Table of Contents
CancerMail from the National Cancer Institute
UI - 21134193
AU - Genty E; Marandas P; Beautru R; Schwaab G; Luboinski B
TI - [Mandibulotomy for cancer of the oral cavity and oropharynx: functional and carcinologic outcome in 107 cases]
SO - Ann Otolaryngol Chir Cervicofac 2001 Feb;118(1):26-34
AD - Departement d'ORL et Chirurgie Cervico-faciale, Institut Gustave Roussy, Villejuif.
We report a series of 107 patients who underwent mandibulotomy at the Gustave-Roussy Institute, France for cancer of the oral cavity and orophaynx between 1998 and 1996. The most common tumor site was the base of the tongue. Most cases were stage T2 or T3. Postoperative radiotherapy was employed except in those who had previous irradiation, either for the same tumor (12 cases) or another cancer (16 cases). The different types of mandibulotomies and osteosynthesis methods were analyzed in relation to postoperative course and functional and oncological outcome at mean follow-up of 6 years. Osteitis was the most frequent complication (14%) requiring hemimandibulectomy in 5 cases. Complications occurred particularly when osteosynthesis was in the pre-or postoperative irradiation field. Osteosynthesis was definitive in 79.4% with good functional results in 76.5%. Previous radiotherapy or use of flaps for closure gave poor function results. We emphasize the advantages of anterolateral mandibulotomy and titanium plates. The local control rate was 81.5% at 6 months and overall survival rat was 51.5% at 5 years with no significant impact of tumor site on survival.
UI - 21134196
AU - Benlyazid A; Lescanne E; Marque A; Robier A; Beutter P; Ployet MJ
TI - [Teratoma of the rhinopharynx and the infratemporal fossa in neonates: report of 3 cases]
SO - Ann Otolaryngol Chir Cervicofac 2001 Feb;118(1):54-60
AD - Unite d'ORL et de Chirurgie Cervico-Faciale, Departement de Chirurgie Pediatrique, Hopital Gatien de Clocheville, 49 bd Beranger, 37044 Tours Cedex.
Teratomas are tumors which develop in childhood or early adulthood, generally in the gonads. More rarely these tumors may be found in an axial localization, notably in cervicofacial forms. We report three cases of teratomas observed in rhinopharynx of three neonates operated at the Clocheville General Hospital. We present the main anatomoclinical features of these tumors, focusing on the cervicofacial forms in neonates. All three cases occurred in female neonates presenting acute dyspnea within the first hours of life, requiring intubation in two cases. The first two tumors invaded the infratemoral region and the third was a pediculated tumor of the velum exteriorized via the mouth. In one case antenatal ultrasound had suggested the diagnosis of a right temporomaxillary tumor. Rapid excision of the rhinopharngyeal component allow extubation for the two intubated infants and pathology diagnosis. In the first infant operated at 2 months, the lateral route was adapted to age, with mandibulotomy with section of the coronoid process but preserving the mandibular condyle. The second infant was operated at the age of 3 weeks using a wide frontotemporoperitonial approach then at the age of 3.5 months for recurrence extending to the floor of the temporal fossa and the middle ear. A type C infratemporal approach was used with lost-bone temporal craniectomy. Per-buccal excision was possible in the third infant with resection at the base of implantation. No recurrence has been observed in the first two cases at 3.5 and 2.5 months follow-up in the first two cases. The third infant was lost to follow-up.
UI - 21198534
AU - Sturgis EM; Dahlstrom KR; Guan Y; Eicher SA; Strom SS; Spitz MR; Wei Q
TI - Alcohol dehydrogenase 3 genotype is not associated with risk of squamous cell carcinoma of the oral cavity and pharynx.
SO - Cancer Epidemiol Biomarkers Prev 2001 Mar;10(3):273-5
AD - Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Alcohol is one of the major risk factors for oral and pharyngeal cancer. The rate-limiting step in alcohol metabolism is the oxidation (activation) of ethanol to acetaldehyde by the alcohol dehydrogenases (ADHs). It has been hypothesized that individuals who are homozygous for the fast allele (ADH(1-1)(3)) are at greater risk for alcohol-related cancers. To test this hypothesis, we investigated the association between the ADH3 genotype and oral and pharyngeal cancer risk in a large racially homogeneous case-control study of 229 patients and 575 matched control subjects with frequency matching on age, sex, and smoking status. Although the smoking status was matched between cases and controls, current and former alcohol use remained a significant risk factor, compared with never use (odds ratio, 2.08; 95% confidence interval, 1.37-3.17; odds ratio, 1.97; 95% confidence interval, 1.25-3.09; and odds ratio, 1.00, respectively). The ADH1(3) allele frequency of controls was 57.4%, consistent with reports of similar racial groups (50-60%). The genotype distribution in controls was also consistent with the Hardy-Weinberg equilibrium (P = 0.51). However, the ADH1(3) allele frequency and ADH(1-1)(3) genotype frequency were not significantly different between cases and controls [55.5% versus 57.4% (P = 0.52), and 30.6% versus 31.3% (P = 0.91), respectively]. There was no association between ADH3 genotypes (ADH(1-1)(3), ADH(1-2)(3), and ADH(2-2)(3)) and risk of oral and pharyngeal cancer (odds ratios, 1.00; 0.96; 95% confidence interval, 0.68-1.37; and odds ratio, 1.23; confidence interval, 0.78-1.93, respectively). Therefore, we found no evidence that supports a main effect of ADH3 genotype or a combined effect of alcohol and ADH3 genotype on risk of cancer of the oral cavity or pharynx.
