insurance Database in South Korea. J Clin Med 2022; 11:jcm11195848. [PMID: 36233715 PMCID: PMC9572981 DOI: 10.3390/jcm11195848] [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: 08/30/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
The association between the development of oral cavity cancer and sex hormones is unclear and inconsistent. This study aimed to evaluate the relationship between menopausal hormone therapy (MHT) and oral cavity cancer in menopausal women in Korea. In this retrospective cohort study, data were provided by the Korean National Health Insurance Service regarding a screening examination conducted from 1 January 2002 to 31 December 2019. Postmenopausal patients aged ≥40 years were considered, including 333,072 women in the MHT group and 847,558 women in the non-MHT group. Participants were divided into MHT types (tibolone, combined estrogen plus progestin by manufacturer, estrogen, combined estrogen plus progestin by physician, and topical estrogen), and the risk factors for oral cavity cancer development were analyzed. There was no significant association between smoking, alcohol consumption, age at menarche, and age at menopause with oral cavity cancer in postmenopausal women. However, the oral estrogen (hazard ratio [HR]: 1.633; 95% confidence interval [CI]: 1.35–1.976) and tibolone groups (HR: 1.633; 95% CI: 1.35–1.976) were associated with an elevated risk of oral cavity cancer. The results of this study suggest that MHT increases the risk of oral cavity cancer in postmenopausal women.
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Gandhi S, Arun KC, Bagul RR, Shah A, Shenoy S. Demography and Pattern of Tobacco Usage in Carcinoma of Upper Aerodigestive Tract. Indian J Otolaryngol Head Neck Surg 2022; 74:1735-1739. [PMID: 36452586 PMCID: PMC9701967 DOI: 10.1007/s12070-019-01733-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022] Open
Abstract
Upper aerodigestive tract (UADT) malignancies account for significant proportion of all malignancies. The aim of the study is to know the demography and patterns of tobacco consumption and the proportion of non-tobacco consumers in patients with UADT carcinoma. Patient diagnosed with primary UADT carcinoma visiting outpatient department in a tertiary centre from February 2009 to May 2011 were included in the study. 150 patients were documented with UADT carcinoma and analysed. Among these 133 were males and 17 were female. 40% of them had smoking, 25% had smokeless tobacco, 13% had both smoking and smokeless tobacco and 22% hadn't had any form of tobacco. Carcinoma larynx is the most common site and glottis is the commonest subsite. Most individuals who developed UADT carcinoma have used tobacco in some form. The high proportion of UADT carcinoma in non-tobacco consumer is alarming.
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Affiliation(s)
- Sachin Gandhi
- Department of Laryngology, Deenanath Mangeshkar Hospital, Pune, India
| | - K. C. Arun
- Department of ENT-HN Surgery, National Academy of Medical Sciences (NAMS), Kathmandu, Nepal
| | | | - Anuj Shah
- Department of Laryngology, Deenanath Mangeshkar Hospital, Pune, India
| | - Supreetha Shenoy
- Department of Laryngology, Deenanath Mangeshkar Hospital, Pune, India
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Características diferenciales de los pacientes con carcinoma escamoso de cabeza y cuello sin antecedentes de consumo de tabaco ni alcohol. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022. [DOI: 10.1016/j.otorri.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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9
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Bonetti Valente V, Mantovan Mazzon B, Urbano Collado F, Conrado Neto S, Lúcia Marçal Mazza Sundefeld M, Ricardo Biasoli É, Issamu Miyahara G, Galera Bernabé D. Clinicopathological and prognostic profile of non-smoking and non-drinking head and neck cancer patients: a population-based comparative study. Oral Oncol 2022; 127:105799. [DOI: 10.1016/j.oraloncology.2022.105799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 12/24/2022]
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10
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Pan C, Rizvi Z. Oral Cancer. Surg Clin North Am 2022; 102:309-324. [DOI: 10.1016/j.suc.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Uddin S, Singh A, Mishra V, Agrawal N, Gooi Z, Izumchenko E. Molecular drivers of oral cavity squamous cell carcinoma in non-smoking and non-drinking patients: what do we know so far? Oncol Rev 2022; 16:549. [PMID: 35340886 PMCID: PMC8941340 DOI: 10.4081/oncol.2022.549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 11/09/2021] [Indexed: 11/23/2022] Open
Abstract
Oral cavity squamous cell carcinoma (OCSCC) is one of the most common head and neck cancers worldwide. It is well known that risk factors for OCSCC include tobacco and excess alcohol consumption. However, in recent years, OCSCC incidence has been increasing in patients without these traditional risk factors. The cause of this increase is unclear and various genetic, environmental, and infectious factors have been hypothesized to play a role. Additionally, there are expert opinions that oral cancer in non-smoking, non-drinking (NSND) patients have a distinct phenotype resulting in more aggressive disease presentation and poorer prognosis. In this review, we summarize the current state of knowledge for oral cavity cancer in patients without traditional risk factors.
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Affiliation(s)
| | - Alka Singh
- Department of Medicine, Section of Hematology and Oncology
| | - Vasudha Mishra
- Department of Medicine, Section of Hematology and Oncology
| | - Nishant Agrawal
- Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, USA
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12
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Deneuve S, Dentand L, Pannard M, Dupret-Bories A, Roux Pierre E, Nokovitch L, Renno T, Perol O, Virard F, Fervers B, Marie P. Oral cavity squamous cell carcinomas in patients with no identified risk factors: Feeling like an outsider. Eur J Cancer Care (Engl) 2022; 31:e13558. [PMID: 35170126 DOI: 10.1111/ecc.13558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 01/03/2022] [Accepted: 01/26/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Head and neck squamous cell carcinomas (HNSCCs) mainly affect smokers and drinkers. However, oral cavity squamous cell cancers (OCSCCs) are increasingly affecting patients with no identified risk factors (NIRFs). This study aimed at characterising their experience of the disease. METHODS Qualitative study based on semi-structured interviews of 20 survivors of OCSCC with NIRF. Methods used in grounded theory approach were applied. RESULTS Patients with NIRF had a similar experience to that of patients with risk factors regarding treatments. The absence of identified causes led to stigma and led the patients to distance themselves, both from the stereotypic HNSCC cancer patient and the identity as a cancer patient. Furthermore, having no identified risk factors seemed to reinforce the fear of recurrence. CONCLUSION This study is the first to address key gaps in knowledge regarding patients with NIRF having survived OCSCC. Their experience is similar to that of patients with orphan diseases. Owing to confrontation with other patients and the repeated questions of caregivers about tobacco/alcohol consumption, these patients felt stigmatised during their treatment. OCSCC patients with NIRF may benefit from guidance and support on how to engage in prevention.
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Affiliation(s)
- Sophie Deneuve
- Surgical Oncology Department, Léon Bérard Cancer Comprehensive Center, Lyon, France.,INSERM 1296, Radiations: Defense, Health and Environment, Léon Bérard Cancer Center, Lyon, France
| | - Lolane Dentand
- GRePS Groupe d'Etude, Lumière University Lyon 2, Lyon, France
| | - Myriam Pannard
- GRePS Groupe d'Etude, Lumière University Lyon 2, Lyon, France
| | - Agnes Dupret-Bories
- Head and Neck Department, Toulouse University Cancer Institute, Toulouse, France
| | - Eric Roux Pierre
- Surgical Oncology Department, Léon Bérard Cancer Comprehensive Center, Lyon, France
| | - Lara Nokovitch
- Surgical Oncology Department, Léon Bérard Cancer Comprehensive Center, Lyon, France
| | - Toufic Renno
- Cancer Research Center of Lyon, INSERM 1052, Claude Bernard University Lyon 1, Villeurbanne, France
| | - Olivia Perol
- INSERM 1296, Radiations: Defense, Health and Environment, Léon Bérard Cancer Center, Lyon, France.,Prevention Cancer Environnement Department, Léon Bérard Cancer Comprehensive Center, Lyon, France
| | - François Virard
- Cancer Research Center of Lyon, INSERM 1052, Claude Bernard University Lyon 1, Villeurbanne, France.,University of Lyon, Faculty of Odontology, Hospices Civils de Lyon, Lyon, France
| | - Beatrice Fervers
- Prevention Cancer Environnement Department, Léon Bérard Cancer Comprehensive Center, Lyon, France.,University of Lyon, Faculty of Odontology, Hospices Civils de Lyon, Lyon, France
| | - Preau Marie
- INSERM 1296, Radiations: Defense, Health and Environment, Léon Bérard Cancer Center, Lyon, France
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Adeoye J, Tan JY, Ip CM, Choi SW, Thomson P. "Fact or fiction?": Oral cavity cancer in nonsmoking, nonalcohol drinking patients as a distinct entity-Scoping review. Head Neck 2021; 43:3662-3680. [PMID: 34313348 DOI: 10.1002/hed.26824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/11/2021] [Accepted: 07/19/2021] [Indexed: 12/20/2022] Open
Abstract
Oral cavity cancer is often described as a lifestyle-related malignancy due to its strong associations with habitual factors, including tobacco use, heavy alcohol consumption, and betel nut chewing. However, patients with no genetically predisposing conditions who do not indulge in these risk habits are still being encountered, albeit less commonly. The aim of this review is to summarize contemporaneous reports on these nonsmoking, nonalcohol drinking (NSND) patients. We performed database searching to identify relevant studies from January 1, 2000 to March 31, 2021. Twenty-six articles from 20 studies were included in this study. We found that these individuals were mostly females in their eighth decade with tumors involving the tongue and gingivobuccal mucosa. This review also observed that these patients were likely diagnosed with early stage tumors with overexpression of programmed death-ligand 1 (PD-L1) and increased intensity of tumor infiltrating lymphocytes. Treatment response and disease-specific prognosis were largely comparable between NSND and smoking/drinking patients.
