Squamous cell carcinomas arising from different types of oral epithelia differ in their tumor and patient characteristics and survival.

A hypothesis that OSCCs originating from different types of oral epithelia may have different patient and tumor characteristics was evaluated in this retrospective analysis of 188 patients with primary OSCC treated at Turku University Central Hospital, Turku, Finland in 1988-1997. The tumors were categorized according to the type of oral epithelium from which they have originated: (1) specialized epithelium (dorsal tongue) (2) keratinized (masticatory) epithelium, (3) non-keratinized (lining) epithelium, and (4) tongue epithelium (epithelium on the lateral border of the tongue). The relevant clinical data, including age, sex, social status, and risk behavior of the patients and clinical presentation, histopathological grading, and treatment of the tumors, as well as the follow-up information, were collected from the patient charts of the hospital. In general, tumor and patient characteristics of OSCCs and survival rates were found to be in line with those of recent analyses reported from other industrialized countries. However, OSCCs in young patients (4.8%) seemed to be clinically at a lower stage and histologically more highly differentiated than those of the other patients. Eight out of 9 (89%) OSCCs in the young patients were located on the lateral tongue. The 5-year recurrence-free rates of the patients according to the epithelial origin of the tumors were as follows: masticatory epithelium 42%, lining epithelium 57%, and epithelium of the lateral border of the tongue 61%. In conclusion, the tumors originating from different types of oral epithelia may have distinct properties with regard to their clinical behavior and responsiveness to the different treatment modalities. It would seem to be meaningful to investigate the molecular characteristics of the different types of oral epithelium in order to elucidate possible differences in their susceptibility to malignant transformation.

[1]  James S. Brown,et al.  The influence of the pattern of mandibular invasion on recurrence and survival in oral squamous cell carcinoma , 2004, Head & neck.

[2]  B. Schmidt,et al.  Tongue and tonsil carcinoma , 2005, Cancer.

[3]  J. Pignon,et al.  Prognostic value of clinicopathological parameters in head and neck squamous cell carcinoma: a prospective analysis. , 1996, British Journal of Cancer.

[4]  M. Nair,et al.  Squamous cell carcinoma of the tongue among young Indian adults. , 2001, Neoplasia.

[5]  K. Vahtsevanos,et al.  Treatment of squamous cell carcinoma of the anterior faucial pillar-retromolar trigone. , 2003, Oral oncology.

[6]  J. Califano,et al.  11:40 AM: A Genetic Progression Model for Head and Neck Cancer: Implications for Field Cancerization , 1996 .

[7]  P. Boyle,et al.  Alcohol, tobacco, diet and the risk of oral cancer: a pooled analysis of three case-control studies. , 1995, European journal of cancer. Part B, Oral oncology.

[8]  M. Nakayama,et al.  Treatment Effects in Patients with Squamous Cell Carcinoma of the Oral Cavity , 2002, Acta oto-laryngologica. Supplementum.

[9]  C. R. Leemans,et al.  Multiple head and neck tumors frequently originate from a single preneoplastic lesion. , 2002, The American journal of pathology.

[10]  Eva Negri,et al.  Risk factors for oral and pharyngeal cancer in young adults. , 2004, Oral oncology.

[11]  C. R. Leemans,et al.  Persistence of genetically altered fields in head and neck cancer patients: biological and clinical implications. , 2001, Clinical cancer research : an official journal of the American Association for Cancer Research.

[12]  W. Mackillop,et al.  Squamous Cell Carcinoma of the Head and Neck in Ontario, Canada, and in Southeastern Norway , 2003, The Laryngoscope.

[13]  P. Laippala,et al.  Cancer of the tongue in patients younger than 40 years. A distinct entity? , 1996, Archives of otolaryngology--head & neck surgery.

[14]  H. Modjtahedi.  Molecular therapy of head and neck cancer , 2005, Cancer and Metastasis Reviews.

[15]  N. Johnson,et al.  Risk factors for oral cancer in newly diagnosed patients aged 45 years and younger: a case-control study in Southern England. , 2004 .

[16]  M. Pandey,et al.  Survival in patients under 45 years with squamous cell carcinoma of the oral tongue , 2003 .

