Oral Cancer Survival Research Articles

Effect of Preoperative Serum Lactate Dehydrogenase-to-Albumin Ratio on the Survival of Oral Cancer: A Retrospective Study.

Several studies have investigated the relationship between serum lactate dehydrogenase-to-albumin ratio (LAR) and the prognosis of cancers. However, no studies have explored the association between serum LAR and the survival of oral cancer (OC). This study was aimed to determine the association of serum LAR with the overall survival (OS) of OC. One hundred and ninety patients with OC were included in this study between January 2018 and December 2019. Log rank test and Kaplan-Meier method were used to compare the survival rate of OC between the low LAR group and the high LAR group. The association between serum LAR and the survival of OC patients was determined via univariate and multivariate Cox regression analyses. Kaplan-Meier analysis and Log rank test indicated that the OS rate in low LAR group was significantly higher than that in high LAR group (P < 0.05). Univariate cox analysis showed that TNM III-IV stage, serum LDH > 162 U/L, and serum LAR > 3.79 were significantly associated with the OS of OC patients. Multivariate Cox analysis suggested that the TNM III-IV stage (HR, 2.317; 95% CI, 1.423-3.774, P = 0.001) and serum LAR > 3.79 (HR, 5.138; 95% CI, 2.245-11.756, P = 0.000) were independently related with poor OS of OC patients. High serum LAR (>3.79) is an independent predictor of adverse prognosis in OC patients. LAR could be used as a promising marker for predicting the OS of OC patients.

Basement membrane-associated gene expression as a predictor of survival in oral cancer

BackgroundThis study sought to investigate the prognostic value of basement membrane (BM)-associated gene expressions in oral cancer.MethodsWe harvested and integrated data on BM-associated genes (BMGs), the oral cancer transcriptome, and clinical information from public repositories. After identifying differentially expressed BMGs, we used Cox and Lasso regression analyses to create a BMG-based risk score for overall survival at various intervals. We then validated this score using the GSE42743 cohort as a validation set. The prognostic potential of the risk scores and their relations to clinical features were assessed. Further, we conducted functional pathway enrichment, immune cell infiltration, and immune checkpoint analyses to elucidate the immunological implications and therapeutic potential of the BMG-based risk score and constituent genes. To confirm the expression levels of the BMG LAMA3 in clinical samples of oral cancer tissue, we performed quantitative real-time PCR (qRT-PCR) and immunohistochemical staining.ResultsThe BMGs LAMA3, MMP14, and GPC2 demonstrated notable prognostic significance, facilitating the construction of a BMG-based risk score. A higher risk score derived from BMGs correlated with a poorer survival prognosis for oral cancer patients. Moreover, the risk-associated BMGs exhibited a significant relationship with immune function variability (P < 0.05), discrepancies in infiltrating immune cell fractions, and immune checkpoint expressions (P < 0.05). The upregulated expression levels of LAMA3 in oral cancer tissues were substantiated through qRT-PCR and immunohistochemical staining.ConclusionThe BMG-based risk score emerged as a reliable prognostic tool for oral cancer, meriting further research for validation and potential clinical application.

The Discovery of Oral Cancer Prognostic Factor Ranking Using Association Rule Mining.

A 5-year survival rate is a predictor for the assessment of oral cancer prognosis. The purpose of this study is to analyze oral cancer data to discover and rank the prognostic factors associated with oral cancer 5-year survival using the association rule mining (ARM) technique. This study is a retrospective analysis of 897 oral cancer patients from a regional cancer center between 2011 and 2017. The 5-year survival rate was assessed. The multivariable Cox proportional hazards analysis was performed to determine prognostic factors. ARM was applied to clinicopathologic and treatment modalities data to identify and rank the prognostic factors associated with oral cancer 5-year survival. The 5-year overall survival rate was 35.1%. Multivariable Cox proportional hazards analysis showed that tumor (T) stage, lymph node metastasis, surgical margin, extranodal extension, recurrence, and distant metastasis of tumor were significantly associated with overall survival rate (p < 0.05). The top associated death within 5 years rule was positive extranodal extension, followed by positive perineural and lymphovascular invasion, with confidence levels of 0.808, 0.808, and 0.804, respectively. This study has shown that extranodal extension, and perineural and lymphovascular invasion were the top ranking and major deadly prognostic factors affecting the 5-year survival of oral cancer.

