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Background and Aim Methods Results Conclusions Oral and esophageal cancers are globally prevalent, especially in East Asia. Over half of head and neck cancer patients developing second primary esophageal cancer (SPEC) were initially diagnosed with oral cavity cancer (OCC). This study assessed the cost‐effectiveness of universal endoscopic screening for early SPEC prevention in newly diagnosed OCC patients at different stages.This study employed Markov cohort models to evaluate the cost‐effectiveness of endoscopic SPEC screening post‐OCC diagnosis (stages 0 to IV) between screened and non‐screened groups. Four surveillance frequencies were assessed: (i) one time, (ii) annual for 3 years, (iii) annual for 10 years, and (iv) annual for life. A hypothetical cohort of 100 000 cases across stages was compared for costs and quality‐adjusted life‐years (QALYs), discounted annually at 3%.All four screening strategies were beneficial for all OCC stages, especially for early‐stage patients, resulting in higher QALYs. Lifetime/annual screening from the payer's perspective proved most favorable, with incremental QALYs of 1.23 at stage 0 and 0.06 at stage IV. Incremental costs for this strategy ranged from NTD 121 331 (USD 4044) at stage 0 to NTD 13 032 (USD 434) at stage IV. Both incremental costs and incremental cost‐effectiveness ratio (ICER) values indicated cost savings from a societal perspective. The ICER values ranged from NTD −626 440 (USD −20 881) at stage 0 and NTD −475 021 (USD −15 834) at stage IV.Overall, our study provided cost‐effectiveness evidences to understanding the cost‐effectiveness of endoscopic screening in OCC patients, particularly emphasizing the benefits of early and consistent screening. [ABSTRACT FROM AUTHOR]

Introduction: The routine assessment of intraoperative margins has long been the standard of care for oral cavity cancers. However, there is a controversy surrounding the best method for sampling surgical margins. The aim of our study is to determine the precision of a new technique for sampling tumor bed margins (TBMs), to evaluate the impact on survival and the rate of free flap reconstructions. Methods: This retrospective cohort study involved 156 patients with primary cancer of the tongue or floor of the mouth who underwent surgery as initial curative treatment. Patients were separated into 2 groups: one using an oriented TBM derived from Mohs' technique, where the margins are taken from the tumor bed and identified with Vicryl sutures on both the specimen and the tumor bed, and the other using a specimen margins (SMs) driven technique, where the margins are taken from the specimen after the initial resection. Clinicopathologic features, including margin status, were compared for both groups and correlated with locoregional control. Precision of per-operative TBM sampling method was obtained. Results: A total of 156 patients were included in the study, of which 80 were in TBM group and 76 were in SM group. Precision analysis showed that the oriented TBM technique pertained a 50% sensitivity, 96.6% specificity, 80% positive predictive value, and an 87.5% negative predictive value. Survival analysis revealed nonstatistically significant differences in both local control (86.88% vs 83.50%; P =.81) as well as local-regional control (82.57% vs 72.32%; P =.21). There was a significant difference in the rate of free flap-surgeries between the 2 groups (30% vs 64.5%; P <.001). Conclusion: Our described oriented TBM technique has demonstrated reduced risk of free flap reconstructive surgery, increased precision, and similar prognostic in terms of local control, locoregional control, and disease-free survival when compared to the SM method. [ABSTRACT FROM AUTHOR]

(1) Background: Oral cavity cancer represents the most common site of origin of head and neck mucosal malignancies. A few limited studies have suggested that chronic irritation, particularly in non-healing ulcers, and fibrotic tissue from poor dentition or ill-fitting dentures had a role in developing mouth cancer. This scoping review aims to evaluate the existing evidence concerning Oral Cavicty Cancer (OCC) in non-smokers/non-drinkers and the relationship with dental trauma. (2) Methods: A scoping review of the PubMed, Embase, and Web of Science databases was completed in adherence with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. (3) Results: Of the 33 articles that met inclusion, in 6 of them authors discussed the role of topography in dental trauma, in 11 articles authors discussed the carcinogenesis mechanism involved in chronic mucosal trauma, in 17 articles data on ill-fitting dentures was included, 4 studies dealt with the effect of broken/sharp teeth on mucosal damage, and in 7 studies the role of oral hygiene was covered. Less frequently discussed topics included gender, risk of neck nodes, and the role of potentially malignant oral disorders. (4) Conclusions: The available literature suggests a potential connection between chronic dental trauma and the development of OCC. Studies have highlighted factors such as denture use and ill-fitting dental appliances as contributors to an increased risk of oral cancer. Interestingly, we still miss data to support the hypothesis that women, particularly those without toxic habits like smoking or alcohol consumption, appear to be disproportionately affected by oral cancer related to chronic dental trauma. [ABSTRACT FROM AUTHOR]

Background: Evaluate whether extranodal extension (ENE) extent impacts outcomes in patients with oral cavity squamous cell carcinoma (OCSCC). Methods: From an institutional database, patients with OCSCC and pathologic ENE who received adjuvant treatment were included. Surgical slides were reviewed to confirm ENE extent. Multivariable Cox regression was used to relate patient/treatment characteristics with disease‐free survival (DFS) and overall survival (OS). ENE was analyzed as both a dichotomous and continuous variable. Results: A total of 113 patients were identified. Between major (>2 mm) versus minor ENE (≤2 mm), there was no significant difference in DFS (HR 1.18, 95%CI 0.72–1.92, p = 0.51) or OS (HR 1.17, 95%CI 0.70–1.96, p = 0.55). There was no significant association between ENE as a continuous variable and DFS (HR 0.97 per mm, 95%CI 0.87–1.4, p = 0.96) or OS (HR 0.96 per mm, 95%CI 0.83–1.11, p = 0.58). Conclusion: No significant relationship was seen between ENE extent and DFS or OS in individuals with OCSCC. [ABSTRACT FROM AUTHOR]

This study employs a two-sample bidirectional Mendelian randomization (MR) approach to systematically evaluate the causal relationship between gut microbiota and oral cavity cancer (OCC). Objective: To address the challenge in establishing the causal relationship between gut microbiota and OCC, we applied a systematic MR analysis. Methods: Utilizing GWAS data from the MiBioGen consortium (18,340 individuals) and UK Biobank (n = 264,137), we selected instrumental variables and employed MR-Egger, weighted median, IVW, and weighted mode analyses. Heterogeneity and pleiotropy were assessed using Cochran's Q test and MREgger intercept test. Results: Our findings indicate, at the order level, Bacteroidales (OR = 0.9990, 95% CI = 0.9980-1.0000, P = 0.046), Burkholderiales (OR = 1.0009, 95% CI = 1.0001-1.0018, P = 0.033), and Victivallales (OR = 0.9979, 95% CI = 0.9962-0.9995, P = 0.037) exhibit causality on OCC in the Weighted median, IVW, and MR-Egger analyses, respectively. At the family level, Alcaligenaceae (OR = 1.0012, 95% CI = 1.0004-1.0019, P = 0.002) and Clostridiaceae1 (OR = 0.9970, 95% CI = 0.9948-0.9992, P = 0.027) show causality on OCC in IVW and MR-Egger analyses. At the genus level, Clostridiumsensustricto1 (IVW, OR = 0.9987, 95% CI = 0.9980-0.9995, P = 0.001; MR-Egger, OR = 0.9978, 95% CI = 0.9962-0.9995, P = 0.035), Desulfovibrio (IVW, OR = 1.0008, 95% CI = 1.0001-1.0015, P = 0.016), Eggerthella (IVW, OR = 0.9995, 95% CI = 0.9990-1.0000, P = 0.048), Eubacterium fissicatena group (IVW, OR = 1.0005, 95% CI = 1.0000-1.0009, P = 0.032), and Holdemanella (IVW, OR = 0.9994, 95% CI = 0.9989-0.9999, P = 0.018) are implicated in causing OCC in related analyses. Conclusion: Our study identifies Burkholderiales order, Alcaligenaceae family, Desulfovibrio genus, and Eubacterium fissicatena group as causally increasing OCC risk. In contrast, Bacteroidales order, Victivallales order, Clostridiaceae1 family, Clostridiumsensustricto1 genus, Eggerthella genus, and Holdemanella genus are causally associated with a decreased OCC risk. However, further investigations are essential to delineate an optimal gut microbiota composition and unravel the underlying mechanisms of specific bacterial taxa in OCC pathophysiology. [ABSTRACT FROM AUTHOR]

