Evaluation and Staging of Oral Cancer (original) (raw)
Related papers
Looking beyond tobacco and alcohol for oral squamous cell carcinoma
2015
Squamous cell carcinoma is the most common malignant neoplasm of the oral cavity. Betel nut chewing, cigarette smoking and alcohol drinking are thought to be the major environment risk factors responsible for the development of oral squamous cell carcinoma (OSCC). Reports of OSCC in patients who never used tobacco and alcohol are infrequent. The aim of this article is to review the current data concerning the possible etiological factors causing OSCC other than tobacco like viral infections, diet, nutrition, chronic irritation, genetic mutations and other. Although it is well known that the incidence of OSCC increases with age, recent trends for a rising incidence particularly relates to cancer in young individuals. Investigations can be routine ranging from simple oral examination, blood test, bone marrow analysis, diet chart analysis as well as molecular analysis through techniques like PCR, ISH (in situ hybridization), DNA sequencing, southern blot and antibody test. This review ...
PLOS ONE, 2020
Oral squamous cell carcinoma (OSCC) has the highest prevalence in head and neck cancers and is the first and second most common cancer in males and females of Pakistan respectively. Major risk factors include peculiar chewing habits like areca nut, betel quid, and tobacco. The majority of OSCC presents at an advanced stage with poor prognosis. On the face of such a high burden of this preventable cancer, there is a relative lack of recent robust data and its association with known risk factors from Pakistan. The aim of this study was to identify the socioeconomic factors and clinicopathological features that may contribute to the development of OSCC. A total of 186 patients diagnosed and treated at a tertiary care hospital, Karachi Pakistan were recruited. Clinicopathological and socioeconomic information was obtained on a structured questionnaire. Descriptive analysis was done for demographics and socioeconomic status (SES) while regression analysis was performed to evaluate the association between SES and chewing habits, tumor site, and tumor stage. The majority of patients were males and the mean age of OSCC patients was 47.62±12.18 years. Most of the patients belonged to low SES (68.3%) and 77.4% were habitual of chewing. Gender (male) and SES were significantly associated with chewing habits (p<0.05). Odds of developing buccal mucosa tumors in chewers (of any type of substance) and gutka users were 2 and 4 times higher than non-chewers respectively. Middle age, chewing habits, and occupation were significantly associated with late stage presentation of OSCC (p<0.05). In conclusion, male patients belonging to low SES in their forties who had chewing habits for years constituted the bulk of OSCC. Buccal mucosa was the most common site in chewers and the majority presented with late stage tumors.
Retrospective analysis of a 6-year cohort of oral squamous cell carcinoma patients
Journal of Advanced Clinical & Research Insights
Purpose: The present study analyzed 53 consecutive patients with oral squamous cell carcinoma (OSCC) over a period of 6 years (from 2006 to 2012) to determine if epidemiological differences correspond to different stages of the disease and affected the survival rate. Methods: In this cohort study, medical records were reviewed retrospectively. The epidemiological data included age, gender, residence, tobacco habit, duration of tobacco use, blood group, and hemoglobin. The clinicopathological features noted were tumor site, tumor size, nodal status, histopathological grade, metastasis, clinical grade, and treatment. We analyzed the relationship of epidemiological characteristics with treatment by the Chi-square test and survival analysis using the Kaplan-Meier curve. The statistical test significance level was set at P < 0.05. Results: Of the 53 patients of OSCC confirmed through histopathological diagnosis, the ratio of female to male was 1.65:1 and mean age was 51.83 ± 12.57 years. Majority of the cases, i.e., 43 (81.13%) were from rural area. 51 (96.22%) patients were tobacco habituates, of which 41 (80.40%) were smokeless tobacco chewers. Buccal mucosa was the most common tumor site, i.e., 23 (43.40%). The clinical presentation of ulcer/ ulceroproliferative cases, i.e., 43 (81.13%) was most frequent. Moreover, statistical significance was observed with univariate association analysis between clinical presentation and treatment; in patients who underwent surgical treatment (P = 0.04). Of 35 (66.04%) patients who underwent surgical treatment, only 7 (20%) patients had recurrence. Survival rate was 90.57% at 3-year follow-up. Conclusion: The clinical presentation and treatment outcome of OSCC patients with the habit of smokeless tobacco is presented. The improved survival rate in our patients could be due to surgery being the main treatment modality and buccal mucosa being the most frequent site.
Emerging patterns in clinico-pathological spectrum of Oral Cancers
Pakistan Journal of Medical Sciences, 2013
Objective: To correlate the clinico-pathological aspects of Oral Squamous Cell Carcinoma (OSCC) with risk factors to determine the present status and variations in the profile. Methodology: One hundred patients of OSCC and one hundred age and sex matched controls were selected. Detailed demographic data, regarding age, gender, marital status, ethnicity, religion, socioeconomic status along with habits, betel quid, tobacco chewing / smoking, alcohol and dietary habits was recorded. Detailed oral examination was carried out for the site of involvement and associated pathology. Histological grade was determined on microscopic examination of Hemotoxylin & Eosin (H&E) stained slides. One hundred age and sex matched controls were also evaluated for this study. Results: Ages of patients ranged from 25 to 80 years with mean age being 47.84 ± 12.18(SD). Maximum cases were detected in the fifth decade. Male: Female ratio was 2.8:1. Age in controls ranged from 22 -73 with male to female ratio being 3.54:1. In patients, most tumors were seen in buccal cavity (54%) followed by tongue (24%). Histologically 60% cases were well differentiated. Strong association with tobacco smoking and chewing, betel quid and its substitutes was detected, with smoking being more prevalent in males and betel quid in females. Significantly less number of controls were observed to be involved in these habits, with almost half having no such addictions. Conclusion: The present clinico-pathological status of oral cancer still emphasizes primary prevention by creating awareness against the devastating effects of tobacco use, betel quid, its substitutes and areca nut, which can go a long way in decreasing the incidence of this disfiguring and lethal condition.
