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Objective: Oral cancer examinations seek to clinically identify early oral cancers and discover premalignancies prior to their progression to invasive cancer. Method and materials: A cross-sectional study was conducted between April and August 2017 to explore and quantify the diagnostic approach used by United States (US) general dental practitioners following discovery of an oral lesion suspicious for malignancy/premalignancy. US licensed general dental practitioners who were clinically active members of the US National Dental Practice-Based Research Network were eligible to participate. Data for analysis were obtained via two questionnaires. Results: The majority of participants were males, practiced full-time, had a suburban primary practice, were born during the 1950s, and graduated dental school in the 1980s or 2000s. After identifying an oral lesion suspicious for premalignancy/malignancy, the next action of most general dental practitioner respondents (65.4%) was to refer the patient for consultation/biopsy. Most general dental practitioners (87.2%) referred to an oral and maxillofacial surgeon; 22% of general dental practitioners reported personally biopsying suspicious lesions. There was a relatively weak association between completing an Advanced Education in General Dentistry or General Practice Residency and subsequently personally performing biopsies on patients with oral lesions suspicious for malignancy/premalignancy (OR 1.33, P = .06). Most written referrals took place electronically and often included information, including lesion location (87.0%), lesion sign/symptoms (85.3%), lesion history (83.9%), radiographs (59.3%), medical history (50.6%), dental history (48.8%), and photographs (42.4%). When a referral biopsy was performed, referring clinicians were most frequently informed of the findings via a written report (96.7%, when positive for malignancy/premalignancy, and 95.4% when negative). Conclusion: A snapshot is presented of current actions taken by US general dental practitioners following the discovery of oral abnormalities suspicious for premalignancy/malignancy. [ABSTRACT FROM AUTHOR]

Introduction: Radiotherapy is an integral component of the comprehensive and sequential treatment approach for advanced oral squamous cell carcinoma (OSCC). One of the significant complications associated with radiotherapy is osteoradionecrosis (ORN), which most frequently affects the mandible. Differentiating between osteoradionecrosis (ORN) and recurrent oral squamous cell carcinoma (ORSCC) can be challenging when relying solely on clinical and radiologic characteristics. The diagnosis becomes even more difficult when bone necrosis of jaw presents as the first clinical symptom. Objectives: This study aims to present the clinical manifestations and treatment processes of patients at our institution who have developed bone necrosis of jaw after radiotherapy and subsequently diagnosed with recurrent oral squamous cell carcinoma (ORSCC). Case presentation: We have collected six patients with recurrent oral squamous cell carcinoma (ORSCC) who developed bone necrosis of jaw after radiotherapy. These patients subsequently underwent surgical repair and reconstruction and were eventually diagnosed with ORSCC. We present a case series reviewing their basic characteristics, radiological reports, surgical treatment, and pathological diagnosis. All six patients initially presented with oral or facial pain and were diagnosed with osteoradionecrosis (ORN) through imaging studies. All patients underwent surgical treatment, with free flaps used to repair postoperative defects. Among them, five patients were diagnosed with tumor recurrence through preoperative or intraoperative frozen biopsy, and one patient was confirmed with recurrence in the osseous resection through postoperative examination. Conclusion: Identified ORSCC in the suspected ORN of the jaw following radiotherapy is relatively rare, yet it poses identification challenges and can significantly impact treatment decisions. Consequently, surgeons must remain vigilant and ensure clear pathological diagnoses for suspicious patients, either before or during surgery. [ABSTRACT FROM AUTHOR]

Oral cancer, the 13th most common globally, is primarily squamous cell carcinoma linked to tobacco, alcohol, and HPV. Despite advances in care, it remains a major health concern due to high mortality and its impact on quality of life. This study analyzed socio-demographic disparities in oral cancer burden using data from 1990 to 2021. We analyzed annual incidence, mortality, and DALYs across 204 countries, using age-standardized rates and the Socio-demographic Index (SDI) to assess development-related impacts. Statistical methods included Kruskal–Wallis tests, linear regression, joinpoint regression for trends, and Exponential Smoothing for forecasts (2022–2030), with analyses conducted in STATA and Python, and p < 0.05 as significant. Incidence was highest in high SDI countries, while mortality and DALYs were highest in low and middle SDI countries (p < 0.001). From 1990 to 2021, incidence increased (AAPC: 0.5–1.0%), while mortality (APC: − 0.5%) and DALYs (APC: − 0.6%) declined in low SDI regions. Significant disparities across SDI categories (p < 0.001) showed incidence rising with socio-demographic development (R2 = 0.102, p < 0.001), with high-middle SDI regions bearing the highest mortality and DALYs. These findings highlight the need for awareness, prevention, early detection, and accessible care, especially in lower SDI regions. [ABSTRACT FROM AUTHOR]

Background: Proliferative Verrucous Leukoplakia (PVL) presents a unique manifestation of Oral Leukoplakia, characterized by its notable propensity for rapid advancement, dynamic clinical and histopathological alterations, and heightened risk of malignant transformation. Aim: The present systematic review explores the demographic characteristics, risk factors, progression patterns, treatment preferences, and outcomes for PVL lesions that undergo malignant transformation. Materials and methods: An electronic search was executed across various databases, such as PubMed, Scopus, Science Direct, Web of Science and Wiley Online Library from 1985 to December 2023, focusing on studies of PVL malignant transformation. Data on demographics, clinical features, treatment, and outcome data were synthesized, with bias assessed using Joanna Briggs Institute Criteria and outcomes evaluated using Comprehensive Meta-Analysis version (CMA) 3.0 software. Results: Among 998 articles, 53 met inclusion criteria, covering 1159 PVL patients, with 48.4% experiencing malignant transformation over an average 6.28 ± 3.73—year follow-up. Most cases had low or moderate bias risk. In the malignant group, females comprised 74.3% of cases, with a mean age of 66.23 ± 7.76 years and had a 1.96 times greater risk of developing cancer (OR 1.96, 95% CI 1.38—2.782; p = 0.001). Gingiva (20%) and gingiva/buccal mucosa (17.4%) were commonly affected. Tobacco and alcohol showed weak associations, with most patients being non-smokers (59.54%) and non-drinkers (78.18%). HPV and candida infection positivity were tested in only a few studies and noted in a limited number of cases (33.3% and 38.46%, respectively). Malignant transformation mainly was invasive carcinoma (86.8%). Surgery was the primary treatment (58.33%), with 55.56% recurrence in 162 cases of data availability on recurrence. Of 228 patients with data availability, 33.77% succumbed to oral cancer from PVL-related oral cancer. Conclusions: PVL, a rare variant of leukoplakia, poses a significant risk of cancer, emphasizing the need for vigilant monitoring and proactive treatment. It mainly affects elderly females without typical cancer risk factors. Understanding its etiology could aid early detection and management. [ABSTRACT FROM AUTHOR]

Background: Oral cancer, including malignancies of the lip, and oral cavity, is associated with significant psychological distress, increasing the risk of suicidal ideation (SI) and suicide attempts (SA). Despite its severe morbidity and mortality, the prevalence of SI and SA and their associated risk factors remain unclear. This systematic review and meta-analysis aimed to quantify the prevalence of SI and SA among oral cancer patients and identify key psychosocial risk factors. Methods: A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases, with an initial search on August 13, 2024, and an update on December 19, 2024. Observational studies reporting SI and SA prevalence in oral cancer patients were included. Study quality was assessed using a modified Newcastle-Ottawa Scale (NOS), and statistical analyses were performed using R version 4.4. Pooled prevalence rates were calculated using a random-effects model, heterogeneity was assessed with I² statistics, sensitivity analysis was performed using a leave-one-out approach, and publication bias was evaluated using Doi plots and LFK index values. Results: From 5,145 articles, 13 studies from Taiwan, South Korea, Canada, Germany, and the United States, involving 899,765 participants, were included. The pooled prevalence of SI was 13.08% (95% CI, 7.41–22.03) with moderate heterogeneity (I² = 65%), while SA prevalence was 0.32% (95% CI, 0.1–0.7) with high heterogeneity (I² = 99%). Key risk factors included depression (OR = 42.83), dysphoria (OR = 8.06), prior cancer history (OR = 4.53), rural residence, and male gender. Conclusion: This review revealed a substantial psychological impact faced by oral cancer patients, with notable prevalence rates of suicidal ideation and suicide attempts. Identifying major risk factors, such as depression and dysphoria, underscores the need for integrating tailored mental health interventions into routine oncological care. [ABSTRACT FROM AUTHOR]

Objective: Transmembrane Emp24 Domain Containing 2 (TMED2) is a mediator of membrane protein trafficking involved in intracellular protein transport. Recent research suggests that TMED2 plays an important role in the development and metastasis of tumors; however, its exact mechanisms in oral cancer (OC) remain unclear. This study aims to elucidate the role and possible mechanisms of TMED2 in OC. Material and Methods: We investigated the impact of TMED2 knockdown on the invasion, migration, and proliferation capabilities of OC cells. Furthermore, we analyzed the in vitro and in vivo interactions between TMED2 and polypeptide-N-acetylgalactosaminyltransferase 7 (GALNT7) as well as explored the regulatory function of TMED2 on GALNT7. The alterations in stem cell markers were assessed using clone formation assays, western blot, and quantitative real-time polymerase chain reaction. Results: The upregulation of TMED2 promoted the proliferation and invasion abilities of OC cells. Further analysis revealed that TMED2 enhanced the stem-like properties and tumorigenicity of OC cells by directly regulating the expression of GALNT7. In vivo and in vitro results suggested that silencing TMED2 expression reduced the incidence of OC. Conclusion: Our data imply that TMED2 stimulates GALNT7 transcription, which in turn amplifies the stem-like characteristics and carcinogenic potential of OC cells. Moreover, the block of TMED2 prevents cancers from growing and spreading in vivo. This finding provides a new therapeutic target for the treatment of OC and highlights the critical role of TMED2 in the condition. [ABSTRACT FROM AUTHOR]

