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Introduction: The oral cavity, the beginning of the digestive system, has diverse lesions affecting it other than Oral Squamous Cell Carcinoma (OSCC). Soft-tissue Tumours (STT) are uncommon lesions. Overlapping of the signs and symptoms in diverse conditions creates significant problems for reaching their definitive diagnosis. Histopathological Examination (HPE) plays a central role in giving their final diagnosis. Assessment of the clinical features, histopathology, along with Immunohistochemistry (IHC), helps in reaching an accurate diagnosis in these cases, which further aids in the proper management of the patient. Aim: To study the spectrum of oral cavity lesions and tumours with emphasis on STT. Materials and Methods: A retrospective cross-sectional study was conducted at the Department of Pathology and Otolaryngology, Dr. Ulhas Patil Medical College, Jalgaon, Maharashtra, India included the oral cavity lesion samples received over two years (from January 2021 to December 2022) in the histopathology section of a Medical College in Maharashtra, India. A total of 170 cases were included in the study. Complete clinical information including age, sex, anatomical location, clinical diagnosis, and histological subtypes were compiled. The HPE diagnosis were classified into four categories-Non neoplastic, Benign, Epithelial Proliferative lesions {including viral/Human Papillomavirus (HPV) related}/Intraepithelial neoplastic lesions/Precursor or Pre-malignant, and malignant with special emphasis on STTs found. The data was statistically analysed and the results were presented as percentages. Full details of the soft-tissue lesions were recorded, entered into an Excel sheet, and studied for the percentage-wise distribution of various recorded parameters. Results: A total of 170 cases were found. Male:female distribution was 2.78:1, and most patients were in the seventh decade, n=38 (22.35%). The most common lesions other than SCC, n=110 (64.71%) found were mucocele, chronic inflammatory lesion and wart. The Buccal Mucosa/Gingivo-buccal Sulcus (GBS) were the most commonly involved site, n=82 (48.24%). Malignant lesions were more common in the sixth and seventh decades, with a male preponderance of 2.71:1. The uncommon STTs found were-Benign: Haemangioma/pyogenic granuloma (n=2), a Schwanomma, and a Proliferative Fasciitis (PF); Malignant: two fibrosarcomas and a high-grade sarcoma. All three malignant STTs were found in males of the sixth decade involving the buccal mucosa. Conclusion: Among the variety of lesions found in the oral cavity, HPE facilitates the recognition of the STT, especially the malignant ones, aiding in proper management. Being an extremely uncommon entity at this site, the documentation of these findings is of utmost importance. [ABSTRACT FROM AUTHOR]

Introduction: The oral cavity, the beginning of the digestive system, has diverse lesions affecting it other than Oral Squamous Cell Carcinoma (OSCC). Soft-tissue Tumours (STT) are uncommon lesions. Overlapping of the signs and symptoms in diverse conditions creates significant problems for reaching their definitive diagnosis. Histopathological Examination (HPE) plays a central role in giving their final diagnosis. Assessment of the clinical features, histopathology, along with Immunohistochemistry (IHC), helps in reaching an accurate diagnosis in these cases, which further aids in the proper management of the patient. Aim: To study the spectrum of oral cavity lesions and tumours with emphasis on STT. Materials and Methods: A retrospective cross-sectional study was conducted at the Department of Pathology and Otolaryngology, Dr. Ulhas Patil Medical College, Jalgaon, Maharashtra, India included the oral cavity lesion samples received over two years (from January 2021 to December 2022) in the histopathology section of a Medical College in Maharashtra, India. A total of 170 cases were included in the study. Complete clinical information including age, sex, anatomical location, clinical diagnosis, and histological subtypes were compiled. The HPE diagnosis were classified into four categories-Non neoplastic, Benign, Epithelial Proliferative lesions {including viral/Human Papillomavirus (HPV) related}/Intraepithelial neoplastic lesions/Precursor or Pre-malignant, and malignant with special emphasis on STTs found. The data was statistically analysed and the results were presented as percentages. Full details of the soft-tissue lesions were recorded, entered into an Excel sheet, and studied for the percentage-wise distribution of various recorded parameters. Results: A total of 170 cases were found. Male:female distribution was 2.78:1, and most patients were in the seventh decade, n=38 (22.35%). The most common lesions other than SCC, n=110 (64.71%) found were mucocele, chronic inflammatory lesion and wart. The Buccal Mucosa/Gingivo-buccal Sulcus (GBS) were the most commonly involved site, n=82 (48.24%). Malignant lesions were more common in the sixth and seventh decades, with a male preponderance of 2.71:1. The uncommon STTs found were-Benign: Haemangioma/pyogenic granuloma (n=2), a Schwanomma, and a Proliferative Fasciitis (PF); Malignant: two fibrosarcomas and a high-grade sarcoma. All three malignant STTs were found in males of the sixth decade involving the buccal mucosa. Conclusion: Among the variety of lesions found in the oral cavity, HPE facilitates the recognition of the STT, especially the malignant ones, aiding in proper management. Being an extremely uncommon entity at this site, the documentation of these findings is of utmost importance.

Different efforts have been made to find better and less invasive methods for the diagnosis and prediction of oral cancer, such as the study of saliva as a source of biomarkers. The aim of this study was to perform a scoping review about salivary molecules that have been assessed as possible biomarkers for the diagnosis of oral squamous cell carcinoma (OSCC). A search was conducted using EBSCO, PubMed (MEDLINE), Scopus, and Web of Science. The research question was as follows: which molecules present in saliva have utility to be used as biomarkers for the early detection of oral cancer? Sixty-two studies were included. Over 100 molecules were assessed. Most of the markers were oriented towards the early diagnosis of OSCC and were classified based on their ability for detecting OSCC and oral potentially malignant disorders (OPMDs), OSCC outcome prediction, and the prediction of the malignant transformation of OPMDs. TNF-α, IL-1β, IL-6 IL-8, LDH, and MMP-9 were the most studied, with almost all studies reporting high sensitivity and specificity values. TNF-α, IL-1β, IL-6 IL-8, LDH, and MMP-9 are the most promising salivary biomarkers. However, more studies with larger cohorts are needed before translating the use of these biomarkers to clinical settings. [ABSTRACT FROM AUTHOR]

