Diagnosis Of Oral Cavity Cancer Research Articles

Socioeconomic Status, Length of Stay, and Postoperative Complications in Oral Cavity Squamous Cell Carcinoma.

Background: Despite universal healthcare in Canada, low socioeconomic status (SES) has been associated with worse survival in oral cavity squamous cell carcinoma (OCSCC) patients. However, the relationship between SES and outcomes during the acute postoperative period is poorly defined. Hamilton, Ontario, presents a unique population with widely varying SES within the same geography. The objective of this study was to examine the relationship between SES, length of hospital stay (LOHS), and postoperative complications in OCSCC. Methods: Newly diagnosed OCSCC patients receiving primary surgical treatment from 2010 to 2014 were identified within a prospectively collected database. Inclusion criteria included age >18 years old, pathological diagnosis of oral cavity cancer, and primary surgical treatment with curative intent. Patients were excluded if they were undergoing palliative treatment or had previous head and neck surgery/radiotherapy. Postal codes were used to identify neighborhood-level socioeconomic variables via 2011 Canada Census data. Income quartiles were defined from groups of neighboring municipalities based on Canada Census definitions. Demographic, social, pathological, staging, and treatment data were collected through chart review. Results: One hundred and seventy-four patients were included in the final analysis. OCSCC patients with lower SES were more likely to be younger (P = .041), male (P = .040), have significant tobacco and alcohol use (P = .001), higher Charlson Comorbidity Index (CCI; P = .014), lower levels of education (P = .001), and have lower employment levels (P = .001). Lower SES patients had higher clinical tumor (P = .006) and clinical nodal (P = .004) staging and were more likely to receive adjuvant therapy (P = .001) and G-tubes (P = .001). Multivariable regression analysis showed that low SES was a statistically significant predictor of postoperative complications [β 2.50 (95% confidence interval (CI) 0.200, 3.17); P = .014] and LOHS [β 2.03 (95% CI 1.06, 2.99); P = .0001]. Tobacco and alcohol use, clinical tumor, and nodal stage, CCI, and planned adjuvant therapy were also statistically significant predictors of postoperative complications and LOHS (P < .05). Conclusion: Patients with lower SES have more advanced OCSCC disease with increased comorbidities that owes itself to more acute postoperative complications and LOHS within this study population. Patients with low SES should be identified as patients that require more support during their cancer treatment.

Oral cavity cancer in patients from the department of head and neck surgery – chair and otorhinolaryngology service of the Hospital de Clínicas – National University of Asunción

Introduction: The oral cavity is continuously exposed to inhaled and ingested carcinogens (mainly tobacco and alcohol), and therefore it is the most common site for the origin of neoplasms in the head and neck region. Methods: A descriptive, retrospective, observational study of non-probabilistic sampling of consecutive cases was carried out. Adult patients with a clinical and pathological diagnosis of oral cavity cancer were included. Results: A series of 17 cases of oral squamous cell carcinoma was included, 13 men (76%) and 4 women (24%). The age of the individuals ranged between 32 and 73 years. 65% of the patients were smokers, and 71% reported consumption of alcoholic beverages. The tongue was the most frequent tumor location, 71% were in stage IV, and with a moderate degree of histological differentiation. Conclusion: Most of the patients in this study were males between 50 and 70 years of age. A high percentage of patients reported smoking, and an even higher percentage of alcohol consumption. The most frequently affected subsite is the tongue, in advanced stages and a moderate degree of differentiation.

Review of the Literature on Oral Cancer: Epidemiology, Management and Evidence-based Traditional Medicine Treatment