641: Explainable AI to identify cut-off of muscle loss associated with survival in oral cavity cancer

641: Explainable AI to identify cut-off of muscle loss associated with survival in oral cavity cancer

Solanum trilobatum leaf extract-derived silver nanoparticles downregulate the PI3K/AKT/mTOR signaling pathway and attenuate oral squamous cell carcinoma cell proliferation

Introduction: Oral cancer’s aggressive nature poses a significant health risk, demanding timely diagnosis and effective treatment. Despite progress in conventional therapies like chemotherapy and surgery, their limitations drive the exploration of alternative strategies. This study assessed Solanum trilobatum-derived silver nanoparticles (AgNPs) in impacting cancer cell cycles, inducing apoptosis, and modulating key pathways, including the phosphoinositide 3-kinase (PI3K)/Protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway, leveraging phytotherapy and nanotechnology—a promising frontier in cancer treatment. Methods: AgNPs were synthesized through the reduction of ions and stabilized using aqueous leaf extracts of S. trilobatum. After the characterization of AgNPs, the mRNA Gene Expression and mitochondrial membrane potentials (MMPs) were assessed. DNA fragmentation was done and DNA pattern by gel documentation system was observed. The study also assessed the modulation of the PI3K/Akt/mTOR cascade, impacting tumor growth and proliferation. Results: Biosynthesized AgNPs were characterized using UV-visible spectrophotometry (UVvis), energy-dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), and Fourier-transform infrared (FTIR) spectroscopy. DNA fragmentation exhibited a typical ladder pattern. Dose-dependent changes in MMP were observed in the treated oral cancer cells. The effect of S. trilobatum-derived AgNPs in targeting the cell signaling pathway correlated significantly with their anticancer potency (P&lt;0.001). Conclusion: This study reveals S. trilobatum leaf extract-based AgNPs as a natural cytostatic agent against oral squamous carcinoma. Utilizing nature’s resources and nanoscale science, they hold promise for enhancing oral cancer treatment outcomes and survival rates.

Are oral cancers effectively palliated with radiotherapy? Outcomes of treatment with a modified QUAD SHOT regimen.

This study assessed a palliative radiotherapy regimen using daily radiation over 4 days for three courses in inoperable head and neck cancers, emphasizing oral primary cancers. Retrospective data of 116 patients treated with a daily dose of 3.6-3.7 Gy in four fractions over 4 days to a total of three courses, with a 2-week gap after every course, were analyzed for survival outcomes. A subgroup analysis was done for oral cancer. Ninety-nine (85%) completed three courses. Overall subjective response rate was 77%. Median overall survival and progression-free survival were 12 months (95% confidence interval [CI]: 8-20) and 8 months (95% CI: 6-10), with numerically higher overall survival in oral cancer. The treatment was well tolerated, with no on-treatment hospitalization or grade 3-4 toxicities. The modified QUAD SHOT regimen is practical for palliation in head and neck cancers.

Incidence, mortality and survival rates of lip, oral cavity and salivary glands cancers in Singapore: A half-century time trend analysis (1968-2017).

