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Obermeier KT, Liokatis P, Smolka W. Comparison of histopathological margins after resection of oral squamous cell carcinoma using sharp dissection versus mono-polar electrocautery in T1 and T2 tumors. Surg Oncol 2023; 51:102010. [PMID: 37907044 DOI: 10.1016/j.suronc.2023.102010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 09/25/2023] [Accepted: 10/22/2023] [Indexed: 11/02/2023]
Abstract
The study aims to compare histopathological margins after resection of oral squamous cell carcinoma (OSCC) with different surgical techniques: conventional sharp resection (SR) with scalpel versus monopolar electrocautery (ME). Hence, the question arises whether thermal damage by performing monopolar electrocautery surgery will lead to close margins more frequently than by using scalpels. 152 patients were included in this study. All patients received a primary tumor resection either performed with SR or with ME. Surgical margins were distributed into two groups: ≥5 mm (clear margins) and < 5 mm (close or involved margins). For comparing homogeneous groups, we considered tumor localizations, diameter and depth of invasion. The results were statistically analyzed by applying the Wilcoxon-Mann-Whitney-U-Test. The distribution of tumor diameter and depth of invasion was equal in both groups. There was no statistically significant difference between the amount of free surgical margins using SR or ME (p = 0.884). According to this study, the use of the monopolar electrocautery for tumor resection in the oral cavity does not increase the rate of compromised resection margins compared to the conventional scalpel.
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Affiliation(s)
| | - Paris Liokatis
- Department of Oral & Maxillofacial Surgery, University of Munich, LMU, Germany
| | - Wenko Smolka
- Department of Oral & Maxillofacial Surgery, University of Munich, LMU, Germany.
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Dixit S, Kumar A, Srinivasan K. A Current Review of Machine Learning and Deep Learning Models in Oral Cancer Diagnosis: Recent Technologies, Open Challenges, and Future Research Directions. Diagnostics (Basel) 2023; 13:diagnostics13071353. [PMID: 37046571 PMCID: PMC10093759 DOI: 10.3390/diagnostics13071353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/25/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Cancer is a problematic global health issue with an extremely high fatality rate throughout the world. The application of various machine learning techniques that have appeared in the field of cancer diagnosis in recent years has provided meaningful insights into efficient and precise treatment decision-making. Due to rapid advancements in sequencing technologies, the detection of cancer based on gene expression data has improved over the years. Different types of cancer affect different parts of the body in different ways. Cancer that affects the mouth, lip, and upper throat is known as oral cancer, which is the sixth most prevalent form of cancer worldwide. India, Bangladesh, China, the United States, and Pakistan are the top five countries with the highest rates of oral cavity disease and lip cancer. The major causes of oral cancer are excessive use of tobacco and cigarette smoking. Many people’s lives can be saved if oral cancer (OC) can be detected early. Early identification and diagnosis could assist doctors in providing better patient care and effective treatment. OC screening may advance with the implementation of artificial intelligence (AI) techniques. AI can provide assistance to the oncology sector by accurately analyzing a large dataset from several imaging modalities. This review deals with the implementation of AI during the early stages of cancer for the proper detection and treatment of OC. Furthermore, performance evaluations of several DL and ML models have been carried out to show that the DL model can overcome the difficult challenges associated with early cancerous lesions in the mouth. For this review, we have followed the rules recommended for the extension of scoping reviews and meta-analyses (PRISMA-ScR). Examining the reference lists for the chosen articles helped us gather more details on the subject. Additionally, we discussed AI’s drawbacks and its potential use in research on oral cancer. There are methods for reducing risk factors, such as reducing the use of tobacco and alcohol, as well as immunization against HPV infection to avoid oral cancer, or to lessen the burden of the disease. Additionally, officious methods for preventing oral diseases include training programs for doctors and patients as well as facilitating early diagnosis via screening high-risk populations for the disease.
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Affiliation(s)
- Shriniket Dixit
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore 632014, India
| | - Anant Kumar
- School of Bioscience and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Kathiravan Srinivasan
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore 632014, India
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Mirzaei A, Ghorbani Z, Manifar S, Bohloli G, Aghakouchakzadeh A. Oral health-related quality of life in patients with oral squamous cell carcinoma: A case–control study. Dent Res J (Isfahan) 2023. [DOI: 10.4103/1735-3327.372653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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Possibilities of photodynamic therapy in the treatment of malignant tumors of the oral cavity. BIOMEDICAL PHOTONICS 2021. [DOI: 10.24931/2413-9432-2021-10-3-32-38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Oral mucosa cancer is a common disease with relatively low survival rates. The standard for the treatment of malignant neoplasms (MNO) of the oral mucosa is the surgical method, chemotherapy and / or radiation therapy. With the introduction of modern protocols and the improvement of current treatment methods, the increase in survival is insignificant due to the development of local and distant relapses, the appearance of simultaneous tumors of the oral cavity. Cosmetic and functional results in patients who have undergone complex treatment for oral cancer are often unsatisfactory. There is an obvious need to develop new approaches to treating patients with cancer of the oral mucosa. Photodynamic therapy (PDT) has similar properties. With the development of endoscopic and fiber-optic equipment, the fields of PDT application have significantly expanded. Foci in the oral cavity and oropharynx became available for PDT. The early stages of oral mucosal cancer are optimal for PDT because large surface defects can be treated with minimal complications. Preservation of subepithelial and collagen structures, which is typical for PDT, promotes healing without the formation of scar processes, thereby achieving an ideal cosmetic and functional effect. The use of PDT in the treatment of oral cavity cancer is not limited only to the initial stages in an independent version. It is possible to use PDT in combination with surgical and radiation treatment. In case of massive tumor processes, PDT is used for palliative purposes. The influence of the adaptive immune response under the influence of PDT is being studied.
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Tsai TY, Huang Y, Iandelli A, Tai SF, Hung SY, Kao HK, Chang KP. The role of postoperative radiotherapy in pN1 oral cavity cancer without extranodal extension. World J Surg Oncol 2021; 19:279. [PMID: 34535149 PMCID: PMC8449449 DOI: 10.1186/s12957-021-02396-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/06/2021] [Indexed: 12/09/2022] Open
Abstract
Background The administration of postoperative radiotherapy remains controversial in pN1 oral cavity cancer patients without extranodal extension. The aim is to determine whether postoperative radiotherapy reduces the neck recurrence rate and improves the survival outcomes of pN1 patients. Methods This study consecutively enrolled 1056 patients with newly diagnosed oral squamous cell carcinoma who underwent tumor wide excision and neck dissection from September 2002 to November 2019. One hundred two pN1 patients without extranodal extension were eligible for analysis. Then, a subgroup analysis of 40 patients was performed after patients with other adverse risk factors (positive margins, close margins, lymphovascular invasion, perineural invasion, tumor depth ≥ 10 mm, and poor histological differentiation) were excluded. Results Of the 102 eligible pN1 patients, 26 patients received surgery alone, and 76 received postoperative radiotherapy. No significant differences were observed in the neck recurrence rate (7.7% vs. 15.8%, p = 0.30). Similarly, in patients without other adverse risk factors, no significant differences were observed in the neck recurrence rate (5% vs. 20%, p = 0.15) between surgery alone group and postoperative radiotherapy group. Moreover, no significant difference was found in the neck recurrence-free survival rate, overall survival, and disease-specific survival (77.1% vs. 52.5%, p = 0.42, 83.5% vs. 64.5%, p = 0.81, and 88.2% vs. 67.9%, p = 0.34, respectively). Conclusion Postoperative radiotherapy did not significantly decrease the probability of neck recurrence and survival outcomes in pN1 patients without extranodal extension. Radical surgery alone may be considered sufficient treatment for pN1 patients without other adverse risk factors.