Oral cavity cancers are part of the upper aerodigestive tract cancers and represent a significant burden worldwide. Its epidemiology varies from country to country with high frequencies in South East Asian countries. Tobacco and alcohol are the main risk factors. Survival of oral cancer is low i.e., less than 40% in the advanced stage (stage III and IV), diagnosis of oral cavity cancer is based on a complete clinical examination of the oral cavity complete with biopsy, bio-markers are an adjunct to screening and diagnosis of oral cavity cancers, surgery, radiotherapy, chemotherapy and immunotherapy are part of the therapeutic armamentarium of oral cancer but also have limitations. Traditional medicine is an important and proven alternative in the treatment and support of patients with oral cavity cancer. Prevention of oral cavity cancers includes not only early detection of precancerous and cancerous lesions but also control of risk factors and education of the population. Surgery, radiotherapy, chemotherapy and immunotherapy are part of the therapeutic strategy of oral cancer treatment but also have limitations. Traditional Medicine is an important and proven alternative in the treatment and support of patients with oral cavity cancer. It is thus desirable to scientifically validate phytochemicals in order to integrate alternative medicine as part of national cancer management strategy. In silico advanced studies on secondary metabolites of medicinal plants traditionally used to treat oral cancer are in progress.

Association of Changes in Medicaid Dental Benefits With Localized Diagnosis of Oral Cavity Cancer

This cohort study uses data from the Surveillance, Epidemiology, and End Results database to examine the association between changes in Medicaid dental insurance coverage in California between 2009 and 2014 and rates of localized oral cavity cancer diagnoses.

Epidemiology and clinical findings of oral squamous cell carcinoma

Background. Oral cancer is one of ten most common causes of death, because of late diagnosis due to its similarity of clinical presentation with some of the benign lesions.The aim of this research is to determine five years’ prevalence of oral squamous cell carcinoma of the patients. Methods. A descriptive cross-sectional study was done.We used SPSS software to analyze data Result. In this study, 101 patients were included, the most patients were in the seventh decade, with chief complaint was oral ulcer (61%), also only 6% of patients had a history of malignancy in their family, 22% had poor oral health status. males had a higher incidence rate than females. Conclusion. Surprisingly tobacco use was markedly low in comparison to other studies. Practical Implications. Early diagnosis of oral cavity cancers leads to proper treatment and increases survival rate of patientr.

Could Bacterial Dysbiosis in the Oral Microbiota be Useful for the Diagnosis of Oral Cavity Cancer?

Could Bacterial Dysbiosis in the Oral Microbiota be Useful for the Diagnosis of Oral Cavity Cancer?

Automated Detection of Oral Pre-Cancerous Tongue Lesions Using Deep Learning for Early Diagnosis of Oral Cavity Cancer

Abstract Discovering oral cavity cancer (OCC) at an early stage is an effective way to increase patient survival rate. However, current initial screening process is done manually and is expensive for the average individual, especially in developing countries worldwide. This problem is further compounded due to the lack of specialists in such areas. Automating the initial screening process using artificial intelligence (AI) to detect pre-cancerous lesions can prove to be an effective and inexpensive technique that would allow patients to be triaged accordingly to receive appropriate clinical management. In this study, we have applied and evaluated the efficacy of six deep convolutional neural network (DCNN) models using transfer learning, for identifying pre-cancerous tongue lesions directly using a small dataset of clinically annotated photographic images to diagnose early signs of OCC. DCNN models were able to differentiate between benign and pre-cancerous tongue lesions and were also able to distinguish between five types of tongue lesions, i.e. hairy tongue, fissured tongue, geographic tongue, strawberry tongue and oral hairy leukoplakia with high classification performances. Preliminary results using an (AI + Physician) ensemble model demonstrate that an automated pre-screening process of oral tongue lesions using DCNNs can achieve ‘near-human’ level classification performance for diagnosing early signs of OCC in patients.

Prognostic Significance of Inflammatory Markers in Patients with Oral Cavity Tumors

Introduction: In the present study, we aimed to evaluate the relationship between neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic immune inflammation index (SII) values and overall survival (OS) and disease-free survival (DFS) in patients undergoing radiotherapy with a diagnosis of oral cavity cancer (OCC).Methods: 58 patients were included who were treated with a diagnosis of OCC who applied to Cumhuriyet University Faculty of Medicine Radiation Oncology Clinic between January 2009 and December 2018. Kaplan-Meier analysis was used to determine OS and DFS. Multivariate Cox regression analysis was also performed to detect independent prognostic factors.Results: All patients had a squamous cell carcinoma (SCC) of the oral cavity composed of 50 tongue SCC and 8 buccal SCC. Cut-off values in ROC analysis: 954 [Area=0.665 (0.511-0.800), p=0.06] for SII, 174 [Area=0.659 (0.608-0.795), p<.001] for PLR and 3.2 [Area=0.699 (0.556-0.841), p=0.016] for NLR. Prognostic factors affecting OS were SII, PLR, NLR and age. SII, NLR, PLR and grade were statistically significant prognostic factors for DFS. However, SII was an independent prognostic factor.Conclusion: In this study, high SII value was found to be an indicator of shorter OS and DFS in patients with OCC.