UI - 21227892
AU - Tavani A; Gallus S; La Vecchi C; Talamini R; Barbone F; Herrero R; Franceschi S
TI - Diet and risk of oral and pharyngeal cancer. An Italian case-control study.
SO - Eur J Cancer Prev 2001 Apr;10(2):191-5
AD - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. email@example.com
The relation between diet and risk of oral and pharyngeal cancer was analysed in a case-control study conducted in North-East Italy between 1996 and 1999. Cases were 132 patients (including 33 women), with incident, histologically confirmed cancer of the oral cavity or pharynx, and controls were 148 subjects (including 45 women) admitted to hospitals for acute conditions unrelated to smoking or alcohol drinking. After allowance for tobacco, alcohol and several other potential confounding factors, significant inverse association with the risk of oral and pharyngeal cancer was found for consumption of total green vegetables (OR 0.37) and total fruit (OR 0.34) with significant trends in risk Compared with alcohol drinkers of < 20 drinks/week and eating > 13 portions/week of total green vegetables, the OR for drinkers of > or = 20 drinks/week and eating < 7 portions/week of green vegetables was 15.44. Our study provides further support to the beneficial effect of high intake of vegetables and fruit, particularly in heavy smokers and alcohol drinkers.
UI - 21218451
AU - Poissonnet G; Dassonville O; Vallicioni J; Debruyne S; Santini J; Demard F
TI - [Use of neck platysma myocutaneous flap for reconstruction substance defects after surgical resection of oropharyngeal tumors. Report of 70 cases]
SO - Ann Otolaryngol Chir Cervicofac 2001 Apr;118(2):102-9
AD - Departements de Chirurgie ORL et Cervico-faciale, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06189 Cedex 2 et Universite de Nice, Sophia Antipolis, Nice France. firstname.lastname@example.org
PURPOSE OF THE STUDY: We analyzed our experience with the cervical platysma myocutaneous flap and reviewed the pertinent literature. We evaluated the harvesting technique, surgical indications, reliability of the flap, its advantages and drawbacks compared with other reconstruction techniques and assessed survival and local control. MATERIALS AND METHODS: This retrospective series included 70 patients with a mean 83-month follow-up. All patients had an oral cavity or oropharyngeal carcioma ranging from T1 to T4, N0 to N2b according to the TNM classification. All underwent one-step surgery with unilateral or bilateral type III elective neck dissection, followed by tumor resection, and reconstruction with a cervical platysma myocutaneous flap. RESULTS: Complications related to flap reliability were observed in 17 cases (24.3%): 1 total necrosis (1.4%), 6 partial necrosis (8.6%), and 10 paddle epidermolysis (14.3%). Median survival and local control were 35 and 59 months respectively. Eight out of 55 preoperative N0 patients were histologically N+ (14.5%). No significant difference in risk of metastasis recurrence was evidenced between N0 and N+ patients (p > 0.05). DISCUSSION: Reconstruction after ablation of oral or oropharyngeal cancer using a cervical platysma myocutaneous flap can be easily combined with an elective neck dissection without increasing the risk of recurrence. The flap must preserve the facial artery and its submental branch and the external jugular vein to ensure reliability. When indications are strictiy applied, the properties of the platysma plasty and the anterolateral cervical situation provide very satisfactory functional and esthetic results.
UI - 21218447
AU - Nallet E; Ameline E; Moulonguet L; Barry B; Guedon C; Depondt J; Gehanno P
TI - [T3 and T4 cancer of the oral cavity, surgical treatment with oral tongue resection]
SO - Ann Otolaryngol Chir Cervicofac 2001 Apr;118(2):74-9
AD - Service d'ORL et de Chirurgie Cervico-Faciale, Hopital Bichat-Claude Bernard, 46, rue Henri-Huchard, 75877 Paris Cedex.
Amputation of the oral tongue is required to treat T3 and T4 bilateral tumors of the anterior two third of the tongue with or without extension to the floor of the mouth. This partial glossectomy was performed initially for 27 patients and as salvage therapy for 35 patients with recurrent diseases. The reconstruction required a flap in all cases, including 8 microvascular free flaps. Two months after surgery, two third of patients had a satisfactory swallowing hability. The functional results were worst for patients operated after radiotherapy. Actuarial survival rates were 37.5% and 22.1% at 3 and 5 years respectively. The survival rate of patients who had surgery as primary modality of treatment was significantly better as compared with those who had radiotherapy before surgery (p=0,018). This surgery offers a perfect control of tumors of the anterior floor and oral tongue and good rehabilitation provided by the conservation of the posterior tongue.
UI - 21384652
AU - Taylor RJ; Wahl RL; Sharma PK; Bradford CR; Terrell JE; Teknos TN; Heard EM; Wolf GT; Chepeha DB
TI - Sentinel node localization in oral cavity and oropharynx squamous cell cancer.