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Affiliation(s)
- Tsung-You Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan
| | - Yenlin Huang
- Department of Pathology, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan
| | - Andrea Iandelli
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan.,Unit of Otorhinolaryngology and Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, Genoa, Italy
| | - Shiao-Fwu Tai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan
| | - Shao-Yu Hung
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan
| | - Huang-Kai Kao
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kai-Ping Chang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Ferenczi Ö, Major T, Akiyama H, Fröhlich G, Oberna F, Révész M, Poósz M, Polgár C, Takácsi-Nagy Z. Results of postoperative interstitial brachytherapy of resectable floor of mouth tumors. Brachytherapy 2020; 20:376-382. [PMID: 33250304 DOI: 10.1016/j.brachy.2020.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/29/2020] [Accepted: 10/22/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to describe the results of postoperative sole interstitial brachytherapy (BT) in patients with resectable floor of mouth tumors. METHODS AND MATERIALS Between January 1998 and December 2017, 44 patients with squamous cell histology, stage T1-3N0-1M0 floor of mouth tumor were treated by excision of the primary lesion with or without neck dissection followed by sole high-dose-rate tumor bed BT with an average dose of 22.7 Gy (10-45 Gy) using rigid metal needles (n = 14; 32%) or flexible plastic catheters (n = 30; 68%). RESULTS During a median followup time of 122 months for surviving patients, the probability of 5- and 10-year local and regional tumor control, overall survival (OS), and disease-specific survival (DSS) was 89% and 89%, 73% and 67%, 52% and 32%, 66% and 54%, respectively. In univariate analysis, lymphovascular invasion was a negative predictor of regional tumor control (p = 0.0062), DSS (p = 0.0056), and OS (p = 0.0325), whereas cervical recurrence was associated with worse DSS (p < 0.0001) and OS (p < 0.0001). The incidence of local Grade 1, 2, and 3 mucositis was 25%, 64%, and 11%, respectively. Grade 4 side effect, that is soft tissue necrosis occurred in four cases (9%). CONCLUSIONS Results of postoperative sole high-dose-rate BT of floor of mouth tumors are comparable with those reported with low-dose-rate BT, and this method could improve local tumor control and DSS compared with exclusive surgical treatment.
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Affiliation(s)
- Örs Ferenczi
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary.
| | - Tibor Major
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary; Department of Oncology, Semmelweis University, Budapest, Hungary
| | - Hironori Akiyama
- Department of Oral Radiology, Osaka Dental University, Osaka, Japan
| | - Georgina Fröhlich
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Ferenc Oberna
- Multidisciplinary Center of Head and Neck Tumours, National Institute of Oncology, Budapest, Hungary
| | - Mónika Révész
- Multidisciplinary Center of Head and Neck Tumours, National Institute of Oncology, Budapest, Hungary
| | - Márton Poósz
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Csaba Polgár
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary; Department of Oncology, Semmelweis University, Budapest, Hungary
| | - Zoltán Takácsi-Nagy
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary; Department of Oncology, Semmelweis University, Budapest, Hungary
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Kim BY, Cho KR, Sohn JH, Kim JY. Sarcomatoid carcinoma after radiotherapy for early-stage oral squamous cell carcinoma: Case report. Medicine (Baltimore) 2019; 98:e16003. [PMID: 31277093 PMCID: PMC6635294 DOI: 10.1097/md.0000000000016003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Sarcomatoid carcinoma is a rare variant of squamous cell carcinoma (SCC) with poor prognosis. Previous radiation has been reported as one of the etiologic factors. PATIENT CONCERNS We describe a case of a 57-year-old man presented with a painless mass in the left supraclavicular area. Five years before, he was diagnosed with SCC in floor of mouth (FOM) and underwent radiotherapy (RT). DIAGNOSES Sonography-guided biopsy on the supraclavicular lymph node revealed diffuse spindle cell proliferation with a focus of squamous differentiation. Local recurrence on primary site or distant metastasis was not obvious on both computed tomography (CT) of the neck and F-fluorodeoxyglucose positron emission tomography CT. The final diagnosis was confirmed as sarcomatoid carcinoma via surgery. INTERVENTIONS The patient underwent surgery including explorative resection of the mouth floor, excision of the submandibular gland, and modified radical neck dissection. Following surgery, the patient received adjuvant radiation therapy. OUTCOMES There were no complications according to the surgery. Six months after adjuvant therapy, distant metastasis to liver was identified. The patient is currently undergoing palliative chemotherapy. LESSONS This may be the first reported case of sarcomatoid carcinoma arising from early-stage SCC in FOM that was previously treated with RT alone. When RT is performed as a single modality for oral SCC, even in an early stage, rigorous follow-up should be performed.
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Affiliation(s)
- Bo Young Kim
- Departments of Otorhinolaryngology—Head and Neck Surgery, Sanggye Paik Hospital
| | - Kyoung Rai Cho
- Departments of Otorhinolaryngology—Head and Neck Surgery, Sanggye Paik Hospital
| | - Jung Heob Sohn
- Departments of Otorhinolaryngology—Head and Neck Surgery, Sanggye Paik Hospital
| | - Jung Yeon Kim
- Department of Pathology, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
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Behavior of squamous cell carcinoma of the floor of the mouth. Is supraomohyoid neck dissection sufficiently safe to manage clinically N0 patients? ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019. [DOI: 10.1016/j.otoeng.2018.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Koyfman SA, Ismaila N, Crook D, D'Cruz A, Rodriguez CP, Sher DJ, Silbermins D, Sturgis EM, Tsue TT, Weiss J, Yom SS, Holsinger FC. Management of the Neck in Squamous Cell Carcinoma of the Oral Cavity and Oropharynx: ASCO Clinical Practice Guideline. J Clin Oncol 2019; 37:1753-1774. [PMID: 30811281 DOI: 10.1200/jco.18.01921] [Citation(s) in RCA: 184] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The aim of the current work is to provide evidence-based recommendations to practicing physicians and others on the management of the neck in patients with squamous cell carcinoma of the oral cavity and oropharynx. METHODS ASCO convened an Expert Panel of medical oncology, surgery, radiation oncology, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1990 through 2018. Outcomes of interest included survival, regional disease control, neck recurrence, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 124 relevant studies to inform the evidence base for this guideline. Six clinical scenarios were devised; three for oral cavity cancer and three for oropharynx cancer, and recommendations were generated for each one. RECOMMENDATIONS For oral cavity cancers, clinical scenarios focused on the indications for and the hallmarks of a high-quality neck dissection, indications for postoperative radiotherapy or chemoradiotherapy, and whether radiotherapy alone is sufficient elective treatment of an undissected neck compared with high-quality neck dissection. For oropharynx cancers, clinical scenarios focused on hallmarks of a high-quality neck dissection, factors that would favor operative versus nonoperative primary management, and clarifying criteria for an incomplete response to definitive chemoradiation for which salvage neck dissection would be recommended. Consensus was reached and recommendations were made for all six clinical scenarios. Additional information is available at www.asco.org/head-neck-cancer-guidelines .
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Affiliation(s)
| | | | - Doug Crook
- 3 Patient representative, Indianapolis, IN
| | | | | | | | | | | | | | - Jared Weiss
- 10 University of North Carolina, Chapel Hill, NC
| | - Sue S Yom
- 11 University of California, San Francisco, San Francisco, CA
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Li S, Huang Z, Chen W, Pan C, Huang Z. Risk factors for postoperative hemorrhage in patients with oral squamous cell carcinoma: A retrospective study. Head Neck 2019; 41:2093-2099. [PMID: 30706556 DOI: 10.1002/hed.25659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 12/22/2018] [Accepted: 01/04/2019] [Indexed: 12/26/2022] Open
Affiliation(s)
- Shihao Li
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
| | - Zixian Huang
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
| | - Weiliang Chen
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
| | - Chaobin Pan
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
| | - Zhiquan Huang
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
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Abstract
Management of oral cavity squamous cell carcinoma has become increasingly driven by emerging evidence as a result of the improved quality of clinical research associating clinicopathologic risk factors with oncologic and survival outcomes. Multiple significant recent changes to treatment guidelines and staging algorithms for oral cavity squamous cell carcinoma reflect evolving understanding of tumor biology and the need for adequately extensive treatment of aggressive disease. This article provides clinicians with a synopsis of the most contemporary management strategies for oral cavity squamous cell carcinoma, framed within the context of historical treatment philosophies.
