A multicenter study of oral malignant tumors from Thailand

Pilot Model for Community Based Oral Cancer Screening Program: Outcome from 4 Northeastern Provinces in Thailand

Management of advanced-stage oral cancer adds a great burden to individuals and health care systems. Community-based oral cancer screening can be beneficial in early detection and treatment. In this study, a novel oral cancer screening program was conducted utilizing an existing network of health care personnel, facilities, and digital database management for efficient coverage of a large population. The screening program considered 392,396 individuals aged ≥40 from four northeastern provinces in Thailand. Three levels of screening were performed: S1 by village healthcare volunteers to identify risk groups, S2 by dental auxiliaries to visually identify abnormal oral lesions, and S3 by dentists for final diagnosis and management. A total of 349,318 individuals were interviewed for S1, and 192,688 were identified as a risk group. For S2, 88,201 individuals appeared, and 2969 were further referred. Out of 1779 individuals who appeared for S3, oral potentially malignant disorders (OPMDs) were identified in 544, non-OPMDs in 1047, doubtful lesions in 52, and no results in 136 individuals. Final treatment was carried out in 704 individuals that included biopsies of 504 lesions, exhibiting 25 cancerous lesions and 298 OPMDs. This study is so far one of the largest oral cancer screening programs conducted in Thailand and showed effective implementation of community-based oral cancer screening.

Biopsied non-dental plaque-induced gingival diseases in a Chinese population: a single-institute retrospective study

Background

While inflammatory diseases such as gingivitis and periodontitis induced by dental plaque biofilms constitute the majority of gingival lesions, gingiva can also be affected by a variety of diseases with aetiologies different from bacterial biofilms. The aim of this study was to retrospectively analyze the frequency and distribution of non-dental plaque-induced gingival diseases (NDPIGDs) in the Chinese population in a single institute.

Methods

A total of 6859 samples of biopsied gingival diseases during the period 2000–2019 were obtained from the Department of Pathology, Peking University Hospital of Stomatology. Lesions were categorized by histopathological diagnosis, pathological characteristics and the new classification of gingival health and gingival diseases/conditions. Demographic information, such as gender, location, and age, were also analyzed.

Results

Among 6859 biopsied NDPIGD samples, the five most frequent diagnoses included oral squamous cell carcinoma (OSCC, n = 2094), fibrous hyperplasia (n = 2026), pyogenic granuloma (n = 478), epithelial dysplasia (n = 477), and epithelial hyperplasia/hyperkeratosis (n = 436). All types could be grouped into nine categories according to their pathological characteristics. The most common biopsied NDPIGDs category was “hyperplastic lesions” (n = 2648, 38.61%), followed by “malignant neoplasms” (n = 2275, 33.17%). The most common diagnosis types in each category were fibrous hyperplasia and OSCC. Of all NDPIGDs, most lesions could be categorized into the new classification of gingival health and gingival diseases/conditions; only 7.07% did not fit the current classification system.

Conclusions

The present study is the first report on the frequency and distribution of biopsied NDPIGDs in a Chinese population. Unlike previous studies, the most prevalent categories were “hyperplastic lesions” and “malignant neoplasms”. The proportion of “malignant neoplasms” and “oral potentially malignant disorders” was remarkably higher than in previous researches. Nevertheless, the study provided epidemiological information on many NDPIGDs, which could be useful for future health policies as well as screening programs.

Analysis of THREE-year prevalence of oral cavity, neck and head tumors - a retrospective single-centre study

The purpose of the study was to retrospectively analyze the prevalence of oral cavity, neck and head tumors recorded at our department over a period of 3 years. Retrospective analysis included archival data on cancer patients treated at our department during the 2015-2017 period. A total of 1005 patients with proven carcinomas were selected for final analysis. Cancers were detected by ultrasound, x-ray, biopsy and clinical diagnosis. The mean age of patients was 58.4±19.3 years. The majority of cases (n=264; 26.3%) were detected in the 7^th decade of life. The most common cancers were basal cell carcinoma in 374 (37.2%) and squamous cell carcinoma in 228 (22.7%) cases. The male-to-female ratio was 1.7:1. There was no statistically significant age difference between genders. Recurrence of tumor occurred in 31 patients. The most common risk factor in both groups was sun exposure. The most common sites were lower lip, cheek and frontal region in men, and cheek region and nose in women (p<0.001). Men were found to be more susceptible to cancer development. This study showed differences between age groups, i.e. elderly patients had a much higher probability of developing cancer as compared to younger patients.

