Oral Oncology Reports最新文献

Introduction

Oral squamous cell carcinoma (OSCC) ranks among the most prevalent epithelial malignancies in the head and neck region. Although it predominantly affects older individuals, there has been a concerning rise in incidence among the younger population in recent years. This study aimed to compare the clinicopathological features of OSCC at our institution distinguishing between young and older age groups.

Methods

In the present retrospective study, histopathologically confirmed cases of OSCC were retrieved and assigned into two groups based on their age. Demographic data along with histopathological parameters were assessed. The data collected were statistically analysed using descriptive analysis, chi-square, kappa and multinomial logistic regression tests. A p-value less than or equal to 0.05 was considered statistically significant.

Results

Of the 707 OSCC patients, 585 were over 40 years old, while 122 were 40 or younger. Both the groups exhibited comparable observations with a high degree of keratinization, moderate nuclear pleomorphism, type 3 pattern of invasion, low tumor budding, high stromal and low intratumoral infiltration of lymphocytes, except lymphoplasmacytic infiltrate which was marked in a higher number of young cases.

Conclusion

OSCC in young and older individuals exhibited similar clinical as well as histopathological findings. Although the increased incidence of OSCC in the young is a cause of concern, so future multicentric studies with a larger sample size are warranted, to shed more light on the behavior and prognosis of OSCC in the young.

Objectives

Reports in the last 2 decades suggest that selected patients with masticator space invasion can be treated surgically with reasonable survival. This study is an attempt to identify prognosticators for disease free (DFS) and overall survival (OS) in surgically treated pT4 buccal mucosa squamous cell carcinoma (BMSCC) patients.

Material and methods

The cohort for this retrospective study comprised 213 patients with pT4a/b BMSCC, treated with curative intent surgery from August 2011 through December 2019. Depending upon masticator space invasion (MSI) patients were divided into 3 groups viz. pT4a, involvement of masseter and/or medial pterygoid (Low MSI) and involvement of lateral pterygoid and/or temporalis (High MSI).

Results

The median follow-up in this study was 45 (2–123) months. The 5-year DFS was 53 %, 42 % and 21 % for pT4a, Low MSI and high MSI groups, respectively. The 5-year OS was 68 %, 43 % and 21 % for these three groups. The MSI (HR 1.5, p = 0.113 for Low MSI, HR 2.98, p < 0.001 for high MSI), perineural invasion (PNI) (HR 2.17, p = 0.001) and extranodal extension (ENE) (HR 2.74, p = 0.001) predicted poor DFS on multivariate analysis. OS was worse in patients with MSI (HR 1.86, p = 0.020 for Low MSI, HR 3.46, p < 0.001 for high MSI), PNI (HR 2.48, p < 0.001) and ENE (HR 3.02, p = 0.001) on multivariate analysis. Adjuvant treatment improved both OS and DFS.

Conclusion

Select patients with masticator space involvement can benefit from aggressive treatment. Radiation with or without chemotherapy in adjuvant setting can further improve prognosis in these patients.

Oral squamous cell carcinoma (OSCC) is a highly aggressive neoplasm of the surface epithelium that arises from the mucosal lining of the mouth. The poor prognosis can be attributed to the complex tumor microenvironment (TME) in OSCC, which is crucial for tumor progression, angiogenesis, invasion, metastasis, and therapeutic resistance. In recent years, three-dimensional (3D) in vitro models have emerged as powerful tools to study OSCC biology and evaluate targeted therapies in a more physiologically relevant context. Advanced models such as tumor spheroids, patient organoids and microfluidic devices offer unique possibilities to reconstitute intricate cellular interactions, ECM dynamics as well as physiological gradients found in the OSCC TME. The 3D OSCC model provides powerful preclinical tools for drug screening and mechanistic studies of this devastating malignancy. In this review, we discuss the role of the tumor-immune microenvironment (TIME) in tumorigenesis and the 3D in vitro cultures in recreating the tumor microenvironment paving the way for the development of personalized medicine in OSCC.