Background: To evaluate the prognostic role of the preoperative pan-immune-inflammation value (PIV) index in patients with oral squamous cell carcinoma (OSCC) after undergoing radical resection and to develop a prognostic prediction model for these patients. Methods: A large cohort study was conducted between January 2015 and March 2022. Univariate and multivariate Cox regression was used to assess the prognostic value of PIV, and propensity score matching (PSM) analysis was used to adjust for potential confounders. Randomized survival forest (RSF) was used to assess the relative importance of preoperative PIV in prognostic prediction. Finally, a Nomogram model was plotted to predict the prognosis of oral cancer patients. Results: A total of 779 patients were enrolled and followed up (mean follow-up time 34.14 ± 24.39). High PIV was significantly associated with worse survival in OSCC patients (hazard ratio [HR] = 1.62, 95% confidence interval [CI]: 1.15–2.29, P = 0.006). The same trend was observed in PSM (HR = 1.55,95% CI: 1.03–2.23, P = 0.035). RSF showed that PIV ranked third in the importance ranking of all prognostic factors. The calibration curves indicated that the Nomogram model was superior in predicting the prognostic 1-, 3-, and 5-year survival of oral cancer patients. Conclusions: PIV is an independent predictor of prognosis in patients with oral squamous cell carcinoma, and a column-line graphical model based on PIV can effectively predict prognosis. [ABSTRACT FROM AUTHOR]

Simple Summary: Oral cancer, a malignant neoplasm with invariable poor prognosis in the last 40 years (5-year survival rate of nearly 50%), accounts for a worldwide incidence of 377,713 new cases annually and 177,757 deaths per year. Oral cancer is usually preceded by oral potentially malignant disorders (OPMDs)—such as leukoplakia, oral lichen planus and oral submucous fibrosis—defined by the WHO Collaborating Centre for Oral Cancer as any mucosal abnormality that is associated with a statistical increased risk of developing oral cancer. Unfortunately, there are currently no tools available to accurately predict whether a patient in the early stages of oral carcinogenesis will develop oral cancer, being the presence and severity of epithelial dysplasia the histological marker universally applied for clinical practice. Nevertheless, this system presents relevant limitations related to imprecise and subjective assessments; therefore, emerging molecular biomarkers are under investigation. Among these biomarkers, retinoblastoma protein (pRb) is a well-recognized tumor suppressor in human oncogenesis, with roles linked to evading growth suppressors, a relevant hallmark of cancer. The loss of pRb expression regulates tumor initiation and early progression of neoplasms, and has been hypothesized to exert an oncogenic role during malignant transformation in early stages of oral carcinogenesis. Objective: The aim of this systematic review and meta-analysis was to qualitatively and quantitatively evaluate the current evidence on the significance of the loss of early stages of oral carcinogenesis in lesions diagnosed according to clinical and/or histopathological criteria and their evolution to oral cancer. Materials and Methods: We searched MEDLINE (through PubMed), Embase, Scopus and Web of Science for primary-level studies published before November 2024, designed as prospective or retrospective longitudinal cohorts, and not restricted by language or publication date. The risk of bias was critically assessed using the QUIPS tool. Meta-analyses, heterogeneity exploration, sensitivity and small-study effect analyses were conducted. Results: The inclusion criteria were met by six primary-level studies, which recruited 330 patients with OPMDs with follow-up data. The loss of pRb expression, assessed through immunohistochemistry, was significantly associated with a higher malignant transformation risk of OPMDs (RR = 1.92, 95%CI = 1.25–2.94, p = 0.003). The leukoplakia subgroup retained this significant association (p = 0.006), being the OPMD where the loss of pRb expression showed the best predictive value for malignant transformation (RR = 2.00, 95%CI = 1.22–3.29). Regarding the immunohistochemical technique and scoring methods, better performance and results were achieved by applying a cutoff point > 10% pRb-positive cells with nuclear staining (RR = 2.10, 95%CI = 1.30–3.38, 95%CI = 0.002). Conclussion: The present systematic review and meta-analysis supports that the loss of expression of the tumor suppressor pRb, assessed through immunohistochemistry, is a predictor of the malignant transformation risk of oral leukoplakias. Future studies are needed in other OPMDs following the recommendations provided based on current evidence gaps. [ABSTRACT FROM AUTHOR]

Simple Summary: The microbiota and Fusobacterium nucleatum (Fn) in particular are potential actors in oral oncology. The evidence about the role of Fn and the potential underlying mechanisms are reviewed on the basis of the more robust evidence concerning colorectal cancer. The translational potential of the different scenarios linking Fn to oral squamous cell carcinoma is discussed. Oral squamous cell carcinoma (OSCC) is one the most prevalent head and neck cancers and represents a major cause of morbidity and mortality worldwide. The main established risk factors for OSCC include tobacco and alcohol consumption and betel quid chewing, which may contribute alone or in combination with other environmental factors to carcinogenesis. The oral microbiota is emerging as a key player in the establishment of the molecular and cellular mechanisms that may trigger or promote carcinogenesis, including in the oral cavity. Among the bacterial species found in the oral microbiota, Fusobacterium nucleatum, an anaerobic bacterium commonly found in oral biofilms and a periodontal pathogen, has gained attention due to solid evidence implicating F. nucleatum in colorectal cancer (CRC). F. nucleatum has been shown to induce chronic inflammation, promote cell proliferation and trigger cellular invasion while deploying immune evasion mechanisms. These experimental findings were first obtained in in vitro and in vivo models of CRC and are being confirmed in studies on OSCC. In this review, we summarize the most recent findings on the role of F. nucleatum in OSCC, discuss the clinical implications in terms of prognosis and provide an overview of the key mechanisms involved. Moreover, we identify research questions and aspects that require investigations to clarify the role of F. nucleatum in OSCC. We anticipate that studies in this emerging field may have a significant clinical impact on the diagnosis, prognosis and management of OSCC. [ABSTRACT FROM AUTHOR]

Background: Survival rate of patients with oral cancer (OC) remains to be very low despite advancements in therapy and surgical techniques. This is attributed to the fact that most OC cases are discovered at a late stage. Dentists play a vital role in early detection of OC through oral mucosal examination, and in informing the patients about avoidable risk factors of the disease, such as tobacco and excessive alcohol use. This study aimed at evaluating knowledge about OC among dental students in Moldova, Armenia and Belarus; three former soviet countries with high rates of tobacco use. Methods: This was a cross-sectional, multi-country study based on self-administered questionnaire. Dental students in their clinical years at three dental faculties in Moldova, Armenia and Belarus were invited to participate in the study. Data collection took place during the period May to September 2019. Association between different categorical variables was investigated using Chi-squared test. A knowledge score ranging from 0–14 was constructed from the obtained data. Differences in the knowledge score between different groups of students was investigated using either student's t-test whenever comparing two groups, or One-way ANOVA with Bonferroni's correction for three or more groups. The level of significance was set to 0.05 for all statistical tests. Results: A total of 642 dental students participated in the study. The mean knowledge score was found to be 6.62 ± 2.61, with 45% of the students scoring below the mean. Students from Belarus had the highest score (7.3 ± 2.14) in comparison to Armenia (6.66 ± 2.64) and Moldova (5.66 ± 2.81), as revealed by ANOVA test. However, we observed a significant increase (p-value < 0.001, ANOVA) in the students' knowledge score as they proceed through study years from third (6.07 ± 2.61) to fifth year (7.49 ± 2.48). In addition, we found that Students with current or previous cigarette smoking habits had significantly (p-value < 0.001, student's t-test) lower mean knowledge score (5.96 ± 2.82) when compared to students who have never been smokers (6.98 ± 2.42). Conclusions: The present study reveals notable gaps in OC knowledge and concerning tobacco use behaviors among dental students in Moldova, Belarus, and Armenia. By providing comprehensive education on risk factors and addressing personal habits, dental schools can better prepare future professionals to play a critical role in OC prevention and management. [ABSTRACT FROM AUTHOR]

Background: Oral squamous cell carcinoma (OSCC) is one of the most prevalent oral cancers in the world. The major etiological factors are considered to be tobacco and alcohol. However, the etiological factors for non-habit associated oral squamous cell carcinoma (NHOSCC) remains an enigma. So we focused in assessing various etiological factors like genetic factor, microbial factor, dental factor and the biochemical factor of non-habit associated oral squamous cell carcinoma. The aim was to assess Harvey Rat Sarcoma Virus gene (HRAS) mutation, total bacterial count, Herpes Simplex Virus-1 (HSV-1), regressive changes of teeth, total antioxidant capacity and its association with NHOSCC. Materials and methods: A total of 564 (n = 564) patients with OSCC were included in the study. Out of 564 patients, 282 patients had NHOSCC and 282 patients had habit associated oral squamous cell carcinoma (HOSCC). The isolated DNA from the tissue was subjected to Sanger's sequencing analysis for mutation analysis of the HRAS gene. The isolated serum was subjected to HSV-1 ELISA analysis and TAC ELISA analysis. The dental cast used to analyze the presence of sharp teeth/ any other form of regressive changes of teeth. Results: Firstly, we found 3 novel pathogenic mutations c.16C > A/p.L6M (missense mutation), c.359 T > C/p.L120P (point mutation), c.382C > T/p.R128W (missense mutation) of HRAS gene in NHOSCC samples by genetic analysis. No significant difference was noted in the total bacterial count between the non-habit associated and habit associated oral squamous cell carcinoma (HOSCC). The binary logistic regression showed patients with HSV1 infection have 2.667 odds (2.667 OR, CI, 1.589- 4.484) of getting NHOSCC and it was found to be statistically significant (p < 0.001).The dental analysis revealed that patients with regressive changes have 4.432 odds (4.432 OR, CI, 2.807- 6.998) of getting NHOSCC and it was found to be statistically significant (p < 0.001). The biochemical analysis revealed patients with lower total antioxidant capacity have 0.671 odds (0.671 OR, CI, 0.621–0.725) of getting NHOSCC and was found to be statistically significant (p < 0.001). Our results suggest that the frequency of HRAS mutation in NHOSCC is high. HSV1, oxidative stress and regressive changes of teeth are associated with NHOSCC. Conclusion: Our results suggest that the frequency of HRAS mutation in NHOSCC is high. HSV1, oxidative stress and regressive changes of teeth are associated with NHOSCC. [ABSTRACT FROM AUTHOR]

