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卢 汉, 张 建, 杨 榕, 徐 乐, 李 庆, 郭 玉, 郭 传. [Clinical factors affecting the prognosis of lower gingival squamous cell carcinoma]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:702-707. [PMID: 37534655 PMCID: PMC10398782 DOI: 10.19723/j.issn.1671-167x.2023.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Indexed: 12/19/2023]
Abstract
OBJECTIVE To define the clinical factors that influence local recurrence and survival in patients with lower gingival squamous cell carcinoma (LGSCC) and determine whether bone invasion is an independent prognostic factor for them. METHODS A total of 104 patients with LGSCC hospitalized in Peking University Stomatology Hospital from June 2013 to December 2015 were enrolled in this retrospective study.All the patients were followed-up for more than 3 years.The degree of bone invasion was assessed using preoperative imaging data (CT and panoramic radiograph).The degree of bone invasion was divi-ded into four categories: no bone invasion, invasion of cortical bone, invasion of bone marrow cavity, and invasion of the mandibular canal.According to the central position of tumor, it was divided into two types: anterior mandibular invasion (anterior region of the mental foramen) and posterior mandibular invasion (posterior region of the mental foramen). RESULTS of different invasion depth groups were compared using Mann-Whitney U test.P value < 0.05 was considered to be statistically significant.Kaplan-Meier survival analysis method was used to draw survival curve, and COX regression was used to explore the risk ratio (HR) and 95% confidence interval (CI) of prognostic factors of LGSCC. RESULTS The follow-up results showed that the 1-, 3-, and 5-year survival rates of LGSCC in this group were 91%, 84%, 82%, respectively.32.7%(34/104) of patients had cervical lymph node metastasis.The cervical lymph node metastasis rate of the anterior segment of the mandible was 12.5%(2/16), and 36.4%(32/88) for the posterior segment of the mandible (P < 0.05).Univariate and multivariate COX analysis showed that the N stage and local recurrence were the prognostic factors of LGSCC patients (P < 0.05). CONCLUSION As the degree of mandibular invasion increases, the prognosis of patients with mandibular gum cancer becomes worse.N stage and local recurrence are prognostic risk factors for LGSCC.The incidence of cervical lymph node metastasis for LGSCC is related to the primary tumor location.It is concluded that tumors located at the posterior of the mandible might be more prone to cervical lymph node metastasis than the anterior of the mandible.Thus various levels of cervical lymph node dissection strategies should be adopted for different sites of LGSCC.
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Affiliation(s)
- 汉 卢
- 北京大学口腔医学院·口腔医院口腔颌面外科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 建运 张
- 北京大学口腔医学院·口腔医院病理科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 榕 杨
- 北京大学口腔医学院·口腔医院口腔颌面外科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 乐 徐
- 北京大学口腔医学院·口腔医院口腔颌面外科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 庆祥 李
- 北京大学口腔医学院·口腔医院口腔颌面外科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 玉兴 郭
- 北京大学口腔医学院·口腔医院口腔颌面外科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 传瑸 郭
- 北京大学口腔医学院·口腔医院口腔颌面外科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
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Ohyama Y, Yamashiro M, Michi Y, Uzawa N, Myo K, Sonoda I, Sumino J, Miura C, Mizutani M, Yamamoto D, Kayamori K, Yoda T. Determination of Significant Prognostic Factors for Maxillary Gingival Squamous Cell Carcinoma in 90 Cases. Indian J Otolaryngol Head Neck Surg 2022; 74:5930-5935. [PMID: 36742798 PMCID: PMC9895216 DOI: 10.1007/s12070-021-02559-z] [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: 12/24/2020] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
Maxillary gingival squamous cell carcinoma (MGSCC) occurs rather infrequently, compared to tongue and mandibular gingival carcinomas, among the cancers of the oral cavity. Therefore, significant numbers of MGSCC cases have not been statistically analysed. The aim of this study is to clarify the prognostic factors for MGSCC. We performed the statistical analysis of 90 MGSCC cases primarily treated in our department from 1999 to 2014. The patients (male: 36, female: 54) were aged between 38 and 93 years, and the mean age was 68.7 years. The number of patients in each tumour stage according to the TNM classification was as follows: T1: 15 cases, T2: 32 cases, T3: 13 cases, and T4: 30 cases. Forty-two patients were treated only by surgery, 5 only by radiotherapy, 3 by preoperative radiotherapy and surgery, and 40 patients were treated by combination therapy with preoperative chemoradiotherapy and surgery. Neck dissections were performed in 40 cases including 29 cases (11 primary and 18 secondary cases) of histopathologically diagnosed lymph node metastases. Extranodal extension was found in 74.3% cases with metastatic lymph nodes. The 5-year overall survival rate was 81.9%. In univariate analysis, the site of occurrence, stage of tumour, lymph node metastasis, and treatment contributed to the 5-year survival rate. Multivariate analysis demonstrated that the site of occurrence (posterior region) was an independent prognostic factor. Seventeen deaths occurred due to the primary disease, while three deaths were caused by other diseases. The posterior region cancers, according to the classification based on site of occurrence, were independent predictors of poor 5-year overall survival rate.