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Affiliation(s)
- Kyle S Ettinger
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Section of Head and Neck Oncologic Surgery and Reconstruction, Mayo Clinic, Mayo College of Medicine, Mail Code: ro_ma_12_12econ, 200 First Street Southwest, Rochester, MN 55905, USA; Department of Oral and Maxillofacial Surgery, Division of Head and Neck Surgery, University of Florida College of Medicine - Jacksonville, 653-1 West 8th Street 2nd FL/LRC, Jacksonville, FL 32209, USA
| | - Laurent Ganry
- Department of Oral and Maxillofacial Surgery, Division of Head and Neck Surgery, University of Florida College of Medicine - Jacksonville, 653-1 West 8th Street 2nd FL/LRC, Jacksonville, FL 32209, USA; Department of Maxillo-facial, Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France
| | - Rui P Fernandes
- Division of Head and Neck Surgery, Head and Neck Oncologic Surgery and Microvascular Reconstruction Fellowship, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine - Jacksonville, University of Florida - Jacksonville, 653-1 West 8th Street 2nd FL/LRC, Jacksonville, FL 32209, USA.
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Cariati P, Cabello Serrano A, Roman Ramos M, Sanchez Lopez D, Fernandez Solis J, Martinez Lara I. Behavior of squamous cell carcinoma of the floor of the mouth. Is supraomohyoid neck dissection sufficiently safe to manage clinically N0 patients? ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018; 70:68-73. [PMID: 29759299 DOI: 10.1016/j.otorri.2018.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 11/30/2022]
Abstract
AIM The main aim of the present report is to study the behavior of SCC of the floor of the mouth. MATERIALS AND METHOD A retrospective analysis was conducted using the records of patients diagnosed with squamous cell carcinoma of the floor of the mouth between 2000 and 2012 in the HUVN. Ninety-three patients with squamous cell carcinoma of the floor of the mouth treated with tumourectomy and selective neck dissection were included in the study. The pattern of distribution of cervical metastases and numerous histological features such as T-stage, N stage, surgical margins, tumor thickness, ECS (extracapsular spread) and vascular invasion were analyzed. RESULTS Level I was the most affected level, followed by Level II. T stage, tumor thickness, and surgical margins showed a strong relationship with the risk of developing a local or cervical failure at follow-up. Overall survival was 52.7%. T stage, tumor thickness, N stage, recurrence, extracapsular spread, and vascular invasion were also associated with a poor prognosis. CONCLUSIONS SCC of the floor of the mouth is an aggressive disease even at early stages. Due to the low rate of positive nodes observed at level IV and V in clinically N0 patients, supraomohyoid neck dissection might be considered sufficiently safe in this group.
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Saggi S, Badran KW, Han AY, Kuan EC, St John MA. Clinicopathologic Characteristics and Survival Outcomes in Floor of Mouth Squamous Cell Carcinoma: A Population-Based Study. Otolaryngol Head Neck Surg 2018; 159:51-58. [PMID: 29436280 DOI: 10.1177/0194599818756815] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To describe the determinants of survival for patients with floor of mouth (FOM) squamous cell carcinoma (SCC) from 1973 to 2013 with the SEER database (Surveillance, Epidemiology, and End Results). Study Design and Setting Retrospective cohort study with a national database. Subjects and Methods The SEER registry was utilized to calculate survival trends for patients with FOM SCC between 1973 and 2013. Patient data were analyzed with respect to age, sex, race, primary site, stage at presentation, tumor size, grade, and treatment modalities (surgery and radiotherapy). Overall survival (OS) and disease-specific survival (DSS) were calculated. Results A total of 14,010 FOM SCC cases were identified. The cohort was 69.5% male, and the median age at diagnosis was 62 years. Forty-six percent of cases were treated with surgery, while 14% received radiotherapy. Kaplan-Meier analysis demonstrated OS and DSS of 39% and 59% at 5 years, respectively. Multivariate analysis showed that age, grade, stage, size, and surgery were determinants for OS and DSS (all P < .05). For early- and advanced-stage cancers, age, grade, size, and surgery predicted OS and DSS, while radiotherapy was a predictor of OS and DSS in advanced-stage tumors only (all P < .05). Conclusion To our knowledge, this study is the largest to date investigating prognostic factors for survival of patients diagnosed with FOM SCC. Determinants of survival include age, grade, stage, size, and surgery. Surgery appears to play a critical role in the management of these tumors.
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Affiliation(s)
- Satvir Saggi
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, UCLA Medical Center, Los Angeles, California, USA
| | - Karam W Badran
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, UCLA Medical Center, Los Angeles, California, USA
| | - Albert Y Han
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, UCLA Medical Center, Los Angeles, California, USA
| | - Edward C Kuan
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, UCLA Medical Center, Los Angeles, California, USA
| | - Maie A St John
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, UCLA Medical Center, Los Angeles, California, USA.,2 Head and Neck Cancer Program, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Zirk M, Safi AF, Buller J, Nickenig HJ, Dreiseidler T, Zinser M, Drebber U, Zöller JE, Kreppel M. Lymph node ratio as prognosticator in floor of mouth squamous cell carcinoma patients. J Craniomaxillofac Surg 2018; 46:195-200. [DOI: 10.1016/j.jcms.2017.11.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/20/2017] [Accepted: 11/20/2017] [Indexed: 11/29/2022] Open
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Stathopoulos P, Smith WP. Close Resection Margins Do Not Influence Local Recurrence in Patients With Oral Squamous Cell Carcinoma: A Prospective Cohort Study. J Oral Maxillofac Surg 2017; 76:873-876. [PMID: 29172031 DOI: 10.1016/j.joms.2017.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/26/2017] [Accepted: 10/26/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE This study investigated the clinical relevance of the distance between the resection margin and tumor cells of the primary sites for oral squamous cell carcinoma, with particular attention to local recurrence rate. PATIENTS AND METHODS All patients diagnosed with oral squamous cell carcinoma from 1995 to 2006 and treated primarily with surgery formed the initial cohort of the study. Patient with various degrees of dysplasia in the margin, patients who received radiotherapy, and patients who died of causes other than oral cancer were excluded. Margins 1 to 5 mm were considered close. A margin of at least 5 mm was considered free of disease (clear). Local recurrence was defined as tumor development at the site of the primary tumor during the follow-up period (≥5 yr). The Fisher exact test was used to determine the relevance of the differences between the studied groups (free vs close margins) in relation to local recurrence. RESULTS Histologic analysis of the specimens was performed. Of the 53 patients, 32 had free margins and 3 of the 32 had a local recurrence. In addition, 21 patients had close margins and 3 of the 21 had a local recurrence. The difference between the 2 groups was not statistically relevant. CONCLUSIONS The authors advocate that the strategy of using close resection margins as a generic indicator for local recurrence and adverse prognosis might have to be reassessed. The histopathologic evidence of tumor cells within a distance less than 0.5 cm from the surgical margins does not necessarily seem to offer a certain indication for additional treatment. Other prognostic factors, such as involvement of cervical lymph nodes and tumor depth, must be considered in the decision making for further treatment.
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Affiliation(s)
- Panagiotis Stathopoulos
- Associate Professor, Dublin Dental University Hospital; Consultant Oral and Maxillofacial Surgeon, St James and Mater Hospitals, Dublin, Ireland.
| | - William P Smith
- Consultant Oral and Maxillofacial Surgeon, Northampton General Hospital, Northampton, United Kingdom
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Quinlan-Davidson SR, Morrison WH, Myers JN, Gunn GB, William WN, Beadle BM, Skinner HD, Gillenwater AM, Frank SJ, Phan J, Johnson FM, Fuller CD, Zafereo ME, Rosenthal DI, Garden AS. Recurrent oral cavity cancer: Patterns of failure after salvage multimodality therapy. Head Neck 2016; 39:633-638. [PMID: 28006086 DOI: 10.1002/hed.24666] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 08/08/2016] [Accepted: 11/04/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND We focused on a cohort of radiation naïve patients who had recurrent oral cavity cancer (recurrent OCC) to assess their outcomes with salvage multimodal therapy. METHODS A retrospective single institutional study was performed of patients with recurrent OCC. Disease recurrence and survival outcomes were assessed. RESULTS Seventy-eight patients were analyzed. All patients had salvage surgery and intensity-modulated radiotherapy (IMRT) and 74% had chemotherapy. Five-year overall survival, recurrence-free survival, and locoregional control rates were 59%, 60%, and 74%, respectively. CONCLUSION Outcomes of radiation naïve patients with recurrent OCC are fair, and seem similar with patients with locally advanced nonrecurrent OCC treated with multimodal therapy. © 2016 Wiley Periodicals, Inc. Head Neck 39: 633-638, 2017.
