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4 Cards in this Set
- Front
- Back
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Risk Factors for Oral Malignancy
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Age (majority of patients >50), Tobacco, Alcohol, Viral, EBV in NPC, Increasingly HPV (oropharynx)!!!, Hereditary, Family history (increased risk by 3.5x), Rare Genetic syndromes: Fanconi’s anemia, 200 x increased risk by third decade of life
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Importance of HPV
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*225% increase in population-level incidence of HPV
positive (HPV+) OPSCC between 1984 and 2004 *Sexual behavior important risk factor for HPV-positive head and neck squamous cell carcinoma *Arising in in the lingual and palatine tonsils *HPV targets preferentially the highly specialized reticulated epithelium lining tonsillar crypts *Non-Keratinizing!! *HPV related oncoprotiens E6 and E7 |
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Treatment for Oropharyngeal Cancer
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*For locally advanced (T3–T4 or N2–N3) oropharyngeal cancer, either surgery and adjuvant radiotherapy with or without concurrent Cisplatin
*Chemoradiation for preservation of speech and swallowing function: *Concurrent Chemotherapy and radiation ---EORTC 91-11(Cisplatin 100mg/m2 + XRT, XRT alone, Cisplatin+5FU followed by XRT) ---TAX 324 (Cisplatin+5FU+Taxotere followed by Carbo+XRT, Cisplatin+5FU followed by Carbo+XRT) |
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Oral Leukoplakia
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*Precancerous lesions of the upper aerodigestive tract keratinizing epithelium: leukoplakia, erythroplakia, mixed leukoerythroplakia (hyperplastic epithelial lesions).
*Harbor an increased risk compared to normal mucosa for transformation into squamous cell carcinoma. When histopathologic evidence of cytologic and architectural atypia w/o invasion, i.e. dysplastic features *Irregular epithelial stratification and loss of basal cells |