Oral Squamous Cell Carcinoma: A 6-Month Clinico-Histopathologic Audit in a Kenyan Population
Open Journal of Stomatology, 2014
Objective: To determine the clinico-histopathologic variations and etiological factors associated with oral squamous cell carcinoma (OSCC). Methods: A descriptive cross-sectional hospital based study was conducted at the University of Nairobi Dental Hospital (UNDH) and Kenyatta National Hospital (KNH) between September 2008 and February 2009. Eighty-two (82) patients presenting with lesions confirmed as OSCC were evaluated for habits identified as risk factors such as tobacco use, alcohol use and betel quid chewing. Demographic features including age and gender as well as clinical parameters such as site of the primary lesion, tumour size and nodal involvement were documented. Incisional biopsies were performed for all patients to confirm the diagnosis and histopathological features noted. Results: The mean age of the patients was 58.49 (range = 14 to 90 years), with a male to female ratio of 1.6:1. Remarkably, 13.4% of the patients were aged 40 years and below. The peak incidence was found to have been in the 6 th-7 th decades. Tobacco use was the main associated etiological factor (73.2%) followed by alcohol use (57.3%). Notably, 25.6% of the cases had no identifiable risk factor. The tongue was the most common site (35%) followed by the palate (22%) (p = 0.03). The least commonly affected site was the floor of the mouth (10%). The most common stage at presentation was stage IV (52.4%) and; the poorly differentiated OSCC was the most common histopathologic variant (48.8%) followed by the well differentiated (30.5%) and moderately differentiated OSCC (20.7%). Conclusion: In the present investigation it is evident that OSCC has a male predilection with a peak incidence in the 6 th-7 th decades and most commonly manifests in the tongue at stage IV with the poorly differentiated subtype being the most common. Of the cases diagnosed 13.4% were aged 40 years and below.
Oral Cancer, 2012
Neoplasms of diverse cellular origin arise in the oral cavity and among these oral squamous cell carcinoma (OSCC) arising from the mucosa of the oral cavity constitutes to over 90% 1, 2. Oral cancer encompasses all the malignancies originating in the oral tissues, including cancers of the lip, tongue, gingiva, floor of the mouth, buccal mucosa, palate and the retromolar trigone. It is the 6 th most common cancer worldwide 3. Oral squamous cell carcinoma is described as an invasive epithelial neoplasm with varying degrees of squamous differentiation and a propensity to early and extensive lymph node metastases, occurring predominantly in alcohol and tobacco using adults generally in the 5 th and 6 th decades of life. Globally about 5, 00,000 new cases of oral and oropharyngeal cancers are diagnosed and three quarters of these are from the developing world 7, 8, 9. Approximately 3, 89,650 cases occurred in the year 2000 out of which 2, 66,672 were in the oral cavity (ICD-9 140-5) and 1, 22,978 for the cancer of oropharynx (ICD-9 146, 8-9). This represented about 5% of all cancers for men and 2% for women 10. Oral and oropharyngeal cancers remain one of the more common cancers in the South and South East Asian countries, as opposed to Western society, where it accounts for only about 1-4% of the of reported cancers incidence 4. For example, the incidence of oral cancer in India is high, constituting about 12% of all cancer in men and 8% in women 5 ; mortality rate is equally high in this population, ranking number one in men and number three in women 6. Oral and oropharyngeal cancers therefore qualify as major public health problem, not only in India, but also globally. Worldwide, oral cancer incidence rates appear to have been stabilizing over the last decade 12 , but the greater frequency of oral cancer in certain regions and among specific populations is a cause for concern since their overall 5-year survival rate is 53% and it has not changed in the last two decades 13. With this heightened awareness, research to further investigate the detection, diagnosis and prevention or oral cancer has recently been included as one of the targeted priorities supported by the National Institute of Dental and Craniofacial Research (NIDR) in the United States 14. The overall 5-year survival rate for patients without clinically evident cervical lymph node metastases is 85%. However, patients with microscopic lymph node metastases have a survival rate of 54%. It has been estimated that 20-50% of patients without clinically evident cervical lymph node metastases do in fact have microscopic metastases and therefore poorer www.intechopen.com Oral Cancer 48 prognosis 87. Among the Indian population, the overall 5-year observed and relative survival rates were 30.5% and 39.7%, respectively. Survival steadily declined with advancing age and advanced clinical stages. 5-year observed survival was 59.1% for localized cancer, 15.7% for cancers with regional extension and 1.6% for those with distant metastasis. Those with tongue, buccal mucosa and retromolar trigone cancers had poor survival rates 11 .
The Epidemiology, Risk Factors and Diagnosis and Treatment of Oral Cancer: An Update
International Journal of Research, 2018
Oral cancer remains one of the most common and challenging malignancies of the head and neck region. Tobacco and alcohol consumption remain the two major risk factors for oral cancer. This review summarizes the incidence, prevalence, epidemiology, risk factors and diagnosis and treatment of oral cancer.