Survival rates and oncologic outcomes of adeno squamous carcinoma of oral cavity: A systematic review

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2026-01-01 Epub Date: 2025-12-13 DOI:10.1016/j.oraloncology.2025.107821

Francesco Chiari , Andrea Luigi Camillo Carobbio , Marco Ferrari , Piero Nicolai , Claudio Donadio Caporale , Pierre Guarino

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引用次数: 0

Abstract

Background

Adenosquamous carcinoma (ASC) of the oral cavity is an uncommon and aggressive malignancy characterized by squamous and glandular histologic components. Due to its rarity, clinical behavior and oncologic outcomes remain poorly defined.

Methods

A systematic literature review was conducted according to PRISMA 2020 guidelines. Comprehensive searches of Embase, PubMed, Scopus, and Cochrane Library identified studies published between 1968 and 2025.

Results

Sixty-one patients were included. The most frequent subsites were tongue (43 %) and floor of mouth (31 %). Transoral surgery was performed in 93 % of cases, with neck dissection in 50 %. Adjuvant therapy was administered in 27 %. Despite 57 % presenting with early-stage disease, recurrence occurred in 42 %: local (36 %), regional (20 %), and distant (10 %). Local recurrence was significantly associated with advanced stage (p = 0.007) and subsite (p = 0.028), highest in floor of mouth (59 %) and gingiva (50 %). Perineural invasion (PNI), lymphovascular invasion (LVI), and positive margins correlated with recurrence and reduced time to recurrence (TTR), disease-specific survival (DSS), and overall survival (OS) (p < 0.001). Two-year TTR, DSS, and OS rates were 47 %, 74 %, and 70 %, respectively—lower than reported for conventional oral squamous carcinoma. Because oral ASC is rare, the evidence is primarily derived from case reports and small retrospective series.

Conclusions

Oral ASC demonstrates high recurrence and poor survival, even in early-stage disease. Prognosis is strongly influenced by PNI, LVI, and margin status, as well as tumor subsite. These findings highlight oral ASC as a distinct and particularly aggressive entity.

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口腔腺鳞癌的生存率和肿瘤预后：一项系统综述。

背景：口腔腺鳞癌（ASC）是一种罕见的侵袭性恶性肿瘤，以鳞状和腺状的组织学成分为特征。由于其罕见性，临床行为和肿瘤预后仍不明确。方法：根据PRISMA 2020指南进行系统文献综述。对Embase、PubMed、Scopus和Cochrane图书馆的综合搜索确定了1968年至2025年间发表的研究。结果：纳入61例患者。最常见的亚部位是舌头（43%）和口腔底部（31%）。经口手术占93%，颈清扫占50%。27%的患者接受辅助治疗。尽管57%的患者表现为早期疾病，但42%的患者出现了复发：局部（36%）、局部（20%）和远处（10%）。局部复发率与晚期（p = 0.007）和亚部位（p = 0.028）有显著相关性，以口腔底（59%）和牙龈（50%）最高。围神经侵袭（PNI）、淋巴血管侵袭（LVI）和阳性切缘与复发、缩短复发时间（TTR）、疾病特异性生存（DSS）和总生存（OS）相关。结论：口服ASC具有高复发率和低生存率，即使在早期疾病中也是如此。PNI、LVI、边缘状态以及肿瘤亚位点对预后有很大影响。这些发现强调口腔ASC是一种独特的、特别具有侵袭性的实体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.