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Affiliation(s)
- John Adeoye
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Jia Yan Tan
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Cheuk Man Ip
- Department of Anesthesia, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Adeoye J, Hui L, Tan JY, Koohi-Moghadam M, Choi SW, Thomson P. Prognostic value of non-smoking, non-alcohol drinking status in oral cavity cancer. Clin Oral Investig 2021; 25:6909-6918. [PMID: 33991259 DOI: 10.1007/s00784-021-03981-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/10/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To compare the treatment response and prognosis of oral cavity cancer between non-smoking and non-alcohol-drinking (NSND) patients and smoking and alcohol-drinking (SD) patients. METHODS A total of 313 consecutively treated patients from 2000 to 2019 were included. Demographic, clinicopathologic, treatment, and prognosis information were obtained. Relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were compared between NSND and SD groups using Kaplan-Meier plots, log-rank test, and multivariate Cox regression analysis. RESULTS Sample prevalence of NSND patients was 54.6%. These patients were predominantly females in their eighth decade with lower prevalence of floor of the mouth cancers compared to SD patients (1.8% vs 14.8%). No difference in the RFS and DSS between both groups was found following multivariable analysis; however, NSND patients had better OS (HR (95% CI) - 0.47 (0.29-0.75); p = 0.002). Extracapsular extension was associated with significantly poorer OS, DSS, and RFS in this oral cavity cancer cohort. CONCLUSION Treatment response and disease-specific prognosis are comparable between NSND and SD patients with oral cavity cancer. However, NSND patients have better OS. CLINICAL RELEVANCE This study shows that oral cavity cancer in NSND is not less or more aggressive compared to SD patients. Although better survival is expected for NSND than SD patients, this is likely due to the reduced incidence of other chronic diseases in the NSND group.
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Affiliation(s)
- John Adeoye
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China. .,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.
| | - Liuling Hui
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Jia Yan Tan
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Mohamad Koohi-Moghadam
- Applied Oral Sciences and Community Dental Care, University of Hong Kong, Hong Kong SAR, China
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
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15
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Deneuve S, Guerlain J, Dupret-Bories A, Majoufre C, Philouze P, Ceruse P, Perreard M, Sigaud N, Barry B, Ransy P, Schultz P, Malard O, Morinière S, Chatellier A, De Monès E, Folia M, Virard F, Fervers B. Oral tongue squamous cell carcinomas in young patients according to their smoking status: a GETTEC study. Eur Arch Otorhinolaryngol 2021; 279:415-424. [PMID: 33877432 DOI: 10.1007/s00405-021-06793-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/31/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Incidence of oral tongue squamous cell carcinoma (OTSCC) is increasing, especially in young adults, despite decreasing tobacco and alcohol consumption. METHODS This multicentric retrospective study of 185 young adults with OTSCC (median follow-up 43 months), investigated risk factors, tumour characteristics and oncological outcomes according to the smoking status. RESULTS Overall, 38% of patients were smokers (S). Non-smokers (NS) were significantly younger than S. Sex ratios were 1.1 for N and 1.8 for S. NS patients were less frequently cannabis or alcohol users than S, but were more likely to have a history of leukoplakia. Second primaries were observed in NS (4.4%) and in S (12.7%). Despite more frequent local relapse in NS (p = 0.018), there was no difference in diagnostic stage and overall survival between groups. CONCLUSION OTSCC affects differently young S and NS patients suggesting the existence of a specific clinical entity of OTSCC in non-smoking young adults.
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Affiliation(s)
- Sophie Deneuve
- Surgical Oncology Department, Léon Bérard Comprehensive Cancer Center, 28 rue Laennec, 69008, Lyon, France. .,INSERM UA8, Radiation: Défense, Santé , Environnement, Lyon, France.
| | - Joanne Guerlain
- Head and Neck Department, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - Agnès Dupret-Bories
- Head and Neck Department, Toulouse University Cancer Institute, Toulouse, France
| | - Claire Majoufre
- Maxillofacial Surgery, CHU Bordeaux Pellegrin, Bordeaux, France
| | | | | | | | - Nicolas Sigaud
- Maxillofacial Surgery, CHU Lyon Sud, Pierre-Bénite, France
| | | | | | | | | | | | | | | | | | - François Virard
- INSERM U1052-CNRS UMR5286, Cancer Research Center, centre Léon Berard, Lyon 1 University, Lyon, France.,Université de Lyon, Faculté d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Béatrice Fervers
- INSERM UA8, Radiation: Défense, Santé , Environnement, Lyon, France.,Cancer and Environnement Department, Léon Bérard Comprehensive Cancer Center, Lyon, France
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16
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Koo K, Mouradov D, Angel CM, Iseli TA, Wiesenfeld D, McCullough MJ, Burgess AW, Sieber OM. Genomic Signature of Oral Squamous Cell Carcinomas from Non-Smoking Non-Drinking Patients. Cancers (Basel) 2021; 13:cancers13051029. [PMID: 33804510 PMCID: PMC7957667 DOI: 10.3390/cancers13051029] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/15/2021] [Accepted: 02/22/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary A clinically distinct cohort of non-smoking non-drinking patients who develop oral cavity squamous cell carcinomas has been identified, with previous work suggesting that these patients tend to be older, female, and have poor outcomes. Our study characterised tumour molecular alterations in these patients, identifying differences in genomic profiles as compared to patients who smoke and/or drink. Associations between molecular alterations and other clinical and pathological characteristics were also explored. Abstract Molecular alterations in 176 patients with oral squamous cell carcinomas (OSCC) were evaluated to delineate differences in non-smoking non-drinking (NSND) patients. Somatic mutations and DNA copy number variations (CNVs) in a 68-gene panel and human papilloma virus (HPV) status were interrogated using targeted next-generation sequencing. In the entire cohort, TP53 (60%) and CDKN2A (24%) were most frequently mutated, and the most common CNVs were EGFR amplifications (9%) and deletions of BRCA2 (5%) and CDKN2A (4%). Significant associations were found for TP53 mutation and nodal disease, lymphovascular invasion and extracapsular spread, CDKN2A mutation or deletion with advanced tumour stage, and EGFR amplification with perineural invasion and extracapsular spread. PIK3CA mutation, CDKN2A deletion, and EGFR amplification were associated with worse survival in univariate analyses (p < 0.05 for all comparisons). There were 59 NSND patients who tended to be female and older than patients who smoke and/or drink, and showed enrichment of CDKN2A mutations, EGFR amplifications, and BRCA2 deletions (p < 0.05 for all comparisons), with a younger subset showing higher mutation burden. HPV was detected in three OSCC patients and not associated with smoking and drinking habits. NSND OSCC exhibits distinct genomic profiles and further exploration to elucidate the molecular aetiology in these patients is warranted.
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Affiliation(s)
- Kendrick Koo
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medial Research, Parkville, VIC 3052, Australia; (K.K.); (D.M.); (A.W.B.)
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia;
| | - Dmitri Mouradov
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medial Research, Parkville, VIC 3052, Australia; (K.K.); (D.M.); (A.W.B.)
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3052, Australia
| | | | - Tim A. Iseli
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
| | - David Wiesenfeld
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia;
| | | | - Antony W. Burgess
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medial Research, Parkville, VIC 3052, Australia; (K.K.); (D.M.); (A.W.B.)
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
| | - Oliver M. Sieber
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medial Research, Parkville, VIC 3052, Australia; (K.K.); (D.M.); (A.W.B.)
