There are more than 100 types of cancer that affect humans, with malignant lesions of the oral cavity representing 5-6% of all cancers. Of the malignant neoplasms affecting the oral and maxillofacial region about 1% are metastatic lesions.
The aim of this review was to analyse the data on metastatic lesions in the oral and maxillofacial region.
Methods
The review was registered in PROSPERO and followed PRISMA guidelines. Searches were conducted in the PubMed. Embase, LILACS and Web of Science databases. Observational studies (case series and case report) reporting metastatic lesions with data to verify diagnosis published in English, Spanish, or Portuguese were considered. Two reviewers selected studies and abstracted data with disagreements being resolved by a third reviewer. Study quality was assessed using the Joanna Briggs Institute tools for care reports or case series. Absolute and relative frequencies were obtained by descriptive analysis. Overall survival was assessed using the Kaplan-Meier method.
Results
- 217 studies (case series and reports) published between 1958 and 2020 from 33 countries were included.
- 348 cases were identified 57.7% males 42.3% females.
- Mean age at diagnosis was 58.29 years (±15.80)
- Jawbones were more commonly affected (53.2%) than soft tissues (40.7%) with the mandible being more affected than the maxilla.
- Clinical presentation was a nodular mass with or without ulceration (n = 280/85.89%).
- 29 different primary sites were reported. The lungs were most common (n = 73/20.97%), followed by breast (n = 42/12.06%), kidney (n = 41/11.78%), skin (n = 24/6.89%), and liver (n = 24/6.89%)
- The overall 3-year and 5-year survival rates were 17.7% and 7.3%, respectively.
Conclusions
The authors concluded: –
Based on the average survival and the number of lesions, it can be concluded that oral metastasis are uncommon and challenging for the clinician.
Comments
While the reviewers have searched a good range of databases restricting the included studies to those published in English, Spanish, or Portuguese may have excluded some relevant reports. The focus of the review was to identify what are the most frequent metastatic lesions that are located in the oral and maxillofacial region and the authors have identified a good number of cases series and reports. The included reports span a wide number of countries but as the authors suggest there unlikely to be an underreporting of cases. The narrative summary presented in the review provides a useful overview of the metastatic lesions in the oral cavity. Future reviews could be improved with more consistent reporting of cases in line with the CARE guidelines for case reports .
Links
Primary Paper
Kirschnick LB, Schuch LF, Cademartori MG, Vasconcelos ACU. Metastasis to the oral and maxillofacial region: A systematic review. Oral Dis. 2022 Jan;28(1):23-32. doi: 10.1111/odi.13611. Epub 2020 Sep 9. PMID: 32790941.
Other references
Dental Elf – 12th Jan 2022
Early detection of oral cancer and oral potentially malignant disorders
