Oral Cavity Carcinoma Patients Research Articles

Oral HPV16 Prevalence in Oral Potentially Malignant Disorders and Oral Cavity Cancers.

The role of human papillomavirus type 16 (HPV16) in oral potentially malignant disorders (OPMD) and oral cavity carcinoma (OC) is still under debate. We investigated HPV16 prevalence in unstimulated saliva, oral rinse samples, oral swabs and tumour biopsies collected from OPMD (n = 83) and OC (n = 106) patients. HPV16 genotype, viral load, physical status (episomal vs. integrated) and tumour p16INK4a expression were determined. Oral HPV16 prevalence was higher in OC than in OPMD, but this difference was not statistically significant (7.5% (8/106) versus 3.6% (3/83), odds ratio (OR): 2.18, 95% confidence interval (CI): 0.56, 8.48, p = 0.26). There was a significant association (p < 0.05) between oral HPV16 infection and heavy tobacco consumption. Real-time PCR results indicated that no integration events occurred in either OPMD or OC cases based on the HPV16 E2/E6 ratio. HPV16 positive OPMD and OC patients had similar HPV16 E2 and E6 viral loads. The inter-rater agreement between tumour p16INK4a expression and oral HPV16 infection was considered as fair (k = 0.361) for OC. Our data suggest that the involvement of HPV16 in oral carcinogenesis is limited.

Nanotechnology in Oral Cavity Carcinoma: Recent Trends and Treatment Opportunities.

Oral cavity carcinoma (OCC) remains an ongoing public health problem. Emerging nanotechnology provides alternative treatment approaches. This review covers the up-to-date literature in the human OCC treatment field. We explored the growing body of evidence to reveal novel and highly promising diagnostic and therapeutic applications of nanotechnology in this field. Various types of nanoparticles have been tested for applications in OCC. Imaging modalities in addition to nanocarriers are discussed. The encouraging contribution of lymphotropic nanoparticles contrast in the diagnosis of metastatic cervical lymph nodes needs to be confirmed. The development of the sentinel lymph node procedure and photodynamic therapy may lead to breakthrough therapies in order improve clinical outcomes and quality of life. In this perspective, cancer nanotechnology has the potential to revolutionize the treatment of OCC patients.

Determination of Factors Associated with Critical Weight Loss in Oral Cavity Carcinoma Patients: A Retrospective Cohort Study

Introduction Critical weight loss is defined as an unintentional weight loss of ≥ 5% at 1 month or ≥ 10% at 6 months from the start of treatment. Critical weight loss leads to deterioration of the immune function and reduced tolerance to treatment (surgery ± radiochemotherapy) as well as increased complication rates. Objective Critical weight loss, defined as a weight loss of ≥ 5% after 1 month or ≥ 10% after 6 months from the start of treatment, is not uncommon in head and neck cancer patients. We aimed to assess the factors associated with critical weight loss during the treatment of oral cavity squamous cell carcinoma patients. Methods A retrospective cohort study was performed at the Aga Khan University Hospital, in Karachi, Pakistan, on 125 patients. Patients receiving adjuvant therapy were considered exposed, and the outcome was critical weight loss. Results The mean age of presentation was 46.9 ± 12.8 years in patients undergoing surgery and adjuvant therapy, with 119 (79.3%) of them being male and 31 (20.7%) female. One hundred and twelve patients (81.3%) developed critical weight loss at 6 months from the start of treatment, and the only significant variable associated with critical weight loss was the stage of the disease ( p = 0.03). Conclusion A large proportion of patients with oral cancer developed critical weight loss requiring a need for intervention. The overall stage of the disease is a significant predictor of critical weight loss in patients undergoing treatment.

Depth of Invasion Alone is Not an Independent Prognostic Factor in Early-Stage Node-Negative Oral Cavity Carcinoma

The use of depth of invasion (DOI) as a prognostic factor and criterion for neck dissection (ND) in patients with oral cavity carcinoma (OCC) has been the topic of multiple clinical analyses. However, these studies are heterogeneous, frequently including patients of any stage and with multiple other histologic risk factors for recurrence. In addition, patients often received adjuvant treatment in the form of chemotherapy and/or radiation. Thus, it is difficult to draw conclusions on the importance of DOI as a true prognostic factor. We created a unique population of patients with DOI as the sole risk factor for recurrence to accurately evaluate whether it is an independent prognostic factor for progression in patients with early-stage node-negative OCC. All patients were drawn from an institutional review-board approved database of OCC patients treated at a single academic institution between 2003 and 2013. A total of 560 patients were retrospectively reviewed. Patients were included in the final analysis if they had pathologic T1-2N0 OCC treated with surgical resection with or without neck dissection (ND). Pathology specimens were independently reviewed by 2 board-certified pathologists to confirm proper evaluation of DOI and other histologic parameters. Patients were excluded if they received adjuvant treatment, chemotherapy for other cancer diagnoses in the follow up period, or if other high-risk pathologic features were present, including: perineural invasion, lymphovascular invasion, positive lymph nodes, and close or positive margins. Kaplan-Meier and Cox proportional hazards regression analyses were performed to identify factors predictive for local (LR) and regional recurrence (RR), as well as progression free survival (PFS). A total of 126 patients with T1-2 N0 OCC were analyzed. Median follow up for the entire cohort was 42.5 months and median overall survival (OS) was 46 months. Median DOI for all sites was 4 mm, with 60 (47.6%) patients with DOI <4 mm and 66 (52.4%) patients with DOI ≥4 mm. There was no significant difference in local (p=0.95), regional (p=0.81), or distant (p=0.96) recurrence between patients with DOI <4 mm and ≥4 mm. In total, 50 (42.9%) patients underwent ND. There was no significant difference in LR among patients with DOI <4 mm and ≥4 mm (p=0.95). In patients with DOI <4 mm, 5-year RR was 0% if ND was performed and 22% if ND was omitted. In the subset of patients with oral tongue carcinoma and DOI <4mm (n=36), there were no regional or distant recurrences in those patients who underwent ND compared to 20% and 4% in patients who did not undergo ND. On multivariate analysis including T stage, gender, age, DOI, and multiple head and neck primaries, the only factor significant for PFS was ND (HR 0.25, p=0.006). In this study, we show that DOI ≥4 mm alone does not predict for worse local, regional, or distant recurrence. ND appeared to improve the RR for even those with DOI <4mm.

Cell division cycle associated 1 as a novel prognostic biomarker and therapeutic target for oral cancer.

Oral cavity carcinoma (OCC) is one of the most common causes of cancer-related death worldwide and has poor clinical outcome after standard therapies. Therefore, new prognostic biomarkers and therapeutic targets for OCC are urgently needed. We selected cell division cycle associated 1 (CDCA1) as a candidate OCC biomarker. Immunohistochemical analysis confirmed that CDCA1 protein was expressed in 67 of 99 OCC tissues (67.7%), but not in healthy oral epithelia. CDCA1 expression was significantly associated with poor prognosis in OCC patients (P=0.0244). Knockdown of CDCA1 by siRNAs significantly increased apoptosis of tumor cells. These data suggest that CDCA1 represents a novel prognostic biomarker and therapeutic target for OCC.

Eating habits in oral cavity carcinoma patients: dietary consideration for the reduction of secondary primary cancer risk

Eating habits in oral cavity carcinoma patients: dietary consideration for the reduction of secondary primary cancer risk