To examine trends in incidence and mortality and evaluate overall survival (OS) of oral cancer in Singapore between 1968 and 2017. All diagnosed oral cancers by anatomical sites and population size were extracted from the Singapore Cancer Registry and the Department of Statistics Singapore. The trend of age-standardized incidence rate (ASIR) and mortality rate (ASMR) (per 100 000 person-years) of the lip, oral cavity and salivary gland cancers were evaluated by Prais-Winsten regressions for each ethnicity and gender. Kaplan-Meier curves were performed to evaluate the OS by anatomical sites in each age group by ethnicity and sex. Overall, 49, 3494 and 1066 people were diagnosed, and 28, 2310 and 476 died from lip, oral cavity and salivary gland cancers, respectively. The oral cavity cancer ASIR and ASMR reduced from 3.07 (1968-1972) to 2.01(2008-2012) and from 2.06 (1978-1982) to 1.21 (2013-2017) per 100 000 person-years, respectively, with both highest in Indians throughout the whole period. Male:Female ratio ranged from 3.43 (1973-1977) to 1.75 (2013-2017) and from 3.41 (1978-1982) to 2.40 (2013-2017) for ASIR and ASMR, respectively. However, both salivary gland cancer ASIR and ASMR increased from 0.50 (1968-1972) to 0.80 (2008-2012) and from 0.18 (1968-1982) to 0.42 (1988-1992) per 100 000 person-years, respectively, with both higher in males since 1993. Oral cavity cancer ASIR decreased for males aged ≥60, and Indian females ≥25, but increased among Chinese females aged ≥60. Oral cavity cancer ASMR decreased among Chinese aged 25-59, and among Malay males and Indian females. Salivary gland cancer ASIR increased among Chinese males aged ≥60 and Malay males aged 25-59; while ASMR increased among Chinese males aged ≥60. The median OS for oral cavity, lip and salivary gland cancers were 3.0, 9.3 and 18.1 years, respectively, with females surviving longer than males. Singapore has experienced a decline in the incidence and mortality of lip, oral cancer, an increase in in the incidence and mortality of salivary gland cancer, with an increase in the median overall survival rate. Monitoring the magnitude of oral cancer burden and the demographic, and temporal variations is necessary for tailoring health planning and setting priorities for future clinical care and research.

Oral cavity cancer incidence and survival trends: A population-based study.

The present study aimed to calculate the burden of oral cavity cancer (OCC) including incidence, mortality rate, survival rate, and influence of predictive factors such as clinicopathological, demographic findings, and treatment modalities. Data in this retrospective study were collected from India's population-based cancer registry (PBCR) from 2010 to 2016. A total of 1051 cases of OCC were noted. Incidence and mortality rates were calculated. The cumulative survival outcome was calculated using Kaplan-Meier (KM) method. Prognostic factors were estimated using the Cox proportional hazard regression model. The age-standardized incidence rates (ASR), and mortality rate (ASMR), of overall OCC cases were 10.1 and 8.4 per 100 thousand population, respectively. Five-year overall survival (OS) was 32.3%. Survival outcome was significantly associated with the given treatment (Chi-square value = 58.17, P = 0.0001) and anatomical site (Chi-square value = 26.70, P = 0.0001). 17.6% of cases in males were <39-year age group. The hazard ratio (HR) in the age group of >50 years was 2.065 (95% CI 1.34-3.18, P = 0.001). Combination therapy had an HR of 2.630 (95% CI 1.91-3.63, P value 0.000). Tonsillar carcinoma (C09) (95% CI 1.04-3.12) had 1.8 times more chances of death than lip carcinoma (C00). OCC cases are increasing in the younger population, and overall, cases show higher mortality rates with reduced survival outcomes. Prognostic factors such as age >50 years, single modality treatment, and alveolar and tonsillar malignancy are associated with poor survival. OCC robust screening by a trained health professional can improve early detection and increases awareness and lower mortality of the disease.

