Demographic and Imaging Features of Oral Squamous Cell Cancer in Serbia: a Retrospective Cross-sectional Study

Overview

Journal BMC Oral Health

Publisher Biomed Central

Specialty Dentistry

Date 2024 Jan 29

PMID 38287310

Authors

Aleksa Janovic

durda Bracanovic

Svetlana Antic

Biljana Markovic-Vasiljkovic

Affiliations

Soon will be listed here.

Abstract

Background: The mortality of oral squamous cell cancer (OSCC) in Serbia increased in the last decade. Recent studies on the Serbian population focused mainly on the epidemiological aspect of OSCC. This study aimed to investigate the demographic and imaging features of OSCC in the Serbian population at the time of diagnosis.

Methods: We retrospectively analyzed computed tomography (CT) images of 276 patients with OSCC diagnosed between 2017 and 2022. Age, gender, tumor site, tumor volume (CT-TV, in cm), depth of invasion (CT-DOI, in mm), and bone invasion (CT-BI, in %) were evaluated. TNM status and tumor stage were also analyzed. All parameters were analyzed with appropriate statistical tests.

Results: The mean age was 62.32 ± 11.39 and 63.25 ± 11.71 for males and females, respectively. Male to female ratio was 1.63:1. The tongue (36.2%), mouth floor (21.0%), and alveolar ridge (19.9%) were the most frequent sites of OSCC. There was a significant gender-related difference in OSCC distribution between oral cavity subsites (Z=-4.225; p < 0.001). Mean values of CT-TV in males (13.8 ± 21.5) and females (5.4 ± 6.8) were significantly different (t = 4.620; p < 0.001). CT-DOI also differed significantly (t = 4.621; p < 0.001) between males (14.4 ± 7.4) and females (10.7 ± 4.4). CT-BI was detected in 30.1%, the most common in the alveolar ridge OSCC. T2 tumor status (31.4%) and stage IVA (28.3%) were the most dominant at the time of diagnosis. Metastatic lymph nodes were detected in 41.1%.

Conclusion: Our findings revealed significant gender-related differences in OSCC imaging features. The predominance of moderate and advanced tumor stages indicates a long time interval to the OSCC diagnosis.

References

Kreimer A, Clifford G, Boyle P, Franceschi S . Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidemiol Biomarkers Prev. 2005; 14(2):467-75. DOI: 10.1158/1055-9965.EPI-04-0551. View

Jethwa A, Khariwala S . Tobacco-related carcinogenesis in head and neck cancer. Cancer Metastasis Rev. 2017; 36(3):411-423. PMC: 5709040. DOI: 10.1007/s10555-017-9689-6. View

Dimitrijevic M, Dukic V, Trivic A . [Evaluation of local and regional spread of malignant tumors of the tongue and floor of the mouth]. Vojnosanit Pregl. 2004; 61(5):507-12. DOI: 10.2298/vsp0405507d. View

Mukherji S, Isaacs D, Creager A, Shockley W, Weissler M, Armao D . CT detection of mandibular invasion by squamous cell carcinoma of the oral cavity. AJR Am J Roentgenol. 2001; 177(1):237-43. DOI: 10.2214/ajr.177.1.1770237. View

Ilic M, Radevic S, Stefanovic V, Cirkovic T, Zurovac T, Savic B . Mortality rate of lip, oral cavity and pharynx malignant tumors in Serbia within a period 1991-2009. Vojnosanit Pregl. 2013; 70(2):189-94. View

Vigneswaran N, Williams M . Epidemiologic trends in head and neck cancer and aids in diagnosis. Oral Maxillofac Surg Clin North Am. 2014; 26(2):123-41. PMC: 4040236. DOI: 10.1016/j.coms.2014.01.001. View

Joo Y, Hwang S, Sun D, Cho K, Park J, Kim M . Relationships between Tumor Volume and Lymphatic Metastasis and Prognosis in Early Oral Tongue Cancer. Clin Exp Otorhinolaryngol. 2013; 6(4):243-8. PMC: 3863674. DOI: 10.3342/ceo.2013.6.4.243. View

