Field change and oral cancer: new evidence for widespread carcinogenesis?

Int J Oral Maxillofac Surg. 2002 Jun;31(3):262-6. doi: 10.1054/ijom.2002.0220.


Patients with oral squamous cell carcinoma (OSCC) are at risk of developing second or multiple primary cancers as a result of field cancerization in the upper aerodigestive tract. In order to quantify the incidence of field change observable in oral mucosa, 26 consecutive new (untreated) patients presenting with a unilateral OSCC (18) or a premaligant lesion (eight) underwent 'mirror image' biopsies from clinically normal-looking mucosa at corresponding anatomical sites. A total of 15 patients (58%) demonstrated histologically abnormal tissue upon microscopic examination: six showed reactive change/cellular atypia associated with chronic irritation, seven exhibited frank dysplasia, whilst two displayed carcinoma-in-situ (CIS) or microinvasive SCC. Although not statistically significant, there was an observable trend for the lateral/ventral tongue and floor of mouth to display increased vulnerability to dysplastic change.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alcohol Drinking
  • Carcinoma, Squamous Cell / secondary*
  • Cell Transformation, Neoplastic
  • Female
  • Humans
  • Leukoplakia, Oral / pathology
  • Male
  • Middle Aged
  • Mouth Mucosa / pathology*
  • Mouth Neoplasms / pathology*
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Neoplasms, Multiple Primary
  • Pharyngeal Neoplasms / secondary*
  • Pilot Projects
  • Precancerous Conditions / pathology
  • Precancerous Conditions / secondary*
  • Respiratory Tract Neoplasms / secondary*
  • Smoking