A systematic review of therapeutic outcomes following treatment of squamous cell carcinoma of the retromolar trigone

Frequency of lymph node metastases at different neck levels in patients with oral squamous cell carcinoma: a systematic review and meta-analysis

BACKGROUND

Currently, neck dissection is a standard treatment for the majority of oral squamous cell carcinoma (OSCC) patients. However, the procedure can lead to a series of complications, significantly reducing patient quality of life and even affecting the antitumor immune response in patients undergoing immunotherapy. Therefore, in the era of precision surgery, gaining a deeper understanding of the patterns of lymph node metastasis (LNM) in OSCC is crucial.

MATERIALS AND METHODS

Literature searches were performed on PubMed, Embase, Web of Science, Cochrane Library, WANFANGDATA, and China National Knowledge Infrastructure (CNKI) (inception to 10 April 2024). In addition, a manual searching was conducted in Scopus, Google Scholar, and Education Resources Information Center (ERIC). The authors included observational studies that evaluated the frequency of LNM in OSCC patients. Systematic review and a random effects model meta-analysis were performed.

RESULTS

The search identified 4694 articles, of which 17 studies included in our study. The authors calculated the frequency of LNM according to the data reported in the articles. Frequency of LNM=number of patients with positive lymph node / number of patients with OSCC. The frequency of LNM was 12% in level I (95% CI: 0.11-0.15, I2 =38.01%), 20% in level II (95% CI: 0.17-0.22, I2 =47.71%), 10% in level III (95% CI: 0.08-0.12, I2 =49.10%), 2% in level IV (95% CI: 0.01-0.03, I2 =27.58%), 1% in level V (95% CI: 0.00-0.01, I2 =11.37%).

CONCLUSION

The frequency of LNM is consistent with the 'cascade theory' and appears to be no significant difference from different primary sites. The frequency of LNM were low in levels I-III and were very low in level IV-V, which implicated that more conservative treatments may be considered for OSCC in the future. This study will help clinicians better determine the extent of surgery and preserve lymph nodes during neck dissection.

Clinical characteristics and prognosis of patients with primary squamous cell carcinoma of the retromolar trigone: A SEER-based analysis

BACKGROUND

Primary squamous cell carcinoma of the retromolar trigone (primary SCC RMT) is an uncommon malignant tumor. There is still much to learn about its clinicopathological characteristics and prognosis. In order to better understand the clinicopathological features and predictive survival aspects of primary SCC RMT, this study examined data from the SEER database from 2000 to 2020. Furthermore, in order to forecast the overall survival (OS) and cancer-specific survival (CSS) of patients with primary SCC RMT, we created nomograms.

METHOD

The Surveillance, Epidemiology and End Results (SEER) database was used to retrieve the information on individuals with primary SCC RMT who received a diagnosis between 2000 and 2020. Both univariate and multivariate analyses were conducted using the Cox proportional risk regression model. Using R software, prognostic nomograms were created to forecast the OS and CSS likelihood. The nomograms' prediction abilities were evaluated using the consistency index (C-index), calibration curve, and receiver operating characteristic (ROC) curve.

RESULT

A total of 1717 patients with primary SCC RMT were included, they were randomly assigned to the primary and validation cohorts in a 7:3 ratio using R software. Multivariate Cox regression revealed that age, marital status, regional nodes positive, Summary stage, TNM stage, T stage, N stage, surgery were independent prognostic factors of OS, and age, marital status, regional nodes positive, tumor sizes, Summary stage, N stage, surgery were independent prognostic factors of CSS in the primary cohort. The C-index of the nomogram OS was 0.705 (95 % CI: 0.685-0.725) and the C-index of CSS was 0.734 (95 % CI:0.714-0.754) in the primary cohort. In validation cohort, the C-index of the nomogram OS and CSS were 0.730 (95 % CI: 0.710-0.750) and 0.723 (95 % CI: 0.684-0.762), respectively. The 1-, 3-, and 5-year OS and CSS rates in the primary cohort and validation cohort were approximately in line with the nomogram estimations, in accordance to the calibration curves.

CONCLUSION

We conducted an analysis using the SEER database to investigate the features, survival outcomes, and prognostic parameters of patients with primary SCC RMT. And we developed two prognostic nomograms that can be used by clinicians to forecast the 1-, 3-, and 5-year overall survival and cancer-specific survival of patients with primary SCC RMT.

Demographic and pathologic factor regression to a growth rate model of p16 ‐negative oral cavity squamous cell carcinoma

Objectives

The current study aims to quantify the growth rate of p16‐negative oral cavity squamous cell carcinoma, characterize causative relationships between demographic risk factors and tumor growth, and examine pathologic findings associated with the tumor growth rate at a tertiary care institution. It is hypothesized that causative relationships will be drawn between the individual sociodemographic and pathologic factors and oral cavity p16‐negative squamous cell carcinoma growth rate.

Methods

Prospectively recruited participants, receiving surgical intervention only, were followed from initial staging CT scan to surgical resection. Interval growth was calculated in cm³/week. Demographic information including age, sex, smoking history, alcohol consumption history, previous all‐type malignancy, previous chemotherapy treatment, previous head or neck radiation exposure, and time interval elapsed between diagnosis and surgery was collected from each participant, and regression analysis was applied to determine causality.

Results

Summary statistics revealed a mean growth rate for the study sample of 1.385cm³/week. Statistically significant regression correlations were detected between tumor growth and alcohol consumption, origination at the retromolar trigone, and clinical nodal stage.

Conclusions

Through a small prospective cohort sample, the current study suggests clinical associations between alcohol consumption, origination at the retromolar trigone, and clinical nodal stage with rate of tumor growth. Future work will validate these relationships in a larger patient cohort, and against stronger modeling techniques.

Level of Evidence

Prospective non‐random cohort design.