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The gastrointestinal system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Sharon J. White, Francis A. Carey
Although oral cancers appear to develop from recognized premalignant lesions, some develop in clinically normal mucosa. Tumours typically present as a non-healing ulcer or a persistent white, red, or speckled patch, which may or may not be symptomatic. Tumours may occur at any intraoral site, although they rarely arise on the hard palate or dorsum of tongue. High-risk sites are the floor of the mouth (Figure 10.12), ventral and lateral aspects of the tongue (Figure 10.13), and the retromolar trigone (the area behind the mandibular third molar tooth). Oral cancer generally has a poorer prognosis the more posteriorly in the mouth it occurs. Histological factors that suggest an adverse prognosis include poor differentiation of tumour cells, increased tumour diameter and depth of invasion, and the presence of neural or lymphovascular invasion. Tumours spread initially to adjacent tissues. This is followed by spread to local then regional lymph nodes. Haematogenous spread is a late complication. The survival rate for intraoral cancer (approximately 50% at 5 years) has shown very little change in the past few decades despite advances in treatment. This is at least in part due to late presentation and detection of the disease.
Oral Cavity Tumours Including Lip Reconstruction
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The registration rate for oral cancer has risen by over 20% in the last 30 years in England and Wales, particularly in those under 65 years of age.3, 4 The increasing incidence of HPV associated oropharyngeal carcinoma may contribute to the reported increase in oral cancer in those publications which do not differentiate between oral cancer and oropharyngeal cancer, however the increase in oral cancer incidence is confirmed in studies specifically isolating the oral cavity site.5 The author has seen a 10% increase in incidence and 20% increase in prevalence of oral cancer in his own practice between 2000 and 2010, cancers of the oral cavity not being associated with HPV. The increasing incidence of oral cancer has been noted in other populations6 and may be as a consequence of increasing alcohol consumption. A comprehensive review of international trends in head and neck cancer highlights concerns regarding alcohol consumption.7 Oral cancer is more common in males, who usually present in the 6th and 7th decade although the incidence of oral cancer in young people seems to be increasing.8, 9 Tobacco and alcohol consumption are the major aetiological factors in the development of oral cancer,10 oral cancer being considered largely preventable.
Gastrointestinal system
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Oral cancer Squamous-cell carcinomaRisk factors: alcohol abuse, smokingSymptoms: – mass in oral cavity– leukoplakia (white patch)– ulceration– pain when opening mouthSigns: cervical lymphadenopathyInvestigations: biopsy of massesManagement: surgery, radiotherapy
Diagnostic and prognostic role of protein and ultrastructural alterations at cell–extracellular matrix junctions in neoplastic progression of human oral malignancy
Published in Ultrastructural Pathology, 2022
Harsh Nitin Dongre, Snehal Mahadik, Chetan Ahire, Pallavi Rane, Shilpi Sharma, Fatima Lukmani, Asawari Patil, Devendra Chaukar, Sudeep Gupta, Sharada Suhas Sawant
Early diagnosis of oral potentially malignant lesions (OPMLs) as well as detection of invasive features in non-metastatic tumors is of paramount clinical importance, as mortality is often high in the late stages.1 Several attempts have been made to establish early diagnostic and prognostic markers for oral cancer, however, so far none has made any impact in routine clinics, mainly due to lack of clinical validation.2,3 Development of oral precancerous lesions/conditions is very common in southern Asia including the Indian subcontinent.4 In the Indian scenario, leukoplakia is the most common OPML contributing to the high incidence of oral cancer.5 As per the latest World Health Organization (WHO) grading system, leukoplakia is a clinical diagnosis for which the histopathological diagnosis may be hyperplasia, dysplasia (mild, moderate, severe), or carcinoma that is characterized by cellular atypia and loss of normal maturation and stratification.6 Although, all leukoplakia lesions do not transform into malignancy, follow-up studies indicate that 4–18% of cases of oral squamous cell carcinomas (OSCC) arise from preexisting lesions including leukoplakia and have the potential to progress into an invasive malignancy.7
Combinatorial therapeutic approach for treatment of oral squamous cell carcinoma
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2019
Rituraj Bharadwaj, Bhanu P. Sahu, Jayanta Haloi, Damiki Laloo, Prajjalendra Barooah, Chenole Keppen, Manab Deka, Subhash Medhi
Oral Cancer is among one of the most common forms of cancer in human and affects mostly the oral cavity and pharynx [1] and 90% of it gets originated in squamous cell [2]. There are a multiple risk factors associated with the cause of oral cancer including an infection of the human papillomavirus, excessive use of tobacco, betel quid and alcohol [3]. Tobacco smoking and alcohol intake play a synergistic role in the cause of oral cancer [4] whereas; the risk of developing oral cancer is three times higher in smokers as compared to non-smokers [5]. The prevalence of oral cancer has shown a higher increase rate in males as compared to that of females [6], moreover, the death rate is approximately 50% worldwide [7], which also represents a poor prognosis in developing countries [8]. High recurrence rates are found in patients undergoing the standard treatment, and delay in initiation of treatment is considered as the most prominent cause for no relevant improvement in the survival rate [9]. Moreover, conventional chemotherapy suffers from numerous drawbacks including poor drug specificity [10], undesired side effects [11] and resistance towards the treatment [12].
Role of Smoking-Mediated molecular events in the genesis of oral cancers
Published in Toxicology Mechanisms and Methods, 2019
Oral cavity (mouth or buccal cavity), forming initial contacts with tobacco smokables, plays an essential role in the digestive system. Smoking is a risk factor for precancerous and cancers ailments of the oral cavity. Nearly 50% of deaths from oral cavity cancer (oral cancer) attribute to smoking (Siegel et al. 2015). Oral cancers have shown alarming prevalence globally, affecting human populations residing in both more developed and less developed countries. Oral cancer is a sub-group of head and neck cancers. Oral squamous cell carcinoma (OSCC), arising from the abnormal squamous epithelial cells, represent the commonly diagnosed forms of oral cancers (Subramanian and Krishnakumar 2017). Smoking practiced either actively (direct/intentional inhalation of noxious tobacco fumes by smokers while using smokables) or passively (unintentional inhalation of fumes by nonsmokers while accompanying the polluted/contaminated environments), induces enhancement in the oxidative stress levels within oral cavity (localized stress) and blood circulation (systemic stress) (Comhair et al. 2011).