[17]  R. Presland,et al.  Epithelial structural proteins of the skin and oral cavity: function in health and disease. , 2000, Critical reviews in oral biology and medicine : an official publication of the American Association of Oral Biologists.

[18]  A. Carvalho,et al.  Predictive factors for diagnosis of advanced-stage squamous cell carcinoma of the head and neck. , 2002, Archives of otolaryngology--head & neck surgery.

[19]  Jimmy D Bell,et al.  Squamous cell carcinoma of the oral cavity in patients aged 45 years and under: a descriptive analysis of 116 cases diagnosed in the South East of England from 1990 to 1997. , 2003, Oral oncology.

[20]  M. Quer,et al.  Distant metastases in head and neck cancer patients who achieved loco‐regional control , 2000, Head & neck.

[21]  R. Dewar,et al.  Trends in the incidence of oral cancer in Nova Scotia from 1983 to 1997. , 2003, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[22]  D. Slaughter,et al.  “Field cancerization” in oral stratified squamous epithelium. Clinical implications of multicentric origin , 1953, Cancer.

[23]  D. Sessions,et al.  Analysis of Treatment Results for Oral Tongue Cancer , 2002, The Laryngoscope.

[24]  D. Goldenberg,et al.  Carcinoma of the dorsum of the tongue , 2000, Head & neck.

[25]  G. Reifenberger,et al.  Recurrent chromosomal imbalances detected in biopsy material from oral premalignant and malignant lesions by combined tissue microdissection, universal DNA amplification, and comparative genomic hybridization. , 1998, The American journal of pathology.

[26]  Nhu D Le,et al.  Carcinoma of the tongue: a case series analysis of clinical presentation, risk factors, staging, and outcome. , 2004, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[27]  L. P. Gartner.  Oral anatomy and tissue types. , 1994, Seminars in dermatology.

[28]  N. Johnson,et al.  Risk factors for squamous cell carcinoma of the oral cavity in young people--a comprehensive literature review. , 2001, Oral oncology.

[29]  E. Wynder,et al.  Oral cavity cancer in non-users of tobacco. , 1993, Journal of the National Cancer Institute.

[30]  R. Jurevic,et al.  Making sense of the epithelial barrier: what molecular biology and genetics tell us about the functions of oral mucosal and epidermal tissues. , 2002, Journal of dental education.

[31]  Johan Wennerberg,et al.  Incidence and survival of squamous cell carcinoma of the tongue in Scandinavia, with special reference to young adults , 2002, International journal of cancer.

[32]  B. Schmidt,et al.  Tobacco smoking history and presentation of oral squamous cell carcinoma. , 2004, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[33]  Guo-Pei Yu,et al.  Head and neck cancer incidence trends in young Americans, 1973-1997, with a special analysis for tongue cancer. , 2002, Archives of otolaryngology--head & neck surgery.

[34]  A. Carvalho,et al.  Sites of recurrence in oral and oropharyngeal cancers according to the treatment approach. , 2003, Oral diseases.

[35]  D. Roberts,et al.  Squamous cell carcinoma of the buccal mucosa: One institution's experience with 119 previously untreated patients , 2003, Head & neck.

[36]  P. Speight,et al.  Clinico-pathological features of squamous cell carcinoma of the oral cavity in patients <40 years of age. , 2005, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[37]  J. Shah,et al.  Management of oral and oropharyngeal cancers. , 2003, Oral diseases.

[38]  R. Spiro,et al.  Cancer of the oral cavity: a comparison between institutions in a developing and a developed nation , 2004, Head & neck.

[39]  C. R. Leemans,et al.  Genetically Altered Fields as Origin of Locally Recurrent Head and Neck Cancer , 2004, Clinical Cancer Research.

[40]  I. Saloniemi,et al.  CD44v6 in developing, dysplastic and malignant oral epithelia. , 2003, Oral oncology.

[41]  D. Trask,et al.  Presentation, treatment, and outcome of oral cavity cancer: A national cancer data base report , 2002 .

[42]  T. Helliwell,et al.  Mandibular invasion in patients with oral and oropharyngeal squamous carcinoma. , 1997, Clinical otolaryngology and allied sciences.