Survival Outcomes and Prognostic Factors in Oral Squamous Cell Carcinoma with Locoregional Recurrence: A Retrospective Analysis

Introduction: Recurrence is known to occur in approximately 25% to 45% of patients treated for oral cancer. It is the most common cause of treatment failure in oral squamous cell carcinoma (OSCC), which adversely affects survival. Although recurrences in the oral cavity may be detected early, survival rates remain low. Aim: To identify the survival outcomes and prognostic factors in OSCC with locoregional recurrence. Materials and Methods: This retrospective study was conducted at the Malabar Cancer Centre between November 2020 to March 2021, analysing patients who were treated with curative intent between January 1997 and December 2017. It included 118 patients with OSCC who experienced recurrence-local, regional, or both-after curative treatment. Demographic variables, clinical variables, and follow-up details were analysed. Characteristics of the primary tumour, including nodal metastasis, stage, Extranodal Extension (ENE), Perineural Invasion (PNI), the extent of treatment, adjuvant therapy, and days to recurrence, were recorded. For the recurrent tumour, site, time to recurrence, and type of treatment received were noted additionally. Overall Survival (OS) was defined from the date of initial diagnosis, while the date of recurrence was determined by pathological confirmation. Statistical analysis was performed using SPSS software, version 20. All significant variables (p&lt;0.05) were then tested in a multivariate analysis using Cox regression methods. Disease-specific survival (DSS) and OS were analysed using the Kaplan-Meier method. Results: A total of 146 patients with OSCC (15.01%) experienced a recurrence-local, regional, or both-upon analysis of 973 OSCC patients who underwent primary curative intent surgery. One hundred eighteen patients were included in the final analysis. Salvage surgery was performed on 65 (55.08%) patients. Thirtyeight patients (32.3%) who presented with early-stage disease initially developed a recurrence, whereas recurrences were more common among patients with advanced-stage disease, accounting for 80 (67.7%) cases. The median age of patients with recurrence was 60 years, with a median follow-up period of 46 months. The median OS time for patients with recurrence was 34 months ranging from 26.343 to 42.457 months. Univariate analysis revealed that nodal stage, salvage surgery, and time to recurrence were significant factors affecting OS. On multivariate analysis, salvage surgery and time to recurrence remained significant factors impacting survival. Conclusion: Salvage surgery and time to recurrence were identified as significant prognostic factors affecting survival outcomes in patients with OSCC experiencing locoregional recurrence. Salvage surgery significantly improves survival in oral cancer, where recurrence is usually detected more easily unlike other subsites. Patients with late recurrences demonstrated better survival outcomes. Tumours that recur early indicated poor oncological outcomes, suggesting an aggressive nature. Tumor biology is essential in guiding treatment options in recurrent settings.

Advances in Raman spectroscopy for characterising oral cancer and oral potentially malignant disorders.

Oral cancer survival rates have seen little improvement over the past few decades. This is mainly due to late detection and a lack of reliable markers to predict disease progression in oral potentially malignant disorders (OPMDs). There is a need for highly specific and sensitive screening tools to enable early detection of malignant transformation. Biochemical alterations to tissues occur as an early response to pathological processes; manifesting as modifications to molecular structure, concentration or conformation. Raman spectroscopy is a powerful analytical technique that can probe these biochemical changes and can be exploited for the generation of novel disease-specific biomarkers. Therefore, Raman spectroscopy has the potential as an adjunct tool that can assist in the early diagnosis of oral cancer and the detection of disease progression in OPMDs. This review describes the use of Raman spectroscopy for the diagnosis of oral cancer and OPMDs based on ex vivo and liquid biopsies as well as in vivo applications that show the potential of this powerful tool to progress from benchtop to chairside.

Factors influencing the 5-year survival rate of oral cancer patients in the Mongolian population: a retrospective cohort study.

