[Impact of the coronavirus pandemic on the diagnosis and treatment of head and neck cancer]. / Einfluss der Corona-Pandemie auf Diagnostik und Therapie von Kopf-Hals-Tumoren.

BACKGROUND: After the first appearance of COVID-19 cases, the virus spread worldwide within a few months. This led to a decrease in medical consultations. The present study investigates whether this effect had an impact on the diagnosis and treatment of head and neck cancer during the period from 2018 to 2022. MATERIALS AND METHODS: Data from the clinical cancer registration center (KKR) of Mecklenburg-Vorpommern from the 2020-2022 period were compared to those from the two previous years (2018, 2019). Demographic data, case numbers, diagnosis data, International Classification of Diseases (ICD) codes, and TNM classifications were recorded. COVID-19 case numbers were obtained from the Robert Koch Institute (RKI). Data were analyzed using the Mann-Whitney U test and Pearson's correlation. RESULTS: A total of 2332 patient cases could be included in this study. During the lockdown there was neither a significant reduction in tumor diagnoses registered at the KKR nor a correlation between COVID-19 case numbers and tumor diagnoses. Significant differences were found in terms of T category in the year 2022 compared to the pre-COVID years 2018 and 2019. Furthermore, there was a shift in the relative frequencies of some ICD-10 codes. CONCLUSION: During the COVID-19 pandemic, no significant differences in tumor diagnoses were observed upon comparing the years 2018 to 2022. Contrary to the expectation of a decrease in case numbers during the pandemic due to the lockdown with an increase in tumor stages, a reduction of the T category could be found in 2022, and a shift in the relative frequencies of some ICD-10 codes in the pandemic period was observed.

The emergence of oral cavity cancer and the stabilization of oropharyngeal cancer: Recent contrasting epidemics in the South Korean population.

BACKGROUND: By analyzing the recent epidemiologic trajectory of head and neck squamous cell carcinoma (HNSCC) in South Korea, we tracked 2 findings that have been reported recently in other countries: the stabilization of human papillomavirus (HPV)-related HNSCC incidence and the acceleration of oral cavity cancer incidence. METHODS: We analyzed data from the comprehensive population-based Korean Central Cancer Registry for the period 1999 to 2017. The age-standardized incidence rate (ASR), annual percent change (APC), and relative survival were calculated. RESULTS: The ASR of total HNSCC decreased from 1999 to 2017 (APC, -0.2 [95% CI, -0.3 to -0.0]), as did the ASR of HPV-unrelated HNSCC (APC, -0.6 [95% CI, -0.8 to -0.5]); however, the ASR of HPV-related HNSCC increased (APC, 2.9 [95% CI, 2.5 to 3.2]). The rapidly increasing incidence of tonsil squamous cell carcinoma, which was the main subsite of HPV-related HNSCC, stabilized after 2011 (APC pre-2011, 6.8 [95% CI, 5.0 to 8.3]; APC post-2011, 1.6 [95% CI, -2.1 to 5.5]), and the difference was significant (P = .017). In contrast, oral cavity cancer incidence demonstrated the only increase among HPV-unrelated subsites, with the increase occurring after 2006 (APC pre-2006, 1.6 [95% CI, 0.3 to 2.8]; APC post-2006, 2.8 [95% CI, 2.2 to 3.5]); the main cause of this change was an increase in the ASR of tongue cancer. CONCLUSION: This study demonstrates the recent stabilization of tonsil cancer incidence and the contrasting increase in oral cavity cancer incidence, unlike other HPV-unrelated cancers. These trends require further surveillance and understanding in terms of tumor biology and prevention.

Does age influence disease-specific survival in patients with squamous cell carcinomas of the head and neck?

BACKGROUND AND OBJECTIVES: The number of patients diagnosed with head and neck squamous cell carcinoma (HNSCC) at an advanced age has increased. The aim of this study is to evaluate the age at which disease-specific survival (DSS) significantly decreases in HNSCC. METHODS: We performed a retrospective study of 5469 patients with HNSCC treated at our center (1985-2016). External validation with 2082 oral squamous cell carcinomas from a collaborative institution from another continent was performed. RESULTS: We observed an orderly decrease in overall survival as age at diagnosis increased. There were no differences in DSS based on age for patients <80 years old (P = .623), while older patients had a significant decrease in DSS. These results were validated in the independent dataset. In a multivariable analysis performed in the test set, compared to patients <80 years old, patients between 80 to 85 had a 1.50 times higher risk of disease-specific death (95% confidence interval [CI]: 1.19-1.89; P = .001), and patients >85 had a 2.19 times higher risk (95% CI: 1.68-2.87; P < .001). CONCLUSIONS: DSS started to significantly decrease in HNSCC at 80 years old. These findings, validated in an independent cohort, indicate that chronological age on its own should not withhold curative treatment in the majority of patients with HNSCC.

A Rare Case of Clear Cell Sarcoma of the Tongue: A Case Report.

