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Oral carcinoma after hematopoietic stem cell transplantation--a new classification based on a literature review over 30 years.

Kruse AL, Grätz KW - Head Neck Oncol (2009)

Bottom Line: Overall, 64 cases were found.All physicians involved in the treatment of post-HSCT patients should be aware of the increased risk, even after 5 years from the development of oral malignancy, in particular when oral graft versus host changes are visible.In order to develop evidence based management, screening and offer adequate therapy as early as possible in this patient group, multicenter studies, involving oncologists and head and neck surgeons, should be established.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Craniomaxillofacial and Oral Surgery, University of Zurich, Zurich, Switzerland. astridkruse@gmx.ch

ABSTRACT

Background: Patients undergoing hematopoietic stem cell transplantation (HSCT) have a higher risk of developing secondary solid tumors, in particular squamous cell carcinoma, because of several risk factors, including full-body irradiation (TBI), chemotherapy, and chronic graft versus host disease (GVHD). Based on the review presented here, a classification of oral changes is suggested in order to provide a tool to detect high-risk patients.

Methods and results: The literature over the last 30 years was reviewed for development of malignoma of the oral cavity after HSCT. Overall, 64 cases were found. In 16 out of 30 cases, the tongue was the primary location, followed by the salivary gland (10 out of 30); 56.4% appeared in a latency time of 5 to 9 years after HSCT. In 76.6%, GVHD was noticed before the occurrence of oral malignancy. Premalignant changes of the oral mucosa were mucositis, xerostomia, and lichenoid changes, developing into erosive form.

Conclusion: All physicians involved in the treatment of post-HSCT patients should be aware of the increased risk, even after 5 years from the development of oral malignancy, in particular when oral graft versus host changes are visible. In order to develop evidence based management, screening and offer adequate therapy as early as possible in this patient group, multicenter studies, involving oncologists and head and neck surgeons, should be established.

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Related in: MedlinePlus

Distritubtion of pretreatment.
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Figure 7: Distritubtion of pretreatment.

Mentions: The pretreatment was specified in only 29 cases (Fig. 7); total body irradiation (TBI) was performed in 17 cases.


Oral carcinoma after hematopoietic stem cell transplantation--a new classification based on a literature review over 30 years.

Kruse AL, Grätz KW - Head Neck Oncol (2009)

Distritubtion of pretreatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2724375&req=5

Figure 7: Distritubtion of pretreatment.
Mentions: The pretreatment was specified in only 29 cases (Fig. 7); total body irradiation (TBI) was performed in 17 cases.

Bottom Line: Overall, 64 cases were found.All physicians involved in the treatment of post-HSCT patients should be aware of the increased risk, even after 5 years from the development of oral malignancy, in particular when oral graft versus host changes are visible.In order to develop evidence based management, screening and offer adequate therapy as early as possible in this patient group, multicenter studies, involving oncologists and head and neck surgeons, should be established.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Craniomaxillofacial and Oral Surgery, University of Zurich, Zurich, Switzerland. astridkruse@gmx.ch

ABSTRACT

Background: Patients undergoing hematopoietic stem cell transplantation (HSCT) have a higher risk of developing secondary solid tumors, in particular squamous cell carcinoma, because of several risk factors, including full-body irradiation (TBI), chemotherapy, and chronic graft versus host disease (GVHD). Based on the review presented here, a classification of oral changes is suggested in order to provide a tool to detect high-risk patients.

Methods and results: The literature over the last 30 years was reviewed for development of malignoma of the oral cavity after HSCT. Overall, 64 cases were found. In 16 out of 30 cases, the tongue was the primary location, followed by the salivary gland (10 out of 30); 56.4% appeared in a latency time of 5 to 9 years after HSCT. In 76.6%, GVHD was noticed before the occurrence of oral malignancy. Premalignant changes of the oral mucosa were mucositis, xerostomia, and lichenoid changes, developing into erosive form.

Conclusion: All physicians involved in the treatment of post-HSCT patients should be aware of the increased risk, even after 5 years from the development of oral malignancy, in particular when oral graft versus host changes are visible. In order to develop evidence based management, screening and offer adequate therapy as early as possible in this patient group, multicenter studies, involving oncologists and head and neck surgeons, should be established.

Show MeSH
Related in: MedlinePlus