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Eltohami YI, Sulaiman AM. Recurrence in Oral Squamous Cell Carcinoma Associated with Wide Field of Cancerization: Analysis of 93 Cases. Indian J Otolaryngol Head Neck Surg 2023; 75:1329-1335. [PMID: 37636723 PMCID: PMC10447784 DOI: 10.1007/s12070-023-03548-0] [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: 12/09/2022] [Accepted: 01/30/2023] [Indexed: 02/15/2023] Open
Abstract
Background The late presentation of oral squamous cell carcinoma (OSCC) patients in the Sudan, with advanced stages and wide field of cancerization, have a negative impact on both the morbidity and the mortality of these patients. The present study aimed to investigate the clinicopathological behavior of OSCC and predictors of development of recurrence in these patients. Methods This a prospective longitudinal study of 93 OSCC patients surgically treated at Khartoum Teaching Dental Hospital. Tumor's associated field of cancerization was identified. The patients were followed clinically on regular basis, for a year, for the development of recurrence. Results Out of the 93 patients, 57 (61.3%) were males and 36 (38.7%) were females. 82% of the patients presented with stage IV tumors, and 58 (62.4%) of the cases had nodal metastasis. Twenty-eight (30%) patients developed recurrence. Of them 17 (18.3%) had regional recurrence, eight (8.6%) had local recurrence and three (3.2%) had locoregional recurrence. Multivariate cox regression analysis showed that Toombak dipping (P.value = 0.001), tumor staging (P.value = 0.039) and presence of mucosal filed changes (P.value = 0.001) were independent predictors for local recurrence and positive pathological lymph nodes (P.value = 0.00) and extranodal extension (P.value = 0.040) were independent predictors for regional recurrence. Conclusion The present study showed that OSCC patients in the Sudan present with advanced lesions, mostly associated with wide field of cancerization particularly Toombak dippers. Overall recurrences were identified in 30% of the cases, regional recurrence was the commonest type followed by local recurrence.
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Onega T, Alford-Teaster J, Leggett C, Loehrer A, Weiss JE, Moen EL, Pollack CC, Wang F. The interaction of rurality and rare cancers for travel time to cancer care. J Rural Health 2023; 39:426-433. [PMID: 35821496 PMCID: PMC10801702 DOI: 10.1111/jrh.12693] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Geographic access to cancer care is known to significantly impact utilization and outcomes. Longer travel times have negative impacts for patients requiring highly specialized care, such as for rare cancers, and for those in rural areas. Scant population-based research informs geographic access to care for rare cancers and whether rurality impacts that access. METHODS Using Medicare data (2014-2015), we identified prevalent cancers and cancer-directed surgeries, chemotherapy, and radiation. We classified cancers as rare (incidence <6/100,000/year) or common (incidence ≥6/100,000/year) using previously published thresholds and categorized rurality from ZIP code of beneficiary residence. We estimated travel time between beneficiaries and providers for each service based on ZIP code. Descriptive statistics summarized travel time by rare versus common cancers, service type, and rurality. FINDINGS We included 1,169,761 Medicare beneficiaries (21.9% in nonmetropolitan areas), 87,399; 7.5% had rare cancers, with 9,133,003 cancer-directed services. Travel times for cancer services ranged from approximately 29 minutes (25th percentile) to 68 minutes (75th percentile). Travel times were similar for rare and common cancers overall (median: 45 vs 43 minutes) but differed by service type; 13.4% of surgeries were >2 hours away for rare cancers, compared to 8.3% for common cancers. Increasing rurality disproportionately increased travel time to surgical care for rare compared to common cancers. CONCLUSIONS Travel times to cancer services are longest for surgery, especially among rural residents, yet not markedly longer overall between rare versus common cancers. Understanding geographic access to cancer care for patients with rare cancers is important to delivering specialized care.