Introduction In head and neck cancer (HNC) patients, fatigue is present throughout the course of treatment and during follow-up. Cancer-related fatigue (CRF) is a significant treatment-related side effect experienced by oral cancer patients during and after treatment. CRF, when coupled with other side effects of oral cavity cancer, patients who undergo definitive treatment have some of the most dramatic acute side effects, and reduced overall quality of life (QoL). Although there are upcoming intervention strategies to manage CRF, the effect of exercise intervention is explored in this study. The rationale for considering exercise to manage CRF is that it may alleviate the combined effect of toxic treatment and decreased levels of activity during the treatment that reduces the capacity for physical performance. Objective This study was conducted to investigate the effectiveness of exercise intervention on CRF, and its influence on functional capacity and QoL among patients with oral cavity cancer during and after their primary cancer treatment. Materials and Methods Oral cavity cancer patients (n = 223), planned for only chemoradiotherapy with curative intent were screened for CRF. Based on the inclusion criteria, 69 patients were grouped randomly into experimental (n = 35) and control (n = 34) groups. Patients in the experimental group were provided structured exercise intervention, while the control group was offered standard and routine care. Structured exercise in this present study comprised moderate-intensity walking and resistance exercises using TheraBand every day for three to five times a week. CRF was assessed using symbolic assessment of fatigue extent and the functional capacity was assessed by 6-minute walk test (6MWT), maximal oxygen uptake (VO 2max), and hand dynamometer. QoL was assessed using the European Organization for Research and Treatment for Cancer-QoL (EORTC QLQ-C30) and the Head and Neck Cancer module (HN35), while distress was assessed by the National Comprehensive Cancer Network (NCCN) Distress Thermometer. Randomized patients were assessed at four points. Result The size effects in fatigue extent (η p2 = 0.40) and fatigue impact (η p2 = 0.41) were found to be moderate, and a positive correlation between 6MWT, fatigue extent, and fatigue impact was observed. Conclusion This study suggests that exercise intervention has a significant positive impact on CRF, most aspects of QoL, and the functional capacity of the patients. [ABSTRACT FROM AUTHOR]

Abstract Background While observational studies and experimental data suggest a link between oral lichen planus (OLP) and oral cavity cancer (OCC), the causal relationship and the role of inflammatory cytokines remain unclear. Methods This study employed a univariable and multivariable Mendelian Randomization (MR) analysis to investigate the causal relationship between OLP and the risk of OCC. Additionally, the potential role of inflammatory cytokines in modulating this association was explored. Instrumental variables were derived from genetic variants associated with OLP (n = 377,277) identified in Finngen R9 datasets, with 41 inflammatory cytokines as potential mediators, and OCC (n = 4,151) as the outcome variable. Analytical methods including Inverse Variance Weighted (IVW), Weighted Median, MR-Egger, and MR-PRESSO were utilized to assess the causal links among OLP, inflammatory cytokines, and OCC risk. Multivariable MR (MVMR) was then applied to quantify the mediating effects of these cytokines in the relationship between OLP and increased OCC risk. Results MR analysis provided strong evidence of a causal relationship between OLP (OR = 1.417, 95% CI = 1.167–1.721, p

Background: Epidemiological studies have provided evidence suggesting an association between Alzheimer’s disease (AD) and various oral manifestations. However, conflicting conclusions have been drawn, and whether a causal association truly exists remains unclear. Methods: In order to investigate the potential causal association between AD and prevalent oral diseases, we conducted a bi-directional two-sample Mendelian randomization analysis based on summary statistics from genome-wide association studies of AD (N = 63,926), as well as mouth ulcer (N = 461,103), oral cavity cancer (N = 4,151), and periodontal disease (N = 527,652). Results: We identified that one standard increase in the risk of AD was causally associated with a reduced risk of oral cavity cancer (OR = 0.76, 95% CI: 0.63–0.92, p = 3.73 × 10−3). In the opposite direction, oral conditions were not causally associated with risk of AD. Conclusion: The present findings contributed to a better understanding of the correlation between AD and oral conditions, specifically oral cavity cancer. These results also identified new avenues for exploring the underlying mechanisms of oral cavity cancer. [ABSTRACT FROM AUTHOR]

Adequate surgical margins are essential in oral cancer treatment, this is, however, difficult to appreciate during training. With advances in training aids, we propose a silicone-based surgical simulator to improve training proficiency for the ablation of oral cavity cancers. A silicone-based tongue cancer model constructed via a 3D mold was compared to a porcine tongue model used as a training model. Participants of varying surgical experience were then asked to resect the tumors with clear margins, and thereafter asked to fill out a questionnaire to evaluate the face and content validity of the models as a training tool. Eleven participants from the Otolaryngology-Head and Neck Surgery unit were included in this pilot study. In comparison to the porcine model, the silicone model attained a higher face (4 vs. 3.6) and content validity (4.4 vs. 4.1). Tumor consistency was far superior in the silicone model compared to the porcine model (4.1 vs. 2.8, p = 0.0042). Fellows and staff demonstrated a better margin clearance compared to residents (median 3.5 mm vs. 1.0 mm), and unlike the resident group, there was no incidence of positive margins. The surgical simulation was overall useful for trainees to appreciate the nature of margin clearance in oral cavity cancer ablation. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether age at first sexual intercourse could lead to any changes in the risk of oral cavity cancer. Methods: A two-sample mendelian randomization was conducted using genetic variants associated with age at first sexual intercourse in UK biobank as instrumental variables. Summary data of Northern American from a previous genome-wide association study aimed at oral cavity cancer was served as outcome. Three analytical methods: inverse variance-weighted, mendelian randomization Egger, and weighted median were used to perform the analysis, among which inverse variance-weighted was set as the primary method. Robustness of the results was assessed through Cochran Q test, mendelian randomization Egger intercept tests, MR PRESSO, leave one out analysis and funnel plot. Results: The primary analysis provided substantial evidence of a positive causal relationship age at first sexual intercourse and the risk of oral cavity cancer (p = 0.0002), while a delayed age at first sexual intercourse would lead to a decreased risk of suffering oral cavity cancer (β = -1.013). The secondary outcomes confirmed the results (all β < 0) and all assessments supported the robustness, too (all p > 0.05). Conclusion: The study demonstrates that a delayed sexual debut would provide protection against OCC, thus education on delaying sexual intercourse should be recommended. [ABSTRACT FROM AUTHOR]

