Study and Treatment of Oral Squamous Cell Carcinoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 18034

Special Issue Editor


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Guest Editor
Department Oral and Maxillofacial Surgery, University Hospital of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
Interests: craniomaxillofacial surgery; oral pathology; oral medicine
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Special Issue Information

Dear Colleagues,

This Special Issue of Cancers deals with the most common type of malignancy of the oral cavity, the oral squamous cell carcinoma (OSCC).

Careful diagnosis, risk-based and adapted treatment as well as adequate follow-up play a key role in the management of oral cancer patients and prevent drawbacks, development of locoregional recurrence, and cancer-related death.

The aim behind this contribution is to give a comprehensive overview on the up-to-date understanding of this disease, including clinical manifestation, diagnosis, and histopathologic features of OSCC, and to augment the current guidelines for its multimodal treatment strategies for professionals and researchers.

Mainly, selected review articles will summarize and highlight the most recent advances achieved in the special fields of the diagnosis and treatment of OSCC. In addition, further research articles on special topics in relation to OSCC are encouraged to contribute to any aspect of the study and treatment of this disease.

Articles dealing with the following topics are provided:

  1. Epidemiology, current classification, and staging of OSCC.
  2. Imaging of OSCC.
  3. Histopathology of OSCC and related histologic and molecular biologic risk factors.
  4. Surgical treatment of OSCC.
  5. Reconstruction options for oral soft and hard tissue.
  6. Radiotherapy, chemotherapy, and immune therapy.
  7. Postoperative care and supportive treatment of patients with OSCC.

Dr. Samer George Hakim
Guest Editor

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Keywords

  • oral squamous cell carcinoma (OSCC)
  • histopathology
  • oral reconstruction
  • radiotherapy immune therapy
  • oral rehabilitation

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Published Papers (6 papers)

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Editorial

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2 pages, 163 KiB  
Editorial
Study and Treatment of Oral Squamous Cell Carcinoma—Insights and Perspectives
by Samer George Hakim and Yu-Xiong (Richard) Su
Cancers 2023, 15(20), 4968; https://doi.org/10.3390/cancers15204968 - 13 Oct 2023
Cited by 3 | Viewed by 1038
Abstract
The prevalence of oral squamous cell carcinoma (OSCC) has increased in recent decades, and its impact on the health system has become a new aspect [...] Full article
(This article belongs to the Special Issue Study and Treatment of Oral Squamous Cell Carcinoma)

