Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Tumours of the Oral Cavity and Mobile Tongue.

The fifth chapter of the upcoming fifth edition of the 2022 World Health Organization Classification of Tumours of the Head and Neck titled Tumours of the oral cavity and mobile tongue, has had some modifications from the 2017 fourth edition. A new section "Non-neoplastic Lesions", introduces two new entries: necrotizing sialometaplasia and melanoacanthoma. The combined Oral potentially malignant disorders and Oral epithelial dysplasia section in the 2015 WHO has now been separated and submucous fibrosis and HPV-associated dysplasia are also discussed in separate sections. Carcinoma cuniculatum and verrucous carcinoma are described in dedicated sections, reflecting that the oral cavity is the most common location in the head and neck for both these entities which have distinct clinical and histologic features from conventional squamous cell carcinoma. This review summarizes the changes in Chapter 5 with special reference to new additions, deletions, and sections that reflect current clinical, histological, and molecular advances.

Study of morphological and textural features for classification of oral squamous cell carcinoma by traditional machine learning techniques.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is the most prevalent form of oral cancer. Very few researches have been carried out for the automatic diagnosis of OSCC using artificial intelligence techniques. Though biopsy is the ultimate test for cancer diagnosis, analyzing a biopsy report is a very much challenging task. To develop computer-assisted software that will diagnose cancerous cells automatically is very important and also a major need of the hour. AIM: To identify OSCC based on morphological and textural features of hand-cropped cell nuclei by traditional machine learning methods. METHODS: In this study, a structure for semi-automated detection and classification of oral cancer from microscopic biopsy images of OSCC, using clinically significant and biologically interpretable morphological and textural features, are examined and proposed. Forty biopsy slides were used for the study from which a total of 452 hand-cropped cell nuclei has been considered for morphological and textural feature extraction and further analysis. After making a comparative analysis of commonly used methods in the segmentation technique, a combined technique is proposed. Our proposed methodology achieves the best segmentation of the nuclei. Henceforth the features extracted were fed into five classifiers, support vector machine, logistic regression, linear discriminant, k-nearest neighbors and decision tree classifier. Classifiers were also analyzed by training time. Another contribution of the study is a large indigenous cell level dataset of OSCC biopsy images. RESULTS: We achieved 99.78% accuracy applying decision tree classifier in classifying OSCC using morphological and textural features. CONCLUSION: It is found that both morphological and textural features play a very important role in OSCC diagnosis. It is hoped that this type of framework will help the clinicians/pathologists in OSCC diagnosis.

The 8th TNM classification for oral squamous cell carcinoma: What is gained, what is lost, and what is missing.

OBJECTIVES: The 8th TNM edition remarkably changed the classification of T and N categories for oral squamous cell carcinoma (OSCC). The present study aims at evaluating the improvement in prognostic power compared to the 7th edition, pros and cons of the modifications, and parameters deserving consideration for further implementations. MATERIALS AND METHODS: All OSCCs treated with upfront surgery at our institution between 2002 and 2017 were included. Demographics, clinical-pathological and treatment variables were retrieved. All tumors were classified according to both the 7th and 8th TNM edition, and patients were grouped according to the shift in T category and stage. Survivals were calculated with the Kaplan-Meier method. Univariate and multivariate analysis were carried out. Receiver Operating Characteristics (ROC) curve analyses were performed to find the best cut-off of DOI (in patients with DOI > 10 mm) and number of involved nodes (in positive neck patients). RESULTS: 244 patients were included. T, N categories, and stage changed in 59.2%, 20.5%, and 49.1% patients, respectively; 41.5% of patients were upstaged. The new T classification well depicted prognosis according to OS. Five-year overall (OS), disease-specific, recurrence-free (RFS) survivals were 60.5%, 70.9%, 59.8%, respectively. According to ROC curves, DOI > 20 mm and 4 positive nodes were the best cutoffs for OS and RFS. CONCLUSION: The novelties introduced in 8th TNM edition were positive. DOI > 20 mm for T4 definition and number of positive nodes (0, <4, 4 or more) for N classification emerged as the most urgent factors to be implemented.

Prognosis of oral squamous cell carcinoma with perineural invasion: A comparative study of classification types.

