Correlation of CTCs with disease progression in Indian oral cancer patients.

e15541 Background: Head and neck squamous cell carcinoma is leading cancer in the India with Oral squamous cell carcinoma (OSCC) as the most frequent subtype. OSCC is classified as a locoregional disease and its increased frequency is attributed to lack of good biomarkers compared to other epithelial cancers. At the time of diagnosis, above 50% of cases present the manifestation of advanced-stage disease, and are predisposed to disease failure in spite of appropriate treatment. Thus, early diagnosis of OSCC can significantly reduce the disease burden. Here we describe regulatory approved method to establish Circulating tumor cells (CTCs) presence in OSCC Indian patients and its positive correlation with various clinicopathological parameters, suggesting the potential use of CTCs as a significant parameter to stratify oral cancer with respect to the disease advancement. Methods: In a cross-sectional observational study, 230 OSCC patients at the different pathological stage of the disease and treatment mode were enrolled. CTCs were isolated using approved OncoDiscover liquid biopsy technology (Drug controller general of India approved), platform technology based on immunomagnetic CTC enumeration. CTCs were detected for CK18 presence and well-defined, DAPI-stained nuclei. Enumerated CTC subsequently analyzed for various clinic-pathological parameters such as pstage, extra-capsular spread (ECS), lymphovascular emboli (LVE), perineural invasion (PNI) and depth of invasion (DOI). CTC cut off values were obtained to differentiate early vs advanced stages with respect to different clinical stages and parameters. Results: CTCs of OSCC patients correlated positively with the cancer stages (clinical as well as pathological) as well as aggressive pathological features. The presence of aggressive pathological features that often suggest the poor outcome of the disease, we observed a 25-50 % increase in CTC number. Early stage, treatment naïve patients had lower number of CTCs. Mean CTC number in advanced-stage patients was 50 % higher than early-stage OSCC patients. Conclusions: Considering a positive correlation of CTC number with various pathophysiological features, CTC can be contemplated as a reliable parameter to predict the disease outcome in oral cancer. The consistent presence of CTC across all disease stages also suggests a probable nature of OSCC as a biological systematic disease. Clinical trial information: CTRI/2018/03/012905.

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Adjunctive Therapy in Oral Cancer

Oral and Maxillofacial Surgery for the Clinician ◽

10.1007/978-981-15-1346-6_84 ◽

2021 ◽

pp. 1903-1913

Author(s):

Amit Dhawan

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Cancer ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Cancer Patients ◽

Squamous Cell ◽

Adjunctive Therapy ◽

Early Stage ◽

Advanced Stage ◽

Oral Cancer Patients

AbstractOral squamous cell carcinoma is the third most common cancer in Indian subcontinent affecting people with lower socioeconomic status. Due to inadequate screening facilities and lack of awareness among individuals most of the oral cancer cases are detected at an advanced stage. As early stage oral squamous cell carcinoma patients can be treated with single modality treatment (surgery or radical radiotherapy), multimodality regimen (surgery followed by concurrent chemoradiation) is adopted for high risk advanced stage cancers with multiple adverse features like extra nodal extension, lymphovascular invasion and perineural spread. The chapter outlines the principles of adjunctive therapy in oral cancer patients with special reference to different techniques, indications of radiotherapy and role of chemotherapeutic regimes in improving the overall survival of advanced stage oral cancer patients.

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Stat3 Expression in Oral Squamous Cell Carcinoma: Association with Clinicopathological Parameters and Survival

The International Journal of Biological Markers ◽

10.1177/172460080602100307 ◽

2006 ◽

Vol 21 (3) ◽

pp. 175-183 ◽

Cited By ~ 19

Author(s):

N.G. Shah ◽

T.I. Trivedi ◽

R.A. Tankshali ◽

J.A. Goswami ◽

D.H. Jetly ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Disease Stage ◽

Clinicopathological Parameters ◽

Early Event ◽

Advanced Stage ◽

Intense Staining

The present study sought to explore the occurrence of signal transducer and activator of transcription 3 (Stat3) in patients with oral squamous cell carcinoma (n=135) and its potential relationship with clinicopathological parameters and survival. Stat3 expression was studied by immunohistochemistry. Cytoplasmic or nuclear localization of Stat3 was observed in 62% of patients, whereas only nuclear Stat3 expression was found in 44%. Stat3 positivity in early-stage patients was 45% compared to 79% in advanced-stage patients. However, early-stage Stat3-positive patients showed a gradual increase in staining intensity, with intense staining seen in 52% of the tumors compared to 18% in Stat3-positive advanced-stage patients, where a gradual decrease in intensity expression was observed (p=0.001). Stat3 showed a significant positive correlation with disease stage (p=0.001), nodal status (p=0.033) and tumor size (p=0.001). Multivariate survival analysis using the Cox proportional hazard regression model showed that nuclear Stat3 was a significant independent prognosticator for both relapse-free survival (p=0.014) and overall survival (p=0.042) in early-stage patients. Our results indicated that Stat3 activation is an early event in oral squamous cell carcinoma and represents a potential risk factor for poor prognosis in early-stage patients.

