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Australian Dental Journal Mar 2018The management of oral cancer is a multidisciplinary endeavour, as each patient presents the treating clinicians with a unique set of challenges the management of which...
The management of oral cancer is a multidisciplinary endeavour, as each patient presents the treating clinicians with a unique set of challenges the management of which impacts on both survival and quality of life. This article focuses on the management of oral cancer. We highlight the epidemiology and risk factors for oral cancer in Australia, the various clinical presentations that occur and the staging of oral cancer. In the vast majority of cases surgery remains the mainstay of treatment. Radiation and medical oncology is usually used in an adjuvant context. Dental professionals play a critical role in many stages of management from the initial detection, to optimising pre treatment dental health and managing the short and long term sequelae of treatment. Monitouring for recurrence and the development of second primary tumours is a key role.
Topics: Australia; Combined Modality Therapy; Head and Neck Neoplasms; Humans; Medical Oncology; Mouth Neoplasms; Neoplasm Recurrence, Local; Quality of Life; Radiation Oncology; Risk Factors; Treatment Outcome
PubMed: 29574808
DOI: 10.1111/adj.12594 -
Journal of Veterinary Dentistry 2015Squamous cell carcinoma (SCC) is the most commonly encountered malignant oral tumor in cats. The etiology of this locally invasive tumor is likely multifactorial.... (Review)
Review
Squamous cell carcinoma (SCC) is the most commonly encountered malignant oral tumor in cats. The etiology of this locally invasive tumor is likely multifactorial. Several risk factors have been identified, including the use of flea collars, and a history of feeding canned food and canned tuna. Clinical signs vary depending on tumor location. The tumor commonly arises from the gingiva and mucosa of the maxilla, mandible, tongue, sublingual area, or tonsillar region. Maxillary SCC commonly presents clinically as an ulcerative lesion, whereas mandibular SCC is commonly proliferative, expansile, and firm. Lingual/sublingual SCC may be ulcerative, necrotic, infiltrative, or proliferative. In general, feline oral SCC is an invasive and malignant neoplasm regardless of its location. Surgery, radiation therapy, chemotherapy and combinations thereof have been attempted with rarely a satisfactory response. Currently, cures are obtained only in a small subset of cats whose tumors are amenable to complete resection, or where resection with microscopic residual disease is followed by definitive radiation therapy. A multimodal treatment approach likely offers the best chance of success. For cats with advanced disease, palliative care may improve patients' quality of life, albeit transiently. Sequelae associated with tumor progression and local tissue destruction often result in euthanasia of feline patients with oral SCC.
Topics: Animals; Carcinoma, Squamous Cell; Cat Diseases; Cats; Mouth Neoplasms
PubMed: 26197688
DOI: 10.1177/089875641503200104 -
Journal of Oral Pathology & Medicine :... Aug 2022Oral erythroplakia has been classically considered as the potentially malignant disorder with the highest rate of malignant development into squamous cell carcinoma.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Oral erythroplakia has been classically considered as the potentially malignant disorder with the highest rate of malignant development into squamous cell carcinoma. This critical systematic review and meta-analysis aim to estimate the malignant development rate of oral erythroplakia and identify the associated risk factors.
METHODS
We performed a bibliographic search in PubMed, Scopus, Web of Science, Embase, and LILACS, with keywords "erythroplakia," "erythroplasia," "malignant transformation," "malignant development," "malignization," "carcinogenesis," "oral cancer," "oral squamous cell carcinoma," "mouth neoplasm," and "prognosis." Meta-analysis was conducted using a random-effects model.
RESULTS
Ten observational studies with 441 patients met the inclusion criteria, whose mean malignant development rate was 12.7% and with a mean follow-up period of patients of 6.66 years. In the initial biopsy, 42.8% of oral erythroplakia were already squamous cell carcinoma. The buccal mucosa was the most frequent location of oral erythroplakia, but the floor of the mouth was the most common site of malignant development. All patients who underwent malignant development showed epithelial dysplasia on the initial diagnostic biopsy.
CONCLUSION
Overall malignant development rate of OE in the meta-analysis was 19.9%. We could not associate any specific clinicopathological feature with the malignant development. The presence of epithelial dysplasia in the initial biopsy remains the worst prognostic factor. Further observational studies on OE are needed, with well-established diagnostic criteria and good clinical follow-up, in order to identify the true risk of malignant development of oral erythroplakia and the related risk factors.