SO - Arch Otolaryngol Head Neck Surg 2001 Aug;127(8):970-4
AD - Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
OBJECTIVE: To evaluate the feasibility and predictive ability of the sentinel node localization technique for patients with squamous cell carcinoma of the oral cavity or oropharynx and clinically negative necks. DESIGN: Prospective, efficacy study comparing the histopathologic status of the sentinel node with that of the remaining neck dissection specimen. SETTING: Tertiary referral center. PATIENTS: Patients with T1 or T2 disease and clinically negative necks were eligible for the study. Nine previously untreated patients with oral cavity or oropharyngeal squamous cell carcinoma were enrolled in the study. INTERVENTIONS: Unfiltered technetium Tc 99m sulfur colloid injections of the primary tumor and lymphoscintigraphy were performed on the day before surgery. Intraoperatively, the sentinel node(s) was localized with a gamma probe and removed after tumor resection and before neck dissection. MAIN OUTCOME MEASURES: The primary outcome was the negative predictive value of the histopathologic status of the sentinel node for predicting cervical metastases. RESULTS: Sentinel nodes were identified in 9 previously untreated patients. In 5 patients, there were no positive nodes. In 4 patients, the sentinel nodes were the only histopathologically positive nodes. In previously untreated patients, the sentinel node technique had a negative predictive value of 100% for cervical metastasis. CONCLUSIONS: Our preliminary investigation shows that sentinel node localization is technically feasible in head and neck surgery and is predictive of cervical metastasis. The sentinel node technique has the potential to decrease the number of neck dissections performed in clinically negative necks, thus reducing the associated morbidity for patients in this group.
UI - 21384653
AU - Rosen A; Rhee TH; Kaufman R
TI - Prediction of aspiration in patients with newly diagnosed untreated advanced head and neck cancer.
SO - Arch Otolaryngol Head Neck Surg 2001 Aug;127(8):975-9
AD - Division of Otolaryngology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ 07103, USA. ROSENAR@UMDNJ.EDU
OBJECTIVES: To determine the prevalence of aspiration in patients with newly diagnosed nontreated advanced head and neck cancer and to determine the ability of the clinical examination to predict aspiration in this patient population. DESIGN: A descriptive prevalence study of the presence of aspiration in patients with advanced (stages III and IV) head and neck cancer and a prospective correlation study between variables of the clinical evaluation with the criterion standard videofluoroscopy. SETTING: Regional veterans affairs medical center. PATIENTS: A consecutive sample of 27 patients without previous treatment or tracheostomy. INTERVENTIONS: All patients underwent evaluation by an otolaryngologist and speech pathologist prior to videofluoroscopy. MAIN OUTCOME MEASURES: Variables in the dysphagia evaluation (consisting of a directed medical history, physical examination, and food challenge), the self-rated 45-item questionnaire, and the clinicians "educated prediction" of aspiration were analyzed with reference to aspiration on videofluoroscopy using univariant analysis. RESULTS: The prevalence of aspiration determined by videofluoroscopy was 41% (11 of 27 patients). Two (6%) of 32 items in the medical history, 1 (4%) of 25 items in the physical examination, and 8 (50%) of 16 items in the food challenge were found to be statistically significantly correlated (P<.05) with aspiration on videofluoroscopy by univariate analysis. Nine (25%) of 45 items in the self-rated questionnaire were correlated with aspiration on videofluoroscopy. The clinicians' educated prediction of aspiration was not correlated with aspiration determined by videofluoroscopy. CONCLUSIONS: Clinical evaluation alone is inadequate in predicting patients who aspirated, determined objectively by videofluoroscopic swallowing study. Further study is needed to develop an efficient dysphagia evaluation to identify patients at risk for aspiration.
UI - 21395058
AU - Brun E; Zatterstrom U; Kjellen E; Wahlberg P; Willen R; Brun A; Perfekt R; Tennvall J
TI - Prognostic value of histopathological response to radiotherapy and microvessel density in oral squamous cell carcinomas.
SO - Acta Oncol 2001;40(4):491-6
AD - Department of Oncology, Jubilee Institute, Lund University, Sweden. email@example.com
The prognostic value of histopathological response to preoperative radiotherapy (50 Gy) in radically resected oral carcinomas was studied in 39 consecutive patients. Microvessel density (MVD) was evaluated for relation to radioresponse and outcome. Resected tumour tissue was examined histopathologically and response to radiotherapy was scored according to induced morphological changes. Pretreatment biopsies were stained with antibodies to von Willebrand factor to evaluate MVD in hot-spot regions, in stromal tissue and in tumour epithelial tissue. Histopathological response to radiotherapy was highly prognostic of local failures and survival (p = 0.002), though microscopic surgical radicality was obtained. In good responders to preoperative radiotherapy, the 5-year survival rate was 68% compared with 24% in poor responders. In 12 patients with local recurrence after radical surgery, 11 had poor histopathological radiotherapy responses. In univariate analysis, a high MVD score in tumour epithelium was associated with poor clinical outcome but MVD did not correlate with histopathological radiotherapy response.
UI - 21390013
AU - Bagla P; Marshall E
TI - Clinical research. Hopkins reviews investment in Indian cancer drug trial.