Head and neck cancer (HNC) is a major public health problem in India. This article presents the HNC burden in different regions of India. The published population-based cancer registries (PBCRs) data from the National Cancer Registry Programme, Bengaluru, and the Tata Memorial Centre, Mumbai, India, were utilised. The 37 PBCRs were divided into six regions including central, east, north, northeast, west and south. The age-standardised incidence rate of HNC was 25.9 (95% CI 25.7-26.1) and 8.0 (95% CI 7.9-8.1) per 100,000 population, respectively, in males and females. HNC accounted for about 26% of all cancer cases in males and 8% in females. The risk of developing HNC was 1 in 33 for males and 1 in 107 for females. The northeastern registries reported the highest incidence rate 31.7 per 100,000 population in males followed by northern (28.5), central (28.3), western (24.4), southern (23.9) and eastern (18.3). In females, the incidence was in the range of 6.2-10.1 per 100,000 population. For all PBCRs together, the HNC burden was two to three times higher in the age group 60+ as compared to 20-39 years. The HNC burden in India is higher than in the USA, UK, Australia, Africa and Brazil. The PBCRs from the south-east Asia region such as the Colombo district, Sri Lanka, as well as Siraha, Saptari, Dhanusha and Mohattari - Nepal have also reported a high burden of HNC. All regions reported mouth as a leading cancer site followed by tongue, larynx, hypopharynx and tonsil except the northeastern region registries where hypopharynx was the top leading cancer. The burden of other sites of HNC is low. Raising awareness of the disease and associated risk factors, providing early detection services, as well as easy access to diagnosis and treatment are required. The government should focus on building the infrastructure and capacity building to control this disease. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigates the potential of exosomal profiles as a tool for early detection of relapse and long-term outcomes in oral squamous cell carcinoma (OSCC) patients undergoing conventional therapy. Examining 27 OSCC patients, this study found a significant reduction in presurgical exosome levels after surgery. Patients experiencing relapse showed higher postsurgical exosome concentrations and larger sizes compared to disease-free individuals. Lower presurgical exosome levels were correlated with better disease-free survival. Receiver operating characteristic analysis indicated the promising diagnostic efficacy of presurgical exosome concentrations in identifying relapse (AUC = 0.82). The findings suggest that presurgical exosomal plasma levels independently predict early recurrence and survival in OSCC, proposing peripheral exosome detection as a novel tool for clinical management with implications for prognosis assessment. Background: Oral squamous cell carcinoma (OSCC) is characterized by an immunosuppressive tumor microenvironment. Their plasma-derived exosomes deliver immunomodulatory molecules and cargo that correlate significantly with clinical parameters. This study aims to assess the exosomal profile as a potential tool for early detection of relapse and long-term outcomes in OSCC patients undergoing conventional therapy. Methods: 27 OSCC patients with a median 38-month follow-up were included in this study. The relationship between NTA-derived parameters and clinical pathological parameters was examined, and receiver operating characteristic (ROC) curves were utilized to evaluate the diagnostic efficacy of these values in detecting cancer relapse. Results: Plasmatic levels of exosomes prior to surgery showed a drastic reduction after surgical intervention (8.08E vs. 1.41 × 109 particles/mL, p = 0.006). Postsurgical concentrations of exosomes were higher in patients who experienced relapse compared to those who remained disease-free (2.97 × 109 vs. 1.11 × 109 particles/mL, p = 0.046). Additionally, patients who relapsed exhibited larger exosome sizes after surgery (141.47 vs. 132.31 nm, p = 0.03). Patients with lower concentrations of exosomes prior to surgery demonstrated better disease-free survival compared to those with higher levels (p = 0.012). ROC analysis revealed an area under the curve of 0.82 for presurgical exosome concentration in identifying relapse. Conclusions: Presurgical exosomal plasmatic levels serve as independent predictors of early recurrence and survival in OSCC. All in all, our findings indicate that the detection of peripheral exosomes represents a novel tool for the clinical management of OSCC, with potential implications for prognosis assessment. [ABSTRACT FROM AUTHOR]

Late detection of oral cancer (OC) cases in Saudi Arabia is concerning. It reduces survival rate and complicates treatment. The ISAC intervention was developed to bridge the gaps observed in dentists' practice of OC examination and patient education. The ISAC stands for I, informing patients of OC screenings; S, screening for OC; A, advising high-risk patients to quit risk factors; and C, connecting patients to advanced services. This study tested the potential effect of the ISAC in influencing dentists' cognitive and behavioral skills, to enhance early detection and prevention of OC. A quasi-experimental study was conducted among dental interns (DIs) at dental setting to test the effect on comprehensive oral cancer examination score (COCE), awareness, self-efficacy, descriptive-norms, and self-reported behavior. Data were collected through triangulation of methods pre and post the intervention at two-months. Multiple linear mixed effects regression models were utilized for data analysis. Between October 2020 and April 2021, 47 DIs participated in the study. The final model showed the significant effects of time (ISAC) on COCE (95% CI = 25.12–29.42, P <.001). DIs had a significant improvement in awareness, self-efficacy, descriptive norms, and self-reported behavior. The findings showed promising effects of the intervention toward the early detection and prevention of OC. Dentists, dental organizations, and policymakers in areas with a high risk of OC could benefit from the current intervention which contributes to capacity building and improved community health. A pragmatic study with a robust design is needed to test the effectiveness of the intervention on a wider scale. [ABSTRACT FROM AUTHOR]

Human Papillomavirus (HPV) associated with oropharyngeal and oral squamous cell carcinoma (OPSCC and OSCC) is escalating over the years. Hence, the present review aims to determine the prevalence of HPV-OSCC and HPV-OPSCC in Asian countries over the last decades. An electronic search was conducted using nine online databases to identify English-language articles on the prevalence of HPV-OPSCC and HPV-OSCC in Asian countries from January 2011 to June 2022. The risk of bias was assessed using the JBI critical appraisal checklist and the level of evidence was determined based on the OCEBM guideline. Single-arm meta-analysis was used to estimate the weighted mean prevalence of HPV-OPSCC and HPV-OSCC among patients in Asia. Subgroup analysis meta-regression and Egger’s tests were also conducted. 59 eligible studies were included with a higher prevalence of HPV-OPSCC (32.6%-37.4%) as compared to HPV-OSCC (10.9%-23.5%). Subgroup analysis revealed that the weighted mean prevalence of HPV-OPSCC was significantly higher (P

The gradual accumulation and inadequate renewal of senescent cells over time drive organismal aging. Senescent cells undergo altered gene expression and release inflammatory mediators collectively termed the senescence-associated secretory phenotype (SASP), which significantly contributes to a spectrum of age-related disorders, including cancer. In the context of carcinogenesis, the SASP produced by senescent cells has been implicated in the promotion of epithelial cancers, including oral squamous cell carcinoma (OSCC), the most common form of oral cancer. Senescent cells within the tumor microenvironment release factors that amplify the growth and invasiveness of neighboring cancer cells. Senotherapeutics, including senolytics and senomorphics, emerge as promising modalities to target senescent cells and their associated inflammatory factors, thereby opening novel avenues for augmenting the efficacy of cancer treatments. Here, we review the general aspects of cellular senescence, focusing on the relation between senescence-related inflammation with cancer development. We also analyze the available evidence linking cellular senescence with OSCC, highlighting possible clinical applications.

Objectives Nicotine is an ingredient of tobacco, and exposure to nicotine increases the risks of various cancers, including oral cancer. Previous studies have focused on the addictive properties of nicotine, but its carcinogenic mechanism has rarely been studied. We aimed to explore the key genes in the process through which nicotine promotes the occurrence and development of oral cancer via data mining and experimental verification. Methods This study involved three parts. First, key genes related to nicotine-related oral cancer were screened through data mining; second, the expression and clinical significance of a key gene in oral cancer tissues were verified by bioinformatics. Finally, the expression and clinical significance of the key gene in oral cancer were histologically investigated, and the effects of its expression on cell proliferation, invasion, and drug resistance were cytologically assessed. Results SERPINE1 was identified as the key gene, which was upregulated in nicotine-treated oral cells and may be an independent prognostic factor for oral cancer. SERPINE1 was enriched in various pathways, such as the tumor necrosis factor and apelin pathways, and was related to the infiltration of macrophages, CD4+T cells, and CD8+T cells. Overexpression of SERPINE1 was associated with N staging and may be involved in hypoxia, angiogenesis, and metastasis. Knockdown of SERPINE1 in oral cancer cells resulted in weakened cell proliferation and invasion ability and increased sensitivity to bleomycin and docetaxel. Conclusion This study revealed SERPINE1 as a key gene for nicotine-related oral cancer, indicating that SERPINE1 may be a novel prognostic indicator and therapeutic target for oral carcinoma.

Different efforts have been made to find better and less invasive methods for the diagnosis and prediction of oral cancer, such as the study of saliva as a source of biomarkers. The aim of this study was to perform a scoping review about salivary molecules that have been assessed as possible biomarkers for the diagnosis of oral squamous cell carcinoma (OSCC). A search was conducted using EBSCO, PubMed (MEDLINE), Scopus, and Web of Science. The research question was as follows: which molecules present in saliva have utility to be used as biomarkers for the early detection of oral cancer? Sixty-two studies were included. Over 100 molecules were assessed. Most of the markers were oriented towards the early diagnosis of OSCC and were classified based on their ability for detecting OSCC and oral potentially malignant disorders (OPMDs), OSCC outcome prediction, and the prediction of the malignant transformation of OPMDs. TNF-α, IL-1β, IL-6 IL-8, LDH, and MMP-9 were the most studied, with almost all studies reporting high sensitivity and specificity values. TNF-α, IL-1β, IL-6 IL-8, LDH, and MMP-9 are the most promising salivary biomarkers. However, more studies with larger cohorts are needed before translating the use of these biomarkers to clinical settings.

