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Remschmidt B, Gaessler J, Brcic L, Wallner J, Muallah D, Rieder M. The impact of COVID-19 on oral squamous cell carcinoma's diagnostic stage-A retrospective study. Oral Dis 2024; 30:216-222. [PMID: 36398463 DOI: 10.1111/odi.14441] [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: 09/21/2022] [Revised: 10/31/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has had an impact on patients' access to primary care services. A timely diagnosis of oral squamosa cell carcinoma is paramount. This study aims to quantify the pandemic's effect on tumor volume at the time of initial diagnosis. MATERIALS AND METHODS In a retrospective study, all primarily diagnosed cancer patients between March 2018 and March 2022 were compiled; the TNM stage and the tumor volume were evaluated. Tumor volumes were calculated using pathology or radiology reports. RESULTS In total, 162 newly diagnosed tumor cases were included in this study. Of these, 76 (46.9%) cases were allocated in the "pre-COVID-19" group and 86 (53.1%) in the "COVID-19" group. Patients diagnosed during the "COVID-19" period showed a significantly advanced T stage (p < 0.001) and larger mean tumor volumes (53.16 ± 73.55 cm3 vs. 39.89 ± 102.42 cm3 ; p = 0.002) when compared to the control group. CONCLUSION Tumor volume and T stage were significantly advanced in the "COVID-19" group when compared to prepandemic data. We hypothesize that the postponement of routine dental check-ups may explain this finding. Hence, dentists and primary care providers are encouraged to place particular emphasis on screening during routine check-ups.
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Affiliation(s)
- Bernhard Remschmidt
- Department of Oral and Maxillofacial Surgery, University Clinic of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
- University Clinic of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Jan Gaessler
- Department of Oral and Maxillofacial Surgery, University Clinic of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
- University Clinic of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Jürgen Wallner
- Department of Oral and Maxillofacial Surgery, University Clinic of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - David Muallah
- Department of Oral and Maxillofacial Surgery, Head and Neurocenter, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Marcus Rieder
- Department of Oral and Maxillofacial Surgery, University Clinic of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
- University Clinic of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
- Department of Oncology, University Clinic for Internal Medicine, Medical University of Graz, Graz, Austria
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Andersen LP, Dietrich MS, Murphy BA, Deng J. Factors associated with quality of life among patients with a newly diagnosed oral cavity and oropharyngeal cancer. Eur J Oncol Nurs 2023; 66:102384. [PMID: 37611502 PMCID: PMC10786603 DOI: 10.1016/j.ejon.2023.102384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 06/07/2023] [Accepted: 07/01/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE The objectives of this report were 1) to examine the quality of life (QOL) of patients with a newly diagnosed oral cavity or oropharyngeal (OCOP) cancer; and 2) to examine factors contributing to QOL before cancer treatment. METHODS The sample included 115 participants with a new diagnosis of OCOP cancer. Participants completed the demographic form, oral cancer disease and treatment form, Hospital Anxiety and Depression Scale (HADS), Brief Health Literacy Screen (BHLS), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Pearson correlations and linear regressions were used for data analysis. RESULTS Participants had a median global health related QOL score of 66.7 (interquartile range, IQR = 50.0, 83.4) with median scores for the subdomains being generally high (all >80 of possible 100). Anxiety and depression were significantly inversely correlated with all areas of EORTC QOL (r = - 0.48 to -0.78, all p < .001). Multivariable associations were strongest with the physical functioning domain (R = 0.56, p < .001), with younger age, higher income, Stage I/II cancer (compared to Stage III/IV) significant contributors to the multiple correlation (beta > ± 0.20, p < .05). CONCLUSIONS Health care providers should be attentive to OCOP cancer patients with older age, lower household income, advanced cancer stage, and presence of anxious and/or depressive symptoms for indicators of poor QOL. CLINICIANS SHOULD CONSIDER THE BENEFIT OF: initiating supportive interventions before cancer treatment among OCOP cancer patients with poor QOL.