Background: Cancer is a significant public health issue all over the world. The diagnosis, treatment and follow-up of cancer patients are a huge health, economic and social burden for societies. The link between the state of health of a country and its economic performance has been proven by numerous studies. The aim of this study was to examine the age-standardized death rate of oral cancer in relation to the economic development of 13 European countries. Methods: Aggregated data were collected from the European Health for All (HFA-DB) database until 2019 and analysed using second degree polynomial functions and correlation analyses, followed by time-series analysis involving vector autoregressive models. Results: We found that in 10 of the 13 surveyed countries, the age-standardized death rate of oral cancer initially increased with GDP growth and then showed a downward trend above a certain level of economic development. Austria had a weak but significant positive effect with the second lag of GDP, Hungary had a significant negative effect with the first lag of GDP, and Italy had a significant negative effect with the second lag of GDP. In most cases, both the first and second lags of GDP changes were not statistically significant, indicating that short-term fluctuations in GDP do not directly influence changes in oral cancer mortality rates. Overall, while there are clear long-term associations between GDP and oral cancer mortality rates, the immediate causal effects of GDP changes on mortality rates are limited, suggesting that other factors and longer-term dynamics could play a more crucial role in this relationship. Conclusions: An increase in a country's economic development alone does not guarantee a decrease in the number of oral cancer patients. Therefore, in order to reduce the number of cases of oral cancer, strengthening education and prevention are essential. [ABSTRACT FROM AUTHOR]

Introduction: To examine the potential predictive roles of the preoperative mean platelet volume (MPV), platelet count (PC), and platelet distribution width (PDW) in patients with oral cancer and their association with the depth of invasion (DOI). Methods: This retrospective study included 122 patients (66 males, 56 females) diagnosed with oral cancer between January 2009 and January 2015 by our Otolaryngology Department. At diagnosis, the mean age was 64.6 ± 13.9 years. The average follow-up period was 39.2 ± 23.9 months. Results: We found significant differences in all parameters (PDW, MPV, PC) based on the positivity of the lymph node and the tumor stage. The mean PDW, MPV, and PC were significantly higher in the exitus group than in the survivor group (P =.010,.036, and.047, respectively). In patients with high PDW, we observed a lower progression-free survival. We observed that PDW had a significant impact on the recurrence of the disease. Platelet distribution width, MPV, and PC were significant prognostic factors. A high PDW increased fatality 4.1 times, and a high MPV increased fatality 4.7 times (P =.040 and.032, respectively). We found in a univariate analysis that tumor grade, PDW, MPV, and PC were predictive factors for fatality. On multivariate analysis, we found that MPV, PC, and predictors were independent of tumor grade. We observed an association between MPV and DOI. Conclusion: High PC, MPV, and PDW could be meaningful prognostic predictors for low survival rates. Mean platelet volume appears to be a more effective marker because it is associated with the DOI and prognosis. However, further research is required to confirm our findings. [ABSTRACT FROM AUTHOR]

This case study highlights the use of cinematic rendering (CR) in preoperative planning for the excision of a cyst in the oral and maxillofacial region of a 60-year-old man. The patient presented with a firm, non-tender mass in the right cheek, clinically suspected to be an epidermoid cyst. Conventional imaging, including dental magnetic resonance imaging (MRI) protocols, confirmed the lesion's size, location, and benign nature. CR reconstructions, combining advanced algorithms and novel skin presets, allow for the generation of highly realistic, three-dimensional visualizations from conventional imaging datasets. CR provided an enhanced, detailed depiction of the lesion within its anatomical context, significantly improving spatial understanding for surgical planning. The surgical excision was performed without complications, and histological analysis confirmed the diagnosis of a benign epidermoid cyst with no evidence of dysplasia or malignancy. This case demonstrates the potential of CR to refine preoperative planning, especially in complex anatomical regions such as the face and jaw, by offering superior visualization of superficial and deep structures. Thus, the integration of CR into clinical workflows has the potential to lead to improved diagnostic accuracy and better surgical outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: This study demonstrates that oral cavity squamous cell carcinomas with high levels of tumor-infiltrating B-lymphocytes (TIL-Bs) have a more favorable prognosis, irrespective of the total amount of tumor-infiltrating lymphocytes. Particularly in early-stage disease, the amount of TIL-Bs could be used to stratify patients who do well on standard-of-care therapy and patients who might need treatment intensification. Further research is warranted to unravel the potential cross-talk between and prognostic value of TIL-Bs and T-lymphocytes combined and their relevance in response to immunotherapy treatments, as well as identify the different subpopulations of TIL-Bs with regard to prognosis. Background/Objectives: Most studies on the interaction between the immune system and cancer focus on T-cells, whereas studies on tumor-infiltrating B-lymphocytes (TIL-Bs) are still underrepresented. The aim of this study was to assess the prognostic impact of TIL-Bs in early- and advanced-stage oral cavity squamous cell carcinoma (OCSCC). Methods: In total, 222 OCSCCs were studied. Consecutive sections were stained for CD45 and CD19. OCSCCs were categorized as either "TIL-B-rich" or "TIL-B-poor", and the survival of both groups was analyzed. Similar analyses were performed for CD45+ TILs and the CD19/CD45 ratio. Matched subgroups of twelve TIL-B-rich and TIL-B-poor tumors were stained for CD3 and CD8 to determine differences in T-cell infiltration, and further spatial interaction between T- and B-cells was evaluated in six samples. Results: Five-year OS was 75.0% for TIL-B-rich and 54.2% for TIL-B-poor OCSCCs (p < 0.001). The survival benefit of TIL-B-rich OCSCCs remained significant after correction for the histopathological characteristics (p = 0.033). While for early-stage tumors, TIL-B richness benefited OS independent of demographic-, clinical, or histopathological features, for advanced-stage disease, this was not the case, although a clear benefit of a TIL-B-rich status was observed, specifically up until 36 months after diagnosis. TIL-B-rich tumors contained more CD3+ TILs (p = 0.007), but not CD8+ TILs. Spatial characterization suggested that TIL-Bs mostly co-localized with CD3+CD8− TILs and that this interaction was increased in TIL-B-rich OCSCC. Conclusions: The presence of TIL-Bs is associated with a more favorable prognosis in OCSCC, in particular for early-stage disease. [ABSTRACT FROM AUTHOR]

Simple Summary: Discharge against medical advice (DAMA) is a complex phenomenon with the potential to disrupt care in hospitalized patients, particularly in oncology, where continuous treatment is crucial for managing disease progression and improving outcomes. This study aimed to explore the prevalence of DAMA among cancer patients in Germany and identify factors associated with its occurrence. Analysis of data from over 51,000 patients hospitalized across 36 facilities revealed a DAMA rate of 0.9%. Younger age (especially under 60 years) and male sex were associated with higher DAMA rates. Patients with cancers of the lip, oral cavity, pharynx, larynx, and liver had the highest DAMA prevalence, while distant metastases showed no significant association. These findings highlight the multifaceted nature of DAMA and suggest that non-clinical factors, such as psychological, social, and economic pressures, may play a critical role in patients' decisions. This study provides a foundation for further research into strategies to better understand and address DAMA in vulnerable groups, improving care and outcomes for hospitalized cancer patients. Background: Discharge against medical advice (DAMA) disrupts continuity of care and is associated with increased readmission rates, morbidity, and mortality. While extensively studied in general hospital populations, its prevalence and associated factors in cancer patients, where treatment adherence is critical for outcomes, remain underexplored. Methods: This multicenter, cross-sectional study analyzed anonymized data from the IQVIA hospital database, including cancer patients hospitalized in 36 German hospitals between January 2019 and December 2023. Multivariate logistic regression assessed associations between DAMA and factors such as age, sex, cancer type, metastases, and comorbidities. Results: Among 51,505 cancer patients, DAMA occurred in 0.9% of hospitalizations. The highest rates were observed in cancers of the lip, oral cavity, and pharynx (2.1%), larynx (2.0%), and liver (1.8%). DAMA was more frequent in younger patients (≤50 years) (OR: 1.73; 95% CI: 1.30–2.14) and males (OR: 1.46; 95% CI: 1.23–1.72). Distant metastases showed no significant association (OR: 0.96; 95% CI: 0.81–1.13). Conclusions: The findings suggest that DAMA in cancer patients is more strongly associated with demographic and social factors than with disease severity. These results provide a basis for exploring strategies that address underlying psychosocial and economic challenges during hospitalization, particularly in younger and male patients. Further research is needed to better understand these associations and their implications for clinical practice. [ABSTRACT FROM AUTHOR]

Simple Summary: This review explores the interpretation of intraepithelial papillary capillary loop (IPCL) classification in the narrow band imaging (NBI) magnification endoscopy of oral lesions. IPCLs are classified from Type 0 to IV. NBI magnification endoscopy is a useful noninvasive method for identifying the malignant transformation of oral potentially malignant disorders (OPMDs). Oral lesions classified as IPCL Type II or higher are atypical epithelial or oral squamous cell carcinoma (OSCC); oral biopsy is recommended for early and accurate diagnosis, and is an indicator of the appropriate biopsy site in the follow-up for OPMDs. The accuracy of NBI magnification endoscopy regarding the malignant transformation of OPMDs and OSCC will be further confirmed in the future. It is expected that NBI magnification endoscopy will be widely used by dentists in hospitals and general dental clinics. Narrow band imaging (NBI) magnification endoscopy for the diagnosis of early-stage oral cavity-related cancer and precancerous lesions can recognize oral lesions as brownish areas, and can observe intraepithelial papillary capillary loops (IPCLs) in the mucosa and submucosa to make a qualitative diagnosis of the lesion and highlight the mucosal surface microstructure to facilitate appropriate diagnosis and early treatment. IPCLs are classified from Type 0 to IV: Type 0 is normal mucosa or no blood vessels observed, e.g., in keratinization; Type I is mainly normal mucosa; Type II is mainly inflammatory sites or non-malignant lesions; Type III is mainly precancerous or suspected malignant lesions; and Type IV is cancerous or malignant lesions. NBI magnification endoscopy is a useful noninvasive method for identifying the malignant transformation of oral potentially malignant disorders (OPMDs). Oral lesions classified as IPCL Type II or higher are atypical epithelial or oral squamous cell carcinoma (OSCC); oral biopsy is recommended for early and accurate diagnosis, and is an indicator of the appropriate biopsy site in the follow-up for OPMDs. In the future, the accuracy of NBI magnification endoscopy for malignant transformation of OPMDs and OSCC will be further confirmed. [ABSTRACT FROM AUTHOR]

