Modern Approach to Oral Cancer

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

Deadline for manuscript submissions: 30 August 2025 | Viewed by 14137

Special Issue Editors


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Guest Editor
Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
Interests: oral cancer; dentistry; oral rehabiliation; laser therapy
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Guest Editor
Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
Interests: oral cancer; oral health; ultrasound and magnetic resonance imaging

Special Issue Information

Dear Colleagues,

In recent years, dentistry has increased coordination in research and begun cooperation with other disciplines.

This Special Issue focuses on the most recent and significant innovations in the treatment and diagnosis of oral cancer, paying attention to multidisciplinary, technological, and research aspects, as well as how they can be involved in oral health and clinical dentistry practice. New molecular mechanisms and approaches in the diagnosis and treatment of oral cancer have been discovered. The applications of this techniques can lead to significant advances in all branches of dental practice. Authors conducting studies on these themes are invited to submit original research articles and reviews.

Dr. Maria Maddalena Marrapodi
Dr. Giuseppe Minervini
Guest Editors

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Keywords

  • oral cancer
  • neoplasm
  • oral surgery oncogenesis
  • dentistry oral health

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Published Papers (8 papers)

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Research

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20 pages, 3941 KiB  
Article
Significance of PD-L1 and Tumor Microenvironment in Laryngeal Squamous Cell Cancer
by Filip Tudor, Blažen Marijić, Emina Babarović and Ita Hadžisejdić
Cancers 2024, 16(15), 2645; https://doi.org/10.3390/cancers16152645 - 25 Jul 2024
Viewed by 726
Abstract
Background: Despite the considerable advancement in the field of medicine over recent decades, laryngeal cancer continues to be a challenge. The field of immune oncology has generated promising immunomodulation therapies and opened up new ways of treatment. Methods: Our retrospective study included 102 [...] Read more.
Background: Despite the considerable advancement in the field of medicine over recent decades, laryngeal cancer continues to be a challenge. The field of immune oncology has generated promising immunomodulation therapies and opened up new ways of treatment. Methods: Our retrospective study included 102 patients diagnosed with laryngeal squamous cell cancer (LSCC). Immunohistochemistry was used to evaluate the expression of PD-L1 and tumor microenvironment cells (CD4, CD8, CD68 and CD163). Results: PD-L1 expression showed statistically significant positive correlations with all examined tumor microenvironment cells. Patients with high CD68 and CD163 expression intratumorally (p = 0.0005 and p = 0.006, respectively) had statistically significant shorter disease-specific survival. Moreover, a statistically shorter time to recurrence was found in patients with high CD68 intratumoral and CD8 overall counts (p = 0.049 and p = 0.019, respectively). Also, high CD8 overall (>23%) and CD68 intratumoral (>2.7%) expression were statistically significant predictors of recurrence (p = 0.028, OR = 3.11 and p = 0.019, OR = 3.13, respectively). Conclusions: Higher CD68 and CD163 expression represented significantly worse prognosticators for clinical outcomes in patients with LSCC. In order to determine which LSCC patients will benefit from anti-PD-1/PD-L1 inhibitors, it is crucial to elucidate the relationship between PD-L1 expression, immune cell distribution and prognosis in LSCC patients. Full article
(This article belongs to the Special Issue Modern Approach to Oral Cancer)
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11 pages, 501 KiB  
Article
Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”
by Franco Ionna, Ettore Pavone, Corrado Aversa, Francesco Maffia, Raffaele Spinelli, Emanuele Carraturo, Giovanni Salzano, Fabio Maglitto, Marco Sarcinella, Roberta Fusco, Vincenza Granata, Secondo Lastoria, Francesco Del Prato and Maria Grazia Maglione