- Department of Medical Biology, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC 3050, Australia; (T.A.I.); (D.W.)
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC 3800, Australia
- Correspondence:
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17
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Mulder FJ, Pierssens DDCG, Baijens LWJ, Kremer B, Speel EJM. Evidence for different molecular parameters in head and neck squamous cell carcinoma of nonsmokers and nondrinkers: Systematic review and meta-analysis on HPV, p16, and TP53. Head Neck 2020; 43:303-322. [PMID: 33098216 PMCID: PMC7756438 DOI: 10.1002/hed.26513] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/30/2020] [Accepted: 10/13/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The goal of this review was to present an overview of the currently identified molecular parameters in head and neck squamous cell carcinoma (HNSCC) of nonsmokers and nondrinkers (NSND). METHODS Following the PRISMA guidelines, a systematic search was performed using the electronic databases PubMed, Embase, and Google Scholar. RESULTS Of the 902 analyzed unique studies, 74 were included in a quantitative synthesis and 24 in a meta-analysis. Human papillomavirus (HPV) was reported as a molecular parameter in 38 studies, followed by p16 and TP53 (23 and 14 studies, respectively). The variety of other molecular parameters concerned sporadic findings in small numbers of NSND. CONCLUSIONS HNSCC in NSND is more often related to HPV and p16 overexpression compared to tumors of smokers-drinkers. In a third of virus-negative tumors, TP53 mutations were detected with a mutational profile associated with aging and ultraviolet light exposure rather than to tobacco consumption.
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Affiliation(s)
- Frans J Mulder
- Department of Otorhinolaryngology and Head & Neck Surgery, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Damiana D C G Pierssens
- Department of Oral and Cranio-Maxillofacial Surgery, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Laura W J Baijens
- Department of Otorhinolaryngology and Head & Neck Surgery, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Bernd Kremer
- Department of Otorhinolaryngology and Head & Neck Surgery, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Ernst-Jan M Speel
- Department of Pathology, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
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18
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Lenouvel D, González-Moles MÁ, Ruiz-Ávila I, Chamorro-Santos C, González-Ruiz L, González-Ruiz I, Ramos-García P. Clinicopathological and prognostic significance of PD-L1 in oral cancer: A preliminary retrospective immunohistochemistry study. Oral Dis 2020; 27:173-182. [PMID: 32583572 DOI: 10.1111/odi.13509] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/02/2020] [Accepted: 06/14/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the relation between PD-L1 expression in oral cavity squamous cell carcinomas and clinicopathological features as well as survival outcomes. METHODS A retrospective immunohistochemical study was carried out on 55 archived tumours from 55 patients. Tumours were stained for PD-L1 and scored by the proportion of tumour cells with positive membranous staining. PD-L1 scores were compared to the patient's clinicopathological characteristics for any significant associations. Kaplan-Meier curves were constructed for PD-L1 positive and negative tumours to investigate any advantage to survival. RESULTS Positive PD-L1 staining was found in 58% of tumours and was significantly more likely in non-smokers, non-drinkers and in tongue squamous cell carcinomas. Increased PD-L1 was also associated with increased lymphocyte infiltration as well as PD-L1 staining in lymphocytes and the epithelium adjacent to tumour invasion. No survival benefit was seen from PD-L1 expression in tumour cells. CONCLUSIONS PD-L1 expression is more common in non-smokers and non-drinkers, and its presence in the adjacent non-tumour epithelium suggests it may be involved in early oncogenesis.
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Affiliation(s)
| | | | - Isabel Ruiz-Ávila
- Biosanitaria Research Institute, Granada, Spain.,Pathology Service, San Cecilio Hospital Complex, Granada, Spain
| | - Clara Chamorro-Santos
- Biosanitaria Research Institute, Granada, Spain.,Pathology Service, San Cecilio Hospital Complex, Granada, Spain
| | - Lucía González-Ruiz
- Dermatology Service, Ciudad Real General University Hospital, Ciudad Real, Spain
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19
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Kanwal M, Haider G, Zareef U, Saleem S. Addiction of tobacco chewing and smoking in the patients of head and neck squamous cell carcinoma: A descriptive epidemiological study in Pakistan. Pak J Med Sci 2019; 35:1712-1717. [PMID: 31777521 PMCID: PMC6861502 DOI: 10.12669/pjms.35.6.1309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective: The associated risk factors for the majority of patients with head and neck squamous cell carcinoma (HNSCC) are tobacco and betel nut abuse, while there also seems to be a rising proportion of patients who report no history of tobacco or betel nut usage. Therefore, objective of the study was to find out potential risk factors and demographics of HNSCC patients addicted to tobacco and/or betel nut, as well as non-addicted patients. Methods: This epidemiological study was conducted in Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, and Jinnah Postgraduate Medical Centre (JPMC) from January to December 2016. All subjects were participants in an epidemiological study of HNSCC. Demographics and clinical characteristics were obtained for 185 addicted and 26 non-addicted patients. Results: Non-addicted patients were more likely to be females (χ2=19.0, p<0.001) and were significantly younger than addicted patients (χ2=21.0, p<0.001). Addicted patients more likely belonged to a lower income group (χ2=14.4, p=0.006) and had a higher proportion of oral cancers (χ2=30.0, p<0.001). Almost all addicted females had oral cancers (97%), whereas more than half of the non-addicted females had oral cancers (53%). Conclusions: Addicted patients commonly have oral cavity cancers. This might be due to the habit of chewing tobacco and/or betel nut that addicted patients have. Non-addicted patients are commonly young females. It is likely that no single known factor is responsible for HNSCC in non-addicted patients, and several occupational exposure studies in future may be important to the etiology of non-addicted patients.
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Affiliation(s)
- Madiha Kanwal
- Madiha Kanwal, PhD Student. The Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan
| | - Ghulam Haider
- Ghulam Haider, MBBS, FCPS (Medicine), FCPS (Oncology), Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan
| | - Uzma Zareef
- Uzma Zareef, BDS, MCPS, (Oral & Maxillo-Facial Surgery), Liaquat College of Medicine and Dentistry (LCMD), Karachi, Pakistan
| | - Saima Saleem
- Saima Saleem, PhD. The Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan
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20
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Panarese I, Aquino G, Ronchi A, Longo F, Montella M, Cozzolino I, Roccuzzo G, Colella G, Caraglia M, Franco R. Oral and Oropharyngeal squamous cell carcinoma: prognostic and predictive parameters in the etiopathogenetic route. Expert Rev Anticancer Ther 2019; 19:105-119. [PMID: 30582397 DOI: 10.1080/14737140.2019.1561288] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Oral and oropharyngeal squamous cell carcinoma (OSCC and OPSCC) represents an increasing problem in the global public health. Indeed, squamous cell carcinoma is the most frequent malignancy in oral cavity and 1 of the 10 most common cancers worldwide. According to the most recent GLOBOCAN estimate in Europe between 2012 and 2015, there was an overall increasing incidence and mortality for oral cancer, mostly HPV-related in the oropharyngeal region with evidence of significant differences from the prognostic and therapeutic point of view. Areas covered: Until now, the management of the patients is based on classical histologic parameters such as TNM and tumor grading, but new molecular and cell markers have been investigated to improve patients' treatment and survival. Therefore, there is a need for new biomarkers characterizing the cancer diversity, with the consequent possibility of patient stratification for specific treatment. Expert commentary: This review aims to discuss some of the most relevant and novel genetic, epigenetic, and histological prognostic biomarkers in oral cancer, highlighting the main differences between HPV-unrelated oral squamous cell carcinoma (OSCC) and HPV-related oropharyngeal squamous cell carcinoma (OPSCC) that may aid in stratifying prognostic subgroups and rationalizing treatment decisions.
