Multiple concomitant oral cavity cancers: Incidence, management, and outcomes.
BACKGROUND
Little is known about the appropriate treatment and long-term survival of patients with multiple concomitant oral cavity cancers (MOC). The aim of this study was to clarify the clinicopathological features of MOC, to compare the prognosis of MOC patients with that of patients with single oral cavity cancers (SOC), and to describe reconstructive options based on the concept of economy in autologous tissue transfer.


METHODS
Data from 603 patients diagnosed with at least one squamous cell carcinoma of the oral cavity who underwent surgery for primary oral cavity cancers between 2006 and 2014 were reviewed retrospectively to identify MOC patients.


RESULTS
Among 603 cases of surgically resected primary oral cancers, 20 cases (3.3%) with MOC were identified. Patients with MOC did not differ from patients with SOC in age, and their index lesions did not differ in pT value, pN value, pathological stage, extracapsule spread, or perineural or bone invasion. The 5-year overall and disease-free survival rates for MOC and SOC cases were 72.6% versus 68.7%, and 65.3% versus 64.8%, respectively (P = 0.785 and 0.770, respectively). The anterolateral thigh flap was widely applied. According to its origin of blood supply, the reconstructive options of MOC patients with separated defects were classified and proposed.


CONCLUSIONS
MOC and SOC were similar in clinicopathological characteristics. The prognosis of patients with MOC was similar to that of patients with SOC. Resections were performed with curative intent. A multidisciplinary team management approach is essential for customized treatment in MOC patients.
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Huang-Kai
HK
Kao
Department of Surgery, Faculty of Medicine, University of Khartoum, Sudan.
Mohamed
M
Abdelrahman
Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Yenlin
Y
Huang
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Keelung and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Chia-Hsuan
CH
Tsai
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Megias J
MJ
Barrera
Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Ngan-Ming
NM
Tsang
Department of Surgery, Royal Alexandra Hospital, Glasgow, United Kingdom.
Adam J
AJ
Couves
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Ming-Huei
MH
Cheng
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Kai-Ping
http://orcid.org/0000-0003-1777-9578
KP
Chang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D009378:Neoplasms, Multiple Primary / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013524:Surgical Flaps; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
OSCC; head and neck; oral cancer; squamous cell carcinoma; synchronous