Topics: Carcinoma in Situ; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Erythroplasia; Humans; Leukoplakia, Oral; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Oral Ulcer; Precancerous Conditions
PubMed: 35488780
DOI: 10.1111/jop.13304 -
Brachytherapy 2021The purpose of this study was to describe the results of postoperative sole interstitial brachytherapy (BT) in patients with resectable floor of mouth tumors. (Review)
Review
PURPOSE
The purpose of this study was to describe the results of postoperative sole interstitial brachytherapy (BT) in patients with resectable floor of mouth tumors.
METHODS AND MATERIALS
Between January 1998 and December 2017, 44 patients with squamous cell histology, stage T1-3N0-1M0 floor of mouth tumor were treated by excision of the primary lesion with or without neck dissection followed by sole high-dose-rate tumor bed BT with an average dose of 22.7 Gy (10-45 Gy) using rigid metal needles (n = 14; 32%) or flexible plastic catheters (n = 30; 68%).
RESULTS
During a median followup time of 122 months for surviving patients, the probability of 5- and 10-year local and regional tumor control, overall survival (OS), and disease-specific survival (DSS) was 89% and 89%, 73% and 67%, 52% and 32%, 66% and 54%, respectively. In univariate analysis, lymphovascular invasion was a negative predictor of regional tumor control (p = 0.0062), DSS (p = 0.0056), and OS (p = 0.0325), whereas cervical recurrence was associated with worse DSS (p < 0.0001) and OS (p < 0.0001). The incidence of local Grade 1, 2, and 3 mucositis was 25%, 64%, and 11%, respectively. Grade 4 side effect, that is soft tissue necrosis occurred in four cases (9%).
CONCLUSIONS
Results of postoperative sole high-dose-rate BT of floor of mouth tumors are comparable with those reported with low-dose-rate BT, and this method could improve local tumor control and DSS compared with exclusive surgical treatment.
Topics: Brachytherapy; Humans; Mouth Floor; Mouth Neoplasms; Neck Dissection; Neoplasm Recurrence, Local
PubMed: 33250304
DOI: 10.1016/j.brachy.2020.10.008 -
Dental Clinics of North America Jan 2018Although the American Joint Committee on Cancer developed its first cancer-specific staging system in 1959, the TNM classification, as it has become known, has undergone... (Review)
Review
Although the American Joint Committee on Cancer developed its first cancer-specific staging system in 1959, the TNM classification, as it has become known, has undergone many revisions mainly due to the advancements in both diagnosis and management of cancer, Although the basic purpose of the cancer staging system has remained fundamentally unchanged, the ease with which the cancer can be staged has evolved with newer methods. This article reviews cancer evaluation for staging, as well as the introduction of a new staging method effective as of 2018.
Topics: Diagnostic Imaging; Humans; Lymphatic Metastasis; Mouth Neoplasms; Neoplasm Invasiveness; Neoplasm Metastasis; Neoplasm Staging; Prognosis
PubMed: 29126493
DOI: 10.1016/j.cden.2017.08.003 -
Cancer Radiotherapie : Journal de La... 2022Intensity modulated radiation therapy and brachytherapy are standard techniques of irradiation for the treatment of oral cavity cancers. These techniques are detailed in...
Intensity modulated radiation therapy and brachytherapy are standard techniques of irradiation for the treatment of oral cavity cancers. These techniques are detailed in terms of indication, planning, delineation and selection of the volumes of interest, dosimetry and patients positioning control. This is an update of the guidelines of the French Society of Radiotherapy Correspondence.
Topics: Brachytherapy; Dental Care; France; Humans; Immobilization; Mouth Neoplasms; Neck Dissection; Patient Positioning; Radiation Oncology; Radiotherapy Dosage; Radiotherapy, Intensity-Modulated
PubMed: 34953711
DOI: 10.1016/j.canrad.2021.11.012 -
Current Treatment Options in Oncology Mar 2019At our institution, locally advanced oral cancer is most commonly treated with surgical resection, immediate reconstruction, and adjuvant radiotherapy with or without... (Review)
Review
At our institution, locally advanced oral cancer is most commonly treated with surgical resection, immediate reconstruction, and adjuvant radiotherapy with or without concurrent systemic therapy depending on final surgical pathologic analysis. There are patients with markedly advanced local or regional disease who unfortunately will have a low probability of cure. We counsel these patients on induction chemotherapy, emphasizing that this is unlikely to result in a smaller volume of surgical resection. In these patients, a good response to induction chemotherapy is more frequently followed by concurrent chemoradiotherapy. We have not been in the practice of commonly recommending definitive chemoradiotherapy for locally advanced oral cancer when upfront surgery is an option. However, as reviewed below, there is a significant rationale for definitive chemoradiotherapy in patients who are surgical candidates, with the hope of good oncologic outcomes, and potential functional organ preservation. The experts who report their experiences in the studies reviewed below provide a strong argument for considering this approach.