OBJECTIVE: To investigate the histological location and extent of perineural invasion (PNI) as prognostic factors. DESIGN: Retrospective review of medical records and histological analysis of 116 patients with oral squamous cell carcinoma (OSCC). SETTING: Two major public tertiary hospitals treating head and neck cancer, Royal Adelaide Hospital and Flinders Medical Centre, in South Australia. PARTICIPANTS: Patients diagnosed with OSCC who underwent primary surgical treatment with curative intent at these two centres from January 1, 2005 through December 31, 2015. MAIN OUTCOME MEASURES: The primary end points were disease-free survival (DFS) and disease-specific survival (DSS). RESULTS: The presence of PNI as a binary factor alone did not significantly influence the clinical outcomes. Extratumoural (ET) PNI as measured from the tumour edge was associated with worse DFS on multivariate analyses. Multifocal PNI was associated with worse DFS and DSS. DFS in multifocal PNI was worse irrespective of whether adjuvant therapy was administered. CONCLUSIONS: The presence of multifocal and ET PNI in OSCC is associated with poor clinical outcomes. Patients with multifocal PNI were associated with worse DFS even with adjuvant therapy.

Fog Computing Employed Computer Aided Cancer Classification System Using Deep Neural Network in Internet of Things Based Healthcare System.

Computer assisted automatic smart pattern analysis of cancer affected pixel structure takes critical role in pre-interventional decision making for oral cancer treatment. Internet of Things (IoT) in healthcare systems is now emerging solution for modern e-healthcare system to provide high quality medical care. In this research work, we proposed a novel method which utilizes a modified vesselness measurement and a Deep Convolutional Neural Network (DCNN) to identify the oral cancer region structure in IoT based smart healthcare system. The robust vesselness filtering scheme handles noise while reserving small structures, while the CNN framework considerably improves classification accuracy by deblurring focused region of interest (ROI) through integrating with multi-dimensional information from feature vector selection step. The marked feature vector points are extracted from each connected component in the region and used as input for training the CNN. During classification, each connected part is individually analysed using the trained DCNN by considering the feature vector values that belong to its region. For a training of 1500 image dataset, an accuracy of 96.8% and sensitivity of 92% is obtained. Hence, the results of this work validate that the proposed algorithm is effective and accurate in terms of classification of oral cancer region in accurate decision making. The developed system can be used in IoT based diagnosis in health care systems, where accuracy and real time diagnosis are essential.

Adenocarcinoma de células basales / Basal cell adenocarcinoma

El adenocarcinoma de células basales, también conocido como carcinoma salival basaloide, adenoma maligno de células basales, es una neoplasia epitelial de bajo grado, infiltrante, localmente destructivo y con tendencia a ser recidivante. Su aparición es entre la 5ª y 6ª década de vida, sin predilección por sexo. Clínicamente se manifiesta con un edema o un aumento repentino de tamaño en la zona, de consistencia firme, crecimiento lento e indoloro. El diagnóstico de certeza es a través de la histopatología; su tratamiento quirúrgico, y tiene buen pronóstico en sus estadios iniciales (AU)

Basal cells adenocarcinoma also known as salivary basaloide carcinoma basal cells malignant adenoma is a low degree, infiltrating, locally destructive and prone to be relapsing, epithelial neoplasia. It occurs between the 5th and 6th decade of life, with no predilection for sex. Clinically it manifests with an edema or sudden increased size in the area, of firm consistency, slow growth and pain-less. Its treatment is surgical and the diagnosis of certainty is histopathological with a good prognosis. The purpose of this presentation is to show the case of a 57- years-old male patient with clinical and anatomopathological diagnosis of adenocarcinoma of basal cells located in the yugal mucosa (AU)

A Novel Surface Enhanced Raman Catheter for Rapid Detection, Classification, and Grading of Oral Cancer.

Fabrication and testing of a novel nanostructured surface-enhanced Raman catheter device is reported for rapid detection, classification, and grading of normal, premalignant, and malignant tissues with high sensitivity and accuracy. The sensor part of catheter is formed by a surface-enhanced Raman scattering (SERS) substrate made up of leaf-like TiO2 nanostructures decorated with 30 nm sized Ag nanoparticles. The device is tested using a total of 37 patient samples wherein SERS signatures of oral tissues consisting of malignant oral squamous cell carcinoma (OSCC), verrucous carcinoma, premalignant leukoplakia, and disease-free conditions are detected and classified with an accuracy of 97.24% within a short detection-cum-processing time of nearly 25-30 min per patient. Neoplastic grade changes detected using this device correlate strongly with conventional pathological data, enabling correct classification of tumors into three grades with an accuracy of 97.84% in OSCC. Thus, the potential of a SERS catheter device as a point-of-care pathological tool is shown for the rapid and accurate detection, classification, and grading of solid tumors.