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Affiliation(s)
- Iacopo Panarese
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Gabriella Aquino
- b Pathology Unit , Istituto dei Tumori 'Fondazione G. Pascale', IRCCS , Naples , Italy
| | - Andrea Ronchi
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Francesco Longo
- c Head and Neck Surgery Unit , Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale", IRCCS , Naples , Italy
| | - Marco Montella
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Immacolata Cozzolino
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Giuseppe Roccuzzo
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Giuseppe Colella
- d Maxillo-Facial Unit, Multidisciplinary Department of Medical, Surgical and Dental Specialties , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Michele Caraglia
- e Department of Precision Medicine , University of Campania "L. Vanvitelli" , Naples , Italy
| | - Renato Franco
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
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21
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DeAngelis A, Breik O, Koo K, Iseli T, Nastri A, Fua T, Rischin D, McCullough M, Wiesenfeld D. Non-smoking, non-drinking elderly females, a 5 year follow-up of a clinically distinct cohort of oral squamous cell carcinoma patients. Oral Oncol 2018; 86:113-120. [PMID: 30409291 DOI: 10.1016/j.oraloncology.2018.09.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/02/2018] [Accepted: 09/05/2018] [Indexed: 02/01/2023]
Abstract
To examine differences in survival and clinical outcomes of elderly patients without traditional risk factors presenting with oral squamous cell carcinoma. Retrospective review of 287 consecutive patients divided into 2 treatment period cohorts treated for oral SCC between the 1st Jan 2007 and 31st Dec 2012. Patients were classified as either smoker-drinkers (SD) or non-smoking, non-drinking (NSND). Only patients with oral sub-site primaries according to ICD-10 were included. Carcinomas of the lip, tonsil, base of tongue and oro-pharyngeal subsites were excluded. Of the study population (N = 287), 24.4% were NSND and 9.75% were NSND elderly (older than 70 years) females. >50% of tumours arose from the oral tongue in NSND patients (p = 0.022) and there was a higher rate of recurrent and persistent disease (42.9% vs 27.6%, p = 0.005). Disease specific survival at 5 years was significantly reduced when NSND elderly females were compared to all other patients (p < 0.001) as well as age matched controls (p = 0.006). This effect was verified independently in each cohort.The results of this study suggest that NSND elderly females are a distinct patient population with poorer disease specific survival outcomes.
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Affiliation(s)
- Adrian DeAngelis
- Oral & Maxillofacial Surgery, Royal Melbourne Hospital, Australia.
| | - Omar Breik
- Oral & Maxillofacial Surgery, Royal Melbourne Hospital, Australia
| | - Kendrick Koo
- Otorhinolaryngology Head & Neck Surgery, Royal Melbourne Hospital, Australia
| | - Tim Iseli
- Otorhinolaryngology Head & Neck Surgery, Royal Melbourne Hospital, Australia
| | - Alf Nastri
- Oral & Maxillofacial Surgery, Royal Melbourne Hospital, Australia; University of Melbourne, Australia
| | - Tsien Fua
- Dept of Radiation Oncology, Peter MacCallum Cancer Centre, Australia.
| | - Danny Rischin
- Dept of Medical Oncology, Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Dept of Oncology, University of Melbourne, Australia.
| | - Michael McCullough
- Melbourne Dental School, University of Melbourne, Australia; Royal Melbourne Hospital, Australia.
| | - David Wiesenfeld
- Victorian Comprehensive Cancer Centre, Australia; Dept of Surgery, University of Melbourne, Australia.
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22
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Singhvi HR, Malik A, Chaturvedi P. The Role of Chronic Mucosal Trauma in Oral Cancer: A Review of Literature. Indian J Med Paediatr Oncol 2017; 38:44-50. [PMID: 28469336 PMCID: PMC5398106 DOI: 10.4103/0971-5851.203510] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Chronic mucosal trauma resulting from sharp teeth, dentures, faulty restoration, or implants has frequently been associated with the development of oral cancer. The definitive evidence for the same is lacking. We undertook a search using the terms – dental trauma, mucosal trauma, oral cancer, squamous cell carcinoma, risk factor, potentially malignant lesion, dental factor, mechanical irritation, dental irritation, and cancer in the following electronic databases: MEDLINE, PubMed, ScienceDirect, Cochrane Database of Systematic Reviews, and Wiley InterScience. The search yielded 788 articles. Of these articles, only 22 articles described chronic mucosal trauma as risk factors for oral cancers and were considered in this review. The review shows that chronic mucosal irritation resulting from ill-fitting dentures may be considered a risk factor for the development of oral cancer, such cancers occur commonly over the lateral border of the tongue. However, no association has been proven between the duration of denture use and cancer formation. In patients without any addiction, such cancers occur more frequently in females. These cancers may present with an early nodal disease but their prognosis and outcomes have not been studied separately till now.
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Affiliation(s)
| | - Akshat Malik
- Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Pankaj Chaturvedi
- Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
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23
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Dediol E, Sabol I, Virag M, Grce M, Muller D, Manojlović S. HPV prevalence and p16INKa overexpression in non-smoking non-drinking oral cavity cancer patients. Oral Dis 2016; 22:517-22. [PMID: 26993152 DOI: 10.1111/odi.12476] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/29/2016] [Accepted: 03/08/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Our aim was to compare HPV and p16INK4a (p16) expression and their influence on survival and prognosis in oral cavity squamous cell cancer (OCSCC), between non-smokers and non-drinkers (NSND) and smokers and drinkers (SD). SUBJECTS AND METHODS Patients with OCSCC treated with surgery from 2000 to 2010 were included in the study. Patients who did not smoke at all or smoked less than 10 pack per years and did not drink alcohol on a daily basis were considered the NSND group. An equal number of SD were the control group. HPV presence was determined from paraffin-embedded blocks investigated by PCR analysis. p16 expression was evaluated with immunohistochemistry. RESULTS The NSND group were mostly younger or older female patients with tongue or gingival cancers. p16 expression was significantly more frequent in NSND patients (27% vs 10%). Patients with stronger p16 expression had significantly worse survival, especially for tongue cancers (P = 0.026). In Cox multivariate analysis, both HPV and p16 expression carried a negative prognosis for NSND patients (P = 0.0351 and P = 0.0260). CONCLUSIONS NSND are a specific population of OCSCC patients. In contrast to oropharyngeal cancer, HPV and p16 expression in OCSCC are negative predictive factors, especially in NSND patients.
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Affiliation(s)
- E Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - I Sabol
- Department of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - M Virag
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - M Grce
- Department of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - D Muller
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Pathology, University Hospital Dubrava, Zagreb, Croatia
| | - S Manojlović
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Pathology, University Hospital Dubrava, Zagreb, Croatia
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24
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Lopes MLDDS, Aquino ARLD, Morais MDLSDA, Medeiros LBD, Silveira ÉJDD. Multiple Second Primary Oral Squamous Cell Carcinomas in a Nonsmoker and Nondrinker Woman: Case Report and Review of the Literature. J Contemp Dent Pract 2015; 16:322-8. [PMID: 26067738 DOI: 10.5005/jp-journals-10024-1684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIM This manuscript aims to describe an unusual case of multiple second primary squamous cell carcinomas (SCCs) in several sites of the oral mucosa in a nonsmoker and nondrinker woman and to discuss the diagnostic criteria, clinicopathological aspects and outcome of second primary tumor (SPT). BACKGROUND Patients treated for SCC of the head and neck are at high risk for developing SPT arising from the same dysplastic mucosal feld. Currently, there is no reliable method to predict which of the patients will develop SPT. CASE DESCRIPTION A 64-year-old nonsmoker and nondrinker woman developed several second primary oral SCCs in 7 years of follow-up, most of them being synchronic, treated by surgery without and with chemotherapy and radiotherapy. CONCLUSION Patients treated for SCC require a long-term and careful follow-up as the development of SPT contributes with significantly negative impact on the prognosis. CLINICAL SIGNIFICANCE This report describes the diagnosis and management of a very unusual case of several SPTs affecting different sites of the oral mucosa in the same patient. Moreover, the patient had no apparent risk factors associated with the development of the oral cancer. Therefore, a brief update concerning SPT and its diagnosis and management is also provided.