Objective: Current guidelines indicate postoperative radiotherapy (PORT) in oral squamous cell carcinoma (OSCC) with perineural invasion (PNI), however, its real benefit has never been proven. The aim of our study is to investigate the benefit of PORT in OSCC patients with PNI in terms of survival and disease control. Data Sources: The Pubmed/MEDLINE, Cochrane Library, and Scopus databases. Review Methods: Patients with PNI + OSCC treated with primary surgery were extracted from the included studies. The pooled logHR was calculated by comparing patients who underwent PORT to those who underwent only observation for overall survival (OS), disease‐specific survival (DSS), disease‐free survival (DFS), and locoregional control (LRC). Results: About 690 patients with primary OSCC and PNI were included from nine studies. 374 (54.2%) patients underwent PORT, while 316 (45.8%) underwent observation. Analyses showed non‐significant difference between the two groups for OS (HR: 1.01; 95% CI: 0.38–2.69), DSS (HR: 2.03; 95% CI: 0.54–7.56), and LRC (HR: 0.89; 95% CI: 0.53–1.50). They showed a significant difference in terms of DFS (HR: 0.86; 95% CI: 0.77–0.97). Conclusion: The real benefit of PORT in OSCC patients with PNI is still unclear, although it may have a positive impact on DFS. Clinicians should consider individual patient's characteristics, tumor factors, and treatment goals when deciding whether to recommend PORT. Further studies are needed to clarify which entity of PNI really benefits from PORT. Level of Evidence: NA Laryngoscope, 134:2019–2027, 2024 [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess recurrence patterns and identify the optimal dose and target volumes of postoperative radiotherapy (PORT) in patients with oral cavity squamous cell carcinoma (OSCC). Methods: Data of 111 patients who received PORT for OSCC between January 2010 and April 2020 were retrospectively reviewed. The median age was 68 years (range 19–88). PORT was administered as initial treatment to 63 patients and as salvage treatment for recurrent tumors to 48 patients. The median prescribed dose was 60 Gy (range 50–66) administered in 30 fractions (range 25–33). Results: Median follow-up time was 73 months (range 24–147). Overall survival (OS), progression-free survival (PFS), local control (LC), and locoregional control (LRC) at 3 years were 55.6%, 45.6%, 74.6%, and 63.1%, respectively. There were no significant differences in OS, PFS, LC, and LRC between the initially diagnosed and postoperative recurrent cases. Of 22 patients (20%) who developed regional nodal recurrences, 17 (15%) and 11 (10%) had in-field and out-of-field recurrences, respectively. Of 105 patients who received irradiation to the primary tumor bed, 24 (23%) developed recurrence at the primary site. The PFS and LC rates were significantly worse in patients receiving ≤ 56 Gy to the primary site than those receiving > 56 Gy (p = 0.016 and p = 0.032, respectively). Conclusion: PORT was effective for postoperative recurrences as well as for initially diagnosed oral cavity cancer. Doses greater than 56 Gy to the primary site may be required in PORT for OSCC. [ABSTRACT FROM AUTHOR]

Background: Traditionally, patients undergoing free flap reconstruction for oral cavity defects have been given nothing by mouth for 6–14 days post‐operatively due to concern for orocutaneous fistula development. Methods: Multiple databases were screened for studies assessing the rate of orocutaneous fistula formation in early (≤5 days) versus late (>5 days) feeding groups following oral cavity free flap reconstruction. Fixed‐ and random‐effects meta‐analyses were used. Results: One randomized controlled trial, one prospective cohort, and three retrospective cohort studies were included. The early feeding group displayed no significant increase in orocutaneous fistula formation (RD = −0.02, p = 0.06) or free flap failure (RD = −0.01, p = 0.39), with a significantly shorter hospital length of stay (mean difference [days] = −2.43, p < 0.01). Conclusions: While further prospective trials are necessary, initiation of oral intake before post‐operative day 5 may be appropriate in properly selected patients following oral reconstruction. [ABSTRACT FROM AUTHOR]

Background and purpose: The volume treated with postoperative radiation therapy (PORT) in patients with oral cavity squamous cell carcinoma (OCSCC) is a mediator of toxicity affecting quality of life. Current guidelines only allow for very limited reduction of PORT volumes. This study investigated the safety and efficacy of de-intensified PORT for patients with OCSCC by refined compartmentalization of the treatment volume. Materials and methods: This retrospective cohort study identified 103 OCSCC patients treated surgically from 2014 to 2019 with a loco-regional risk profile qualifying for PORT according to guidelines. PORT was administered only to the at-risk compartment and according to a refined compartmentalization concept (CC). Oncological outcome of this CC cohort was compared to a historical cohort (HC) of 98 patients treated before the CC was implemented. Results: Median follow-up time was 4.5 and 4.8 years in the CC and HC cohorts, respectively. In the CC cohort, a total of 72 of 103 patients (70%) had a pathological risk profile that allowed for further compartmentalization and, hence, received a reduced treatment volume or omission of PORT altogether. Loco-regional control at 3 and 5 years was 77% and 73% in the CC cohort versus 78% and 73% in the HC (p = 0.93), progression-free survival was 72% and 64% versus75% and 68% (p = 0.58), respectively. Similarly, no statistically significant difference was seen in other outcome measures. Conclusions: De-intensified PORT limiting the treatment volume to the at-risk compartment or avoiding PORT altogether for low-risk patients with OCSCC does not seem to compromise disease control in this retrospective comparison. Based on these hypothesis-generating findings, a prospective study is being planned. [ABSTRACT FROM AUTHOR]

Background: While observational studies and experimental data suggest a link between oral lichen planus (OLP) and oral cavity cancer (OCC), the causal relationship and the role of inflammatory cytokines remain unclear. Methods: This study employed a univariable and multivariable Mendelian Randomization (MR) analysis to investigate the causal relationship between OLP and the risk of OCC. Additionally, the potential role of inflammatory cytokines in modulating this association was explored. Instrumental variables were derived from genetic variants associated with OLP (n = 377,277) identified in Finngen R9 datasets, with 41 inflammatory cytokines as potential mediators, and OCC (n = 4,151) as the outcome variable. Analytical methods including Inverse Variance Weighted (IVW), Weighted Median, MR-Egger, and MR-PRESSO were utilized to assess the causal links among OLP, inflammatory cytokines, and OCC risk. Multivariable MR (MVMR) was then applied to quantify the mediating effects of these cytokines in the relationship between OLP and increased OCC risk. Results: MR analysis provided strong evidence of a causal relationship between OLP (OR = 1.417, 95% CI = 1.167–1.721, p < 0.001) and the risk of OCC. Furthermore, two inflammatory cytokines significantly influenced by OLP, IL-13 (OR = 1.088, 95% CI: 1.007–1.175, P = 0.032) and IL-9 (OR = 1.085, 95% CI: 1.005–1.171, P = 0.037), were identified. Subsequent analysis revealed a significant causal association only between IL-13 (OR = 1.408, 95% CI: 1.147–1.727, P = 0.001) and higher OCC risk, establishing it as a potential mediator. Further, MVMR analysis indicated that IL-13 (OR = 1.437, 95% CI = 1.139–1.815, P = 0.002) mediated the relationship between OLP and OCC, accounting for 8.13% of the mediation. Conclusion: This study not only elucidates the potential causal relationship between OLP and the risk of OCC but also highlights the pivotal mediating role of IL-13 in this association. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion This study provides an epidemiological description of cancer in the lip, oral cavity, and oropharynx in the South and South‐East Asia region.The number of new cases and deaths was extracted from the GLOBOCAN 2020 and the CI5 series. We present age‐standardized incidence and mortality rates per 100,000 inhabitants. To assess temporal trends, we estimated the annual percent change.The incidence rates (ASR) for lip and oral cavity cancer in South and South‐East Asia were highest in Taiwan (30.2), Sri Lanka (16.5), India (14.8), and Pakistan (13.2) among males. For oropharyngeal cancer, the highest rates were found in Taiwan (4.7), Bangladesh, Sri Lanka, and India (4.3, 2.9, and 2.6, respectively). Incidence rates were consistently higher in males compared to females. Overall, trends in lip and oral cavity cancer incidence were either stable or decreasing in most of the populations evaluated. In India, an increase in rates among males contrasted with a decline among females over the study period.Incidence and mortality rates of oral cavity cancer in South and South‐East Asia are among the highest globally. Our results suggest an optimistic trend of reduction in oral cavity rates in the region, despite an increase in rates among Indian males. [ABSTRACT FROM AUTHOR]

