Original Article

The Clinicopathological presentation of oral squamous cell carcinoma in Iraqi population

Abstract

Background and Aim: Oral cancer is a major public health issue worldwide; it remains a highly lethal and disfiguring disease, it is primarily a disease of epithelial origin, it has various clinicopathological pictures. is to demonstrate various clinical and pathological presentations of oral squamous cell carcinoma in Iraqi population. Materials and Methods: A total of 80 cases of histologically diagnosed squamous cell carcinoma collected from the main centers of Sulaymaniyah teaching hospital/Hiwa cancer center Hospital/Sulaymaniyah/Iraq were analyzed according to age, sex, site, clinical, and pathological presentation of oral squamous cell carcinoma at the time of presentation, and histological grading. Results: Patients in their sixth decade of life were the most commonly affected with a male-tofemale ratio of 1.4:1. The tongue was the most frequently affected site, followed by the floor of the mouth. The most common clinical presentation is ulceration and swelling. More than 40% of the cases were well-differentiated squamous cell carcinoma. Conclusion: Oral cancer is increasingly seen as a major health problem, in line with the general trend in the region, the need for inter-professional health care delivery approaches for reducing oral cancer mortality and improving patients’ quality of life. Keywords: Squamous cell carcinoma; Oral cancer; Clinical presentation; Histopathology; Tumorgrading.
1. Rivera C. Essentials of oral cancer. Int J Clin Exp Pathol. 2015;8(9):11884-94
2. Neville, B., Damm, D. & Allen, C. et al. Oral & Maxillofacial Pathology. 2nd ed. Phila. 2002, PA: Saunders, p.337-369.
3. Gorsky M, Littner MM, Sukman Y, Begleiter A, The prevalence of Oral cancer in relation to the ethnic origin of Israeli Jews. Oral Surg Oral Med Oral Pathol. 1994;78(3): p.408–411
4. J. P. Shah and Z. Gil. Current Concepts in Management of Oral Cancer-Surgery. Oral Oncology. 2009;45(4): p.394-401.
5. E. Attar, S. Dey, A. Hablas, I. A. Seifeldin, M. Ramadan, L. S. Rozek and A. S. Soliman. Head and Neck Cancer in a Developing Country: A Population-Based Perspective Across 8 Years. Oral Oncology. 2010;46(8): p.591-596.
6. J. Bagan, G. Sarrion and Y. Jimenez. Oral Cancer: Clinical Features. Oral Oncology. 2010;46(6): p.414-417.
7. S. Petti. Lifestyle Risk Factors for Oral Cancer. Oral Oncology. 2009;45(4): p.340-350.
8. Ribeiro ACP, Silva ARS, Simonato LE, et al. Clinical and histopathological analysis of oral squamous cell carcinoma in young people: A descriptive study in Brazilians. Br J Oral Maxillofac Surg. 2009;47(2): p.95-98
9. Losi-Guembarovski R, Menezes RP, Poliseli F, et al. Oral carcinoma epidemiology in Paraná State, Southern Brazil. Cad Saude Publica. 2009;25(2): p.393-400.
10. Sadri Gh.H, Mahjub H. Tobacco smoking and oral cancer: A meta-analysis. J Res Health Sci. 2007;7(1): p.18-23.
11. Kingsley K, O’Malley S, Ditmyer M, et al. Analysis of oral cancer epidemiology in the US reveals state-specific trends: implications for oral cancer prevention. BMC Public Health. 2008; 8:87.
12. Brennan P, Lewis S, Hashibe M, et al. Pooled analysis of alcohol dehydrogenase genotypes and head and neck cancer. Am J Epidemiol. 2001;159: p.1-16.
13. Mehrotra R, Yadav S. Oral squamous cell carcinoma: Etiology, pathogenesis and prognostic value of genomic alterations. Indian J Cancer. 2006;43: p.60-66.
14. Chen E. Why Socioeconomic Status Affects the Health of Children: A Psychosocial Perspective. Current Directions Psychological Science. 2004;13: p.112-115.
15. Gele AA, Harslof I. Types of social capital resources and self-rated health among the Norwegian adult population. Int J Equity Health. 2010; 9:8.
16. Hashibe M, Jacob BJ, Thomas G, et al. Socio-economic status, lifestyle factors and oral premalignant lesions. Oral Oncol. 2003; 39: p.664-671.

17. Morelatto RA, Herrera MC, Fernández EN, Corball AG, López de Blanc SA. Diagnostic delay of oral squamous cell carcinoma in two diagnosis centers in Córdoba Argentina. J Oral Pathol Med. 2007; 36: p.405-8.
18. Sobin L, Gospodarowicz M, Wittekind C. TNM Classification of Malignant Tumours. 7th edition. Chichester: Wiley-Blackwell; 2009.
19. Leemans CR, Braakhuis BJ, Brakenhoff RH. The molecular biology of head and neck cancer. Nat Rev Cancer. 2011; 11(1): p.9–p.9-22.
20. Massano J, Regateiro FS, Januário G, Ferreira A. Oral squamous cell carcinoma: review of prognostic and predictive factors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(1): p.67–76.
21. Chen YK, Huang HC, Lin LM, Lin CC. Primary oral squamous cell carcinoma: an analysis of 703 cases in southern Taiwan. Oral Oncol. 1999;35(2): p.173–179.
22. Kademani D, Bell RB, Bagheri S, Holmgren E, Dierks E, Potter B, Homer L. Prognostic factors in intraoral squamous cell carcinoma: the influence of histologic grade. J Oral Maxillofac Surg. 2005;63(11): p.1599–1605.
23. Po Wing Yuen A, Lam KY, Lam LK, Ho CM, Wong A, Chow TL, Yuen WF, Wei WI. Prognostic factors of clinically stage I and II oral tongue carcinoma-A comparative study of stage, thickness, shape, growth pattern, invasive front malignancy grading, Martinez-Gimeno score, and pathologic features. Head Neck. 2002;24(6): p.513–520.
24. OC P, Pillai G, Patel S, Fisher C, Archer D, Eccles S, Rhys-Evans P. Tumour thickness predicts cervical nodal metastases and survival in early oral tongue cancer. Oral Oncol. 2003;39(4): p.386–390
25. S. Warnakulasuriya. Global Epidemiology of Oral and Oropharyngeal Cancer. Oral Oncology. 2009;45(4): p.309-316.
26. C. Scully and J. Bagan. Oral Squamous Cell Carcinoma Overview. Oral Oncology. 2009; 45(4): p. 301- 308.
27. Boring, C., Squires, T. & Tong, T. Cancer Statistics. Cancer J Clin. 1994; 44(1): p.7-26.
28. Silverman, S. Jr, Dillon, W. & Fischbein N. Oral Cancer. 4th ed. Hamilton, Ontario, Canada: BC Decker Inc;1998, p.41-66.
29. Silverman S Jr, Shillitoe EF. Etiology and Predisposing Factors. In: Silverman S Jr. Oral Cancer, 4th ed. Hamilton, Ontario, Canada: BC Decker Inc;1998, p.7-24.
30. Ghoshal S, Mallick I, Panda N, Sharma SC. Carcinoma of the buccal mucosa: analysis of clinical presentation, outcome and prognostic factors. Oral Oncol. 2006;42(5): P.533-539.
31. Morelatto RA, Herrera MC, Fernandez EN, Corball AG, Lopez de Blanc SA. Diagnostic delay of oral squamous cell carcinoma in two diagnosis centers in Cordoba Argentina. J Oral Pathol Med. 2007;36(7): p.405-8.

