title: Implication for second primary cancer from visible oral and oropharyngeal premalignant lesions in betel-nut chewing related oral cancer.
abstract: Visible oral and oropharyngeal premalignant lesions may be used to monitor for a second primary oral cancer. To control for bias, we focused on the visible oral and oropharyngeal premalignant lesions of patients with oral cancer with a positive betel-nut chewing habit. Visible oral and oropharyngeal premalignant lesions that can predict second primary oral cancers were studied.
  
  
  
  Nine hundred ninety-seven patients with positive betel-nut chewing habits and oral cancer were enrolled in this retrospective cohort study. We analyzed the relevance of their visible oral and oropharyngeal premalignant lesion incidence and relative clinicopathological variables to the development of a second primary oral cancer.
  
  
  
  Second primary oral cancer risk was significantly higher in patients with positive visible oral and oropharyngeal premalignant lesions (P < .0001), especially in younger patients (P = .0023; ≤40 years: adjusted odds ratio [OR] 2.66; 40-60 years: adjusted OR 2.61). The heterogeneous leukoplakia was (adjusted OR 2.17) higher than homogeneous leukoplakia.
  
  
  
  The predictive value and practicality of visible oral and oropharyngeal premalignant lesions make it a potentially valuable marker in follow-ups of patients with a positive betel-nut chewing habit with oral cancer, especially young patients with heterogeneous leukoplakia.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Shyun-Yu
authors.initials: SY
authors.lastname: Liu
authors.affiliation: Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: I-Jung
authors.initials: IJ
authors.lastname: Feng
authors.affiliation: Center for Teeth Bank and Dental Stem Cell Technology, Taipei Medical University, Taipei, Taiwan.|College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Wu
authors.affiliation: Department of Electrical Engineering, Southern Taiwan University, Tainan, Taiwan.
authors.forename: Ching-Yuan
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Center for Teeth Bank and Dental Stem Cell Technology, Taipei Medical University, Taipei, Taiwan.|College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.|College of Science and Technology, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chao-Nan
authors.initials: CN
authors.lastname: Hsiung
authors.affiliation: Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan.|Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan.
authors.forename: Hsueh-Wei
authors.initials: HW
authors.lastname: Chang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Lioying, Tainan, Taiwan.
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Min-Te
authors.initials: MT
authors.lastname: Chang
authors.affiliation: Department of Dentistry, Chiali Chi Mei Hospital, Tainan, Taiwan.
authors.forename: Hsi-Chien
authors.initials: HC
authors.lastname: Yu
authors.affiliation: School of Dentistry, Taipei Medical University, Taipei, Taiwan.|Division of Orthodontics, Wan-Fang Medical Center, Taipei Medical University, Taipei, Taiwan.
authors.forename: Sheng-Yang
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Tainan, Taiwan.|School of Dentistry, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Yen
mesh_terms: D000328:Adult; D017677:Age Distribution; D001114:Areca / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007972:Leukoplakia, Oral / Q000473:pathology*; D008297:Male; D008409:Mastication; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000209:etiology* / Q000473:pathology; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution
keywords: erythroplakia; leukoplakia; oral and oropharyngeal; premalignant lesion; second primary oral cancer