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Affiliation(s)
- Yoshio Ohyama
- Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, 10-93, Outemachi, Aoi-ku, Shizuoka-shi, Shizuoka 420-8690 Japan
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
| | - Masashi Yamashiro
- Department of Dentistry and Oral Surgery, NTT Medical Center, 5-9-22 Higashigotannda, Shinagawa-ku, Tokyo 141-8625 Japan
| | - Yasuyuki Michi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
| | - Narikazu Uzawa
- Department of Oral and Maxillofacial Surgery II, Osaka University, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Kunihiro Myo
- Department of Head and Neck Surgery, Gunma Prefectural Cancer Center, 617-1 Takahayashinishi-cho, Oota-shi, Gunma 373-0828 Japan
| | - Itaru Sonoda
- Department of Dentistry and Oral Surgery, Moriyama Memorial, 4-3-1 Kitakasai, Edogawa-ku, Tokyo 134-0081 Japan
| | - Jun Sumino
- Department of Oral Surgery, Saitama Cancer Center, 780, Komuro, Inamachi, Kitaadachigun, Saitama 362-0806 Japan
| | - Chika Miura
- Department of Oral Surgery, Japanese Red Cross Aahikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi 326-0843 Japan
| | - Miho Mizutani
- Department of Dentistry and Oral Surgery, NTT Medical Center, 5-9-22 Higashigotannda, Shinagawa-ku, Tokyo 141-8625 Japan
| | - Daisuke Yamamoto
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
| | - Kou Kayamori
- Department of Oral Pathology, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
| | - Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan
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Sun Z, Xia B, Zhang M, Xu S, Ma Y, Zhang X. Case report: Prompt response to radiotherapy and chemotherapy combined with crizotinib in gingival sarcomatoid squamous cell carcinoma with MET 14 mutation. Front Oncol 2022; 12:1006516. [PMID: 36147925 PMCID: PMC9486213 DOI: 10.3389/fonc.2022.1006516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAs a kind of squamous cell carcinoma of head and neck (HNSCC), gingival sarcomatoid squamous cell carcinoma (GSSCC) is a rare biphasic malignant neoplasm. To date, surgical resection was often utilized for gingival squamous cell carcinoma (GSCC), while for patients with advanced gingival carcinoma who cannot tolerate surgery, radiotherapy and chemotherapy can be regarded as a treatment strategy. Many molecular-targeted drugs were investigated and approved for the treatment of malignant diseases, including hematologic diseases and solid tumors. Although targeted therapies such as EGFR inhibitors have shown therapeutic efficacy in HNSCC, there are still some patients who cannot benefit from it. New therapeutic targets and strategies should be further explored.Case presentationAn 83-year-old woman was referred to our hospital with left lower gingival mass for more than 1 month in June 2021. Pathologic diagnosis is sarcomatoid squamous cell carcinoma. Due to the large tumor at the time of diagnosis and poor quality of life, the patient was intolerant to surgery, so she was given radiotherapy (RT) combined with concurrent chemotherapy (CT) with albumin bound paclitaxel. According to next-generation sequencing (NGS) results (MET exon 14 skipping mutation-positive), she was treated with crizotinib, a tyrosine kinase inhibitor that targets MET. Through the comprehensive treatment, the patient’s condition promptly improved, clinical complete remission (CR) was achieved in 2 months, and 9-month progression-free survival (PFS) was obtained. She finally died from non-cancer-related diseases.ConclusionHere we report the treatment of a GSSCC patient with MET mutation, who responded to crizotinib promptly and positively. It provides a new reference for understanding MET abnormalities in GSSCC and offers a new idea for the targeted treatment of gingival carcinoma.