SO - Science 2001 Aug 10;293(5532):1024
UI - 21416732
AU - Yamamoto G; Shimada T; Nishida T; Ishida Y; Iba T; Nakata T; Ohtsuki T; Takigami K; Yamaguchi Y; Yoshitake K; Tanaka A; Tsuda Y
TI - [Evaluation of a combination chemotherapy with nedaplatin and 5-FU for oral cancers]
SO - Gan To Kagaku Ryoho 2001 Aug;28(8):1111-5
AD - Dept. of Oral and Maxillofacial Surgery, Shiga University of Medical Science.
Nedaplatin (cis-diammine-glycolato platinum: CDGP) is a platinum compound with a molecular weight of 303.18 that was recently developed in Japan. There have been reports of the antineoplastic effects of Nedaplatin on cancers in the cranio-cervical region, lung, esophagus, urinary bladder, testis, ovary, and uterus. In this study, we performed combined therapy of CDGP and fluorouracil (5-FU) for 8 patients with oral cancers, and evaluated the results to elucidate the clinical effect and adverse side effects. The subjects were 8 patients with squamous cell carcinoma (5 males and 3 females aged 33-65 years). The primary carcinoma regions were the tongue in 5 patients, oral floor in 2 patients, and mandibular gingiva in 1 patient. The T-classification was T2 in 6 patients and T4 in 2 patients, and the clinical staging was Stage II in 5 patients, Stage III in 1 patient and Stage IV in 2 patients. We first administered 700 mg/m2 5-FU per day from day 1 to day 5 (total dose 3,500 mg/m2), then 90 mg/m2 CDGP on day 5. The clinical effect was evaluated as a partial response in all cases, showing a 100% success rate. The histopathological findings of resected tumors were evaluated by Ohboshi and Shimozato's classification. One patient was Grade IIA, 5 patients Grade IIB, and 2 patients Grade III. The adverse side effects were slight myelotoxicity, gagging, nausea, alopecia, and stomatitis less than Grade II. Although the oral cancers in this study were extroverted superficial ulcerative cancers, and the number of patients was low at 8, this combined therapy is considered useful and worth evaluating in further accumulated cases.
UI - 21183461
AU - Protsenko AV; Sirotina MV
TI - [Observation of cancer of triple localization]
SO - Klin Khir 2000 Jun;(6):61-2
UI - 21225884
AU - Bhattathiri VN
TI - Relation of erythrocyte and iron indices to oral cancer growth.
SO - Radiother Oncol 2001 May;59(2):221-6
AD - Clinical Radiobiology Section, Department of Radiotherapy, Regional Cancer Centre, 695-011, Trivandrum, India.
BACKGROUND AND PURPOSE: Anaemia is known to influence prognosis of head and neck cancer patients, but how anaemia and tumour growth influences each other is not clear. The present study investigates the relation of erythrocyte and iron indices of oral cancer patients to primary tumour size (Tsize), invasiveness and lymph node involvement. MATERIALS AND METHODS: The haemoglobin (Hb), erythrocyte count (RBC), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), Serum iron (SFe), transferrin iron-binding capacity (TIBC) and transferrin saturation (%Fe) were evaluated in 217 untreated patients with epidermoid cancer of the bucco-gingivo-palatine area. The association of erythrocyte and iron indices with sex, tumour size groups, invasion of adjacent structures and lymph node involvement, as well as the relation of SFe to Hb were analyzed. RESULTS: Most of the patients were anaemic in terms of Hb (63%), RBC (43%) and PCV (48.4%) but almost all had normal or higher MCH (97.3%) and MCV (93.3%) though MCHC was less than normal in 70.7%. Normal or higher SFe was seen in nearly 70% and TIBC in 45% of patients. Hb, RBC and PCV were significantly lower in women, but there was no difference between men and women in the case of MCV, MCH and MCHC. Primary tumour size showed negative association with Hb, RBC and PCV but positive association with MCH (< 2 cm: 29.7 pg; 2-4 cm: 31.4 pg; > 4 cm: 31. 7 pg; P = 0.04) and MCHC (< 2 cm: 29.9; 2-4 cm: 31.5; > 4 cm: 32.1; P = 0.006). MCV, SFe, TIBC and %Fe did not show any relation to primary tumour size. None of the indices had any relation to invasion of adjacent structures or lymph node involvement. MCH, MCHC and MCV were not different in men and women but women had significantly lower Hb, RBC and PCV. The SFe showed poor correlation with Hb. CONCLUSIONS: The negative association of Hb, RBC and PCV with tumour size is most likely due to chronic RBC destruction, probably tumour induced, with the products of haemolysis such as polyamines, glutathione, iron, etc., promoting tumour growth, and the positive association with MCH and MCHC reflects compensatory regeneration attempts by bone marrow. Lack of relation between the iron indices and tumour parameters and the poor correlation between SFe and Hb is probably due to utilization of iron by both bone marrow and tumours. Lack of difference in MCH and MCHC between men and women obviates the need of using separate cut-off values for the two sexes, unlike Hb, RBC and PCV. The study suggests that anaemia in oral cancer patients represents a tumour-host interaction and that evaluation of all erythrocyte indices should be part of research on cancer related anaemia.