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Affiliation(s)
- Maria Luiza Diniz de Sousa Lopes
- PhD Student, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil, Phone: 558432154138, e-mail:
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25
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Mochizuki Y, Harada H, Ikuta M, Shimamoto H, Tomioka H, Tanaka K, Hirai H, Omura K. Clinical characteristics of multiple primary carcinomas of the oral cavity. Oral Oncol 2015; 51:182-9. [DOI: 10.1016/j.oraloncology.2014.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/17/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
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26
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Qaisi M, Vorrasi J, Lubek J, Ord R. Multiple primary squamous cell carcinomas of the oral cavity. J Oral Maxillofac Surg 2014; 72:1511-6. [PMID: 24813779 DOI: 10.1016/j.joms.2014.03.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 03/05/2014] [Accepted: 03/19/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE There is a subset of patients who develop multiple primary squamous cell carcinomas (SCCs) of the oral cavity. The aim of this study was to better characterize this group of patients and determine whether there are any associated risk factors. MATERIALS AND METHODS This is a retrospective review of all patients treated for oral SCCs at the University of Maryland Department of Oral and Maxillofacial Surgery from November 1989 to February 2013. The inclusion criteria were patients who developed at least 3 primary oral cancers. Lesions were considered separate primaries if they involved different anatomic regions within the oral cavity and were more than 2 cm apart or if they occurred more than 5 years apart. RESULTS Of 1,478 patients treated during this time frame, 20 met the inclusion criteria. There were 14 women and 6 men (female-to-male ratio, 2.3:1). Nineteen were Caucasian and 1 was of Indian ethnicity. The average number of primaries per patient was 3.9 (range, 3 to 6 primaries). The mean age at first diagnosis was 63.3 years (44 to 86 yr). The mean interval between the different primaries was 32 months (0 to 228 months). The most common site involved was the gingiva (45% of cases), followed by the tongue, buccal mucosa, retromolar fossa, and soft or hard palate. The mean follow-up was 118 months (22 to 342 months). Eleven patients developed nodal disease. Of those 11 patients, 9 died of the disease (<20% survival). The average time to neck involvement was 66.4 months. The average time from last neck involvement to death was 11.5 months. More than half the patients were nonsmokers or had quit more than 10 years before the first diagnosis. All patients quit smoking during the course of their treatment yet continued to develop multiple primaries. Three patients had proliferative verrucous leukoplakia (PVL), and 4 patients had biopsy-proved lichen planus. CONCLUSION The incidence of multiple primary SCCs within the oral cavity appears to more commonly involve Caucasian women without risk factors, although lichen planus and PVL might play a role. The gingiva appears to be the most commonly involved primary site, and subsequent primaries tend to be restricted to the oral cavity. Close observation and early expectant treatment appear to improve prognosis and survival in these patients. Cervical nodal metastases adversely affected survival (P = .02) as did the development of more than 4 primary carcinomas (P = .04).
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Affiliation(s)
- Mohammed Qaisi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Adjunct Assistant Professor, Department of Otolaryngology, University of Mississippi Medical Center, Jackson, MS; previously Fellow in Oral-Head and Neck Oncology, Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD.
| | - John Vorrasi
- Resident, Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD
| | - Joshua Lubek
- Assistant Professor and Fellowship Director, Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD
| | - Robert Ord
- Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD
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Pagliuca G, Martellucci S, Degener AM, Pierangeli A, Greco A, Fusconi M, De Virgilio A, Gallipoli C, de Vincentiis M, Gallo A. Role of Human Papillomavirus in the Pathogenesis of Laryngeal Dysplasia. Otolaryngol Head Neck Surg 2014; 150:1018-23. [DOI: 10.1177/0194599814525749] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 02/06/2014] [Indexed: 11/16/2022]
Abstract
Objective A synergistic effect between smoking and alcohol intake is the major cause of premalignant and malignant lesions of the larynx, but the risk factors and pathogenesis of the neoplastic transformation in nonsmokers remain poorly defined. The aim of this retrospective study is to establish the relationship between smoking habits and human papillomavirus (HPV) infection in laryngeal dysplasia. Study Design Cross-sectional study. Setting Academic university hospital. Subjects and Methods HPV DNA was amplified from 30 paraffin-embedded laryngeal dysplasia tissue specimens by the polymerase chain reaction using 2 groups of different consensus primers (MYO9/MY11 and LCRF1-4, E7R1-4). Fifteen samples were taken from smokers and 15 from nonsmokers. Results The present investigation failed to demonstrate the HPV genome in all samples of laryngeal precancerous lesions, whereas HPV was detected in 4 laryngeal papilloma samples used as control to confirm the reliability of our method on paraffin-embedded samples. Conclusions Although the small number of cases in our series limits the power of our statistical analysis, the absence of viral genomes in the specimens analyzed in this study suggests the lack of a relationship between HPV infection and laryngeal dysplasia in smokers as well as in nonsmokers.
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Affiliation(s)
- Giulio Pagliuca
- Department of Medico-Surgical Sciences and Biotechnologies, Otorhinolaryngology Section “Sapienza” University of Rome, Italy
| | - Salvatore Martellucci
- Department of Medico-Surgical Sciences and Biotechnologies, Otorhinolaryngology Section “Sapienza” University of Rome, Italy
| | - Anna Marta Degener
- Department of Molecular Medicine, Section of Virology “Sapienza” University of Rome, Italy
| | - Alessandra Pierangeli
- Department of Molecular Medicine, Section of Virology “Sapienza” University of Rome, Italy
| | - Antonio Greco
- Department of Sensorial Organs, Otorhinolaryngology Section “Sapienza” University of Rome, Italy
| | - Massimo Fusconi
- Department of Sensorial Organs, Otorhinolaryngology Section “Sapienza” University of Rome, Italy
| | - Armando De Virgilio
- Department of Sensorial Organs, Otorhinolaryngology Section “Sapienza” University of Rome, Italy
| | - Camilla Gallipoli
- Department of Medico-Surgical Sciences and Biotechnologies, Otorhinolaryngology Section “Sapienza” University of Rome, Italy
| | - Marco de Vincentiis
- Department of Sensorial Organs, Otorhinolaryngology Section “Sapienza” University of Rome, Italy
| | - Andrea Gallo
- Department of Medico-Surgical Sciences and Biotechnologies, Otorhinolaryngology Section “Sapienza” University of Rome, Italy
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Moyses RA, López RVM, Cury PM, Siqueira SAC, Curioni OA, Gois Filho JFD, Figueiredo DLA, Tajara EH, Michaluart P. Significant differences in demographic, clinical, and pathological features in relation to smoking and alcohol consumption among 1,633 head and neck cancer patients. Clinics (Sao Paulo) 2013; 68:738-44. [PMID: 23778492 PMCID: PMC3674275 DOI: 10.6061/clinics/2013(06)03] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 02/01/2013] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE As a lifestyle-related disease, social and cultural disparities may influence the features of squamous cell carcinoma of the head and neck in different geographic regions. We describe demographic, clinical, and pathological aspects of squamous cell carcinoma of the head and neck according to the smoking and alcohol consumption habits of patients in a Brazilian cohort. METHODS We prospectively analyzed the smoking and alcohol consumption habits of 1,633 patients enrolled in five São Paulo hospitals that participated in the Brazilian Head and Neck Genome Project - Gencapo. RESULTS The patients who smoked and drank were younger, and those who smoked were leaner than the other patients, regardless of alcohol consumption. The non-smokers/non-drinkers were typically elderly white females who had more differentiated oral cavity cancers and fewer first-degree relatives who smoked. The patients who drank presented significantly more frequent nodal metastasis, and those who smoked presented less-differentiated tumors. CONCLUSIONS The patients with squamous cell carcinoma of the head and neck demonstrated demographic, clinical, and pathological features that were markedly different according to their smoking and drinking habits. A subset of elderly females who had oral cavity cancer and had never smoked or consumed alcohol was notable. Alcohol consumption seemed to be related to nodal metastasis, whereas smoking correlated with the degree of differentiation.
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Affiliation(s)
- Raquel Ajub Moyses
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Disciplina de Cirurgia de Cabeça e Pescoço (LIM28), São Paulo/SP, Brasil.
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Non-smoking non-drinking elderly females: a clinically distinct subgroup of oral squamous cell carcinoma patients. Int J Oral Maxillofac Surg 2013; 42:929-33. [PMID: 23702369 DOI: 10.1016/j.ijom.2013.04.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 04/11/2013] [Accepted: 04/15/2013] [Indexed: 11/23/2022]
Abstract
There is growing interest in non-smoking non-drinking (NSND) patients presenting with oral squamous cell carcinoma (OSCC). There are, however, few published reports of OSCC in the elderly. We describe a subgroup of elderly NSND patients presenting with OSCC. Patients with SCC of the oral cavity were retrospectively assessed from the Head and Neck Oncology Tumour Stream database of the Royal Melbourne Hospital. Epidemiological and clinical data for 169 consecutive patients were reviewed and analysed. NSND patients were more likely to be females with a higher median age at presentation. They were more likely to have maxillary alveolus tumours and oral tongue tumours, with retromolar or mandibular tumours less likely. Second primary tumours for this subgroup were confined to the oral cavity. NSND elderly females experienced a worse disease-specific mortality. We have identified a distinct subgroup of elderly female patients presenting with OSCC not associated with the traditional risk factors of tobacco and alcohol, who have a worse prognosis. Altered management algorithms may prove beneficial for these patients, and further investigation and genetic analysis are required to delineate the aetiology of these carcinomas.