Backgrounds: We aimed to clarify the outcomes of postoperative radiotherapy (PORT) after salvage neck dissection for cervical lymph node (LN) recurrence in oral cavity cancer. Methods: We retrospectively evaluated overall survival (OS), recurrence‐free survival (RFS), recurrence patterns, and adverse events of 51 patients with high‐risk features receiving PORT after salvage neck dissection between 2009 and 2019. Results: After a median follow‐up of 7.4 years from PORT initiation, the 7‐year OS and RFS rates were 66.3% (95% CI: 54.0–81.3) and 54.6% (95% CI: 42.1–70.9), respectively. Age <70 years and isolated LN recurrence were significantly associated with longer OS and RFS. Among the 22 patients who experienced recurrence, 14 experienced recurrence within the radiation field. PORT‐related grade 3 acute mucositis (35%) and late adverse events (osteoradionecrosis [4%] and laryngeal stenosis [2%]) were observed. Conclusions: PORT after salvage neck dissection for cervical LN recurrence achieved good survival with acceptable toxicity. [ABSTRACT FROM AUTHOR]

Pain has a certain number of physical, psychological and social consequences. Pain is of particular importance in the postoperative period for patients with tumors of the oral cavity and of the oropharynx. The effectiveness of analgesia in the postoperative period is a serious problem in maxillofacial surgery. Postoperative pain is not always removable, sometimes it becomes chronic. Pronounced pain syndrome in the postoperative period is experienced by 40 to 75% of patients, but 50% of patients experience pain of medium and high intensity. The aim of this study was a comparative assessment of the effectiveness of a new alternative method of a long-term postoperative regional analgesia and the use of non-narcotic analgesics in patients with tumors of the oral cavity and oropharynx in the postoperative period. The study was conducted in 48 patients (38 men, 10 women, average age 58,05±12,31 years) with tumors of the oral cavity and oropharynx. Patients were divided into two groups depending on the method of postoperative analgesia. In the main group (22 patients) pain was suppressed by a long-term postoperative regional analgesia. In the control group (26 patients) analgesia was performed with non-narcotic analgesics. To control the effectiveness of analgesia, a visual analog scale was used, the duration of analgesia and the manifestation of dysphagia on the day 1, 3 and 10 after surgical intervention as well as similar effects were assessed. On the day 10 of using a long-term postoperative regional analgesia, a positive trend towards a reduction in pain syndrome was observed (2.0±0.63), in contrast to drugs of general action (p

AbstractHigher tobacco and alcohol use have led to a consistent increase in head and neck cancer incidence rates. Currently employed chemotherapeutic and surgical treatment are associated with significant drawbacks. Herein, we evaluated the anti-tumour effect of gold nanoparticles as a vehicle for the delivery of a triple chemotherapy drug formulation and elucidated the potential underlying mechanism. The hydrodynamic size of docetaxel, cisplatin, and 5-fluorouracil physically co-adsorbed on Au nanoparticles was 56 ± 0.8 nm, showing a negative zeta potential. Fourier transform infra-red spectroscopy data confirmed that the triple chemotherapy drug successfully interacted with the gold nano-carrier. Au nanoparticles exhibited high loading efficacy of docetaxel (61%), cisplatin (75%), and 5-fluorouracil (90%), with a controlled drug release profile at 24 h. The triple chemotherapy drug formulation was tested in human oral cavity cancer cell line (KB). Cytotoxicity achieved through a synergistic effect between the treatments led to apoptosis, with a lower half-maximal inhibitory concentration indicating higher cytotoxicity than that of plain docetaxel-cisplatin-fluorouracil. Taken together, we demonstrated that the docetaxel-cisplatin-fluorouracil-gold complex exhibited excellent cytotoxicity in KB cells, superior to that docetaxel-cisplatin-fluorouracil.HIGHLIGHTSThe docetaxel-cisplatin-fluorouracil-Au complex showed a controlled drug-release profile at 24 h.The docetaxel-cisplatin-fluorouracil-Au complex exhibited enhanced internalisation efficiency in cells.Au nanoparticles were biocompatible, with no change in apoptosis among cell line.Spherical Au nanoparticles allowed a high volume of incorporated docetaxel, cisplatin, and 5-fluorouracil to steadily attach onto cells.

(1) Background: Oral cavity cancer represents the most common site of origin of head and neck mucosal malignancies. A few limited studies have suggested that chronic irritation, particularly in non-healing ulcers, and fibrotic tissue from poor dentition or ill-fitting dentures had a role in developing mouth cancer. This scoping review aims to evaluate the existing evidence concerning Oral Cavicty Cancer (OCC) in non-smokers/non-drinkers and the relationship with dental trauma. (2) Methods: A scoping review of the PubMed, Embase, and Web of Science databases was completed in adherence with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. (3) Results: Of the 33 articles that met inclusion, in 6 of them authors discussed the role of topography in dental trauma, in 11 articles authors discussed the carcinogenesis mechanism involved in chronic mucosal trauma, in 17 articles data on ill-fitting dentures was included, 4 studies dealt with the effect of broken/sharp teeth on mucosal damage, and in 7 studies the role of oral hygiene was covered. Less frequently discussed topics included gender, risk of neck nodes, and the role of potentially malignant oral disorders. (4) Conclusions: The available literature suggests a potential connection between chronic dental trauma and the development of OCC. Studies have highlighted factors such as denture use and ill-fitting dental appliances as contributors to an increased risk of oral cancer. Interestingly, we still miss data to support the hypothesis that women, particularly those without toxic habits like smoking or alcohol consumption, appear to be disproportionately affected by oral cancer related to chronic dental trauma.

Background: This study aimed to explore the prognostic utility of the preoperative platelet‐to‐albumin ratio (PAR) among patients with oral cavity squamous cell carcinoma (OSCC). Methods: We retrospectively reviewed of 355 patients with surgically‐treated OSCC between 2008 and 2017. The optimal PAR cutoff for patient stratification was determined through X‐tile analysis. Prognostic variables for disease‐free survival (DFS) and overall survival (OS) were identified using Cox proportional hazards models. We developed a PAR‐based nomogram to predict personalized OS. Results: We determined the optimal PAR cutoff to be 7.45. A PAR of ≥7.45 was an independent negative prognostic factor for DFS and OS (hazard ratio = 1.748 and 2.386; p = 0.005 and p < 0.001, respectively). The developed nomogram demonstrates the practical utility of PAR and accurately predicts personalized OS. Conclusions: The preoperative PAR is a promising and cost‐effective prognostic biomarker for patients with surgically‐treated OSCC; the PAR‐based nanogram accurately predicts OS for such patients. [ABSTRACT FROM AUTHOR]

Background: Treatment for resectable oral cavity cancer (OCC) often includes combinations of surgery and radiotherapy (RT), but there is no conclusive information on the preferred treatment order. The aim of this study was to assess the costs and cost-effectiveness of two alternative treatment regimens for patients with OCC, reflecting pre- and post-operative RT, from a societal perspective. Methods: The study used data from the ARTSCAN 2 randomised controlled trial, which compares pre-operative accelerated RT with post-operative conventionally fractionated RT. Two-hundred-forty patients were included in the analysis of treatment outcomes. Direct costs were retrieved from the hospital's economic systems, while indirect costs were obtained from national registries. Cost-effectiveness was assessed and a sensitivity analysis was performed. Overall survival (OS) at 5 years, was used as effect measure in the analysis. Results: Two-hundred-nine patients completed the treatments and had retrievable data on costs. Mean direct costs (inpatient and outpatient care) were € 47,377 for pre-operative RT and € 39,841 for post-operative RT (p = 0.001), while corresponding indirect costs were € 19,854 and € 20,531 (p = 0.89). The incremental cost, i.e., the mean difference in total cost between the treatment regimens, was € 6859 paralleled with a 14-percentage point lower OS-rate at 5 years for pre-operative RT (i.e., 58 vs. 72%). Thus, pre-operative RT was dominated by post-operative RT. Conclusions: From a societal perspective, post-operative RT for patients with resectable OCC is the dominant strategy compared to pre-operative RT. [ABSTRACT FROM AUTHOR]