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Affiliation(s)
- Lucy P Andersen
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Mary S Dietrich
- Vanderbilt University, Department of Biostatistics, Schools of Medicine & Nursing, Nashville, TN, USA.
| | - Barbara A Murphy
- Vanderbilt Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Jie Deng
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA.
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Gheibollahi H, Mousavi S, Babaei A. Factors associated with survival and patient's quality of life after segmental mandibulectomy. Support Care Cancer 2023; 31:366. [PMID: 37253883 DOI: 10.1007/s00520-023-07831-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/23/2023] [Indexed: 06/01/2023]
Abstract
AIM This study aimed to explore the survival rate and quality of life (QoL) in patients who underwent segmental mandibulectomy and determine the associated factor with survival rate and QoL. MATERIAL AND METHODS In this cross-sectional study, all patients who underwent segmental mandibular resection in the referral center of Shiraz University of Medical Sciences, Iran, during 2015-2019 were included. Inclusion criteria were segmental mandibulectomy due to any pathology and age of more than 8 years old. Demographic, clinical data and patient survival were recorded. EORTC QLQ-HN43 was used to evaluate QoL. RESULTS Totally, 82 patients were studied. The overall 3-year survival rate was 69.5% (57 patients) (mean ± SD: 1.35 ± 1.03 years). According to univariate analysis, age (p-value = 0.001), hospital lengths of stay (p-value < 0.001), gender (p-value = 0.014, OR = 4.143), education (p-value = 0.015, OR = 0.291), pathology (p-value < 0.001, OR = 17.000), metastasis (p-value = 0.018, OR = 4.894), neck dissection (p-value < 0.001, OR = 52.381), frozen margin (p-value < 0.001 OR = 8.000), recurrence (p-value = 0.001, OR = 6.273), and status of chemoradiotherapy (p-value < 0.001) were significantly associated with survival rate. Logistic regression revealed that survival was associated with gender (p-value = 0.040, OR = 23.689), level of education (p-value = 0.019, OR = 0.019), and neck dissection (p-value = 0.019, OR = 175.781). According to univariate analysis, pathology (p-value = 0.003), neck dissection (p-value = 0.024), frozen margin (p-value = 0.004), and chemoradiotherapy (p-value = 0.026) were significantly associated with QoL. Linear regression revealed that QoL was associated with none of the measured factors. CONCLUSION In conclusion, gender, level of education, and neck dissection were related to 3-year patients' survival. None of the measured factors in this study were associated with QoL.
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Affiliation(s)
- Hamed Gheibollahi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sona Mousavi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Amirhossein Babaei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
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Creaney G, McMahon AD, Ross AJ, Bhatti LA, Paterson C, Conway DI. Head and neck cancer in the UK: what was the stage before COVID-19? UK cancer registries analysis (2011-2018). Br Dent J 2022; 233:787-793. [PMID: 36369569 PMCID: PMC9650177 DOI: 10.1038/s41415-022-5151-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022]
Abstract
Introduction People who present with more advanced stage head and neck cancer (HNC) are associated with poorer outcomes and survival. The burden and trends of advanced stage HNC are not fully known at the population level. The UK national cancer registries routinely collect data on HNC diagnoses.Aims To describe trends in stage of diagnosis of HNCs across the UK before the COVID-19 pandemic.Methods Aggregated HNC incidence data were requested from the national cancer registries of the four UK countries for the ten most recent years of available data by subsite and American Joint Commission on Cancer stage at diagnosis classification. Additionally, data for Scotland were available by age group, sex and area-based socioeconomic deprivation category.Results Across the UK, rates of advanced stage HNC had increased, with 59% of patients having advanced disease at diagnosis from 2016-2018. England had a lower proportion of advanced disease (58%) than Scotland, Wales or Northern Ireland (65-69%) where stage data were available. The completeness of stage data had improved over recent years (87% by 2018).Conclusion Prior to the COVID-19 pandemic, diagnoses of HNC at an advanced stage comprised the majority of HNCs in the UK, representing the major challenge for the cancer healthcare system.