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Tumor depth of invasion and prognosis of early‐stage oral squamous cell carcinoma: A meta‐analysis

Oral Diseases ◽

10.1111/odi.13194 ◽

2019 ◽

Vol 26 (7) ◽

pp. 1357-1365 ◽

Cited By ~ 6

Author(s):

Patrícia Carlos Caldeira ◽

Andrea María López Soto ◽

Maria Cássia Ferreira Aguiar ◽

Carolina Castro Martins

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Meta Analysis ◽

Depth Of Invasion ◽

Tumor Depth

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Depth of invasion (DOI) as a predictor of cervical nodal metastasis and local recurrence in early stage squamous cell carcinoma of oral tongue (ESSCOT)

PLoS ONE ◽

10.1371/journal.pone.0202632 ◽

2018 ◽

Vol 13 (8) ◽

pp. e0202632 ◽

Cited By ~ 18

Author(s):

Muhammad Faisal ◽

Muhammad Abu Bakar ◽

Albash Sarwar ◽

Mohammad Adeel ◽

Fatima Batool ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Local Recurrence ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Nodal Metastasis ◽

Depth Of Invasion ◽

Oral Tongue

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The Outline of Prognosis and New Advances in Diagnosis of Oral Squamous Cell Carcinoma (OSCC): Review of the Literature

Journal of Oral Oncology ◽

10.1155/2013/519312 ◽

2013 ◽

Vol 2013 ◽

pp. 1-13 ◽

Cited By ~ 9

Author(s):

Esam Ahmad Omar

Keyword(s):

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Oral Cancer ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Imaging Techniques ◽

Publication Date ◽

Depth Of Invasion ◽

Tumour Thickness

Objective. Oral squamous cell carcinoma (OSCC) has a remarkable incidence over the world and a fairly strenuous prognosis, encouraging further research on the prognostic factors and new techniques for diagnosis that might modify disease outcome. Data Sources. A web-based search for all types of articles published was initiated using Medline/Pub Med, with the key words such as oral cancer, prognostic factors of oral cancer, diagnostic method of oral cancer, and imaging techniques for diagnosis of oral cancer. The search was restricted to articles published in English, with no publication date restriction (last update April, 2013). Review Methods. In this paper, I approach the factors of prognosis of OSCC and the new advances in diagnostic technologies as well. I also reviewed available studies of the tissue fluorescence spectroscopy and other noninvasive diagnostic aids for OSCC. Results. The outcome is greatly influenced by the stage of the disease (especially TNM). Prognosis also depends or varies with tumour primary site, nodal involvement, tumour thickness, and the status of the surgical margins. Conclusion. Tumour diameter is not the most accurate when compared to tumour thickness or depth of invasion, which can be related directly to prognosis. There is a wide agreement on using ultrasound guided fine needle aspiration biopsies in the evaluation of lymph node metastasis.

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Role of Depth of Invasion in Evaluation and Management of Early-stage Oral Cavity Squamous Cell Carcinoma

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1311 ◽

2017 ◽

Vol 8 (2) ◽

pp. 84-88

Author(s):

Bahbak Shariat-Madar ◽

Jeffrey C Liu

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Lymph Node Staging ◽

Depth Of Invasion ◽

Disease Free

ABSTRACT Aim To evaluate the existing body of literature and impact of depth of invasion (DOI) in early-stage oral cavity squamous cell carcinoma (OCSCC) and its role in predicting occult cervical lymph node metastases. Background The prognosis for early-stage T1 to T2 disease OCSCC is relatively poor compared with other mucosal subsites within the head and neck. Primary tumor DOI can help prognosticate high-risk tumors for additional treatment. Review results There are unequivocal management implications in the literature demonstrating a role for elective neck dissection in early-stage OCSCC based on DOI. Following appropriate patient selection, there may be a role for sentinel lymph node biopsy in regional lymph node staging in early-stage OCSCC. Conclusion There are a multitude of studies demonstrating novel strategies to appropriately treat early-stage OCSCC, which are increasingly becoming standard of care. These strategies are altering the overall and disease-free survival of early-stage OCSCC. Despite advances, locoregional recurrence remains a challenge in this disease. Clinical significance Herein, the authors highlight a number of advances in the management of early-stage OCSCC as described in the literature, which are having an impact on disease-free and overall survival. How to cite this article Shariat-Madar B, Liu JC. Role of Depth of Invasion in Evaluation and Management of Early-stage Oral Cavity Squamous Cell Carcinoma. Int J Head Neck Surg 2017;8(2):84-88.

