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Beegum F, Trimukhe A. Traversing the Terrain: Potential Pitfalls within the AJCC 8th Edition Staging System for Lip and Oral Cavity Cancers. Head Neck Pathol 2024; 18:62. [PMID: 38958825 PMCID: PMC11222341 DOI: 10.1007/s12105-024-01663-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/01/2024] [Indexed: 07/04/2024]
Abstract
In 1977, the American Joint Committee on Cancer (AJCC) introduced the inaugural Cancer Staging Manual, which implemented the T (tumor extent), N (regional lymph node status), and M (presence or absence of distant metastasis) staging system. This systematic approach aimed to convey the extent of disease across various cancer types, providing clinicians with a practical framework to plan treatment strategies, predict prognosis, and assess outcomes. The AJCC 8th edition, effective from January 1, 2018, continues this tradition. However, certain shortcomings persist in the AJCC 8th edition, as identified through clinical experience. Specifically, challenges arise in accurately assessing depth of invasion in unique histological variants of oral squamous cell carcinoma (e.g., Oral verrucous carcinoma, Carcinoma cuniculatum, and Papillary squamous cell carcinoma) and minor salivary gland tumors. Additionally, discrepancies exist in the perception of bone invasion patterns and in reporting practices. There is also a need for staging guidelines for malignant odontogenic tumors and multifocal tumors of the oral cavity, supplemented by diagrammatic representations. Lastly, there is a call for comprehensive staging criteria for carcinomas of the ear, external auditory canal, and temporal bone. We advocate for the inclusion of these considerations in future editions of the AJCC Cancer Staging Manual.
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Affiliation(s)
- Faseela Beegum
- Department of Oncopathology, Malabar Cancer Centre (PGIOSR), Kodiyeri, Muzhikkara - MCC Rd, Illathaazha, Thalassery, Kerala, 670103, India
| | - Akshay Trimukhe
- Department of Oncopathology, Malabar Cancer Centre (PGIOSR), Kodiyeri, Muzhikkara - MCC Rd, Illathaazha, Thalassery, Kerala, 670103, India.
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Patel AM, Vedula S, Haleem A, Choudhry HS, Tseng CC, Park RCW. Elective Neck Dissection for cT1-4 N0M0 Head and Neck Verrucous Carcinoma. Otolaryngol Head Neck Surg 2023; 169:1187-1199. [PMID: 37278222 DOI: 10.1002/ohn.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the survival benefit of elective neck dissection (END) over neck observation in cT1-4 N0M0 head and neck verrucous carcinoma (HNVC). STUDY DESIGN Retrospective cohort study. SETTING The 2006 to 2017 National Cancer Database. METHODS Patients with surgically resected cT1-4 N0M0 HNVC were selected. Linear, binary logistic, Kaplan-Meier, and Cox proportional hazards regression models were utilized. RESULTS Of 1015 patients satisfying inclusion criteria, 223 (22.0%) underwent END. The majority of patients were male (55.4%) and white (91.0%) with disease of the oral cavity (67.6%) classified as low grade (90.0%) and cT1-2 (81.8%). The minority of ENDs (4.0%) detected occult nodal metastases. The rate of END increased from 2006 to 2017 for both cT1-2 (16.3% vs 22.0%, p = .126, R2 = 0.405) and cT3-4 (41.7% vs 70.0%, p = .424, R2 = 0.232) disease but these trends were not statistically significant. Independent predictors of undergoing END included treatment at an academic facility (adjusted odds ratio [aOR]: 1.75, 95% confidence interval [CI]: 1.19-2.55), cT3-4 disease (aOR: 3.31, 95% CI: 2.16-5.07), and tumor diameter (aOR: 1.09, 95% CI: 1.01-1.19) (p < 0.05). The 5-year overall survival (OS) of patients treated with and without END was 71.3% and 70.6%, respectively (p = .661). END did not significantly reduce the 5-year hazard of death (adjusted hazard ratio: 1.25, 95% CI: 0.91-1.71, p = .172). END did not significantly improve 5-year OS in univariate and multivariate analyses stratified by several patient, facility, tumor, and treatment characteristics. CONCLUSION END does not confer an appreciable survival benefit in HNVC, even after stratifying univariate and multivariate analyses by several patient, facility, tumor, and treatment characteristics. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Aman M Patel
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Sudeepti Vedula
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Afash Haleem
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Hassaam S Choudhry
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Christopher C Tseng
- Department of Otolaryngology-Head and Neck Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Richard Chan Woo Park
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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3
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Moss WJ, Kwon D, Wu N, Brett P. Complete clinicoradiographic remission following immunotherapy treatment for an unresectable, multiply-recurrent oral verrucous carcinoma: A letter to the editor. Oral Oncol 2023; 146:106567. [PMID: 37778230 DOI: 10.1016/j.oraloncology.2023.106567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023]
Affiliation(s)
- William J Moss
- Commonwealth Healthcare Corporation, Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, 1 Navy Hill Rd, Garapan, Saipan, MP 96950, USA; VinUniversity, Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, Vinhomes Ocean Park, Gia Lâm, Hanoi, Viet Nam.