Revisão dos aspectos morfológicos e imunoistoquímicos do linfoma difuso de grandes células B (LDGCB) com ênfase em boca / Review of the morphological and immunohistochemical aspects of diffuse large B cell lymphoma (DLBCL) with emphasis on the mouth

Os linfomas compreendem um grupo diverso de neoplasias malignas, provenientes de células do sistema imunológico em diferentes estágios de diferenciação. Objetivo: o propósito deste artigo é facilitar o diagnóstico do linfoma difuso de grandes células B (LDGCB) por meio de seus aspectos clínicos, morfológicos e imunoistoquímicos, além de suas peculiaridades como manifestação primária em boca. Revisão de literatura: foi realizada uma revisão narrativa da literatura por intermédio de artigos selecionados nas bases de dados PubMed, Medline, SciELO e Lilacs, pela busca por palavras-chave. Aspectos relacionados a classificação e manifestações clínicas também foram considerados, a fim de facilitar o entendimento da lesão e de suas particularidades em boca. Verificou-se que o LDGCB representa a variante mais comum em boca. Os sinais e sintomas clínicos relacionados a essa condição podem ser: aumento de volume, dor, ulceração, alteração de cor da mucosa ou até mesmo parestesia. Morfologicamente, os LDGCBs apresentam células grandes, com padrão de crescimento difuso, citoplasma escasso, nucléolos evidentes e mitoses. Na imunoistoquímica, os LDGCBs são geralmente positivos para CD20 e outros marcadores da linhagem B (CD19, CD79a, PAX5 e CD138), dependendo do estágio de maturação em que se encontram as células B. Considerações finais: o diagnóstico do LDGCB em boca representa um desafio contínuo para os patologistas, em função da heterogeneidade de suas características morfológicas e imunofenotípicas.(AU)

Lymphomas comprise a diverse group of malignant neoplasias from cells of the immune system at different stages of differentiation. Objective: this article aimed to facilitate the diagnosis of diffuse large B-cell lymphoma (DLBCL) through its clinical, morphological, and immunohistochemical aspects, as well as its particularities as a primary manifestation in the mouth. Literature Review: hence, a narrative review of the literature was performed using articles selected in the PubMed, Medline, SciELO, and Lilacs databases through keyword search. Aspects related to classification and clinical manifestations were also considered to facilitate the understanding of the lesion and its particularities in the mouth. It was verified that the diffuse large B-cell lymphoma (DLBCL) represents the most common variant in the mouth. The clinical signs and symptoms related to this condition may be increased volume, pain, ulceration, changed mucosal color, or even paresthesia. Morphologically, DLBCL presents large cells with diffuse growth pattern, scarce cytoplasm, evident nucleoli, and mitoses. In immunohistochemistry, DLBCL is usually positive for CD20 and other markers of lineage B (CD19, CD79a, PAX5, and CD138) depending on the maturation stage in which B cells are found. Final considerations: the diagnosis of oral DLBCL represents a continuous challenge for pathologists due to the heterogeneity of its morphological and immunophenotypic characteristics.(AU)

Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early-stage oral squamous cell carcinoma.

AIMS: In the 8th edition of the American Joint Committee on Cancer TNM staging manual, tumour infiltration depth and extranodal extension are added to the pathological classification for oral squamous cell carcinoma. The currently available 8th TNM validation studies lack patients with conservative neck treatment, and changes in the classification especially affect patients with small tumours. The aim of this study was to determine the potential impact of the changes in the 8th edition pTNM classification on the prognosis and treatment strategy for oral squamous cell carcinoma in a well-defined series of pT1-T2 patients with long-term follow-up. METHODS AND RESULTS: Two hundred and eleven first primary pT1-T2 oral squamous cell carcinoma patients, with surgical resection as primary treatment, were analysed retrospectively. One hundred and seventy-three patients underwent a neck dissection, and 38 patients had frequent clinical neck assessments. Long-term follow-up (median 64 months) and reassessed tumour infiltration depth were available. Classification according to the 8th edition criteria resulted in 36% total upstaging with the T classification and 16% total upstaging with the N classification. T3-restaged patients (n = 30, 14%) had lower 5-year disease-specific survival rates than T2-staged patients (81% versus 67%, P = 0.042). Postoperative (chemo)radiotherapy could have been considered in another seven (3%) patients on the basis of the 8th edition criteria. CONCLUSIONS: Addition of tumour infiltration depth and extranodal extension in the 8th TNM classification leads to the identification of oral squamous cell carcinoma patients with a worse prognosis who might benefit from an improved postoperative treatment strategy.