UI - 21285824
AU - Wu JG; Xu YZ; Sun CW; Soloway RD; Xu DF; Wu QG; Sun KH; Weng SF; Xu GX
TI - Distinguishing malignant from normal oral tissues using FTIR fiber-optic techniques.
SO - Biopolymers 2001;62(4):185-92
AD - Department of Chemistry, Medical School of Stomatology, Peking University, Beijing 100871, China. firstname.lastname@example.org
Oral tissue samples were studied using mid-IR fiber-optic attenuated total reflectance spectroscopy and other spectral techniques. The 1745 cm(-1) band, which is assigned to the ester group (C==O) vibration of triglycerides, is a reliable marker that is present in normal tissues but absent or a weak band in malignant oral tissues. Other bands such as C--H stretching bands and the amide bands are also helpful in distinguishing malignant tissues from normal tissues. Subtraction spectra confirmed the above conclusion. In addition, Raman spectroscopic measurements were in agreement with the results observed from FTIR spectra. Copyright 2001 John Wiley & Sons, Inc.
UI - 21314487
AU - Devine JC; Rogers SN; McNally D; Brown JS; Vaughan ED
TI - A comparison of aesthetic, functional and patient subjective outcomes following lip-split mandibulotomy and mandibular lingual releasing access procedures.
SO - Int J Oral Maxillofac Surg 2001 Jun;30(3):199-204
AD - Regional Maxillofacial Unit, University Hospital Aintree, UK.
Good access to the site of oral cancer is essential to allow for adequate three-dimensional resection of the tumour. Splitting the lower lip in conjunction with a mandibulotomy offers excellent access to all areas of the mouth and pharynx, but this inevitably produces a facial scar and there is morbidity associated with the healing of the mandibulotomy. An alternative approach is the mandibular lingual releasing technique, which provides good access to the oral cavity and avoids the morbidity associated with lip-split mandibulotomy. The aim of this study was to compare aesthetic, functional and patient subjective outcomes between the two access procedures. One hundred and fifty patients had oral access procedures between 1992-95 (ninety lip-split mandibulotomy and sixty mandibular lingual release). Thirty patients fulfilled selection criteria (primary surgery as treatment, tumour size < 5.1 cm, anterior oral cavity tumours, and reconstructed with a radial forearm free flap) and 10 patients from each group were able to attend a review appointment for objective clinical assessment of their speech, tongue mobility, lip competence and temperomandibular signs. Using items from the University of Washington quality of life questionnaire patient subjective outcomes were assessed. Using standardised photographs the clinician and lay persons assessed the overall post-operative facial appearance. The patients also assessed their own facial appearance using a similar scoring method. Resection margins were similar in both groups and it would seem that both methods provide adequate access to the anterior oral cavity. Clinical examination showed no differences in function between the two access procedures. Although there was a small number, the lip-split mandibulotomy group reported significantly better speech, swallowing and chewing. Previous concerns about a possible detrimental effect on appearance following lip-split, were not borne out in this study.
UI - 21314489
AU - Rogers SN; Lowe D; Brown JS; Vaughan ED
TI - The relationship between length of stay and health-related quality of life in patients treated by primary surgery for oral and oropharyngeal cancer.
SO - Int J Oral Maxillofac Surg 2001 Jun;30(3):209-15
AD - Regional Maxillofacial Unit, University Hospital Aintree, Aintree Trust, Liverpool, UK. email@example.com
A patient's length of hospital admission is simple to measure, whilst their health related quality of life (HRQOL) is much more challenging. Similar clinical and demographic factors may exist between an increased length of stay (LOS) and a worse HRQOL outcome. The aim of this study was to assess whether LOS could serve as a proxy marker of HRQOL. One hundred and thirty consecutive patients with previously untreated oral and oropharyngeal squamous cell carcinoma were recruited. All had primary surgery. The University of Washington questionnaire (UW-QOL) and the European Organisation for Research and Treatment core cancer questionnaire (EORTC C30) were self-completed preoperatively, after 6 months and 1 year. The median LOS following laser/primary closure/split skin grafts (21 patients) was 2 days compared to 16 days following microvascular free flap reconstruction (105 patients). In the free flap group the best predictors of LOS were age, tumour size and early medical/surgery complications. Patients with a LOS greater than 16 days (median) reported significantly worse chewing (P = 0.008), swallowing (P = 0.002) and cumulative UW-QOL score (P = 0.01). No significant differences were seen in the EORTC C30. Length of stay is potentially a useful indicator of health related quality of life because it is linked by tumour size, however, the relationship is confounded by age, which tends to influence length of stay more than health related quality of life.
UI - 21408416
AU - Lee HC; Yin PH; Yu TN; Chang YD; Hsu WC; Kao SY; Chi CW; Liu TY; Wei YH
TI - Accumulation of mitochondrial DNA deletions in human oral tissues -- effects of betel quid chewing and oral cancer.
SO - Mutat Res 2001 Jun 27;493(1-2):67-74
AD - Department of Biochemistry and Center for Cellular and Molecular Biology, National Yang-Ming University, Taipei 112, Taiwan, ROC.
