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Recurrence in Oral Squamous Cell Carcinoma Associated with Wide Field of Cancerization: Analysis of 93 Cases

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Abstract

Background

The late presentation of oral squamous cell carcinoma (OSCC) patients in the Sudan, with advanced stages and wide field of cancerization, have a negative impact on both the morbidity and the mortality of these patients. The present study aimed to investigate the clinicopathological behavior of OSCC and predictors of development of recurrence in these patients.

Methods

This a prospective longitudinal study of 93 OSCC patients surgically treated at Khartoum Teaching Dental Hospital. Tumor’s associated field of cancerization was identified. The patients were followed clinically on regular basis, for a year, for the development of recurrence.

Results

Out of the 93 patients, 57 (61.3%) were males and 36 (38.7%) were females. 82% of the patients presented with stage IV tumors, and 58 (62.4%) of the cases had nodal metastasis. Twenty-eight (30%) patients developed recurrence. Of them 17 (18.3%) had regional recurrence, eight (8.6%) had local recurrence and three (3.2%) had locoregional recurrence. Multivariate cox regression analysis showed that Toombak dipping (P.value = 0.001), tumor staging (P.value = 0.039) and presence of mucosal filed changes (P.value = 0.001) were independent predictors for local recurrence and positive pathological lymph nodes (P.value = 0.00) and extranodal extension (P.value = 0.040) were independent predictors for regional recurrence.

Conclusion

The present study showed that OSCC patients in the Sudan present with advanced lesions, mostly associated with wide field of cancerization particularly Toombak dippers. Overall recurrences were identified in 30% of the cases, regional recurrence was the commonest type followed by local recurrence.

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Data Availability

The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.

References

  1. Aggarwal A, Upadhyay N, Ajai K (2012) Oral field cancerization: an update. J Dent Sci Oral Rehab 3(4):23–26

    Google Scholar 

  2. Jayam R (2010) Oral field cancerization: a review. J Indian Aca Oral Med Radiol 22(4):201–205

    Article  Google Scholar 

  3. Brennan J, Mao L, Hruban R (1995) Molecular assessment of histopathological staging in squamous-cell carcinoma of the head and neck. N Engl J Med 332:345–429

    Article  Google Scholar 

  4. Mufeed A, Chatra L, Shenai P (2009) Field cancerization of oral cavity- A case report and an update. Intern J Dent Sci 7(1):7–10

    Google Scholar 

  5. Manjunath S, Sabharwal R, Kumar M (2014) Oral field cancerization: an update. Univ Res J Dent 4:10–15

    Article  Google Scholar 

  6. Hong W, Lippman S, Itri L (1990) Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck. N Engl J Med 323(12):795–801

    Article  CAS  PubMed  Google Scholar 

  7. García R (2016) The role of salvage surgery in oral squamous cell carcinoma. Plast Aesthet Res 3:189–196

    Article  Google Scholar 

  8. Liu C-H, Wang P-C (2013) Patterns of recurrence and second primary tumors in oral squamous cell carcinoma treated with surgery alone. Kaohsiung J Med Sci 29:554–559

    Article  PubMed  Google Scholar 

  9. Slaughter D, Southwick H, Smejkal W (1953) Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer 3:963–968

    Article  Google Scholar 

  10. Tabor M, Brakenhoff R, Houten V (2001) Persistence of genetically altered fields in head and neck cancer patients: Biological and clinical implications. Clin Cancer Res 7:1523–1532

    CAS  PubMed  Google Scholar 

  11. Osman T, Satti A, Boe O, Yang Y, Ibrahim S, Suleiman A (2010) Pattern of malignant tumors registered at a referral oral and maxillofacial hospital in Sudan during 2006 and 2007. J Cancer Res Ther 6(4):473–477

    Article  PubMed  Google Scholar 

  12. Mahmoud M, Suleiman A, Eltohami Y (2019) Pattern of regional recurrence following neck dissection in oral squamous cell carcinoma. Int J oral Maxillofac surg 3:244–248

    Google Scholar 

  13. Holmes J, Martin R, Gutta R (2010) Characteristics of head and neck cancer patients referred to an oral and maxillofacial surgeon in the United States for management. J Oral Maxillofac Surg 68(3):555–561

    Article  PubMed  Google Scholar 

  14. Shield K (2017) The global incidence of lip, oral cavity, and pharyngeal cancers by subsite in 2012. CA Cancer J Clin 67(1):51–64

    Article  PubMed  Google Scholar 

  15. Greaves L (2014) Can tobacco control be transformative? Reducing gender inequity and tobacco use among vulnerable populations. Int J Environ Res 11(1):792–803

    Google Scholar 

  16. Elbeshir E, Abdeen H, Idris A, Abbas K (1989) Snuff dipping and oral cancer in Sudan: a retrospective study. Br J Oral Maxillofac Surg 27(3):243–248

    Article  CAS  PubMed  Google Scholar 

  17. Suleiman A (2015) Oral Cancer in Sudan: risk factors and clinical presentation, 2nd edn. University of Khartoum press, Khartoum

