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Tumor subsites and risk of osteoradionecrosis of the jaw in patients with oral cavity cancer: a national-based cohort study

European Archives of Oto-Rhino-Laryngology volume 278, pages 3425–3433 (2021)Cite this article

Abstract

Purpose

The association between the tumor subsites of the oral cavity and the risk of osteoradionecrosis of the jaw (ORNJ) remains unclear. We study the correlation between oral cavity tumor subsites and the risk of ORNJ in a nationwide population-based database.

Methods

We enrolled 16,701 adult patients with oral cavity cancers who were treated with radiotherapy between 2000 and 2013. The subsites of the oral tumor, treatments of oral cavity cancers, and the timing of tooth extraction were examined for their association with ORNJ in oral cancer patients.

Results

903 patients (5.40%) developed ORNJ. Of the relevant variables, pre-RT mandible surgery, tooth extraction either before or after RT, and tumor sites were associated with the risk of ORNJ. The adjusted HRs for ORNJ in the mouth floor, gums, retromolar, and buccal cancer were 2.056 (1.490–2.837), 1.909 (1.552–2.349), 1.683 (1.105–2.562), and 1.303 (1.111–1.528), respectively, compared with the risk of tongue cancer. There was no significant difference in the risk of ORNJ between the pre-RT extraction group, the during-RT extraction group, and the post-RT extraction (less than 6 months) group; the post-RT extraction (more than 6 months) group had a significantly higher risk of ORNJ.

Conclusions

This study demonstrated that oral cavity tumor subsite is an independent risk factor of ORNJ after RT. Post-RT extraction (less than 6 months) group did not carry a significantly higher risk of ORNJ compared with pre-RT extraction group or during RT extraction group.

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Acknowledgements

The authors expressed their appreciation to the Department of Medical Education and Research and Research Center of Medical Informatics in Kaohsiung Veterans General Hospital for inquiries and assistance in the data processing.

Funding

This study was supported by grants (VGHKS104-133 and VGHKS108-D12-1) from Kaohsiung Veterans General Hospital and the Taiwan Health Promotion Administration. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Pei-Hsun Liao

  2. School of Medicine, National Defense Medical Center, Taipei, Taiwan

    Pei-Hsun Liao

  3. Department of Statistics, National Cheng Kung University, Tainan, Taiwan

    Chi-Hsiang Chu

  4. Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Yao-Min Hung

  5. School of Medicine, National Yang Ming University, Taipei, Taiwan

    Yao-Min Hung

  6. Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan

    Yao-Min Hung

  7. Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan

    Yao-Min Hung

  8. Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Pei-Ling Tang

  9. Department of Nursing, Meiho University, Pingtung, Taiwan

    Pei-Ling Tang

  10. College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan

    Pei-Ling Tang

  11. School of Dentistry, Chung Shan Medical University, 110, Sec. 1, Chien-Kuo N. Rd., 40201, Taichung, Taiwan

    Tsu-Jen Kuo

  12. Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan

    Tsu-Jen Kuo

  13. Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan

    Tsu-Jen Kuo

  14. Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Tsu-Jen Kuo

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  1. Pei-Hsun Liao
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  4. Pei-Ling Tang
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  5. Tsu-Jen Kuo
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Correspondence to Tsu-Jen Kuo.

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Cite this article

Liao, PH., Chu, CH., Hung, YM. et al. Tumor subsites and risk of osteoradionecrosis of the jaw in patients with oral cavity cancer: a national-based cohort study. Eur Arch Otorhinolaryngol 278, 3425–3433 (2021). https://doi.org/10.1007/s00405-020-06529-z

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  • DOI: https://doi.org/10.1007/s00405-020-06529-z

Keywords

  • Oral cavity cancer
  • Osteoradionecrosis
  • Cohort study
  • Radiotherapy