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Affiliation(s)
- Grant Creaney
- Clinical Lecturer in Dental Public Health, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
| | - Alex D McMahon
- Reader (Dental School), School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Alastair J Ross
- Senior Lecturer in Human Factors in Health Care, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - Claire Paterson
- Consultant Clinical Oncologist, Beatson West of Scotland Cancer Centre, NHS Greater Glasgow and Clyde, UK
| | - David I Conway
- Professor of Dental Public Health,, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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Donor Site Morbidity and Quality of Life after Microvascular Head and Neck Reconstruction with a Chimeric, Thoracodorsal, Perforator-Scapular Flap Based on the Angular Artery (TDAP-Scap-aa Flap). J Clin Med 2022; 11:jcm11164876. [PMID: 36013116 PMCID: PMC9410144 DOI: 10.3390/jcm11164876] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Extensive defects in the head and neck area often require the use of advanced free flap reconstruction techniques. In this study, the thoracodorsal perforator-scapular free flap technique based on the angular artery (TDAP-Scap-aa flap) was postoperatively evaluated regarding the quality of life and the donor site morbidity using the standardized SF-36 and DASH questionnaires (short form health 36 and disabilities of the arm, shoulder and hand scores). Over a five-year period (2016−2020), 20 selected cases (n = 20) requiring both soft and hard tissue reconstruction were assessed. On average, the harvested microvascular free flaps consisted of 7.8 ± 2.1 cm hard tissue and 86 ± 49.8 cm2 soft tissue components. At the donor site (subscapular region), only a mild morbidity was observed (DASH score: 21.74 ± 7.3 points). When comparing the patients’ postoperative quality of life to the established values of the healthy German norm population, the observed SF-36 values were within the upper third (>66%) of these established norm values in almost all quality-of-life subcategories. The mild donor site morbidity and the observed quality of life indicate only a small postoperative impairment when using the TDAP-Scap-aa free flap for the reconstruction of extensive maxillofacial defects.
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Granström B, Holmlund T, Laurell G, Fransson P, Tiblom Ehrsson Y. Addressing symptoms that affect patients' eating according to the Head and Neck Patient Symptom Checklist ©. Support Care Cancer 2022; 30:6163-6173. [PMID: 35426524 PMCID: PMC9135877 DOI: 10.1007/s00520-022-07038-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 04/04/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this prospective study was to assess which nutritional impact symptoms (NIS) interfere with oral intake in patients with head and neck cancer (HNC) and how the symptoms interfere with body weight loss, up to 1 year after treatment. METHODS This was a prospective study of 197 patients with HNC planned for treatment with curative intention. Body weight was measured before the start of treatment, at 7 weeks after the start of treatment, and at 6 and 12 months after completion of treatment. NIS and NIS interfering with oral intake at each follow-up were examined with the Head and Neck Patient Symptom Checklist© (HNSC©). RESULTS At 7 weeks of follow-up, patients experienced the greatest symptom and interference burden, and 12 months after treatment the NIS scorings had not returned to baseline. One year after treatment, the highest scored NIS to interfere with oral intake was swallowing problems, chewing difficulties, and loss of appetite. At all 3 follow-ups, the total cumulative NIS and NIS interfering with oral intake were associated with body weight loss. Factors increasing the risk for a body weight loss of ≥ 10% at 12 months after treatment were pain, loss of appetite, feeling full, sore mouth, difficulty swallowing, taste changes, and dry mouth. Women scored higher than men in NIS and NIS interfering with oral intake. Furthermore, during the study period about half of the population had a body weight loss > 5%. CONCLUSION Because both nutritional and clinical factors may affect body weight, this study highlights the importance of a holistic approach when addressing the patients' nutritional issues. TRIAL REGISTRATION ClinicalTrials.gov NCT03343236, date of registration: November 17, 2017.