Increased Presence of Perineural Invasion in the Tongue and Floor of the Mouth: Could It Represent a More Aggressive Oral Squamous Cell Carcinoma, or Do Larger Aggressive Tumors Cause Perineural Invasion?

PURPOSE: Despite data showing worse outcomes and aggressive disease behavior, perineural invasion (PNI) has not been well characterized in terms of tumor location, histopathologic features, or cervical lymph node status. The specific aims of this study were to measure correlations between PNI, tumor location, and other known histopathologic characteristics used to define aggressive disease. MATERIALS AND METHODS: This was a retrospective cohort study of adult patients with primary squamous cell carcinoma of the oral cavity who underwent neck dissection. We excluded patients whose neck was previously treated with surgery or radiation therapy. Demographic and histopathologic variables of interest were obtained from patient charts. The primary outcome of interest was PNI, and the predictors of interest included tumor location, histopathologic tumor characteristics, and cervical lymph node status. For continuous variables, mean differences were compared by t tests. For categorical variables, the differences in the distribution of the proportions were analyzed with the χ2 test. All variables were entered simultaneously into a multivariate logistic regression model to control for possible confounding. Statistical significance for the study was set at P < .05. RESULTS: Three hundred sixty-eight patients met the study criteria. PNI showed statistically significant correlations with lymph node status, tumor depth, and specific primary tumor location. PNI was more likely to be seen in tumors located in the tongue or floor of the mouth. Tumors with PNI had a deeper depth of invasion: 15.9 ± 10.9 mm versus 10.2 ± 10.0 mm (P < .001). PNI tumors had a higher mean total number of positive nodes: 2.85 ± 5.23 versus 0.83 ± 1.80 (P < .001). CONCLUSIONS: PNI is statistically correlated with tongue and floor-of-the-mouth subsites within the oral cavity, as well as larger tumors, deeper tumors, and disease that has progressed to the lymph nodes. Whether this correlation represents causation in either direction remains unknown.

Historical Evolution of the Polymorphous Adenocarcinoma.

The 2017 World Health Organization Classification of Head and Neck Tumors introduced for the first time the diagnostic terminology "cribriform variant of polymorphous adenocarcinoma". This nomenclature attempts to reconciliate the ongoing taxonomical controversy related to cribriform adenocarcinoma of tongue. In order to better understand this classification conundrum, it is imperative for pathologist to comprehend the historical evolution of polymorphous adenocarcinoma formerly known as polymorphous "low grade" adenocarcinoma. This review highlights our understanding of these tumors since their origins.

Comparison of the Seventh and Eighth Editions of the American Joint Committee on Cancer pT and pN Classifications as Predictors of Survival in Patients With Oral Squamous Cell Carcinoma.

Objectives: We retrospectively compared the seventh and eighth editions of American Joint Committee on Cancer (AJCC) TNM frameworks as disease-free survival (DFS) and overall survival (OS) predictors in oral squamous carcinomas (OSCCs). Methods: We restaged the 342 patients with the revised pT and pN criteria and performed survival analyses. Results: The 3-year DFS (mean follow-up, 364 days; recurrences, 99) was 50%, and the 5-year OS (mean follow-up, 615 days; deaths, 69) was 42%. The eight edition pN classification was an independent multivariate survival predictor. The revised TNM criteria upstaged pT, pN, and stage groupings in 99 (38.8%), 58 (37.3%), and 101 (29.5%) patients. The latter two groups revealed significantly worse DFS and OS compared with those whose categorizations had remained unaltered. In addition, their classification/staging criteria demonstrated superior discrimination, monotonicity, and accuracy for survival estimations. Conclusions: Of the competing AJCC staging criteria, the revised pN classification was the most powerful system to predict OSCC survivals.

What does the 4th edition of the World Health Organization Classification of Head and Neck Tumors (2017) bring new about mucosal melanomas?