Objective: To determine the overall surgical outcomes of infranotch T4b oral cancers and compare them with T4a oral cancers. Methods: PubMed, EMBASE and Cochrane databases from 2000 to 2022 were systematically searched. Clinical studies reporting at least one outcome following curative surgery and adjuvant therapy for comparison of patients with either infranotch T4b (IN–T4b) or T4a tumour. The heterogeneity of the included studies was determined using Tau-squared, Chi-squared, and the Higgins I2 test. The random effects model was used to determine the log odds ratio (logOR). Results: The systematic review comprised 11,790 patients from 16 included studies. Seven studies were included in the meta-analysis (n = 11,381). For IN–T4b patients, the pooled 2 and 5 year overall survival (OS) were 59.3% and 53.2%, 2 and 5 year disease-free survival (DFS) 57.9% and 48.4%, 2 and 5 year disease-specific survival (DSS) 72% and 68%, and 2 and 5 year local control (LC), 47% and 56%, respectively. There was no statistically significant difference in 2 year OS [logOR = 0.28 (−0.47, 1.03), p = 0.46, confidence interval (CI) = 95%], 5 year OS [logOR = 0.7 (−0.4, 1.8), p = 0.54, CI = 95%], 2 year DFS [logOR = 0.22 (−0.35, 0.79), p = 0.45, CI = 95%], 5 year DFS [logOR = 0.17 (−0.42, 0.77), p = 0.57, CI = 95%], 2 year LC [logOR = 0.47 (−0.33, 1.26), p = 0.25, CI = 95%] and 5 year LC [logOR = 0.34 (−0.31, 0.99), p = 0.31, CI = 95%] between IN–T4b and T4a oral cancers. Conclusion: Results of this meta-analysis suggest that IN–T4b oral cancers have similar outcomes to T4a oral cancers, which supports down-staging IN–T4b cancers to T4a cancers. [ABSTRACT FROM AUTHOR]

Background and purposeThe volume treated with postoperative radiation therapy (PORT) in patients with oral cavity squamous cell carcinoma (OCSCC) is a mediator of toxicity affecting quality of life. Current guidelines only allow for very limited reduction of PORT volumes. This study investigated the safety and efficacy of de-intensified PORT for patients with OCSCC by refined compartmentalization of the treatment volume.Materials and methodsThis retrospective cohort study identified 103 OCSCC patients treated surgically from 2014 to 2019 with a loco-regional risk profile qualifying for PORT according to guidelines. PORT was administered only to the at-risk compartment and according to a refined compartmentalization concept (CC). Oncological outcome of this CC cohort was compared to a historical cohort (HC) of 98 patients treated before the CC was implemented.ResultsMedian follow-up time was 4.5 and 4.8 years in the CC and HC cohorts, respectively. In the CC cohort, a total of 72 of 103 patients (70%) had a pathological risk profile that allowed for further compartmentalization and, hence, received a reduced treatment volume or omission of PORT altogether. Loco-regional control at 3 and 5 years was 77% and 73% in the CC cohort versus 78% and 73% in the HC (p = 0.93), progression-free survival was 72% and 64% versus75% and 68% (p = 0.58), respectively. Similarly, no statistically significant difference was seen in other outcome measures.ConclusionsDe-intensified PORT limiting the treatment volume to the at-risk compartment or avoiding PORT altogether for low-risk patients with OCSCC does not seem to compromise disease control in this retrospective comparison. Based on these hypothesis-generating findings, a prospective study is being planned.

Abstract Objective To determine the overall surgical outcomes of infranotch T4b oral cancers and compare them with T4a oral cancers. Methods PubMed, EMBASE and Cochrane databases from 2000 to 2022 were systematically searched. Clinical studies reporting at least one outcome following curative surgery and adjuvant therapy for comparison of patients with either infranotch T4b (IN–T4b) or T4a tumour. The heterogeneity of the included studies was determined using Tau-squared, Chi-squared, and the Higgins I 2 test. The random effects model was used to determine the log odds ratio (logOR). Results The systematic review comprised 11,790 patients from 16 included studies. Seven studies were included in the meta-analysis (n = 11,381). For IN–T4b patients, the pooled 2 and 5 year overall survival (OS) were 59.3% and 53.2%, 2 and 5 year disease-free survival (DFS) 57.9% and 48.4%, 2 and 5 year disease-specific survival (DSS) 72% and 68%, and 2 and 5 year local control (LC), 47% and 56%, respectively. There was no statistically significant difference in 2 year OS [logOR = 0.28 (−0.47, 1.03), p = 0.46, confidence interval (CI) = 95%], 5 year OS [logOR = 0.7 (−0.4, 1.8), p = 0.54, CI = 95%], 2 year DFS [logOR = 0.22 (−0.35, 0.79), p = 0.45, CI = 95%], 5 year DFS [logOR = 0.17 (−0.42, 0.77), p = 0.57, CI = 95%], 2 year LC [logOR = 0.47 (−0.33, 1.26), p = 0.25, CI = 95%] and 5 year LC [logOR = 0.34 (−0.31, 0.99), p = 0.31, CI = 95%] between IN–T4b and T4a oral cancers. Conclusion Results of this meta-analysis suggest that IN–T4b oral cancers have similar outcomes to T4a oral cancers, which supports down-staging IN–T4b cancers to T4a cancers.

Abstract Background The risk of extracolonic cancer is increased in inflammatory bowel disease (IBD) patients, but it is not clear whether there is a causal relationship. We aimed to systematically estimate the causal relationship between IBD and extracolonic cancers. Methods Independent genetic variants strongly associated with IBD were extracted as instrumental variables from genome-wide association study (GWAS) conducted by the International IBD Genetics Consortium including 12,882 IBD patients, 5956 Crohn’s disease (CD) patients, and 6968 ulcerative colitis (UC) patients. Three sources of cancer GWAS were selected as outcome data. Two-sample Mendelian randomization (MR) analysis was conducted to assess the causal effects of IBD on 32 extracolonic cancers. The meta-analysis was applied to assess the combined causal effect with multiple MR results. Results IBD, CD, and UC have potential causal associations with oral cavity cancer (IBD: OR = 1.180, 95% CI: 1.059 to 1.316, P = 0.003; CD: OR = 1.112, 95% CI: 1.008 to 1.227, P = 0.034; UC: OR = 1.158, 95% CI: 1.041 to 1.288, P = 0.007). Meta-analysis showed a significant positive causal relationship between IBD and breast cancer (OR = 1.059; 95% CI: 1.033 to 1.086; P