Background: Oral cancer screening requires analysis capable of detecting changes preceding the clinical manifestation. Oral cytopathology studies as an oral cancer screening have shown promising results. This study aims to evaluate the use of cytopathology in a quali‐quantitative analysis using Papanicoloau staining. Methods: Four experimental groups were evaluated: control (CG), exposed to carcinogens (EG), potentially malignant disorder with and without epithelial dysplasia (D‐OPMDG and ND‐OPMDG) and oral squamous cell carcinoma (OSCCG). Oral smears were collected using a Cytobrush® and conventional exfoliative cytology. Results: Oral Papanicolaou smears from 143 individuals were analysed in 8100 images. Qualitatively, non‐lesional groups exhibited minimal suspected cases (20% in CG and 5% in EG), in the OPMD groups the ability to identify altered cells was low (40% in D‐OPMDG and 0% in ND‐OPMDG). Conversely, a notable 100% accuracy was achieved in the OSCCG. Quantitatively, a higher percentage of anucleated and a lower percentage of intermediate cells were observed in the OPMDG; a higher proportion of parabasal/suspicious cells was observed in OSCCG. The optimal threshold for improved accuracy in detecting suspected malignancies occurs when the count of parabasal/suspicious cells exceeds 8/100 cells examined. Cytomorphometric analysis revealed a higher nucleus/cytoplasm ratio (N/C) in OSCCG, with a best cutoff point indicating enhanced accuracy in discerning suspected malignancies when exceeding 17% of cells exhibiting this elevated ratio. Conclusion: It is possible to suggest updates in cytomorphometric and quantitative analysis in the modified Bethesda system for the oral cavity including objective criteria in the risk classification, therefore improving oral cancer screening. [ABSTRACT FROM AUTHOR]

Aim: Radiation-induced oral mucositis (OM) is the most common complication presenting with chemo radiation therapy of oral cavity cancer. Tobacco use, oral hygiene and nutritional status are important entities that impact the incidence of OM. These entities must also be studied along with treatment planning strategies, to alleviate its incidence. Our study aims to present a novel method to model the OM incidence using a mucosal surface contour (MSC). Methods: Computed tomography (CT) images of 60 oral cavity patients who have started their intensity-modulated radiation therapy (IMRT)/volumetric-modulated arc therapy (VMAT) with concomitant chemotherapy (Cisplatin) were delineated with MSC as one of the organs at risk by three expert radiation oncologists. V30, V50 and Dmean doses of MSC and the PTV 60 (planning target volume for 60 Gy), along with Dmax of PTV60, were extracted from the dose volume histograms. OM toxicity was assessed once weekly, and the outcome was scored using CTCAE v5·0 grading. Tobacco use (Tb), oral hygiene (OHy) and nutritional status (Ns) were also numerically scored. A multiple linear regression analysis was done using the patient parameters and the outcome scores as predictor variables and response variables, respectively. Optimal dose volume constraints (Dmean, V30, V50) for a 20% reduction of OM were derived from the mathematical equations. Another 20 patients were planned prospectively using IMRT/VMAT with the above resulted in dose constraints. Clinical outcome was scored for these patients using CTCAE v5·0. Outcome results of the two phases (60 patients and 20 patients) were statistically compared with two-sample t -test. Results: For MSC, three mathematical equations were formulated using multiple linear regression analysis. Derived values of V30, V50 and Dmean constraints were used for dose optimisation in the second phase of treatment planning. It has showed a statistically significant deviation from the first phase of the study, with a confidence interval of 95% (p value: 0·0348) by introducing calculated dose constraints for MSC in dose optimisation. Conclusion: In this study, the feasibility of using multiple linear regression analysis to model OM incidence in radiation therapy clinics was explored. Derived dose–volume constraints for MSC could be used in IMRT/VMAT optimization to reduce its incidence. Patient treatment could be individualised by incorporating dose–volume parameters, nutritional status, tobacco use and oral hygiene status in the treatment planning procedure. [ABSTRACT FROM AUTHOR]

Fibrolipoma is defined as a typical lipoma transected by variable amounts of paucicellular and collagenous fibrous components. Oral and lingual fibrolipomas are well-recognized histological entities in human medicine that are slightly more prevalent in females, occur most commonly after the fourth decade, and arise from the buccal mucosa. The documentation of this neoplasm in the oral cavity is lacking in veterinary medicine. Through a multi-institutional retrospective compilation of cases submitted to diagnostic pathology services, here we describe the clinical and pathologic features of oral fibrolipomas in dogs. A total of 112 cases of oral fibrolipomas in dogs were retrieved. The mean age was 10.1 years (range 2–16 years, ±2.63 years standard deviation), with an average tumor size of 1.7 cm (range 0.2–8 cm, ±1.1 cm standard deviation). The most common location was the tongue (57.1%, 64/112), followed by the buccal mucosa (15.2%, 16/112), sublingual area (8.0%, 9/112), gingiva and lip (4.5%, 5/112 each), and palate (1 case). The anatomical location of oral fibrolipomas only differed significantly among the dog breeds (P <.001) but not among sex, age, anamnesis, or reason for submission. The tumor was most commonly reported in males (69.7%, 78/112), and in 62.5% (70/112) of the cases, the tumor was an incidental finding. Fibrolipoma should be considered a differential diagnosis when considering benign lingual and other oral soft tissue masses in dogs. [ABSTRACT FROM AUTHOR]

Objectives: Oral cancer (OC) is the most common malignant tumor of the head and neck (HN) and ranks 16th among the most frequently diagnosed cancers worldwide. A systematic review and meta-analysis aimed to provide an evidence-based analysis of the relationship between polyomaviruses and oral cancer. Methods: The global online databases was used to identify relevant studies published between January 2000 and September 2024. The quality of each article was assessed using the Newcastle-Ottawa Scale (NOS) checklist. Data analysis was performed using STATA Ver. 11 software, and the standard error was calculated using the binomial distribution formula. The heterogeneity of the study results was assessed using the I-square and Q index, while publication bias was examined using the Begg's test. In addition, a random effects model was used to determine the risk difference (RD), and a forest plot diagram was used to present the results with 95% confidence intervals. The Trim and Fill test was applied to estimate publication bias, and sensitivity analysis was performed to assess the influence of individual studies on the overall estimate. Results: Of the nine studies, the relationship between BK virus (BKV) and the Merkel cell polyomavirus (MCV) and oral cancer was investigated. In five primary studies, and by combining the results of these studies, the risk of oral cancer in MCV and BKV-positive individuals was significantly higher than in the negative groups by 13% (RD: 0.13, 95% CI: 0.00, 0.26) and 2% (RD: 0.02, 95% CI: -0.03, 0.07), respectively. In addition, the association between JC virus (JCV) and oral cancer was investigated in six primary studies. By combining the results of these studies, the risk of oral cancer in JCV-positive individuals was 1% higher than that in JCV-negative individuals (RD: 0.01, 95% CI: -0.02, 0.06). Discussion: This meta-analysis showed that there was a significant association between MCV and oral cancer, and the risk of oral cancer in MCV- positive individuals was 13% higher than that in MCV- negative individuals. More preliminary studies are needed on the association between BKV and JCV and the risk of oral cancer. [ABSTRACT FROM AUTHOR]

Simple Summary: Saliva is a vital fluid with diverse roles in oral and systemic health, including digestion, oral protection, and microbiome balance and support wound healing. It also serves as a non-invasive diagnostic tool, reflecting overall health and cancer. While saliva can protect against oral cancer, it may promote tumor progression and metastasis through exosomes and microRNA components. This review explores saliva's biological functions, its role in head and neck cancer progression/metastasis, and the potential therapeutic tool. Saliva plays a multifaceted role in oral health and systemic well-being. It supports digestion, protects oral tissues, maintains a healthy oral microbiome, and facilitates wound healing. Additionally, saliva serves as a diagnostic tool that reflects systemic health and disease/therapeutic states. Furthermore, although saliva shows a protective effect against oral cancer development, once tumor formation occurs, it may be involved in tumor progression and metastasis via exosomes and microRNAs. This review discusses the essential role of saliva; its relationship with the development, progression, and metastasis of head and neck squamous cell carcinoma (HNSCC); liquid biopsy tools for early diagnosis and monitoring of HNSCC; and the potential of exosomes as therapeutic agents. [ABSTRACT FROM AUTHOR]

Simple Summary: Oral cancer remains one of the most common cancers globally, with invasive treatment often resulting in significant disfigurement and psychosocial distress. During the COVID-19 pandemic, the mandatory mask-wearing policies offered a unique opportunity to assess the impact of facial coverings on the quality of life (QoL) of these patients. This study provides valuable insights into how a simple intervention—mask-wearing—can positively influence the well-being of patients. It enhanced the QoL of oral cancer patients, reduced social anxiety and improved self-perception, indicating the dual role of masks as both a health protective measure and a psychosocial tool. Background: Treatments for oral squamous cell carcinomas (OSCCs) often result in significant aesthetic and functional issues, impacting patients' quality of life (QoL). The COVID-19 pandemic's mask mandates may have provided psychosocial benefits by concealing facial disfigurements, potentially reducing stigma. This study aimed to assess the impact of mask-wearing on the QoL of patients surgically treated for OSCC. Methods: This single-center, cross-sectional study, conducted from June 2022 to December 2023, included patients who had completed their treatment and returned home before or during the mask-wearing mandate. They answered a questionnaire using a four-point Likert scale to evaluate the mask-wearing's impact on QoL and the influence on it of physical appearance, tumor localization, radiotherapy, and treatment end date. Results: The questionnaire analysis found a high internal consistency among the questions (Cronbach's alpha = 0.931). Considering 41 patients (median age 69, 63% male), wearing a mask significantly improved QoL, with a mean score of 1.66 compared to a score of 2.00 for patients not wearing it (p < 0.001). This improvement was particularly notable for appearance concerns, fear of perception by family or others, and sociability apprehension. The QoL, with or without mask use, was not significantly modified when considering physical appearance, tumor localization, radiotherapy, or end date of the treatment, as demonstrated by two-way ANOVA tests and multiple linear regression. Conclusions: Mask-wearing positively impacted QoL in OSCC patients, providing psychological relief from disfigurement and social stigma. Masks offer a simple, accessible solution to enhance QoL while awaiting a definitive prosthetic treatment, suggesting that their continued use could be beneficial in supportive care strategies. [ABSTRACT FROM AUTHOR]

