Second primary oral squamous cell carcinoma after radiotherapy: a retrospective cohort study

Risk factors for the occurrence of infection in patients with oral squamous cell carcinoma after restorative reconstruction and its impact on recurrence and quality of life: a retrospective cohort study

Background

Worldwide, there are approximately 300,000 new cases of oral squamous cell carcinoma (OSCC) and 100,000 deaths each year. The complexity of oral and maxillofacial structures leads to a high risk of surgical infection such as radical tumor resection and free flap reconstruction. Previous studies have shown that diabetes mellitus, previous radiotherapy, oral-neck communication, etc. are risk factors for postoperative infection, but the influence of time on prognosis has not been clarified in detail. This study supplements this aspect and provided a reference for improving the quality of life of patients.

Methods

We retrospectively analyzed a total of 168 patients who developed OSCC from July 2014 to September 2019. According to the inclusion and exclusion criteria of this study, the general data questionnaire designed by ourselves was used to sort out the general characteristics and clinical data of the subjects. The t test, Chi-square test and binary logistic regression were used for statistical analysis. Surgical site infections (SSI) are defined as infections associated with surgical procedures. The quality of life was evaluated by the 36-Item Short Form Survey (SF-36) score. A 3-year follow-up was conducted by telephone, Email and outpatient review.

Results

Among the 168 patients, the total number of postoperative infections was 22 (13.1%). Binary logistic regression analysis showed that body mass index (BMI) (OR =0.029, P=0.039), American Society of Anesthesiologists (ASA) classification (OR =21.443, P=0.042), preoperative radiotherapy (OR =19.993, P=0.022), Jaw resection status (OR =29.665, P=0.021), Perioperative transfusion (OR =29.148, P=0.020), preoperative white blood cell count (OR =1.763, P=0.017), albumin level (OR =0.853, P=0.033) were independent influencing factors between the two groups (P<0.05). Except for the social functioning and role-emotional dimensions, all dimensions of SF-36 in patients with infection were significantly lower than those without infection.

Conclusions

The incidence of postoperative infection after restorative and reconstructive surgery for OSCC deserves the attention of clinicians. For high-risk infected persons, relevant anti-infection measures should be taken early against the infectious source, and the possibility of nosocomial infection should be attached great importance in clinical work. After discharge, patients should also actively do follow-up, education and other related work to reduce the incidence of postoperative infection.

Oral Squamous Cell Carcinoma and Concomitant Primary Tumors, What Do We Know? A Review of the Literature

Head and neck cancer is among the top ten cancers worldwide, with most lesions in the oral cavity. Oral squamous cell carcinoma (OSCC) accounts for more than 90% of all oral malignancies and is a significant public health concern. Patients with OSCC are at increased risk for developing concomitant tumors, especially in the oral cavity, due to widely genetically susceptible mucosa to carcinogenic factors. Based on fulfilling specific criteria, these concomitant tumors can be called second primary tumors (SPTs), which can be further categorized into metachronous and synchronous tumors. This research reviews the literature that investigated the concurrent OSCC with second or multiple primaries to improve understanding of the definition, classification guidelines, and its effect on cancer survival. It also highlights the current investigation methods, the variation of standard treatment approaches due to such a phenomenon, and preventive measures discussed in the literature.

Secondary Oral Cancer after Systemic Treatment of Hematological Malignancies and Oral GVHD: A Systematic Review

(1) Purpose: In this article, the authors decided to systematically review the available literature to identify potential correlations regarding secondary oral carcinoma occurring after hematological systemic treatment and oral chronic graft-versus-host disease. (2) Methods: Medline (PubMed) and Scopus (Elsevier) databases were searched, including articles from the years 2002-2022. The 33 unique results were assessed by a PRISMA flowchart, and we rejected 24 papers and included 9 articles in the review. (3) Results: The majority of patients suffered from the oral form of chronic graft-versus-host disease before the diagnosis of oral malignancy. Two common cancer sites were the tongue and buccal mucosa. The exact percentage of secondary oral carcinoma after hematopoietic stem cell transplantation could not be estimated due to a lack of data. (4) Conclusions: Every physician taking part in the follow-up of patients after hematological treatment should be aware of the possibility of secondary neoplastic disease in the oral cavity, especially in patients with oral graft-versus-host disease. Proper follow-up protocols and monitoring are needed in this patient group as the cause of these cancers appears to be multifactorial.