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Affiliation(s)
- Sean R Quinlan-Davidson
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - William H Morrison
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey N Myers
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gary B Gunn
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - William N William
- Department of Thoracic/Head and Neck Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Beth M Beadle
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Heath D Skinner
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ann M Gillenwater
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Steven J Frank
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jack Phan
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Faye M Johnson
- Department of Thoracic/Head and Neck Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Clifton D Fuller
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark E Zafereo
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David I Rosenthal
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adam S Garden
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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Cerrati EW, Nguyen SA, Farrar JD, Lentsch EJ. The efficacy of photodynamic therapy in the treatment of oral squamous cell carcinoma: a meta-analysis. EAR, NOSE & THROAT JOURNAL 2016; 94:72-9. [PMID: 25651350 DOI: 10.1177/014556131509400208] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We performed an extensive review of the literature to compare the efficacy of photodynamic therapy (PDT) to surgical resection, the current standard of care, in the treatment of adults with early-stage (T1-2N0M0) squamous cell carcinoma (SCC) of the oral cavity. Since patients who receive PDT are chosen with a high degree of selectivity, particular care was taken when extracting data for comparison. For outcomes measures, PDT was assessed in terms of a complete response to therapy, and surgery was evaluated in terms of locoregional control. Recurrences were also analyzed. We found 24 studies--12 for each treatment--to compare for this meta-analysis. In comparing a complete response to PDT and locoregional control with surgery, we found no statistically significant difference (mean difference [MD]: 1.166; 95% confidence interval [CI]: 0.479 to 2.839). With respect to recurrences, again no statistically significant difference was observed (MD: 0.552; 95% CI: 0.206 to 1.477). We conclude that PDT is as effective as primary surgical resection for the treatment of early-stage SCC of the oral cavity and that it is a valid function-preserving approach to treatment.
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Affiliation(s)
- Eric W Cerrati
- Department of Otolaryngology, NYU Langone Medical Center, 462 First Ave., New York, NY 10016, USA.
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18
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Will the mininvasive approach challenge the old paradigms in oral cancer surgery? Eur Arch Otorhinolaryngol 2016; 274:1279-1289. [DOI: 10.1007/s00405-016-4221-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/18/2016] [Indexed: 02/06/2023]
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19
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Fives C, Feeley L, O'Leary G, Sheahan P. Importance of lymphovascular invasion and invasive front on survival in floor of mouth cancer. Head Neck 2015; 38 Suppl 1:E1528-34. [DOI: 10.1002/hed.24273] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2015] [Indexed: 01/30/2023] Open
Affiliation(s)
- Cassie Fives
- Department of Pathology; Cork University Hospital; Cork Ireland
| | - Linda Feeley
- Department of Pathology; Cork University Hospital; Cork Ireland
| | - Gerard O'Leary
- Department of Otolaryngology - Head and Neck Surgery; South Infirmary Victoria University Hospital; Cork Ireland
| | - Patrick Sheahan
- Department of Otolaryngology - Head and Neck Surgery; South Infirmary Victoria University Hospital; Cork Ireland
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20
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Ernani V, Saba NF. Oral Cavity Cancer: Risk Factors, Pathology, and Management. Oncology 2015; 89:187-95. [PMID: 26088938 DOI: 10.1159/000398801] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 04/07/2015] [Indexed: 11/19/2022]
Abstract
Oral cavity cancers are predominantly squamous cell carcinomas, which arise from premalignant lesions through a multistep carcinogenesis process. Tobacco and alcohol are the major etiologic factors, although human papillomavirus has also recently been implicated as a causative agent. The possibility of a second primary malignancy should be considered during the diagnostic evaluation of head and neck cancers, as well as during the posttreatment surveillance phase. The goals of treatment are not only to improve survival outcomes but also to preserve organ function. These cancers are generally treated with a combination of surgery, radiation therapy, and chemotherapy. A multidisciplinary approach, involving surgeons, medical oncologists, and radiation oncologists, as well as dentists, dietitians, and rehabilitation therapists, is generally required for optimal treatment planning and management of patients with head and neck cancer.
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Affiliation(s)
- Vinicius Ernani
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Ga., USA
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Anderson CR, Sisson K, Moncrieff M. A meta-analysis of margin size and local recurrence in oral squamous cell carcinoma. Oral Oncol 2015; 51:464-9. [PMID: 25716108 DOI: 10.1016/j.oraloncology.2015.01.015] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 01/20/2015] [Accepted: 01/25/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Excision margins for oral squamous cell carcinoma (OSCC) are poorly understood. Close (<5mm) and involved (<1mm) pathological margins are key indicators of the need for adjuvant treatment. This review aimed to assess the impact of pathological margin size on local recurrence rates. METHODS MEDLINE and EMBASE were searched for studies that looked at local recurrence following excision of primary OSCC without adjuvant therapy. Five studies met the inclusion criteria. RESULTS Recurrence rates were pooled to give a 21% absolute risk reduction (95% confidence interval 12-30%, p=<0.00001) in local recurrence with margins clear by more than 5mm. Unweighted pooled recurrence rates were 20% in patients with margins clear by more than 5mm. CONCLUSION These findings suggest that a 5mm pathological margin is the minimum acceptable margin size in OSCC.
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Affiliation(s)
- Caroline Rachael Anderson
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, United Kingdom.