Cancers 2024, 16(6), 1153; https://doi.org/10.3390/cancers16061153 - 14 Mar 2024
Cited by 2 | Viewed by 2060 | Correction
Abstract
Oral tongue squamous-cell carcinoma (OTSCC) is the most prevalent malignancy in the head and neck region. Lymphatic spread, particularly to cervical lymph nodes, significantly impacts 5-year survival rates, emphasizing the criticality of precise staging. Metastatic cervical lymph nodes can decrease survival rates by [...] Read more.
Oral tongue squamous-cell carcinoma (OTSCC) is the most prevalent malignancy in the head and neck region. Lymphatic spread, particularly to cervical lymph nodes, significantly impacts 5-year survival rates, emphasizing the criticality of precise staging. Metastatic cervical lymph nodes can decrease survival rates by 50%. Yet, elective neck dissection (END) in T1–2 cN0 patients proves to be an overtreatment in around 80% of cases. To address this, sentinel lymph node biopsy (SLNB) was introduced, aiming to minimize postoperative morbidity. This study, conducted at the ENT and Maxillofacial Surgery department of the Istituto Nazionale Tumori in Naples, explores SLNB’s efficacy in early-stage oral tongue squamous-cell carcinoma (OTSCC). From January 2020 to January 2022, 122 T1/T2 cN0 HNSCC patients were enrolled. Radioactive tracers and lymphoscintigraphy identified sentinel lymph nodes, aided by a gamma probe during surgery. Results revealed 24.6% SLN biopsy positivity, with 169 SLNs resected and a 21.9% positivity ratio. The study suggests SLNB’s reliability for T1-2 cN0 OTSCC patient staging and early micrometastasis detection. Full article
(This article belongs to the Special Issue Modern Approach to Oral Cancer)
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11 pages, 3869 KiB  
Article
Intraoral Ultrasound versus MRI for Depth of Invasion Measurement in Oral Tongue Squamous Cell Carcinoma: A Prospective Diagnostic Accuracy Study
by Mikkel Kaltoft, Christoffer Holst Hahn, Marcus Wessman, Martin Lundsgaard Hansen, Tina Klitmøller Agander, Fatemeh Makouei, Irene Wessel and Tobias Todsen
Cancers 2024, 16(3), 637; https://doi.org/10.3390/cancers16030637 - 1 Feb 2024
Cited by 4 | Viewed by 2224
Abstract
Oral squamous cell carcinoma (OSCC) of the tongue is the most common type of oral cavity cancer, and tumor depth of invasion (DOI) is an important prognostic factor. In this study, we investigated the accuracy of intraoral ultrasound and magnetic resonance imaging (MRI) [...] Read more.
Oral squamous cell carcinoma (OSCC) of the tongue is the most common type of oral cavity cancer, and tumor depth of invasion (DOI) is an important prognostic factor. In this study, we investigated the accuracy of intraoral ultrasound and magnetic resonance imaging (MRI) for assessing DOI in patients with OSCC. Histopathological measurement of DOI was used as a reference standard. We conducted a prospective study including patients planned for surgical treatment of OSCC in the tongue. The DOI was measured in an outpatient setting by intraoral ultrasound and MRI, and was compared to the histopathological DOI measurements. Bland–Altman analysis compared the mean difference and 95% limits of agreement (LOA) for ultrasound and MRI, and the Wilcoxon signed-rank test was used to test for significance. The correlation was evaluated using Pearson’s correlation coefficient. We included 30 patients: 26 with T1 or T2 tumors, and 4 with T3 tumors. The mean difference from histopathology DOI was significantly lower for ultrasound compared to MRI (0.95 mm [95% LOA −4.15 mm to 6.06 mm] vs. 1.90 mm [95% LOA −9.02 mm and 12.81 mm], p = 0.023). Ultrasound also led to significantly more correct T-stage classifications in 86.7% (26) of patients compared to 56.7% (17) for MRI, p = 0.015. The Pearson correlation between MRI and histopathology was 0.57 (p < 0.001) and the correlation between ultrasound and histopathology was 0.86 (p < 0.001). This prospective study found that intraoral ultrasound is more accurate than MRI in assessing DOI and for the T-staging of oral tongue cancers. Clinical practice and guidelines should implement intraoral ultrasound accordingly. Full article
(This article belongs to the Special Issue Modern Approach to Oral Cancer)
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Review