The Neck Imaging Reporting and Data System (NI-RADS) is a valuable tool for post-operative imaging evaluation in head and neck cancer patients. Yet, its specific utility in oral cavity cancer, especially in early post-operative contrast-enhanced computed tomography (C.E. CT), remains underexplored, despite potential therapeutic implications. This retrospective study aims to assess frequency of observations at both Primary and Regional levels, evaluate inter-reviewer concordance, and explore whether NI-RADS scores in early post-operative C.E. CT scans correlate with patient survival outcomes. This study involved a cohort of consecutive patients who had undergone surgical treatment for oral cavity squamous cell carcinoma (OSCC). Early post-operative contrast-enhanced computed tomography (CE-CT) scans, conducted within less than 90 days from surgery, were included for analysis. Two experienced radiologists (RC and MP) independently reviewed the CE-CT scans and assigned NI-RADS scores to different findings. NI-RADS scores ranged from 1 (indicating no suspicion of recurrence) to 3 (indicating a high suspicion of recurrence). The Kaplan-Meier survival analysis was employed to evaluate the correlation between NI-RADS scores and patient overall survival. In this study, 42 CE-CT scans were reviewed. One patient couldn't be evaluated for the primary tumor due to metal artifacts. NI-RADS scores at the primary site were: RC - 25 cases (NI-RADS 1), 9 cases (NI-RADS 2a), 5 cases (NI-RADS 2b), and 2 cases (NI-RADS 3); MP - 24 cases (NI-RADS 1), 7 cases (NI-RADS 2a), 5 cases (NI-RADS 2b), and 2 cases (NI-RADS 3).At the regional level: RC - 37 cases (NI-RADS 1), 2 cases (NI-RADS 2), 3 cases (NI-RADS 3); MP - 38 cases (NI-RADS 1), 1 case (NI-RADS 2), 3 cases (NI-RADS 3). The Cohen's kappa statistic indicated substantial inter-reviewer agreement for the primary tumor (kappa = 0.91, 95%CI 0.79-1.00) and regional lymph nodes (kappa = 0.92, 95%CI 0.77-1.00), confirming reliable NI-RADS score assignment. Patients with a NI-RADS score of 3 at the primary tumor level had a shorter median OS of 7 months compared to those with NI-RADS scores of 1, 2a, and 2b, who had a median OS of 68 months. This difference was statistically significant with a p-value of 0.006. The study demonstrates that NI-RADS scores in early post-operative contrast-enhanced computed tomography (CE-CT) scans can provide valuable insights into patient outcomes. Further research and validation of NI-RADS in OSCC management are warranted to solidify its clinical relevance. Additionally, exploring the utility of NI-RADS in larger patient populations can provide more robust evidence for its integration into clinical practice. [ABSTRACT FROM AUTHOR]

Background: The risk of extracolonic cancer is increased in inflammatory bowel disease (IBD) patients, but it is not clear whether there is a causal relationship. We aimed to systematically estimate the causal relationship between IBD and extracolonic cancers. Methods: Independent genetic variants strongly associated with IBD were extracted as instrumental variables from genome-wide association study (GWAS) conducted by the International IBD Genetics Consortium including 12,882 IBD patients, 5956 Crohn's disease (CD) patients, and 6968 ulcerative colitis (UC) patients. Three sources of cancer GWAS were selected as outcome data. Two-sample Mendelian randomization (MR) analysis was conducted to assess the causal effects of IBD on 32 extracolonic cancers. The meta-analysis was applied to assess the combined causal effect with multiple MR results. Results: IBD, CD, and UC have potential causal associations with oral cavity cancer (IBD: OR = 1.180, 95% CI: 1.059 to 1.316, P = 0.003; CD: OR = 1.112, 95% CI: 1.008 to 1.227, P = 0.034; UC: OR = 1.158, 95% CI: 1.041 to 1.288, P = 0.007). Meta-analysis showed a significant positive causal relationship between IBD and breast cancer (OR = 1.059; 95% CI: 1.033 to 1.086; P < 0.0001) as well as a potential causal relationship between CD and breast cancer (OR = 1.029; 95% CI: 1.002 to 1.055; P = 0.032) based on combining multiple MR results. Conclusions: This comprehensive MR analysis suggested that genetically predicted IBD, as well as its subtypes, may be a risk factor in the development of oral cavity and breast cancer. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer-related fatigue (CRF) is a common side-effect of cancer and its treatments, but few studies have investigated CRF in head and neck cancer. Using data from 2847 patients included in the Head and Neck 5000 prospective clinical cohort, we investigated CRF over 12 months from cancer diagnosis. At baseline, shortly after diagnosis, 27.8% of patients had CRF. This rose to 44.7% at 4 months and fell to 29.6% at 12 months. In adjusted models, the likelihood of having CRF over 12 months was significantly higher in patients who were female, current smokers, and had comorbid conditions or depression at baseline. It was also higher in patients with stage 3 or 4 disease and who had multimodal treatment. The high prevalence of CRF indicates that there is a need for additional interventions and supports for affected HNC patients; these could be targeted towards patients in the higher risk groups. Cancer-related fatigue (CRF) is a common side-effect of cancer and its treatments. For head and neck cancer (HNC), CRF may exacerbate the symptom burden and poor quality-of-life. Using data from the Head and Neck 5000 prospective clinical cohort, we investigated clinically important CRF over a year post-diagnosis, assessing temporal trends, CRF by HNC site and treatment received, and subgroups at higher risk of CRF. Recruitment was undertaken in 2011–2014. Socio-demographic and clinical data, and patient-reported CRF (EORTC QLQ-C30 fatigue subscale score ≥39 of a possible 100) were collected at baseline (pre-treatment) and 4- and 12- months post-baseline. Mixed-effects logistic multivariable regression was used to investigate time trends, compare cancer sites and treatment groups, and identify associations between clinical, socio-demographic and lifestyle variables and CRF. At baseline, 27.8% of 2847 patients scored in the range for clinically important CRF. This was 44.7% at 4 months and 29.6% at 12 months. In the multivariable model, after adjusting for time-point, the odds of having CRF over 12 months were significantly increased in females and current smokers; those with stage 3/4 disease, comorbidities and multimodal treatment; and those who had depression at baseline. The high prevalence of clinically important CRF indicates the need for additional interventions and supports for affected HNC patients. These findings also identified patient subgroups towards whom such interventions could be targeted. [ABSTRACT FROM AUTHOR]

Pain has a certain number of physical, psychological and social consequences. Pain is of particular importance in the postoperative period for patients with tumors of the oral cavity and of the oropharynx. The effectiveness of analgesia in the postoperative period is a serious problem in maxillofacial surgery. Postoperative pain is not always removable, sometimes it becomes chronic. Pronounced pain syndrome in the postoperative period is experienced by 40 to 75% of patients, but 50% of patients experience pain of medium and high intensity. The aim of this study was a comparative assessment of the effectiveness of a new alternative method of a longterm postoperative regional analgesia and the use of non-narcotic analgesics in patients with tumors of the oral cavity and oropharynx in the postoperative period. The study was conducted in 48 patients (38 men, 10 women, average age 58,05±12,31 years) with tumors of the oral cavity and oropharynx. Patients were divided into two groups depending on the method of postoperative analgesia. In the main group (22 patients) pain was suppressed by a long-term postoperative regional analgesia. In the control group (26 patients) analgesia was performed with non-narcotic analgesics. To control the effectiveness of analgesia, a visual analog scale was used, the duration of analgesia and the manifestation of dysphagia on the day 1, 3 and 10 after surgical intervention as well as similar effects were assessed. On the day 10 of using a long-term postoperative regional analgesia, a positive trend towards a reduction in pain syndrome was observed (2.0±0.63), in contrast to drugs of general action (p<0.05). Over the course of a long-term postoperative regional analgesia it was noted that analgesic effect increases from blockade to blockade. In 80% of patients of the main group, stage II-IVa the act of swallowing was nearly restored, only in 2 patients 2 degree of dysphagia was observed (p<0.05). The advantage of the proposed method in the adequacy and duration of analgesia was established (p<0.05), as well as a lower frequency of side effects – 9.1% and 23.3%, and restoration of act of swallowing (p<0.05). The technique of longterm postoperative regional analgesia allows reducing the invasiveness of the manipulation. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to identify factors predicting outcomes following pectoralis major myocutaneous flap reconstruction in complex oromandibular defects. Methods: A prospective cohort study was conducted at a tertiary care oncology center in South Asia from January 2020 to May 2022 to include consecutive cases of complex oromandibular defects reconstructed with pectoralis major myocutaneous flap. During pectoralis major myocutaneous flap harvest surgical modifications were incorporated to preserve the choke vessel from the fourth intercostal perforator and lateral pedicle supply apart from the main pedicle from acromiothoracic artery. Results: In our series of 196 patients, overall flap compromise was noted in 17.6% with the most common pattern of failure being partial fullthickness necrosis (n = 23) and complete flap loss was identified in only 3 cases. The factors that showed statistically significant correlation with flap outcome in the univariate model were female sex (42.9% vs. 14.9%) associated with a higher incidence of flap compromise, while bipaddle pectoralis major myocutaneous flap (2.2% vs. 17.3%) and larger surface area of skin paddle (>49 cm²) (20.2%, 16%, and 0% in <49 cm², 50-96 cm², and >96 cm², respectively) were factors favoring a better outcome. Factors that emerged as independent prognostic variables in the multivariate model were female sex (odds ratio: 9.801, P = .001) and high body mass index (odds ratio: 1.19, P = .03) signifying a higher incidence of flap compromise. Conclusion: Pectoralis major myocutaneous flap is still the "workhorse" of head and neck reconstruction. Nevertheless, the female sex and high body mass index may serve as deterrents to the success of this flap. [ABSTRACT FROM AUTHOR]

