METHODS: Detailed, retrospective clinico-pathological analysis of potentially malignant lesions undergoing malignant transformation, from a 590 patient cohort treated by interventional laser surgery and followed for a mean of 7.3 years, was undertaken. Clinical outcome was documented at study census date (31 December 2014).
RESULTS: A total of 99 patients (16.8%) developed cancer: 71 (12%) seen "unexpectedly" upon excision and 28 (4.8%) progressing to malignancy at a median of 87.3 months post-surgery. Thirty "unexpected" excisions were micro-invasive (42.3%) arising primarily in severely dysplastic precursors (75%) at ventro-lateral tongue and floor of mouth sites (54.5%); 1 patient (1.4%) had a cancer-related death, whilst 58 (81.7%) were disease free. A total of 19 of 28 "progressive" cancers (67.9%) arose at new sites, with erythroleukoplakia a significant predictor of malignancy (P = .0019). Nine (32.1%) developed at the same precursor site, with 6 (77.7%) on the ventro-lateral tongue and floor of mouth. Three (10.7%) were micro-invasive, 9 patients (32.1%) died from metastatic disease and 12 (42.9%) were disease free (P < .001).
CONCLUSION: Squamous carcinoma may arise at the site of a precursor lesion as transformation or new-site development via field cancerisation. Whilst interventional surgery facilitates early diagnosis and treatment of occult disease, thus reducing risk from same-site transformation, new-site cancer is a significant long-term risk for patients with potentially malignant disorder.
Subjects and Methods: In an analytical cross-sectional design, we used simple random sampling technique to select 242 multiracial Malaysian male fishermen aged between 18 and 75 years from five fishing villages located at Gurney Drive, Tanjong Tokong, Tanjong Bungah, Batu Ferringhi, and Teluk Bahang to participate in this study. During four consecutive weekends in January 2017, we conducted face-to-face interviews with participants using a pre-validated, interviewer-administered WHO oral health questionnaire. We categorized participants as having "good" or "poor" oral health based on a mean cutoff score of 14. Multivariate regression models were fitted to assess the oral health status and associated lifestyle factors among the study population, using SPSS version 22.
Results: We achieved a response rate of 97.6%. Overall, the prevalence of poor oral health in this study was 47.5%. "Income" (RM/month), "type of fishing," "additional occupation," "age" (years), "frequency of pies, buns consumed," and "frequency of sweets, soft drinks consumed" were significant predictors of oral health status among the fishermen.
Conclusion: Poor oral health is relatively highly prevalent among the fishermen in our study. The oral health status of fishermen in Teluk Bahang was consistent with the national average and significantly associated with their sociodemographic and lifestyle factors. Targeted interventions are required to arrest and reverse this trend.