| | - Daniel Kwon
- University of Southern California Keck School of Medicine, Department of Otolaryngology-Head and Neck Surgery, 1450 San Pablo Street, Suite 5800 Los Angeles, CA 90033, USA
| | - Nathaniel Wu
- University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Peter Brett
- Commonwealth Healthcare Corporation, Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, 1 Navy Hill Rd, Garapan, Saipan, MP 96950, USA
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Nnko KA, Rwakatema DS, Bina SM, Mwita SF, Mremi A. Management of huge verrucous carcinoma of lower lip: A case report at a tertiary hospital in northern Tanzania. Clin Case Rep 2023; 11:e7457. [PMID: 37273669 PMCID: PMC10238704 DOI: 10.1002/ccr3.7457] [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: 02/08/2023] [Revised: 04/22/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023] Open
Abstract
Key Clinical Message Well-differentiated variant of squamous cell carcinoma. Slow growing, exophytic, cauliflower-like growth easily confused with a viral wart. Cutaneous, anogenital, and oral variant exist. Risk factors for oral variant include alcohol and smoking. Histopathologically exhibits lobules with a pushing margin and blunt borders. Abstract Verrucous carcinoma (VC) is a low-grade variant of squamous cell carcinoma with specific clinicopathologic features and good prognosis when affecting skin. We report the case VC of lip in a-70-year-old lady. She underwent surgical excision with excellent outcomes. A brief review of the literature is provided.
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Affiliation(s)
- Kanankira A. Nnko
- Department of Dental SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Deogratius S. Rwakatema
- Department of Dental SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Steven M. Bina
- Department of Dental SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
| | - Samweli F. Mwita
- Department of Dental SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
| | - Alex Mremi
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of PathologyKilimanjaro Christian Medical CentreMoshiTanzania
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Kristofelc N, Zidar N, Strojan P. Oral verrucous carcinoma: a diagnostic and therapeutic challenge. Radiol Oncol 2023; 57:1-11. [PMID: 36942907 PMCID: PMC10039467 DOI: 10.2478/raon-2023-0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Verrucous carcinoma is a low-grade variant of squamous cell carcinoma with specific morphologic, cytokinetic and clinical features. Despite low mitotic activity and slow growth, it can infiltrate adjacent tissues in advanced stages but does not metastasize. The most frequently affected site is the oral cavity. The following article provides latest updates in the etiology, clinical presentation, diagnostics and treatment options in oral verrucous carcinoma and discusses the existing dilemmas linked to this unique malignancy. CONCLUSIONS Oral verrucous carcinoma must be differentiated from conventional squamous cell carcinoma due to its less aggressive behaviour with a more favourable prognosis. Close communication between clinician and pathologist is mandatory for making a correct diagnosis. Primary surgery with negative surgical margins seems to be the most successful treatment. However, management recommendations are not uniform since they are mostly based on case reports and small retrospective case series. Prospective and pooled multi-institutional studies are therefore needed.