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To evaluate disparity between clinical and pathological tumor-node-metastasis staging in oral cavity squamous cell carcinoma patients and its impact on overall survival: An institutional study

South Asian Journal of Cancer ◽

10.4103/2278-330x.175957 ◽

2015 ◽

Vol 04 (04) ◽

pp. 183-185 ◽

Cited By ~ 3

Author(s):

Karan Gupta ◽

Naresh K Panda ◽

Jaimanti Bakshi ◽

Ashim Das

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Tnm Staging ◽

Advanced Stage ◽

Tumor Node Metastasis ◽

Node Metastasis ◽

N Stage

Abstract Background: Accurate clinical staging is important for patient counseling, treatment planning, prognostication, and rational design of clinical trials. In head and neck squamous cell carcinoma, discrepancy between clinical and pathological staging has been reported. Objective: To evaluate any disparity between clinical and pathological tumor-node-metastasis (TNM) staging in oral cavity squamous cell carcinoma (OCSCC) patients and any impact of the same on survival. Materials and Methods: Retrospective chart review from year 2007 to 2013, at a tertiary care center. Statistical Analysis: All survival analyses were performed using SPSS for Windows version 15 (Chicago, IL, USA). Disease-free survival curves were generated using Kaplan-Meier algorithm. Results: One hundred and twenty-seven patients with OCSCC were analyzed. Seventy-nine (62.2%) were males and 48 (37.8%) females with a mean age at presentation 43.6 years (29-79 years). The highest congruence between clinical and pathological T-staging seen for clinical stage T1 and T4 at 76.9% and 73.4% with pathological T-stage. Similarly, the highest congruence between clinical and pathological N-stage seen for clinical N0 and N3 at 86.4% and 91.7% with pathological N-stage. Of clinically early stage patients, 67.5% remained early stage, and 32.5% were upstaged to advanced stage following pathological analysis. Of the clinically advanced stage patients, 75% remained advanced, and 25% were pathologically downstaged. This staging discrepancy did not significantly alter the survival. Conclusion: Some disparity exists in clinical and pathological TNM staging of OCSCC, which could affect treatment planning and survival of patients. Hence, more unified and even system of staging for the disease is required for proper decision-making.

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Intraoperative Depth of Invasion Is Accurate in Early-Stage Oral Cavity Squamous Cell Carcinoma

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2019.02.016 ◽

2019 ◽

Vol 77 (8) ◽

pp. 1704-1712 ◽

Cited By ~ 3

Author(s):

Justine Moe ◽

Jonathan B. McHugh ◽

Aaron M. Udager ◽

Thomas M. Braun ◽

Joseph I. Helman ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Depth Of Invasion

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Early stage squamous cell carcinoma of the lower lip: predictive factors for recurrence

The Journal of Laryngology & Otology ◽

10.1017/s0022215116000311 ◽

2016 ◽

Vol 130 (4) ◽

pp. 369-372 ◽

Cited By ~ 6

Author(s):

Y Ozkul ◽

M Songu ◽

A Imre ◽

E Tunc ◽

Z Ozkul ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Local Recurrence ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Clinicopathological Parameters ◽

Lower Lip ◽

Neck Metastasis ◽

Tumour Thickness

AbstractObjective:This study aimed to evaluate the effect of tumour thickness on other clinicopathological parameters in early stage lower lip squamous cell carcinoma.Methods:Forty-six consecutive patients with lower lip squamous cell carcinoma were included in the study. Demographic, clinical and pathological data were retrospectively collected.Results:The mean follow-up period for all patients was 32.0 ± 18.9 months. Forty-four tumours were staged as T1 and two were T2. Twelve patients underwent neck dissection. Two patients presented with neck metastasis in the follow-up period. Four patients (8.7 per cent) had local recurrence. Correlation analysis revealed a significant relationship between microscopic tumour thickness and local tumour recurrence (r = 0.328, p = 0.045).Conclusion:Surgical margin control is important to prevent local recurrence, especially in thicker tumours. In addition, neck metastasis is rare in early stage lower lip squamous cell carcinoma. A ‘wait and see’ policy might be preferred in early stage T1 lower lip squamous cell carcinoma cases.

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