| | - Katherine Sisson
- Department of Histopathology, Norfolk and Norwich University Hospitals, Colney Lane, Norwich NR4 7UY, United Kingdom
| | - Marc Moncrieff
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, United Kingdom; Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospitals, Colney Lane, Norwich NR4 7UY, United Kingdom
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22
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Yuan Z, Wang H, Hu Z, Huang Y, Yao F, Sun S, Wu B. Quercetin Inhibits Proliferation and Drug Resistance in KB/VCR Oral Cancer Cells and Enhances Its Sensitivity to Vincristine. Nutr Cancer 2014; 67:126-36. [DOI: 10.1080/01635581.2015.965334] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Herman MP, Dagan R, Amdur RJ, Morris CG, Werning JW, Vaysberg M, Mendenhall WM. Postoperative radiotherapy for patients at high risk of recurrence of oral cavity squamous cell carcinoma. Laryngoscope 2014; 125:630-5. [DOI: 10.1002/lary.24938] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 08/18/2014] [Accepted: 08/27/2014] [Indexed: 11/12/2022]
Affiliation(s)
- Michael P. Herman
- Department of Radiation Oncology; University of Florida College of Medicine; Gainesville Florida U.S.A
| | - Roi Dagan
- Department of Radiation Oncology; University of Florida College of Medicine; Gainesville Florida U.S.A
| | - Robert J. Amdur
- Department of Radiation Oncology; University of Florida College of Medicine; Gainesville Florida U.S.A
| | - Christopher G. Morris
- Department of Radiation Oncology; University of Florida College of Medicine; Gainesville Florida U.S.A
| | - John W. Werning
- Department Otolaryngology; University of Florida College of Medicine; Gainesville Florida U.S.A
| | - Mikhail Vaysberg
- Department Otolaryngology; University of Florida College of Medicine; Gainesville Florida U.S.A
| | - William M. Mendenhall
- Department of Radiation Oncology; University of Florida College of Medicine; Gainesville Florida U.S.A
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Omura K. Current status of oral cancer treatment strategies: surgical treatments for oral squamous cell carcinoma. Int J Clin Oncol 2014; 19:423-30. [DOI: 10.1007/s10147-014-0689-z] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Indexed: 12/21/2022]
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Alvarez J, Bidaguren A, McGurk M, Diaz-Basterra G, Brunsó J, Andikoetxea B, Martín J, Barbier L, Arteagoitia I, Santamaría J. Sentinel node biopsy in relation to survival in floor of the mouth carcinoma. Int J Oral Maxillofac Surg 2014; 43:269-73. [DOI: 10.1016/j.ijom.2013.10.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 09/17/2013] [Accepted: 10/24/2013] [Indexed: 02/06/2023]
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26
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Early squamous cell carcinoma of the oral tongue: Comparing margins obtained from the glossectomy specimen to margins from the tumor bed. Oral Oncol 2013; 49:1077-82. [DOI: 10.1016/j.oraloncology.2013.07.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/24/2013] [Accepted: 07/27/2013] [Indexed: 11/21/2022]
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27
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Yang Z, Deng R, Sun G, Huang X, Tang E. Cervical metastases from squamous cell carcinoma of hard palate and maxillary alveolus: A retrospective study of 10 years. Head Neck 2013; 36:969-75. [PMID: 23733304 DOI: 10.1002/hed.23398] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/05/2013] [Accepted: 05/23/2013] [Indexed: 12/27/2022] Open
Affiliation(s)
- Zinan Yang
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
- Department of Oral and Maxillofacial Surgery; Hospital of Stomatology, Guangzhou Medical University; Guangzhou Guangdong province People's Republic of China
| | - Runzhi Deng
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
| | - Guowen Sun
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
| | - Xiaofeng Huang
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
| | - Enyi Tang
- Department of Oral and Maxillofacial Surgery; Stomatological Hospital Affiliated Medical School; Nanjing University; Nanjing Jiangsu province People's Republic of China
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Künzel J, Psychogios G, Koch M, Mantsopoulos K, Kapsreiter M, Iro H. Results of treatment for pT1/pT2 carcinomas of the floor of mouth. Acta Otolaryngol 2013; 133:1000-5. [PMID: 23869669 DOI: 10.3109/00016489.2013.796090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONCLUSION In pT2 floor of mouth cancer (FOMC), a standardized neck dissection (ND) should be carried out, due to the high risk of occult metastases. In cases of pT1 carcinomas with a clinically negative neck using high imaging standards and expertise a tight 'wait and watch' strategy can be used. OBJECTIVE To report on the oncologic results with primary surgical treatment of pT1/pT2 FOMC and to examine the benefit of elective ND in cN0. METHODS This was a retrospective study design including 216 patients who were treated between 1980 and 2010 for pT1/2 FOMC. The 5-year disease-specific survival (DSS), local and (loco)regional control based on the T and N classification and depth of infiltration were investigated. RESULTS DSS was 79.5% and (loco)regional control was 89.8%. DSS in patients staged pN0 was significantly higher, at 84.6%, than in those staged pN+, at 60%. ND was performed in 165 patients, and adjuvant therapy was administered in 124 patients. Ninety patients (41.7%) were staged cN0, and 53.3% of them underwent elective ND. The risk of occult metastases was 4.8% in pT1 and 28.6% in pT2. A depth of infiltration of ≥ 5 mm showed a markedly higher relative frequency of occult neck metastases and pN+ status.
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Affiliation(s)
- Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg Medical School, Germany
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29
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Canis M, Ihler F, Martin A, Wolff HA, Matthias C, Steiner W. Enoral laser microsurgery for squamous cell carcinoma of the oral cavity. Head Neck 2013; 36:787-94. [DOI: 10.1002/hed.23365] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 02/20/2013] [Accepted: 04/11/2013] [Indexed: 12/16/2022] Open
Affiliation(s)
- Martin Canis
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Göttingen; Germany
| | - Friedrich Ihler
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Göttingen; Germany
| | - Alexios Martin
- Department of Audiology and Phoniatrics; University of Berlin; Germany
| | - Hendrik A. Wolff
- Department of Radiation Oncology; University of Göttingen; Germany
| | - Christoph Matthias
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Göttingen; Germany
| | - Wolfgang Steiner
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Göttingen; Germany
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30
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de Visscher SAHJ, Melchers LJ, Dijkstra PU, Karakullukcu B, Tan IB, Hopper C, Roodenburg JLN, Witjes MJH. mTHPC-mediated photodynamic therapy of early stage oral squamous cell carcinoma: a comparison to surgical treatment. Ann Surg Oncol 2013; 20:3076-82. [PMID: 23686100 DOI: 10.1245/s10434-013-3006-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Indexed: 01/25/2023]
Abstract
BACKGROUND mTHPC-mediated photodynamic therapy (PDT) is used for treatment of early head and neck squamous cell carcinoma. This study is a retrospective comparison of PDT with transoral surgery in the treatment of early primary squamous cell carcinoma of the oral cavity/oropharynx. METHODS PDT data were retrieved from four study databases; surgical results were retrieved from our institutional database. To select similar primary tumors, infiltration depth was restricted to 5 mm for the surgery group. A total of 126 T1 and 30 T2 tumors were included in the PDT group, and 58 T1 and 33 T2 tumors were included in the surgically treated group. RESULTS Complete response rates with PDT and surgery were 86 and 76% for T1, respectively, and for T2 63 and 78%. Lower local disease-free survival for PDT compared to surgery was found. However, when comparing the need for local retreatment, no significant difference for T1 tumors was found, while for T2 tumors surgery resulted in significantly less need for local retreatment. No significant differences in overall survival between surgery and PDT were observed. CONCLUSIONS PDT for T1 tumors results in a similar need for retreatment compared to surgery, while for T2 tumors PDT performs worse. Local disease-free survival for surgery is better than for PDT. This may be influenced by the benefit surgery has of having histology available. This allows an early decision on reintervention, while for PDT one has to follow a wait-and-see policy. Future prospective studies should compare efficacy as well as morbidity.
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Affiliation(s)
- Sebastiaan A H J de Visscher
- Department of Oral and Maxillofacial Surgery, Division of Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Ntomouchtsis A, Xinou K, Patrikidou A, Paraskevopoulos K, Kechagias N, Tsekos A, Balis G, Gerasimidou D, Thuau H, Mangoudi D, Vahtsevanos K. Pilot study of intraoperative digital imaging with the use of a mammograph for assessment of bone surgical margins in the head and neck region. Clin Radiol 2013; 68:e136-42. [DOI: 10.1016/j.crad.2012.10.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Revised: 10/19/2012] [Accepted: 10/31/2012] [Indexed: 10/27/2022]
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32
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Wolff KD, Follmann M, Nast A. The diagnosis and treatment of oral cavity cancer. DEUTSCHES ARZTEBLATT INTERNATIONAL 2012; 109:829-35. [PMID: 23248713 DOI: 10.3238/arztebl.2012.0829] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 10/04/2012] [Indexed: 01/17/2023]
Abstract
BACKGROUND About 10,000 persons are diagnosed as having carcinoma of the oral cavity or the throat in Germany every year. Squamous-cell carcinoma accounts for 95% of cases. METHODS We systematically reviewed the pertinent literature on predefined key questions about these tumors (which were agreed upon by a consensus of the investigators), concerning imaging, the removal of cervical lymph nodes, and resection of the primary tumor. RESULTS 246 clinical trials were selected for review on the basis of 3014 abstracts. There was only one randomized, controlled trial (evidence level 1-); the remaining trials reached evidence levels 2++ to 3. Patients with mucosal changes of an unclear nature persisting for more than two weeks should be examined by a specialist without delay. The diagnosis is made by computed tomography or magnetic resonance imaging along with biopsy and a standardized histopathological examination. Occult metastases are present in 20% to 40% of cases. Advanced disease (stages T3 and T4) should be treated by surgery followed by radiotherapy, with or without chemotherapy. 20% of the patients overall go on to have a recurrence, usually within 2 to 3 years of the initial treatment. The 5-year survival rate is somewhat above 50%. Depending on the radicality of surgery and radiotherapy, there may be functional deficits, osteoradionecrosis, and xerostomia. The rate of loss of implants in irradiated bone is about 10% in 3 years. CONCLUSION The interdisciplinary planning and implementation of treatment, based on the patient's individual constellation of findings and personal wishes, are prerequisites for therapeutic success. Reconstructive measures, particularly microsurgical ones, have proven their usefulness and are an established component of surgical treatment.
