ORAL CANCER Edited by Kalu U. E. Ogbureke Oral Cancer Edited by Kalu U. E. Ogbureke Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Anja Filipovic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Oral Cancer, Edited by Kalu U. E. Ogbureke p. cm. ISBN 978-953-51-0228-1 Contents Preface IX Part 1 Epidemiology and Risk Factors 1 Chapter 1 Overview of Oral Cancer 3 Kalu U. E. Ogbureke and Christopher Bingham Chapter 2 Oral Squamous Cell Carcinoma Clinical Aspects 21 Nicolás Bolesina, Fabián L. Femopase, Silvia A. López de Blanc, Rosana A. Morelatto and María Alicia Olmos Chapter 3 Oral Cancer – An Overview 47 Raghu Radhakrishnan, Bijayata Shrestha and Dipshikha Bajracharya Chapter 4 A Literature Analysis of the Risk Factors for Oral Cancer 65 Shih-An Liu Chapter 5 Oral Cancer and Potentially Cancerous Lesions – Early Detection and Diagnosis 79 C. S. Farah, P. J. Ford, K. Allen, A. Vu and M. J. McCullough Chapter 6 Environmental Factors Identified in the Etiology of Oral Cancers in Taiwan 107 Chi-Ting Chiang, Tsun-Kuo Chang, Ie-Bin Lian, Che-Chun Su, Kuo-Yang Tsai and Yaw-Huei Hwang Chapter 7 The Changing Aetiology of Oral Cancer and the Role of Novel Biomarkers to Aid in Early Diagnosis 129 Michael J. McCullough, Gareema Prasad, Sarah Zhao and Camile S. Farah Chapter 8 p53 Mutation and Multiple Primary Oral Squamous Cell Carcinomas 149 Nur Mohammad Monsur Hassan, Mitsuhiro Tada, Jun-ichi Hamada, Masanobu Shindoh, Haruhiko Kashiwazaki, Yutaka Yamazaki, Yuichi Ashikaga, Tetsuya Moriuchi, Nobuo Inoue and Akira Sasaki VI Contents Part 2 Diagnosis and Management 171 Chapter 9 Timing of Oral Cancer Diagnosis: Implications for Prognosis and Survival 173 Pablo Varela Centelles, Juan Manuel Seoane-Romero, Iria Gómez, Pedro Diz-Dios, Nilce Santos de Melo and Juan Seoane Chapter 10 Diagnostic Aids in Oral Cancer Screening 189 Pegah Mosannen Mozafari, Zahra Delavarian and Nooshin Mohtasham Chapter 11 Microsurgical Reconstruction of the Oral Cavity and Oropharynx After Cancer Ablation 209 Mônica Lúcia Rodrigues, Hugo Fontan Köhler and Luiz Paulo Kowalski Chapter 12 Salivary Diagnostics in Oral Cancer 227 S. Gokul Chapter 13 Blood Groups and Oral Lesions Diagnostics 249 Carlos Campi, Livia Escovich, Liliana Racca, Amelia Racca, Carlos Cotorruelo and Claudia Biondi Chapter 14 Management of Early-Stage Tongue Cancer 267 Kiyoto Shiga, Katsunori Katagiri, Ayako Nakanome, Takenori Ogawa and Toshimitsu Kobayashi Chapter 15 Functional Biomarkers of Oral Cancer 277 Masumi Tsuda and Yusuke Ohba Part 3 Molecular Pathogenesis 295 Chapter 16 Epigenetic Profiling of Oral Cancer 297 A. Santoro, G. Pannone, S. Papagerakis, R. Serpico, A. Guida, L. Lo Muzio and P. Bufo Chapter 17 Model of Chromosomal Instability in Oral Carcinogenesis and Progression 327 Walter Giaretti Chapter 18 Expression of Metallothionein in Oral Cancer 339 Dziegiel Piotr, Pula Bartosz and Podhorska-Okolow Marzena Chapter 19 Reduced Expression of Syndecan-1 in Oral Cancer 359 Takashi Muramatsu Chapter 20 Epithelial-Mesenchymal Interactions in Oral Cancer Metastasis 373 Silvana Papagerakis and Giuseppe Pannone Preface Human cancers of the oral and oropharyngeal areas have since emerged as significant public health challenge globally, but particularly so in countries of the Southeast Asia. Although the oral cavity and oropharynx are as easily accessible as is the population at risk, early diagnosis has been painfully slow when compared to the enhanced early detection of cancers of the breast, colon, prostate, and melanoma. As a result, the mortality rate from oral cancer for the past four decades has remained high, at over 50%, in spite of advances in treatment modalities. This contrasts with a considerable decrease in mortality rates for cancers of the breast, colon, prostate, and melanoma during the same period. In spite of increased diligence on the part of the clinicians in their examination of patients at risk, early diagnosis of oral cancer continues to be impeded and elusive because of the persistence of outdated paradigms, and the lack of an easily available diagnostic adjunct. This is particularly evident in the persistent challenge of deciphering the malignant potentials of the various oral premalignant lesions (OPLs). In order to increase the early detection of oral cancer with the attendant increase in survival rates, and OPLs with the likelihood of transition to oral cancer, there is the need to identify diagnostic screening modalities that accurately predict the malignant potentials of OPLs. This book is an attempt to provide a comprehensive, yet reference-friendly, update encompassing the spectrum of etiologic/risk factors, current clinical diagnostic tools, management philosophies, and molecular biomarkers and progression indicators of oral and oropharyngeal cancers. Accordingly, the scope has necessitated the painstaking contributions, from notable experts drawn from across the globe, of detailed reviews and nascent research reports on aspects of the subject matter. For convenience of reference, the book has been divided into three sections: Section I (Epidemiology and Risk Factors; Chapters 1-8) covers various aspects and perspectives of the Epidemiology and Etiologic/risk factors of oral and oropharyngeal cancers, while Section II (Diagnosis and Management; Chapters 9-15) provides an update of the various diagnostic and treatment modalities. Finally, Section III (Molecular Pathogenesis; Chapters 16-20) covers highlights on selected but recent advances on the molecular processes involved in the biology of oral X Preface cancer as well as their potential significance in diagnosis, management, and therapeutic approaches to oral cancer. Kalu U. E. Ogbureke, BDS, MSc, DMSc, JD, FDSRCS, FDSRCPS(G), FRCPath College of Dental Medicine Georgia Health Sciences University USA [...]