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Durr ML, van Zante A, Li D, Kezirian EJ, Wang SJ. Oral Tongue Squamous Cell Carcinoma in Never-Smokers. Otolaryngol Head Neck Surg 2013; 149:89-96. [DOI: 10.1177/0194599813482876] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives (1) To compare clinical characteristics, survival, and recurrence between never-smokers and ever-smokers with oral tongue squamous cell carcinoma (OTSCC). (2) To assess the relationship between clinicopathologic characteristics and survival/recurrence in OTSCC. Study Design Historical cohort study. Setting Academic university medical center. Subjects and Methods This is a study of 120 patients with OTSCC who were treated from January 1999 to February 2010. Clinicopathologic factors were compared between never-smokers and ever-smokers using t tests and χ2 tests. Cox regression analyses examined their association with survival and recurrence. Results Of 120 subjects, 66 (55%) were prior or current smokers. There were no significant differences in clinicopathologic factors between ever-smokers and never-smokers. After adjustment for clinicopathologic factors, multivariate Cox regression analysis demonstrated decreased overall survival for never-smokers, but this difference was not significant (hazard ratio [HR], 2.84; P = .056). Increased depth of tumor invasion (HR per millimter invasion, 1.09; P = .005), nodal metastasis (HR, 7.1; P = .025), and stage III or IV disease (HR, 9.45 and 7.31; P = .026 and .029, respectively) were associated with decreased overall survival. Perineural invasion (HR, 8.56; P = .005) and lymphovascular invasion (HR, 6.01; P = .011) were associated with disease recurrence. Conclusion Overall survival may be decreased in never-smokers with OTSCC. Greater depth of tumor invasion and more advanced stage disease are associated with decreased survival. Perineural invasion and lymphovascular invasion are associated with disease recurrence.
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Affiliation(s)
- Megan L. Durr
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Annemieke van Zante
- Department of Pathology, University of California, San Francisco, California, USA
| | - David Li
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Eric J. Kezirian
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Steven J. Wang
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, California, USA
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Oral Squamous Cell Carcinoma From Users and Nonusers of Tobacco and Alcohol. Appl Immunohistochem Mol Morphol 2013; 21:148-53. [DOI: 10.1097/pai.0b013e3182558b65] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Li R, Koch WM, Fakhry C, Gourin CG. Distinct Epidemiologic Characteristics of Oral Tongue Cancer Patients. Otolaryngol Head Neck Surg 2013; 148:792-6. [DOI: 10.1177/0194599813477992] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives Oral tongue cancer may have a distinct epidemiological profile from other mucosal neoplasms of the oral cavity. We sought to further define the demographic characteristics associated with oral tongue cancer to determine if unique characteristics exist compared with other oral cavity cancers. Study Design Cross-sectional analysis using cross-tabulations and multivariate regression modeling. Setting The Maryland Health Service Cost Review Commission database. Subjects and Methods Discharge data from a state database were queried to perform a cross-sectional analysis of oral cancer cases treated surgically from 1990 to 2009. Results A total of 1688 oral cancer cases comprised the study population, with 719 (42.6%) of cases involving the oral tongue. Tongue cancer comprised 31.6% of oral cancers in black patients and 44.1% of oral cancer in white patients ( P = .011). Racial disparities in oral tongue cancer were identified for age at diagnosis, with significantly fewer black patients younger than 40 years (3.8%) compared with whites (11.3%; P = .006). After controlling for all other variables, oral tongue cancer patients were significantly less likely to be older than 40 years (odds ratio [OR], 0.40; P < .001), black (OR, 0.53; P = .001), have Medicare payor status (OR, 0.55; P = .002), and advanced comorbidity (OR, 0.22; P < .001), in contrast to other oral cancer subsites. Conclusion The racial and socioeconomic qualities of oral tongue cancer patients differ significantly from other oral cancers. This younger, healthier subgroup of oral cancer patients demonstrates a distinct population at risk for cancer of the oral tongue.
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Affiliation(s)
- Ryan Li
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wayne M. Koch
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Carole Fakhry
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Christine G. Gourin
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
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Farshadpour F, Roepman P, Hordijk GJ, Koole R, Slootweg PJ. A gene expression profile for non-smoking and non-drinking patients with head and neck cancer. Oral Dis 2012; 18:178-83. [PMID: 22035108 DOI: 10.1111/j.1601-0825.2011.01861.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE A small subset of patients with head and neck squamous cell carcinoma are non-smoking and non-drinking and have distinct clinical characteristics. We aimed to identify a possible different genetic profile for these patients when compared with their smoking and drinking counterparts. MATERIALS AND METHODS The gene expression data previously detected from primary tumors located in the oral cavity and oropharynx, using DNA microarray was analyzed for their differential expression between non-smoking and non-drinking patients (n = 15) and smoking and drinking patients (n = 89). Student's T-test (P < 0.05) and 10-fold cross-validation procedure (100 times repeated) were performed to determine differentially expressed genes. RESULTS Non-smoking and non-drinking patients were older, mostly female and had oral cavity-localized tumors, whereas smoking and drinking patients were younger male patients with 81% oral cavity and 19% oropharynx tumors. A set of 49 differentially expressed genes were detected. Among others, seven genes related to interferon-γ were upregulated and two genes linked to NFKB pathway were downregulated. CONCLUSIONS Differentially expressed genes in non-smoking and non-drinking patients possibly indicate the presence of a different cellular response to carcinogenic events in these patients. Further studies are warranted to validate this gene set and explore possible therapeutic implications to improve prognosis for these patients.
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Affiliation(s)
- F Farshadpour
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
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Pfeiffer J, Wiech T, Maier W, Ridder GJ, Laszig R, Birkenhäger R. Head and neck cancer in young adults and nonsmokers: study of cancer susceptibility by genome-wide high-density SNP microarray mapping. Acta Otolaryngol 2011; 131:1091-8. [PMID: 21631177 DOI: 10.3109/00016489.2011.590151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CONCLUSION Our results raise the question as to whether specific patterns of 'germline loss of heterozygosity (LOH)' could contribute to the genetic susceptibility for head and neck squamous cell carcinoma (HNSCC). OBJECTIVES HNSCC usually occurs in older individuals with a history of smoking. However, about 5% of HNSCC patients have never used tobacco or develop this disease at an exceptionally young age. Therefore, genetic susceptibility must contribute significantly to HNSCC risk. The objective was to introduce a novel approach that might help to unveil candidate genes contributing to cancer predisposition and to identify individuals at risk for HNSCC, and to present our observations with this method in a specific group of patients. METHODS High-resolution SNP (single-nucleotide polymorphism) microarray mapping for homozygous stretches in germline DNA was performed in 12 patients who appeared particularly susceptible to develop HNSCC, because they were exceptionally young or never users of tobacco. RESULTS We could identify strings of consecutive homozygous SNPs that were much longer than would be expected to appear by chance alone, indicating regions of DNA deletions that we named germline LOH.
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Affiliation(s)
- Jens Pfeiffer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Freiburg, Germany
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36
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van Monsjou HS, Balm AJ, van den Brekel MM, Wreesmann VB. Oropharyngeal squamous cell carcinoma: A unique disease on the rise? Oral Oncol 2010; 46:780-5. [DOI: 10.1016/j.oraloncology.2010.08.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 08/26/2010] [Accepted: 08/28/2010] [Indexed: 10/19/2022]
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Kruse AL, Bredell M, Grätz KW. Oral squamous cell carcinoma in non-smoking and non-drinking patients. HEAD & NECK ONCOLOGY 2010; 2:24. [PMID: 20920351 PMCID: PMC2958869 DOI: 10.1186/1758-3284-2-24] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Accepted: 10/04/2010] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Of the many different factors associated with an increased risk for oral squamous cell carcinoma (SCC), tobacco and alcohol seem to be the most studied. The aim of the current study was to evaluate the clinicopathologic characteristics of patients without the mentioned risk factors. PATIENTS AND METHODS Out of 278 patients (159 male and 119 female patients) with oral SCC, 67 patients had no history of tobacco or alcohol use. The minimum follow-up time was 12 months. RESULTS Of the 67 patients, 45 (67.2%) were women, and the mean age was 70 years. The most common tumor sites were mandibular alveolar ridge (22) and maxilla (18). Fifteen patients experienced a recurrence, and 10 developed lymph node metastases during the follow-up period. CONCLUSION The group of patients with no tobacco and alcohol use tends toward a higher proportion of females, a higher proportion of patients over 70 years, and a higher number of oral maxillary SCC.
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Affiliation(s)
- Astrid L Kruse
- University Hospital Zurich, Department of Craniomaxillofacial and Oral Surgery, Zurich/Switzerland.