Research

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13 pages, 1621 KiB  
Article
Adjuvant Radiotherapy in Patients with Squamous Cell Carcinoma of the Oral Cavity or Oropharynx and Solitary Ipsilateral Lymph Node Metastasis (pN1)—A Prospective Multicentric Cohort Study
by Peer W. Kämmerer, Silke Tribius, Lena Cohrs, Gabriel Engler, Tobias Ettl, Kolja Freier, Bernhard Frerich, Shahram Ghanaati, Martin Gosau, Dominik Haim, Stefan Hartmann, Max Heiland, Manuel Herbst, Sebastian Hoefert, Jürgen Hoffmann, Frank Hölzle, Hans-Peter Howaldt, Kilian Kreutzer, Henry Leonhardt, Rainer Lutz, Maximilian Moergel, Ali Modabber, Andreas Neff, Sebastian Pietzka, Andrea Rau, Torsten E. Reichert, Ralf Smeets, Christoph Sproll, Daniel Steller, Jörg Wiltfang, Klaus-Dietrich Wolff, Kai Kronfeld and Bilal Al-Nawasadd Show full author list remove Hide full author list
Cancers 2023, 15(6), 1833; https://doi.org/10.3390/cancers15061833 - 18 Mar 2023
Cited by 4 | Viewed by 2789
Abstract
(1) Background: Evaluation of impact of adjuvant radiation therapy (RT) in patients with oral squamous cell carcinoma of the oral cavity/oropharynx (OSCC) of up to 4 cm (pT1/pT2) and solitary ipsilateral lymph node metastasis (pN1). A non-irradiated group with clinical follow-up was chosen [...] Read more.
(1) Background: Evaluation of impact of adjuvant radiation therapy (RT) in patients with oral squamous cell carcinoma of the oral cavity/oropharynx (OSCC) of up to 4 cm (pT1/pT2) and solitary ipsilateral lymph node metastasis (pN1). A non-irradiated group with clinical follow-up was chosen for control, and survival and quality of life (QL) were compared; (2) Methods: This prospective multicentric comprehensive cohort study included patients with resected OSCC (pT1/pT2, pN1, and cM0) who were allocated into adjuvant radiation therapy (RT) or observation. The primary endpoint was overall survival. Secondary endpoints were progression-free survival and QL after surgery; (3) Results: Out of 27 centers, 209 patients were enrolled with a median follow-up of 3.4 years. An amount of 137 patients were in the observation arm, and 72 received adjuvant irradiation. Overall survival did not differ between groups (hazard ratio (HR) 0.98 [0.55–1.73], p = 0.94). There were fewer neck metastases (HR 0.34 [0.15–0.77]; p = 0.01), as well as fewer local recurrences (HR 0.41 [0.19–0.89]; p = 0.02) under adjuvant RT. For QL, irradiated patients showed higher values for the symptom scale pain after 0.5, two, and three years (all p < 0.05). After six months and three years, irradiated patients reported higher symptom burdens (impaired swallowing, speech, as well as teeth-related problems (all p < 0.05)). Patients in the RT group had significantly more problems with mouth opening after six months, one, and two years (p < 0.05); (4) Conclusions: Adjuvant RT in patients with early SCC of the oral cavity and oropharynx does not seem to influence overall survival, but it positively affects progression-free survival. However, irradiated patients report a significantly decreased QL up to three years after therapy compared to the observation group. Full article
(This article belongs to the Special Issue Study and Treatment of Oral Squamous Cell Carcinoma)
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17 pages, 3213 KiB  
Article
Osseous Union after Jaw Reconstruction with Fibula-Free Flap: Conventional vs. CAD/CAM Patient-Specific Implants
by Michael Knitschke, Magdalena Yonan, Fritz Christian Roller, Jörn Pons-Kühnemann, Sameh Attia, Hans-Peter Howaldt, Philipp Streckbein and Sebastian Böttger
Cancers 2022, 14(23), 5774; https://doi.org/10.3390/cancers14235774 - 24 Nov 2022
Cited by 12 | Viewed by 2041
Abstract
This is a monocentric, retrospective study of patients who underwent successful immediate or delayed maxilla or mandible reconstructions with FFF from January 2005 to December 2021. Panoramic radiograph, computed tomography scans, and cone-beam CTs were analyzed concerning the osseous union of the intersegmental [...] Read more.
This is a monocentric, retrospective study of patients who underwent successful immediate or delayed maxilla or mandible reconstructions with FFF from January 2005 to December 2021. Panoramic radiograph, computed tomography scans, and cone-beam CTs were analyzed concerning the osseous union of the intersegmental junctions between maxillary or mandibular native jaw and fibular bone. The primary parameter was to estimate the status of osseous union according to osteosynthesis type. A total number of 133 patients (PSI: n = 64, non-PSI: n = 69) were included in the present study. The mean age was 56.7 ± 14.0 (Range: 14.7–82.7); the primary diagnosis was in 105 patients a malignant (78.9%) and in 20 patients a benign (15.0%) tumor. Mandible reconstruction was performed on 103 patients (77.4%), and on 30 patients (22.6%), maxilla reconstruction was performed. The radiographic images provided a rate of incomplete osseous union (IOU) of about 90% in both groups in the first 6 months. Imaging between 6 and 12 months reveals an IOU rate in the non-PSI group of 46.3% vs. 52.5% in the PSI group, between 12 and 24 months, an IOU rate of 19.6% vs. 26.1%, between 24 and 36 months 8.9% vs. 21.7%, and after 36 months the IOU rate decreases to 4.2% vs. 18.2%. Multivariate logistic regression shows that only osteosynthesis type (OR = 3.518 [95%-CI = 1.223–10.124], p = 0.02) and adjuvant radiotherapy (OR = 4.804 [95%-CI = 1.602–14.409], p = 0.005) are independent risk factors for incomplete osseous union. Cox regression revealed that the variables plate-system (Hazard ratio, HR = 5.014; 95 %-CI: 1.826–3.769; p = 0.002) and adjuvant radiotherapy (HR = 5.710; 95 %-CI: 2.066–15.787; p < 0.001) are predictors for incomplete osseous union. In our study, the rate of incomplete bony fusion was significantly higher in the PSI group. Jaw-to-fibula apposition zones were significantly more affected than intersegmental zones. In multivariate analysis, a combination of osteosynthesis with PSI and adjuvant radiotherapy could be identified as a risk constellation for incomplete ossification. Full article
(This article belongs to the Special Issue Study and Treatment of Oral Squamous Cell Carcinoma)
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15 pages, 2367 KiB  
Article
Epidemiological Study of p16 Incidence in Head and Neck Squamous Cell Carcinoma 2005–2015 in a Representative Northern European Population
by Mari Mylly, Linda Nissi, Teemu Huusko, Johannes Routila, Samuli Vaittinen, Heikki Irjala, Ilmo Leivo and Sami Ventelä
Cancers 2022, 14(22), 5717; https://doi.org/10.3390/cancers14225717 - 21 Nov 2022
Cited by 6 | Viewed by 1995
Abstract
The incidence of human papillomavirus (HPV)-associated head and neck squamous cell carcinomas (HNSCC) has increased globally. Our research goal was to study HNSCC incidence in a representative Northern European population and evaluate the utility of the HPV surrogate marker p16 in clinical decision-making. [...] Read more.
The incidence of human papillomavirus (HPV)-associated head and neck squamous cell carcinomas (HNSCC) has increased globally. Our research goal was to study HNSCC incidence in a representative Northern European population and evaluate the utility of the HPV surrogate marker p16 in clinical decision-making. All new HNSCC patients diagnosed and treated in Southwest Finland from 2005–2015 (n = 1033) were identified and analyzed. During the follow-up period, the incidence of oropharyngeal (OPSCC) and oral cavity squamous cell carcinoma (OSCC) increased, while the incidence of laryngeal squamous cell carcinoma (LSCC) decreased. This clinical cohort was used to generate a population-validated tissue microarray (PV-TMA) archive for p16 analyses. The incidence of p16 positivity in HNSCC and OPSCC increased in southwest Finland between 2005 and 2015. p16 positivity was mainly found in the oropharynx and was a significant factor for improved survival. p16-positive OPSCC patients had a better prognosis, regardless of treatment modality. All HNSCC patients benefited from a combination of chemotherapy and radiotherapy, regardless of p16 expression. Our study reaffirms that p16 expression offers a prognostic biomarker in OPSCC and could potentially be used in cancer treatment stratification. Focusing on p16 testing for only OPSCC might be the most cost-effective approach in clinical practice. Full article
(This article belongs to the Special Issue Study and Treatment of Oral Squamous Cell Carcinoma)
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Review

