Xiaoyu Lin1, Xiaoshan Wu1, Aly Gomaa2, Jie Chen1, Limeng Wu1, Xiaoyue Xie3,4, Yaqin Hu1, Canhua Jiang5. 1. Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China. 2. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Minia University, Minya, 11435, Egypt. 3. Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing, 100190, China. 4. School of Mathematical Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China. 5. Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China. canhuaj@csu.edu.cn.
Abstract
OBJECTIVE: Chewing betel quid (CBQ) is popular in Southeast Asia, resulting in a high incidence of oral squamous cell carcinoma (OSCC). The incidence of multiple primary oral cancer (MPOC) has gradually increased and has become one of the main causes of OSCC treatment failure. However, it is unclear whether the high incidence of MPOC is also correlated with the habit of CBQ. MATERIALS AND METHODS: In this retrospective study, 915 OSCC patients were enrolled. MPOC incidence and characteristics were analyzed. CBQ and other risk factors for MPOC were investigated by chi-squared test and logistic stepwise regression analysis. RESULTS: Among 915 patients, 15 were diagnosed with synchronous MPOC. After follow-up, 60 of 915 patients developed a second or third primary lesion site and were diagnosed with metachronous MPOC. The remaining 840 patients were then diagnosed with single primary oral cancer (SPOC). The cumulative incidence of MPOC in all OSCC patients was 8.2%. CBQ and the related oral submucous fibrosis (OSF) were found to be independent risk factors of MPOC (P < 0.001). Both MPOC and SPOC patients with a CBQ habit were much younger than those who did not have a CBQ habit (P < 0.001). The buccal mucosa was the most common primary occurrence site (35.9%) in MPOC cases, and almost all MPOC patients with buccal cancer had previously suffered from OSF (88.9%). CONCLUSION: CBQ and CBQ-related OSF, for the first time, are identified as the independent risk factors of MPOC. Prevention and treatment of OSF as well as cessation of CBQ are expected to become new approaches to reduce the incidence of MPOC. CLINICAL RELEVANCE: More frequent physical examinations should be undertaken in OSCC patients with CBQ or CBQ-related OSF.
OBJECTIVE: Chewing betel quid (CBQ) is popular in Southeast Asia, resulting in a high incidence of oral squamous cell carcinoma (OSCC). The incidence of multiple primary oral cancer (MPOC) has gradually increased and has become one of the main causes of OSCC treatment failure. However, it is unclear whether the high incidence of MPOC is also correlated with the habit of CBQ. MATERIALS AND METHODS: In this retrospective study, 915 OSCCpatients were enrolled. MPOC incidence and characteristics were analyzed. CBQ and other risk factors for MPOC were investigated by chi-squared test and logistic stepwise regression analysis. RESULTS: Among 915 patients, 15 were diagnosed with synchronous MPOC. After follow-up, 60 of 915 patients developed a second or third primary lesion site and were diagnosed with metachronous MPOC. The remaining 840 patients were then diagnosed with single primary oral cancer (SPOC). The cumulative incidence of MPOC in all OSCCpatients was 8.2%. CBQ and the related oral submucous fibrosis (OSF) were found to be independent risk factors of MPOC (P < 0.001). Both MPOC and SPOC patients with a CBQ habit were much younger than those who did not have a CBQ habit (P < 0.001). The buccal mucosa was the most common primary occurrence site (35.9%) in MPOC cases, and almost all MPOCpatients with buccal cancer had previously suffered from OSF (88.9%). CONCLUSION: CBQ and CBQ-related OSF, for the first time, are identified as the independent risk factors of MPOC. Prevention and treatment of OSF as well as cessation of CBQ are expected to become new approaches to reduce the incidence of MPOC. CLINICAL RELEVANCE: More frequent physical examinations should be undertaken in OSCCpatients with CBQ or CBQ-related OSF.
Authors: Maira Adeel; Hira Andaleeb; Saad Shakil; Sareema Eman Akhtar; Talal Almas; Abdulla K AlSubai; Sara AlNajdi; Aryam Mohammed Alenizi; Khaled Saeed Obaid Aldhaheri; Shakil Aqil Journal: Ann Med Surg (Lond) Date: 2022-09-08