Endocan is a novel endothelium derived soluble dermatan sulfate proteoglycan. It has the property of binding to a wide range of bioactive molecules associated with cellular signaling and adhesion and thus regulating proliferation, differentiation, migration, and adhesion of different cell types in health and disease. An increase in tissue expression or serum level of endocan reflects endothelial activation and neovascularization which are prominent pathophysiological changes associated with inflammation and tumor progression. Consequently, endocan has been used as a blood-based and tissue-based biomarker for various cancers and inflammation and has shown promising results.

More than half of patients with oral cancer recur even after multimodality treatment and recurrent oral cancers carry a poorer prognosis when compared to other sites of head and neck. The best survival outcome in a recurrent setting is achieved by salvage surgery; however, objective criteria to select an ideal candidate for salvage surgery is difficult to frame, as the outcome depends on various treatment-, tumor-, and patient-related factors. The following is summarizes various tumor- and treatment-related factors that guide our decision-making to optimize oncologic and functional outcomes in surgical salvage for recurrent oral cancers. Short disease-free interval, advanced tumor stage (recurrent and primary), extracapsular spread and positive tumor margins in a recurrent tumor, regional recurrence, and multimodality treatment of primary tumor all portend worse outcomes after surgical salvage. Quality of life after surgical intervention has shown improvement over 1 year with a drastic drop in pain scores. Various trials are underway evaluating the combination of immunotherapy and surgical salvage in recurrent head and neck tumors, including oral cavity, which may widen our indications for salvage surgery with improved survival and preserved organ function.

Context:Oxidative stress is a major determinant in carcinogenesis and serum total antioxidant capacity (TAC) indirectly reflects the level of oxidative stress. Although oral cancer is the third most frequent cancer in Indian population, there are no standard noninvasive marker for early detection and monitoring therapeutic response in oral cancer patients.Aims:This study was carried out to investigate implications of serum TAC in oral cancer by evaluating pre- and post-operative levels in oral cancer patients.Settings and Designs:It was a prospective single blinded study.Subjects and Methods:Serum TAC was measured using ferric-reducing antioxidant power assay. Pre- and post-operative values were estimated and compared in 30 oral cancer patients who underwent surgery.Statistical Analysis Used:Paired t-test was used to compare pre- and post-operative values.Results:Compared to the normal value, both pre- and post-operative serum TAC were significantly low in oral cancer patients. However, there was no statistically significant difference between pre- and postoperative levels.Conclusions:In this study, low mean serum TAC was detected in oral cancer patients. However, its diagnostic and prognostic significance in oral cancer needs further investigation.

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