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Farshadpour F, Kranenborg H, Calkoen EVB, Hordijk GJ, Koole R, Slootweg PJ, Terhaard CH. Survival analysis of head and neck squamous cell carcinoma: Influence of smoking and drinking. Head Neck 2010; 33:817-23. [DOI: 10.1002/hed.21549] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2010] [Indexed: 01/02/2023] Open
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A80G polymorphism of reduced folate carrier 1 (RFC1) gene and head and neck squamous cell carcinoma etiology in Brazilian population. Mol Biol Rep 2010; 38:1071-8. [DOI: 10.1007/s11033-010-0204-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 06/11/2010] [Indexed: 11/26/2022]
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Montaldo C, Mastinu A, Zorco S, Santini N, Pisano E, Piras V, Denotti G, Peluffo C, Erriu M, Garau V, Orrù G. Distribution of human papillomavirus genotypes in sardinian patients with oral squamous cell carcinoma. Open Virol J 2010; 4:163-8. [PMID: 21249161 PMCID: PMC3023062 DOI: 10.2174/1874357901004010163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 04/15/2010] [Accepted: 05/10/2010] [Indexed: 11/22/2022] Open
Abstract
Human papillomaviruses (HPVs) seem to play an important role in the pathogenesis of gynecological carcinomas and in head and neck carcinomas. The aim of this study was to detect and genotype HPVs in fresh oral squamous cell carcinoma (OSCC) from a Sardinian population, and to determine whether HPV presence was significantly associated with the development of OSCC. The oral mucosa tissues were obtained from 120 samples (68 OSCC and 52 control samples) taken from a Sardinian population seen at the Dental Clinic of the Department of Surgery and Odontostomatological Sciences, University of Cagliari (Italy) and the “ Ospedale SS Trinità”, Cagliari (A.S.L. 8) between 2007 and 2008. PCR was used for the detection of HPV DNA and the genotype was determined by DNA sequencing. The frequency of HPV infection was evaluated in relation to age, sex, smoking and alcohol use. Statistical analysis was performed using the SPSS 11.5 software. The results showed the presence of HPV-DNA in 60.3% of OSCC with HPV-16 (51.2%) being the most frequent genotype. In these Sardinian OSCC patients, HPV-DNA was detected more in males (65.8%) than in females (34.1%) while controls show a 0% of HPV presence. HPV positive was highly associated with OSCC among subjects with a history of heavy tobacco and alcohol use and among those with no such history. A greater frequency of high risk HPV presence was observed in patients with OSCC compared to health control patients. In addition these results suggested that oral HPV presence could be associated in OSCC subjects. Our results need more analyses to detect the HPV-DNA integration into tumoral cells.
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Affiliation(s)
- Caterina Montaldo
- Surgery Department of Odontostomatological Sciences, Odontostomatology Section, O.B.L., University of Cagliari, Cagliari, Italy
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Harris SL, Kimple RJ, Hayes DN, Couch ME, Rosenman JG. Never-smokers, never-drinkers: unique clinical subgroup of young patients with head and neck squamous cell cancers. Head Neck 2010; 32:499-503. [PMID: 19691028 DOI: 10.1002/hed.21220] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Young patients represent an increasing subgroup with head and neck cancer. METHODS Patients between 18 and 39 years of age with newly diagnosed and previously untreated squamous cell cancers were identified. RESULTS Seventy-eight patients met the selection criteria: 28 patients were never-smokers/never-drinkers (NSNDs), and 50 patients reported tobacco or alcohol abuse (smokers and/or drinkers [SD]). NSND patients were diagnosed at a younger median age (31.5 years vs 35.5 years, p = .007), were more likely to be female (75% vs 30%, p < .001) and white (89% vs 60%, p = .006), and were more likely to have tumors of the oral tongue (57% vs 24%, p = .003) and T1 disease (47% vs 20%, p = .01). There was no difference in 10-year relapse-free survival, but a suggestion of improved 10-year overall survival for NSND patients (71% vs 46%, p = .10). CONCLUSIONS Young patients with head and neck squamous cell carcinoma (HNSCC) appear to have unique clinical profiles based on history of alcohol and tobacco abuse.
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Affiliation(s)
- Stephen L Harris
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
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Ryerson AB, Peters ES, Coughlin SS, Chen VW, Gillison ML, Reichman ME, Wu X, Chaturvedi AK, Kawaoka K. Burden of potentially human papillomavirus-associated cancers of the oropharynx and oral cavity in the US, 1998-2003. Cancer 2008; 113:2901-9. [PMID: 18980273 DOI: 10.1002/cncr.23745] [Citation(s) in RCA: 221] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND As human papillomavirus (HPV) vaccination becomes widely available in the US for cervical cancer prevention, it may also affect the rates of other cancers potentially associated with HPV. The objective of the current study was to describe the incidence rates of oropharyngeal and oral cavity cancers in the US with a focus on anatomic sites potentially associated with HPV infection. METHODS Incident cases diagnosed between 1998 and 2003 identified through 39 population-based registries that participate in the National Program of Cancer Registries and/or the Surveillance, Epidemiology, and End Results Program were examined. The incidence rates of potentially HPV-associated oropharyngeal and oral cavity cancers by various characteristics were estimated. The 1998 through 2003 trends in these rates were also compared with rates for sites not previously shown to be associated with HPV (comparison sites). RESULTS In all, 44,160 cases of potentially HPV-associated cancers of the oropharynx and oral cavity were identified, including 19,239 (43.6%) tonsillar, 16,964 (38.4%) base of tongue, and 7957 (18.0%) other oropharyngeal cancers. The incidence rates for these sites were highest among blacks, and higher among non-Hispanics and men than among Hispanics and women. The annual incidence rates of potentially HPV-associated cancers of the tonsil and base of tongue both increased significantly from 1998 through 2003 (annual percentage change [APC], 3.0; P < .05 for both sites), whereas the incidence rates of cancer at the comparison sites generally decreased. CONCLUSIONS The results of the current study provide baseline incidence rates of potentially HPV-associated cancers of the oropharynx and oral cavity that can be compared with rates after the widespread implementation of the HPV vaccination.
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Affiliation(s)
- A Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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Farshadpour F, Hordijk GJ, Koole R, Slootweg PJ. Head and neck squamous cell carcinoma in non-smoking and non-drinking patients with multiple tumors: etiologic significance of p53 and Ki-67 in non-tumorous epithelium. J Oral Pathol Med 2008; 37:549-54. [DOI: 10.1111/j.1600-0714.2008.00657.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hsu YB, Chang SY, Lan MC, Huang JL, Tai SK, Chu PY. Second primary malignancies in squamous cell carcinomas of the tongue and larynx: an analysis of incidence, pattern, and outcome. J Chin Med Assoc 2008; 71:86-91. [PMID: 18290253 DOI: 10.1016/s1726-4901(08)70080-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Head and neck cancer patients have a higher risk of developing a second primary malignancy (SPM) than the general population. This study was conducted to identify the characteristics of SPM and its impact on survival in patients with squamous cell carcinoma of the tongue (TSCC) and larynx (LSCC). METHODS A retrospective study was conducted of 538 patients who were treated by surgery primarily for TSCC (n = 146) and LSCC (n = 392) from 1990 to 2000. The incidence, site, and overall survival of SPMs were evaluated. RESULTS Seventy-seven patients developed SPM during the follow-up period (median, 73 months), including 18 (12%) with TSCC and 59 (15%) with LSCC. Fifty-six percent of SPMs of the TSCC group appeared in the oral cavity. Among the SPMs of LSCC patients, 54% developed in the lung (31%) and larynx (24%). The 5-year overall survival after the diagnosis of SPM in the head and neck was 39%, compared to 29% for SPM in other areas (p = 0.010). CONCLUSION SPMs after treatment of TSCC and LSCC are similar in incidence but distinct in pattern. SPMs within the head and neck are associated with a better prognosis than those outside this area.
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Affiliation(s)
- Yen-Bin Hsu
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, ROC
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Tran N, Rose BR, O'Brien CJ. Role of human papillomavirus in the etiology of head and neck cancer. Head Neck 2007; 29:64-70. [PMID: 16823878 DOI: 10.1002/hed.20460] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Head and neck cancer is the world's sixth most common cancer, but despite advances in treatment, there has been no significant decline in the mortality rate. In recent years, there has been mounting epidemiologic and experimental evidence of a role for human papillomavirus (HPV) as the etiologic agent of a subset of head and neck cancers. The association is strongest for oropharyngeal cancers, especially those of the tonsil. HPV 16 is invariably the predominant type. HPV-positive cancers have been shown to be biologically distinct, clustering among nonsmokers and light drinkers, and have been associated with a favorable prognosis. This review examines the current findings of HPV in head and neck cancers and discusses implications for developing new treatments.
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Affiliation(s)
- Nham Tran
- Sydney Head and Neck Cancer Institute, Sydney Cancer Centre, Royal Prince Alfred Hospital and the University of Sydney, P. O. Box M 142, Missenden Road, Camperdown NSW 2050, Australia.