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Affiliation(s)
- Brith Granström
- Department of Clinical Science, Otorhinolaryngology, Umeå University, 901 87, Umeå, Sweden.
| | - Thorbjörn Holmlund
- Department of Clinical Science, Otorhinolaryngology, Umeå University, 901 87, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, 751 85, Uppsala, Sweden
| | - Per Fransson
- Department of Nursing, Umeå University, 901 87, Umeå, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, 751 85, Uppsala, Sweden
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Ou M, Wang G, Yan Y, Chen H, Xu X. Perioperative Symptom Burden and Its Influencing Factors in Patients with Oral Cancer: A Longitudinal Study. Asia Pac J Oncol Nurs 2022; 9:100073. [PMID: 35692731 PMCID: PMC9184294 DOI: 10.1016/j.apjon.2022.100073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/17/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The aim of this study was to identify the symptom burden of perioperative oral cancer patients, its trajectory, and the factors influencing it. Methods A longitudinal, repeated measures design with consecutively identified sampling was used to recruit oral cancer patients scheduled for surgical treatment. Data collected included sociodemographic and clinical information, nutritional risk by the Nutritional Risk Screening 2002, and symptom burden by M. D. Anderson Symptom Inventory-Head and Neck Module (MDASI-HN) at preoperation, 7 days postsurgery, and 1 month postsurgery. Results Perioperative patients with oral cancer had multiple symptoms. Pain, difficulty swallowing/chewing, and mouth/throat sores (61.9%–76.1%) were the most prevalent symptoms before surgery. The symptom burden was the highest at 7 days after surgery, with the most prevalent symptoms, including difficulty swallowing/chewing, difficulty with voice/speech, and problems with mucus (87.8%–95.4%). At 1 month postsurgery, the 3 main symptoms were numbness or tingling, difficulty swallowing/chewing, and difficulty with voice/speech (all 87.8%). Treatment stage, job, comorbidity, cancer stage, adjuvant therapy, and Nutritional Risk Screening 2002 score were correlated with symptom burdens. Conclusions Our study illustrates that perioperative oral cancer patients have multiple symptoms and high symptom burdens, especially at 7 days postsurgery, with prominent symptoms and symptom burdens varying with the treatment stage.
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Affiliation(s)
- Meijun Ou
- Head and Neck Surgery Department, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Guifen Wang
- School of Nursing, University of South China, Hengyang, China
| | - Yixia Yan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hong Chen
- Head and Neck Surgery Department, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xianghua Xu
- Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- Corresponding author.
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Validation of the German-language version of the Liverpool Oral Rehabilitation Questionnaire version 3 and evaluation of oral-health-related quality of life among patients with squamous cell carcinoma of the head and neck. J Craniomaxillofac Surg 2021; 49:1081-1087. [PMID: 34210565 DOI: 10.1016/j.jcms.2021.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/01/2021] [Accepted: 06/15/2021] [Indexed: 01/07/2023] Open
Abstract
The aim of this study was to translate the Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) into German and validate this version in order to assess oral-health-related quality of life (OHRQoL) among head and neck cancer patients. This study was conducted at a German university clinic among patients who had completed therapy for squamous cell carcinoma of the head and neck (HNSCC). The original English-language LORQv3 was translated into German according to the forward-backward approach. Validity and reliability were evaluated using further questionnaires related to OHRQoL and psychological impairments. Subgroups were built with reference to oral rehabilitation status and type of cancer therapy. Furthermore, OHRQoL was evaluated. Test-retest reliability was assessed by weighted kappa with a 10-14 day interval. Data were analysed by using Spearman's correlation and the following tests: Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney U and Cronbach's alpha. The level of significance was set at α = 0.05. Analysis of the LORQv3 evaluations revealed excellent Cronbach's alpha and high test-retest reliability. Construct validity were supported by the data. LORQv3 summary score and domains were significantly affected by status of oral rehabilitation (p = 0.003, p = 0.008, p = 0.024) and treatment approach (p < 0.001, p = 0.025, p = 0.035). The German version of the LORQv3 showed high reliability and validity and an impaired OHRQoL of HNSCC patients. It can therefore be recommended for the assessment of OHRQoL.