Summary: Reconstruction of the mandible following hemimandibulectomy is difficult and complex.The appropriate approach to condylar reconstruction remains controversial. In this report, the authors propose the concept of “short ramus reconstruction” after hemimandibulectomy. In this technique, a neocondyle is constructed around the base of the condyle to avoid trismus and ankylosis. Four patients underwent short condylar reconstruction using fibula free flaps. Post-surgery, no patient developed trismus or ankylosis. Centric occlusion, good masticatory function, and favourable aesthetic outcomes were achieved in all cases. “Short ramus reconstruction” is a simple and convenient method to reconstruct the mandible following hemimandibulectomy.

Objectives: In this study, we investigated the expression of zinc alpha-2 glycoprotein in oral squamous cell carcinoma tissue samples. Additionally, ascertained its association to the oral cancer stage and subscale parameters (TNM). Methods: This observational study was conducted at Ziauddin University from January to December 2020. Using the Open-Epi software, the sample size of 120 oral squamous cell carcinomas was calculated at 95% confidence interval and a 5% margin of error. Ethical approval was taken from the Institutional Ethical Review Committee. Histologically diagnosed cases of oral squamous cell carcinoma were obtained from the Histopathology Department of Ziauddin University, Karachi. Study data was analyzed through SPSS version-20 and p-value ≤0.05 considered as significant. Oneway ANOVA and Multiple linear regression were applied for analysis of data. Results: In the study, none of the oral squamous cell carcinoma tissue samples from the later stages were stained for ZAG. However 71% (35/49) of the early stage OSCC samples showed positive IHC results for ZAG expression in the cytoplasm. One-way ANOVA indicates that high ZAG expression was significantly associated with smaller tumor size (p<0.001), lymph node involvement (p=0.002), early stages of OSCC (p<0.001) and less differentiated tumor (p=0.001). The site of the tumor was also significantly associated with ZAG staining (p<0.001). Conclusion: Zinc alpha-2 glycoprotein expressed in the early stages of oral cancer development so that effective treatment modalities can be planned as per the patient's status. This may also assist a clinician to achieve tumor-free surgical margins and monitor the post treatment outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: An oral cavity tumor, known as an oral squamous cell carcinoma (OSCC), has a five-year survival rate of just about 50%. Novel, easily, available biomarkers for prognosis evaluation are still required. Despite advancements in diagnosis and therapy, this rate has not grown in recent decades. Our study indicated that a lower expression of a protein named E-cadherin is related with a poor prognosis for OSCC patients. This evidence came from the meta-analysis of 25 studies, including 2553 patients, in which E-cadherin protein expression was assessed in their tumor sample by immunohistochemistry. This study highlights the promising role of E-cadherin assessment during routine histopathology diagnoses to support prognostic decision-making, and to pave the way for future studies to counteract its role in cancer progression. Oral squamous cell carcinoma (OSCC) is characterized by poor survival, mostly due to local invasion, loco-regional recurrence, and metastasis. Given that the weakening of cell-to-cell adhesion is a feature associated with the migration and invasion of cancer cells, different studies have explored the prognostic utility of cell adhesion molecules such as E-cadherin (E-cad). This study aims to summarize current evidence in a meta-analysis, focusing on the prognostic role of E-cad in OSCC. To find studies meeting inclusion criteria, Scopus, Web of Science, EMBASE, Medline, and OpenGrey databases were systematically assessed and screened. The selection process led to 25 studies, which were considered eligible for inclusion in the meta-analysis, representing a sample of 2553 patients. E-cad overexpression was strongly associated with longer overall survival (OS) with Hazard Ratio (HR)  = 0.41 95% confidence interval (95% CI) (0.32–0.54); p < 0.001 and disease-free survival with HR 0.47 95% CI (0.37–0.61); p < 0.001. In terms of OS, patients with tongue cancer experienced better survivability when expressing E-cad with HR 0.28 95% CI (0.19–0.43); p < 0.001. Globally, our findings indicate the prognostic role of the immunohistochemical assessment of E-cad in OSCC and its expression might acquire a different role based on the oral cavity subsites. [ABSTRACT FROM AUTHOR]

Background: Oral squamous cell carcinoma (OSCC) is characterized by an immunosuppressive tumor microenvironment. Their plasma-derived exosomes deliver immunomodulatory molecules and cargo that correlate significantly with clinical parameters. This study aims to assess the exosomal profile as a potential tool for early detection of relapse and long-term outcomes in OSCC patients undergoing conventional therapy. Methods: 27 OSCC patients with a median 38-month follow-up were included in this study. The relationship between NTA-derived parameters and clinical pathological parameters was examined, and receiver operating characteristic (ROC) curves were utilized to evaluate the diagnostic efficacy of these values in detecting cancer relapse. Results: Plasmatic levels of exosomes prior to surgery showed a drastic reduction after surgical intervention (8.08E vs. 1.41 × 109 particles/mL, p = 0.006). Postsurgical concentrations of exosomes were higher in patients who experienced relapse compared to those who remained disease-free (2.97 × 109 vs. 1.11 × 109 particles/mL, p = 0.046). Additionally, patients who relapsed exhibited larger exosome sizes after surgery (141.47 vs. 132.31 nm, p = 0.03). Patients with lower concentrations of exosomes prior to surgery demonstrated better disease-free survival compared to those with higher levels (p = 0.012). ROC analysis revealed an area under the curve of 0.82 for presurgical exosome concentration in identifying relapse. Conclusions: Presurgical exosomal plasmatic levels serve as independent predictors of early recurrence and survival in OSCC. All in all, our findings indicate that the detection of peripheral exosomes represents a novel tool for the clinical management of OSCC, with potential implications for prognosis assessment.

Statement of the Problem: Oral squamous cell carcinoma (OSCC) constitutes more than 90% of oral malignancies. The main risk factors of OSCC include cigarette smoking and alcohol. However, since not all smokers or alcohol drinkers develop this disease, other factors have also been suggested including genetic characteristics of every person to be implicated in the probability of developing OSCC. Purpose: Our aim in this study is to investigate the possible relationship between fingerprint patterns and the probability of developing OSCC. Materials and Method: In a cross sectional study, we had 140 patients in 2 groups as OSCC and cancer free. Fingerprints were recorded by fingerprint scanner device. The fingerprint patterns were categorized into three major groups and four subgroups. Groups were tested by chi-square. Results: The relationship between the main fingerprint patterns and incidence of OSCC became significant (p= 0.037). The frequency of the main pattern of Arch was significantly higher in the experimental group than in the control group (p< 0.05). Considering the main patterns of Loop and Whorl, no significant difference existed between the two groups. Furthermore, the frequency of subtype patterns of Double Whorl and Central Pocket Whorl was significantly higher in the control group than in the experimental group (p< 0.05). Conclusion: Since dermatoglyphics is contingent upon genetic variations, fingerprint can be used for investigating the susceptibility of people in developing different diseases, though further studies are required in this regard. This method is in no way a substitute for gold standard methods for diagnosis.

Aim: The aim of this study was to develop and initially assess the psychometric properties of the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer (CSES‐OC). Methods: In total, 28 items in the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer were originally employed for a reliability and validity test based on expert suggestions and qualitative findings. The Cronbach's alpha coefficient and test–retest reliability were evaluated with the pilot sample, which included 30 caregivers. The main test, which included 107 caregivers during May 2016 to 2018, was used to execute the exploratory factor analysis (EFA) and concurrent validity. Results: The results of the main test showed a Cronbach's alpha coefficient of.95 for the revised 18‐item total scale after EFA. Four factors (acquiring resources, managing sudden and uncertain patient conditions, managing patient‐related nutritional issues and exploring and making decisions on patient care) were classified from EFA of the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer. The r coefficient was.59 (P <.01), which supported the concurrent validity between CSES‐OC and General Self‐Efficacy Scale. Conclusion: The study results show appropriate psychometric properties for the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer that was constructed for evaluating caregiver caregiving self‐efficacy in caring for family members with oral cancer. Summary statement: What is already known about this topic? It is important to evaluate the caregivers' positive belief in their family members care abilities if they are to accomplish the tasks required of them when faced various difficulties at home.There is no instrument that measured perceived caregiving self‐efficacy in caregiver in caring for a sick family member with oral cancer. What this paper adds? Cronbach's alpha coefficient, test–retest reliability, exploratory factor analysis and concurrent validity supported the psychometric properties of Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer.This Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer contains four dimensions: acquiring resources, managing sudden and uncertain patient conditions, managing patient‐related nutritional issues and exploring and making decisions on patient care. The implications of this paper: Caregiver Caregiving Self‐Efficacy Scale is appropriate to appraise the caregivers' competence beliefs relevant to caregiving at home. [ABSTRACT FROM AUTHOR]