Accumulation of mitochondrial DNA (mtDNA) mutations in human tissues has been associated with intrinsic aging and environmental insult. Recently, mtDNA mutations have been detected in various tumors, including head and neck tumors. However, the factors affecting the occurrence and accumulation of mtDNA deletions in tumor tissues are poorly understood. In Taiwan, betel quid chewing is a major risk factor for oral cancer. Using polymerase chain reaction (PCR) techniques, we examined large-scale deletions of mtDNA in 53 pairs of tumor and non-tumor oral tissues from the patients with or without betel quid chewing history. The results revealed that irrespective of the history of betel quid chewing, the incidences of the 4977bp deletion and other deletions of mtDNA were lower in the tumor portion as compared with the non-tumor portion. The average proportions of the 4977bp deleted mtDNA in the tumor tissues of the betel quid chewers and non-betel quid chewers were 13- and 5-fold, respectively, lower than those in the corresponding non-tumor tissues. Moreover, the average proportion of 4977bp deleted mtDNA was significantly higher (P<0.05) in the non-tumor oral tissues of the patients with betel quid chewing history than that of the patients without the history of betel quid chewing. These results suggest that betel quid chewing may increase mtDNA mutation in human oral tissues and that accumulation of mtDNA deletions and subsequent cytoplasmic segregation of these mutations during cell division could be an important contributor to the early phase of oral carcinogenesis.
UI - 21393030
AU - Li N; Jia M; Yuan R
TI - [Reconstruction of the mandible and soft tissue defects with the osteomyocutaneous free fibula flap]
SO - Zhonghua Zheng Xing Wai Ke Za Zhi 2000 Jan;16(1):20-1
AD - Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Qingdao Medical College, Qingdao 266003, PR China.
OBJECTIVE: In order to ascertain a material that is ideal both for reconstruction of the composite mandibular defects and for osseointegrated implantation. METHODS: Fifteen osteomyocutaneous fibula flaps were transferred for reconstruction of the mandible and surrounding soft tissues. The characters of the blood supply of the flap, the operation course, the relation of the fibula and dental implants were observed. RESULTS: The osteomyocutaneous fibula flap was supplied by double vessels. The blood supply was reliable even after the fibula was cut into several segments. Periosteal circulation was its main blood supply. The postoperative contour and function of the mandibular region were good. The flap also favours dental implants and denture. CONCLUSION: The osteomyocutaneous fibula flap was the ideal material to reconstruct the defects of mandible and surrounding soft tissues.
UI - 21230825
AU - Bosetti C; Franceschi S; Negri E; Talamini R; Tomei F; La Vecchia C
TI - Changing socioeconomic correlates for cancers of the upper digestive tract.
SO - Ann Oncol 2001 Mar;12(3):327-30
AD - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. firstname.lastname@example.org
BACKGROUND: Cancers of the upper digestive tract have long been associated with low socio-economic levels. It has however been suggested that in recent times the social gradient for these cancers is leveling off. PATIENTS AND METHODS: Data from three case-control studies on oral, pharyngeal and oesophageal cancer conducted in Northern Italy during the periods 1984-1992 and 1992-1997 were combined and re-analyzed. Cases were subjects admitted to the major teaching and general hospitals in the areas under study with incident, histologically confirmed cancer of the oral cavity and pharynx (n = 1126) and oesophagus (n = 714). Controls were subjects admitted to the same hospitals for a wide spectrum of acute, non-neoplastic conditions, not related to smoking or alcohol consumption (n = 4642). RESULTS: In the 1980s a significant association was observed with low education and social class level. The multivariate odds ratios for oral, pharyngeal and oesophageal cancers combined was 1.78 for the lowest versus the highest educational level, and 1.75 for the lowest versus the highest social class. No consistent pattern of risk was observed with any of the socio-economic indicators considered in the studies conducted in the 1990s. CONCLUSIONS: The present study indicates that the socio-economic correlates of cancers of the upper digestive tract have changed over the last few years in Italy, with a disappearance of the social gradient.
UI - 21230826
AU - Franceschi S; Dal Maso L; Levi F; Conti E; Talamini R; La Vecchia C
TI - Leanness as early marker of cancer of the oral cavity and pharynx.
SO - Ann Oncol 2001 Mar;12(3):331-6
AD - Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano (PN), Italy.
BACKGROUND: It is not clear whether the purported association of leanness with cancer of the oral cavity and pharynx was due to cancer-related weight loss or to the influence of factors associated with leanness. PATIENTS AND METHODS: Seven hundred fifty-four incident cases of cancers of the oral cavity and pharynx and 1775 controls, admitted to hospital for acute, non-neoplastic diseases, in Italy and Switzerland. Questionnaire included height, lifetime history of weight and of physical activity, waist and hip measurements, and a validated food-frequency section. RESULTS: Leanness at diagnosis was associated with elevated risk in men (adjusted odds ratio, OR for 5-unit decrease in body-mass index, BMI = 1.9; 95% confidence interval (CI): 1.6-2.2 in men). Male cases were significantly leaner than control subjects at the age of 30 and of 50. Thinner women also had an increased risk, but the inverse association with BMI was non linear. In both sexes, the association with leanness was restricted to smokers and moderate/heavy drinkers, but was not accounted for by drinking and smoking habits, nor by differences in physical activity or dietary habits. CONCLUSIONS: Leanness appears to be an early marker of some unknown biological effect of smoking and/or of alcohol abuse, which may contribute to the prediction of cancers of the oral cavity and pharynx. Cessation of smoking and substantial reduction of alcohol intake may improve nutritional status, besides stopping carcinogen exposure.
