Early Diagnosis of Oral Cancer: A Complex Polyhedral Problem with a Difficult Solution

New Insights for an Advanced Understanding of the Molecular Mechanisms in Oral Squamous Cell Carcinoma

Oral squamous cell carcinoma (OSCC), the most common type of head and neck cancer, remains a highly challenging cancer to treat, largely due to the late diagnosis in advanced stages of the disease, which occurs in more than half of cases [...].

Primary Management of Operable Locally Advanced Oral Cavity Squamous Cell Carcinoma: Current Concepts and Strategies

INTRODUCTION

Locally advanced oral cavity carcinoma (LAOCSCC) is primarily treated with surgery followed by radiotherapy with or without chemotherapy.

METHODS

A review of literature using PubMED was performed for studies reporting the management of LAOCSCC. Based on the reviewed literature and opinions of experts in the field, recommendations were made.

RESULTS

Studies have shown that outcomes following resection of T4a and infranotch (inferior to mandibular notch) T4b are comparable. We discuss the concept of compartmental resection of LAOCSCC and issues concerning the management of the neck. Further, patients who refuse or are unable to undergo surgery can be treated with chemoradiotherapy with uncertain outcomes. The role of neoadjuvant chemotherapy has shown promise for organ (mandibular) preservation in a select subset of patients.

CONCLUSION

The management strategy for LAOCSCC should be determined in a multidisciplinary setting with emphasis on tumor control, functional preservation, and quality of life of the patient.

Top 100 most cited papers on diagnostic aids for oral cancer: A bibliometric analysis

BACKGROUND

Oral cancer (OC) is a multifactorial disease that affects the oral cavity. The mortality rate is approximately 50 % and a high percentage of patients are diagnosed in advanced stages. Early diagnosis has been well demonstrated to improve overall survival, mainly when detected at a localized stage. Non-invasive techniques can help identify malignant features in real time, thus improving the path to diagnosis. This study aimed to perform a bibliometric analysis of the top 100 articles cited on diagnostic aids for oral cancer.

METHODS

Articles from 2000 to 2023 in Scopus were scanned using five OC topic titles crossed with 27 diagnostic aid keywords. Duplicate manuscripts were eliminated using Microsoft Excel software and publications were ranked according to their citation count. This study selected and analyzed the top 100 most cited English-language papers.

RESULTS

86,676 citations were accumulated by the top 100 articles most cited. 2011 was the year with the highest number of publications with OC papers. The article with the most citations obtained a total of 30,832. The United States was the country with the most publications, with a total of 45, and UCLA was the institution with the most publications (7) among the top 100 most cited papers.

CONCLUSIONS

This study identified the top 100 most cited articles on diagnostic aids for oral cancer. These results can help dentists, specialists, healthcare providers, and researchers become familiar with the most influential publications in this field.

An Evidence-Based Update on the Potential for Malignancy of Oral Lichen Planus and Related Conditions: A Systematic Review and Meta-Analysis

A systematic review and a meta-analysis is presented on published articles on the malignant transformation of oral lichen planus (OLP) and related conditions, which, based on current evidence, updates an earlier systematic review published by our research group that included publications until November 2018. In this updated study (Nov-2023) we searched MEDLINE, Embase, Web of Science, and Scopus. We evaluated the methodological quality of studies (QUIPS tool) and carried out meta-analyses. The inclusion criteria were met by 101 studies (38,083 patients), of which, 20 new primary-level studies (11,512 patients) were published in the last 5 years and were added to our updated study. The pooled malignant transformation ratio was 1.43% (95% CI = 1.09-1.80) for OLP; 1.38% (95% CI = 0.16-3.38) for oral lichenoid lesions; 1.20% (95% CI = 0.00-4.25) for lichenoid reactions; and 5.13% (95% CI = 1.90-9.43) for OLP with dysplasia. No significant differences were found between the OLL or LR groups and the OLP subgroup (p = 0.853 and p = 0.328, respectively), and the malignant transformation was significantly higher for the OLP with dysplasia group in comparison with the OLP group (p = 0.001). The factors that had a significant impact with a higher risk of malignant transformation were the presence of epithelial dysplasia, a higher methodological quality, the consumption of tobacco and alcohol, the location of lesions on the tongue, the presence of atrophic and erosive lesions, and infection by the hepatitis C virus. In conclusion, OLP behaves as an oral potentially malignant disorder (OPMD), whose malignancy ratio is probably underestimated as a consequence essentially of the use of inadequate diagnostic criteria and the low methodological quality of the studies on the subject.

Rapid multi-task diagnosis of oral cancer leveraging fiber-optic Raman spectroscopy and deep learning algorithms

Introduction

Oral cancer, a predominant malignancy in developing nations, represents a global health challenge with a five-year survival rate below 50%. Nonetheless, substantial reductions in both its incidence and mortality rates can be achieved through early detection and appropriate treatment. Crucial to these treatment plans and prognosis predictions is the identification of the pathological type of oral cancer.

Methods

Toward this end, fiber-optic Raman spectroscopy emerges as an effective tool. This study combines Raman spectroscopy technology with deep learning algorithms to develop a portable intelligent prototype for oral case analysis. We propose, for the first time, a multi-task network (MTN) Raman spectroscopy classification model that utilizes a shared backbone network to simultaneously achieve different clinical staging and histological grading diagnoses.

Results

The developed model demonstrated accuracy rates of 94.88%, 94.57%, and 94.34% for tumor staging, lymph node staging, and histological grading, respectively. Its sensitivity, specificity, and accuracy compare closely with the gold standard: routine histopathological examination.

Discussion

Thus, this prototype proposed in this study has great potential for rapid, non-invasive, and label-free pathological diagnosis of oral cancer.

Denture Stomatitis and Candida albicans in the Indian Population: A Systematic Review and Meta-Analysis

Denture stomatitis (DS), a common oral condition among denture wearers, is frequently associated with Candida albicans (C. albicans) colonization. This systematic review and meta-analysis aimed to provide a comprehensive assessment of DS prevalence and its relationship with C. albicans in the Indian population. We conducted a thorough search of multiple databases for studies without any limitation to the publication timeframe, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were assessed for quality and included in the meta-analysis. Data regarding DS prevalence, risk factors, and C. albicans colonization were extracted and analyzed. A total of four studies comprising 415 participants were included in the review. The overall odds ratio (OR) and risk ratio (RR) for the prevalence of C. albicans in DS patients were 0.75 (95% CI 0.56 to 0.99) and 0.83 (95% CI 0.70 to 1.00), respectively, indicating a statistically significant association between DS and C. albicans colonization. Several risk factors, including continuous denture wearing, advanced denture age, poor denture hygiene, and high sugar intake, were identified as contributing to DS development. This systematic review and meta-analysis highlight the substantial burden of DS and its association with C. albicans colonization in the Indian population. The findings emphasize the need for comprehensive oral care, improved denture hygiene, dietary counseling, and interventions to enhance salivary flow in denture wearers to mitigate the risk of DS. These insights can inform healthcare providers and policymakers to develop targeted strategies for DS prevention and management in India. Furthermore, this study emphasizes the significance of oral health awareness and preventive strategies in groups with a high frequency of denture usage in a larger population.