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27 pages, 1572 KiB  
Review
Epidemiology, Diagnostics, and Therapy of Oral Cancer—Update Review
by Julia Kijowska, Julia Grzegorczyk, Katarzyna Gliwa, Aleksandra Jędras and Monika Sitarz
Cancers 2024, 16(18), 3156; https://doi.org/10.3390/cancers16183156 - 14 Sep 2024
Viewed by 1911
Abstract
Oral cavity and lip cancers are the 16th most common cancer in the world. It is widely known that a lack of public knowledge about precancerous lesions, oral cancer symptoms, and risk factors leads to diagnostic delay and therefore a lower survival rate. [...] Read more.
Oral cavity and lip cancers are the 16th most common cancer in the world. It is widely known that a lack of public knowledge about precancerous lesions, oral cancer symptoms, and risk factors leads to diagnostic delay and therefore a lower survival rate. Risk factors, which include drinking alcohol, smoking, HPV infection, a pro-inflammatory factor-rich diet, and poor oral hygiene, must be known and avoided by the general population. Regular clinical oral examinations should be enriched in an oral cancer search protocol for the most common symptoms, which are summarized in this review. Moreover, new diagnostic methods, some of which are already available (vital tissue staining, optical imaging, oral cytology, salivary biomarkers, artificial intelligence, colposcopy, and spectroscopy), and newly researched techniques increase the likelihood of stopping the pathological process at a precancerous stage. Well-established oral cancer treatments (surgery, radiotherapy, chemotherapy, and immunotherapy) are continuously being developed using novel technologies, increasing their success rate. Additionally, new techniques are being researched. This review presents a novel glance at oral cancer—its current classification and epidemiology—and will provide new insights into the development of new diagnostic methods and therapies. Full article
(This article belongs to the Special Issue Modern Approach to Oral Cancer)
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20 pages, 1935 KiB  
Review
The Impact of Oral Microbiome Dysbiosis on the Aetiology, Pathogenesis, and Development of Oral Cancer
by Jasminka Talapko, Suzana Erić, Tomislav Meštrović, Marinka Mravak Stipetić, Martina Juzbašić, Darko Katalinić, Sanja Bekić, Dora Muršić, Josipa Flam, Dino Belić, Davor Lešić, Rajko Fureš, Manda Markanović and Ivana Škrlec
Cancers 2024, 16(17), 2997; https://doi.org/10.3390/cancers16172997 - 28 Aug 2024
Viewed by 1289
Abstract
Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer. Although the oral cavity is an easily accessible area for visual examination, the OSCC is more often detected at an advanced stage. The global prevalence of OSCC is around 6%, [...] Read more.
Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer. Although the oral cavity is an easily accessible area for visual examination, the OSCC is more often detected at an advanced stage. The global prevalence of OSCC is around 6%, with increasing trends posing a significant health problem due to the increase in morbidity and mortality. The oral cavity microbiome has been the target of numerous studies, with findings highlighting the significant role of dysbiosis in developing OSCC. Dysbiosis can significantly increase pathobionts (bacteria, viruses, fungi, and parasites) that trigger inflammation through their virulence and pathogenicity factors. In contrast, chronic bacterial inflammation contributes to the development of OSCC. Pathobionts also have other effects, such as the impact on the immune system, which can alter immune responses and contribute to a pro-inflammatory environment. Poor oral hygiene and carbohydrate-rich foods can also increase the risk of developing oral cancer. The risk factors and mechanisms of OSCC development are not yet fully understood and remain a frequent research topic. For this reason, this narrative review concentrates on the issue of dysbiosis as the potential cause of OSCC, as well as the underlying mechanisms involved. Full article
(This article belongs to the Special Issue Modern Approach to Oral Cancer)
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17 pages, 5665 KiB  
Review
Pathogenesis of Warthin’s Tumor: Neoplastic or Non-Neoplastic?
by Ryogo Aoki and Takuji Tanaka