Simple Summary: Upfront surgical resection with safe margins is a mainstay of treatment in oral cancers. The postoperative risk stratification of the resection margin is currently determined through surgical pathology according to a cut-off width of 5 mm. However, evidence to support the validity of this cut-off point of 5 mm is not strong, and was largely obtained from retrospective clinical studies. In this review, we summarize surgical concepts for oral cancer, postoperative risk stratification based on current guidelines and propose a dynamic cut-off value for postoperative risk stratification in oral cancer. The optimal cut-off point of the resection margin was recently debated in oral cancer. To evaluate the current evidence of the dynamic criteria of the resection margin, a review of the available literature was performed. Studies were sourced from PubMed and EMBASE by searching for the keywords "mouth neoplasm", "oral cancer", "oral cavity cancer", "oral squamous cell carcinoma", "tongue cancer", "margins of excision", "surgical margin" and "resection margin". We found approximately 998 articles on PubMed and 2227 articles on EMBASE. A total of 3225 articles was identified, and 2763 of those were left after removing the duplicates. By applying advanced filters about the relevance of the subjects, these were narrowed down to 111 articles. After the final exclusion, 42 full-text articles were reviewed. The universal cut-off criteria of 5 mm used for determining the resection margin status has been debated due to recent studies evaluating the impact of different margin criteria on patient prognosis. Of note, the degree of the microscopic extension from the gross tumor border correlates with tumor dimensions. Therefore, a relatively narrow safety margin can be justified in early-stage oral cancer without the additional risk of recurrence, while a wide safety margin might be required for advanced-stage oral cancer. This review suggests a surgical strategy to adjust the criteria for risk grouping and adjuvant treatments, according to individual tumor dimensions or characteristics. In the future, it might be possible to establish individual tumor-specific surgical margins and risk stratification during or after surgery. However, the results should be interpreted with caution because there is no strong evidence (e.g., prospective randomized controlled studies) yet to support the conclusions. Our study is meaningful in suggesting future research directions and discussions. [ABSTRACT FROM AUTHOR]

Human epidermal growth factor receptor 2/neu (HER2/neu) is known to serve as a prognostic and predictive biomarker in several cancers such as breast, gastric and ovarian cancers. In head and neck squamous cell carcinoma, HER2/neu expression is seen but in a fluctuated manner. Hence, its role as a prognostic factor in oral squamous cell carcinoma (OSCC) needs evaluation. To determine the HER 2/neu overexpression in OSCC patients and its association with clinical and pathological parameters. 74 patients of OSCC treated between 2016 and 2018 were included in the study. Immunohistochemistry was done on tissue samples from these patients and HER2/neu expression was measured. Both biopsy and resected specimens were considered for the study. Out of 74 patients, 47.3% (35) were operated and 52.7% (39) were not operated due to loss to follow-up. No significant association was found (p = 0.636, OR = 0.68, CI = 0.14–3.34) between lymphovascular invasion (LVI) and HER2/neu expression. Similar results were seen for perineural invasion (PNI) (p = 0.490, OR = 0.53, CI = 0.88–3.24), depth of invasion (p = 0.21), grade of tumor (p = 0.214), clinical-stage (p = 0.511) and pathological stage (p = 0.091). No significant association existed between HER2/neu expression and LVI, PNI, clinical-stage, the grade of tumor and the pathological stage of oral squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Chronic hyperplastic candidiasis (CHC) is a prototypical oral lesion caused by chronic Candida infection. A major controversy surrounding CHC is whether this oral lesion owns malignant transformation (MT) potential. The aim of the present study was to evaluate current evidence on the MT of CHC and to determine the variables which have the greatest influence on cancer development. Bibliographical searches included PubMed, Embase, Web of Science, Scopus and LILACS. The cohort studies and case series used to investigate the MT of CHC were deemed suitable for inclusion. The quality of the enrolled studies was measured by the Joanna Briggs Institute scale. Moreover, we undertook subgroup analyses, assessed small study effects, and conducted sensitivity analyses. From 338 studies, nine were finally included for qualitative/quantitative analysis. The overall MT rate for CHC across all studies was 12.1% (95% confidential interval, 4.1–19.8%). Subgroup analysis showed that the MT rate increased when pooled analysis was restricted to poor quality studies. It remains complex to affirm whether CHC is an individual and oral, potentially malignant disorder according to the retrieved evidence. Prospective cohort studies to define the natural history of CHC and a consensus statement to clarify a proper set of diagnostic criteria are strongly needed. PROSPERO ID: CRD42022319572. [ABSTRACT FROM AUTHOR]

Abstract Background Soft palate defects created during oral cancer surgery may prevent complete palatal closure and trigger palatopharyngeal insufficiency. One current treatment employs a rigid obturator prosthesis; an extension of acrylic resin at the level of the hard palate ensures surface contact with the remaining musculature. Unfortunately, airflow escape often causes hypernasality, compromises speech intelligibility, and creates swallowing problems (including leakage of food and fluid into the nasal airway). We plan to test a new removable denture featuring a thick dental dam that serves as a membrane obturator. The principal objective of the clinical trial is a comparison of speech handicap levels after 1 month in patients with acquired velar insufficiencies who wear either the new device or a conventional, rigid obturator. The secondary objectives are between-device comparisons of the swallowing handicaps and the health-related qualities of life. Methods The VELOMEMBRANE trial is a superiority, open-labeled, two-way, random crossover clinical trial. Adult patients exhibiting velar or palatovelar substance loss after tumor excision and who are indicated for rigid obturator-mediated prosthetic rehabilitation will be recruited in two teaching hospitals in France. Fourteen participants will be randomly allocated to wear both prostheses for 1-month periods in either order. The new membrane obturator is a removable resin prosthesis incorporating a rigid extension that holds a dental dam to restore the soft palate. The primary outcome will be the extent of phonation-related disability (the overall score on the Voice Handicap Index [VHI]). The secondary outcomes will be the Deglutition Handicap Index and health-related quality of life scores of the European Organization for Research and Treatment of Cancer (EORTC). Discussion High-quality evidence will be provided to document the utility of a new medical device that may greatly improve the management and quality of life of patients with acquired velar insufficiency. Trial registration ClinicalTrials.gov NCT04009811 . Registered on 4 July 2019

Introduction: Screening programs with the use of specific diagnostic tools in asymptomatic patients are useful in identifying suspicious oral lesions and aid in the early diagnosis of oral cancer. The objective of the present study was to compare the oral rub and rinse technique with the conventional exfoliative cytology in the screening of oral malignant and potentially malignant diseases. Materials and Methods: An oral cancer screening program was conducted in the Dakshina Kannada district of Karnataka, India. The oral rub and rinse technique was performed on patients who had red/white lesions in the oral mucosa followed by the conventional exfoliative cytology. Scalpel biopsy was performed to confirm for presence or absence of malignancy in cases wherever indicated. Descriptive statistics (frequency and percentage) were used in the present study. Results: A total of 848 subjects were screened for oral cancer and precancer. About 112 participants had premalignant/malignant lesions and biopsy was performed on 30 subjects. Of these, 27.7% were Class I smears, 39.3% were Class II smears, 22.3% were Class III smears, 4.5% were Class IV smears, and 6.2% were unsatisfactory using the conventional technique, whereas the oral rub and rinse technique showed 26.8% Class I smears, 42.9% Class II smears, 19.6% Class III smears, 6.2% Class IV smears, 0.9% Class V smears, and 3.6% unsatisfactory. Conclusion: Although both the techniques could detect malignancy, the oral rub and rinse technique showed better cellular clarity and sample adequacy when compared to conventional exfoliative cytology, which makes it a practical tool in resource-challenged settings.

