What do systematic reviews say?

Vital staining (e.g. toluidine blue, tolonium chloride) vs Surgical or punch biopsy with histological assessment

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  Sensitivity 0.86 [0.79, 0.90]
  20 studies
  Low

COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  There were no eligible studies evaluating light-based detection.
  0 studies
  No studies found

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Concomitant (concurrent) chemoradiotherapy led to lower locoregional control, concurrent chemoradiotherapy (platinum +… compared with radiotherapy alone (non-resectable tumours); GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  RR 0.75 [0.61, 0.93]
  3 studies
  GRADE not reported

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

COE with vital rinsing (toluidine blue/tolonium chloride) showed no clear difference in detection rate of oral pre-malignant and malignant lesions after… compared with conventional oral examination (COE) alone (moderate certainty).

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Rate ratio 1.05 [0.74, 1.41]
  1 study · 7975 participants
  Moderate

Combined index tests (e.g. vital staining plus light-based detection or cytology) vs Surgical or punch biopsy with histological assessment

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  Specificity 0.71 [0.53, 0.84]
  9 studies
  Very low

Surgery +/- radiotherapy + (adjuvant) chemotherapy vs Surgery +/- radiotherapy alone (observation or adjuvant radiotherapy only)

Surgery +/- radiotherapy + (adjuvant) chemotherapy showed no clear difference in overall survival, adjuvant chemotherapy vs observation alone… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy… (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.95 [0.73, 1.22]
  5 studies · 353 participants
  Moderate

Chemotherapy (any regimen; added to, or compared with, locoregional treatment) vs Locoregional treatment and/or an alternative chemotherapy regimen

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Harms/toxicity were planned but very little quantitative data suitable for analysis were found; toxicity reported narratively and not quantified or GRADE-rated.
  Studies not reported
  GRADE not reported

COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000) vs Conventional oral examination (COE) alone

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible studies; planned comparative analysis (COE vs COE with light-based detection) not populated in this version.
  0 studies
  No studies found

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Concomitant (concurrent) chemoradiotherapy led to lower disease-free survival, concurrent chemoradiotherapy vs radiotherapy… compared with radiotherapy alone (non-resectable tumours); GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.74 [0.67, 0.80]
  13 studies
  GRADE not reported

COE with vital rinsing (toluidine blue/tolonium chloride) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible study evaluated COE with vital rinse as a stand-alone screen against the reference standard in this version.
  0 studies
  No studies found

Surgery +/- radiotherapy + (adjuvant) chemotherapy vs Surgery +/- radiotherapy alone (observation or adjuvant radiotherapy only)

Surgery +/- radiotherapy + (adjuvant) chemotherapy led to lower disease-free survival, adjuvant concurrent chemoradiation vs… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy…; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.84 [0.72, 0.97]
  4 studies
  GRADE not reported

Surgery +/- radiotherapy + (adjuvant) chemotherapy vs Surgery +/- radiotherapy alone (observation or adjuvant radiotherapy only)

Surgery +/- radiotherapy + (adjuvant) chemotherapy probably leads to lower overall survival, adjuvant concurrent chemoradiation vs adjuvant… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy… (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.84 [0.72, 0.98]
  4 studies · 1097 participants
  Moderate

COE with blood/salivary (biomarker) analysis vs COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible studies; planned comparative analysis (COE with light-based detection vs COE with blood/salivary analysis) not populated in this version.
  0 studies
  No studies found

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Induction chemotherapy plus locoregional treatment (radiotherapy… showed no clear difference in overall survival, induction cisplatin + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone (low certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.71 [0.37, 1.35]
  2 studies · 389 participants
  Low

Brush biopsy (oral cytology) vs Surgical or punch biopsy with histological assessment

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  Specificity 0.94 [0.88, 0.97]
  20 studies
  Moderate

Mouth self-examination (MSE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 2 (no pooled analysis): specificity 1.00 (95% CI 1.00 to 1.00), 0.95 (95% CI 0.88 to 0.99), 0.44 (95% CI 0.20 to 0.70), and 0.54 (95% CI 0.37 to 0.69) across the 4 studies. Certainty VERY LOW.
  4 studies · 35059 participants
  Very low

Visual examination (VE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 1 (no pooled analysis): for the 7 low-prevalence studies specificity ranged from 0.94 (95% CI 0.88 to 0.97) to 0.99 (95% CI 0.98 to 1.00); for the 3 higher-prevalence studies specificity ranged from…
  10 studies · 25568 participants
  Low

Combined index tests (e.g. vital staining plus light-based detection or cytology) vs Surgical or punch biopsy with histological assessment

• Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
  Sensitivity 0.78 [0.45, 0.94]
  9 studies
  Very low

Chemotherapy regimen A (+/- locoregional treatment) vs Chemotherapy regimen B (+/- locoregional treatment)

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Locoregional control reported in 12 studies; not pooled. Olasz 2000 RR 0.50 (0.26 to 0.96); Prevost 2005 RR 1.48 (1.04 to 2.11); Molinari 1982 RR 0.35 (0.19 to 0.66).
  12 studies
  GRADE not reported

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Concomitant (concurrent) chemoradiotherapy probably leads to lower overall survival, concurrent chemoradiotherapy vs radiotherapy alone… compared with radiotherapy alone (non-resectable tumours) (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.74 [0.67, 0.83]
  24 studies · 2852 participants
  Moderate