The high mortality rate of head and neck cancers, particularly oral cancer, poses a significant health challenge in developing nations such as Mongolia. This retrospective survival analysis study was conducted to identify factors influencing the 5-year survival rate of oral squamous cell carcinoma patients. The study analyzed data from 173 patients diagnosed with oral squamous cell carcinoma, including multiple variables such as age, gender, residence, education, tobacco and alcohol consumption, oral health indicators, family history, precancerous conditions, cancer characteristics, treatment, rehabilitation, cancer recurrence, and 5-year survival. Survival analysis was conducted using the Kaplan-Meier method, and STATA was used for statistical analysis. The study revealed a 5-year survival rate of 50.3% for oral cancer patients, with a survival rate of 38% for tongue cancer patients. Age, residence, cancer stage, and cancer recurrence were identified as significant survival predictors. Compared to those aged 60 or younger, the hazard ratio (HR) for patients aged 61 or older was 1.52. Survival was associated with female gender (HR = 0.47, CI = 0.29-0.77). Urban residence was associated with decreased survival (HR = 1.92, CI = 1.22-3.05). Significantly worse survival was associated with the presence of cancer recurrence (HR = 1.99, CI = 1.15-3.04). Oral cancer patients in stage IV had a fourfold higher risk of mortality compared to those in stage I (HR = 4.08, CI = 1.2-13.84). This research highlights the influence of age, urban habitation, and cancer recurrence on oral cancer survival. Age, urban residence, and cancer recurrence were all associated with decreased survival, whereas cancer at stage IV substantially increased the risk of death. The significance of early detection, treatment, and active surveillance to identify oral cancer at an early stage is highlighted by these findings. Compared to industrialized nations, Mongolia's lower oral cancer survival rates emphasize the need to increase public awareness and education. A comprehensive approach is required to improve oral cancer patient survival rates and quality of life, including emphasizing early detection through active surveillance, implementing preventive measures, and advancing cancer education initiatives.

Allergic sensitization does not influence advancement or survival in oral cancer

A history of allergies has been said to be associated with a lower risk of head and neck cancer compared to the general population. However, it is not known whether having an allergic sensitization influences the prognosis and advancement of cancer disease. Thus, the aim of the study was to investigate the relationship between allergic sensitization and oral cancer advancement and patient survival. Allergen-specific IgE antibodies were investigated by ImmunoCAP™ Rapid in consecutive 80 patients with oral cancer. ImmunoCAP Rapid system tests a mix of representative inhalant allergens such as birch, timothy grass, mugwort, house dust mite, cat, dog, cockroach, olive (pollen), wall pellitory and mold. Eighty patients met the inclusion criteria for the study. Fifteen patients (19%) had positive ImmunoCAP test. There was no statistically significant difference in primary tumour size (T-stage) between groups (60% in allergy vs 68% in non-allergy had T1–T2 stage and 40% vs 32% T3–T4, respectively, p = 0.570). 27% of patients with allergy had nodal metastases compared with 37% of patients without allergy (p = 0.557). Both groups had comparable short-term survival. In conclusion, allergic sensitization does not seem to influence either the advancement or the short-term survival of patients with oral squamous cell carcinoma.

Abstract C010: Racial and ethnic differences in stage of presentation, comorbidity burden, and overall survival of oral cavity cancer