Oral cancer constitutes around 2.1% and it is the sixth-most common malignancy worldwide and the third-most common type of malignancy in India. The purpose of this systematic review is to find the prediction of survival rate among oral cancer patients using artificial intelligence (AI) and its forms like machine learning. Suitable articles were identified by searching PubMed, Trip database, Cochrane, and Google Scholar host databases. The search was done with the help of PIO analysis where the population stands for oral cancer patients, the intervention given here were AI and its subsets and the outcome were diagnosis and survival prediction of oral cancer. The screening of the titles and abstracts was done, and only those articles that fulfilled the eligibility criteria were selected. The search resulted in 451 articles, of which only six articles that fulfilled the criteria were included. The studies showed that AI models were able to predict the 5-year survival rate among oral cancer patients. The accuracy of the decision tree classifier, logistic regression, and boosted decision tree models were 76%, 60%, and 88.7%, respectively. Modern age diagnosed people tend to have a longer survival rate than those diagnosed in the past. The limitation was that these studies were created using retrospective cohorts, but for validation, they must be compared with prospective cohorts. These studies are important for identification and survival prediction, which will contribute to future advancements, change in the treatment plan, and reduce health-care problems.

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign non-neoplastic vascular lesion. A typical presentation consists of a subcutaneous nodule that may simulate other clinical entities. Presentation in the oral cavity is uncommon. It is thought to develop as an abnormal proliferative reaction of endothelial cells in a process of impaired thrombogenesis. When endothelial proliferation occurs, a differential diagnosis with a soft tissue sarcoma, in particular an angiosarcoma, should be performed. We report a case of a 68-year-old female patient who presented with a lesion on the upper lip of 3 months' duration. Surgical resection revealed an IPEH. 1 year later, the patient showed a local recurrence requiring excision with clear margins. Pathological and immunohistochemical features can help us distinguish these lesions from those requiring more aggressive treatment. The gold standard is surgical resection with clear margins. Accurate preoperative diagnosis is essential to avoid overtreatment. Emphasis should be placed on clinical, radiological and histological studies. [ABSTRACT FROM AUTHOR]

Background: Oral erythroplakia has been classically considered as the potentially malignant disorder with the highest rate of malignant development into squamous cell carcinoma. This critical systematic review and meta‐analysis aim to estimate the malignant development rate of oral erythroplakia and identify the associated risk factors. Methods: We performed a bibliographic search in PubMed, Scopus, Web of Science, Embase, and LILACS, with keywords "erythroplakia," "erythroplasia," "malignant transformation," "malignant development," "malignization," "carcinogenesis," "oral cancer," "oral squamous cell carcinoma," "mouth neoplasm," and "prognosis." Meta‐analysis was conducted using a random‐effects model. Results: Ten observational studies with 441 patients met the inclusion criteria, whose mean malignant development rate was 12.7% and with a mean follow‐up period of patients of 6.66 years. In the initial biopsy, 42.8% of oral erythroplakia were already squamous cell carcinoma. The buccal mucosa was the most frequent location of oral erythroplakia, but the floor of the mouth was the most common site of malignant development. All patients who underwent malignant development showed epithelial dysplasia on the initial diagnostic biopsy. Conclusion: Overall malignant development rate of OE in the meta‐analysis was 19.9%. We could not associate any specific clinicopathological feature with the malignant development. The presence of epithelial dysplasia in the initial biopsy remains the worst prognostic factor. Further observational studies on OE are needed, with well‐established diagnostic criteria and good clinical follow‐up, in order to identify the true risk of malignant development of oral erythroplakia and the related risk factors. [ABSTRACT FROM AUTHOR]

Head and neck cancer (HNC) affects over 890,000 people annually worldwide and has a mortality rate of 50%. Aside from poor survival, HNC pain impairs eating, drinking, and talking in patients, severely reducing quality of life. Different pain phenotype in patients (allodynia, hyperalgesia, and spontaneous pain) results from a combination of anatomical, histopathological, and molecular differences between cancers. Poor pathologic features (e.g., perineural invasion, lymph node metastasis) are associated with increased pain. The use of syngeneic/immunocompetent animal models, as well as a new mouse model of perineural invasion, provides novel insights into the pathobiology of HNC pain. Glial and immune modulation of the tumor microenvironment affect not only cancer progression but also pain signaling. For example, Schwann cells promote cancer cell proliferation, migration, and secretion of nociceptive mediators, whereas neutrophils are implicated in sex differences in pain in animal models of HNC. Emerging evidence supports the existence of a functional loop of cross-activation between the tumor microenvironment and peripheral nerves, mediated by a molecular exchange of bioactive contents (pronociceptive and protumorigenic) via paracrine and autocrine signaling. Brain-derived neurotrophic factor, tumor necrosis factor α, legumain, cathepsin S, and A disintegrin and metalloprotease 17 expressed in the HNC microenvironment have recently been shown to promote HNC pain, further highlighting the importance of proinflammatory cytokines, neurotrophic factors, and proteases in mediating HNC-associated pain. Pronociceptive mediators, together with nerve injury, cause nociceptor hypersensitivity. Oncogenic, pronociceptive mediators packaged in cancer cell–derived exosomes also induce nociception in mice. In addition to increased production of pronociceptive mediators, HNC is accompanied by a dampened endogenous antinociception system (e.g., downregulation of resolvins and µ-opioid receptor expression). Resolvin treatment or gene delivery of µ-opioid receptors provides pain relief in preclinical HNC models. Collectively, recent studies suggest that pain and HNC progression share converging mechanisms that can be targeted for cancer treatment and pain management. [ABSTRACT FROM AUTHOR]

Oral cancer constitutes around 2.1% and it is the sixth-most common malignancy worldwide and the third-most common type of malignancy in India. The purpose of this systematic review is to find the prediction of survival rate among oral cancer patients using artificial intelligence (AI) and its forms like machine learning. Suitable articles were identified by searching PubMed, Trip database, Cochrane, and Google Scholar host databases. The search was done with the help of PIO analysis where the population stands for oral cancer patients, the intervention given here were AI and its subsets and the outcome were diagnosis and survival prediction of oral cancer. The screening of the titles and abstracts was done, and only those articles that fulfilled the eligibility criteria were selected. The search resulted in 451 articles, of which only six articles that fulfilled the criteria were included. The studies showed that AI models were able to predict the 5-year survival rate among oral cancer patients. The accuracy of the decision tree classifier, logistic regression, and boosted decision tree models were 76%, 60%, and 88.7%, respectively. Modern age diagnosed people tend to have a longer survival rate than those diagnosed in the past. The limitation was that these studies were created using retrospective cohorts, but for validation, they must be compared with prospective cohorts. These studies are important for identification and survival prediction, which will contribute to future advancements, change in the treatment plan, and reduce health-care problems. [ABSTRACT FROM AUTHOR]

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Statement of the Problem: Oral squamous cell carcinoma (OSCC) constitutes more than 90% of oral malignancies. The main risk factors of OSCC include cigarette smoking and alcohol. However, since not all smokers or alcohol drinkers develop this disease, other factors have also been suggested including genetic characteristics of every person to be implicated in the probability of developing OSCC. Purpose: Our aim in this study is to investigate the possible relationship between fingerprint patterns and the probability of developing OSCC. Materials and Method: In a cross sectional study, we had 140 patients in 2 groups as OSCC and cancer free. Fingerprints were recorded by fingerprint scanner device. The fingerprint patterns were categorized into three major groups and four subgroups. Groups were tested by chi-square. Results: The relationship between the main fingerprint patterns and incidence of OSCC became significant (p= 0.037). The frequency of the main pattern of Arch was significantly higher in the experimental group than in the control group (p< 0.05). Considering the main patterns of Loop and Whorl, no significant difference existed between the two groups. Furthermore, the frequency of subtype patterns of Double Whorl and Central Pocket Whorl was significantly higher in the control group than in the experimental group (p< 0.05). Conclusion: Since dermatoglyphics is contingent upon genetic variations, fingerprint can be used for investigating the susceptibility of people in developing different diseases, though further studies are required in this regard. This method is in no way a substitute for gold standard methods for diagnosis. [ABSTRACT FROM AUTHOR]