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Affiliation(s)
- Klaus-Dietrich Wolff
- Clinic and Policlinic for Oro-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, München, Germany.
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de Visscher SAHJ, Dijkstra PU, Tan IB, Roodenburg JLN, Witjes MJH. mTHPC mediated photodynamic therapy (PDT) of squamous cell carcinoma in the head and neck: a systematic review. Oral Oncol 2012; 49:192-210. [PMID: 23068024 DOI: 10.1016/j.oraloncology.2012.09.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 09/17/2012] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Photodynamic therapy (PDT) is used in curative and palliative treatment of head and neck squamous cell carcinoma (HNSCC). To evaluate available evidence on the use of mTHPC (Foscan®) mediated PDT, we conducted a review of the literature. MATERIALS AND METHODS A systematic review was performed by searching seven bibliographic databases on database specific mesh terms and free text words in the categories; "head and neck neoplasms", "Photodynamic Therapy" and "Foscan". Papers identified were assessed on several criteria by two independent reviewers. RESULTS The search identified 566 unique papers. Twelve studies were included for our review. Six studies reported PDT with curative intent and six studies reported PDT with palliative intent, of which three studies used interstitial PDT. The studies did not compare PDT to other treatments and none exceeded level 3 using the Oxford levels of evidence. Pooling of data (n=301) was possible for four of the six studies with curative intent. T1 tumors showed higher complete response rates compared to T2 (86% vs 63%). PDT with palliative intent was predominantly used in patients unsuitable for further conventional treatment. After PDT, substantial tumor response and increase in quality of life was observed. Complications of PDT were mostly related to non-compliance to light restriction guidelines. CONCLUSION The studies on mTHPC mediated PDT for HNSCC are not sufficient for adequate assessment of the efficacy for curative intent. To assess efficacy of PDT with curative intent, high quality comparative, randomized studies are needed. Palliative treatment with PDT seems to increase the quality of life in otherwise untreatable patients.
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Affiliation(s)
- S A H J de Visscher
- Department of Oral and Maxillofacial Surgery, Division of Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
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Abstract
Ablative surgery for malignancies of the upper aerodigestive tract is the most common reason why the reconstructive surgeon is called upon to reconstruct adult head and neck defects. An understanding of the pathophysiology and treatment of head and neck malignancy is vital to the reconstructive surgeon so that restoration of both form and function can be achieved. It is important to understand the behavior of cancers of each head and neck subsite, as staging and ultimately the treatment of tumors from each subsite is different. Historically, the standard treatment of head and neck cancer was surgery and/or primary radiation therapy with surgical salvage for failure. Beginning in the 1980s, advances in chemotherapy and concurrent delivery with radiation offered new options to standard surgical therapy. Over the past two decades, the concept of organ preservation using chemotherapy together with radiation therapy has been definitively established. Yet, even with the strides made over these two decades with chemoradiation, surgical treatment of head and neck cancer and reconstruction thereof will be an important treatment option for the foreseeable future. Therefore, the relationship between the extirpative and reconstructive surgeon is vital, and a clear understanding of the biology and behavior of head and neck malignancy is crucial to successful patient outcomes.
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A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer. Eur Arch Otorhinolaryngol 2012; 270:1093-7. [PMID: 22773192 PMCID: PMC3580137 DOI: 10.1007/s00405-012-2104-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 06/21/2012] [Indexed: 11/05/2022]
Abstract
Photodynamic therapy (PDT) of early stage oral cavity tumors have been thoroughly reported. However, statistical comparison of PDT to the surgical treatment is not available in published literature. We have identified and matched cohorts of patients with early stage oral cavity cancers undergoing surgery (n = 43) and PDT (n = 55) from a single institute experience. The groups are matched demographically and had the same pre-treatment screening and follow-up schedule. Both groups consisted only of tumors thinner than 5 mm to ensure comparability. The endpoints were local disease free survival, disease free survival, overall survival and response to initial treatment. Local disease free survival at 5 years were 67 and 74 % for PDT and surgery groups, respectively [univariate HR = 1.9 (p = 0.26), multivariable HR = 2.7 (p = 0.13)]. Disease free survival at 5 years are 47 and 53 % for PDT and surgery groups, respectively [univariate HR = 0.8 (p = 0.52), multivariable HR = 0.75 (p = 0.45)]. Overall survival was 83 and 75 % for PDT and surgery groups, respectively [(univariate HR = 0.5 (p = 0.19), multivariable HR = 0.5 (p = 0.17)]. In the PDT group, six patients (11 %) and in the surgery group 11 patients (26 %) had to receive additional treatments after the initial. All of the tested parameters did not have statistical significant difference. Although there is probably a selection bias due to the non-randomized design, this study shows that PDT of early stage oral cavity cancer is comparable in terms of disease control and survival to trans-oral resection and can be offered as an alternative to surgical treatment.
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Hwang YS, Zhang X, Park KK, Chung WY. An orthotopic and osteolytic model with a newly established oral squamous cell carcinoma cell line. Arch Oral Biol 2012; 58:218-25. [PMID: 22621906 DOI: 10.1016/j.archoralbio.2012.04.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 04/19/2012] [Accepted: 04/30/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Despite the availability of advanced clinical diagnostic systems, the overall 5-year survival rate for patients with oral squamous cell carcinoma (OSCC) has remained relatively poor over the past 2 decades. Appropriate animal models need to be developed according to the specific purpose of cancer research. However, most of the currently available oral cancer cell lines do not precisely reflect the characteristics of bone-invasive OSCC and cannot serve as suitable tools in the development of new therapeutic reagents against bone-invasive OSCC. Here, we assessed the orthotopic and osteolytic mouse model with newly established OSCC cell line. DESIGN We assessed the orthotopic and osteolytic mouse model using the newly established OSCC cells. In addition, the incidences of tumorigenesis and histopathological results were determined. RESULTS The newly established YD-39 cell line grows in a monolayer sheet and has highly invasive. The transplanted YD-39 cells developed stable tumours in the tongues and calvaria region of the nude mice. The tumours in nude mice grafted with YD-39 cells had a high incidence of transplantability in both mouse models tested and a similar morphology to their respective original tumour. Therefore, both animal models might be feasible animal models to assess the efficacy of anti-cancer drugs. CONCLUSIONS This type of animal model approach might be has the added advantage of potentially accelerating the biological discovery process.
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Affiliation(s)
- Young Sun Hwang
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Graduate School, Yonsei University, 134, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea.
| | - Xianglan Zhang
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Graduate School, Yonsei University, 134, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea; Department of Pathology, Yanbian University Hospital, Yanji City, Jilin Province, China
| | - Kwang-Kyun Park
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Graduate School, Yonsei University, 134, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea; Department of Oral Biology, Graduate School, Yonsei University, 134, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea; The Applied Life Sciences, Graduate School, Yonsei University, 134, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea
| | - Won-Yoon Chung
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Graduate School, Yonsei University, 134, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea; Department of Oral Biology, Graduate School, Yonsei University, 134, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea; The Applied Life Sciences, Graduate School, Yonsei University, 134, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea.