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Affiliation(s)
- Zhenhua Sun
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
- Graduate School of North China University of Science and Technology, Tangshan, China
| | - Bingjie Xia
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
- Graduate School of Hebei North University, Zhangjiakou, China
| | - Ming Zhang
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
- *Correspondence: Ming Zhang,
| | - Shuai Xu
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
- Graduate School of Hebei North University, Zhangjiakou, China
| | - Yingqian Ma
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
| | - Xianbo Zhang
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
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Adjuvant therapy improves survival in pT4aN0 oral cavity squamous cell carcinoma with bone invasion. Am J Otolaryngol 2022; 43:103303. [PMID: 34894450 DOI: 10.1016/j.amjoto.2021.103303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/28/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The prognostic significance of bone invasion in oral cavity squamous cell carcinoma (OCSCC) after accounting for tumor size, nodal spread, and surgical margins is controversial. The aim of this study is to determine whether patients with pT4aN0 oral cavity squamous cell carcinoma with bone invasion have improved overall and disease-free survival with adjuvant treatment. METHODS We conducted a retrospective review of medical records from 64 patients with stage pT4aN0 due to mandibular involvement who underwent surgery from 2000 to 2020. Kaplan-Meier analysis compared disease-free survival and overall survival between groups who underwent surgery only versus surgery and adjuvant therapy. The prognostic impact of adjuvant therapy was assessed using multivariate analysis and reported as hazard ratios. RESULTS There were no statistically significant differences in clinicopathologic features or mean follow-up between patients who received surgery only and patients who received surgery with RT/CCRT (radiotherapy/concurrent chemoradiation therapy). 5-year disease-free (42.5% versus 65.9%, p = 0.02) and overall survival (43.6% versus 69.0%, p = 0.014) were improved in groups who received surgery and RT/CCRT. Regression analysis controlling for clinicopathologic characteristics, including tumor size, identified radiation as an independent predictor of improved disease-free survival (HR: 0.04, p < 0.001) and overall survival (HR: 0.10, p < 0.001). CONCLUSION Adjuvant RT/CCRT in patients with pT4N0 OCSCC with mandibular bone involvement is associated with improved disease-free and overall survival. This association was significant regardless of tumor pathologic features such as size or margin status. These findings may help guide physicians in counseling patients regarding risks and benefits of adjuvant RT/CCRT and inform practice guidelines.
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Ishikawa Y, Umezawa R, Yamamoto T, Ito K, Jingu K. Long-Term Survival Following Palliative Chemoradiotherapy in an Elderly Patient With Advanced Squamous Cell Carcinoma in the Right Mandibular Gingiva. Cureus 2022; 14:e22142. [PMID: 35186607 PMCID: PMC8844173 DOI: 10.7759/cureus.22142] [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] [Accepted: 02/11/2022] [Indexed: 11/05/2022] Open
Abstract
Advanced squamous cell carcinoma (SCC) of the mandibular gingiva in elderly patients is difficult to cure. The treatment policy for elderly patients with advanced SCC of the mandibular gingiva has not been clear. We report a case of right mandibular gingival carcinoma that was successfully treated by palliative chemoradiotherapy. An 83-year-old female complained of pain and an ulcer in her right mandibular gingiva. Oral examination revealed a lesion of about 20 mm in size in the right mandibular gingiva. A diagnosis of SCC in the right mandibular gingiva was made by histology. Imaging findings revealed some right neck lymph node metastases. Based on these findings, a clinical diagnosis before treatment was SCC in the right mandibular gingiva (cT4aN2bM0, stage IV) by the 7th edition of the Union of International Cancer Control. She refused to receive definitive surgery or chemoradiotherapy due to concerns about the invasiveness of these definitive therapies and requested palliative chemoradiotherapy. We delivered S-1 (a combination of tegafur, gimeracil, and oteracil) and radiation therapy (RT) to the primary tumor alone with 30 Gy in 10 fractions using 4-megavoltage equipment via a multiple leaf collimator by three-dimensional RT. Although we could not complete the delivery of S-1 because of an acute side effect, the palliative chemoradiotherapy resulted in a complete response, and the lymph node metastases also disappeared. The patient remains in complete remission for 5 years without surgery or chemotherapy. Palliative chemoradiotherapy for elderly patients with mandibular gingival carcinoma is considered to be one of the therapeutic options.