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Lee YS, Cho CM, Cho KB, Heo J, Jung MK, Kim SB, Kim KH, Kim TN, Lee DW, Han J, Kim HG, Kim D, Kim H. Difficult Biliary Cannulation from the Perspective of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Identifying the Optimal Timing for the Rescue Cannulation Technique. Gut Liver 2021; 15:459-465. [PMID: 32000469 PMCID: PMC8129666 DOI: 10.5009/gnl19304] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/03/2019] [Accepted: 11/18/2019] [Indexed: 12/17/2022] Open
Abstract
Background/Aims Recently, the European Society of Gastrointestinal Endoscopy (ESGE) proposed criteria for “difficult biliary cannulation” during endoscopic retrograde cholangiopancreatography (ERCP). This study aimed to investigate the clinical relevance of the ESGE criteria from the perspective of post-ERCP pancreatitis (PEP). Methods An ERCP database was prospectively maintained between November 2014 and December 2015 across six teaching hospitals in South Korea. The ESGE criteria (biliary cannulation time, the number of cannulation attempts, and inadvertent pancreatic duct [PD] manipulation) were recorded in this database as well as other technical factors. Logistic regression analysis was used to identify risk factors for PEP. Then, the PEP prediction model was investigated using decision tree analysis. Results We analyzed 1,067 consecutive patients with naïve papilla. The overall rate of PEP was 6.6%. Multivariate analysis revealed that female sex (odds ratio [OR], 1.860; 95% confidence interval [CI], 1.124 to 3.078), a selective biliary cannulation duration >5 minutes (OR, 3.282; 95% CI, 1.641 to 6.566), and inadvertent PD manipulation (OR, 2.614; 95% CI, 1.480 to 4.617) were significant factors affecting PEP. Decision tree analysis revealed that biliary cannulation time (χ2=49.857, p<0.001) and inadvertent PD manipulation (χ2=8.556, p=0.010) were decisive factors. PEP occurred in 3.9%, 11.8%, and 16.2% of patients with biliary cannulation duration lasting 3 to 5 minutes, >5 minutes, and >5 minutes with inadvertent PD manipulation, respectively. Conclusions Biliary cannulation time and inadvertent PD manipulation could be relevant indicators of PEP, and 5 minutes might be used as a cutoff value for the implementation of the rescue cannulation technique. (Gut Liver 2021;15-465)
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Affiliation(s)
- Yoon Suk Lee
- Department of Internal Medicine, Inje University College of Medicine, Goyang, Korea
| | - Chang Min Cho
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Jun Heo
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Min Kyu Jung
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Dong Wook Lee
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Jimin Han
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Ho Gak Kim
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Daejin Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Hyunsoo Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
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Pieralli S, Spies BC, Schweppe F, Preissner S, Nelson K, Heiland M, Nahles S. Retrospective long-term clinical evaluation of implant-prosthetic rehabilitations after head and neck cancer therapy. Clin Oral Implants Res 2021; 32:470-486. [PMID: 33501694 DOI: 10.1111/clr.13716] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/24/2020] [Accepted: 01/19/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess clinical and patient-reported outcomes of implant-prosthetic rehabilitations in patients with a history of head-neck cancer (HNC), treated with tumor resection without (TR) or with adjuvant radiotherapy (TR/RT). A healthy cohort rehabilitated with the same reconstructive protocols served as control group (C). MATERIALS AND METHODS A total of 28 women and 29 men were considered in the present retrospective study. Participants received 322 implants, finally supporting 79 prosthetic reconstructions. Primary outcome was the assessment of implant and prosthetic survival rates. Furthermore peri-implant soft tissue parameters (attached peri-implant mucosa, AM; modified bleeding and plaque indices, mBI/mPI; probing depth, PD) and prosthetic technical complications were documented. Patient-reported outcome measures (PROMs) by means of visual analog scales (VAS) and the Oral Health Impact Profile German 14 form (OHIP G14) were collected. For statistical purposes Chi-square and Mann-Whitney-U-Test were adapted. RESULTS After a mean follow-up of 81.2 ± 50.3 months, implant survival rate was 98.1% (HNC-TR), 98.2% (HNC-TR/RT) and 100.0% (C), respectively (four implants failed in the HNC groups). HNC-TR/RT showed significant higher mPI and mBI compared to C. Within HNC-TR/RT, vestibuloplasty significantly reduced mBI and PD values. No failures occurred at the prosthetic level. Overall, higher VAS scores were reported for bar- compared with Locator-retained prostheses. Furthermore, increased OHIP G14 values resulted for HNC-TR/RT. CONCLUSIONS High survival rates on implant and prosthetic level were observed. The use of soft tissue grafts resulted in stabilization of the peri-implant mucosa in irradiated patients. In terms of retention and chewing ability, participants preferred bars over Locator attachments.