Topics: Biomarkers, Tumor; Clinical Decision-Making; Combined Modality Therapy; Disease Management; Disease Susceptibility; Humans; Mouth Neoplasms; Neoplasm Staging; Prognosis; Treatment Outcome
PubMed: 30874958
DOI: 10.1007/s11864-019-0631-8 -
The British Journal of Oral &... Sep 2022
Review
Topics: Humans; Mouth Neoplasms; Neck Dissection; Neoplasm Staging
PubMed: 35843759
DOI: 10.1016/j.bjoms.2021.08.011 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2018Head and neck cancer are one of the most common neoplasm pathologies in humans. The aim of this study was to analyze the type, characteristics, treatment and evolution... (Observational Study)
Observational Study
BACKGROUND
Head and neck cancer are one of the most common neoplasm pathologies in humans. The aim of this study was to analyze the type, characteristics, treatment and evolution of oral neoplasm or precancerous lesion in a sample of Andalusian population (Spain) derived from the Oncology Rehabilitation Hospital Unit during a period of 20 years.
MATERIAL AND METHODS
A retrospective descriptive study was carried out during the years 1991 and 2011 analyzing the type, characteristics, treatment and follow-up of oral neoplasm in the Oral and Maxillofacial Surgery Unit of the Universitary Hospital Virgen del Rocio. The inclusion criteria were patients whose underlying pathology was any type of benign or malignant neoplasm or presence of precancerous lesion that, after treatment, had been referred to the Prosthetic Rehabilitation Unit.
RESULTS
Of the initial analyzed sample of 60 patients, only 45 patients met the inclusion criteria. Of the final sample analyzed, 31 subjects were men (68.9%) and 14 women (31.1%) (p = 0.0169). The mean age of the sample was 57 years ± 13.83, been more frequently in older people with more than 50 years (73.3%) (p = 0.0169). The most common type of neoplasm was epidermoid carcinoma (64.4%). The site most frequently found in squamous cell carcinoma was the floor of the mouth (31%). The most frequent treatment modality was surgery with postoperative radiotherapy (42.2%). All patients had a minimum follow-up of 5 years, and a recurrence in this period was identified in 11.1% of the sample. Multivariate logistic regression showed a statistically significant association for the variables age (p = 0.0063) and smoking (p = 0.0434).
CONCLUSIONS
Epidermoid carcinoma is the most frequent tumor in the oral cavity, where increase age and smoking are confirmed as associated risk factors.
Topics: Adult; Female; Humans; Male; Middle Aged; Mouth Neoplasms; Retrospective Studies; Risk Factors; Spain; Time Factors; Young Adult
PubMed: 29274149
DOI: 10.4317/medoral.21839 -
Der Radiologe Nov 2020Oral cavity malignancies are the most common tumors in the field of ear, nose and throat medicine or otorhinolaryngology worldwide. It comprises a heterogeneous group... (Review)
Review
CLINICAL/METHODICAL ISSUE
Oral cavity malignancies are the most common tumors in the field of ear, nose and throat medicine or otorhinolaryngology worldwide. It comprises a heterogeneous group of tumors, the knowledge of which is necessary to meet the different requirements of diagnostics and therapy.
STANDARD RADIOLOGICAL METHODS
Computed tomography (CT), magnetic resonance imaging (MRI), sonography (US), nuclear medical procedures (NUK).
PERFORMANCE
The above-mentioned diagnostics are used in a complementary manner.
ACHIEVEMENTS
Early diagnosis of the tumor improves staging and thus the patient's therapy and prognosis.
PRACTICAL RECOMMENDATIONS
The radiologist plays an important role in the interdisciplinary treatment of malignant tumors of the oral cavity. Despite great progress in radiotherapy, oncology and immunotherapy, surgery still plays an important role in the treatment of malignant diseases of the oral cavity.
Topics: Humans; Magnetic Resonance Imaging; Mouth Neoplasms; Neoplasm Staging; Prognosis; Tomography, X-Ray Computed
PubMed: 33025131
DOI: 10.1007/s00117-020-00756-5