Aim: To determine the influence of prognostic factors on the survival of patients who had been diagnosed with lymphoma of the oral cavity and maxillofacial region (OC/MR) and received care at the National Institute for Neoplastic Diseases (INEN). Materials and Methods: This was a retrospective cohort study. This type of study is classified as observational, analytic, longitudinal, and retrospective. The sample consisted of cases diagnosed with primary lymphoma of the OC/MR (151 altogether), over the 13 years included in the study (1997–2010). The sample only included patients for whom histopathological diagnosis was confirmed by re-evaluation of the histological section. Clinical histories were reviewed to retrieve the following variables as potential prognostic factors: age, sex, location of the lesion, size, signs/symptoms, diagnosis, clinical stage, international prognostic index, serum lactate dehydrogenase levels, extranodal involvement, and treatment. The study was approved by the hospital Institutional Review Board. The following statistical analyses were applied: (1) analysis by actuarial technique and Kaplan–Meier product-limit method for survival and (2) univariate analysis with the log-rank test and multivariate analysis using Cox regression model for prognostic factors and hazard function. Results: Out of the 151 patients diagnosed, 50 were included in the study. Survival at 2 and 5 years was 69% and 47%, respectively. Multivariate analysis showed that survival is influenced by presence of pain, clinical stage, extranodal involvement, and treatment type. A single significant variable was established as the best hazard function: clinical stage III/IV, with patients at these stages being 6.86 times more likely to die than patients at clinical stage I/II. Conclusion: Based on the methodology and statistical analyses used, it was mainly found that survival at 5 years was lower than specified in international reports and that prognostic factors influencing survival jointly were pain, clinical stage, extranodal involvement, and treatment. For hazard function, it was found that the probability of dying was high when the patient was at clinical stage III/IV, which had the greatest influence or created the highest risk of dying among all prognostic factors analyzed. [ABSTRACT FROM AUTHOR]

Introduction: The head and neck are frequent sites for the development of cutaneous cancer and squamous cell carcinoma of the skin (SCC), one of the more frequent malignant non-melanoma skin neoplasms in Chile (436 per 100,000 inhabitants). Between 5-10% skin SCC progresses aggressively generating metastasis to parotid and cervical lymph nodes. Case Report: A 82 years old male, presents painful increased volume lesion in the mandibular area. He has a history of chronic arterial hypertension, acute renal failure, SCC of the scalp, extra-pulmonary tuberculosis, chronic sun exposure and smoking. Extraoral examination showed a 4 cm lesion in the posterior third of the mandibular branch, with undefined edges, a firm consistency and painful on palpation. Intraorally, erythematous mucosa is observed, as well as lack of lubrication, tenderness and cortical bone expansion. Incisional biopsy is performed, imaging and histological exams are requested. The results indicate the presence of SCC, and therefore referral to secondary care. Many risk factors are associated with SCC development, with ultraviolet radiation the most relevant in this case, favoring its appearance on the scalp. The probability of metastasis is low, but when it happens, the majority of cases that started in the scalp, disseminate to the parotid and cervical region. Conclusion: The SCC has a good prognosis. However, there are antecedents, such as size and location, that must alert the professional to perform the monitoring, early screening, control of metastatic nodes in maxillofacial area.

Oral squamous cell carcinoma (OSCC) is characterized by poor survival, mostly due to local invasion, loco-regional recurrence, and metastasis. Given that the weakening of cell-to-cell adhesion is a feature associated with the migration and invasion of cancer cells, different studies have explored the prognostic utility of cell adhesion molecules such as E-cadherin (E-cad). This study aims to summarize current evidence in a meta-analysis, focusing on the prognostic role of E-cad in OSCC. To find studies meeting inclusion criteria, Scopus, Web of Science, EMBASE, Medline, and OpenGrey databases were systematically assessed and screened. The selection process led to 25 studies, which were considered eligible for inclusion in the meta-analysis, representing a sample of 2553 patients. E-cad overexpression was strongly associated with longer overall survival (OS) with Hazard Ratio (HR) = 0.41 95% confidence interval (95% CI) (0.32–0.54); p < 0.001 and disease-free survival with HR 0.47 95% CI (0.37–0.61); p < 0.001. In terms of OS, patients with tongue cancer experienced better survivability when expressing E-cad with HR 0.28 95% CI (0.19–0.43); p < 0.001. Globally, our findings indicate the prognostic role of the immunohistochemical assessment of E-cad in OSCC and its expression might acquire a different role based on the oral cavity subsites.

Background: Soft palate defects created during oral cancer surgery may prevent complete palatal closure and trigger palatopharyngeal insufficiency. One current treatment employs a rigid obturator prosthesis; an extension of acrylic resin at the level of the hard palate ensures surface contact with the remaining musculature. Unfortunately, airflow escape often causes hypernasality, compromises speech intelligibility, and creates swallowing problems (including leakage of food and fluid into the nasal airway). We plan to test a new removable denture featuring a thick dental dam that serves as a membrane obturator. The principal objective of the clinical trial is a comparison of speech handicap levels after 1 month in patients with acquired velar insufficiencies who wear either the new device or a conventional, rigid obturator. The secondary objectives are between-device comparisons of the swallowing handicaps and the health-related qualities of life.Methods: The VELOMEMBRANE trial is a superiority, open-labeled, two-way, random crossover clinical trial. Adult patients exhibiting velar or palatovelar substance loss after tumor excision and who are indicated for rigid obturator-mediated prosthetic rehabilitation will be recruited in two teaching hospitals in France. Fourteen participants will be randomly allocated to wear both prostheses for 1-month periods in either order. The new membrane obturator is a removable resin prosthesis incorporating a rigid extension that holds a dental dam to restore the soft palate. The primary outcome will be the extent of phonation-related disability (the overall score on the Voice Handicap Index [VHI]). The secondary outcomes will be the Deglutition Handicap Index and health-related quality of life scores of the European Organization for Research and Treatment of Cancer (EORTC).Discussion: High-quality evidence will be provided to document the utility of a new medical device that may greatly improve the management and quality of life of patients with acquired velar insufficiency.Trial Registration: ClinicalTrials.gov NCT04009811 . Registered on 4 July 2019. [ABSTRACT FROM AUTHOR]

Background: The rapid migration from rural to urban region results in mushrooming of slums in India. Urban-slums are comparatively poor vulnerable groups which are mostly affected with oral cancer due to higher exposure to risk factors like tobacco use. Aims: To assess pattern of tobacco consumption, awareness about oral cancer and related health education needs in urban slums of Jodhpur city. Methods: Study was conducted during July 2018Nov 2018 in slum of Jodhpur city. On the basis of cluster sampling strategy data were collected from 1200 participants regarding tobacco use and perception regarding oral cancer to identify health education needs in urban slums. Descriptive statistics, Chi-square test, multivariate logistics analysis were used and P < 0.05 was considered statistically significant. Results: A total of 1200 participants were surveyed, out of which 48.5% were males. Among the study population, 58.5% (n = 462/789) males and 41.45% (n = 327/789) females were consuming tobacco in one or more forms. The statistical association between: age and bidi, gutka, zarda consumption; gender and bidi, cigarette, gutka consumption was found to be significant (P < 0.001). The younger population (1530 years) has more willingness to quit tobacco than the older population. (OR = 1.52, 95% CI = 1.092.11). Almost 56% were aware of oral cancer. Conclusions: An effective information, education and communication (IEC) strategy for tobacco cessation should be designed with focus on different education needs according to age, gender, and education status of slum population. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the oncologic safety of submental island flap (SIF) reconstruction in clinically node-negative oral cancer patients. Forty-four clinically node-negative oral cancer patients with tumour size T1–T3 were divided into two groups. The Submental group consisted of 21 patients, who underwent submental island flap reconstruction whereas the control group consisted of 23 patients who underwent reconstruction with other locoregional or free flaps. The locoregional recurrence rate (LRR) and recurrence-free survival (RFS) in these two groups were assessed and compared. The follow-up period in the two groups ranged from six to 28 months, with a median follow-up period of 15 months and 21 months, respectively. Results showed that the LRR in the control and the submental group was 21.7% and 19%, respectively (p = 0.825). Kaplan–Meier curve showed that the difference in recurrence-free survival in the two groups was not statistically significant (p = 0.749). Multivariate and bivariate analyses did not establish any relationship between the predictive parameters and locoregional recurrence. Thus, the Submental island flap is a reliable and versatile locoregional flap for the reconstruction of post-resection defects in oral cancer. It has no predictive influence on locoregional recurrence in clinically node-negative oral cancer patients. [ABSTRACT FROM AUTHOR]