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Affiliation(s)
- Nejc Kristofelc
- Department of Otorhinolaryngology, General Hospital Dr. Franc Derganc Nova Gorica, Šempeter pri Gorici, Ljubljana Slovenia
| | - Nina Zidar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Primoz Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Pal US, Maurya H, Yadav SK, Kumar V, Sowmya MV, Singh R. Protocol for Treatment of Oral Verrucous Carcinoma - A Systematic Review and Meta-Analysis. Ann Maxillofac Surg 2023; 13:88-94. [PMID: 37711531 PMCID: PMC10499276 DOI: 10.4103/ams.ams_65_23] [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: 04/01/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 09/16/2023] Open
Abstract
Background The objective of this study is to provide a structured protocol for the treatment of verrucous carcinoma (VC) based on size, bone invasion, recurrence and whether neck dissection is necessary or not. In addition, the study evaluates the probability of a wrong histopathological diagnosis. Data Sources A search was conducted in the Cochrane Library, PubMed and Google from January 1962 to October 2022 by using MeSH terms and keywords. Studies reporting treatment modalities for VC and different histopathological diagnoses after excision of the lesion were selected except case reports and review articles. Study Eligibility Criteria Thirteen articles were selected. Six hundred and thirty cases of VC were treated by surgery, surgery + neck dissection, radiotherapy, chemotherapy and combination therapy. Statistical analysis revealed surgical treatment as a preferred option. Despite being enlarged, the lymph node was negative for metastasis. So, in OVC cases neck dissection adds only unnecessary morbidity to patients. Participants and Interventions Radiotherapy or chemotherapy can be used to downstage the disease. 23.3% of cases reported wrong histopathology diagnosis. Study Appraisal and Synthesis Methods Patients treated for squamous cell carcinoma (SCC) will only experience unnecessary morbidity unless the correct diagnosis is made between VC and hybrid VC. Irrespective of size VC does not metastasise until there are no foci of SCC. Conclusions Surgical excision of T1- and T2-sized lesions can be performed under local anaesthetic as a biopsy procedure. T3 or T4 lesion can be resected with a safe margin. If it comes as hybrid VC or VC with close margin (0.5 cm, <0.5 cm), neck dissection and further margin should be excised as a second procedure respectively.
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Affiliation(s)
- Uma Shanker Pal
- Department of Oral and Maxillofacial Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Harshita Maurya
- Department of Oral and Maxillofacial Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Shailendra Kumar Yadav
- Department of General Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar
- Department of Plastic and Reconstructive Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Meleti Venkata Sowmya
- Department of Oral and Maxillofacial Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Ranjeet Singh
- Department of Oral and Maxillofacial Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
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Rath S, Gandhi AK, Rastogi M, Agarwal A, Singhal A, Sharma V, Khurana R, Singh HB, Nanda SS, Hadi R, Husain N. Treatment Pattern and Outcomes in Verrucous Carcinoma of Oral Cavity: A Single Institutional Retrospective Analysis from a Tertiary Cancer Center and Review of Literature. Indian J Otolaryngol Head Neck Surg 2022; 74:1790-1796. [PMID: 36452609 PMCID: PMC9702423 DOI: 10.1007/s12070-020-01798-w] [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: 12/30/2019] [Accepted: 01/22/2020] [Indexed: 11/27/2022] Open
Abstract
Verrucous carcinoma (VC) is a locally invasive uncommon histopathological variant of oral squamous cell cancer. There is paucity of literature regarding control rates in these cases. We intend to report the outcomes in terms of administered treatment and control rates. 28 patients of oral cavity verrucous carcinomas treated at our institute from March 2014 to December 2018 were reviewed retrospectively. Demographic profile, histopathological features and clinical outcomes were analyzed. Statistical analysis was performed with SPSS for Mac (version 23.0). Median age was 54 years (range 31-75) with M:F ratio of 25:3. Buccal mucosa was the most common site. All patients underwent surgical resection except one. Of these, 24 had neck dissection; 12 had supra-omohyoid neck dissection, eleven had modified neck dissection and one patient underwent radical neck dissection. Three patients had their histology upgraded to squamous cell carcinomas in the post-operative histopathology. The post-operative staging was as follows: 21% stage I and 35% stage II. One patient opted for non-surgical approach and received radical concurrent chemoradiotherapy. Median follow up was 12 months (range 6-36). Two patients had local failures and one had a regional failure. No distant metastasis was found. There was one death. 14-Months survival rate was 92%. Estimated 18 month loco-regional control rate was 92%. Curative surgical resection remains the cornerstone for VC of oral cavity. Any change of histopathology post-operatively to squamous cell carcinoma is a poor prognostic sign and needs appropriate adjuvant treatment.