Introduction: Cancer remains a leading cause of death globally, with patients frequently experiencing malnutrition due to both the disease and its treatment, which negatively affects their quality of life and treatment outcomes. Oral nutritional supplements (ONS) provide a noninvasive solution to improve nutritional status, but poor patient adherence limits their effectiveness. Studies on ONS adherence vary in their definitions and assessment tools, creating inconsistencies. A scoping review is essential to synthesize these studies and establish a foundation for future research and clinical practice. Method: We systematically searched six databases, including Web of Science, PubMed, and Scopus, up to August 2024. Our criteria focused on oncology patients, ONS interventions, and outcomes related to adherence definitions, assessment methods, and adherence rates. Results: 37 studies from 2005 to 2024 met the inclusion criteria. Definitions of ONS adherence and assessment methods vary widely, with the most common definition being the ratio of actual intake to the recommended amount. The assessment tools included self-reported ONS diaries, and MMAS scores, among others. Adherence rates also vary significantly, with some studies reporting a decline in adherence over time. Conclusion: The lack of standardized definitions and assessment methods for ONS adherence across studies hinders comparability. Future research should focus on developing standardized, comprehensive adherence assessment tools that incorporate both quantitative and qualitative data. This would allow for a better understanding of adherence factors and enable more targeted interventions to improve long-term adherence in cancer patients. [ABSTRACT FROM AUTHOR]

Background: The DNA ploidy and the S phase fraction (SPF) are associated with advanced tumors progression. The present study aimed to investigate the clinicopathological behavior of oral squamous cell carcinoma(OSCC) and the prognostication of the DNA ploidy and the SPF on its clinical outcomes. Methods: This a prospective longitudinal study of 93 OSCC patients (186 specimens). Using high resolution flowcytometry, DNA analysis and SPF were performed for the primary tumor, field of cancerization and a control normal field. The patients were followed clinically for the development of recurrence or second primary tumor(SPT). Results: All the 93 patients are associated with wide field of cancerization. Out of the total number of cases, 28 (30%) patients developed recurrence. Of them 17 (18.3%) had regional recurrence, and eight (8.6%) had local recurrence. Second primary tumors were identified in 14 (15.1%) of the cases. Nodal metastasis, overall recurrence and SPTs were significantly associated with DNA aneuploidy and high SPF. High SPF and DNA hyperploidy showed a 28% increased risk of local recurrence (P.value = 0.032). Conclusion: In a series of 93 oral cancers who had wide field of cancerization, 30% of the patients developed recurrence, and 15% developed second primary tumors. The DNA ploidy and the SPF were independent prognosticators for the prediction of OSCC outcomes. [ABSTRACT FROM AUTHOR]

Background: Oral cancer is a pressing health concern in the Saudi Arabia (SA), with rising incidence and mortality rates. Despite the efforts in raising awareness, gaps persist in knowledge, attitudes, and practices (KAP) related to oral cancer prevention (OCP) among dental health professionals. This study aimed to identify the key factors influencing engagement in oral cancer prevention activities among dental students and professionals in Saudi. It examines the impact of socio-demographic characteristics and assesses their KAP related to oral cancer prevention. Method: A cross-sectional study was conducted between November 2023 and February 2024 using a pre-validated online questionnaire distributed among oral health providers across various regions and sectors in SA. The survey included questions about participants' KAP toward OCP. Descriptive statistics and logistic regression analyses were used to analyze the data. Results: Out of 400 oral health providers invited, 157 completed the survey. The findings showed a discrepancy between knowledge and practice. While awareness of OC was generally high, this did not consistently lead to favourable attitudes or effective practices. The engagement in OCP activities was significantly associated with good knowledge, practice and favourable attitude scores. Profession significantly influenced participation, with clinicians (P = 0.013, OR = 0.131, 95% CI: 0.026–0.653) and those in administrative roles (P = 0.030, OR = 0.101, 95% CI: 0.013–0.804) both less likely to participate compared to dental students. Knowledge was a significant predictor (P = 0.002), with providers demonstrating poor knowledge being far less likely to participate (OR = 0.053, 95% CI: 0.008–0.339). Conclusion: The study identified a critical need for enhancing OCP education and training among oral health providers in SA. The findings indicate that continuous, targeted, and culturally sensitive training could bridge the existing KAP gap, potentially leading to improved early detection and management of OC, thereby reducing its morbidity and mortality rates in the region. [ABSTRACT FROM AUTHOR]

Objective: We aimed to develop an AI-based model that uses a portable electronic oral endoscope to capture intraoral images of patients for the detection of oral cancer. Subjects and methods: From September 2019 to October 2023, 205 high-quality annotated images of oral cancer were collected using a portable oral electronic endoscope at the Chinese PLA General Hospital for this study. The U-Net and ResNet-34 deep learning models were employed for oral cancer detection. The performance of these models was evaluated using several metrics: Dice coefficient, Intersection over Union (IoU), Loss, Precision, Recall, and F1 Score. Results: During the algorithm model training phase, the Dice values were approximately 0.8, the Loss values were close to 0, and the IoU values were around 0.7. In the validation phase, the highest Dice values ranged between 0.4 and 0.5, while the Loss values increased, and the training loss began to decrease gradually. In the test phase, the model achieved a maximum Precision of 0.96 with a confidence threshold of 0.990. Additionally, with a confidence threshold of 0.010, the highest F1 score reached was 0.58. Conclusion: This study provides an initial demonstration of the potential of deep learning models in identifying oral cancer. [ABSTRACT FROM AUTHOR]

Primary intraosseous mucoepidermoid carcinoma is a rare malignancy originating from minor or ectopic salivary gland tissue within the jawbones, presenting diagnostic challenges, especially in young patients. This article is aimed at oral and maxillofacial radiologists, surgeons, oncologists, and dental practitioners who encounter such cases, highlighting the importance of early recognition for effective treatment planning. Two cases of primary intraosseous mucoepidermoid carcinoma in the maxilla are presented. The first involves a 27-year-old female with pain and swelling in the left upper jaw. Cone-beam computed tomography showed a multicystic hypodense lesion with bicortical expansion and palatal perforation. The second case features a 15-year-old with similar radiographic findings but with additional lymph node involvement, indicating a more aggressive disease. The first case was localized and painful, while the second was painless, with the lesion extending into the maxillary sinus. Diagnoses were confirmed via fine needle aspiration cytology and histopathology, followed by surgical resection. These cases highlight the need for clinicians to consider primary intraosseous mucoepidermoid carcinoma as a differential diagnosis for jaw swellings across all ages. Advanced imaging, particularly cone-beam computed tomography, is crucial for precise diagnosis and early intervention, leading to improved patient outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: Lip and oral cavity cancer caused over 177,000 deaths globally in 2020, but patient survival increases with earlier diagnosis. One barrier to early diagnosis is the invasive nature of biopsies needed for diagnosis. Automated diagnosis systems have the potential to perform non-invasive diagnosis by pairing novel imaging data with deep learning models. Given the variability between patients, access to a sufficiently large training database from human subjects limits deep learning applications. We propose a model that maps non-invasive images of oral tissue to a diagnosis by encouraging the model to group normal samples close together (reducing variability between patients). Our model improves non-invasive oral cancer diagnosis through a robust training process that only requires a small amount of data. This work shows how we can address small data challenges through model architecture and training, rather than through the collection of larger databases or manual corrections and normalizations. Background: Multispectral autofluorescence lifetime imaging systems have recently been developed to quickly and non-invasively assess tissue properties for applications in oral cancer diagnosis. As a non-traditional imaging modality, the autofluorescence signal collected from the system cannot be directly visually assessed by a clinician and a model is needed to generate a diagnosis for each image. However, training a deep learning model from scratch on small multispectral autofluorescence datasets can fail due to inter-patient variability, poor initialization, and overfitting. Methods: We propose a contrastive-based pre-training approach that teaches the network to perform patient normalization without requiring a direct comparison to a reference sample. We then use the contrastive pre-trained encoder as a favorable initialization for classification. To train the classifiers, we efficiently use available data and reduce overfitting through a multitask framework with margin delineation and cancer diagnosis tasks. We evaluate the model over 67 patients using 10-fold cross-validation and evaluate significance using paired, one-tailed t-tests. Results: The proposed approach achieves a sensitivity of 82.08% and specificity of 75.92% on the cancer diagnosis task with a sensitivity of 91.83% and specificity of 79.31% for margin delineation as an auxiliary task. In comparison to existing approaches, our method significantly outperforms a support vector machine (SVM) implemented with either sequential feature selection (SFS) (p = 0.0261) or L1 loss (p = 0.0452) when considering the average of sensitivity and specificity. Specifically, the proposed approach increases performance by 2.75% compared to the L1 model and 4.87% compared to the SFS model. In addition, there is a significant increase in specificity of 8.34% compared to the baseline autoencoder model (p = 0.0070). Conclusions: Our method effectively trains deep learning models for small data applications when existing, large pre-trained models are not suitable for fine-tuning. While we designed the network for a specific imaging modality, we report the development process so that the insights gained can be applied to address similar challenges in other non-traditional imaging modalities. A key contribution of this paper is a neural network framework for multi-spectral fluorescence lifetime-based tissue discrimination that performs patient normalization without requiring a reference (healthy) sample from each patient at test time. [ABSTRACT FROM AUTHOR]

Simple Summary: This article discusses the potential benefits and limitations of oral cancer screening. While early detection can be beneficial, there is limited evidence that screening programs significantly reduce deaths from oral cancer. The issue lies partly in how the effectiveness of screening programs is measured, with studies showing that higher detection rates do not necessarily translate to fewer deaths. The review highlights the importance of critical evaluation of screening programs and the need for improved dentist education and technology to reduce the burden of oral cancer. The authors advocate for a balanced, evidence-based approach to integrate screening into broader oral health strategies. Screening is widely believed to facilitate early detection and improve health outcomes; however, recent evidence questions its overall benefits, highlighting the need for a critical assessment of cancer screening programs. The simplicity of clinical oral examination and the easy accessibility of the oral cavity make oral cancer a suitable candidate for opportunistic screening. Despite this uniqueness, studies that solidly assess the efficacy and cost-effectiveness of oral cancer screening are scanty, and the only large randomized trial undertaken so far shows limited evidence of mortality reduction through population screening. Research indicates that while early detection rates following screening may increase, they do not necessarily translate into decreased oral cancer deaths. This article emphasizes the need for a nuanced understanding of the benefits of screening, awareness of deceptive metrics and inherent biases in the context of early detection, and the importance of improving dentist education and introducing new technologies to enhance clinical decision-making. The review calls for a balanced and evidence-based approach to oral cancer screening, integrating it with broader oral health initiatives to maximize public health outcomes. [ABSTRACT FROM AUTHOR]