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Affiliation(s)
- Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
- Division of Radiology, Tohoku Medical and Pharmaceutical University, Sendai, JPN
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
| | - Kengo Ito
- Division of Radiology, Tohoku Medical and Pharmaceutical University, Sendai, JPN
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
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Yang SS, Zhong XH, Wang HX, Min AJ, Wang WM. Nomograms for Predicting Cancer-Specific Survival of Patients with Gingiva Squamous Cell Carcinoma: A Population-Based Study. Curr Med Sci 2021; 41:953-960. [PMID: 34693495 DOI: 10.1007/s11596-021-2435-x] [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: 07/06/2020] [Accepted: 03/29/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVE The use of the traditional American Joint Committee on Cancer (AJCC) staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma (GSCC) patients. We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system. METHODS Patients were identified from SEER database. Variables were selected by a backward stepwise selection method in a Cox regression model. A nomogram was used to predict cancer-specific survival rates for 3, 5 and 10 years in patients with GSCC. Several basic features of model validation were used to evaluate the performance of the survival model: consistency index (C-index), receiver operating characteristic (ROC) curve, calibration chart, net weight classification improvement (NRI), comprehensive discriminant improvement (IDI) and decision curve analysis (DCA). RESULTS Multivariate analyses revealed that age, race, marital status, insurance, AJCC stage, pathology grade and surgery were risk factors for survival. In particular, the C-index, the area under the ROC curve (AUC) and the calibration plots showed good performance of the nomogram. Compared to the AJCC system, NRI and IDI showed that the nomogram has improved performance. Finally, the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC, whether training set or a validation set. CONCLUSION We developed and validated the first GSCC prognosis nomogram, which has a better prognostic value than the separate AJCC staging system. Overall, the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3, 5 and 10 years.
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Affiliation(s)
- Si-Si Yang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Xiao-Huan Zhong
- Department of Orthodontics, Center of Stomatology, Xiangya Hospital of Central South University, Changsha, 410008, China
| | - Hui-Xin Wang
- Department of Orthodontics, Center of Stomatology, Xiangya Hospital of Central South University, Changsha, 410008, China
| | - An-Jie Min
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Wei-Ming Wang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, 410008, China.
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Mukai Y, Hayashi Y, Koike I, Koizumi T, Sugiura M, Oguri S, Takano S, Kioi M, Sato M, Mitsudo K, Hata M. Impact of superselective intra-arterial and systemic chemoradiotherapy for gingival carcinoma; analysis of treatment outcomes and prognostic factors. BMC Cancer 2020; 20:1154. [PMID: 33243168 PMCID: PMC7691076 DOI: 10.1186/s12885-020-07638-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: 08/07/2020] [Accepted: 11/15/2020] [Indexed: 11/10/2022] Open
Abstract
Background We compared outcomes and toxicities between concurrent retrograde super-selective intra-arterial chemoradiotherapy (IACRT) and concurrent systemic chemoradiotherapy (SCRT) for gingival carcinoma (GC). Methods We included 84 consecutive patients who were treated for non-metastatic GC ≥ stage III, from 2006 to 2018, in this retrospective analysis (IACRT group: n = 66; SCRT group: n = 18). Results The median follow-up time was 24 (range: 1–124) months. The median prescribed dose was 60 (6–70.2) Gy (IACRT: 60 Gy; SCRT: 69 Gy). There were significant differences between the two groups in terms of 3-year overall survival (OS; IACRT: 78.8, 95% confidence interval [CI]: 66.0–87.6; SCRT: 50.4, 95% CI: 27.6–73.0; P = 0.039), progression-free survival (PFS; IACRT: 75.6, 95% CI: 62.7–85.2; SCRT: 42.0, 95% CI: 17.7–70.9; P = 0.028) and local control rates (LC; IACRT: 77.2, 95% CI: 64.2–86.4; SCRT: 42.0, 95% CI: 17.7–70.9; P = 0.015). In univariate analysis, age ≥ 65 years, decreased performance status (PS) and SCRT were significantly associated with worse outcomes (P < 0.05). In multivariate analysis, age ≥ 65 years, clinical stage IV, and SCRT were significantly correlated with a poor OS rate (P < 0.05). Patients with poorer PS had a significantly worse PFS rate. Regarding acute toxicity, 22 IACRT patients had grade 4 lymphopenia, and osteoradionecrosis was the most common late toxicity in both groups. Conclusions This is the first report to compare outcomes from IACRT and SCRT among patients with GC. ALL therapy related toxicities were manageable. IACRT is an effective and safe treatment for GC.