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Affiliation(s)
- Satyajeet Rath
- Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Ajeet Kumar Gandhi
- Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Madhup Rastogi
- Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Akash Agarwal
- Department of Surgical Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Ashish Singhal
- Department of Surgical Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Vikash Sharma
- Department of Surgical Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Rohini Khurana
- Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Harikesh Bahadur Singh
- Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Sambit Swarup Nanda
- Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Rahat Hadi
- Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
| | - Nuzhat Husain
- Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India
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Naik AN, Silverman DA, Rygalski CJ, Zhao S, Brock G, Lin C, Puram SV, Rocco JW, Baliga S, VanKoevering KK, Old MO, Seim NB, Kang SY. Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma. Laryngoscope 2022; 132:1953-1961. [PMID: 34989407 DOI: 10.1002/lary.30009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/16/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS We investigate the clinicopathologic and treatment factors associated with the use of postoperative radiation therapy (PORT) and its effect on overall survival (OS) for patients with oral cavity verrucous carcinoma (VC). STUDY DESIGN Retrospective cohort study. METHODS A retrospective cohort study of the National Cancer Database (NCDB) from 2006 to 2015 was performed. Multivariable logistic regression was used to identify independent predictive factors associated with the use of PORT. Cox Regression survival and propensity score analyses were used to evaluate the effect of PORT on mortality. RESULTS A total of 356 adult patients with primary oral cavity VC who underwent definitive surgical resection were identified. A total of 10.7% of patients underwent definitive surgical resection followed by PORT. Variables associated with PORT included distance to the hospital per 10 miles (adjusted odds ratio [aOR], 0.81 [95% confidence interval (CI), 0.70-0.95]) and stage III-IV disease (aOR, 12.13 and 23.92, respectively). Multivariable Cox regression survival analysis indicated no evidence of survival benefit in patients undergoing PORT compared to surgery alone (adjusted hazard ratio 1.50 [0.74-3.05], P = .23). Propensity score analysis also showed no OS benefit with the use of PORT (P = .41). CONCLUSIONS Variables associated with the use of PORT on multivariable analysis included closer distance to hospital and stage III-IV disease. No clear survival benefit with PORT was identified on either multivariable survival analysis or propensity score analysis. These results suggest that surgery alone with negative margins may be the optimal treatment for patients with oral cavity VC. LEVEL OF EVIDENCE 4 Laryngoscope, 2022.