Oral cancer became a very common condition. WHO estimates that there are 4 cases of lip and oral cavity cancer for every 100,000 people worldwide. The early diagnosis of cancers is currently a top focus in the health sector. Recent systematic reviews and meta-analyses have identified promising biomarkers for early detection in several original research investigations. However, it is still unclear the quality of these evidence and which biomarker performs the best in terms of early detection. Therefore, the objective was, to map the methodological and reporting quality of available oral squamous cell carcinoma (OSCC) or head/neck squamous cell carcinoma (HNSCC) systematic reviews and meta-analysis. Secondly, to evaluate diagnostic accuracy of salivary biomarkers for common craniofacial cancers and to compare the diagnostic value of different salivary biomarkers. PubMed, Scopus, Web of Science, Embase and Cochrane Library electronic databases were used to map the methodological and reporting quality of the systematic reviews and meta-analysis conducted on the HNSCC, OSCC using the AMSTAR-2 checklist. The inclusion criteria were systematic reviews and meta-analysis published in the topic of HNSCC and OSCC biomarkers. Exclusion criteria were no animal studies; original primary studies, due to limitation of competency in other languages articles with language other than English were excluded. The sensitivity and specificity were calculated for salivary biomarkers and ranked according to network meta-analysis principles. A total of N = 5893 patients were included from four meta-analysis studies. All together, these included n = 37 primary studies. n = 94 biomarkers were pooled from these four meta-analyses and categorised into the stages at which they were detected (I-IV). In OSCC, Chemerin and MMP-9 displayed the highest sensitivity, registering 0.94 (95% CI 0.78, 1.00) and a balanced accuracy of 0.93. Phytosphingosine closely followed, with a sensitivity of 0.91 (95% CI 0.68, 0.99) and a balanced accuracy of 0.87. For HNSCC, the top three biomarkers are Actin, IL-1β Singleplex, and IL-8 ELISA. Actin leads with a sensitivity of 0.91 (95% CI 0.68–0.99), a specificity of 0.67, and an overall accuracy of 0.79. Subsequently, IL-1β Singleplex exhibits a sensitivity of 0.62 (95% CI 0.30–0.88), a specificity of 0.89, and an accuracy of 0.75, followed by IL-8 ELISA with a sensitivity of 0.81 (95% CI 0.54–0.97), a specificity of 0.59, and an accuracy of 0.70. In conclusion, there was highest sensitivity for MMP-9 and chemerin salivary biomarkers. There is need of further more studies to identify biomarkers for HNSCC and OSCC. • Methodological and reporting quality of systematic reviews and meta-analysis was more than 50% based on AMSTAR-2 assessment. • UPLC-MS (31.79%) was the most used method to detect the salivary biomarkers followed by RT-qPCR (11.26%). • Chemerin & MMP-9 show top sensitivity in OSCC followed by Phytosphingosine. • Top 3 biomarkers for HNSCC are Actin, IL-1β Singleplex and IL-8 ELISA. • Top biomarkers in early OSCC I-II: chemerin, MMP-9, Phytosphingosine, Pipecolinic acid. [ABSTRACT FROM AUTHOR]

Statement of the Problem: One of the main signs of cancer development is increasing of cell proliferation activity. Expression of the Ki-67 as a cell proliferation marker is extensively utilized in pathology studies as an indicator of proliferation in human tumors. According to studies, Ki-67 plays an effective role in the pathology of malignant and pre-malignant oral mucosa lesions. Purpose: The current study aimed to systematically review the Ki-67 expression in oral lichen planus without dysplasia and compare it with oral epithelial dysplasia. Materials and Method: In this meta-analysis, all articles in the English language were searched in databases including Web of Science, PubMed, Embase, Scopus, and Google Scholar until July 2023. MeSH terms and free keywords were used in the search step. Expression of Ki-67 in oral lichen planus and oral epithelial dysplasia was analyzed by Comprehensive Meta-Analysis software. Results: Nine hundred and two articles related to the searched words were found. According to the selection criteria, 12 retrospective articles were selected. Low quality was not observed in any of the records by the Newcastle-Ottawa scale and most of them had a relatively good quality. Totally, 593 patients were examined. The heterogeneity between studies was not significant. The meta-analysis results indicated a significantly lower Ki-67 expression in oral lichen planus without dysplasia in comparison to oral epithelial dysplasia. Conclusion: The more intense expression level of Ki-67 in oral epithelial dysplasia compared with oral lichen planus was observed. The ki-67 expression could be utilized to indicate the existence and intensity of epithelial dysplasia and disease progression. [ABSTRACT FROM AUTHOR]

Background: Trismus therapy is often delayed after jaw reconstruction to avoid hardware failure or non‐union. The aim of this study is to document the forces that have been applied to patients undergoing free flap reconstruction of the oral cavity in the 12 months following oral cavity reconstruction, and to analyze the associations between force and maximal interincisal opening (MIO) over time. Methods: Participants with trismus after free flap reconstruction of the oral cavity completed a 10‐week jaw stretching program using Restorabite™. Primary outcome measures included the minimum and maximal force applied by a trismus device during rehabilitation, MIO, bone union, and health‐related quality of life outcomes up to 12 months postoperatively. Results: A mean of 20.6 Newtons (N) was used during passive exercises and 38.9 N during active exercises was used during trismus therapy. The mean increase in MIO for the 45 participants after 10 weeks, 6 months, and 12 months of therapy was 8.4 mm (p < 0.001), 12.6 mm (p < 0.001), 12.7 mm (p < 0.001), respectively. There was no significant difference in the mean minimal (p = 0.37) or mean maximal (p = 0.08) force applied between those who underwent osseous free flap reconstruction compared to fasciocutaneous only, respectively. In patients who underwent osseous reconstruction, 25 (67.6%) had complete bone union and 12 (32.4%) had partial union at 12 months postsurgery. Conclusions: In participants undergoing osseous free flap reconstruction, there was no association between the force applied to the rates of bone union. Further research to define safe and optimal loading may benefit patients undergoing jaw reconstruction. [ABSTRACT FROM AUTHOR]

Purpose: To assess the implant survival rate in mandibles reconstructed with free fibula flap after oral tumor resection after 1 year of prosthetic loading. A secondary objective was to compare immediate or delayed implant placement protocols in this population. Materials and Methods: Electronic and manual searches were performed on different databases for controlled and prospective trials that indicated implant survival rate. This systematic review followed PRISMA guidelines. Risk of bias was evaluated using Cochrane Collaboration tools. Meta-analyses heterogeneity source assessment and GRADE evaluation were performed among studies with identical follow-ups. Results: Among 305 primarily selected articles, 109 were eligible after reading the title and abstract, and 8 were included after full-text reading: 2 randomized controlled trials and 6 prospective studies comprising 140 patients and 507 implants. Meta-analyses estimated an overall survival rate of 97% (95% CI: 94% to 99%) after 1 year of prosthetic loading. The survival rate was 98% (95% CI: 94% to 100%) with immediate implantation and 97% (95% CI: 90% to 99%) with delayed implantation. Only 3 studies reported radiotherapy treatment, with no real impact on implant survival rate. Overall, 69% of tumors were benign. Conclusions: Implant placement in vascularized fibula flaps in the mandible is recommended for patients undergoing segmental mandibular reconstruction after tumor resection. Within the limitations of this study, no significant difference in survival rates was found between immediate and delayed implant placement. [ABSTRACT FROM AUTHOR]

Objective: Oral squamous cell carcinoma (OSCC) is a common malignant tumor worldwide. Surfeit 4 (SURF4) is a member of the surfeit gene family and plays a regulatory role in various cellular processes, such as protein transport and lipid metabolism. Therefore, this study aims to investigate the regulatory role and mechanisms of SURF4 in OSCC. Material and Methods: Serum samples were collected from the normal control and OSCC groups. The function of OSCCs was analyzed through Transwell, 5-ethynyl-2'-deoxyuridine incorporation, and Cell Counting Kit-8 assays. Selected proteins were measured by Western blot analysis. Additional vectors for the overexpression (OE) and knockdown of SURF4 were established. Aerobic glycolysis (AG) was detected through cellular glucose consumption and lactate production assays. Results: A significant increase was observed in protein and messenger RNA (mRNA) levels of serum SURF4 in OSCC patients compared with the control group (P < 0.001). The knockdown of SURF4 alleviated proliferation, invasion, and metastasis in OSCC (P < 0.001). Overexpressing SURF4 aggravated proliferation and invasion in OSCC and increased the levels of stem cell genes Octamer-binding Transcription Factor 4 and Sex-determining Region Y-box 2 (P < 0.001). Furthermore, adenosine triphosphate levels, lactate levels, and extracellular acidification rate were found to be elevated in the OE SURF4 group, along with higher levels of AG-related regulatory proteins (P < 0.001). Inhibiting AG with glycolysis inhibitor 2-deoxyglucose effectively impeded proliferation and invasion in OSCC. Conclusion: SURF4 plays a role in OSCC by regulating AG to enhance proliferation, tumor stemness, invasion, and metastasis. [ABSTRACT FROM AUTHOR]

Background: Adenocarcinoma not otherwise specified (NOS) is an uncommon malignant minor salivary gland tumor. We report gallium-67 SPECT/CT and diffusion-weighted MRI (DWI) in the palatal tumor, especially a rare case with adenocarcinoma NOS. Case presentation: An 85-year-old female patient presented with swelling on the palate within 3 months. DWI and apparent diffusion coefficient (ADC) maps indicated high and low signal intensities on the lesion, respectively. ADC value of the lesion was 0.58 × 10–3 mm2s−1. Gallium-67 SPECT/CT showed increased uptake on the lesion and no metastasis. The maximum SUV for the palatal lesion was 7.36. Histopathological diagnosis by a biopsy was adenocarcinoma NOS. Conclusion: The gallium-67 SPECT/CT and DWI should be effective for assessment of the palatal tumor. [ABSTRACT FROM AUTHOR]

