Implication for second primary cancer from visible oral and oropharyngeal premalignant lesions in betel-nut chewing related oral cancer

Head Neck. 2017 Jul;39(7):1428-1435. doi: 10.1002/hed.24777. Epub 2017 Apr 6.

Abstract

Background: Visible oral and oropharyngeal premalignant lesions may be used to monitor for a second primary oral cancer. To control for bias, we focused on the visible oral and oropharyngeal premalignant lesions of patients with oral cancer with a positive betel-nut chewing habit. Visible oral and oropharyngeal premalignant lesions that can predict second primary oral cancers were studied.

Methods: Nine hundred ninety-seven patients with positive betel-nut chewing habits and oral cancer were enrolled in this retrospective cohort study. We analyzed the relevance of their visible oral and oropharyngeal premalignant lesion incidence and relative clinicopathological variables to the development of a second primary oral cancer.

Results: Second primary oral cancer risk was significantly higher in patients with positive visible oral and oropharyngeal premalignant lesions (P < .0001), especially in younger patients (P = .0023; ≤40 years: adjusted odds ratio [OR] 2.66; 40-60 years: adjusted OR 2.61). The heterogeneous leukoplakia was (adjusted OR 2.17) higher than homogeneous leukoplakia.

Conclusion: The predictive value and practicality of visible oral and oropharyngeal premalignant lesions make it a potentially valuable marker in follow-ups of patients with a positive betel-nut chewing habit with oral cancer, especially young patients with heterogeneous leukoplakia.

Keywords: erythroplakia; leukoplakia; oral and oropharyngeal; premalignant lesion; second primary oral cancer.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Distribution
  • Areca / adverse effects*
  • China / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Leukoplakia, Oral / pathology*
  • Male
  • Mastication
  • Middle Aged
  • Mouth Neoplasms / epidemiology
  • Mouth Neoplasms / etiology*
  • Mouth Neoplasms / pathology
  • Neoplasms, Second Primary / etiology*
  • Neoplasms, Second Primary / pathology
  • Oropharyngeal Neoplasms / epidemiology
  • Oropharyngeal Neoplasms / etiology*
  • Oropharyngeal Neoplasms / pathology
  • Precancerous Conditions / epidemiology
  • Precancerous Conditions / pathology*
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution