A clinicopathological study of squamous cell carcinoma of oral cavity and oropharynx in non-smoker and non-drinker patients

Authors

  • Namrita Mehmi Department of Otorhinolaryngology, Government Medical College, Patiala, Punjab, India http://orcid.org/0000-0002-8467-4779
  • Sanjeev Bhagat Department of Otorhinolaryngology, Government Medical College, Patiala, Punjab, India
  • Navneet Kaur Department of Pathology, Government Medical College, Patiala, Punjab, India
  • Ravinder Singh Department of Otorhinolaryngology, Government Medical College, Patiala, Punjab, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20220146

Keywords:

Oral cavity, Oropharynx, Non-smoker, Non-drinker, Squamous cell carcinoma

Abstract

Background: To describe the clinicopathological variables of the Squamous cell carcinoma (SCC) of oral cavity and oropharynx in non-smoker and non-drinker patients (NSND).

Methods: A retrospective review of thirty NSND patients with proven SCC of oral cavity and oropharynx in ENT department at Government Medical College Patiala. Data collected included demographics, aetiological factors, site, symptoms, nodal metastasis, histopathological grading and TNM staging at presentation.

Results: In oral cavity cancers, patients presented commonly in 4th decade whereas in oropharynx, commonly in 6th decade. NSND patients were more likely to be female, male female ratio being 43:56. In NSND women, 82% had oral cavity SCC and 18% had oropharyngeal SCC. 13% of NSND patients reported sharp tooth, 10% reported regular environmental exposure, and 10% reported occupational exposure followed by lichen planus (6.67%). In oral cavity SCC, maximum incidence was that of oral tongue (59.1%) and in oropharyngeal SCC, base of tongue (62.5%) was most commonly involved. Overall, well differentiated SCC predominated in both oral cavity and oropharyngeal carcinoma in our study. In oral cavity SCC, maximum patients presented in early tumor staging i.e T1 and T2 (81.8%) and early overall staging (stage I and II).In oropharyngeal SCC, maximum patients presented in advanced tumor staging i.e T3 and T4 (62.5%) and advanced overall staging (stage III, IV).

Conclusions: In NSND patients, potential factors like sharp tooth, environmental smoke, occupational exposure and lichen planus may contribute to SCC in oral cavity and oropharynx.

Author Biography

Namrita Mehmi, Department of Otorhinolaryngology, Government Medical College, Patiala, Punjab, India

Consultant, department of ent, Park Hoapital, Gurugram

References

Harris SL, Kimple RJ, Hayes DN, Couch ME, Rosenman JG. Never-smokers, never-drinkers: unique clinical subgroup of young patients with head and neck squamous cell cancers. Head Neck. 2010;32:499-503.

Llewellyn CD, Linklater K, Bell J, Johnson NW, Warnakulasuriya KA. Squamous cell carcinoma of the oral cavity in patients aged 45 years and under: a descriptive analysis of 116 cases diagnosed in the South East of England from1990 to 1997. Oral Oncol. 2003;39:106-14.

Wiseman SM, Swede H, Loree TR. Squamous cell carcinoma of the head and neck in nonsmokers and nondrinkers: an analysis of clinicopathologic characteristics and treatment outcomes. Ann SurgOncol. 2003;10:551-57.

Bross ID, Coombs J. Early onset of oral cancer among women who drink and smoke. Oncology. 1976;33:136-9.

Koch WM, Lango M, Sewell D, Zahurak M, Sidransky D. Head and neck cancer in nonsmokers: a distinct clinical and molecular entity. Laryngoscope. 1999;109:1544-51.

Hodge KM, Flynn MB, Drury T. Squamous cell carcinoma of the upper aerodigestive tract in nonusers of tobacco. Cancer. 1985;55:1232-5.

Panis X, Demange L, Froissart D, Nguyen TD. Squamous cell carcinoma of upper aero-digestive tract in women. Radiother Oncol. 1988;13:175-9.

Costantinides MS, Rothstein SG, Persky MS. Squamous cell carcinoma in older patients without risk factors. Otolaryngol Head Neck Surg. 1992;106:275-7.

Agudelo D, Quer M, Leon X. Laryngeal carcinoma in patients without a history of tobacco and alcohol use. Head Neck. 1997;19:200-4.

Lemon FR, Walden RT, Woods RW. Cancer of the lung and mouth in seventh-day adventists. Cancer. 1964;17:486-97.

Philips RL. Role of life-style and dietary habits in risk of cancer among seventh-day Adventists. Cancer Res. 1975;35:3513-22.

De boer MF, Sanderson RJ, Damhuis RA. The effects of alcohol and smoking upon the age, anatomic sites and stage in the development of cancer of oral cavity and oropharynx in females in the south west Netherlands. Eur Otorhinolaryngol. 1997;254:177-9 .

Farshadpour F, Hordijk GJ, Koole R, Slootweg PJ. Non-smoking and non-drinking patients with head and neck squamous cell carcinoma: a distinct population. Oral Dis. 2007;13:239-43.

Dahlstrom K, Little JA, Sturgis EM. Squamous cell carcinoma of the head and neck in never smoker–never drinkers: a descriptive epidemiologic study. Head Neck. 2008;30:75-84.

Strugis EM, Pytynia KB. After the smoke clears: environmental and occupational risks for carcinoma of the upper aerodigestive tract. Cancer J. 2005;11:96-103.

Fouret P, Monceaux G, Temam S. Human papilloma virus in head and neck squamous cell carcinoma in nonsmokers. Arch Otolaryngol Head Neck Surg. 1997;123:513-6.

Smith EM, Hoffman HT, Summersgill KS. Human papilloma virus and risk of oral cancer. Laryngoscope. 1998;108:1098-103.

Koch WM, Mcquone S. Clinical and molecular aspects of squamous cell carcinoma of the head and neck inthe nonsmoker and nondrinker. Curr Opin Oncol. 1997;9:257-61.

Gillison ML, Shah KV. Human papilloma virus in head and neck squamous cell carcinoma: mounting evidence for an etiologic role for human papilloma virus in a subset of head and neck cancers. Curr Opin Oncol. 2001;13:183-8.

Gillison ML, Koch WM, Shah KV. Human papilloma virus in head and neck squamous cell carcinoma: are some head and neck cancers a sexually transmitted disease? Curr Opin Oncol. 1999;11:191-9.

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Published

2022-01-25

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Original Research Articles