A multi-centre evaluation of malignant odontogenic tumours in Nigeria

Introduction

odontogenic tumors originate from neoplastic transformation of the remnants of tooth forming apparatus. There are varying degrees of inductive interactions between odontogenic ectomesenchyme and epithelium during odontogenesis, leading to lesions that vary from benign to malignant. Malignant odontogenic tumours (MOTs) are very rare and are classified according to embryonic tissue of origin. Recently, there has been a few changes to the classification of MOTs according to the World Health Organization's (WHO) classification in 2017. This study aims to evaluate and reclassify MOTs, using a multi-centre approach in some major tertiary dental hospitals in Nigeria.

Methods

this study reviewed the clinicopathological data on 63 cases of MOT diagnosed over 25 years in five major tertiary dental hospitals in Nigeria. All MOT cases were reclassified according to the recent revision to the 2017 WHO classification of odontogenic tumours.

Results

from a total of 10,446 biopsies of oral and jaw lesions seen at the 5 study centres over the 25-year study period, 2199 (21.05%) cases were found to be odontogenic tumours (OTs), of which 63 were MOT. MOTs constituted 0.60% of the total biopsy cases and 2.86% of OTs. Odontogenic carcinomas presented with a mean age higher than odontogenic sarcomas. According to our 2017 WHO reclassification of MOTs, odontogenic carcinomas, ameloblastic carcinomas and primary intraosseous carcinomas were found to be the top three lesions, respectively. Carcinosarcomas were found to be extremely rare.

Conclusion

using a multi-centre approach is a robust way to reduce diagnostic challenges associated with rare maxillofacial lesions such as MOTs.

Distribution of biopsied non plaque-induced gingival lesions in a Chilean population according to the classification of periodontal diseases

Background

Many gingival lesions are not induced by plaque. The aim of this study was to analyze the frequency of biopsied non-plaque-induced gingival lesions (NPIGL) in a Chilean population.

Methods

One thousand twelve cases of biopsied gingival lesions with confirmed anatomopathologic diagnosis were included, from the records of the Oral Pathology Referral Institute (OPRI), Faculty of Dentistry, University of Chile, between years 1990 and 2009.

Results

The most frequent non plaque-induced gingival lesions categories from biopsied cases included hyperplastic lesions, malignancies and benign neoplasms. The most frequent diagnoses in each category were fibrous hyperplasia (35.47%), squamous cell carcinoma (3.85%) and giant cell fibroma (2.08%), respectively. From all lesions, only 8.3% fitted in the specified categories of the current classification of periodontal diseases.

Conclusions

The most frequent biopsied NPIGL were hyperplastic lesions and neoplasms. These categories represent relevant lesions to be included in a future periodontal classification system to improve the care needs of the patients, as well as early diagnosis and treatment.

Oral cancer: A multicenter study

Background

To determine the prevalence and clinicopathologic features of the oral cancer patients.

Material and Methods

Biopsy records of the participating institutions were reviewed for oral cancer cases diagnosed from 2005 to 2014. Demographic data and site of the lesions were collected. Sites of the lesion were subdivided into lip, tongue, floor of the mouth, gingiva, alveolar mucosa, palate, buccal/labial mucosa, maxilla and mandible. Oral cancer was subdivided into 7 categories: epithelial tumors, salivary gland tumors, hematologic tumors, bone tumors, mesenchymal tumors, odontogenic tumors, and others. Data were analyzed by descriptive statistics using SPSS software version 17.0.

Results

Of the 474,851 accessioned cases, 6,151 cases (1.30%) were diagnosed in the category of oral cancer. The mean age of the patients was 58.37±15.77 years. A total of 4,238 cases (68.90%) were diagnosed in males, whereas 1911 cases (31.07%) were diagnosed in females. The male-to-female ratio was 2.22:1. The sites of predilection for oral cancer were tongue, labial/buccal mucosa, gingiva, palate, and alveolar mucosa, respectively. The three most common oral cancer in the descending order of frequency were squamous cell carcinoma, non-Hodgkin lymphoma and mucoepidermoid carcinoma.

Conclusions

Although the prevalence of oral cancer is not high compared to other entities, oral cancer pose significant mortality and morbidity in the patients, especially when discovered late in the course of the disease. This study highlights some anatomical locations where oral cancers are frequently encountered. As a result, clinicians should pay attention to not only teeth, but oral mucosa especially in the high prevalence area as well since early detection of precancerous lesions or cancers in the early stage increase the chance of patient being cured and greatly reduce the mortality and morbidity. This study also shows some differences between pediatric and elderly oral cancer patients as well as between Asian and non-Asian oral cancer patients.

Key words:Oral cancer, prevalence, clinic-pathologic features, retrospective study.