Background: We aimed to define the indications for sentinel lymph node biopsy (SLNB), the third option for cervical treatment in oral cancer with negative cervical lymph nodes. Methods: The greatest depth of invasion (DOI) and long diameter (LD) of the primary site were used as exposures. SLN metastasis was considered the outcome. Results: In three trials conducted between 2009 and 2016, 158 patients were eligible and reassigned to this study group. The scatterplot based on the respective values of DOI and LD would eventually be divided into three sections. In cases of sections T1, T2, and T3, the proportions of SLN metastasis positivity were 21.3%, 35.3%, and 51.2%, respectively. In certain cases of T1 with 2 mm < DOI ≤ 5 mm and 8 mm < LD ≤ 20 mm, the proportion of SLN metastasis positivity was 40.9%. Conclusions: SLNB‐navigated or assisted neck dissection can be added as an effective procedure for N0 neck control. [ABSTRACT FROM AUTHOR]

Simple Summary: Oral squamous cell carcinomas (OSCCs) pose significant therapeutic challenges. Despite the advancement of treatment methods, they are still characterised by a poor prognosis. The isotopic abundance of oral cancers reflects their biology. A better understanding of OSCC biology may improve treatment outcomes. In this study, the isotopic compositions of the nitrogen and carbon of OSCC tissue samples were investigated across different oral cancer localisations. The correlations between the isotopic composition and clinical and histological advancement were established. The results suggest that assessment of the isotopic composition might serve as a valuable tool for determining tumour biology and behaviour. The aim of this paper was to characterise the isotopic composition of oral squamous cell carcinoma (OSCC) specimens of different areas of the oral cavity. Secondly, we assessed whether there was a correlation between clinical stages of OSCC and isotopic abundance. The IRMS procedure was performed on 124 samples derived from 31 patients with OSCC of 15 N and 13 C to assess the isotopic composition. From each individual, four samples from the tumour, two from the margins, and two samples of healthy oral mucous membranes were derived. The two samples from the tumour and two samples from the margin were additionally subjected to histopathological assessment. Then, statistical analysis was conducted. Tumour infiltration tissues of the lower lip were characterised by higher mean δ13C values compared to samples derived from cancers of the other oral cavity regions (−23.82 ± 1.21 vs. −22.67 ± 1.35); (p = 0.04). The mean percentage of nitrogen content in tumour tissues was statistically higher in patients with the most advanced cancers (11.89 ± 0.03%) versus the group of patients with II and III stage cancers (11.12 ± 0.02%); (p = 0.04). In patients at stage IV, the mean δ13C value in the cancer samples equalled −22.69 ± 1.42 and was lower than that in patients at less severe clinical stages (p = 0.04). Lower lip cancer tissues differed in the isotopic abundance of carbon in comparison with tissues derived from the group of combined samples from other locations. Values of δ13C observed in specimens derived from lower lip cancers were similar to those observed in healthy oral mucous membranes. Cancer tissues obtained from patients in the last stage of OSCC had a different isotopic composition in comparison with those obtained from earlier stages. To confirm these observations, further research on larger groups of patients is needed. [ABSTRACT FROM AUTHOR]

Introduction: Oral cancer is one of the most common cancers in Northern India. Carcinogenic substances found in cigarette or tobacco can cause inflammation of the lining of oral cavity and pathogenesis of oral cavity cancer. Tumor necrosis factor is a pro‐inflammatory cytokine involved in the immunoinflammatory diseases. The aim of this research was to determine the impact of smoking and tobacco chewing and polymorphism in TNFα −238 G/A and TNFα −308 G/A, on the risk to precancerous oral lesions and oral cavity cancer. Methods: Genotyping was done by polymerase chain reaction and restriction fragment length polymorphism method in 75 patients with oral cavity cancer, 75 patients confirmed with precancerous lesions, and 100 controls. Results: TNFα −238 G/A SNP was not associated with the risk of oral precancerous lesions or oral cavity cancer. TNFα −308 G/A was strongly associated with precancerous lesions and oral cancer. No correlation was found between smoking or tobacco chewing habits and TNFα −238 and TNFα −308 G/A polymorphism with oral precancerous lesions and oral cavity cancer. Conclusion: The study shows no significant interaction between smoking or tobacco chewing habits and polymorphism in TNFα −238 and TNFα −308 G to A with precancerous lesions and oral cancer although TNFα −308 G/A was strongly associated with precancerous lesions and oral cancer. [ABSTRACT FROM AUTHOR]

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Abstract Introduction Opportunistic oral cancer screening during visits to the dentist is a non-invasive and accessible option for detection of pre-malignant lesions and early-stage malignancies. The objective of this study was to investigate the knowledge, practices, and attitudes towards oral cancer screening among dentists. Methods A 42-item survey was sent to 650 dental professionals affiliated with the University of Toronto. Data regarding training/practice characteristics, knowledge of oral cavity cancer, current screening practices, attitudes towards screening, and remuneration were collected. Results Ninety-one dentists responded. Most obtained their dental degree from Canada (71.4%) and were practicing in large urban centers (87.9%). Most dentists correctly identified the oral tongue (87.8%) and floor of mouth (80%) as the two of most common sites of oral cavity cancer but only 56% correctly identified the most common presentation. 91% performed intra/extra oral examinations at every patient visit. Only 9.9% of dentists discussed the risk factors of oral cancer and 33% were not familiar with resources for smoking cessation and alcohol abuse. International medical graduates were more likely to discuss risk factor management than Canadian medical graduates (p

ObjectiveTo summarize the latest evidence on head and neck cancer epidemiology from the International Head and Neck Cancer Epidemiology (INHANCE) consortium.Subjects and methodsINHANCE was established in 2004 to elucidate the etiology of head and neck cancer through pooled analyses of individual-level data on a large scale. We summarize results from recent INHANCE-based publications updating our 2015 overview.ResultsSeventeen papers were published between 2015 and May 2020. These studies further define the nature of risks associated with tobacco and alcohol, and occupational exposures on head and neck cancer. The beneficial effects on incidence of head and neck cancer were identified for good oral health, endogenous and exogenous hormonal factors, and selected aspects of diet related to fruit and vegetables. INHANCE has begun to develop risk prediction models and to pool follow-up data on their studies, finding that ~30% of cases had cancer recurrence and 9% second primary cancers, with overall- and disease-specific 5-year-survival of 51% and 57%, respectively.ConclusionsThe number and importance of INHANCE scientific findings provides further evidence of the advantages of large-scale internationally collaborative projects and will support the development of prevention strategies.