UI - 21232934
AU - Wang HM; Ng SH; Wang CH; Liaw CT; Chen JS; Yang TS; Chen IH
TI - Intra-arterial plus i.v. chemotherapy for advanced bulky squamous cell carcinoma of the buccal mucosa.
SO - Anticancer Drugs 2001 Apr;12(4):331-7
AD - Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
From July 1994 to December 1996, 41 patients with previously untreated, advanced bulky squamous cell carcinoma arising from the buccal mucosa (BSCC) were enrolled. All patients were males with a median age of 47 years (range 29-72). The tumor extent was stage III/IV: three of 38, T4: 85%, N2-3: 20%. Patients were initially scheduled to receive intra-arterial (i.a.) chemotherapy, followed by i.v. chemotherapy and regional therapy. The i.a. chemotherapy catheter was properly placed by external carotid artery angiography via the femoral artery. The i.a. chemotherapy consisted of cisplatin (P) 100 mg/m(2) day 1 plus 5-fluorouracil (F) 1000 mg/m(2) day 1-4, and the i.v. chemotherapy consisted of PF (10 patients) or PF plus methotrexate 200 mg/m(2) day 15 and 22 (31 patients). All chemotherapy regimens were administered at 4-week intervals. The response rate of i.a. plus i.v. chemotherapy for the primary site was 85% (35 of 41) with 29% complete remission (CR) (12 of 41). The response and CR rates of neck nodes were 82% (14 of 17) and 41% (seven of 17), respectively. The combined overall response rate was 80% (33 of 41) with a 29% CR (12 of 41). Major toxicity from i.a. chemotherapy of WHO grade > or = 3 included: mucositis of infusion area (76%), hemialopecia (56%) and leukopenia (5%). Three neurologic complications of i.a. chemotherapy including one hemiparesis occurred. The median follow-up time was 47 months (range 36-66 months), and the overall survival and disease-free survival were both 34% (14 of 41). Four patients were cured with chemotherapy alone and eight patients (19.5%) were cured without surgical intervention. Using i.a. chemotherapy as a cytoreductive therapy followed by subsequent i.v. chemotherapy produces a high response rate and an encouraging degree of complete response rate in advanced bulky BSCC. However, toxicity management and catheter placement will need to be improved in order to better define the role of this therapy in advanced BSCC.
UI - 21382291
AU - Rebol J; Takac I; Bumber Z
TI - Intraoral sonographic evaluation of parapharyngeal space tumors.
SO - J Clin Ultrasound 2001 Jun;29(5):302-5
AD - Department of Otorhinolaryngology, Maribor Teaching Hospital, Ljubljanska 5, 2101 Maribor, Slovenia.
We performed transcutaneous (external) sonography and then intraoral sonography to evaluate 3 parapharyngeal space tumors (1 vagal paraganglioma, 1 pleomorphic adenoma, and 1 carcinoma arising in a pleomorphic adenoma). All 3 patients had medial displacement of a tonsil. In all cases, we could measure the size and see the borders of the tumors and their relation to other structures on intraoral sonography. Intraoral sonography is useful for differentiating between unilaterally enlarged and medially displaced tonsils. Copyright 2001 John Wiley & Sons, Inc.
UI - 21298275
AU - Hong SX; Cha IH; Lee EW; Kim J
TI - Mandibular invasion of lower gingival carcinoma in the molar region: its clinical implications on the surgical management.
SO - Int J Oral Maxillofac Surg 2001 Apr;30(2):130-8
AD - Department of Oral and Maxillofacial Surgery, Yonsei University, College of Dentistry, Seoul, Korea.
The spread pattern of a tumour and its extent in the mandible are important in the management of gingival cancer. Sixteen patients with gingival squamous cell carcinoma (SCC) involving the mandible in the molar region were included in this study. Resection specimens of the mandibular bone and adjacent cancer were histologically analysed to identify the type and characteristics of invasion and were compared with the radiological features. Our results showed that the actual width of invasion was underestimated to a greater extent than the actual depth of invasion. For horizontal aspects, four dentate cases had horizontal intramedullary spread underneath intact mucosa or cortical bone extended from the main foci of tumour that infiltrated through the occlusal surface. For vertical aspects, nerve invasion took place in only one of 16 specimens, while five cases showed downward infiltration beyond the inferior alveolar canal without nerve involvement, so that the pattern of tumour spread was mostly transmedullary rather than perineural in previously non-irradiated cases. These cases with deep infiltration showed the infiltrative type of invasion in the dentate mandible. And when the tumour was related with previous dental extractions or curettage, it tended to be more extensive than what was predicted from an imaging point of view. These pathological and clinical features affecting the tumour spread should be considered in the management of gingival SCC in the molar region.
UI - 21298276
AU - Shintani S; Yoshihama Y; Ueyama Y; Terakado N; Kamei S; Fijimoto Y; Hasegawa Y; Matsuura H; Matsumura T
TI - The usefulness of intraoral ultrasonography in the evaluation of oral cancer.