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Affiliation(s)
- Tracy Onega
- Department of Population Health Sciences and Huntsman Cancer Institute; University of Utah, Salt Lake City, UT
| | - Jennifer Alford-Teaster
- Norris Cotton Cancer Center at Dartmouth, Lebanon, NH; Geisel School of Medicine at Dartmouth, Lebanon, NH
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
| | - Chris Leggett
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
| | - Andrew Loehrer
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
- Department of Surgery, Dartmouth-Hitchcock
| | - Julie E. Weiss
- Norris Cotton Cancer Center at Dartmouth, Lebanon, NH; Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Erika L. Moen
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Catherine C. Pollack
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Fahui Wang
- Graduate School and Department of Geography & Anthropology, Louisiana State University, Baton Rouge, LA
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de Heus E, Engelen V, Dingemans I, Richel C, Schrieks M, van der Zwan JM, Besselink MG, van Berge Henegouwen MI, van Herpen CML, Duijts SFA. Differences in health care experiences between rare cancer and common cancer patients: results from a national cross-sectional survey. Orphanet J Rare Dis 2021; 16:249. [PMID: 34074302 PMCID: PMC8170927 DOI: 10.1186/s13023-021-01886-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/21/2021] [Indexed: 11/15/2022] Open
Abstract
Background Patients with rare cancers face challenges in the diagnostic and treatment phase, and in access to clinical expertise. Since studies on health care experiences of these patients in comparison to patients with more common cancers are scarce, we aimed to explore these differences. Methods Data were cross-sectionally collected among (former) adult cancer patients through a national online survey in the Netherlands (October 2019). Descriptive statistics were reported and subgroups (rare vs. common patients) were compared. Results In total, 7343 patients (i.e., 1856 rare and 5487 common cancer patients) participated. Rare cancer patients were more often diagnosed and treated in different hospitals compared to common cancer patients (67% vs. 59%, p < 0.001). Rare cancer patients received treatment more often in a single hospital (60% vs. 57%, p = 0.014), but reported more negative experiences when treated in multiple hospitals than common cancer patients (14% vs. 9%, p < 0.001). They also more often received advise from their physician about the hospital to go to for a second opinion (50% vs. 36%, p < 0.001), were more likely to choose a hospital specialized in their cancer type (33% vs. 22%, p < 0.001), and were more willing to travel as long as necessary to receive specialized care than common cancer patients (55% vs. 47%, p < 0.001). Conclusions Rare and common cancer patients differ in their health care experiences. Health care for rare cancer patients can be further improved by proper referral to centers of expertise and building a clinical network specifically for rare cancers. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01886-2.
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Affiliation(s)
- Eline de Heus
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands. .,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Vivian Engelen
- Dutch Federation of Cancer Patients Organisations (Nederlandse Federatie Van Kankerpatiëntenorganisaties, NFK), Utrecht, The Netherlands
| | - Irene Dingemans
- Dutch Federation of Cancer Patients Organisations (Nederlandse Federatie Van Kankerpatiëntenorganisaties, NFK), Utrecht, The Netherlands
| | - Carol Richel
- Dutch Breast Cancer Association (Borstkankervereniging Nederland, BVN), Utrecht, The Netherlands
| | - Marga Schrieks
- Dutch Federation of Cancer Patients Organisations (Nederlandse Federatie Van Kankerpatiëntenorganisaties, NFK), Utrecht, The Netherlands
| | - Jan Maarten van der Zwan
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands
| | - Marc G Besselink
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mark I van Berge Henegouwen
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Carla M L van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Bisschop JAS, Kloosterman FR, van Leijen-Zeelenberg JE, Huismans GW, Kremer B, Kross KW. Experiences and preferences of patients visiting a head and neck oncology outpatient clinic: a qualitative study. Eur Arch Otorhinolaryngol 2017; 274:2245-2252. [PMID: 28132135 PMCID: PMC5383674 DOI: 10.1007/s00405-017-4453-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/04/2017] [Indexed: 10/30/2022]
Abstract
The objective of this study is to report on an in-depth evaluation of patient experiences and preferences at a Head and Neck Oncology outpatient clinic. A qualitative research design was used to determine the experiences and preferences of Head and Neck Cancer patients in an Oncology Outpatient Clinic, Maastricht University Medical Center, The Netherlands. Head and Neck Cancer Patients, treated for at least 6 months at the Oncology Clinic, were included. A qualitative research design with patient interviews was used. All interviews were recorded and transcribed verbatim to increase validity. Analysis was done with use of the template approach and qualitative data analysis software. Three of the six dimensions predominated in the interview: (1) respect for patients' values, preferences and expressed need, (2) information, communication and education and (3) involvement of family and friends. The dimensions physical comfort; emotional support; coordination and integration of care were considered to be of less significance. The findings from this study resulted in a deeper understanding of patients' experiences and preferences and can be useful in the transition towards a more patient-centered approach of health care.