Cancers 2024, 16(5), 912; https://doi.org/10.3390/cancers16050912 - 23 Feb 2024
Cited by 2 | Viewed by 3348
Abstract
Warthin’s tumor is the second most frequent neoplasm next to pleomorphic adenoma in the salivary gland, mostly in the parotid gland. The epithelial cells constituting a tumor are characterized by the presence of mitochondria that undergo structural and functional changes, resulting in the [...] Read more.
Warthin’s tumor is the second most frequent neoplasm next to pleomorphic adenoma in the salivary gland, mostly in the parotid gland. The epithelial cells constituting a tumor are characterized by the presence of mitochondria that undergo structural and functional changes, resulting in the development of oncocytes. In addition to containing epithelial cells, Warthin’s tumors contain abundant lymphocytes with lymph follicles (germinal centers) that are surrounded by epithelial cells. The pathogenesis of Warthin’s tumor is not fully understood, and several hypotheses have been proposed. The risk factors for the development of Warthin’s tumor, which predominantly occurs in males, include aging, smoking, and radiation exposure. Recently, it has been reported that chronic inflammation and aging cells promote the growth of Warthin’s tumor. Several reports regarding the origin of the tumor have suggested that (1) Warthin’s tumor is an IgG4-related disease, (2) epithelial cells that compose Warthin’s tumor accumulate mitochondria, and (3) Warthin’s tumor is a metaplastic lesion in the lymph nodes. It is possible that the pathogenesis of Warthin’s tumor includes mitochondrial metabolic abnormalities, accumulation of aged cells, chronic inflammation, and senescence-associated secretory phenotype (SASP). In this short review, we propose that DNA damage, metabolic dysfunction of mitochondria, senescent cells, SASP, human papillomavirus, and IgG4 may be involved in the development of Warthin’s tumor. Full article
(This article belongs to the Special Issue Modern Approach to Oral Cancer)
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15 pages, 318 KiB  
Review
Intraoperative Assessment of Resection Margin in Oral Cancer: The Potential Role of Spectroscopy
by Máté Vlocskó, József Piffkó and Ágnes Janovszky
Cancers 2024, 16(1), 121; https://doi.org/10.3390/cancers16010121 - 26 Dec 2023
Cited by 1 | Viewed by 1370
Abstract
In parallel with the increasing number of oncological cases, the need for faster and more efficient diagnostic tools has also appeared. Different diagnostic approaches are available, such as radiological imaging or histological staining methods, but these do not provide adequate information regarding the [...] Read more.
In parallel with the increasing number of oncological cases, the need for faster and more efficient diagnostic tools has also appeared. Different diagnostic approaches are available, such as radiological imaging or histological staining methods, but these do not provide adequate information regarding the resection margin, intraoperatively, or are time consuming. The purpose of this review is to summarize the current knowledge on spectrometric diagnostic modalities suitable for intraoperative use, with an emphasis on their relevance in the management of oral cancer. The literature agrees on the sensitivity, specificity, and accuracy of spectrometric diagnostic modalities, but further long-term prospective, multicentric clinical studies are needed, which may standardize the intraoperative assessment of the resection margin and the use of real-time spectroscopic approaches. Full article
(This article belongs to the Special Issue Modern Approach to Oral Cancer)

Other

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1 pages, 138 KiB  
Correction
Correction: Ionna et al. Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”. Cancers 2024, 16, 1153
by Franco Ionna, Ettore Pavone, Corrado Aversa, Francesco Maffia, Raffaele Spinelli, Emanuele Carraturo, Giovanni Salzano, Fabio Maglitto, Marco Sarcinella, Roberta Fusco, Vincenza Granata, Secondo Lastoria, Francesco Del Prato and Maria Grazia Maglione
Cancers 2024, 16(14), 2551; https://doi.org/10.3390/cancers16142551 - 16 Jul 2024
Viewed by 498
Abstract
In the published publication [...] Full article
(This article belongs to the Special Issue Modern Approach to Oral Cancer)
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