Abstract Background: Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancer subsites. Head and neck cancer (HNC) has the third worst Black vs. White five-year survival rate of all cancers in the United States. Among the most important determinants of survival in OSCC and HNC in general are clinical factors such as stage of disease presentation and patients' comorbidity burden. It is unclear, however, how these prognostic clinical factors differ based on sex, or race and ethnicity. This study aimed to examine racial/ethnic and sex differences in stage of presentation, comorbidity burden, and overall survival in a cohort of adult patients with OSCC in the United States. Methods: We used the 2004 to 2018 data from the National Cancer Data Base (NCDB) and created a cohort of adult patients with OSCC. Our outcomes of interests were stage of disease presentation, grouped as early-stage vs late-stage, comorbidity burden (scored as 0, 1, 2, 3+), and overall survival. We used multivariable logistic regression to estimate the odds of late-stage presentation and higher comorbidity burden based on race/ethnicity and sex, while controlling for other clinical and non-clinical covariates. We also calculated the adjusted hazard ratios to estimate overall survival using Cox regression model. Results: Our final sample included 185,358 patients, with the majority of our sample comprised of males (68%), Non-Hispanic (NH) White patients (85%), 62% presenting with late-stage disease, and 78% with a comorbidity score of 0. In our final models, male patients were significantly more likely to present with late-stage disease compared to females (aOR =1.21; 95% CI:1.15,1.26). NH Black patients (aOR = 1.85;95%CI:1.68,2.04), Hispanic patients (aOR =1.56; 95% CI:1.39,1.74), and NH Other patients (aOR = 1.22; 95% CI:1.091.37) were more likely to present with late-stage disease compared to NH White patients. Regarding comorbidity burden, NH Black patients (aOR =1.60; 95%CI: 1.26,2.03) were more likely to have the highest comorbidity burden (comorbidity score 3+) compared to NH White patients. Finally, female patients had slightly higher survival odds than male patients (aHR = 0.97; 95% CI:0.96,1.00), while Hispanic patients (aHR = 1.17; 95% CI:1.10,1.24) and NH Other patients (aHR =1.32; 95% CI:1.25,1.40) had worse survival odds compared to NH White patients. Conclusion: There is significant racial/ethnic and gender disparities in stage of presentation and comorbidity burden in patients with OSCC, and racial/ethnic minorities seem to fair worse. It is important to improve outcomes for patients with OSCC and to recognize and mitigate racial and gender disparities. Citation Format: Dina K. Abouelella, Alexandra Belcastro, Shreya P. Ramkumar, Meng Chen, Rong Jiang, Melissa C. White, Oluwole A. Babatunde, Eric Adjei Boakye, Tammara L. Watts, Trinitia Y. Cannon, Nosayaba Osazuwa-Peters. Racial and ethnic differences in stage of presentation, comorbidity burden, and overall survival of oral cavity cancer [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C010.

Survival Analysis in Oral Cancer Patients: A Reliable Statistical Analysis Tool

Clinical trials or follow-up studies sometimes necessitate the long-term monitoring of patients, with an emphasis on crucial events such as mortality, recurrence, severe medication responses, or the advent of new illnesses. These studies cover a range of follow-up times, from a few weeks to several years. Analyzing such data necessitates the use of specialized statistical approaches such as time-to-event analysis and survival analysis. This method is extremely useful in clinical research, providing crucial insights into therapies. The three basic purposes of survival analysis are to determine and analyze survival/hazard functions using survival data, compare these functions, and evaluate how explanatory factors relate to survival time. This methodology is useful for investigating event timing in a variety of situations, notably in clinical studies where event-based data is common. This paper is intended to serve as a primer for researchers, exposing them to the wide range of methods accessible in the discipline of survival analysis. Researchers have the ability to traverse the complex terrain of clinical trial data distinguished by variable follow-up durations, by diving into this approach. The key to survival analysis is its capacity to provide subtle insights into the temporal elements of patient reactions, providing a full view of intervention success. We have taken the cases of oral cancer survival analysis studies and put a light on methods and association used there.

Oral Cancer Knowledge, Practices, and Attitudes: A Survey of Libyan Dentists

Dentists play an important role in early detection of oral cancerous lesions. several studies indicate that dentists lack knowledge in oral cancer etiology and diagnosis. Role in the control studies assessing dentists' oral cancer awareness in Libya are lacking. Objectives: This study examined the oral cancer awareness and practice among dentists in Libya. Materials and methods: : Administered questionnaires were distributed on dentists working in private and public clinics in the city of Benghazi. Participants’ responses to the questionnaire were analyzed using descriptive and analytical statistics. Results: Three hundred dentists returned completed questionnaires; 237 (79%) females and 63 (21%) males and most of them were under 40 years old 227 (75.7%). Although most dentists were knowledgeable about the most common site, type, and screening method of oral cancer, only about half of the dentists were aware of tobacco as the main risk factor and biopsy as the most proper diagnostic technique for oral cancer. Despite that 86% of the dentists reported that they perform mucosal examination as part of their routine dental examination, about half of the dentists reported lack of confidence in detecting oral cancer and most dentists expressed need for further education and training in this area. Conclusion: Overall, this study highlighted the importance of introducing continuous education and training programs to dentists which could increase oral cancer prevention and survival rates among oral cancer patients.

