Clinical Features of Oral Multiple Primary Carcinomas Compared with Oral Single Primary Carcinoma

Abstract

Background Owing to the increase in the older population and the increased life span, the number of patients with oral multiple primary carcinomas will increase. Predicting the second and third carcinoma clinically is difficult, and the presence of second or third carcinomas is a factor that determines the prognosis of oral carcinoma. In this study, we examined the clinical features of oral multiple primary carcinomas treated in our department. Methods We retrospectively reviewed the medical records of patients with oral squamous cell carcinoma who underwent radical treatment at and were followed by the Department of Oral and Maxillofacial Surgery, Tottori University Hospital from January 2003 to October 2017. Results This study included 261 patients: 241 patients had oral single primary carcinoma and 20 patients had oral multiple primary carcinomas. Oral multiple primary carcinomas showed female predilection and occurred more frequently in the lower gingiva and significantly less frequently in the tongue (P < 0.01). Oral multiple primary carcinomas showed a significantly higher recurrence rate (P < 0.01). The 5-year overall survival of oral single primary carcinoma patients was 88.0% compared with 95% for oral multiple primary carcinomas, with no significant difference (log rank test, P = 0.54). However, the 15-year survival rate dropped to 28.1% in oral multiple primary carcinomas. The cumulative disease incidence rates of metachronous second primary carcinoma from first carcinoma at 5 years and 10 years were 3.45% and 5.36%, respectively. Conclusion Oral multiple primary carcinomas rarely occur in the tongue. The 5-year survival rate showed no difference between single and multiple carcinoma patients, but over longer observation, the prognosis of multiple carcinoma was poor owing to a high recurrence rate. Because of the high recurrence rate and risk of further metachronous carcinoma in oral multiple primary carcinomas, longer-term follow-up is required.

Detection of Merkel cell polyomavirus in multiple primary oral squamous cell carcinomas

“…In the present study, 6 of 115 patients (5.2%) developed multiple oral cancers. Although the reports from Qaisi et al, Kawasaki et al, and Friedrich did not mention the characteristics of the multiple oral cancers [7][8][9], we identified oral MCPyV infection (including consideration of both infection rate and DNA load) as a risk factor for multiple primary OSCCs in a Japanese population. This evidence is further supported by the fact that all 6 patients with multiple primary OSCCs were never-smokers and only one was a regular alcohol drinker.…”

“…On the other hand, many cases involve the development of oral cancers in the absence of any history of daily smoking or drinking, and other risk factors besides smoking and drinking may thus be involved. Oral cancer patients frequently have multiple primary cancers in the oral cavity and other organs, such as the upper gastrointestinal tract and lungs [7][8][9][10][11]. Such phenomena are explained by the concept of field cancerization and cell competition, in which various gene mutations and epigenetic abnormalities accumulate in tissues and organs that have been exposed to cancer-inducing factors over a prolonged period [12][13][14][15][16].…”

High‐dose‐rate remote brachytherapy for metachronous second primary carcinoma of soft palate by iridium 192 isotope in an afterload surface mold

“…HDR has the advantage of high dose radiation at the target area sparing the remaining tissues, thereby minimizing post radiation sequelae and enhancing the quality of life. [1][2][3][4][5]12,13 Since the radiation implant was placed after the accurate seating of the mold at each radiotherapy session, it was an afterload brachytherapy mold. 13 This minimized the risk of radiation exposure to the patient and to the personnel handling the mold.…”

“…Metachronous second primary carcinoma (MCSPC) are tumors occurring in areas close to the region of primary carcinoma, which have been detected 6 months or more after the index carcinoma is treated. [1][2][3][4][5] High dose rate (HDR) brachytherapy is preferred for local tumor control and to conserve form and function in treatment of MCSPC. [6][7][8][9] A brachytherapy mold is used to carry the radioisotope as radiation source.…”

Multiple primary squamous cell carcinomas of the oral cavity: A cross-sectional study in vietnam

“…From 2003 to 2017, Kawasaki reported on 261 patients with oral cavity SCC, including 241 patients with a single primary carcinoma and 20 patients with MPSCs [ 17 ]. MPSCs were more prevalent in females and occurred more frequently in the lower gingival than in the tongue (p < 0.01).…”