... diagnosis of cancer of the oral cavity Br J Oral Maxillofac Surg 2008; 46: 187-191 Jemal A, Siegel R, Xu J, Ward E Cancer statistics, 2010 CA Cancer J Clin 2010; 60:277-300 Johnson NW A global view of the epidemiology of cancer of oral cancer In Oral Cancer: Detection of Patients and Lesions at Risk, ed Johnson, N.W 1991 Ch.1 Cambridge: Cambridge University Press Johnson NW Tobacco use and oral Cancer: ... transformation rate in oral submucous fibrosis over a 17-year period Community Dent Oral Epidemiol 1985; 13: 340-341 18 Oral Cancer Neville BW, Damm DD, Allen CM, et al Oral & Maxillofacial Pathology 2nd ed Phila., PA: Saunders; 2009; 337-369 Neville BW, Day TA Oral cancers and precancerous lesions CA cancer J Clin 2002; 52: 195215 Ord RA, Blanchaert RH Jr Current management of oral cancer A multidisciplinary... drinking, and cancer of the oral cavity and oropharynx among U.S veterans Cancer 1993; 72:1369-1375 Mashberg A, Samit A Early diagnosis of asymptomatic oral and oropharyngeal squamous cancers CA Cancer J Clin 1995; 45: 328-351 Mashberg A, Samit AM Early detection, diagnosis, and management of oral oropharyngeal cancer J Cancer Clinicians 1989; 39: 67-88 Mashberg A Diagnosis of early oral and oropharyngeal... carcinomas from regional sites distant to the oral cavity Overview of Oral Cancer 5 3 Etiologic risk factors for oral cancer Oral cancer is a multifactorial disease Exposure to one of three broad groups of carcinogenic stimuli, namely, chemical, physical, and viral, is known to induce cancer in genetically and systemically conditioned oral mucosa Within the oral cavity, it appears that carcinomas are... these areas (Parkin et al., 1998) The estimated annual incidence of cancer ranges from 48 to 225 per 100,000 in developing countries (Parkin et al., 1998) 2 Oral cancer – Epidemiologic overview Oral cancer encompasses all malignancies originating in the oral cavity Oral cancer ranks sixth in the overall incidence for the 10 most common cancer sites worldwide and third in the developing countries (Johnson,... alcohol and tobacco in the aetiology of head and neck cancer: A case-control study in the Doubs region of France Oral Oncol, Eur J Cancer 1995; 31B: 301-309 Banoczy J, Csiba A Occurrence of epithelial dysplasia in oral leukoplakia Oral Surg 1976; 42:766-774 Barnard NA, Scully C, Eveson JW, et al Oral cancer development in patients with oral lichen planus J Oral Pathol Med 1993; 22: 421-424 Barr BBB, Benton... 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Jr (ed) Oral Cancer, 4th ed Hamilton, Ontario, Canada: BC Decker, Inc., 1998: 165-170 Flaitz CM, Nichols CM, Adler-Storthz K, et al Intraoral squamous cell carcinoma in human immunodeficiency syndrome virus infection A clinicopathologic study Oral Surg Oral Med Oral Pathol Oral radiol Endod 1995; 80: 55-62 Forastiere A, Goepfert H, Goffinet D, et al NCCN practice guidelines for head and neck cancer. .. symptomatic stage 5 Diagnosis and management of oral cancer Early diagnosis of oral cancer has emerged as a priority public health objective whereby oral health professional play leading role (Neville and Day, 2002) It is presumed that early diagnosis of cancer should lead to less damage from interventional treatment and to a better Overview of Oral Cancer 13 prognosis Because most individual are seen... available diagnostic adjunct In order to increase the early detection of oral cancers, and by so doing increase the survival rates of oral cancer patients, there is therefore the need to identify diagnostic screening modalities that identify early oral malignant lesions with precision About 95% of oral cancers are classified histologically as oral squamous cell carcinoma (OSCC; Mashberg, 2000; Johnson, 2001, . metastatic carcinomas from regional sites distant to the oral cavity. Overview of Oral Cancer 5 3. Etiologic risk factors for oral cancer Oral cancer is a multifactorial disease. Exposure to one. For statistical purposes, oral cancer is often grouped together with cancers of the pharynx as “oropharyngeal” cancer (Daftary et al., 1992). In the Western world, oral cancer is relatively uncommon,. Bajracharya Chapter 4 A Literature Analysis of the Risk Factors for Oral Cancer 65 Shih-An Liu Chapter 5 Oral Cancer and Potentially Cancerous Lesions – Early Detection and Diagnosis 79 C. S. Farah,