On 2017 Jan 05, Alan Roger Santos-Silva commented:

The spectrum of oral squamous cell carcinoma in young patients

We read with interest the current narrative review published by Liu et al [1], in Oncotarget. The article itself is interesting, however, they appear to have misunderstood our article [2] because they seem to believe that there was a cause-effect relationship between orthodontic treatment and tongue squamous cell carcinoma (SCC) at young age. This idea might provide anecdotal information about the potential of orthodontic treatment to cause persistent irritation on oral mucosa and lead to oral SCC. Thus, we believe that it is relevant to clarify that the current understanding about the spectrum of oral SCC in young patients points out three well-known groups according to demographic and clinicopathologic features: (1). 40-45 years old patients highly exposed to alcohol and tobacco diagnosed with keratinizing oral cavity SCC; (2). <45 years old patients, predominantly non-smoking males, diagnosed with HPV-related non-keratinizing oropharyngeal SCC; and (3). Younger than 40-year-old patients, mainly non-smoking and non-drinking females diagnosed with keratinizing oral tongue SCC (HPV seems not to be a risk factor in this group) [3-5]. Therefore, chronic inflammation triggered by persistent trauma of the oral mucosa must not be considered an important risk factor in young patients with oral cancer.

References: 1. Liu X, Gao XL, Liang XH, Tang YL. The etiologic spectrum of head and neck squamous cell carcinoma in young patients. Oncotarget. 2016 Aug 12. doi: 10.18632/oncotarget.11265. [Epub ahead of print]. 2. Santos-Silva AR, Carvalho Andrade MA, Jorge J, Almeida OP, Vargas PA, Lopes MA. Tongue squamous cell carcinoma in young nonsmoking and nondrinking patients: 3 clinical cases of orthodontic interest. Am J Orthod Dentofacial Orthop. 2014; 145: 103-7. 3. Toner M, O'Regan EM. Head and neck squamous cell carcinoma in the young: a spectrum or a distinct group? Part 1. Head Neck Pathol. 2009; 3: 246-248. 4. de Castro Junior G. Curr Opin Oncol. 2016; 28: 193-194. 5.Santos-Silva AR, Ribeiro AC, Soubhia AM, Miyahara GI, Carlos R, Speight PM, Hunter KD, Torres-Rendon A, Vargas PA, Lopes MA. High incidences of DNA ploidy abnormalities in tongue squamous cell carcinoma of young patients: an international collaborative study. Histopathology. 2011; 58: 1127-1135.

Authors: Alan Roger Santos-Silva [1,2]; Ana Carolina Prado Ribeiro [1,2]; Thais Bianca Brandão [1,2]; Marcio Ajudarte Lopes [1]

[1] Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil. [2] Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Correspondence to: Alan Roger Santos-Silva Department of Oral Diagnosis, Piracicaba Dental School, UNICAMP Av. Limeira, 901, Areão, Piracicaba, São Paulo, Brazil, CEP: 13414-903 Telephone: +55 19 2106 5320 alanroger@fop.unicamp.br

On 2017 Jan 05, Alan Roger Santos-Silva commented:

The spectrum of oral squamous cell carcinoma in young patients

We read with interest the current narrative review published by Liu et al [1], in Oncotarget. The article itself is interesting, however, they appear to have misunderstood our article [2] because they seem to believe that there was a cause-effect relationship between orthodontic treatment and tongue squamous cell carcinoma (SCC) at young age. This idea might provide anecdotal information about the potential of orthodontic treatment to cause persistent irritation on oral mucosa and lead to oral SCC. Thus, we believe that it is relevant to clarify that the current understanding about the spectrum of oral SCC in young patients points out three well-known groups according to demographic and clinicopathologic features: (1). 40-45 years old patients highly exposed to alcohol and tobacco diagnosed with keratinizing oral cavity SCC; (2). <45 years old patients, predominantly non-smoking males, diagnosed with HPV-related non-keratinizing oropharyngeal SCC; and (3). Younger than 40-year-old patients, mainly non-smoking and non-drinking females diagnosed with keratinizing oral tongue SCC (HPV seems not to be a risk factor in this group) [3-5]. Therefore, chronic inflammation triggered by persistent trauma of the oral mucosa must not be considered an important risk factor in young patients with oral cancer.

References: 1. Liu X, Gao XL, Liang XH, Tang YL. The etiologic spectrum of head and neck squamous cell carcinoma in young patients. Oncotarget. 2016 Aug 12. doi: 10.18632/oncotarget.11265. [Epub ahead of print]. 2. Santos-Silva AR, Carvalho Andrade MA, Jorge J, Almeida OP, Vargas PA, Lopes MA. Tongue squamous cell carcinoma in young nonsmoking and nondrinking patients: 3 clinical cases of orthodontic interest. Am J Orthod Dentofacial Orthop. 2014; 145: 103-7. 3. Toner M, O'Regan EM. Head and neck squamous cell carcinoma in the young: a spectrum or a distinct group? Part 1. Head Neck Pathol. 2009; 3: 246-248. 4. de Castro Junior G. Curr Opin Oncol. 2016; 28: 193-194. 5.Santos-Silva AR, Ribeiro AC, Soubhia AM, Miyahara GI, Carlos R, Speight PM, Hunter KD, Torres-Rendon A, Vargas PA, Lopes MA. High incidences of DNA ploidy abnormalities in tongue squamous cell carcinoma of young patients: an international collaborative study. Histopathology. 2011; 58: 1127-1135.

Authors: Alan Roger Santos-Silva [1,2]; Ana Carolina Prado Ribeiro [1,2]; Thais Bianca Brandão [1,2]; Marcio Ajudarte Lopes [1]

[1] Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil. [2] Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Correspondence to: Alan Roger Santos-Silva Department of Oral Diagnosis, Piracicaba Dental School, UNICAMP Av. Limeira, 901, Areão, Piracicaba, São Paulo, Brazil, CEP: 13414-903 Telephone: +55 19 2106 5320 alanroger@fop.unicamp.br