Mortality and associated influencing factors among oral cancer patients in western China: A retrospective cohort study from 2016 to 2021.

Few studies have examined oral cancer-related mortality in Guangxi. This study aimed to explore the incidence and characteristics of oral cancer and to identify the risk factors for oral cancer-related mortality. The study was conducted to provide a reference for clinical treatment and to improve the survival rate of patients with oral cancer. A total of 271 patients with oral cancer who were treated in the Stomatology Hospital of Guangxi Medical University from 2016 to 2017 were selected as the research subjects. The follow-up lasted until the middle of 2021. The survival rate and mean survival time of 271 patients were calculated by the Kaplan-Meier method. Cox proportional hazard models and stratified analysis were used to explore the related factors that affect the mortality of patients. Nomogram plots were used to visualize the relationships among multiple variables. Among 271 patients with oral cancer, the 2-year and 5-year overall survival rates were 83.8% and 68.5% respectively. The results of multivariate analysis showed that, age, pathological type, surgery and readmission were significant factors affecting survival. When the above factors were incorporated into nomogram plots and stratified analysis, the results showed that the risk of death after treatment in patients with oral cancer aged > 55 years was 1.693 times higher than that in patients aged ≤ 55 years (HR, hazard ratio [HR] = 1.795, 95% confidence intervals [CI] = 1.073, 3.004). The risk of death after surgical treatment was 0.606 times higher than that without surgical treatment (HR = 0.590, 95% CI = 0.367, 0.948). Patients who were readmitted had a 2.340-fold increased risk of death compared with patients who were not readmitted (HR = 2.340, 95% CI = 1.267,4.321). Older age, surgery, and readmission were risk factors for mortality among patients with oral cancer. The median survival time of 271 patients with oral cancer was 52.0 months. Patients under the age of 55 years old and those who choose surgical treatment tend to have a better prognosis and a longer survival. Oral cancer-related mortality is affected by age, treatment mode, readmission, and other factors. All of these factors are worthy of clinical attention for their prevention and control.

An Exploration of Black Men's Attitudes and Experiences Communicating with Dentists about Oral and Pharyngeal Cancer.

Poor oral and pharyngeal cancer (OPC) survival among Black men is partially due to their limited knowledge about OPCs, which is exacerbated by dentists' limited training and discomfort in discussing OPC risk factors. The purpose of this study was to assess the attitudes and experiences that Black men have communicating with dentists about OPCs. To qualitatively assess these attitudes and experiences, a focus group guide and recruitment strategy were developed using a community engagement approach. Data were analyzed using grounded theory. Twenty-three self-identified Black men participated in three focus groups through the Zoom platform (mean age of 46.1 years). Four main themes emerged, which identified that participants: (1) had little knowledge of OPCs; (2) felt that addressing OPC risk among Black men was not a priority for dentists; (3) stressed the importance of dentists acknowledging the complexity of how race and gender affects Black men's healthcare experiences; and (4) expressed a benefit to receiving information from multiple social networks. The focus groups provided context for how dentists might engage with Black men in discussions about OPC prevention and treatment.