The recently published 4th Edition of the World Health Organization Classification of Head and Neck Tumors addresses the most relevant and updated aspects of tumor biology, including clinical presentation, histopathology, immunohistochemistry, and prognosis of head and neck tumors. The objective of the present study is to compare these updates to the 3rd edition of that book with regard to mucosal melanomas and to highlight the potential factors that differ those tumors from cutaneous melanomas. We observed progress in the understanding of oral and sinonasal mucosal melanomas, which also present themselves, in the molecular scope, differently form cutaneous melanomas.

Tumor classification with MALDI-MSI data of tissue microarrays: A case study.

With mass spectrometry imaging (MSI) on tissue microarrays (TMAs) a large number of biomolecules can be studied for many patients at the same time, making it an attractive tool for biomarker discovery. Here we investigate whether lymph node metastasis can be predicted from MALDI-MSI data. Measurements are performed on TMAs and then filtered based on spectral intensity and the percentage of tumor cells, after which the resulting data for 122 patients is further preprocessed. We assume differences between patients with and without metastasis are expressed in a limited number of features. Two univariate feature selection methods are applied to reduce the dimensionality of the MALDI-MSI data. The selected features are then used in combination with three classifiers. The best classification scores are obtained with a decision tree classifier, which classifies about 72% of patients correctly. Almost all the predictive power comes from a single peak (m/z 718.4). The sensitivity of our classification approach, which can be generically used to search for biomarkers, is investigated using artificially modified data.

Is the 8th edition of the Union for International Cancer Control staging of oral cancer good enough?

Depth of invasion is an important predictor of survival. A study by the International Consortium (ICOR) for Outcome Research proposed incorporation of it (together with the greatest surface dimension, or the anatomical criteria, or both) into the T stage. This has been adopted in part by the 8th edition of the Union for International Cancer Control (UICC) TNM 8 classification of malignant tumours for oral squamous cell carcinoma (SCC). Our aim was to verify depth of invasion as an independent prognostic factor, and to validate the staging by comparing it with that specified in the 7th edition (TNM 7) and the T-staging model proposed by the International Consortium. We retrospectively studied 449 patients who had had operations for a previously untreated primary oral cancer between 2006 and 2014 at a single centre, and analysed the independent predictive value of depth of invasion for both disease-specific and overall survival. It was an independent predictor of disease-specific survival as were sex, perineural invasion, and N stage. It was also an independent predictor of overall survival together with sex and N status. Staging in TNM 8 gave a better balance of distribution than that in TNM 7, but did not discriminate between prognosis in patients with T3 and T4 disease. The proposed International Consortium rules for T-staging gave an improved balance in distribution and hazard discrimination. The incorporation of depth of invasion into the T-staging rules for oral SCC improved prognostic accuracy and is likely to influence the selection of patients for adjuvant treatment. Our findings suggest that the TNM 8 staging lacks hazard discrimination in patients with locally-advanced disease because its T4 staging is restricted to anatomical criteria.

What does the 4th edition of the World Health Organization Classification of Head and Neck Tumors (2017) bring new about mucosal melanomas?

Abstract: The recently published 4th Edition of the World Health Organization Classification of Head and Neck Tumors addresses the most relevant and updated aspects of tumor biology, including clinical presentation, histopathology, immunohistochemistry, and prognosis of head and neck tumors. The objective of the present study is to compare these updates to the 3rd edition of that book with regard to mucosal melanomas and to highlight the potential factors that differ those tumors from cutaneous melanomas. We observed progress in the understanding of oral and sinonasal mucosal melanomas, which also present themselves, in the molecular scope, differently form cutaneous melanomas.

Trend of oral and pharyngeal cancer mortality in Brazil in the period of 2002 to 2013.

OBJECTIVE: To analyze the trend of oral and pharyngeal cancer mortality rates in the period of 2002 to 2013 in Brazil according to sex, anatomical site, and macroregion of the country. METHODS: The mortality data were obtained from the Mortality Information System and the population data were obtained from the Brazilian Institute of Geography and Statistics. The trend of the rates standardized by sex and age was calculated using the Prais-Winsten estimation, and we obtained the annual percentage change and the respective 95% confidence intervals, analyzed according to sex, macroregion, and anatomical site. RESULTS: The average coefficient of oral cancer mortality was 1.87 per 100,000 inhabitants and it remained stable during the study period. The coefficient of pharyngeal cancer mortality was 2.04 per 100,000 inhabitants and it presented an annual percentage change of -2.6%. Approximately eight in every 10 deaths occurred among men. There was an increase in the rates of oral cancer in the Northeast region (annual percentage change of 6.9%) and a decrease in the Southeast region (annual percentage change of -2.9%). Pharyngeal cancer mortality decreased in the Southeast and South regions with annual percentage change of -4.8% and -5.1% respectively. Cancer mortality for tonsil, other major salivary glands, hypopharynx, and other and unspecified parts of mouth and pharynx showed a decreasing trend while the other sites presented stability. CONCLUSIONS: Pharyngeal cancer mortality decreased in the period of 2002 to 2013. Oral cancer increased only in the Northeast region. Mortality for tonsil cancer, other major salivary glands, hypopharynx, and other and ill-defined sites in the lip, oral cavity, and pharynx decreased.