Finding an oral potentially malignant disorder in screening program is related to early diagnosis of oral cavity cancer – Experience from real world evidence

ObjectivesOur study evaluates the effectiveness of the Taiwan Oral Mucosal Screening (TOMS) program in stage-shift among oral cavity cancer patients, and identifies the related factors with early cancer diagnosis. Materials and methodsThis retrospective cohort study used the Taiwan Cancer Registry (TCR), TOMS and Taiwan Death Registry (TDR) databases. We identified oral cavity cancer patients (ICD-C-O: C00-C06) from the TCR during 2012–2015. Patients’ screening history, first screening status and subsequent screenings were analyzed with cancer stages and survival outcomes. ResultsThe 5-year survival rates for stages 0–4 were 83.9%, 82.1%, 72.7%, 60.1% and 38.0%. Among 18,625 patients identified from the TCR, 37% did not have any prior screenings. Patients with prior positive or negative screenings all had better survival rates (3-year: 71.4% and 68.7% vs. 63.5%, Log-rank p-value < 0.0001). The best chance for early-stage diagnosis occurs in oral potentially malignant disorder (OPMD, OR = 1.99, 95% CI = 1.78–2.22, p < 0.0001) patients at their first screenings. The hazard ratios (HR) for patients with prior screenings indicated a significant survival benefit. The group of incomplete diagnosis confirmation also has better survival (HR = 0.78, 95% CI = 0.81–0.93, p < 0.0001), and a greater chance of early diagnosis at subsequent screenings. ConclusionWhile TOMS improved stage-shift for early cancer diagnosis, we found no obvious differences in participants with cancers at screening (stages 0–1: 26.3% vs. 27.8% in non-screening group). Survival benefit and early diagnosis are found in most of screening groups, and identifying an OPMD is particularly essential to early diagnosis of oral cavity cancer patients.

Predictors of quality of life in head and neck cancer survivors up to 5years after end of treatment: a cross-sectional survey.

This study aimed to assess quality of life (QoL) in head and neck cancer (HNC) survivors and determine factors predictive of poor QoL in the first 5years after the end of treatment. A cross-sectional survey, including the Quality of Life in Adult Cancer Survivors (QLACS) measure, was sent to HNC survivors in three Scottish health regions, with responses linked to routinely collected clinical data. Independent sample t tests, ANOVAs, Pearson correlations and multiple hierarchical regressions were used to explore associations between and to determine the contribution made by demographic, lifestyle and clinical factors to predicting 'generic' and 'cancer-specific' quality of life. Two hundred eighty patients (65%) returned questionnaires. After adjustment, multivariate analysis showed that younger age, lower socio-economic status, unemployment and self-reported comorbidity independently contributed to poorer generic and cancer-specific quality of life. In addition to these factors, having had a feeding tube or a diagnosis of oral cavity cancer were independently predictive of poorer cancer-specific quality of life. Socio-economic factors and comorbidity are important predictors of QoL in HNC survivors. These factors and the detrimental long-term effects of feeding tubes need further attention in research and practice.