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Shin M, Matsuo K, Tada T, Fukushima H, Furuta H, Ozeki S, Kadowaki T, Yamamoto K, Okamoto M, Jimi E. The inhibition of RANKL/RANK signaling by osteoprotegerin suppresses bone invasion by oral squamous cell carcinoma cells. Carcinogenesis 2011; 32:1634-40. [PMID: 21890459 DOI: 10.1093/carcin/bgr198] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Oral squamous cell carcinomas (OSCCs) are malignant tumors that frequently invade the maxilla and mandibular bone. However, the molecular mechanisms underlying bone invasion by OSCC are unclear. Recent studies showed that receptor activator of nuclear factor κB (RANK) was expressed not only in osteoclast precursors but also in tumor cells. Therefore, we examined whether RANK ligand (RANKL)/RANK signaling regulates bone invasion by OSCC cells in vivo and in vitro. We first injected human OSCC B88 cells into the masseter region of nude mice. Mice were treated for 3 weeks with osteoprotegerin (OPG), the decoy receptor for RANKL. Treatment with OPG decreased bone invasion by B88 cells, reduced the number of osteoclasts and increased B88 cell apoptosis. However, OPG did not affect apoptosis and proliferation in B88 cells in vitro, suggesting that the effects of OPG on apoptosis in B88 cells are restricted in a bone environment. RANK was expressed in the B88 cells and in OSCC cells from patients. RANKL induced NF-κB activation and extracellular signal-regulated kinase phosphorylation in B88 cells and enhanced B88 cell migration in a modified chemotaxis chamber equipped with a gelatin-coated filter. OPG inhibited RANKL-induced NF-κB activation, extracellular signal-regulated kinase phosphorylation and cell migration. Our data clearly indicate that RANKL/RANK inhibition suppresses bone invasion by inhibiting osteoclastogenesis and cancer cell migration and by inducing apoptosis of cancer cells via indirect anticancer action in vivo.
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Affiliation(s)
- Masashi Shin
- Department of Biosciences, Kyushu Dental College, Kitakyushu, Fukuoka 803-8580, Japan
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Watanabe A, Taniguchi M, Tsujie H, Hosokawa M, Fujita M, Sasaki S. Clinical impact of iodine staining for diagnosis of carcinoma in situ in the floor of mouth, and decision of adequate surgical margin. Auris Nasus Larynx 2011; 39:193-7. [PMID: 21885222 DOI: 10.1016/j.anl.2011.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 07/28/2011] [Accepted: 08/03/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The use of iodine staining has been recommended for the early detection of squamous cell carcinoma (SCC) in the upper aerodigestive tract. The purpose was to verify the effectiveness of iodine staining in detecting early squamous cell carcinoma in the floor of mouth. METHODS Between 1995 and 2005, otolaryngological examinations including the floor of mouth were performed for 2278 esophageal cancer patients as a screening program of high-risk patient group. Iodine staining was applied to a lightly reddish and/or white patch, and/or uneven lesions in the floor of the mouth. Forceps biopsy was performed for demarcated unstained or lightly stained lesions. Three patients with the tumors in the floor of mouth, which were diagnosed as more over T2 level just by visual examination, were excluded from this study. If SCC was found in the specimen, mucosal resection was performed with a safety margin of 2mm from the unstained or lightly stained lesion. The incidence, rate of carcinoma in situ, and prognosis of cancer of the floor of mouth (CFOM) were assessed. RESULTS Iodine staining was performed for 72 of 2278 patients (3.2%) according to the presence of suspicious reddish and/or whitish and/or uneven lesions. Of these, unstained or lightly stained areas after iodine staining were recognized in 47 patients and SCC was revealed in 28 of 47 patients. The diagnosis of other 19 patients included inflammatory mucosa (n=11), low grade dysplasia (n=6), and hyperkeratosis (n=2). Sensitivity and specificity of iodine staining for detecting SCC were 100% and 59.6%, respectively. Pathological diagnosis of the 28 patients included squamous cell carcinoma in situ (n=12), microinvasive squamous cell carcinoma (n=15) disease, and focal invasive squamous cell cancer (n=1). Twenty-four of 28 patients were treated with mucosal resection without mandible resection. The other 4 patients did not receive the treatment of CFOM due to concomitant far advanced esophageal cancer. In 24 patients undergoing mucosal resection, no patients developed local recurrence or metastasis to the cervical lymph nodes during an average of 74.2 months of follow-up period (from 7 to 156 months). The 5-year cause-specific survival of these patients was 100%. CONCLUSION The use of iodine staining as a part of otolaryngological examinations may be beneficial for the early detection of CFOM, including carcinoma in situ and micro-invasive SCC. Moreover, it would be very useful to determine an adequate surgical margin for locally mucosal resection.
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Affiliation(s)
- Akihito Watanabe
- Department of Otolaryngology, Keiyukai Sapporo Hospital, Sapporo, Japan.
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Ogawa T, Matsuura K, Shiga K, Tateda M, Katagiri K, Kato K, Saijo S, Kobayashi T. Surgical treatment is recommended for advanced oral squamous cell carcinoma. TOHOKU J EXP MED 2011; 223:17-25. [PMID: 21187696 DOI: 10.1620/tjem.223.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Oral squamous cell carcinoma is one of the most frequent types of head and neck cancers in Japan. Although recent reports have shown positive results of non-surgical treatment for advanced head and neck squamous cell carcinoma, including tongue cancer, no clear treatment strategies have been established for oral cancers, except for tongue cancer. To assess appropriate therapies, we conducted a retrospective chart review of 114 Japanese patients with oral cancers that were pathologically diagnosed as squamous cell carcinoma, excluding tongue cancers. The overall and the disease specific 5-year survival rates were 53% and 61%, respectively. Univariate and multivariate analyses revealed a lower stage (I, II, or III) and non-surgical treatment as good and poor prognostic factors of oral squamous cell carcinoma, respectively, based on their hazard ratios of 0.17 (95% CI 0.045-0.60, p = 0.0061) and 5.3 (95% CI 2.7-11, p < 0.0001). Furthermore, impact of surgery was well documented in the operable stage IVa cancers (p = 0.00015). The surgical treatment consisted of the wide resection of the primary tumor and the neck dissection for stage III or IV tumors. The present data also suggest that adjunctive therapy, such as post-operative radiation therapy or post-operative chemo-radiation therapy, shows no survival benefit compared to the surgery alone. We therefore recommend the surgical treatment for advanced oral squamous cell carcinoma in Japanese patients. These results would be helpful in future clinical trials, especially in non-surgical treatment studies of oral squamous cell carcinoma in Japan.
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Affiliation(s)
- Takenori Ogawa
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan.
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Montes DM, Carlson ER, Fernandes R, Ghali GE, Lubek J, Ord R, Bell B, Dierks E, Schmidt BL. Oral maxillary squamous carcinoma: An indication for neck dissection in the clinically negative neck. Head Neck 2010; 33:1581-5. [DOI: 10.1002/hed.21631] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 08/13/2010] [Accepted: 09/06/2010] [Indexed: 11/07/2022] Open
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Kobayashi K, Tanaka Y, Horiguchi S, Yamamoto S, Toshinori N, Sugimoto A, Okamoto Y. The effect of radiotherapy on NKT cells in patients with advanced head and neck cancer. Cancer Immunol Immunother 2010; 59:1503-9. [PMID: 20582589 PMCID: PMC11030092 DOI: 10.1007/s00262-010-0877-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Accepted: 06/03/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cancer immunotherapy with NKT cells is a potential new treatment strategy for advanced head and neck cancer. NKT cell therapy is promising due to its unique anti-tumor activity and higher degree of safety compared to current therapies. Radiotherapy is indispensable as a standard treatment for advanced head and neck cancer. To elucidate the possibility of using NKT cells as an adjuvant immunotherapy with radiotherapy, we examined the effect of radiotherapy on NKT cells in patients with head and neck cancer. METHODS The number, IFN-gamma production and proliferation capacity of NKT cells were analyzed before and after 50 Gy radiation therapy in 12 patients with stage IV head and neck squamous cell carcinoma. The cytotoxic activity of NKT cells was examined in vitro. RESULTS The number of NKT cells in the blood varied widely between patients. After radiation therapy, the population of CD3 T cells decreased significantly, while the NKT cell population remained stable. The number of NKT cells was the same after radiation therapy as before. IFN-gamma production from NKT cells collected just after radiotherapy was impaired after stimulation with exogenous ligand, but the proliferative responses of these NKT cells was enhanced in comparison to those collected before radiation therapy. Furthermore, the proliferated NKT cells displayed a significant level of anti-tumor activity. CONCLUSION NKT cells are relatively resistant to radiation and might therefore be suitable for adjuvant immunotherapy to eradicate remnant cancer cells in patients who have undergone radiation therapy.