Clear cell sarcoma (CCS), previously known as soft tissue melanoma due to similarities with melanoma, is a rare and aggressive neoplasm. This tumor predominantly occurs in the lower limbs and rarely affects the tongue, as well as other head and neck locations. To our knowledge, only five cases have been reported in the English literature. CCS presents many similar morphological and immunohistochemical features to those of melanomas, sarcomatoid cell carcinoma, angiomatoid histiocytoma, and Ewing sarcoma, which makes the diagnosis difficult, especially in cases of uncommon locations. The treatment is based on oncological surgery and adjuvant radiation therapy as these tumors show low sensitivity to chemotherapy. This study aimed to report a case of an 88-year-old male patient who presented a large, rapidly growing nodular lesion on the right border of the mobile tongue diagnosed with CCS of the tongue.

Implication of the New AJCC pT Classification of SCC of the Lip Comparing With Other Oral Subsites.

OBJECTIVE: To determine the implication of the new AJCC staging system for pT classification in a cohort of patients with SCC of the lip mucosa and compare it to other oral cavity sites. METHODS: Retrospective cohort of 744 patients treated between 2002 and 2017, by the Head and Neck Surgery Department of the University of Sao Paulo. RESULTS: Of 95 lip patients, 42 had pT upstage (58.1% of pT1 to pT2-3 and 50% of pT2 to pT3). Similar DFS/OS observed for those pT1 maintained or upstaged to pT2-3, pT2 patients upstaged to pT3 presented worse OS (49.4% versus 92.3%, P = .032). The comparison between lip and other mouth topographies, denoted better prognosis for pT1-2, but not for pT3-4a. Lip tumors had lower DOI, rates of perineural/angiolymphatic invasion, nodal metastasis, recurrence, and death. CONCLUSION: The inclusion of DOI to the new pT classification better stratifies patients with SCC of the lip mucosa upstaged to pT3 by assessing inferior OS. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E2770-E2776, 2021.

Oral potentially malignant disorders: an overview of more than 20 entities.

Cancer of the oral cavity accounts for approximately 3% of all malignancies diagnosed annually in 270,000 patients world-wide. Oral cancer is the 12th most common cancer in women and the 6th in men. Many oral squamous cell carcinomas develop from potentially malignant disorders (PMDs). Lack of awareness about the signs and symptoms of oralPMDs in the general population and even healthcare providers is believed to be responsible for the diagnostic delay of these entities. The aim of this article is to update and improve the knowledge of healthcare providers about oral PMDs.

Impacto de la modificación de la exposición a factores de riesgo en la incidencia de cáncer de cavidad oral en Colombia a 2050 / Impact of modification of risk factor prevalence on the incidence of oral cavity cancer in Colombia by the year 2050

Resumen Introducción: En Colombia, en el periodo 2007-2011, se estima que se diagnosticaron alrededor de 1.500 casos de cáncer de cavidad oral y que por esta causa fallecieron 500 personas, en su mayoría eran hombres. La etiología de esta enfermedad está relacionada con el virus del papiloma humano y, el consumo de alcohol y de cigarrillo. Este estudio buscó cuantificar el efecto en la incidencia del cáncer de cavidad oral del cambio hipotético en la prevalencia de factores de riesgo como consumo de alcohol y, de cigarrillo e infección por virus del papiloma humano en Colombia para el periodo 2015-2050. Métodos: Modelo de simulación macro basado en datos secundarios. Resultados: Según los escenarios simulados, al eliminar el consumo de cigarrillo, alcohol e infección por virus del papiloma humano en la población colombiana probablemente sería posible evitar del 27,6% al 82,1% de los casos nuevos de cáncer de cavidad oral en el país en el periodo 2015-2050. Conclusiones: Bajo los supuestos de un escenario basado en las expectativas de la OMS, las estimaciones del modelo elaborado prevé un posible aumento de los casos de cáncer de cavidad oral asociados al consumo de alcohol y un bajo impacto en la prevención con las medidas actuales, por lo que puede ser necesario que se pongan en marcha acciones para disminuir el consumo de alcohol, así como de cigarrillo. Aunque la dirección de los cambios está bien demostrada en los resultados, es importante tener en cuenta que un modelo de simulación depende de muchos supuestos y por ende tiene limitaciones.

Abstract: Introduction: It is estimated that in the period 2007-2011, around 1500 new cases of oral cavity were diagnosed in Colombia, and that around 500 people died of this cause, the majority men. The etiology of this disease is related to the human papilloma virus, alcohol and cigarette use. This study tries to quantify the effect on oral cancer incidence of a hypothetical change in the prevalence of these risk factors in the period 2015-2050. Methods: macrosimulation models based on secondary data. Results: According to the simulated scenarios, elimination of cigarette and alcohol use and elimination of infection by the human papillomavirus in the Colombian population, would probably prevent 27.6 % to 82.1 % of all new cases of oral cavity cancer expected to occur in the period 2015-2050. Conclusions: according to the projections produced by the World Health Organization and the models we specified, there will be a potential increase in the number of new patients diagnosed with oral cavity cancer associated with the use of alcohol and a low impact of the interventions currently in place. It will be necessary to implement measures to descrease alcohol consumption and sustain current efforts to reduce cigarette use. It is important to take into account the limitations of the simulation models.