This study confirmed the value of a scoring system based on laryngoscopic characteristics and patient age for predicting the histologic results in vocal leukoplakia. It is helpful for classifying vocal leukoplakia and pretreatment planning. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1998-E2003, 2016.

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BackgroundOur study aimed to compare the outcomes of surgical treatment of tongue cancer patients in three different age groups.MethodsFrom 2004 to 2013, we retrospectively analyzed the clinical data of 1,712 patients who were treated in the four institutions constituting the Chang Gung Memorial Hospitals (CGMH). We divided and studied the patients in three age groups: Group 1, younger (<65 years); Group 2, young old (65 to <75); and Group 3, older old patients (≥75 years).ResultsMultivariate analyses determined the unfavorable, independent prognostic factors of overall survival to be male sex, older age, advanced stage, advanced T, N classifications, and surgery plus chemotherapy. No significant differences were found in adjusted hazard ratios (HR) of death in early-stage disease (stage I–II) among Group 1 (HR 1.0), Group 2 (HR 1.43, 95% confidence interval (CI) [0.87–2.34], p = 0.158), and Group 3 (HR 1.22, 95% CI [0.49–3.03], p = 0.664) patients. However, amongst advanced-stage patients (stage (III–IV)), Group 3 (HR 2.53, 95% CI [1.46–4.38], p  = 0.001) showed significantly worse survival than the other two groups after other variables were adjusted for. Fourteen out of 21 older old, advanced-staged patients finally died, and most of the mortalities were non-cancerogenic (9/14, 64.3%), and mostly occurred within one year (12/14, 85%) after cancer diagnosis. These non-cancer cause of death included underlying diseases in combination with infection, pneumonia, poor nutrition status, and trauma.ConclusionsOur study showed that advanced T classification (T3–4), positive nodal metastasis (N1–3) and poorly differentiated tumor predicted poor survival for all patients. Outcome of early-stage patients (stage I–II) among three age groups were not significantly different. However, for advanced-stage patients (stage III–IV), the older old patients (≥75) had significantly worse survival than the other two patient groups. Therefore, for early-stage patients, age should not deny them to receive optimal treatments. However, older old patients (≥75) with advanced cancer should be comprehensively assessed by geriatric tools before surgical treatment and combined with intensive postoperative care to improve outcome, especially the unfavorable non-cancerogenic mortalities within one year after cancer diagnosis.

Multiple primary tumors (MPT), especially in the hypopharynx and esophagus, are challenging in patients with head and neck cancer (HNC). Alcohol and alcohol-metabolizing genes were reported to be related to upper digestive tract cancers. Here, we investigated whether the genotypes of alcoholmetabolizing enzymes (ADH1B, ADH1C, and ALDH2) affected patients' susceptibility to developing MPTs. We recruited 659 male patients with HNC between March 1996 and February 2017. Age-and gender-matched controls were also recruited. A total of 164 patients with HNC were identified to have second or third malignancies. The single-nucleotide polymorphisms in ADH1B (rs1229984), ADH1C (rs698), and ALDH2 (rs671) were analyzed by Taq-Man assays. The prevalence of ALDH2 à 2 allele carriers is significantly higher than that of à 1 à 1 homo-zygotes for oral cavity (P ¼ 0.013) and oropharyngeal cancers (P ¼ 0.012). For ADH1B, the number of à 1 allele carriers is significantly higher than that of à 2 à 2 homozygotes for oropharyngeal (P ¼ 0.017) and hypopharyngeal cancers (P < 0.001). ADH1C (rs698) SNPs are not significantly associated with tumor subsites (all P > 0.05). Polymorphisms in ALDH2 (à 2 allele carriers) and ADH1B (à 1 allele carriers) significantly increase the risk of developing MPTs in the upper digestive tract [P < 0.001, OR (95% confidence interval (CI): 5.186 (2.444-11.004) and P < 0.05, OR (95% CI): 2.093 (1.149-3.812), respectively]. ALDH2 (rs671) à 2 and ADH1B (rs1229984) à 1 allele carriers were shown to develop MPTs in the upper digestive tract. Genetic information may be used to identify high-risk patients for the development of MPTs.

BackgroundC-reactive protein (CRP) is an early marker for inflammation, and a relationship between serum CRP levels and survival in oral cancer has been demonstrated previously. In this study, we investigated the roles of CRP in different oral cancer subsites.MethodsThree hundred and forty-three oral squamous cell carcinoma patients between June 1999 and March 2015 were retrospectively reviewed. Serum CRP levels were measured preoperatively.ResultsThe elevation of CRP levels (≥5.0 mg/L) was significantly correlated with pathologic tumor status, pathologic nodal status, nodal extracapsular spread, tumor stage, skin invasion, tumor depth (≥10 mm), and bone invasion. The correlation between elevation of CRP and clinicopathologic factors was more evident in the buccal cancer compared to other tumor subsites. The disease-free survival and overall survival correlation was significant in buccal cancer (p = 0.003 and p < 0.001) but not in tongue cancer (p = 0.119 and p = 0.341) or other oral cancer subsites (p = 0.246 and p = 0.696).ConclusionsPreoperative serum CRP level was a prognosticator in oral squamous cell carcinoma, and its effect was more prominent in buccal cancer that occurs more frequently in areca-quid (AQ) endemic regions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-017-1116-5) contains supplementary material, which is available to authorized users.