Impact on patients with oral squamous cell carcinoma in different anatomical subsites: a single-center study in Taiwan.

The incidence of oral cavity squamous cell carcinoma (OSCC) is particularly high in South Asia. According to the National Comprehensive Cancer Network, OSCC can arise in several subsites. We investigated survival rates and the clinical and pathological characteristics of OSCC in different anatomical subsites in the Taiwanese population. We retrospectively analyzed data for 3010 patients with OSCC treated at the Changhua Christian Hospital. Subsequently, we compared clinical and pathological features of OSCC in different subsites. Pathological T4 stage OSCCs occurred in the alveolar ridge and retromolar trigone in 56.4% and 43.7% of cases, respectively. More than 25% of patients with tongue OSCC and 23.4% of those with retromolar OSCC had lymph node metastasis. The prognosis was worst for hard palate OSCC (hazard ratio 1.848; p < 0.001) and alveolar ridge OSCC (hazard ratio 1.220; p = 0.017). Retromolar OSCC recurred most often and tongue OSCC second most often. The risk for cancer-related mortality was highest for hard palate OSCC, followed by alveolar ridge and retromolar OSCC. We found distinct differences in survival among the different subsites of OSCC. Our findings may also help prompt future investigations of OSCC in different subsites in Taiwanese patients.

Factors related to advanced stage oral squamous cell carcinoma in southern Thailand.

A critical factor that indicates a poor prognosis of oral squamous cell carcinoma (OSCC) is advanced stage disease. This study, therefore, aimed to identify the factors related to advanced stage (TNM staging III, IV) OSCC in Thailand. There were 161 patients with squamous cell carcinoma of the oral cavity and lip (ICD-9 140, 141, 143-5), included in the study. Sixty-two per cent of the patients presented with advanced stage disease. Information on demographic characteristics, risk habits, health-seeking behaviour prior to health care professional (HCP) consultation, tumour characteristics and patient and professional delay was obtained by questionnaire-based interview of the patients. These variables were included as initial variables in a logistic regression to calculate the odds ratio (OR) of advanced versus early stage OSCC. Having traditional herbal medication before HCP consultation significantly increased the risk of advanced stage OSCC (OR 5.77; 95% C.I. 1.25-26.62). Floor of mouth location of tumour was associated with a lower risk of advanced stage disease (OR 0.27; 95% C.I. 0.09-0.82) as was having an ulcer (OR 0.43, 95% C.I. 0.02-0.89). The findings indicate that having traditional herbal medication before HCP consultation increased the risk of advanced stage disease. The lower risk of advanced stage OSCC associated with ulcerative tumours and those on the floor of the mouth may be due to their being more readily detected by the patients.

The effect of iron deficiency on experimental oral carcinogenesis in the rat.

The effect of iron deficiency on oral carcinogenesis was investigated in 30 young adult male Charles River white rats. In 15 animals, prior to the start of carcinogen treatment, iron deficiency anaemia was produced and subsequently maintained by a combination of low iron diet (12 mg Fe2+ kg-1 diet) and repeated venesection. Fifteen control animals were fed the same diet supplemented with iron to approximately 140 mg FE2+ kg-1 diet. All animals were treated with the carcinogen 0.5% 4-Nitroquinoline-N-oxide in propylene glycol which was painted on the palate 3 times weekly. Animals were killed when tumours were grossly evident. The mean haemoglobin levels at the start of carcinogen applications were 10.1 g dl-1 in the anaemic group and 14.1 g dl-1 in the control group, and at the time of killing were 8.2 g dl-1 in anaemic animals and 13.8 g dl-1 in controls. The incidence of animals developing squamous cell carcinomas was similar in both groups, but tumour development was significantly earlier in iron-deficient animals (mean 183 days) compared to controls (mean 229 days). Iron-deficient animals showed a significantly greater incidence of tongue tumours and control animals showed a significantly greater incidence of palatal tumours.