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Farshadpour F, Hordijk GJ, Koole R, Slootweg PJ. Non-smoking and non-drinking patients with head and neck squamous cell carcinoma: a distinct population. Oral Dis 2007; 13:239-43. [PMID: 17305629 DOI: 10.1111/j.1601-0825.2006.01274.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To recognize specific clinicopathological characteristics of non-smoking and non-drinking (NSND) head and neck squamous cell carcinoma (HNSCC) patients. This can increase our knowledge regarding a potentially different carcinogenesis in these patients. STUDY DESIGN/METHODS Retrospective analysis of data for 195 NSND patients with HNSCC and comparison with data for patients with HNSCC obtained from the Netherlands Cancer Registry. RESULTS Compared with all HNSCC patients in the Netherlands, our NSND patients with HNSCC were typically female (n = 142; 73%vs 26%), old at disease presentation (mean 73 years vs 64 years), and had tumors mainly of the oral cavity (n = 130; 66%vs 25%). Most tumors were stage I (n = 67; 34%) and stage IVA (n = 59; 30%). The incidence of second primary tumors (SPTs) was high (n = 32; 16%), mainly occurring in the oral cavity (n = 26; 13%). DISCUSSION/CONCLUSION Our study confirms that NSND HNSCC patients have different clinicopathological characteristics from those of the overall HNSCC population; however, the frequency of SPTs is as high in NSND patients as in patients who smoke and drink alcohol. More research, and particularly molecular data are needed to obtain a better understanding of head and neck cancer in NSND patients.
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Affiliation(s)
- F Farshadpour
- Department of Otolaryngology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
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Ragin CCR, Modugno F, Gollin SM. The epidemiology and risk factors of head and neck cancer: a focus on human papillomavirus. J Dent Res 2007; 86:104-14. [PMID: 17251508 DOI: 10.1177/154405910708600202] [Citation(s) in RCA: 241] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Head and neck cancer was the eighth leading cause of cancer death worldwide in 2000. Although the incidence of head and neck squamous cell carcinoma (HNSCC) in the United States is relatively low, survival is poor and has not improved for several decades. While tobacco and alcohol are the primary risk factors for HNSCC development, epidemiological studies report a strong association with human papillomavirus (HPV) in a subset of HNSCC. More than 95% of cervical squamous cell carcinomas are linked to persistent HPV infection; evidence demonstrates that HPV is a necessary carcinogen. Not all HPV-positive HNSCC express the viral oncogenes (E6 and E7), which suggests that HPV may function as a carcinogen in a smaller proportion of HNSCC. This review presents our current understanding of the relationship between HPV and HNSCC, and describes future research directions that may lead to a better understanding of the involvement of HPV in head and neck cancer.
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Affiliation(s)
- C C R Ragin
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261, USA.
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Dahlstrom KR, Little JA, Zafereo ME, Lung M, Wei Q, Sturgis EM. Squamous cell carcinoma of the head and neck in never smoker–never drinkers: A descriptive epidemiologic study. Head Neck 2007; 30:75-84. [PMID: 17694557 DOI: 10.1002/hed.20664] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND While the attributed risk factors for the vast majority of patients with squamous cell carcinoma of the head and neck (SCCHN) are smoking and alcohol abuse, there appears to be a rising proportion of SCCHN patients who report no significant smoking or drinking history. This study reports the demographic and potential risk factors of a large series of never smoker-never drinker (NSND) patients. METHODS All subjects were participants in a prospective epidemiologic study of incident SCCHN. We obtained demographic data, clinical characteristics, and potential etiologic factors for 172 NSND patients and 1131 ever smoker-ever drinker (ESED) patients. RESULTS.: NSND patients were more likely to be female and to present at extremes of age, but overall were significantly younger than ESED patients. NSND patients had a higher proportion of oral cavity and oropharyngeal cancers than ESED patients had. Eleven percent of NSND patients (17% of NSND men) reported regular use of noncigarette tobacco products or marijuana, 41% (45% of NSND women) reported regular environmental exposure to tobacco smoke, 24% (36% of NSND men) reported regular occupational exposures to carcinogens/toxins, and 30% had a history of gastroesophageal reflux disease. More than half the NSND patients with an oropharyngeal primary were serologically positive for human papillomavirus type 16. CONCLUSION NSND patients with SCCHN are commonly young women with oral tongue cancer, elderly women with gingival/buccal cancer, or young to middle-aged men with oropharyngeal cancer. While several exposures studied may be important to the etiology of a subset of these cancers in NSND patients, it is likely that no single known factor is responsible for a majority of SCCHN in NSNDs.
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Affiliation(s)
- Kristina R Dahlstrom
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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Prior SL, Griffiths AP, Baxter JM, Baxter PW, Hodder SC, Silvester KC, Lewis PD. Mitochondrial DNA mutations in oral squamous cell carcinoma. Carcinogenesis 2006; 27:945-50. [PMID: 16407369 DOI: 10.1093/carcin/bgi326] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
It has previously been demonstrated that mitochondrial DNA (mtDNA) mutations within the ND2 gene of histologically normal parotid salivary gland tissue of smokers may be molecular biomarkers for smoking-induced mtDNA damage. Oral squamous cell carcinoma (SCC) is strongly related to cigarette smoking; therefore, we used PCR and direct sequencing to establish whether mtDNA mutations were also present in oral SCC which could be used as additional biomarkers for smoking-associated DNA damage. In addition to searching for mutations in the ND2 gene, the mitochondrial D-Loop was also analysed. Three mutation hotspots were observed in the D-Loop at nt 146, 152 and 186, two of which (nt 146 and 152) have also been implicated in oesophageal SCC, another smoking-related cancer. The mutation hotspot observed at nt 186 has not previously been reported in other tumours. Furthermore, we show that the mutations previously reported within the ND2 gene in normal parotid tissue of smokers were not evident in these samples, but that a mutation hotspot occurs at nucleotide 4917 in oral SCC. We also show that D-Loop mutations occur predominantly in male smokers and female non-smokers and that this association with gender is statistically significant (P = 0.003). We conclude that the mtDNA mutation hotspots found in this study, in particular nt 186, are potential biomarkers for oral SCC. However, owing to gender-specific differences in occurrence in smokers and non-smokers, and a lack of environmental smoking history, in general, it is difficult to associate these mutations with mtDNA damage induced by smoking. If the mutations observed in the subset of male patients are smoking induced, given our previous findings, mutation hotspots in the ND2 gene may be tissue specific suggesting the causative mutagens for mtDNA damage within these tissues are likely to be different.
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Affiliation(s)
- S L Prior
- School of Biological Sciences, University of Wales Swansea, Swansea, SA2 8PP, UK
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Bhattacharyya N, Nayak VK. Survival outcomes for second primary head and neck cancer: a matched analysis. Otolaryngol Head Neck Surg 2005; 132:63-8. [PMID: 15632911 DOI: 10.1016/j.otohns.2004.08.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Determine whether survival for second primary head and neck cancer is truly poorer than survival for first primaries. METHODS From the Surveillance, Epidemiology and End Results database, 2 cohorts were constructed. One cohort consisted of patients with exactly 1 head and neck primary malignancy; the second cohort consisted of patients with exactly 2 head and neck primaries, restricted to second primaries of the tongue, tonsil, glottic larynx, and hypopharynx with squamous cell carcinoma (SCCA) histology. Demographic and extent of disease data were extracted. For each primary site, matched Kaplan-Meier survival analysis was conducted comparing overall survival between the two cohorts matching for primary site, year of diagnosis, age, gender, and cancer stage. RESULTS A total of 242 cases of second head neck primary were successfully matched to patients with single primary disease. Among 96 patients with oral tongue SCCA, mean (median) survival was 40.1 (28) months after the second primary diagnosis versus 52.2 (32) months for matched single primary patients ( P = 0.552, log-rank test). Among 45 tonsillar carcinomas, mean survival was 42.8 (30) versus 90.9 (NA) months for the second primary and single primary cohorts, respectively ( P = 0.028). Among 52 matched glottic carcinomas, mean survival was 46.4 (27) versus 103.5 (120) months for the 2 cohorts, respectively ( P < 0.001). Among 49 hypopharyngeal carcinomas, mean survival was 35.6 (19) versus 53.9 (21) months, respectively ( P = 0.373). CONCLUSIONS Survivals for second primary head and neck malignancies may be poorer than survivals for comparable first primaries, but in this analysis we did not find this difference to be statistically significant for all subsites. Second primary survival will vary from site to site. EBM RATING B-3.
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Affiliation(s)
- Neil Bhattacharyya
- Division of Otolaryngology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
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