Proliferative verrucous leukoplakia (PVL) is an aggressive and distinct type of oral precancerous lesion characterized by warty surfaced white plaque diffusely involving oral mucosa. Surgical excision is the treatment of choice. However, PVL has persistent and recurrent growth patterns, requiring multiple surgical procedures. Surgical intervention is especially challenging if PVL extends between teeth limiting access. These interproximally located lesions have a high propensity to undergo malignant transformation. We report a case of a 53-year-old man with recurrent PVL diffusely covering the maxillary and mandibular gingiva. Despite complete surgical excisions, PVL recurred, and a focal area in the interproximal mandibular gingiva progressed to invasive squamous cell carcinoma requiring marginal resection. The remaining PVL areas were treated with topical imiquimod (toll-like receptor 7 agonist) for six months, resulting in complete clinical and histological resolution. Topical agents can cover a larger surface area and penetrate in between interproximal areas. Importantly, it allows for maximal local exposure with minimal systemic toxicity, essential for long-term treatment and prophylactic use of the agent to prevent relapse. [ABSTRACT FROM AUTHOR]

Background: Solitary fibrous tumor (SFT) is a rare mesenchymal lesion that has a wide anatomic distribution. However, this lesion rarely occurs in the oral or maxillofacial region. Methods: A retrospective review was performed to evaluate the clinical symptoms, radiological images, pathology and immunohistochemistry results of 9 patients with SFTs treated between January 2015 to April 2024 in our institute. Surgical tumor resection was administered to all patients. Follow-up for these patients spanned until the conclusion of April 2024. Results: The series contained 3 males and 6 females, with the mean age 50.6 years (range: 25 to 73 years). The tumors were distributed at six different sites, including the tongue, submandibular region, cheek, sublingual gland, mandible, and hard palate. Clinically, the mass grew gradually and usually without obvious clinical symptoms. On imaging examination, the boundaries of all the tumors were clear, except for one patient with a mandibular tumor. Surgical excision was performed in all patients. Histological characteristics and positive immunostaining for STAT6, CD99, CD34 and Bcl-2 were the most important criteria for a final diagnosis. All tumors were positive for CD34 and Bcl-2. Only one tumor was negative for STAT6. While CD99 was negative in one case and weakly positive in two cases. All patients had no local recurrence during the follow-up period ranging from 1 to 100 months (mean 41.4 months). Conclusions: Benign SFTs occurring in the oral and maxillofacial region are rare, and surgery is the primary treatment for this tumor. It usually presents as a distinctly bordered heterogeneous mass on imaging. The tumors can compress surrounding bone tissue leading to bone resorption, and in rare cases, it may exhibit invasive resorption. SFTs should be included in the differential diagnosis of lesions in the oral and maxillofacial region. [ABSTRACT FROM AUTHOR]

Background: Oral cavity cancer (OCC) represents a significant public health burden in South Asia, ranking as the most prevalent cancer affecting males in Pakistan and contributing considerably to morbidity and mortality. The objective of this study was to evaluate the survival rates in patients diagnosed with OCC in the Pakistani population and identify the factors influencing survival. Methods: This was a retrospective cohort study conducted at the Aga Khan University Hospital Karachi, Pakistan. A total of 2238 cases diagnosed with OCC from May 2011 through December 2020, who met the inclusion criteria, were included. Survival analyses at 1-, 3- and 5-year intervals were performed using the Kaplan-Meier method. Adjusted hazard ratios (HR) and their 95% confidence intervals (CIs) were estimated using a Cox regression model to identify the factors significantly influencing survival. Results: Among all cases, 54.0% were diagnosed in individuals 50 years of age and below and 73.0% were tobacco users. Overall survival, 1-year, 3-year, and 5-year survival rates were 54.9%, 88.9%, 81.6%, and 75.9% respectively. After adjustment for all the significant confounding and prognostic factors, age was an important factor showing that adults > 50 years had poorer survival compared to ≤ 50 years (HR = 1.43, 95% CI = 1.11–1.83). Poorly differentiated grade of OCC compared to well-differentiated grade (HR = 2.49, 95% CI = 1.61–3.84) and stage IV compared to earlier stages (HR = 3.56, 95% CI = 2.13–5.94) were also associated with poor survival. Conclusion: Notably, there was a high occurrence of late stage (III and IV) OCC in individuals aged ≤ 50 years, with the buccal mucosa being the most common site involved. Moreover, a large proportion of our patients had a history of tobacco use. Patients with advanced-stage disease and poorly differentiated grade showed poor survival. Therefore, public awareness about tobacco control for OCC prevention and earlier diagnosis of OCC is urgently needed in our Pakistani population. [ABSTRACT FROM AUTHOR]

Simple Summary: This article aims to provide a first-of-its-kind summary of the literature on oral capillaroscopy—a non-invasive technique used to study the structure of tiny blood vessels beneath the mouth's surface in different conditions and lesions. This research has shown that oral capillaroscopy can provide both qualitative and quantitative insights into the health of these microvessels and highlight differences and peculiarities in specific diseases and conditions. This technology has promising applications in oral pathology and oncology, where it can be used to study cancer-related blood vessel growth in real time and monitor chronic inflammatory diseases. Future research may focus on using capillaroscopy to image oral potentially malignant disorders and better understand their microvascular components for diagnostic and prognostic purposes. The oral cavity may suffer from diseases and lesions of different natures that can result in changes to the underlying microvasculature. These changes are typically observed during the examination of biopsy samples, but there is still a need to investigate methods for characterizing them in live tissues. Capillaroscopy, a medical imaging technique using polarized light and magnification, has shown promise in providing enhanced imaging of the oral mucosa microvasculature in preliminary studies. The present work proposed to review the literature on what capillaroscopy is, its applications in the imaging of oral mucosa microvasculature, and its diagnostic and prognostic significance in various diseases and conditions. While there is the limited literature available, further research in oral capillaroscopy, particularly in the field of oral oncology, is needed to determine its potential benefits in diagnosing and predicting outcomes for potentially malignant oral disorders and cancers. [ABSTRACT FROM AUTHOR]

Simple Summary: Therapeutic decisions made during the treatment of patients with oral squamous cell carcinomas (OSCCs) significantly impact the overall course of the disease. A critical stage in the treatment process is the accurate histopathological assessment of excised tumors. The precision of the specimen description and the comprehensiveness of the information provided to the pathologist are of paramount importance. To address this, a multidisciplinary team comprising a maxillofacial surgeon, a pathologist, and an engineer was assembled. The team's objective was to devise a user-friendly protocol for virtual communication between the surgeon and the pathologist. Leveraging available software and a 3D scanner, a virtual communication protocol was formulated, enabling the generation of virtual images of excised tumors. Moreover, a methodology for applying annotations and marking specific areas (e.g., margins) directly on the tumor surfaces was developed. Consequently, this approach has afforded the team extensive capabilities for effectively conveying and archiving precise information. Background: The histopathological assessment is critical in the comprehensive treatment process for patients diagnosed with oral squamous cell carcinoma (OSCC). A detailed and precise specimen characterization is essential to facilitate effective surgeon–pathologist communication. Methods: In response to this need, a user-friendly virtual communication protocol utilizing a 3D scanner has been developed. This study involved 50 patients with OSCC, whose resected tumors were directly scanned in the operating room and subsequently annotated and characterized using available software. Results: The direct application of annotations and descriptions onto the virtual tumor specimens significantly enhanced the quantity and accuracy of information conveyed to the pathologist. Conclusions: The proposed solution's repeatability and standardized approach make integration into routine clinical practice feasible, thereby establishing a potential new standard in the field. [ABSTRACT FROM AUTHOR]

Simple Summary: Head and neck cancer (HNC), especially oral squamous cell carcinoma (OSCC), is a common and increasingly prevalent cancer worldwide. OSCC is challenging to treat due to its aggressive nature and resistance to standard therapies like surgery, radiation, and chemotherapy, particularly in advanced stages. Cetuximab, a drug targeting EGFR (a protein that supports cancer cell growth), is often used but has limitations in effectiveness. This study explores a new approach by combining Cetuximab with drugs that target proteins involved in cell division, specifically MPS-1, Aurora-B, and KSP. These proteins help cancer cells progress through the cell cycle and are crucial for tumor survival. By blocking both EGFR and these cell division proteins, the study aimed to increase the effectiveness of Cetuximab in killing OSCC cells. Results showed that targeting MPS-1, Aurora-B, or KSP alongside EGFR led to more cancer cell death, suggesting that this combined approach could reduce treatment resistance. Analysis of patient samples confirmed that these proteins are significant in OSCC. This combined therapy strategy shows promise for improving outcomes in OSCC and potentially other head and neck cancers. Background/Objectives: Head and neck cancer (HNC) is among the most common cancer types globally, with its incidence expected to increase significantly in the coming years. Oral squamous cell carcinoma (OSCC), the predominant subtype, exhibits significant heterogeneity and resistance to treatment. Current therapies, including surgery, radiation, and chemotherapy, often result in poor outcomes for advanced stages. Cetuximab, an EGFR inhibitor, is widely used but faces limitations. This study explores the combined inhibition of EGFR and mitotic proteins to enhance treatment efficacy. Methods: We analyzed the effects of co-treating OSCC cells with small molecules targeting MPS-1 (BAY1217389), Aurora-B (Barasertib), or KSP (Ispinesib), alongside Cetuximab. The rationale is based on targeting EGFR-mediated survival pathways and the mitotic checkpoint, addressing multiple cell cycle phases and reducing resistance. Results: Our findings indicate that inhibiting MPS-1, Aurora-B, or KSP enhances Cetuximab's therapeutic potential, promoting increased cancer cell death. Additionally, we examined EGFR, MPS-1, Aurora-B, and KSP expression in OSCC patient samples, revealing their clinicopathologic significance. Conclusions: This combinatorial approach suggests a promising strategy to improve treatment outcomes in OSCC. [ABSTRACT FROM AUTHOR]

