Oral cavity and oropharyngeal cancers – surgical treatments

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This update of a Cochrane review of the relative benefits and harms of different surgical treatment modalities for oral cavity and oropharyngeal cancers includes 15 RCTs. Moderate-certainty evidence from 5 RCTs showed trials that elective neck dissection of clinically negative neck nodes at the time of removal of the primary oral cavity tumour is superior to therapeutic neck dissection, with increased survival and disease-free survival, and reduced locoregional recurrence.

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Oral leukoplakia – malignant transformation rate

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This review of the rate of malignant transformation (MT) of oral leukoplakia and potential risk factors included 26 mainly retrospective studies. The findings indicate a MT of 7.2% (95%CI; 5.40 to 9.10%) similar to those of another recent review whihc estimated MT as 9.8% (95%CI; 7.9 to 11.7%).

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Radiotherapy and dental implant survival

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This review assessing the effect of radiotherapy on the survival of dental implants in patients with head and neck cancer included 7 studies involving a total of 441 patients. implant survival rate was lower in irradiated patients with odds ratio = 4.77 (95%CI; 2.57 to 8.89) based on 4 studies.

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Salivary lactate dehydrogenase in oral and potential malignant disorders

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Study findings suggest a number of uses for visual aid support of Thickness Indicator Model tubes

In her first Dental Elf blog Iris Vaid looks at a review of salivary lactate dehydrogenase (LDH) as a potential diagnostic marker for oral cancer and oral potentially malignant disorders.

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Tooth extraction prior to head and neck radiotherapy and osteoradionecrosis risk

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28 mainly retrospective studies were included in this review which aimed to determine if tooth extraction prior to head and neck radiotherapy (RT )is associated with a reduced risk of developing osteoradionectosis (ORN). The findings showed a significant association of post-RT dental extractions with the risk of ORN development, odds ratio = 1.98 (95%CI: 1.17 to 3.35. However the certainty of the evidence was low to moderate.

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Oral examination for detecting oral cancer

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This review of the diagnostic accuracy of visual inspection compared with biopsy (gold standard) for the diagnosis or oral cancer and oral potentially malignant dissorders included 18 studies. For malignant lesions the pooled sensitivity was 88% (95%CI; 73% to 95%) and specificity 81%(95%CI; 51% to 95%).

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Metastatic lesions in the oral and maxillofacial region

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Patients with cancer and comorbid depression have worse anxiety, pain, fatigue, and functioning than do other patients with cancer.

This review of metastatic neoplasms in the oral cavity included 217 observational studies from 33 countries. The 348 cases identified arose from 29 primary sites the most common being lung (21%) and breast (12%).

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Chemotherapy for oral cavity and oropharyngeal cancer

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This review of whether chemotherapy, in addition to radiotherapy and/or surgery for oral cavity and oropharyngeal cancer, results in improved overall survival included 100 studies. the findings indicated some benefit only when used in a few specific circumstances.

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