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Affiliation(s)
- Stefano Pieralli
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Felix Schweppe
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Saskia Preissner
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katja Nelson
- Department of Oral and Maxillofacial Surgery, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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Yuwanati M, Gondivkar S, Sarode SC, Gadbail A, Desai A, Mhaske S, Pathak SK, N Khatib M. Oral health-related quality of life in oral cancer patients: systematic review and meta-analysis. Future Oncol 2021; 17:979-990. [PMID: 33541115 DOI: 10.2217/fon-2020-0881] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: The purpose of this meta-analysis was to evaluate the impact of oral health on quality of life in oral cancer patients (OCPs). Methods: PubMed, Scopus and Web of Science databases were searched for publications on oral health-related quality of life (OHRQoL) in OCP and the information was extracted according to the PRISMA guidelines. A random effect model was used to obtain the pooled standard mean differences of Oral Health Impact Profile (OHIP)-14 questionnaire responses in meta-analysis. Results: total of 12 research papers were analyzed and revealed poor OHRQoL in OCPs (standard mean difference: 2.53; 95% CI: 1.55-3.50; p < 0.00001) compared with healthy individuals due to the effects of oncotherapy. Moreover, OHRQoL deteriorated with combinations of different treatment modalities. Conclusion: Oral health and oncotherapy can affect the quality of life in OCPs.
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Affiliation(s)
- Monal Yuwanati
- Department of Oral & Maxillofacial Pathology, People's College of Dental Sciences & Research Centre, People's University, Bhopal, 462037, Madhya Pradesh, India
| | - Shailesh Gondivkar
- Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, 440009, Maharashtra, India
| | - Sachin C Sarode
- Department of Oral Pathology & Microbiology, Dr DY Patil Dental College & Hospital, Dr DY Patil Vidyapeeth, Pune, 411018, Maharashtra, India
| | - Amol Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, 440018, Maharashtra, India
| | - Ami Desai
- Department of Oral & Maxillofacial Pathology, People's College of Dental Sciences & Research Centre, People's University, Bhopal, 462037, Madhya Pradesh, India
| | - Shubhangi Mhaske
- Department of Oral & Maxillofacial Pathology, People's College of Dental Sciences & Research Centre, People's University, Bhopal, 462037, Madhya Pradesh, India
| | - Sandeep K Pathak
- Central Library, Indian Institutes of Science Education & Research, Bhopal, 462006, Madhya Pradesh, India
| | - Mahalaqua N Khatib
- Division of Evidence Synthesis, School of Epidemiology & Public Health, Datta Meghe Institute of Medical Sciences (DU), Wardha, 442004, Maharashtra, India
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12
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Complex Mandibular Reconstruction for Head and Neck Squamous Cell Carcinoma-The Ongoing Challenge in Reconstruction and Rehabilitation. Cancers (Basel) 2020; 12:cancers12113198. [PMID: 33143098 PMCID: PMC7693398 DOI: 10.3390/cancers12113198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/17/2020] [Accepted: 10/23/2020] [Indexed: 11/21/2022] Open
Abstract
Simple Summary Cancer therapy includes a broad range of microvascular free flaps that may restore defects and improve patients’ quality of life. This is particularly important for head and neck squamous cell carcinoma (HNSCC) and composite mandibular reconstructions, containing tissues of bone, muscle, and skin, which may be problematic due to their magnitude and sensitive location. The subscapular system offers a highly valuable donor site with the most versatility and the potential for rapid rehabilitation. Interestingly, other donor sites are more commonly used internationally. Therefore, we evaluated the use of the subscapular system free flap (SFF), which is the most commonly used free flap at our department. To our knowledge, this retrospective study represents the largest number of SFF cases reported to date in the literature. Furthermore, we examined the quality of life in a subgroup of patients, combining prospective occurrences to provide insight into overall rehabilitation from the patients’ viewpoints. Abstract Large head and neck squamous cell carcinoma (HNSCC) tumors affecting the mandible require a versatile reconstruction to maintain form, function, and quality of life. Large defect reconstruction of soft and hard tissue in the head and neck necessitates, at best, one vascular system including various tissues by large dimensions. The subscapular flap