Importance: Metastases to the submandibular gland (SMG) from oral cavity primaries are very rare. Hence, a gland-preserving level IB dissection technique is a feasible option without compromising the lymph node yield (LNY). Objective: To assess the feasibility and noninferiority of the SMG-preserving dissection technique to the conventional en bloc removal of level IB in terms of LNY in patients with cN0 oral squamous cell carcinoma (OSCC) undergoing elective neck dissection. Design: Parallel-design, single-center, open-label, randomized controlled trial. Setting: Tertiary care health care center—Department of Otorhinolaryngology-Head & Neck Surgery, AIIMS Rishikesh. Participants: Thirty-eight (n = 38) participants with 46 (n = 46) neck dissection specimens of OSCC were randomly allocated (1:1) into gland-preserving (n1 = 23) and en bloc (n2 = 23) dissection groups. Intervention: Elective neck dissection comparing SMG-sparing level IB dissection technique versus en bloc level IB dissection. Main Outcome Measures: LNY, lymph node density, and level IB operative time in both groups were compared between groups (α <.05). Results: Median LNY (P =.543) and lymph node density (P = 1.000) in level IB did not show significant differences between the groups. LNY in level IB by gland-preserving technique is also not inferior to the conventional en bloc dissection technique (mean difference = 0.217; 95% CI: [−0.597, 1.032]; P =.593). The mean level IB operative time is significantly longer in the gland-preserving group (P <.001). Conclusions and Relevance: None of the examined SMGs were involved by the tumor. SMG-preserving technique is noninferior to the traditional technique of level IB clearance and can be used in elective neck dissections without compromising the LNY. Functional neck dissection has greatly evolved to decrease patient morbidity, and this method can be adopted in case-specific situations. Trial registration: The trial was registered in the Clinical Trials Registry—India (CTRI/2022/05/042344) on May 2, 2023, https://ctri.nic.in/. [ABSTRACT FROM AUTHOR]

Background: Data suggest that buccal mucosa squamous cell carcinoma (SCC) is the most common malignancy in India. In this study, we presented our 5-year clinical experience with oral SCC and examined factors associated with surgical outcomes. Methods: In this retrospective study, 45 patients diagnosed with SCC of buccal mucosa (January 2013–December 2018) underwent wide local excision (WLE) and neck dissection at our institution. Adjuvant radiotherapy (RT)/chemotherapy (CT) was given. Most were aged 60–69 (44.4%, n = 20), mean age of 58 ± 8.2 years, with a female-to-male ratio of 1.14. Tumor thickness, extracapsular spread (ECS), and survival were analyzed with ≥ 5-year follow-up for different stages. Results: The data was analyzed revealing that the T1 stage was most common (55.6%, n = 25), followed by T3 and T4 (15.6%, n = 7 each), then T2 (13.3%, n = 6). Smaller tumors had lower grades. Nodal involvement was seen in 44.4% (n = 20), with N2 stage being the most frequent. Larger tumors had a greater propensity for invasion. Survival probability was 71.1%. The T1 stage showed a higher survival rate than other stages. Nodal involvement reduced survival probability (29.5%). ECS with neural and vascular invasion significantly lowered survival (12%). All associations were highly significant (P < 0.001). Conclusion: Effective locoregional control is crucial for managing buccal mucosa SCC. Supraomohyoid neck dissection is recommended, even for the clinically negative neck with tumor thickness greater than 0.4 cm. Postoperative RT with or without CT, clear margins, and early detection enhance the survival outcomes of the patients. [ABSTRACT FROM AUTHOR]

Background and Aims: To study the unknown influencing factors of delayed medical treatment behavior in oral cancer patients in western China and to develop a prediction model on the risk of delayed medical treatment in oral cancer patients. Method: We investigated oral cancer patients attending a tertiary Grade A dental hospital in western China from June 2022 to July 2023. The logistic regression and four machine learning models (nearest neighbors, the RBF SVM, random forest, and QDA) were used to identify risk factors and establish a risk prediction model. We used the established model to predict the data before and after the COVID-19 pandemic and test whether the prediction effect can still remain stable and accurate under the interference of COVID-19. Result: Out of the 495 patients included in the study, 122 patients (58.65%) delayed seeking medical treatment before the lifting of the restrictions of the pandemic, while 153 patients (53.13%) did so after the lifting of restrictions. The logistic regression model revealed that living with adult children was a protective factor for patients in delaying seeking medical attention, regardless of the implementation of pandemic control measures. After comparing each model, it was found that the statistical indicators of the random forest algorithm such as the AUC score (0.8380) and specificity (0.8077) ranked first, with the best prediction performance and stable performance. Conclusions: This study systematically elucidates the critical factors influencing patient delay behavior in oral cancer diagnosis and treatment, employing a comprehensive risk prediction model that accurately identifies individuals at an elevated risk of delay. It represents a pioneering large-scale investigation conducted in western China, focusing explicitly on the multifaceted factors affecting the delayed medical treatment behavior of oral cancer patients. The findings underscore the imperative of implementing early intervention strategies tailored to mitigate these delays. Furthermore, this study emphasizes the pivotal role of robust social support systems and positive family dynamics in facilitating timely access to healthcare services for oral cancer patients, thereby potentially improving outcomes and survival rates. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusions We aimed to investigate the pattern, risk, and treatment of subsequent events after curative‐intent treatment of lip cancer.This retrospective cohort study included 313 patients treated for lip cancer from 2011 to 2021 in a tertiary oncological center.After a median follow‐up time of 29.16 months, 145 (46.32%) patients presented with second primary tumors, 93% of which were skin carcinomas. Locoregional recurrence occurred in 7.9% of cases, with 2.5% with nodal recurrence. The 1‐, 5‐, and 10‐year cumulative second primary tumor probabilities were 32.8%, 60.92%, and 70.92%, respectively. A higher risk was observed in elderly patients and basal cell carcinoma cases located on the cutaneous surface of the upper lip. Regional metastasis but not second primary tumors negatively impacted survival.Our study helps fill a literature gap, structuring specific recommendations regarding evaluations and follow‐up protocols for patients with lip cancer. Since cutaneous second primary tumors were the most common second event, standard skin examination is key. Age and histology were significant predictors for second primary tumors. For cases of locally advanced lip squamous cell carcinoma, standard guidelines for head and neck cancer must be followed. [ABSTRACT FROM AUTHOR]

Background: The challenges associated with ensuring widespread system changes to enable early diagnosis and prevention of oral cancer could benefit from interprofessional practice. A needs assessment study was conducted to inform the Interprofessional Education and Collaborative Practice (IPECP) course related to oral cancer. The primary objectives of this study were 1) to establish a tool assess the knowledge attitude and practice (KAP) related to prevention and early detection of oral cancer of health professional students, and 2) to assess the same KAP of pre-licensure dental students. Additional objectives were to consider the possibility that dental students would demonstrate good scores related to early detection and prevention of oral cancer thus indicating their readiness for interprofessional learning and collaborative practice. Methods: Two questionnaires were utilized for this study which included 1) Readiness for interprofessional learning was assessed using the pre- validated tool of Readiness for Interprofessional Learning Scale (RIPLS) 2) A questionnaire to assess the KAP related to early diagnosis and prevention of oral cancer which was developed, validated, and evaluated. Statistical analysis includes, descriptive statistics, Mann–Whitney U test, Ordered logistic regression and Probit analysis. p value was set at < 0.05. Results: A total of 130 dental students (74.6% female) were included in the study. Mean scores related to KAP were 15.96 ± 1.394, 4.70 + 1.146, 7.02 ± 1.019 respectively. The mean score of RIPLS was 73.15 ± 15.961. The probability of overall samples to have good RIPLS scores was around 0.68 to 0.76 (Male 0.68—0.82 & Female 0.68 -0.74). The percentage of students having good knowledge score was 93.8%, good attitude score was around 54.6% and good practice score was around 90%. Conclusion: Knowledge and practice related to prevention and early detection of oral cancer were scored highly. Attitude scores were lower in a relatively higher proportion of participants and needed to be addressed in the curriculum. RIPLS score indicates a positive attitude towards interprofessional learning. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate patient‐reported quality of life and incidence of decision regret in patients undergoing radial (RFFF) and ulnar forearm‐free flaps (UFFF) reconstruction. Materials and Methods: Patients undergoing either RFFF or UFFF were assessed with the University of Washington Quality of Life (UW‐QOL) and Oral Health Impact Profile (OHIP‐14) questionnaires, and the Decision Regret Scale (DRS), both before and at least 12 months post‐reconstruction. Results: In total, 40 RFFF and 40 UFFF were included. Harvesting time was longer in RFFF (p = 0.043), and the donor‐site defect was significantly larger in RFFF than in UFFF (p = 0.044). Patients with UFFF scored better UW‐QOL in the appearance, pain, activity, mood, and social functioning domains (p < 0.05). However, the RFFF group excelled in swallowing and chewing domains. The DRS score revealed a significant difference between RFFF and UFFF, with scores of 36.26 versus 27.36, respectively. Moreover, the mean DRS score reduced at 12 months compared with 6 months, significantly superior for UFFF. Conclusion: Oral cancer patients reconstructed with UFFF exhibited a better appearance, social domain, and mild decision regret compared with RFFF, indicating that the UFFF may contribute to improving postoperative quality of life in oral cancer patients. [ABSTRACT FROM AUTHOR]

Objective: Carcinoma ex‐pleomorphic adenoma (CEXPA) represents a malignant transformation from a recurrent or primary pleomorphic adenoma (PA), and the immune response may be essential in this process. Therefore, in this study, we aimed to identify and quantify subpopulations of dendritic cells (DCs) in CEXPA, residual PA in CEXPA (rPA), and PA. Materials and Methods: A multicenter study was performed collecting salivary gland tumor (SGT) samples from three Oral and Maxillofacial Pathology Centers. A tissue microarray containing 41 samples of CEXPA and 22 samples of PA was included in this study and submitted to immunohistochemical reactions against CD1a, CD83, CD207, and Ki67 antibodies. Results: Both PA and rPA showed a higher quantification of CD207+ and CD83+ cells when compared to CEXPA (p < 0.001 and p < 0.01, respectively). There was also a difference when comparing the cell proliferation index between PA/rPA and CEXPA using the Ki‐67 marker (p = 0.043). However, there was no difference in the DC population regarding clinical parameters such as sex, anatomical location, size, and metastases (p > 0.06). Conclusions: Immunohistochemical profile of DC subpopulations and cell proliferation biomarkers in SGTs can contribute as an important tool in the differentiation of benign and malignant tumors or detection of initial areas with malignant transformation. [ABSTRACT FROM AUTHOR]