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Affiliation(s)
- Jeroen A S Bisschop
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Fabienne R Kloosterman
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Geert Willem Huismans
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bernd Kremer
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kenneth W Kross
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
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Cutilli T, Leocata P, Dolo V, Altobelli E. p53 as a prognostic marker associated with the risk of mortality for oral squamous cell carcinoma. Oncol Lett 2016; 12:1046-1050. [PMID: 27446392 DOI: 10.3892/ol.2016.4742] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 04/22/2016] [Indexed: 11/05/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is often associated with a poor prognosis. The purpose of the present study was to investigate survival and the risk of mortality in OSCC with regard to stage, tumor site and p53 expression. A retrospective study was performed on 150 non-consecutive cases of OSCC that were observed between January 1992 and January 2012, and were selected from a total of 580 patients according to the criteria of the homogeneity of histopathological grading (G2). The medical records were reviewed for 48 cases with disease at stage I [37 males, age 64.7±5.7 years (mean age±standard deviation); 11 females, age 70.0±3.37 years]; 27 cases with stage II (15 males, age 64.5±5.6 years; 12 females, age 69.2±3.9 years); 58 cases with stage IVa (42 males, age 66.9±5.3 years; 16 females, age 64.2±6.5 years); and 17 cases with stage IVb (16 males, age 65.7±5.4 years; 1 female, age 69 years). Monoclonal p53 antibody (clone DO-7) was used to perform the p53 immunohistochemical study. A significant association was found between the site of the tumor and p53 overexpression (P<0.0001). Stage I-II cases showed a higher cumulative probability of a 24-month survival time than stage IVa-IVb cases (P<0.0001). Cheek, floor and soft palate tumors showed a worse prognosis (P<0.0001) and tumors with p53 overexpression >50% showed a poor survival rate (P<0.0001) compared with tumors of the attached gingiva, tongue and retromolar trigone. The findings allowed the quantification of the risk mortality from OSSC with regard to stage, tumor site and the p53 expression pattern of the tumor. Data supported the absolute indications for wide surgical margins (radical surgery) in cases of T1-T2 N0 tumors of the tongue, floor, retromolar trigone and attached gingiva when p53 overexpression is >50% in association with a higher risk of mortality compared with when p53 overexpression is <50%.
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Affiliation(s)
- Tommaso Cutilli
- Department of Life, Health and Environmental Sciences, Maxillofacial Surgery Unit, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Pietro Leocata
- Department of Life, Health and Environmental Sciences, Pathological Anatomy Unit, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Vincenza Dolo
- Department of Life, Health and Environmental Sciences, Clinical Pathology Unit, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Emma Altobelli
- Department of Life, Health and Environmental Sciences, Medical Statistics and Epidemiology Unit, University of L'Aquila, I-67100 L'Aquila, Italy
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Kaing L, Manchella S, Love C, Nastri A, Wiesenfeld D. Referral patterns for oral squamous cell carcinoma in Australia: 20 years progress. Aust Dent J 2016; 61:29-34. [DOI: 10.1111/adj.12314] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2015] [Indexed: 12/15/2022]
Affiliation(s)
- L Kaing
- The Royal Melbourne Hospital; Melbourne Victoria Australia
| | - S Manchella
- The Royal Melbourne Hospital; Melbourne Victoria Australia
| | - C Love
- The Royal Melbourne Hospital; Melbourne Victoria Australia
| | - A Nastri
- The Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Surgery and Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - D Wiesenfeld
- The Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Surgery and Melbourne Dental School; The University of Melbourne; Victoria Australia
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SOUSA MICHELECARDOSO, ALVES MONICAGHISLAINEOLIVEIRA, SOUZA LUCIANOALBINO, BRANDÃO ADRIANAAIGOTTIHABERBECK, ALMEIDA JANETEDIAS, CABRAL LUIZANTONIOGUIMARÃES. Correlation of clinical, cytological and histological findings in oral squamous cell carcinomas. Oncol Lett 2014; 8:799-802. [PMID: 25013502 PMCID: PMC4081384 DOI: 10.3892/ol.2014.2212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 04/24/2014] [Indexed: 11/23/2022] Open
Abstract
The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, which were then submitted to modal expression analysis, which considers the higher frequency scores, thus relating the variables. The cytological findings demonstrated that the majority of the cases had malignant potential. Exfoliative cytology should be used as a supplementary tool for the diagnosis of OSCC, as it enables the early detection of these lesions. However, cytology should not be used as a substitute for histopathological examination.
