Secondary Squamous Cell Carcinoma of the Oral Cavity after Nasopharyngeal Carcinoma

Abstract

The main goal of this study was to analyze the prognosis of secondary oral squamous cell carcinoma (SCC) with a comparison with sporadic oral SCC by a matched-pair design. Materials and Methods Records of patients with surgically treated primary oral SCC were reviewed, and a total of 83 patients with previous history of radiotherapy for nasopharyngeal carcinoma (NPC) were retrospectively enrolled. A matched-pair study was performed, each NPC survivor was matched with two sporadic oral SCC patients by age, sex, primary tumor site, adverse pathologic characteristics, disease stage, neck node status, and tumor stage. The overall survival (OS) and disease-specific survival (DSS) rates were calculated by the Kaplan-Meier method; independent prognostic factors were evaluated by the Cox proportional hazards method. Results Compared with sporadic oral SCC patients, NPC survivors were less likely to be smokers (p=0.004), perineural invasion and lymphovascular invasion were more common in NPC survivors (both p < 0.001). The 5-year OS and DSS rates in NPC survivors were 47% and 54%, respectively; the 5-year OS and DSS rates in sporadic oral SCC patients were 62% and 67%, respectively; the difference was significant (both p < 0.05). In survival analysis, disease stage remained to be independent prognostic factor for both the OS and DSS. Conclusion NPC survivors had worse OS and DSS than sporadic oral SCC patients, NPC survivors were less likely to be smokers, but had higher opportunity of perineural invasion and lymphovascular invasion. Disease stage was the most important predictor for the survival in NPC survivors.

Significance of SUV Max for Predicting Occult Lymph Node Metastasis and Prognosis in Early-Stage Tongue Squamous Cell Carcinoma

“…is finding was consistent with previous studies [21][22][23]. Poor tumor differentiation was indicated by a higher Ki-67 index, a higher SUV max value, and an enhanced invasion ability of cancer cells [24].…”

Lingual Lymph Node Metastasis in cT1-2N0 Tongue Squamous Cell Carcinoma: Is It an Indicator for Elective Neck Dissection

“…In current study, the overall occult metastasis rate was 27.8%, but the occult metastasis rate was just 17.5% for T1 disease, all patients underwent END. Therefore, there was a number of patients were over-treated, there were at least three aspects for explaining this phenomenon: firstly, the high requirement of routine follow-up of wait-andsee policy was usually out of our patients' ability, as described by our previous studies (13,25), patients in our cancer hospital usually came from low income family and remote districts; secondly, there was abundant evidence indicating that there was often a low salvage rate on disease recurrence in patients who do not have prophylactic therapy of the clinically N0 neck (1-5), thirdly, also the most important one, there were no reliable predictors for occult neck lymph node metastasis from previous studies.…”

Impact of submandibular gland preservation in neck management of early-stage buccal squamous cell carcinoma on locoregional control and disease-specific survival

“…Drinkers were defined as those who consumed at least one alcoholic drink per day for at least 1 year, and smokers were defined as those who smoked on a daily basis or who had quit smoking for less than 5 years [ 24 ]. Perineural invasion (PNI) was considered to be present if tumor cells were identified within the perineural space and/or nerve bundle; lymphovascular infiltration (LVI) was positive if tumor cells were noted within the lymphovascular channels [ 25 ]. The pathologic DOI was measured from the level of the adjacent normal mucosa to the deepest point of tumor infiltration, regardless of the presence or absence of ulceration [ 26 ].…”