Does anatomic subsite influence oral cavity cancer mortality? A SEER database analysis

Abstract

Objective To determine if there are differences in mortality from oral cavity squamous cell carcinoma (OCSCC) based on oral cavity (OC) subsites. Methods Using the Surveillance, Epidemiology, and End Results Program (SEER) 9 database, patients with sequence number 0 or 1 squamous cell OCSCC were analyzed by OC subsite for 5‐year cause‐specific mortality (CSM) from OCSCC. Proportional hazards regression determined the association between 5‐year CSM and OC subsites while controlling for treatment modality, stage, and demographic characteristics using hazard ratios. Significance was set at alpha = 0.05. Results 20,647 OC patients were included in the regression analysis. The most commonly diagnosed sites were floor of mouth (34.4%) and oral tongue (34.3%). Floor of mouth, upper gum, and retromolar trigone were associated with lower CSM compared to oral tongue. Not receiving surgery and receiving radiation were associated with increased CSM, and CSM increased with cancer staging when distant or regional disease was compared to localized disease. Also, patients diagnosed at 60 years or older and black patients had increased CSM. Conclusion Among OCSCC patients, those with oral tongue cancer are more likely to experience CSM than patients with floor of mouth, upper gum, and retromolar trigone cancer. It is important to understand these mortality related differences in the management of OCSCC patients. Understanding subsite‐specific mortality may benefit prognosis counseling of OCSCC patients and elicit subsite‐directed research as a means to improve outcomes. Level of Evidence NA Laryngoscope, 129:1400–1406, 2019

Value of lingual lymph node metastasis in patients with squamous cell carcinoma of the tongue

“…Squamous cell carcinoma (SCC) of the tongue is the most common cancer malignancy of the oral cavity, and the prognosis of these patients has not improved significantly despite advances in diagnosis and treatment. Usually, the most frequent failure pattern is locoregional recurrence within 2 years of initial treatment .…”

Analysis of primary oral and oropharyngeal squamous cell carcinoma in inhabitants of Beijing, China—A 10-year continuous single-center study

“…A previous study utilizing the Surveillance, Epidemiology, and End Results (SEER) database included 20,647 patients with OSCC diagnosed between 1975 and 2013. In that study, oor of the mouth and oral tongue represented the most common disease subsites, followed in descending order by gums, retromolar trigone, buccal mucosa, and hard palate 14 . In regions of China, South East Asia, and India, however, carcinoma of the buccal mucosa is one of the most common forms of OSCC 15,16,17. The difference in the predominant sites of occurrence of cancers may largely be related to various habits prevalent in the respective regions, such as the incidence of OSCC of the buccal mucosa results from the endemic regional practice of chewing betel quid.…”

Which Clinicopathologic Factors Affect the Prognosis of Gingival Squamous Cell Carcinoma: A Population Analysis of 4,345 Cases

“…Other studies have likewise found an increased rate of mandibular gingival lesions without significant differences in prognoses. 2,6 Although most lesions were low to intermediate grade, over 40% of cases were stage IV. It is important to acknowledge that, by definition, advanced staging does not necessarily indicate higher rates of disseminated disease.…”

“…1 Oral SCCs are typically classified by their anatomic subsite owing to regional differences in presentation and propensity for spread. 2 As such, the oral cavity can be broadly divided into the lips, oral tongue, floor of the mouth, buccal mucosa, gingiva, retromolar trigone, and hard palate. 1 The gingiva is the third most common site of oral SCC, after the tongue and floor of the mouth 2,3 ; however, because gingival malignancies are infrequent relative to other benign gingival lesions, 4,5 gingival cancer poses a diagnostic challenge for clinicians, who may not suspect a malignancy in light of other more commonly encountered pathologies.…”

“…2 As such, the oral cavity can be broadly divided into the lips, oral tongue, floor of the mouth, buccal mucosa, gingiva, retromolar trigone, and hard palate. 1 The gingiva is the third most common site of oral SCC, after the tongue and floor of the mouth 2,3 ; however, because gingival malignancies are infrequent relative to other benign gingival lesions, 4,5 gingival cancer poses a diagnostic challenge for clinicians, who may not suspect a malignancy in light of other more commonly encountered pathologies. Furthermore, because the attached gingiva is relatively thin, gingival cancers show early invasion of the underlying bone, and the prognostic implications of this behavior are presently unclear.…”