Women and squamous cell carcinomas of the oral cavity and oropharynx: is there something new?
ABSTRACT Incidence of squamous cell carcinoma (SCC) of the oral cavity and oropharynx is increasing in French female patients. The objective of this study was to study the clinical and demographic characteristics and the prognosis of this female population. Secondary outcomes were to determine if a subgroup of patient had a different prognosis.
A prospective study from 1989 to 2002 of all female patients presenting SCC of the upper aerodogestive tract was conducted. Data for 171 women were extracted. Clinical and histological features were analyzed using chi(2) and log-rank tests along with the Kaplan Meier method and multivariate analysis using the Cox regression procedure.
Mean patient age was 62 years. Of the study population, 48.5% used tobacco and 34.5% used alcohol. The relative risk of death for overall and cancer-specific survival increased for patients below the age of 45 or over the age of 70 (95% Cl; 0.3-1.05; P = .0085). Tobacco consumption decreased cancer-specific and overall survival (P = .0008 and .0001, respectively). The other prognostic factors we found were tumor and nodal status, previous or simultaneous cancer, oral cavity primary site.
Prognosis of oropharyngeal and oral squamous cell carcinomas is less favorable in females who smoke as well as in younger and older women. With these patients, the oversight must be closer. Smoking, however, should be stopped.
- SourceAvailable from: scielo.br[Show abstract] [Hide abstract]
ABSTRACT: Tobacco and alcohol are the main extrinsic etiological factors for the genesis of oral squamous cell carcinoma (SCC), but it is still not clear if the presence of these factors interfere with clinical, pathologic and molecular characteristics or with the prognosis of the disease. In the present study, these characteristics were reviewed, establishing comparisons between the lesions of patients exposed and not exposed to tobacco and alcohol. We observed that oral SCC in non smokers and non alcohol drinkers occur mainly in female patients, under 50 or over 70 years old. The lesions tend to be less aggressive in this group of patients and have a better prognosis. The molecular characteristics of these malignant tumors also appear to be influenced by the presence of these habits, once mutations of p53 have been associated with tobacco and alcohol use. The understanding of the differences between the neoplasms of these two groups of patients can contribute to the management of this cancer, which could lead to advances in the determination of more appropriate therapeutic measures.Revista Odonto Ciência. 12/2011; 27(1):69-73.
- [Show abstract] [Hide abstract]
ABSTRACT: The aim of this cohort study was to quantify the effect of alcohol on the risk of oral cancer in different strata of folate intake, controlling for known confounders. A cohort of 87,621 women in the Nurses' Health Study was followed up from 1980 to 2006, and 147 incident oral cancer cases were reported and confirmed. Data on alcohol intake and diet were obtained through self-reported food frequency questionnaires every 4 years. Cox proportional regression analysis was conducted to estimate the adjusted risk ratios (RR) and 95% confidence intervals (95% CI). When compared with nondrinkers, the adjusted RRs (95% CIs) for alcohol intake were 0.59 (0.39-0.87) for 0.1-14.9 g/d, 1.15 (0.67-1.97) for 15-29.9 g/d, and 1.92 (1.08-3.40) for ≥30 g/d. We observed a significant interaction between alcohol and folate intakes (P = 0.02). The cancer risk for subjects with high alcohol (≥30 g/d) and low folate (<350 μg/d) intakes was significantly elevated (RR, 3.36; 95% CI, 1.57-7.20) as compared with nondrinkers with low folate intake. The risk associated with high alcohol intake (≥30 g/d) was reduced to 0.98 (0.35-2.70) in the high-folate (≥350 μg/d) group as compared with nondrinkers with high folate intake. High alcohol intake is associated with significantly increased oral cancer risk, especially in women with low folate intake. A significant interaction between alcohol and folate intakes seems to affect oral cancer risk in women, a finding with potential public health utility.Cancer Epidemiology Biomarkers & Prevention 10/2010; 19(10):2516-24. · 4.56 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: OBJECTIVES: Salivary ALDH3A1 protects the oral cavity from aromatic and medium-chain aliphatic aldehydes originating from food and air pollution and generated during oxidative stress. Due to their reactivity, aldehydes may exhibit an irritating effect as well as cytotoxic, genotoxic, mutagenic and even carcinogenic effects. The aim of this study was to verify whether lower ALDH3A1 activity is a risk factor for oral cavity cancer. SUBJECTS AND METHODS: Fasting saliva samples were collected one day before and about one week after surgery from patients with oral cancer (OCC) (n = 59), other tumours (cysts, neoplasms) (n = 108), gnathic defects and fractures (controls after the surgery) (n = 63), and from healthy volunteers (n = 116). Enzyme activity was measured using a fluorometric method. RESULTS: Total ALDH3A1 activity [U g(-1) ] in patients with OCC was statistically lower than in patients with keratocystic odontogenic tumour (KCOT) (P = 0.00697), odontogenic cysts (OC) (P < 0.00001), neoplasms (P = 0.03343) and the healthy volunteers up to and over 40 years old (P < 0.00001; P = 0.00019). The activity in the saliva of OCC after surgery was lower than in the healthy volunteers (P < 0.00001) and in the groups with fractures (P = 0.00303) and gnathic defects (P = 0.00538). CONCLUSION: Low salivary ALDH activity may be a risk factor for oral cancer development.Oral Diseases 01/2013; · 2.38 Impact Factor