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Affiliation(s)
- Akash N Naik
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Dustin A Silverman
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis Health System, Sacramento, California, U.S.A
| | | | - Songzhu Zhao
- Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University, Columbus, Ohio, U.S.A
| | - Guy Brock
- Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University, Columbus, Ohio, U.S.A
| | - Chen Lin
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, U.S.A
| | - Sidharth V Puram
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - James W Rocco
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Sujith Baliga
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Kyle K VanKoevering
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Matthew O Old
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Nolan B Seim
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Stephen Y Kang
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
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Prakash S, Radha, Kumar M, Kumari N, Thakur M, Rathour S, Pundir A, Sharma AK, Bangar SP, Dhumal S, Singh S, Thiyagarajan A, Sharma A, Sharma M, Changan S, Sasi M, Senapathy M, Pradhan PC, Garg NK, Ilakiya T, Nitin M, Abdel-Daim MM, Puri S, Natta S, Dey A, Amarowicz R, Mekhemar M. Plant-Based Antioxidant Extracts and Compounds in the Management of Oral Cancer. Antioxidants (Basel) 2021; 10:1358. [PMID: 34572990 PMCID: PMC8466097 DOI: 10.3390/antiox10091358] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 12/11/2022] Open
Abstract
Oral cancer continues to be a leading cause of death worldwide, and its prevalence is particularly high in developing countries, where people chew tobacco and betel nut on a regular basis. Radiation-, chemo-, targeted-, immuno-, and hormone-based therapies along with surgery are commonly used as part of a treatment plan. However, these treatments frequently result in various unwanted short- to long-term side effects. As a result, there is an urgent need to develop treatment options for oral cancer that have little or no adverse effects. Numerous bioactive compounds derived from various plants have recently attracted attention as therapeutic options for cancer treatment. Antioxidants found in medicinal plants, such as vitamins E, C, and A, reduce damage to the mucosa by neutralizing free radicals found in various oral mucosal lesions. Phytochemicals found in medicinal plants have the potential to modulate cellular signalling pathways that alter the cellular defence mechanisms to protect normal cells from reactive oxygen species (ROS) and induce apoptosis in cancer cells. This review aims to provide a comprehensive overview of various medicinal plants and phytoconstituents that have shown the potential to be used as oral cancer therapeutics.
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Affiliation(s)
- Suraj Prakash
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, India; (S.P.); (N.K.); (M.T.); (S.R.); (S.P.)
| | - Radha
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, India; (S.P.); (N.K.); (M.T.); (S.R.); (S.P.)
| | - Manoj Kumar
- Chemical and Biochemical Processing Division, ICAR—Central Institute for Research on Cotton Technology, Mumbai 400019, India
| | - Neeraj Kumari
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, India; (S.P.); (N.K.); (M.T.); (S.R.); (S.P.)
| | - Mamta Thakur
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, India; (S.P.); (N.K.); (M.T.); (S.R.); (S.P.)
| | - Sonia Rathour
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, India; (S.P.); (N.K.); (M.T.); (S.R.); (S.P.)
| | - Ashok Pundir
- School of Mechanical and Civil Engineering, Shoolini University of Biotechnology and Management Sciences, Solan 173229, India;
| | - Abhishek Kumar Sharma
- School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, India;
| | - Sneh Punia Bangar
- Department of Food, Nutrition, & Packaging Sciences, Clemson University, Clemson, SC 29634, USA;
| | - Sangram Dhumal
- Division of Horticulture, RCSM College of Agriculture, Kolhapur 416004, India;
| | - Surinder Singh
- Dr. S.S. Bhatnagar University Institute of Chemical Engineering and Technology, Panjab University, Chandigarh 160014, India;
| | - Anitha Thiyagarajan
- Department of Postharvest Technology, Horticultural College and Research Institute, Periyakulam 625604, India;
| | - Anshu Sharma
- Department of Food Science and Technology, Dr. Y.S. Parmar University of Horticulture and Forestry, Nauni 173230, India;
| | - Munisha Sharma
- Sri Shankara Cancer Hospital and Research Centre, Bengaluru 560004, India;
| | - Sushil Changan
- Division of Crop Physiology, Biochemistry and Post-Harvest Technology, ICAR-Central Potato Research Institute, Shimla 171001, India;
| | - Minnu Sasi
- Division of Biochemistry, ICAR—Indian Agricultural Research Institute, New Delhi 110012, India;
| | - Marisennayya Senapathy
- Department of Rural Development and Agricultural Extension, College of Agriculture, Wolaita Sodo University, Wolaita Sodo, SNNPR, Ethiopia;
| | - Prakash Chandra Pradhan
- Division of Agricultural Chemicals, ICAR—Indian Agricultural Research Institute, New Delhi 110012, India;
| | - Nitin Kumar Garg
- Division of Biochemistry, Sri Karan Narendra Agriculture University, Jobner 303329, India;
| | - Tamilselvan Ilakiya
- Department of Vegetable Science, Tamil Nadu Agricultural University, Coimbatore 641003, India;
| | - Mukesh Nitin
- Department of Tech. Biosciences, Digianalix, South Samaj Street, Tharpakhna, Ranchi 834001, India;
| | - Mohamed M. Abdel-Daim
- Pharmacy Program, Department of Phamaceutical Sciences, Batterjee Medical College, P.O. Box 6231, Jeddah 21442, Saudi Arabia;
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Sunil Puri
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, India; (S.P.); (N.K.); (M.T.); (S.R.); (S.P.)