Validation of methylation markers for diagnosis of oral cavity cancer

PurposeActivation of proto-oncogenes and inactivation of tumour suppressor genes are the major genetic alterations involved in carcinogenesis. The increase in methylation at the promoter region of a tumour suppressor gene can lead to gene inactivation, selecting cells with proliferative advantage. Thus, promoter hypermethylation is considered a marker in a variety of malignant tumours, including oral cavity. Experimental designThe methylation pattern of eight genes was evaluated in 40 oral cavity squamous cell carcinomas (OSCCs) and 40 saliva samples from healthy individuals by Q-MSP. Different combinations of genes were also assessed in order to identify gene panels that could better distinguish between OSCC and saliva samples. ResultsCCNA1, DAPK, DCC and TIMP3 methylation were highly specific for being found in the OSCC samples. Moreover, the combination of these genes improved detection when compared with single markers, reaching values of 92.5% for sensitivity and specificity (when using the panel CCNA1, DCC, TIMP3). Moreover, DAPK, DCC and TIMP3 were hypermethylated in nearly 90% of clinically T1 and T2 cases. ConclusionThe pursuing of this panel of hypermethylated genes is an important tool for the detection of individuals with OSCC. Moreover, the identification of these markers in early stages of OSCC shows the feasibility of using the panel on saliva as possible biomarkers for early diagnosis. The lack of association between the methylation status of these genes and clinical characteristics shows that they are able to distinguish OSCC cases irrespective of social and clinical factors (gender, age, human papillomavirus (HPV) status, clinical stage, vascular embolisation and perineural invasion).

OP069: Changes quality of life in newly diagnosed oral cavity cancer patients – Overall trajectory, related factors and sub-patterns of QOL during the first 12-month of diagnosis

The diagnosis of oral cavity cancers and treatments/disease related distress from the oral–facial areas may influence patients’ quality of life (QOL). The purposes of this study were to (1) examine the changes of symptoms (physical distress), psychological distress (depression and anxiety) and QOL during the first 12 months of being diagnosed as oral cavity cancer, (2) identify factors related to overall QOL, and (3) identify QOL sub-patterns in newly diagnosed oral cavity cancer patients in Taiwan. A 12-month prospective longitudinal study was conducted to assess the changes of symptom, psychological distress and QOL. Subjects were recruited from three medical centers in Northern Taiwan and were assessed on 6 time points (days before operation, 1, 2, 3, 6 12 months post surgery/T1–T6, respectively). The psychometrically validated Chinese version instruments were used, including (1) Symptom Severity Scale (SSS), (2) Hospital Anxiety and Depression Scale (HADS), (3) University of Washington Quality of Life (UW-QOL), and (4) Background Information Form. In addition to the descriptive statistics, the Generalized Estimating Equations (GEE) was applied to identify the overall QOL related factors. The latent class growth modeling was used to identify the potential QOL sub-patterns. Data were collected after Institute Review Board (IRB) approval and patients’ consents. A total of 150 eligible subjects completed the 12 months assessments. Overall, patients reported moderate levels of QOL with the worst QOL during the first three months post-surgery (T2–T4). However, some delayed problems were also reported, including dry mouth, swallowing problem, chewing dysfunction and employment concern. Patients having reconstruction surgery, more advanced cancer stage, higher levels of depression and symptom severity, without job, and having lower education level were found to have lower levels of QOL across the time. QOL sub-patterns were also identified. Results of the study provide the evidence-based information to health care professionals to better help oral cavity cancer patients with timely interventions. Future studies should also test the effects of these interventions on improving patients’ QOL.

Survival of patients with oral cavity cancer in Germany.

The purpose of the present study was to describe the survival of patients diagnosed with oral cavity cancer in Germany. The analyses relied on data from eleven population-based cancer registries in Germany covering a population of 33 million inhabitants. Patients with a diagnosis of oral cavity cancer (ICD-10: C00-06) between 1997 and 2006 are included. Period analysis for 2002–2006 was applied to estimate five-year age-standardized relative survival, taking into account patients' sex as well as grade and tumor stage. Overall five-year relative survival for oral cavity cancer patients was 54.6%. According to tumor localization, five-year survival was 86.5% for lip cancer, 48.1% for tongue cancer and 51.7% for other regions of the oral cavity. Differences in survival were identified with respect to age, sex, tumor grade and stage. The present study is the first to provide a comprehensive overview on survival of oral cavity cancer patients in Germany.

Measurement of epithelial thickness within the oral cavity using optical coherence tomography (OCT)

Optical coherence tomography (OCT) is a promising method in the early diagnosis of oral cavity cancer. The objective of the present study is to determine normal values of epithelial thickness in the oral cavity, as no such data are to be found in the literature. In healthy test persons, epithelial thickness of the oral mucosa was determined with the help of OCT separately for each side at nine different locations. Special attention was directed to those sites having the highest incidence for the development of dysplasias and carcinomas. Depending on the location within the oral cavity, the epithelium demonstrated a varying thickness. The highest values were found in the region of the tongue and the cheek, whereas the floor of the mouth showed the thinnest epithelium. Our data serve as reference values for detecting oral malignancy and determining the approximate grade of dysplasia. In this circumstance, a differentiated view of the different regions is important due to the variation in thickness of the epithelium within the normal oral cavity.