    Google Scholar 

  18. Russo LL, Muzio EL, Colella G, Bizzoca ME, Panzarella V, Campisi G et al (2021) Oral squamous cell carcinoma on Gingiva, Edentulous Ridge and Retromolar Pad: a Case Series. Oral 1:159–167

    Article  Google Scholar 

  19. Zargoun IM, Bingle L, Speight PM (2017) DNA ploidy and cell cycle protein expression in oral squamous cell carcinomas with and without lymph node metastases. Pathol Med 46(9):738–743

    CAS  Google Scholar 

  20. Shah J, Gil Z (2009) Current concepts in management of oral cancer-surgery. Oral Oncol 45(4):394–401

    Article  PubMed  Google Scholar 

  21. Contaldo M, Napoli AD, Pannone G, Franco R, Ionna F, Feola A et al (2013) Prognostic implications of node metastatic features in OSCC: a retrospective study on 121 neck dissections. Oncol Rep 30(6):2697–2704

    Article  PubMed  Google Scholar 

  22. Alim N (2018) Recurrence of Oral Squamous Cell Carcinoma in Surgically Treated Patients at Khartoum Teaching Dental Hospital. Sudan. University of Khartoum. MSc thesis

  23. Cheng Y, Tsai M, Chiang C, Tsai S, Liu T, Lou P et al (2018) Adjuvant radiotherapy after curative surgery for oral cavity squamous cell carcinoma and treatment effect of timing and duration on outcome-A Taiwan Cancer Registry national database analysis. Cancer Med 14(7):3073–3083

    Article  Google Scholar 

  24. Doshi P, Shah A, Patel B, Jhabuawala F (2011) Histological grading of oral Cancer: a comparison of different Systems and their relation to Lymph Node Metastasis. Natl J Community Med 2(1):136–142

    Google Scholar 

  25. Ribeiro A, Alan S, Luciana S (2009) Clinical and histopathological analysis of oral squamous cell carcinoma in young people: a descriptive study in brazilians. Br J Oral Maxillofac Surg 47(2):95–98

    Article  PubMed  Google Scholar 

  26. Oregan E, Toner M, Finn S, Fan C, Ring M, Hagmar B et al (2008) p16INK4A genetic and epigenetic profies differ in relation to age and site in head and neck squamous cell carcinomas. Hum Pathol 39(3):452–458

    Article  CAS  PubMed  Google Scholar 

  27. Jain P, Sharan R, Manikantan K, Clark G, Chatterjee S, Mallick I (2020) Redefining adequate margins in oral squamous cell carcinoma: outcomes from close and positive margins. Eur Arch Otorhinolaryngol 277(4):1155–1165

    Article  PubMed  Google Scholar 

  28. Jerjes W, Upile T, Petrie A (2010) Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients. Head Neck Oncol 20:2–9

    Google Scholar 

  29. Anderson C, Sisson K, Moncrieff M (2015) A meta-analysis of margin size and local recurrence in oral squamous cell carcinoma. Oral oncol 51(5):464–469

    Article  PubMed  Google Scholar 

  30. Priya S, Cruz A, Pai P (2012) Cut margins and disease control in oral cancers. J Cancer Res Ther 8(1):74–79

    Article  CAS  PubMed  Google Scholar 

  31. Wolfensberger M, Zbaeren P, Dulguerov P, Muller W, Arnoux A, Schmid S (2001) Surgical treatment of early oral carcinoma-results of a prospective controlled multicenter study. Head Neck 23(7):525–530

    Article  CAS  PubMed  Google Scholar 

  32. Carvalho A, Magrin J, Kowalski L (2003) Sites of recurrence in oral and oropharyngeal cancers according to the treatment approach. Oral Dis 9(3):108–112

    Article  Google Scholar 

  33. Feller L, Lemmer J (2011) Cancer metastasis: a short account. SADJ 66:180–183

    CAS  PubMed  Google Scholar 

  34. Kim M, Califano J (2004) Molecular pathology of head-and-neck cancer. Int J Cancer 112:545–553

    Article  CAS  PubMed  Google Scholar 

  35. Reibel J (2003) Prognosis of oral pre-malignant lesions: significance of clinical, histopathological, and molecular biological characteristics. Crit Rev Oral Biol Med 14:47–62

    Article  PubMed  Google Scholar 

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No funding was obtained for this study.

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Authors and Affiliations

  1. faculty of dentistry, University of Khartoum, Khartoum , Sudan

    Yousif Idris Eltohami & Ahmed Mohamed Sulaiman

Authors
  1. Yousif Idris Eltohami
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  2. Ahmed Mohamed Sulaiman
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Correspondence to Yousif Idris Eltohami.

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All authors hereby declare that all cases have been examined and approved by the appropriate ethics committee of University of Khartoum, Sudan. The patients were fully informed of the procedures and possible risks, and informed written consent was taken.

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Eltohami, Y.I., Sulaiman, A.M. Recurrence in Oral Squamous Cell Carcinoma Associated with Wide Field of Cancerization: Analysis of 93 Cases. Indian J Otolaryngol Head Neck Surg 75, 1329–1335 (2023). https://doi.org/10.1007/s12070-023-03548-0

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  • DOI: https://doi.org/10.1007/s12070-023-03548-0

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