Background: Proliferative verrucous/multifocal leukoplakia (PVML) is an oral potentially malignant disorder (OPMD) that exhibits high rates of malignant development (MD). This study aimed to analyse the risk of MD of PVML, as well as to investigate the possible risk factors associated with its malignization. Methods: A bibliographical search of the PubMed, Embase, Web of Science, and Scopus databases was conducted. PVML MD rates were calculated as a pooled proportion, and the risk factors were calculated as risk ratios, using fixed and random models based on the presence of heterogeneity. Results: From a total of 417 records, 16 articles were retrieved for inclusion. The subgroup analysis revealed a higher MD rate in the studies that were conducted in America, and, likewise, said studies involved a longer follow‐up time (>6 years). There was a non‐significant lower risk of malignization among males. A negative correlation was observed between MD and the year in which the studies were published. Conclusions: The pooled MD of PVML was 65.8% (95% CI: 55.3–76.2, p < 0.001). Prospective studies of PVML must be designed using simple and universal clinical diagnostic criteria to be able to make an early diagnosis of this important OPMD and acknowledge the frequency of MD. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the presence of immature CD1a+ and mature CD83+ dendritic cells in oral squamous cell carcinoma, to compare immunoreactivity between smokers and nonsmokers, and to correlate the results with histopathological grading. In this observational study, twenty-eight paraffin-embedded biopsies of oral squamous cell carcinoma were retrospectively retrieved and submitted to immunohistochemistry for immature CD1a+ and mature CD83+. Descriptive and statistical analyses were performed. The sample consisted of 18 man (64.3%) and 10 women (35.7%), with a mean age of 64.6 years in the nonsmoker group and 53.2 years in the smoker group. The tongue (11 cases, 39.2%) was the most commonly affected anatomical site, followed by gingiva (6 cases, 21.4%). Histopathological grading revealed 7 low-grade and 7 high-grade malignancy cases in each group, and no correlation with the number of positive DCs. The number of immature CD1a+ was not significantly different between smoker and nonsmoker groups, while a lower number of mature CD83+ was detected in the smoker group (p = 0.001). Smoking changes the oral immune system and decreases the ability to activate and mature dendritic cells, which may influence the development and progression of oral squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Introduction: Screening programs with the use of specific diagnostic tools in asymptomatic patients are useful in identifying suspicious oral lesions and aid in the early diagnosis of oral cancer. The objective of the present study was to compare the oral rub and rinse technique with the conventional exfoliative cytology in the screening of oral malignant and potentially malignant diseases. Materials and Methods: An oral cancer screening program was conducted in the Dakshina Kannada district of Karnataka, India. The oral rub and rinse technique was performed on patients who had red/white lesions in the oral mucosa followed by the conventional exfoliative cytology. Scalpel biopsy was performed to confirm for presence or absence of malignancy in cases wherever indicated. Descriptive statistics (frequency and percentage) were used in the present study. Results: A total of 848 subjects were screened for oral cancer and precancer. About 112 participants had premalignant/malignant lesions and biopsy was performed on 30 subjects. Of these, 27.7% were Class I smears, 39.3% were Class II smears, 22.3% were Class III smears, 4.5% were Class IV smears, and 6.2% were unsatisfactory using the conventional technique, whereas the oral rub and rinse technique showed 26.8% Class I smears, 42.9% Class II smears, 19.6% Class III smears, 6.2% Class IV smears, 0.9% Class V smears, and 3.6% unsatisfactory. Conclusion: Although both the techniques could detect malignancy, the oral rub and rinse technique showed better cellular clarity and sample adequacy when compared to conventional exfoliative cytology, which makes it a practical tool in resource-challenged settings. [ABSTRACT FROM AUTHOR]

Carbonic anhydrase IX (CAIX) is a hypoxia-related protein considered as a predictor for oral squamous cell carcinoma (OSCC) biological behaviour. Nevertheless, this prognostic value is still yet to be validated. We aim to quantify prognostic significance of CAIX overexpression in OSCC by meta-analysis. We performed searches in MEDLINE, EMBASE, SCOPUS, WOS, WHO’S databases, CPCI, and OATD from inception to August 2019. Overall survival (OS), disease-free survival (DFS), locoregional control (LC), and disease-specific survival (DSS) were considered as outcomes of interest. Overall 18 studies were included. CAIX overexpression was associated with worse OS (hazard ratio [HR] = 1.45 95% confidence interval [CI] 1.17–1.80) and DFS (HR = 1.98 95% CI 1.18–3.32). To the contrary, it was neither associated with LC (HR = 1.01 95% CI 0.50–2.02) nor with DSS (HR = 1.35 95% CI 0.78–2.33). Heterogeneity was negligible in all analyses except for DSS. Small studies effect was not significant for OS and DFS. This study shows that immunohistochemical CAIX assessment is a useful OSCC prognostic biomarker.

The optimal cut-off point of the resection margin was recently debated in oral cancer. To evaluate the current evidence of the dynamic criteria of the resection margin, a review of the available literature was performed. Studies were sourced from PubMed and EMBASE by searching for the keywords “mouth neoplasm”, “oral cancer”, “oral cavity cancer”, “oral squamous cell carcinoma”, “tongue cancer”, “margins of excision”, “surgical margin” and “resection margin”. We found approximately 998 articles on PubMed and 2227 articles on EMBASE. A total of 3225 articles was identified, and 2763 of those were left after removing the duplicates. By applying advanced filters about the relevance of the subjects, these were narrowed down to 111 articles. After the final exclusion, 42 full-text articles were reviewed. The universal cut-off criteria of 5 mm used for determining the resection margin status has been debated due to recent studies evaluating the impact of different margin criteria on patient prognosis. Of note, the degree of the microscopic extension from the gross tumor border correlates with tumor dimensions. Therefore, a relatively narrow safety margin can be justified in early-stage oral cancer without the additional risk of recurrence, while a wide safety margin might be required for advanced-stage oral cancer. This review suggests a surgical strategy to adjust the criteria for risk grouping and adjuvant treatments, according to individual tumor dimensions or characteristics. In the future, it might be possible to establish individual tumor-specific surgical margins and risk stratification during or after surgery. However, the results should be interpreted with caution because there is no strong evidence (e.g., prospective randomized controlled studies) yet to support the conclusions. Our study is meaningful in suggesting future research directions and discussions.

Chronic hyperplastic candidiasis (CHC) is a prototypical oral lesion caused by chronic Candida infection. A major controversy surrounding CHC is whether this oral lesion owns malignant transformation (MT) potential. The aim of the present study was to evaluate current evidence on the MT of CHC and to determine the variables which have the greatest influence on cancer development. Bibliographical searches included PubMed, Embase, Web of Science, Scopus and LILACS. The cohort studies and case series used to investigate the MT of CHC were deemed suitable for inclusion. The quality of the enrolled studies was measured by the Joanna Briggs Institute scale. Moreover, we undertook subgroup analyses, assessed small study effects, and conducted sensitivity analyses. From 338 studies, nine were finally included for qualitative/quantitative analysis. The overall MT rate for CHC across all studies was 12.1% (95% confidential interval, 4.1–19.8%). Subgroup analysis showed that the MT rate increased when pooled analysis was restricted to poor quality studies. It remains complex to affirm whether CHC is an individual and oral, potentially malignant disorder according to the retrieved evidence. Prospective cohort studies to define the natural history of CHC and a consensus statement to clarify a proper set of diagnostic criteria are strongly needed. PROSPERO ID: CRD42022319572.