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Affiliation(s)
- Yuki Mukai
- Departments of Radiation Oncology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| | - Yuichiro Hayashi
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Izumi Koike
- Departments of Radiation Oncology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Toshiyuki Koizumi
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Madoka Sugiura
- Departments of Radiation Oncology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Senri Oguri
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Shoko Takano
- Departments of Radiation Oncology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Mitomu Kioi
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Mizuki Sato
- Departments of Radiation Oncology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Kenji Mitsudo
- Departments of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Masaharu Hata
- Departments of Radiation Oncology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
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Cunha JLS, Déda Júnior WG, Sanchéz-Romero C, Bezerra BT, de Albuquerque-Júnior RLC. Gingival squamous cell carcinoma mimicking a non-neoplastic proliferative lesion in an older patient. Gerodontology 2020; 37:303-306. [PMID: 32809256 DOI: 10.1111/ger.12454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/23/2019] [Accepted: 11/23/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To report a case of gingival squamous cell carcinoma (SCC) in an elderly patient mimicking a non-neoplastic proliferative lesion. BACKGROUND Oral SCC is a well-recognised malignancy of the oral cavity that may mimic benign reactive proliferative processes. METHODS An excisional biopsy was performed, and the diagnosis was gingival SCC. CONCLUSION It is essential that both the clinician and pathologist to be aware of such a presentation to allow for proper diagnosis and treatment.
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Affiliation(s)
- John Lennon Silva Cunha
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Wilson Gonçalves Déda Júnior
- Laboratory of Morphology and Experimental Pathology, Institute of Technology and Research, Tiradentes University (UNIT), Aracaju, Brazil
| | - Celeste Sanchéz-Romero
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
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9
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Wang SW, Lee CH, Lin MS, Chi CW, Chen YJ, Wang GS, Liao KW, Chiu LP, Wu SH, Huang DM, Chen L, Shen YS. ZnO Nanoparticles Induced Caspase-Dependent Apoptosis in Gingival Squamous Cell Carcinoma through Mitochondrial Dysfunction and p70S6K Signaling Pathway. Int J Mol Sci 2020; 21:ijms21051612. [PMID: 32111101 PMCID: PMC7084801 DOI: 10.3390/ijms21051612] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/07/2020] [Accepted: 02/20/2020] [Indexed: 12/17/2022] Open
Abstract
Zinc oxide nanoparticles (ZnO-NPs) are increasingly used in sunscreens, food additives, pigments, rubber manufacture, and electronic materials. Several studies have shown that ZnO-NPs inhibit cell growth and induce apoptosis by the production of oxidative stress in a variety of human cancer cells. However, the anti-cancer property and molecular mechanism of ZnO-NPs in human gingival squamous cell carcinoma (GSCC) are not fully understood. In this study, we found that ZnO-NPs induced growth inhibition of GSCC (Ca9-22 and OECM-1 cells), but no damage in human normal keratinocytes (HaCaT cells) and gingival fibroblasts (HGF-1 cells). ZnO-NPs caused apoptotic cell death of GSCC in a concentration-dependent manner by the quantitative assessment of oligonucleosomal DNA fragmentation. Flow cytometric analysis of cell cycle progression revealed that sub-G1 phase accumulation was dramatically induced by ZnO-NPs. In addition, ZnO-NPs increased the intracellular reactive oxygen species and specifically superoxide levels, and also decreased the mitochondrial membrane potential. ZnO-NPs further activated apoptotic cell death via the caspase cascades. Importantly, anti-oxidant and caspase inhibitor clearly prevented ZnO-NP-induced cell death, indicating the fact that superoxide-induced mitochondrial dysfunction is associated with the ZnO-NP-mediated caspase-dependent apoptosis in human GSCC. Moreover, ZnO-NPs significantly inhibited the phosphorylation of ribosomal protein S6 kinase (p70S6K kinase). In a corollary in vivo study, our results demonstrated that ZnO-NPs possessed an anti-cancer effect in a zebrafish xenograft model. Collectively, these results suggest that ZnO-NPs induce apoptosis through the mitochondrial oxidative damage and p70S6K signaling pathway in human GSCC. The present study may provide an experimental basis for ZnO-NPs to be considered as a promising novel anti-tumor agent for the treatment of gingival cancer.
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Affiliation(s)
- Shih-Wei Wang
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan;
- Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chien-Hsing Lee
- Department of Pharmacology, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Ming-Shen Lin
- Department of Water Resources and Environmental Engineering, Tamkang University, New Taipei City 251, Taiwan;
| | - Chih-Wen Chi
- Department of Nursing, MacKay Medical College, New Taipei City 252, Taiwan;
- Department of Medical Research, MacKay Memorial Hospital, Taipei 104, Taiwan
| | - Yu-Jen Chen
- MacKay Junior College of Medicine, Nursing, and Management, Taipei 112, Taiwan;
- Department of Radiation Oncology, MacKay Memorial Hospital, Taipei 104, Taiwan
| | - Guo-Shou Wang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan; (G.-S.W.); (K.-W.L.)