32. Jones AS, Beasley N, Houghton D, Husband DJ. The effects of age on survival and other parameters in squamous cell carcinoma of the oral cavity, pharynx and larynx. Clin Otolaryngol Allied Sci. 1998;23(1): p.51-6.
33. Carinci F, Pelucchi S, Farina A, Bonsetti G, Mastrandrea M, Calearo C. Site-dependent survival in cancer of the oral cavity. J Craniofac Surg. 1997;8(5): p.399-403.
34.J. Bagan, G. Sarrion and Y. Jimenez. Oral Cancer: Clinical Features. Oral Oncology. 2010; 46(6); p. 414-417.
35.I. O. Bello, Y. Soini and T. Salo. Prognostic Evaluation of Oral Tongue Cancer: Means, Markers and Perspectives (I). Oral Oncology. 2010; 46(9): p.630-635.
36.S. Warnakulasuriya. Global Epidemiology of Oral and Oropharyngeal Cancer. Oral Oncology. 2009;45(4): p.309-316.
37.Neville BW and Day TA. Oral Cancer and Precancerous Lesions. CA Cancer J Clin. 2002; 52(4): p.195-215.
38. S. R. Larsen, J. Johansen, J. A. Sorensen and A. Krogdahl. The Prognostic Significance of Histological Features in Oral Squamous Cell Carcinoma. Journal of Oral Pathology and Medicine. 2009; 38(8): p. 657-662.
39.V. M. van Houten, C. R. Leemans, J. A. Kummer, J. Dijkstra, D. J. Kuik, M. W. van den Brekel, G. B. Snow and R. H. Brakenhoff. Molecular Diagnosis of Surgical Margins and Local Recurrence in Head and Neck Cancer Patients: A Prospective Study. Clinical Cancer Research. 2004; 10(11): p. 3614-3620.
40.Johnson NW, Jayasekara P, Amarasinghe AA. Squamous cell carcinoma and precursor lesions of the oral cavity: epidemiology and etiology. Periodontol 2000. 2011;57: p.19–37.
41.Al-Rawi NH, Talabani NG. Squamous cell carcinoma of the oral cavity: a case series analysis of clinical presentation and histological grading of 1425 cases from Iraq. Clin Oral Invest. 2008;12: p.15–18
42.Gervásio OL, Dutra RA, Tartaglia SM, Vasconcellos WA, Barbosa AA, Aguiar MC. Oral squamous cell carcinoma: a retrospective study of 740 cases in a Brazilian population. Braz Dent J. 2001;12: p.57–61
43.Grimm M. Prognostic value of clinicopathological parameters and outcome in 484 patients with oral squamous cell carcinoma: microvascular invasion (V+) is an independent prognostic factor for oral squamous cell carcinoma. Clin Transl Oncol. 2012;14: p.870–880
44.Losi-Guembarovski R, Menezes RP, Poliseli F, Chaves VN, Kuasne H, Leichsenring A, et al. Oral carcinoma epidemiology in Paraná State, Southern Brazil. Cad Saude Publica. 2009;25: p.393–400.
45. Andisheh-Tadbir A, Mehrabani D, Heydari ST. Epidemiology of squamous cell carcinoma of the oral cavity in Iran. J Craniofac Surg. 2008;19: p.1699–1702
46.. Effiom OA, Adeyemo WL, Omitola OG, Ajayi OF, Emmanuel MM, Gbotolorun OM. Oral squamous cell carcinoma: a clinical and pathologic review of 233 cases in Lagos, Nigeria. J Oral Maxillofac Surg. 2008;66: p.1595–1599

47.Gaitán-Cepeda LA, Peniche-Becerra AG, Quezada-Rivera DQ. Trends in frequency and prevalence of oral cancer and oral squamous cell carcinoma in Mexicans. A 20 years retrospective study. Med Oral Patol Oral Cir Bucal. 2011;16: p. 460–467
48.Jainkittivong A, Swasdison S, Thangpisityotin M, Langlais RP. Oral squamous cell carcinoma: a clinicopathological study of 342 Thai cases. J Contemp Dent Pract. 2009;10: E033–E040
49.Kruse AL, Bredell M, Grätz KW. Oral cancer in men and women: are there differences? Oral Maxillofac Surg. 2011;15: p.51–55.
50.Marocchio LS, Lima J, Sperandio FF, Corrêa L, Sousa SO. Oral squamous cell carcinoma: an analysis of 1564 cases showing advances in early detection. J Oral Sci. 2010;52: p.267–273.
51.Rivero ER, Nunes FD. HPV in oral squamous cell carcinomas of a Brazilian population: amplification by PCR. Braz Oral Res. 2006;20: p.21–24
52.Albuquerque R, López-López J, Marí-Roig A, Jané-Salas E, Roselló-Llabrés X, Santos JR. Oral tongue squamous cell carcinoma (OTSCC): alcohol and tobacco consumption versus non-consumption. A study in a Portuguese population. Braz Dent J. 2011;22: p.517–521
53.Nemes JA, Redl P, Boda R, Kiss C, Márton IJ. Oral cancer report from Northeastern Hungary. Pathol Oncol Res. 2008;14: p.85–92.
54.Kaminagakura E, Villa LL, Andreoli MA, Sobrinho JS, Vartanian JG, Soares FA, et al. High-risk human papillomavirus in oral squamous cell carcinoma on young patients. Int J Cancer. 2012;130: p.1726–1732
55.Marur S, D'Souza G, Westra WH, Forastiere AA. HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol. 2010;11: p.781–789
56.. Larsen SR, Johansen J, Sørensen JA, Krogdahl A. The prognostic significance of histological features in oral squamous cell carcinoma. J Oral Pathol Med. 2009; 38:657–662
57.Scott SE, Grunfeld EA, McGurk M. Patient's delay in oral cancer a systematic review. Community Dent Oral Epidemiol. 2006;34: p.337–343
58.Pereira MC, Oliveira DT, Landman G, Kowalski LP. Histologic subtypes of oral squamous cell carcinoma: prognostic relevance. J Can Dent Assoc. 2007;73: p.339–344
59.Woolgar JA, Triantafyllou A. Squamous cell carcinoma and precursor lesions: clinical pathology. Periodontol 2000. 2011;57: p.51–72
60.Rekha KP, Angadi PV. Verrucous carcinoma of the oral cavity: a clinical and pathologic appraisal of 133 cases in Indians. Oral Maxillofac Surg. 2010;14: p.211–218
61.C. Scully and J. Bagan. Oral Squamous Cell Carcinoma Overview. Oral Oncology 2009; 45(4): p.301- 308.
62.J. Bagan, G. Sarrion and Y. Jimenez. Oral Cancer: Clinical Features. Oral Oncology. 2010; 46(6): p.414-417