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Affiliation(s)
- MICHELE CARDOSO SOUSA
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - MONICA GHISLAINE OLIVEIRA ALVES
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - LUCIANO ALBINO SOUZA
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - ADRIANA AIGOTTI HABERBECK BRANDÃO
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - JANETE DIAS ALMEIDA
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - LUIZ ANTONIO GUIMARÃES CABRAL
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
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8
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Väisänen JA, Syrjälä AMH, Pesonen PRO, Pukkila MJ, Koivunen PT, Alho OP. Characteristics and medical-care-seeking of head and neck cancer patients: a population-based cross-sectional survey. Oral Oncol 2014; 50:740-5. [PMID: 24856187 DOI: 10.1016/j.oraloncology.2014.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 04/25/2014] [Accepted: 04/27/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Well-known risk factors, such as smoking and alcohol consumption, easily denounce head and neck cancer patients as smokers, alcohol abusers, and persons who are socially excluded and have low socioeconomic status. To diagnose these patients as early as possible, we should not have a prejudiced assumption of their characteristics. MATERIALS AND METHODS We collected detailed data on patient characteristics and health behavior and explored whether these traits had any effect on seeking medical advice in a population-based cross-sectional study involving 85 patients with head and neck cancer diagnosed between January 2003 and December 2007, residing in two health care districts (population 1,600,000) in Finland. The data were gathered from patient charts and questionnaires. The questionnaire data were compared with the general population in Finland. RESULTS We found these patients to be ordinary elderly people whose demographic and social features resembled those of the general population. They smoked more often, but otherwise had a rather healthy lifestyle. Only half were aware that smoking and alcohol consumption were risk factors of head and neck cancer. In a multivariate analysis, fear of physicians (adjusted odds ratio 11.0; 95% confidence interval 1.2-103), medical-care-seeking for symptoms other than pain (18.5; 2.2-156), and not suspecting cancer (11.2; 1.7-75.1) were independent risk factors for delayed consultation (combined appraisal and help-seeking interval over 3 months). CONCLUSION Head and neck cancer patients deviated from the same-aged general population only in excessive smoking. Fear of doctors, having no pain, and no suspicion of cancer resulted in delayed medical-care-seeking.
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Affiliation(s)
- Janne A Väisänen
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
| | | | | | - Matti J Pukkila
- Department of Otorhinolaryngology - Head and Neck Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Petri T Koivunen
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Olli-Pekka Alho
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
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Habbous S, Harland LTG, La Delfa A, Fadhel E, Xu W, Liu FF, Goldstein D, Waldron J, Huang SH, O'Sullivan B, Liu G. Comorbidity and prognosis in head and neck cancers: Differences by subsite, stage, and human papillomavirus status. Head Neck 2013; 36:802-10. [DOI: 10.1002/hed.23360] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 02/01/2013] [Accepted: 04/11/2013] [Indexed: 01/16/2023] Open
Affiliation(s)
- Steven Habbous
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Biostatistics; Princess Margaret Hospital; Toronto Ontario Canada
| | - Luke T. G. Harland
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
| | - Anthony La Delfa
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
| | - Ehab Fadhel
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
| | - Wei Xu
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Biostatistics; Princess Margaret Hospital; Toronto Ontario Canada
| | - Fei-Fei Liu
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - David Goldstein
- Department of Otolaryngology - Head and Neck Surgery; Princess Margaret Cancer Centre; University Health Network, University of Toronto; Toronto Ontario Canada
| | - John Waldron
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - Shao-Hui Huang
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - Brian O'Sullivan
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - Geoffrey Liu
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Medical Biophysics and Epidemiology; Division of Epidemiology; Dalla Lana School of Public Health; University of Toronto; Toronto Ontario Canada