system seems to meet these standards. A retrospective study was conducted focusing on clinical data, including an analysis of the quality of life with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires, (QLQ-C30 and QLQ-H&N43). A total of 154 patients (122 males, 32 females; age range: 31–71 years, mean: 54.5 years) treated at our department from 1983 through to 2019 were included. Of the subscapular system free flaps (SFFs), 147 were based on the angular artery branch of the thoracodorsal pedicle (95.45%), and the remaining seven cases (4.55%) were lateral scapular border flaps. Mean mandible defect length was 7.3 cm. The mean skin paddle dimension was 86.8 cm2. The most common recipient artery was the thyroid superior artery (79.22%). Major postoperative complications occurred in 13 patients (8.44%). This study confirms that SFFs offer excellent soft and hard tissue quality, component independence, a large arc of rotation length, and a large gauge of pedicle, making them the gold standard for the reconstruction of large composite defects of mandibular HNSCC tumors.
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13
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Soldera EB, Ortigara GB, Bonzanini LIL, Schulz RE, Danesi CC, Antoniazzi RP, Linhares Ferrazzo K. Clinical and sociodemographic factors associated with oral health-related quality of life in survivors of head and neck cancer. Head Neck 2020; 42:886-897. [PMID: 31961033 DOI: 10.1002/hed.26063] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 12/06/2019] [Accepted: 12/17/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Factors related to head and neck cancer and the treatment of the disease can affect quality of life. The aim of this study was to determine factors associated with the severity of impact on oral health-related quality of life (OHRQoL) in survivors of head and neck cancer using a multivariate analysis. METHODS This cross-sectional study evaluated 90 volunteers who had completed radiotherapy at least 3 months earlier. OHRQoL was assessed using oral health impact profile (OHIP-14) and the data were analyzed using robust variance poisson regression models. RESULTS The mean total OHIP-14 score was 23.98 ± 12.55. Patients with hyposalivation had 56% higher (worse) mean OHIP-14 total scores (CI:1.11-2.18) and patients with advanced stage tumors had 31% higher mean OHIP-14 total scores (CI:1.03-1.66) in multivariate analyses. CONCLUSION OHRQoL of survivors of head and neck cancer experienced a negative impact following radiotherapy. The impact was associated with hyposalivation and advanced stage tumors.
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Affiliation(s)
- Eloisa B Soldera
- Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | | | | | - Riéli E Schulz
- Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Cristiane C Danesi
- Department of Pathology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Raquel P Antoniazzi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Kívia Linhares Ferrazzo
- Department of Pathology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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14
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Alabi RO, Elmusrati M, Sawazaki-Calone I, Kowalski LP, Haglund C, Coletta RD, Mäkitie AA, Salo T, Almangush A, Leivo I. Comparison of supervised machine learning classification techniques in prediction of locoregional recurrences in early oral tongue cancer. Int J Med Inform 2019; 136:104068. [PMID: 31923822 DOI: 10.1016/j.ijmedinf.2019.104068] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 12/10/2019] [Accepted: 12/26/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND The proper estimate of the risk of recurrences in early-stage oral tongue squamous cell carcinoma (OTSCC) is mandatory for individual treatment-decision making. However, this remains a challenge even for experienced multidisciplinary centers. OBJECTIVES We compared the performance of four machine learning (ML) algorithms for predicting the risk of locoregional recurrences in patients with OTSCC. These algorithms were Support Vector Machine (SVM), Naive Bayes (NB), Boosted Decision Tree (BDT), and Decision Forest (DF). MATERIALS AND METHODS The study cohort comprised 311 cases from the five University Hospitals in Finland and A.C. Camargo Cancer Center, São Paulo, Brazil. For comparison of the algorithms, we used the harmonic mean of precision and recall called F1 score, specificity, and accuracy values. These algorithms and their corresponding permutation feature importance (PFI) with the input parameters were externally tested on 59 new cases. Furthermore, we compared the performance of the algorithm that showed the highest prediction accuracy with