Lymph node level ratio as a predictor of survival in oral cavity squamous cell carcinoma

ObjectiveTo evaluate whether nodal yields and ratios based on level serves as prognostic indicators in patients with oral cavity squamous cell carcinoma undergoing neck dissection. Materials and MethodsA retrospective analysis of 342 patients with oral cavity squamous cell carcinoma treated surgically between 1998 and 2017 were included.Demographics and clinicopathologic data were collated. Disease specific survival and overall survival were analyzed via Kaplan-Meier method and log-rank test as well as univariable and multivariable Cox models. ResultsTotal nodal yield is associated with improved overall and disease specific survival (p < 0.01). Total positive nodal yield (p < 0.01), positive nodal ratio per level (p < 0.001), and identification of <4 lymph nodes/level (p < 0.001) are associated with worse disease specific survival and overall survival. A ratio of at least 4 lymph nodes/level dissected yields the maximal hazard ratio on for both disease specific and overall survival optimizes the Kaplan-Meier split between survival groups. After controlling for sex, age, margin status, disease stage, extranodal extension, perineural invasion, and lymphovascular invasion as fixed covariates in the Cox models, a nodal level ratio of 4 lymph nodes/level provides hazard ratio (95% CI) of 3.59 (1.69, 7.60); p < 0.0006) for disease free survival and 2.90 (1.54, 5.46; p < 0.001) for overall survival. ConclusionNodal level ratio of < 4 lymph nodes/level is associated with worse disease specific and overall survival in oral cavity squamous cell carcinoma. This level-specific metric may prove useful qualitatively and in predicting survival in oral cavity cancer with broader utility to address variations in levels of neck dissection performed.

Health-related quality of life, functional outcomes, and complications after sentinel lymph node biopsy and elective neck dissection in early oral cancer: A systematic review.

Elective neck dissection improves survival in early oral cancer. Sentinel lymph node biopsy may also do this with less morbidity. This systematic review compared health-related quality of life, functional outcomes, and complications after sentinel lymph node biopsy and elective neck dissection in early oral cancer. PRISMA guidelines were followed. Thirteen studies met inclusion criteria. Results favoring sentinel lymph node biopsy were found in complications, scar length and appearance, length of hospital stay, time to drain removal, and objective shoulder measures at timepoints up to 12 months. Where differences in health-related quality of life were found, methodological issues make their clinical significance questionable. Sentinel lymph node biopsy was associated with fewer complications and statistically better outcomes in a number of physical measures. There is as yet no strong evidence to suggest it is associated with better health-related quality of life outcomes. While a number of health-related quality of life outcome measures show promise, their interpretation is hampered by methodological concerns. Further rigorous research is required to address this.

Tumor Budding and Poor Prognosis in Oral Cancer: A Systematic Review and Meta-Analysis.

Tumor budding (TB) has been investigated in several types of solid tumors. In oral cancer, studies show its association with survival. However, for its implementation in routine histological analyses, results with a high certainty of evidence are needed. Therefore, the aim of this systematic review is to explore the association between tumor budding and overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) in oral cancer. A search was performed in Embase, PubMed, Scopus, Livivo, Web of Science, and Google Scholar. We adopted the following inclusion criteria: studies that evaluate tumor budding in oral cancer, that investigate survival, and presenting cohort design. We excluded reviews and studies without hazard-ratio (HR) data. This systematic review included 22 studies and showed an association between TB and survival. High-grade TB is associated with a worse OS in univariate analysis (HR = 3.11; 95% CI: 2.06-4.69, p<0.01) and multivariate analysis (HR = 2.62; 95% CI: 1.64-4.20, p<0.01); with a poorer DSS in univariate (HR = 2.43; 95% CI: 1.94-3.03, p<0.01) and multivariate analysis (HR = 2.01; 95% CI: 1.43-2.83, p< 0.01); and with a worse DFS in univariate (HR = 1.94; 95% CI: 1.44-2.62, p<0.01) and multivariate analysis (HR = 2.15; 95% CI: 1.31-3.53, p< 0.01). Sensitivity analysis showed that the results are robust, and no significant publication bias was identified in univariate analysis for DFS (Egger's test: p = 0.94). The certainty of the evidence was graded as low or very low. Our findings indicate that TB is an independent prognostic factor of OS, DSS, and DFS in oral cancer. However, further studies are needed to increase the certainty of the evidence.