| | - Suman Natta
- ICAR—National Research Centre for Orchids, Pakyong 737106, India;
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, 86/1 College Street, Kolkata 700073, India;
| | - Ryszard Amarowicz
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland;
| | - Mohamed Mekhemar
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrecht’s University, 24105 Kiel, Germany
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Hamman J, Howe CL, Borgstrom M, Baker A, Wang SJ, Bearelly S. Impact of Close Margins in Head and Neck Mucosal Squamous Cell Carcinoma: A Systematic Review. Laryngoscope 2021; 132:307-321. [PMID: 34143492 DOI: 10.1002/lary.29690] [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: 01/21/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS The aim of the study is to investigate whether close surgical margins impact oncologic outcomes compared to clear or involved surgical margins. We hypothesize that close surgical margins portend worse outcomes compared with clear margins, but improved outcomes compared with involved margins. STUDY DESIGN Systematic review. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement standards, a systematic search was conducted for studies that reported oncologic outcomes following excision of primary mucosal head and neck squamous cell carcinoma (HNSCC). A meta-analysis was then performed, comparing local recurrence (LR), locoregional recurrence (LRR), and overall survival (OS) in patients with clear, close, and involved margins. RESULTS Twenty-six studies met the inclusion criteria, totaling 8,435 patients. About 96% of our included cases involved the oral cavity, 2% involved the oropharynx, and 2% other. Also, 68% of cases were T1/T2 and 32% were T3/T4. On meta-analysis, clear margins were associated with lower incidence of 5-year LR relative risk (RR) 0.50, 95% confidence interval [CI] 0.38-0.65) and higher 5-year OS (RR 1.22, 1.11-1.35), when compared with close margins. Involved margins had higher incidence of 5-year LR (RR 1.75, 1.16-2.64), higher incidence of LRR at last follow-up (RR 1.66, 1.37-2.00), and no difference in 5-year OS (RR 0.82, 0.60-1.11), when compared with close margins. CONCLUSIONS There is a stepwise improvement in oncologic outcomes as surgical margin categorically improves from involved to close to clear. Patients with close margins therefore may benefit from adjuvant therapy. Further research is required to investigate whether these findings are seen in non-oral cavity cases because they were underrepresented in this analysis. Laryngoscope, 2021.
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Affiliation(s)
- Justin Hamman
- Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona, U.S.A
| | - Carol L Howe
- University of Arizona Health Sciences Library, Tucson, Arizona, U.S.A
| | - Mark Borgstrom
- University Information Technology Services, University of Arizona, Tucson, Arizona, U.S.A
| | - Audrey Baker
- Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona, U.S.A
| | - Steven J Wang
- Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona, U.S.A
| | - Shethal Bearelly
- Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona, U.S.A
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Hassan Saad R, Halawa SM, Zidan AM, Emara NM, Abdelghany OA. Malignant transformation of oral squamous cell papilloma: a case report. Int J Surg Case Rep 2020; 75:348-351. [PMID: 32980707 PMCID: PMC7522575 DOI: 10.1016/j.ijscr.2020.09.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/06/2020] [Accepted: 09/06/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Oral squamous papilloma is a benign tumor, but its potential for malignant transformation has yet to be studied. The authors report an unusual case presentation of an oral squamous cell carcinoma (SCC) arising from a squamous cell papilloma (SCP). CASE PRESENTATION A 61 years old immunocompromised female patient complained of an asymptomatic white mass on the buccal mucosa. The diagnosis of squamous cell papilloma (SCP) was made, and the benign nature of the lesion was confirmed by two biopsies. The lesion suddenly increased in size, and the third biopsy revealed a malignant squamous cell carcinoma (SCC) grade II. At this stage, radical surgical intervention was the treatment of choice, and reconstruction with a combination of the pectoralis major and deltopectoral flaps was performed. DISCUSSION Clinical and histopathological diagnosis of oral squamous papilloma is challenging. Reconstruction of composite head and neck defects is another challenge, especially in elderly and immunocompromised patients. The whole process of diagnosis and progress of the presented case might provide useful knowledge regarding the nature of the lesion and its future management. CONCLUSION The authors emphasize the need for establishing a clear understanding of potentially malignant oral lesions. Close observation, multiple biopsies, early detection, precise diagnosis, and a multidisciplinary team approach are all of paramount importance.