- Department of Orthopaedics, MacKay Memorial Hospital, Taipei 104, Taiwan
| | - Kuang-Wen Liao
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan; (G.-S.W.); (K.-W.L.)
- Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, Hsinchu 300, Taiwan
| | - Li-Pin Chiu
- General Education Center, University of Taipei, Taipei 100, Taiwan;
- Division of General Surgery, Taipei City Hospital, Taipei 103, Taiwan
| | - Shu-Hui Wu
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli County 350, Taiwan;
| | - Dong-Ming Huang
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli County 350, Taiwan;
- Correspondence: (D.-M.H.); (L.C.); (Y.-S.S.); Tel.: +886-37-246-166 (ext. 38105) (D.-M.H.); +886-2-2621-5656 (ext. 2682) (L.C.); +886-2-2636-0303 (ext. 1422) (Y.-S.S.)
| | - Luke Chen
- Department of Water Resources and Environmental Engineering, Tamkang University, New Taipei City 251, Taiwan;
- Correspondence: (D.-M.H.); (L.C.); (Y.-S.S.); Tel.: +886-37-246-166 (ext. 38105) (D.-M.H.); +886-2-2621-5656 (ext. 2682) (L.C.); +886-2-2636-0303 (ext. 1422) (Y.-S.S.)
| | - Yung-Shuen Shen
- Institute of Geriatric Welfare Technology and Science, MacKay Medical College, New Taipei City 252, Taiwan
- Correspondence: (D.-M.H.); (L.C.); (Y.-S.S.); Tel.: +886-37-246-166 (ext. 38105) (D.-M.H.); +886-2-2621-5656 (ext. 2682) (L.C.); +886-2-2636-0303 (ext. 1422) (Y.-S.S.)
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10
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Namin AW, Bollig CA, Harding BC, Dooley LM. Implications of Tumor Size, Subsite, and Adjuvant Therapy on Outcomes in pT4aN0 Oral Cavity Carcinoma. Otolaryngol Head Neck Surg 2020; 162:683-692. [DOI: 10.1177/0194599820904679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective To determine if tumor size, subsite, and adjuvant radiation therapy (AXRT) are associated with overall survival (OS) in patients with pT4aN0 oral cavity squamous cell carcinoma (OSCC) who underwent mandibulectomy with negative surgical margins (NSMs). Study Design Retrospective cohort study. Setting National Cancer Database (NCDB). Subjects and Methods Retrospective analysis of the NCDB that included patients diagnosed with pT4aN0 OSCC who underwent mandibulectomy with NSMs between 2004 and 2015. The association of age, Charlson-Deyo score (CDS), tumor size, subsite, and AXRT with OS was analyzed. The cases were divided into 3 subgroups based on maximal tumor dimension for subgroup analysis; tumors ≤2.0 cm, tumors 2.1 to 4.0 cm, and tumors >4.0 cm. Results For the entire cohort; age ( P < .001; hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.02-1.03), CDS ( P = .013; HR, 0.57; 95% CI, 0.37-0.89), tongue subsite ( P = .003; HR, 2.01; 95% CI, 1.27-3.40), floor of mouth subsite ( P = .001; HR, 1.76; 95% CI, 1.28-2.42), tumor size ( P < .001; HR, 0.57; 95% CI, 0.45-0.72), and AXRT ( P < .001; HR, 1.46; 95% CI, 1.24-1.72) were associated with OS on multivariate analysis. On subgroup analysis, AXRT not significantly associated with OS in patients with gingival, hard palate, retromolar trigone, and not specified tumors ≤2.0 cm ( P = .323; HR, 1.29; 95% CI, 0.78-2.15). Conclusions In patients with pT4aN0 OSCC who underwent mandibulectomy with NSMs, age, CDS, tongue subsite, floor of mouth subsite, tumor size, and AXRT are associated with OS. AXRT was not significantly associated with overall survival in patients with gingival, hard palate, retromolar trigone, and not specified tumors ≤2.0 cm.
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Affiliation(s)
- Arya W. Namin
- Department of Otolaryngology–Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Craig A. Bollig
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Brette C. Harding
- Department of Otolaryngology–Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Laura M. Dooley
- Department of Otolaryngology–Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA
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