Risk of second primary cancer in patients with head and neck squamous cell carcinoma: a systemic review and meta-analysis.

OBJECTIVES: Second primary cancer is a common event in patients with head and neck squamous cell carcinoma. However, the incidence and relevant factors vary by studies. We conducted a systematic review and meta-analysis of observational studies to estimate the incidence and relevant risk factors. MATERIALS AND METHODS: PubMed and Web of Science were searched for studies published between January 2000 and December 2020 that reported the incidence of SPC in HNSCC patients. Per 1000-person-year incidence and odds ratios were used to estimate the incidence and potential risk factors. Due to the high heterogeneity, random-effects models were used to estimate the incidence and 95% confidence interval. RESULTS: Seven thousand seven hundred thirteen articles were identified from the databases, in which 60 studies were included in this meta-analysis. The pooled incidence of the total, synchronous, and metachronous SPC in patients with HNSCC were 29.116 per 1000-person-year, 6.960 per 1000-person-year, and 26.025 per 1000-person-year, respectively. The head and neck region was the most common area where SPC occurred, followed by the lung (7.472 per 1000-person-year) and upper digestive tract (2.696 per 1000-person-year). Smoking, alcohol consumption, betel quid chewing, primary cancer of T1-2, and N0 were risk factors, while HPV infection (OR 0.47, 95% CI 0.30-0.72) was the protective factor. CONCLUSIONS: SPC is frequently observed in HNSCC patients and had great impact on the prognosis. The findings could promote a more individualized follow-up strategy for SPC in HNSCC patients. CLINICAL RELEVANCE: This systemic review and meta-analysis provide sufficient evidence for the establishment of the follow-up strategy for head and neck squamous cancer patients.

Effects of Streptococcus mutans and their metabolites on the wear behavior of dental restorative materials.

The wear behavior of dental restorative materials is highly related to the biolubricating medium in the oral environment. Bacteria, along with their metabolic products, are essential substances in the oral cavity and have not been studied as a potential factor affecting lubrication performance during mastication. In this study, the effects of the Streptococcus mutans bacterial cells and their metabolites were investigated on the wear behavior of resin composites, polymer-infiltrated ceramic networks and zirconium-lithium silicate glass-ceramics. A reciprocating friction test and quantitative analysis of the wear morphology were utilized to determine the coefficient of friction (COF) and wear resistance of the test materials. The results showed that the bacterial metabolite medium significantly reduces the COF and wear rate of the three restorative materials and provide better protection against superficial abrasion. When tested under lactic acid medium, a key acid production in bacterial metabolites, similar wear reduction results were observed in the three materials, which confirmed that lactic acid should be accountable for the excellent lubricating property of bacterial metabolites. Furthermore, the resin composite with lower wettability exhibited a more significant wear reduction than the other two materials when lubricating with a bacterial metabolite medium. These findings provide novel insights into the biological basis of lubrication mechanisms in the oral cavity under high-loading and low-velocity conditions.