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Affiliation(s)
- Kouichi Kobayashi
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Yuriko Tanaka
- Graduate School of Medicine, Toho University, Tokyo, Japan
| | - Shigetoshi Horiguchi
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Shouji Yamamoto
- Department of Radiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nakayama Toshinori
- Department of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akira Sugimoto
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
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Sklenicka S, Gardiner S, Dierks EJ, Potter BE, Bell RB. Survival Analysis and Risk Factors for Recurrence in Oral Squamous Cell Carcinoma: Does Surgical Salvage Affect Outcome? J Oral Maxillofac Surg 2010; 68:1270-5. [DOI: 10.1016/j.joms.2009.11.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 11/18/2009] [Accepted: 11/18/2009] [Indexed: 10/19/2022]
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Langendijk JA, Ferlito A, Takes RP, Rodrigo JP, Suárez C, Strojan P, Haigentz M, Rinaldo A. Postoperative strategies after primary surgery for squamous cell carcinoma of the head and neck. Oral Oncol 2010; 46:577-85. [PMID: 20400361 DOI: 10.1016/j.oraloncology.2010.03.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 03/29/2010] [Accepted: 03/29/2010] [Indexed: 11/20/2022]
Abstract
This review discusses the role of adjuvant treatment after curative surgery for patients with head and neck squamous cell carcinoma (HNSCC). In general, patients with unfavourable prognostic factors have a high-risk of loco-regional recurrence and subsequent worse survival after surgery alone and are therefore considered proper candidates for adjuvant treatment by either postoperative radiotherapy alone or postoperative chemoradiation. Selection of the most optimal adjuvant treatment strategy should be based on the most important prognostic factors. In this review, the different treatment strategies will be discussed in general. More specifically, we will discuss the role of the interval between surgery and radiotherapy, the overall treatment time of radiation, the selection of target volumes for radiation and the value of adding concomitant chemotherapy to postoperative radiation.
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Affiliation(s)
- Johannes A Langendijk
- Department of Radiation Oncology, University Medical Center Groningen/University of Groningen, Groningen, The Netherlands.
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Contemporary management of cancer of the oral cavity. Eur Arch Otorhinolaryngol 2010; 267:1001-17. [PMID: 20155361 PMCID: PMC2874025 DOI: 10.1007/s00405-010-1206-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Accepted: 01/12/2010] [Indexed: 12/19/2022]
Abstract
Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction have evolved significantly. Because of the profound functional and cosmetic importance of the oral cavity, management of oral cavity cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction. The purpose of this review is to discuss the most current management options for oral cavity cancers.
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Survival Analysis and Risk Factors for Recurrence in Oral Squamous Cell Carcinoma: Does Surgical Salvage Affect Outcome? J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.joms.2009.05.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tada T, Shin M, Fukushima H, Okabe K, Ozeki S, Okamoto M, Jimi E. Oral squamous cell carcinoma cells modulate osteoclast function by RANKL-dependent and -independent mechanisms. Cancer Lett 2009; 274:126-31. [DOI: 10.1016/j.canlet.2008.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Revised: 08/06/2008] [Accepted: 09/03/2008] [Indexed: 11/29/2022]
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Lim YC, Choi EC. Surgery alone for squamous cell carcinoma of the oral cavity: survival rates, recurrence patterns, and salvage treatment. Acta Otolaryngol 2008; 128:1132-7. [PMID: 18607922 DOI: 10.1080/00016480801901691] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION Surgery alone may be a reliable and feasible treatment of choice in selected patients with squamous cell carcinoma (SCC) of the oral cavity, given the proper indications. OBJECTIVE To evaluate the results of treatment of oral cavity SCC patients with surgery alone in a single institution. PATIENTS AND METHODS Between 1992 and 2004, 76 patients with previously untreated SCC of the oral cavity who had surgery alone without any other adjuvant treatment modalities were included in our study. RESULTS The 5-year overall rate, disease-specific survival rates, and locoregional control rate of all 76 patients were 69%, 83%, and 73%, respectively. A total of 16 patients (21%) presented with recurrences (8 with regional recurrences, 5 with local, 2 with locoregional, and 1 with distant metastasis). Four (6%) of the patients with primary T1 or T2 stage and one (50%) of those with T4 stage had recurrence at the primary site. The regional recurrence rate of patients with < or = N1 and > or = N2b was 10% (6 of 59) and 67% (2 of 3), respectively. Three of four patients who had recurrence at the primary site and attempted salvage treatment have been cured. However, only one of five patients with nodal recurrence and salvage treatment has recovered.
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Shi Z, Stack MS. Urinary-type plasminogen activator (uPA) and its receptor (uPAR) in squamous cell carcinoma of the oral cavity. Biochem J 2008; 407:153-9. [PMID: 17880283 DOI: 10.1042/bj20071037] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OSCC (oral squamous cell carcinoma) is the most common oral malignancy and is estimated to affect approx. 350000 new patients worldwide this year. OSCC is characterized by a high degree of morbidity and mortality, as most patients exhibit local, regional and distant metastasis at the time of diagnosis. Recent genome-wide screening efforts have identified the serine proteinase uPA (urinary-type plasminogen activator, also known as urokinase) as a strong biomarker for prediction of poor disease outcome and a key candidate for molecular classification of oral neoplasms using a 'gene signature' approach. The proteinase uPA binds a surface-anchored receptor designated uPAR (uPA receptor), focalizing proteolytic activity to the pericellular milieu. Furthermore, uPA-uPAR can interact with transmembrane proteins to modify multiple signal transduction pathways and influence a wide variety of cellular behaviours. Correlative clinical data show elevated uPA-uPAR in oral tumour tissues, with tumours exhibiting high levels of both uPA and uPAR as the most invasive. Combined in vitro, pre-clinical and clinical data support the need for further analysis of uPA-uPAR as a prognostic indicator as well as a potential therapeutic target in OSCC.
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Affiliation(s)
- Zonggao Shi
- Department of Pathology and Anatomical Sciences, M214E Medical Sciences Building, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, USA
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Liao CT, Chang JTC, Wang HM, Ng SH, Hsueh C, Lee LY, Lin CH, Chen IH, Huang SF, Cheng AJ, Yen TC. Analysis of risk factors of predictive local tumor control in oral cavity cancer. Ann Surg Oncol 2008; 15:915-22. [PMID: 18165878 DOI: 10.1245/s10434-007-9761-5] [Citation(s) in RCA: 215] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2007] [Accepted: 11/25/2007] [Indexed: 11/18/2022]
Abstract
BACKGROUND Survival in oral cavity squamous cell carcinoma (OSCC) depends heavily on locoregional control. In this study, we sought to determine the independent prognosticators for local tumor control, disease-specific survival (DSS), and overall survival (OS) rates in a series of OSCC patients undergoing radical surgery. METHODS We retrospectively reviewed 827 consecutive OSCC patients undergoing radical surgery from January 1998 to March 2005. Postoperative radiotherapy was performed in patients with pT4 tumors, positive lymph node(s), or close margins (< or = 4 mm). Local control rates and survivals were plotted using the Kaplan-Meier method. RESULTS On multivariate analysis (MVA), unfavorable prognostic factors for local control were pathological margins < or = 7 mm (P < 0.001), pathological tumor depth > or = 10 mm (P < 0.001), pathological positive lymph node(s) (P = 0.001), and the presence of betel quid chewing (P = 0.012). The same predictors, with the exception of betel quid chewing and pathological positive lymph node(s), were independently associated with DSS and OS in MVA. A prognostic scoring system was formulated by summing up the four significant local control covariates from MVA. Patients with scores of 3-4 had a significantly poorer local control rate compared to patients with scores of 0-2 (score 3 versus score 0-2: P < 0.001; score 4 versus score 0-2: P < 0.001) CONCLUSIONS Taken together, our data suggest that pathological margins and pathological tumor depth are major independent prognosticators not only for local tumor control, but also for DSS and OS.
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Affiliation(s)
- Chun-Ta Liao
- Department of Otorhinolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
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Arosarena OA, Madsen M, Haug R. Special considerations with floor of mouth and tongue cancer. Oral Maxillofac Surg Clin North Am 2007; 18:521-31. [PMID: 18088850 DOI: 10.1016/j.coms.2006.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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