Oral cancer: A multicenter study

Background: To determine the prevalence and clinicopathologic features of the oral cancer patients. Material and Methods: Biopsy records of the participating institutions were reviewed for oral cancer cases diagnosed from 2005 to 2014. Demographic data and site of the lesions were collected. Sites of the lesion were subdivided into lip, tongue, floor of the mouth, gingiva, alveolar mucosa, palate, buccal/labial mucosa, maxilla and mandible. Oral cancer was subdivided into 7 categories: epithelial tumors, salivary gland tumors, hematologic tumors, bone tumors, mesenchymal tumors, odontogenic tumors, and others. Data were analyzed by descriptive statistics using SPSS software version 17.0. Results: Of the 474,851 accessioned cases, 6,151 cases (1.30%) were diagnosed in the category of oral cancer. The mean age of the patients was 58.37±15.77 years. A total of 4,238 cases (68.90%) were diagnosed in males, whereas 1911 cases (31.07%) were diagnosed in females. The male-to-female ratio was 2.22:1. The sites of predilection for oral cancer were tongue, labial/buccal mucosa, gingiva, palate, and alveolar mucosa, respectively. The three most common oral cancer in the descending order of frequency were squamous cell carcinoma, non-Hodgkin lymphoma and mucoepidermoid carcinoma. Conclusions: Although the prevalence of oral cancer is not high compared to other entities, oral cancer pose significant mortality and morbidity in the patients, especially when discovered late in the course of the disease. This study highlights some anatomical locations where oral cancers are frequently encountered. As a result, clinicians should pay attention to not only teeth, but oral mucosa especially in the high prevalence area as well since early detection of precancerous lesions or cancers in the early stage increase the chance of patient being cured and greatly reduce the mortality and morbidity. This study also shows some differences between pediatric and elderly oral cancer patients as well as between Asian and non-Asian oral cancer patients (AU)

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Evolution of oral neoplasm in an andalusian population (Spain).

BACKGROUND: Head and neck cancer are one of the most common neoplasm pathologies in humans. The aim of this study was to analyze the type, characteristics, treatment and evolution of oral neoplasm or precancerous lesion in a sample of Andalusian population (Spain) derived from the Oncology Rehabilitation Hospital Unit during a period of 20 years. MATERIAL AND METHODS: A retrospective descriptive study was carried out during the years 1991 and 2011 analyzing the type, characteristics, treatment and follow-up of oral neoplasm in the Oral and Maxillofacial Surgery Unit of the Universitary Hospital Virgen del Rocio. The inclusion criteria were patients whose underlying pathology was any type of benign or malignant neoplasm or presence of precancerous lesion that, after treatment, had been referred to the Prosthetic Rehabilitation Unit. RESULTS: Of the initial analyzed sample of 60 patients, only 45 patients met the inclusion criteria. Of the final sample analyzed, 31 subjects were men (68.9%) and 14 women (31.1%) (p = 0.0169). The mean age of the sample was 57 years ± 13.83, been more frequently in older people with more than 50 years (73.3%) (p = 0.0169). The most common type of neoplasm was epidermoid carcinoma (64.4%). The site most frequently found in squamous cell carcinoma was the floor of the mouth (31%). The most frequent treatment modality was surgery with postoperative radiotherapy (42.2%). All patients had a minimum follow-up of 5 years, and a recurrence in this period was identified in 11.1% of the sample. Multivariate logistic regression showed a statistically significant association for the variables age (p = 0.0063) and smoking (p = 0.0434). CONCLUSIONS: Epidermoid carcinoma is the most frequent tumor in the oral cavity, where increase age and smoking are confirmed as associated risk factors.