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Cutilli T, Leocata P, Dolo V, Altobelli E. Evaluation of p53 protein as a prognostic factor for oral cancer surgery. Br J Oral Maxillofac Surg 2013; 51:922-7. [PMID: 23791033 DOI: 10.1016/j.bjoms.2013.05.150] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 05/24/2013] [Indexed: 11/17/2022]
Abstract
We have analysed concentrations of the p53 protein in advanced oral carcinomas immunohistochemically and genetically to detect the percentage of overexpression of this antioncogene that indicates a high probability of mutation. This would point to it being a useful prognostic factor, if we consider the importance of the relation between genetic alterations of p53 and poor overall survival. Seventy-five non-consecutive patients with oral squamous cell carcinoma and metastatic nodes were enrolled if there was homogeneity in histopathological grading (G2) of their tumours, and they were treated according to a multidisciplinary treatment plan. Monoclonal antibodies, extraction of DNA, and amplification of the polymerase chain reaction (PCR) were used for the immunohistochemical and genetic analyses. There was a significant inverse correlation between p53 overexpression and response to chemotherapy and a stronger association between high P53 overexpression (%) and a genetic mutation of p53 (p=0.0001). More than 50% overexpression indicated a strong probability of genetic mutation. There was no association between response to chemotherapy and age-groups or TNM classification (p=0.2), but there was a significant one between sex and site of tumour (p<0.001). Three prognostic factors were significantly related to prognosis: site of tumour (p=0.01), response to chemotherapy (p=0.002), and immuno p53 (p=0.0001). A tumour that is characterised by p53 overexpression of more than 50% indicates a poor prognosis.
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Affiliation(s)
- Tommaso Cutilli
- Department of Life, Health & Environmental Sciences, Maxillofacial Surgery Unit, University of L'Aquila, Italy.
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Abstract
NSP 5a3a is a novel structural protein found to be over-expressed in certain cancer cell lines in-vitro such as Hela, Saos-2, and MCF-7 while barely detectable levels in normal body tissues except for Testis. This particular isoform has been known to interact with cyto- nuclear proteins B23, known to be involved in multi-faceted cellular processes such as cell division, apoptosis, ribosome biogenesis, and rRNA processing, as well as with hnRNP-L, known to be involved with RNA metabolism and rRNA processing. A previous preliminary investigation of NSP 5a3a as a potential target in Head and Neck Carcinoma revealed a novel p73 dependent mechanism through which NSP 5a3a induced apoptosis in Head and Neck cell lines when over-expressed in-vitro. Our present investigation further elucidated a novel dual axis signaling point by which NSP 5a3a induces apoptosis in Head and Neck cell line HN30 through p73-DAXX and TRAF2-TRADD. Interestingly, this novel mechanism appears independent of canonical caspases involved in the intrinsic mitochondrial pathway as well as those in the death receptor pathway thru TRAF2 and TRADD.
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12
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Saghafi N, Lam DK, Schmidt BL. Cannabinoids attenuate cancer pain and proliferation in a mouse model. Neurosci Lett 2010; 488:247-51. [PMID: 21094209 DOI: 10.1016/j.neulet.2010.11.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 11/08/2010] [Accepted: 11/13/2010] [Indexed: 12/22/2022]
Abstract
We investigated the effects of cannabinoid receptor agonists on (1) oral cancer cell viability in vitro and (2) oral cancer pain and tumor growth in a mouse cancer model. We utilized immunohistochemistry and Western blot to show that human oral cancer cells express CBr1 and CBr2. When treated with WIN55,212-2 (non-selective), ACEA (CBr1-selective) or AM1241 (CBr2-selective) agonists in vitro, oral cancer cell proliferation was significantly attenuated in a dose-dependent manner. In vivo, systemic administration (0.013M) of WIN55,212-2, ACEA, or AM1241 significantly attenuated cancer-induced mechanical allodynia. Tumor growth was also significantly attenuated with systemic AM1241 administration. Our findings suggest a direct role for cannabinoid mechanisms in oral cancer pain and proliferation. The systemic administration of cannabinoid receptor agonists may have important therapeutic implications wherein cannabinoid receptor agonists may reduce morbidity and mortality of oral cancer.
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Affiliation(s)
- Negin Saghafi
- UCSF School of Dentistry, University of California San Francisco, United States
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