Quantification of betel quid chewing and cigarette smoking in oral cancer patients

Betel quid chewing and cigarette smoking are two of the risk factors for some dental diseases as well as oral cavity cancer in Taiwan. The aim of the study was to quantify these factors in oral cavity cancer patients and compare the prevalence of these factors in patients and the general population. A questionnaire was designed to evaluate betel quid chewing, cigarette smoking and alcohol drinking in 254 patients, who had squamous cell carcinoma of the oral cavity, and had received surgical excision at the Changhua Christian Hospital in Taiwan between 2005 and 2008. The results were compared with those of population of Taiwan, based on a nation-wide survey with sample of 26 744 people. We found that more than 80% of the male patients were both betel quid chewers and smokers. Few women in the survey practiced betel quid chewing, cigarette smoking or alcohol drinking. Chewers and smokers usually started the habits in their 20s. On average, a chewer patient consumed 12 508 betel quid pieces per year, for 23.3 years before the diagnosis of oral cavity cancer, making the total amount of betel quid consumed nearly 310 000 pieces; and a smoker patient consumed 469 packs per year, for 28.5 years before diagnosis, making the total number of about 14 000 packs. Patients with both habits had the age at diagnosis 4 years earlier than the smoker-only patients, 5 years earlier than the chewer-only patients, and 6 years earlier than those with neither. On average, it took two decades of betel quid chewing and cigarette smoking before oral cavity cancer diagnosis, making the life-time consumption of these substances an astonishing amount. Betel quid chewing and cigarette smoking patients are more likely to be diagnosed with oral cavity cancer at a younger age than those who have just one habit or none. Patients that smoke more are not only more likely to be diagnosed at a younger age, but also at an advanced stage.

Is dental care utilization associated with oral cavity cancer in a large sample of community‐based United States residents?

Cancer of the oral cavity and pharynx remains one of the 10 leading causes of cancer deaths in US. Besides smoking and alcohol consumption, there are no well-established risk factors. While poor dental care had been implicated, it is unknown if lack of dental care, implying poor dental hygiene predisposes to oral cavity cancer. This study aimed to assess the relationship between dental care utilization during the past 12 months and the prevalence of oral cavity cancer. A cross-sectional design of the National Health Interview Survey of Adult, noninstitutionalized US residents (n=30 475) was used to assess the association between dental care utilization and self-reported diagnosis of oral cavity cancer. Chi-square statistic was used to examine the crude association between the explanatory variable, dental care utilization and other covariates, while unconditional logistic regression was used to assess the relationship between oral cavity cancer and dental care utilization. There were statistically significant differences between those who utilized dental care during the past 12 months and those who did not with respect to education, income, age, marital status, and gender (P<0.05), but not health insurance coverage (P=0.53). In addition, those who utilized dental care relative to those who did not were 65% less likely to present with oral cavity cancer, prevalence odds ratio (POR), 0.35, 95% confidence interval (CI), 0.12-0.98. Further, higher income, advanced age, people of African heritage, and unmarried status were statistically significantly associated with oral cavity cancer (P<0.05), but health insurance coverage, alcohol use, and smoking were not, P>0.05. After simultaneously controlling for the relevant covariates, the association between dental care and oral cavity cancer did persist but imprecise. Thus, when compared with those who did not use dental care, those who did were 62% less likely to be diagnosed with oral cavity cancer, adjusted POR, 0.38, 95% CI, and 0.13-1.10. Among US adults residing in community settings, use of dental care during the past 12 months was marginally statistically significantly associated with oral cavity cancer, but clinically relevant in assessing oral cavity cancer prevalence in this sample. However, because of the nature of our data, which restricts temporal sequence, a large sample prospective study that may identify modifiable factors associated with oral cavity cancer development, namely poor dental care is needed.