Background: The global incidence of lip and oral cavity cancers (OCCs) and oropharyngeal cancers (OPCs) is steadily increasing. While tobacco and alcohol consumption are established risk factors, a considerable proportion of these cancers has become attributed to human papilloma virus (HPV) infection. We aimed to describe the occurrence and identify potential risk factors of OCCs and OPCs across the Russian Federation during 2007-2018. Methods: We conducted an ecological analysis using publicly accessible data from the P.A. Herzen Moscow Oncology Research Institute. Incidence and mortality rates by jurisdiction were mapped for geospatial analysis. We predefined 11 potential contributing risk factors and used univariable and multivariable Poisson regression model with backwards stepwise variable selection to identify associated factors with OCC and OPC. Results: A total of 190,585 individuals were diagnosed with OCCs and OPCs in Russia between 2007-2018. Non-uniform geographic distribution of cancer cases was noted where the Far Eastern Federal District had the highest rate of OCC and the Central Federal District of OPCs. Districts with high weekly alcohol consumption had significantly higher incidence and mortality rates in both sexes. Districts with high rates of daily smoking had higher incidence of OCC among females, and those with low smoking trends had lower mortality rates for OCCs and OPCs. Conclusion: We detail the burden of OCCs and OPCs across Russia, with the aim of elucidating modifiable risk factors and proposing evidence-based prevention strategies. Tobacco/alcohol sales control measures and smoking/drinking cessation programs should continue to be prioritized as public health measures, especially for females. [ABSTRACT FROM AUTHOR]

to compare the rate of occult contralateral neck metastases (OCNM) in oral and oropharyngeal squamous cell carcinomas (SCC) reaching or crossing the midline and to identify risk factors for OCNM. we conducted a single-center retrospective study of oral and oropharyngeal SCC with contralateral cN0 neck. The cohort was divided into a midline-reaching (MR; approaching the midline from up to 10 mm) group and a midline-crossing (MC; exceeding the midline by up to 10 mm) group. Clinical N-status was assessed by a radiologist specializing in head and neck imaging. All patients underwent contralateral elective neck dissection (END). A total of 98 patients were included in this study, 59 in the MR group and 39 in the MC group. OCNM were present in 17.3% of patients, 20.3% in the MR group and 12.8% in the MC group (p = 0.336). In multivariable analysis, MR/MC status as well as distance from the midline (in mm) were not identified as risk factors for OCNM. Conversely, oropharyngeal primary and clinical N-status above N1 were significantly associated with a higher risk of OCNM, with odds ratios (OR) of 3.98 (95% CI = 1.08–14.60; p = 0.037) and 3.41 (95% CI = 1.07–10.85; p = 0.038) respectively. in patients with oral and oropharyngeal SCC extending close to or beyond the midline, tumor origin and clinical N-status should carry the most weight when dictating the indications for contralateral END, rather than the midline involvement in itself. [ABSTRACT FROM AUTHOR]

Oral cavity cancer (OCC) is one of the most common cancers, in which more than 500,000 new cases and 350,000 related deaths occur every year worldwide. It is necessary to develop technologies that are objective, cutting-edge, and enable early, precise diagnosis. A patient's chances of surviving OCC are greatly increased when it is predicted in its early stages. In this work, a novel deep learning-based modified convolutional neural network (MCNN) for accurately detect and classify the normal, and abnormal cases of oral cavity. Initially, the images are gathered from Sheffield & Piracicaba datasets and these images are pre-processed using contrast limited adaptive histogram equalization which is used to reduce the noise from the input images. The proposed MCNN is improved version of convolutional neural network, in which the parameters of CNN are optimized with Stochastic gradient optimization algorithm to classify into normal and abnormal. The proposed MCNN is trained simultaneously using the initial dataset and the supplemented dataset. To train the MCNN, the source image size of the MCNN was used instead of resizing the complete images to fit the input file size of each pre-trained network. The effectiveness of the proposed MCNN is examined using several parameters like accuracy, precision, recall, specificity and F1 score. The experimental fallouts illustrate that the proposed MCNN achieves the overall accuracy of 97.96%, which is comparatively high than the state-of-the art techniques in OCC detection. [ABSTRACT FROM AUTHOR]

Purpose: Few studies have been conducted on the association between oral cavity cancer and metabolic diseases. This study aimed to investigate the relationship between oral cavity cancer and metabolic diseases. Methods: This cohort study used the database of the Korean National Health Insurance Service, which contains medical data of 97% of the Korean population. Oral cavity cancer occurred in a total of 2718 patients. Metabolic syndrome was defined according to IDF criteria. The Cox proportional hazard regression model was used. Results: The HR for oral cavity cancer in patients with metabolic syndrome was 1.113(95% CI 1.006–1.232), which was significantly higher than that in normal patients, especially in males (p = 0.0386). When the number of metabolic syndrome factors was ≥ 3, the HR of oral cavity cancer was 1.191(95% CI 1.026–1.383), which was significantly higher than that of 0 metabolic syndrome factors, especially in males (p = 0.0218). When the number of metabolic syndrome factors was ≥ 3, the HR for oral cavity cancer was 1.439(95% CI 1.066–1.942), which was significantly higher than that of 0 metabolic syndrome factors, especially in males aged < 50 years (p = 0.0173). Conclusion: Metabolic syndrome increases the risk of oral cavity cancer only in males. In addition, the incidence of oral cavity cancer increased as the number of factors constituting metabolic syndrome increased, only in young males aged < 50 years. Thus, metabolic syndrome is an important risk factor for oral cavity cancer, particularly in young males. [ABSTRACT FROM AUTHOR]

We investigated the prognostic utility of preoperative neck lymph node-to-primary tumor maximum standardized uptake value ratios (NTRs) in oral cavity squamous cell carcinoma (OSCC). We retrospectively reviewed the medical records of 141 consecutive patients who were diagnosed as having OSCC and had received fluorodeoxyglucose–positron emission tomography within 2 weeks prior to radical surgery between 2009 and 2018. To determine the optimal NTR cutoff, receiver operating characteristic analysis for overall survival (OS) was executed. The NTR's prognostic value for disease-free survival (DFS) and OS were determined through Cox proportional hazards analysis and the Kaplan–Meier method. We determined the median (range) follow-up duration to be 35.2 (2.1–122.4) months. The optimal NTR cutoff was 0.273, and patients with a higher NTR (≥0.273) exhibited significantly worse DFS and OS (p = 0.010 and 0.003, respectively). A higher NTR (≥0.273) predicted poorer DFS (hazard ratio: 2.696, p = 0.008) and OS (hazard ratio: 4.865, p = 0.003) in multivariable analysis. We created a nomogram on the basis of the NTR, and it could accurately predict OS (concordance index: 0.774). Preoperative NTRs may be a useful prognostic biomarker for DFS and OS in patients with OSCC who have undergone surgery. NTR-based nomograms may also be helpful prognostic tools in clinical trials. [ABSTRACT FROM AUTHOR]

(1) Background: The assessment of resection margins during surgery of oral cavity squamous cell cancer (OCSCC) dramatically impacts the prognosis of the patient as well as the need for adjuvant treatment in the future. Currently there is an unmet need to improve OCSCC surgical margins which appear to be involved in around 45% cases. Intraoperative imaging techniques, magnetic resonance imaging (MRI) and intraoral ultrasound (ioUS), have emerged as promising tools in guiding surgical resection, although the number of studies available on this subject is still low. The aim of this diagnostic test accuracy (DTA) review is to investigate the accuracy of intraoperative imaging in the assessment of OCSCC margins. (2) Methods: By using the Cochrane-supported platform Review Manager version 5.4, a systematic search was performed on the online databases MEDLINE-EMBASE-CENTRAL using the keywords "oral cavity cancer, squamous cell carcinoma, tongue cancer, surgical margins, magnetic resonance imaging, intraoperative, intra-oral ultrasound". (3) Results: Ten papers were identified for full-text analysis. The negative predictive value (cutoff < 5 mm) for ioUS ranged from 0.55 to 0.91, that of MRI ranged from 0.5 to 0.91; accuracy analysis performed on four selected studies showed a sensitivity ranging from 0.07 to 0.75 and specificity ranging from 0.81 to 1. Image guidance allowed for a mean improvement in free margin resection of 35%. (4) Conclusions: IoUS shows comparable accuracy to that of ex vivo MRI for the assessment of close and involved surgical margins, and should be preferred as the more affordable and reproducible technique. Both techniques showed higher diagnostic yield if applied to early OCSCC (T1–T2 stages), and when histology is favorable. [ABSTRACT FROM AUTHOR]