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Affiliation(s)
- Reem Hassan Saad
- Department of Cranio-Maxillofacial Surgery, Nasser Institute for Research and Treatment, Cairo, Egypt; Department of Oral and Maxillofacial Surgery, National Bank Hospital For Integral Care, El Katameya, Cairo, Egypt.
| | - Samir Mohamed Halawa
- Department of Oral and Maxillofacial Surgery, Benha University Hospitals, Benha, Egypt
| | - Ahmed Mohamed Zidan
- Department of Surgical Oncology, Faculty of Medicine, Benha University, Benha, Egypt
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Shekar P, Ramya N, Reddy BR. Reporting frequency of potentially malignant oral disorders and oral cancer: A 10-year retrospective data analysis in a teaching dental institution. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2020. [DOI: 10.4103/jdrntruhs.jdrntruhs_6_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Shetty SS, Kudpaje A, Rao V, Thakur S, Ramaswamy V. Nascent verrucous hyperplasia - A transition to cutaneous squamous cell carcinoma. Heliyon 2019; 5:e02356. [PMID: 31485536 PMCID: PMC6717160 DOI: 10.1016/j.heliyon.2019.e02356] [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: 06/18/2019] [Revised: 08/01/2019] [Accepted: 08/19/2019] [Indexed: 11/25/2022] Open
Abstract
Cutaneous squamous cell carcinoma is a common global cancer with Ultraviolet light recognized as the most significant risk factor. The other definite or plausible risk factors include immunosuppression, infection with oncogenic viruses, exposure to toxins, chemicals, chronic inflammatory skin disease and a high body mass index. This case highlights the rarity of the pathology in terms of size, the subtle transition of verrucous hyperplasia to cutaneous squamous cell carcinoma over a period of time and the fallibility of the frozen section report in deciding the optimum resection margins. The initial innocuous presentation represented a diagnostic challenge as it can be mistaken for other benign entities. A correlation between the history, clinical presentation, tumor biology and the histopathological characteristics helped us to unlock the jigsaw puzzle of approaching a rare condition with a modification in the surgical approach.
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Affiliation(s)
- Sameep S Shetty
- Health Care Global Enterprises Ltd, Bangalore 560027, #8 Kalinga Rao Road, Sampangi Ram Nagar, India.,Manipal College of Dental Sciences, Mangalore 575001, Light House Hill Road Manipal Academy of Higher Education, A Constituent of MAHE, India
| | - Akshay Kudpaje
- Consultant Head and Neck Oncologist, Health Care Global Enterprises Ltd, Bangalore, India
| | - Vishal Rao
- Department of Head and Neck Oncology, Health Care Global Enterprises Ltd, Bangalore, India
| | - Shalini Thakur
- Health Care Global Enterprises Ltd, Bangalore 560027, #8 Kalinga Rao Road, Sampangi Ram Nagar, India
| | - Veena Ramaswamy
- Health Care Global Enterprises Ltd, Bangalore 560027, #8 Kalinga Rao Road, Sampangi Ram Nagar, India
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