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20 pages, 1615 KiB  
Review
Invasion-Associated Reorganization of Laminin 332 in Oral Squamous Cell Carcinomas: The Role of the Laminin γ2 Chain in Tumor Biology, Diagnosis, and Therapy
by Alexander Berndt, Nikolaus Gaßler and Marcus Franz
Cancers 2022, 14(19), 4903; https://doi.org/10.3390/cancers14194903 - 7 Oct 2022
Cited by 7 | Viewed by 2657
Abstract
Invasion of the connective tissue by carcinoma cells is accompanied by disintegration and reorganization of the hemidesmosomes, which connect the basement membrane to the basal epithelial cells. In terms of mediating the basement membrane, i.e., basal cell interactions, the heterotrimeric laminin 332 is [...] Read more.
Invasion of the connective tissue by carcinoma cells is accompanied by disintegration and reorganization of the hemidesmosomes, which connect the basement membrane to the basal epithelial cells. In terms of mediating the basement membrane, i.e., basal cell interactions, the heterotrimeric laminin 332 is the most important bridging molecule. Due to this distinct function, laminin 332, especially its gamma 2 chain, came into the focus of cancer research. Specific de novo synthesis and deposition patterns of laminin 332 are evident upon development and progression of oral squamous cell carcinomas (OSCCs). Loss from the basement membrane, cytoplasmic accumulation, and extracellular deposition are associated with crucial processes such as stromal activation and immune response, epithelial to mesenchymal transition, and tumor cell budding. In networks with components of the tumor microenvironment, altered expression of laminin 332 chains, proteolytic processing, and interaction with integrin receptors seem to promote cancer cell migration. Indeed, reorganization patterns are shown to have a high diagnostic and prognostic value. Here, we summarize the current knowledge on laminin 332 reorganization in OSCCs with special focus on its gamma 2 chain and provide, based on the current literature, evidence on its promising role as a grading and monitoring parameter and as a potential therapeutic target. Full article
(This article belongs to the Special Issue Study and Treatment of Oral Squamous Cell Carcinoma)
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16 pages, 1498 KiB  
Review
Current Trends in the Reconstruction and Rehabilitation of Jaw following Ablative Surgery
by Jane J. Pu, Samer G. Hakim, James C. Melville and Yu-Xiong Su
Cancers 2022, 14(14), 3308; https://doi.org/10.3390/cancers14143308 - 7 Jul 2022
Cited by 14 | Viewed by 6051
Abstract
The reconstruction and rehabilitation of jaws following ablative surgery have been transformed in recent years by the development of computer-assisted surgery and virtual surgical planning. In this narrative literature review, we aim to discuss the current state-of-the-art jaw reconstruction, and to preview the [...] Read more.
The reconstruction and rehabilitation of jaws following ablative surgery have been transformed in recent years by the development of computer-assisted surgery and virtual surgical planning. In this narrative literature review, we aim to discuss the current state-of-the-art jaw reconstruction, and to preview the potential future developments. The application of patient-specific implants and the “jaw-in-a-day technique” have made the fast restoration of jaws’ function and aesthetics possible. The improved efficiency of primary reconstructive surgery allows for the rehabilitation of neurosensory function following ablative surgery. Currently, a great deal of research has been conducted on augmented/mixed reality, artificial intelligence, virtual surgical planning for soft tissue reconstruction, and the rehabilitation of the stomatognathic system. This will lead to an even more exciting future for the functional reconstruction and rehabilitation of the jaw following ablative surgery. Full article
(This article belongs to the Special Issue Study and Treatment of Oral Squamous Cell Carcinoma)
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