Background: It remains unclear whether the use of adjunctive diagnostic screening methods improves the diagnostic efficacies of oral premalignant and cancerous lesions. Objective of review: We evaluated the diagnostic accuracy of narrow‐band imaging used to detect oral cancer and precancerous lesions defined employing different narrow‐band imaging criteria. Type of review: Systematic review and meta‐analyses. Search strategy: We searched PubMed, Scopus, the Web of Science, Embase, Google Scholar and the Cochrane Central Register of Controlled Trials to May 2020. Evaluation methods: Three different criteria for oral mucosal vascular changes using narrow‐band imaging were compared: class I: well‐demarcated brownish areas with thick dark spots and/or winding vessels; class II: intraepithelial papillary capillary looping of grades 2, 3 and 4; and class III: intraepithelial papillary capillary looping of grades 3 and 4. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (ver. 2) tool. We compared narrow‐band imaging to conventional white‐light imaging. Results: We included 10 prospective or retrospective studies (1374 patients). To detect all dysplastic and cancerous lesions, the class I criteria afforded the optimal specificity and sensitivity; the area under the summary receiver operating characteristic curve was 0.918. To detect highly dysplastic and advanced cancerous lesions, the class III criteria afforded appropriate specificity and sensitivity. The summary receiver operating characteristic curve was 0.905. When using the class III criteria, narrow‐band imaging afforded better specificity (0.941 [range 0.920, 0.9572], P <.0001) compared to white‐light imaging (0.520 [range 0.409, 0.629]). However, the white‐light imaging data were inconsistent and the ranges were broad; narrow‐band imaging may be considerably more accurate than white‐light imaging when using the class III criteria. Conclusion: Narrow‐band imaging diagnosed oral premalignant or cancerous lesions much more reliably than white‐light imaging. [ABSTRACT FROM AUTHOR]

Background: Podoplanin (PDPN) is a glycoprotein associated with epithelial‐mesenchymal transition, invasion, and metastasis in several types of malignancies, including oral and oropharyngeal squamous cell carcinoma (OSCC). The aim of this systematic review (SR) was to summarize and critically appraise the available evidence about the association between PDPN immunoexpression and clinicopathological features and its utility as a prognostic marker in OSCC. Methods: Five electronic databases and three gray literature databases were searched for immunohistochemical studies, which were selected in a two‐phase process. Results: From 721 records identified, 22 cohort and seven analytical cross‐sectional studies were included. Few studies reported that PDPN expression was associated with poorer survival rates in OSCC: overall survival = 4/12, disease‐free survival = 4/7, and cancer‐specific survival = 2/4 studies. Positive associations were most frequently reported on lymph node involvement, higher histopathological grade, and advanced clinical stages. Conclusion: Within limitations of this SR, PDPN may be associated with lymph node involvement, histopathological grade, and clinical stage of OSCC. Current evidence suggests that PDPN could be a useful prognostic marker for OSCC that needs further exploration. [ABSTRACT FROM AUTHOR]

Background: The rapid migration from rural to urban region results in mushrooming of slums in India. Urban-slums are comparatively poor vulnerable groups which are mostly affected with oral cancer due to higher exposure to risk factors like tobacco use. Aims: To assess pattern of tobacco consumption, awareness about oral cancer and related health education needs in urban slums of Jodhpur city. Methods: Study was conducted during July 2018Nov 2018 in slum of Jodhpur city. On the basis of cluster sampling strategy data were collected from 1200 participants regarding tobacco use and perception regarding oral cancer to identify health education needs in urban slums. Descriptive statistics, Chi-square test, multivariate logistics analysis were used and P < 0.05 was considered statistically significant. Results: A total of 1200 participants were surveyed, out of which 48.5% were males. Among the study population, 58.5% (n = 462/789) males and 41.45% (n = 327/789) females were consuming tobacco in one or more forms. The statistical association between: age and bidi, gutka, zarda consumption; gender and bidi, cigarette, gutka consumption was found to be significant (P < 0.001). The younger population (1530 years) has more willingness to quit tobacco than the older population. (OR = 1.52, 95% CI = 1.092.11). Almost 56% were aware of oral cancer. Conclusions: An effective information, education and communication (IEC) strategy for tobacco cessation should be designed with focus on different education needs according to age, gender, and education status of slum population.

Carbonic anhydrase IX (CAIX) is a hypoxia-related protein considered as a predictor for oral squamous cell carcinoma (OSCC) biological behaviour. Nevertheless, this prognostic value is still yet to be validated. We aim to quantify prognostic significance of CAIX overexpression in OSCC by meta-analysis. We performed searches in MEDLINE, EMBASE, SCOPUS, WOS, WHO'S databases, CPCI, and OATD from inception to August 2019. Overall survival (OS), disease-free survival (DFS), locoregional control (LC), and disease-specific survival (DSS) were considered as outcomes of interest. Overall 18 studies were included. CAIX overexpression was associated with worse OS (hazard ratio [HR] = 1.45 95% confidence interval [CI] 1.17–1.80) and DFS (HR = 1.98 95% CI 1.18–3.32). To the contrary, it was neither associated with LC (HR = 1.01 95% CI 0.50–2.02) nor with DSS (HR = 1.35 95% CI 0.78–2.33). Heterogeneity was negligible in all analyses except for DSS. Small studies effect was not significant for OS and DFS. This study shows that immunohistochemical CAIX assessment is a useful OSCC prognostic biomarker. [ABSTRACT FROM AUTHOR]

Objective: To assess prognostic factors of patients with operable oral cavity squamous cell carcinoma (OSCC), focusing on the associations with smoking/alcohol exposure and age. Materials and Methods: A total of 247 patients with OSCC who received curative surgery ± adjuvant radiotherapy were analyzed. The patient subgroups were divided according to pretreatment smoking/alcohol exposure. Individuals aged 45 years or less were classified as younger patients. Results: The median follow‐up was 52.2 months. The 5‐year locoregional progression‐free survival (LRFFS), distant metastasis‐free survival (DMFS), overall survival (OS), and cancer‐specific survival (CSS) rates were 85.2%, 88.3%, 78.1%, and 83.5%, respectively. An advanced stage, differentiation, and lympho‐vascular space invasion were significantly associated with lower OS and CSS. In a subgroup analysis of younger patients (n = 49), more smoking/alcohol exposure was significantly associated with better OS (hazard ratio [HR]: 0.21, 95% confidence interval [CI]: 0.05–0.95, p =.043). With increasing age, the HR for smoking/alcohol exposure with respect to OS increased up to 11.59 (95% CI: 1.49–89.84, p =.019) in older patients. Conclusion: Younger OSCC patients with non‐ or less smoking/alcohol exposure showed unfavorable outcomes. The prognostic significance of pretreatment smoking/alcohol exposure changed from favorable to detrimental with increasing age in operable OSCC. [ABSTRACT FROM AUTHOR]

Tobacco and betel quid are the most common cause of oral cancer in India. Very often oral cancers are preceded by a visible oral precursor lesion called as potentially malignant disorder (PMD). Aim: The aim of this study was to assess the prevalence of oral PMDs associated with habits in urban and rural areas of Puducherry Union territory, India. Methods: A cross-sectional descriptive study in urban and rural areas of Puducherry was conducted. The study group comprised of 450 patients with positive history of oral habits. A standard structured questionnaire was designed to record information about demographic details, socioeconomic status, type, duration and frequency of habits followed by clinical oral examination by single trained and calibrated examiner to detect the presence of PMD. Statistical analysis used: EpiData software (version 3.1). Descriptive statistics were presented for all variables. Pearson’s Chi-Square test and adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated to estimate the suspected risk factors for PMD by using multivariate logistic regression analysis. P-value of ≤ 0.05 was considered to be statistically significant. Results: Prevalence of habit associated oral PMD was 64.2%. Females were more prone to develop PMDs (68.3%) as compared to males (62.8%). PMD was more common in the age group of 51-60 years (69.2%). Smoking with alcohol consumption was the most common oral habit. Habits, socio-economic status and diet were significantly associated with development of oral PMDs in our study population. Multivariate logistic regression analysis showed that chronic betel quid chewing and smoking were significant risk factors for PMD. Increased frequency of vegetable consumption reduced the risk of PMD. Conclusions: Oral PMD were observed in more than half of the subjects with oral habits in Puducherry. Clearly, there is an increased risk of PMD with increased duration of tobacco and betel quid use in this region. Patients and public need to be educated regarding PMD and encouraged to quit habits so as to prevent high risk population from developing cancer.