Abstract

Simple SummaryHead and neck squamous cell carcinoma (HNSCC) is a group of common and aggressive tumors. Recently, oral microbiota has been credited as an important player in carcinogenesis. However, the available knowledge is not always consistent and sometimes conflicting. Therefore, the present comprehensive systematic review of the current clinical reports was conducted to evaluate the role of oral microbiota in HNSCC. Importantly, this study addresses whether oral microbiota targeting could provide diagnostic, prognostic or therapeutic utility in cancer patients. We also discussed the current limitations of this newly emerging field and the potential related strategies for the management of patients with HNSCC and possibly other solid tumors.Head and neck squamous cell carcinoma (HNSCC) comprises the majority of tumors in head and neck tissues. The prognosis of HNSCC has not significantly improved for decades, signifying the need for new diagnostic and therapeutic targets. Recent evidence suggests that oral microbiota is associated with carcinogenesis. Thus, we conducted a comprehensive systematic review to evaluate the current evidence regarding the role of oral microbiota in HNSCC and whether their targeting may confer diagnostic, prognostic or therapeutic utility. Following the screening of 233 publications retrieved from multiple databases, 34 eligible studies comprising 2469 patients were compiled and critically appraised. Importantly, many oral pathogens, such as Porphyromonas gingivalis and Fusobacterium nucleatum were linked to certain oral potentially malignant lesions and various types of HNSCC. Furthermore, we summarized the association between the expression profiles of different oral bacterial species and their tumorigenic and prognostic effects in cancer patients. We also discussed the current limitations of this newly emerging area and the potential microbiota-related strategies for preventing and treating HNSCC. Whilst many clinical studies are underway to unravel the role of oral microbiota in cancer, the limited available data and experimental approaches reflect the newness of this promising yet challenging field.

Highlights

  • Head and neck squamous cell carcinoma (HNSCC) arises from the mucosal lining of the oral cavity, pharynx and larynx and it comprises the majority of tumors in the head and neck region [1,2]

  • Baseline Characteristics of the Studies The included 34 studies comprised a total of 4432 participants

  • In the present systematic review, we summarized and analyzed a total of 34 studies involving 4432 participants, of which 2294 were HNSCC patients

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Summary

Introduction

Head and neck squamous cell carcinoma (HNSCC) arises from the mucosal lining of the oral cavity, pharynx and larynx and it comprises the majority of tumors in the head and neck region [1,2]. HNSCCs are among the most prevalent cancers with an estimated incidence of 880,000 new cases and 440,000 deaths in 2020 alone [3]. In India, oral squamous cell carcinoma (OSCC) is causing most of the cancer-related deaths among men [3]. An increasing incidence of aggressive OSCC has been reported in young female patients with no history of exposure to such traditional risk factors [5].

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