the prognostic significance of depth of invasion (DOI). RESULTS The results showed that the average specificity of all the algorithms was 71% . The SVM showed an accuracy of 68% and F1 score of 0.63, NB an accuracy of 70% and F1 score of 0.64, BDT an accuracy of 81% and F1 score of 0.78, and DF an accuracy of 78% and F1 score of 0.70. Additionally, these algorithms outperformed the DOI-based approach, which gave an accuracy of 63%. With PFI-analysis, there was no significant difference in the overall accuracies of three of the algorithms; PFI-BDT accuracy increased to 83.1%, PFI-DF increased to 80%, PFI-SVM decreased to 64.4%, while PFI-NB accuracy increased significantly to 81.4%. CONCLUSIONS Our findings show that the best classification accuracy was achieved with the boosted decision tree algorithm. Additionally, these algorithms outperformed the DOI-based approach. Furthermore, with few parameters identified in the PFI analysis, ML technique still showed the ability to predict locoregional recurrence. The application of boosted decision tree machine learning algorithm can stratify OTSCC patients and thus aid in their individual treatment planning.
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Affiliation(s)
- Rasheed Omobolaji Alabi
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland.
| | - Mohammed Elmusrati
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | - Iris Sawazaki-Calone
- Oral Pathology and Oral Medicine, Dentistry School, Western Parana State University, Cascavel, PR, Brazil
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | - Caj Haglund
- Research Programs Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Tuula Salo
- Department of Pathology, University of Helsinki, Helsinki, Finland; Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland; Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland; Institute of Biomedicine, Pathology, University of Turku, Turku, Finland; Faculty of Dentistry, University of Misurata, Misurata, Libya
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, Turku, Finland
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15
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Davudov MM, Harirchi I, Arabkheradmand A, Garajei A, Mahmudzadeh H, Shirkhoda M, Motiee-Langroudi M, Mirzajani Z, Zebardast J, Montazeri A. Evaluation of quality of life in patients with oral cancer after mandibular resection: Comparing no reconstruction, reconstruction with plate, and reconstruction with flap. Medicine (Baltimore) 2019; 98:e17431. [PMID: 31593097 PMCID: PMC6799791 DOI: 10.1097/md.0000000000017431] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
This cross-sectional study aimed to assess and compare quality of life in patients with advanced oral cavity tumors after mandibular resection in 3 groups (no reconstruction, reconstruction with plate, and reconstruction with flap) at the Cancer Institute, affiliated to Tehran University of Medical Sciences. Quality of life was measured using the European Organization for Research and Treatment of Cancer core quality of life questionnaire and European Organization for Research and Treatment of Cancer head and neck cancer-specific quality of life questionnaire-35 items. The comparison was tested using Kurskal-Wallis analysis. All 120 patients were entered into the study. The mean age of patients was 48.5 (standard deviation = 18.1) years. Patients presented with advanced stage of the disease and underwent mandibular resection with no reconstruction (n = 40), reconstruction with plate (n = 41), and reconstruction with flap (n = 39). The findings showed that in general, there were no statistically significant differences in quality of life among 3 groups except for speech problem (P = .4), dry mouth (P = .03), and feeling ill (P = .04). Although there were no significant differences in quality of life among patients in 3 groups, overall patients who received reconstruction with flap reported better functioning and fewer symptoms. Those who did not receive any reconstruction reported the worse conditions.
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Affiliation(s)
- Mahammad M. Davudov
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan
| | - Iraj Harirchi
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Arabkheradmand
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Garajei
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Habibollah Mahmudzadeh
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maziar Motiee-Langroudi
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zoheir Mirzajani
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan
| | - Jayran Zebardast
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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