63.R. Mazeron, Y. Tao, A. Lusinchi and J. Bourhis. Current Concepts of Management in Radiotherapy for Head and Neck Squamous-Cell Cancer. Oral Oncology. 2009; 45(4): p. 402-408
64. Barker, G., Barker, B. & Gier, R. Oral management of the cancer patient: A guide for the health professional. Kansas City, MO: University of Missouri - Kansas City (1996).
65.Zhang H, Dziegielewski PT, Biron VL, Szudek J, Al-Qahatani KH, O’Connell DA, et al. Survival outcomes of patients with advanced oral cavity squamous cell carcinoma treated with multimodal therapy: a multi-institutional analysis. Journal of Otolaryngology - Head & Neck Surgery. 2013;42(1):30.
66.Mortazavi H, Safi Y, Baharvand M, Rahmani S. Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree. Int J Dent. 2016;2016:7278925.
67.John S, Hassuji RM, Rajashekhar B. Speech and swallowing outcomes in buccal mucosa carcinoma. Indian J Palliat Care. 2011;17(3):238-40.
68.Yardimci G, Kutlubay Z, Engin B, Tuzun Y. Precancerous lesions of oral mucosa. World J Clin Cases. 2014;2(12):866-72.
69. Jansma, J., Vissink, A. & Jongebloed, W., Retief, D., Johannes’s-Gravenmade, E. Natural and induced radiation caries: a SEM study. Am J Dent. 1993;6(3): p.130–136.
70. Jongebloed, W., Gravenmade, E. & Retief, D. Radiation caries. A review and SEM study. Am J Dent. 1988;1(4): p.139–146.
71. Brandizzi, D., Gandolfo, M., Velazco, M., Cabrini, R. & Lanfranchi, H. Clinical features and evolution of oral cancer: A study of 274 cases in Buenos Aires, Argentina. Med Oral Patol Oral Cir Bucal. 2008;13(9): p.544-548
72. Jovanovic, A., Schulten, E. & Kostense, P. et al. Tobacco and alcohol related to the anatomical site of oral squamous cell carcinoma. J Oral Pathol Med. 1993; 22(10): p.459-462.
73. Shah, J., Candela, F. & Poddar, A. The patterns of cervical lymph node metastasis from squamous carcinoma of the oral cavity. Cancer. 1990; 66(4): p.109-113.
74. Tshering Vogel DW, Zbaeren P, Thoeny HC. Cancer of the oral cavity and oropharynx. Cancer Imaging. 2010;10(1):62-72.
75. Boudewijn, J., Braakhuis, A., Otto Visser, C. & René Leemans, A. Oral and oropharyngeal cancer in The Netherlands between 1989 and 2006: Increasing incidence, but not in young adults. Oral Oncol. 2009; 45(85): p.87-89.
76. Chandu A., G. Adams, A. C. H. Smith. Factors affecting survival in patients with oral cancer: an Australian perspective. Int. J. Oral Maxillofac Surg. 2005; 34(5): p.514–520.
77. Kerdpon, D. & Sriplung, H. Factors related to delay in delay in diagnosis of oral squamous cell carcinoma in southern Thailand. Oral Oncol. 2001; 37(2); p.127-131.
78. Kowalski, L. & Carvalho, A. Influence of time delay and clinical upstaging in the prognosis of head and neck cancer. Oral Oncol. 2001; 37(1): p.94-98.
79. Shah, J. & Lydiatt, W. Treatment of cancer of the head and neck. CA Cancer J Clin. 1995; 45, p.352–368.
80. Allison, P., Franco, E. & Feine, J. Predictors of professional diagnostic delay for upper aerodigestive tract carcinoma. Oral Oncol. 1998; 34(2): p. 127–32.
Files
IssueVol 8, No 3 (Summer 2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jcr.v8i3.8839
Keywords
Squamous cell carcinoma Oral cancer Clinical presentation Histopathology Tumor grading

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mahmood B, Gataa IS, Mustafa U. The Clinicopathological presentation of oral squamous cell carcinoma in Iraqi population. J Craniomaxillofac Res. 2022;8(3):129-142.