Arya S, Rane P, Deshmukh A . Oral cavity squamous cell carcinoma: role of pretreatment imaging and its influence on management. Clin Radiol. 2014; 69(9):916-30. DOI: 10.1016/j.crad.2014.04.013. View

Stepovic M, Stajic D, Sekulic M, Rajkovic Z, Djonovic N . Analysis of Mortality from Carcinomas Primary Localized in Region of Lip, Oral Cavity and Pharynx in Central Serbia, 1999-2015. Iran J Public Health. 2020; 49(2):274-282. PMC: 7231697. View

10.

Lane A, Buckmire R, Mukherji S, Pillsbury 3rd H, Meredith S . Use of computed tomography in the assessment of mandibular invasion in carcinoma of the retromolar trigone. Otolaryngol Head Neck Surg. 2000; 122(5):673-7. DOI: 10.1016/S0194-5998(00)70194-X. View

11.

Mahajan A, Ahuja A, Sable N, Stambuk H . Imaging in oral cancers: A comprehensive review. Oral Oncol. 2020; 104:104658. DOI: 10.1016/j.oraloncology.2020.104658. View

12.

Mihajlovic J, Pechlivanoglou P, Miladinov-Mikov M, Zivkovic S, Postma M . Cancer incidence and mortality in Serbia 1999-2009. BMC Cancer. 2013; 13:18. PMC: 3561276. DOI: 10.1186/1471-2407-13-18. View

13.

Brown J, Griffith J, Phelps P, BROWNE R . A comparison of different imaging modalities and direct inspection after periosteal stripping in predicting the invasion of the mandible by oral squamous cell carcinoma. Br J Oral Maxillofac Surg. 1994; 32(6):347-59. DOI: 10.1016/0266-4356(94)90024-8. View

14.

Kuznetsov S, Yu Q, Spieler B, Hartsough R, Zhu X, Murnan E . Can Radiographic Tumor Volume of Oral Squamous Cell Carcinoma Help Predict Clinical and Pathological Tumor Features?. J Oral Maxillofac Surg. 2021; 79(12):2582-2592. DOI: 10.1016/j.joms.2021.06.012. View

15.

Almangush A, Makitie A, Triantafyllou A, de Bree R, Strojan P, Rinaldo A . Staging and grading of oral squamous cell carcinoma: An update. Oral Oncol. 2020; 107:104799. DOI: 10.1016/j.oraloncology.2020.104799. View

16.

Lydiatt W, Patel S, OSullivan B, Brandwein M, Ridge J, Migliacci J . Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017; 67(2):122-137. DOI: 10.3322/caac.21389. View

17.

Ebrahimi A, Gil Z, Amit M, Yen T, Liao C, Chaturvedi P . The prognosis of N2b and N2c lymph node disease in oral squamous cell carcinoma is determined by the number of metastatic lymph nodes rather than laterality: evidence to support a revision of the American Joint Committee on Cancer staging system. Cancer. 2014; 120(13):1968-74. DOI: 10.1002/cncr.28686. View

18.

Cantrell S, Peck B, Li G, Wei Q, Sturgis E, Ginsberg L . Differences in imaging characteristics of HPV-positive and HPV-Negative oropharyngeal cancers: a blinded matched-pair analysis. AJNR Am J Neuroradiol. 2013; 34(10):2005-9. PMC: 3951375. DOI: 10.3174/ajnr.A3524. View

19.

Conway D, Purkayastha M, Chestnutt I . The changing epidemiology of oral cancer: definitions, trends, and risk factors. Br Dent J. 2018; 225(9):867-873. DOI: 10.1038/sj.bdj.2018.922. View

20.

Trotta B, Pease C, Rasamny J, Raghavan P, Mukherjee S . Oral cavity and oropharyngeal squamous cell cancer: key imaging findings for staging and treatment planning. Radiographics. 2011; 31(2):339-54. DOI: 10.1148/rg.312105107. View