SO - Int J Oral Maxillofac Surg 2001 Apr;30(2):139-43
AD - Department of Oral and Maxillofacial Surgery II, Okayama University Dental School, Japan. email@example.com
Many studies focused on the tumour thickness in oral squamous cell carcinomas, suggesting a relationship with the occurrence of cervical metastasis. Accurate preoperative assessment of the tumour thickness of oral cancer would provide useful information for targeting those patients who need elective treatment of the neck. Some useful diagnostic aids to evaluate oral cancer are computed tomography (CT), magnetic resonance imaging (MRI), and intraoral ultrasonography. The purpose of the present study is to compare intraoral ultrasonography with CT and MRI in delineating the disease extent and in measuring the tumour thickness of oral carcinoma. Thirty-nine patients with oral cancer were preoperatively evaluated with intraoral ultrasonography, and CT, and in 26 of them MRI was carried out. High-quality ultrasonographic images were obtained and the tumour thickness was measured within 1 mm. However, in most tumours less than 5.0 mm in thickness, CT and MRI could not detect a sufficient density difference from the normal tissue to accurately delineate the extent of the tumour. There was a significant correlation between measurements by intraoral ultrasonography and the histological sections. The present study shows that ultrasonography is superior to CT and MRI in assessment of the primary lesion of oral carcinoma.
UI - 21298277
AU - Kovacs AF
TI - Influence of chemotherapy on endosteal implant survival and success in oral cancer patients.
SO - Int J Oral Maxillofac Surg 2001 Apr;30(2):144-7
AD - Department of Oral, Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe-University Medical School, Frankfurt am Main, Germany. A.Kovacs@em.uni-frankfurt.de
Little is known about the effect of chemotherapy on the osseointegration and survival of endosteal dental implants. In a retrospective study, two groups of patients were compared: one group consisting of 30 oral cancer patients received postsurgical adjuvant chemotherapy with either cis- or carboplatin and 5-fluorouracil in three cycles and were treated subsequently with 106 dental implants placed in the mandible; the other group consisting of 17 patents suffering from oral cancer was prescribed with 54 dental implants placed in the mandible after oncological surgery. No patient was treated with radiotherapy. Twenty patients in the first group were successfully provided with a prosthetic superstructure (mean time of function: 35.8 months) compared to 16 patients in the second group (mean time of function: 36.2 months). The observation time was 10 years. A life-table analysis based on defined success parameters demonstrated no significant difference between implant survival in either group. It was concluded that chemotherapy with cis- or carboplatin and 5-fluorouracil was not detrimental to the survival and success of dental implants in the mandible.
UI - 21293163
AU - Hebert C; Coletta RD; Norris K; Nikitakis N; Lopes M; Sauk JJ
TI - Non-natural CBP2 binding peptides and peptomers modulate carcinoma cell adhesion and invasion.
SO - J Cell Biochem 2001 Apr 2-27;82(1):145-54
AD - Department of Pathology, University of Maryland, Baltimore 666 W. Baltimore Street Baltimore, Maryland 21201, USA.
A combinatorial approach that utilized a repertoire of bacteriophage-peptides has identified a number of non-natural CBP2 binding peptides. Moreover, co-localization of some of these peptides with CBP2 in a number of tumor cell lines demonstrated that the peptides were directed to an intracellular location spatially coincident with the normal distribution of CBP2 [Sauk et al., 2000]. From among these sequences WHYPWFQNWAMA and LDSRYSLQAAMY were the most effective CBP2 binding peptides and best fulfilled the combinatorial motif containing deep hydrophobic pockets. When the hydropathic profiles of collagen alpha1(IV) and alpha2 (IV) were compared with these dodecapeptides, the hydropathic profiles of WHYPWFQNWAMA and LDSRYSLQAAMY closely matched those of alpha1(IV) 414-452 and alpha1(IV)531-543. These peptides were shown to be functional peptidomimics and possessed the ability to alter cell adhesion and invasion of human squamous cell carcinoma cell lines. Peptomers were formed of these non-natural peptides to explore the role that a repetitive peptide may have on cell adhesion. The enhanced cell adhesion observed with the peptomers required both CBP2 antibodies and integrin antibodies for inhibition. The enhanced adhesion observed even in the face of combined antibody inhibition was consistent with such complexes possessing correspondingly slower dissociation rates. Thus, suggesting that peptomers may function in a like manner to multimeric peptide MHC complexes (tetramers) binding more than one cell receptor on a specific cell. These findings evoke both peptidomimics of native ligands and their peptomers as potential reagents by which to target tumor cells for chemotherapy, imaging, or retargeting viral vectors for gene therapy. Copyright 2001 Wiley-Liss, Inc.
UI - 21377608
AU - Anderson CF
TI - ...and things that go bump in the night.
SO - Tex Dent J 2001 Jun;118(6):430
UI - 21377900
AU - Gordon S; Geist RY; Hirschman B; Geist J
TI - Oral pathology quiz. Case 4. Squamous cell carcinoma.
SO - J Mich Dent Assoc 2001 Jun;83(5):36-7, 39
AD - Department of Diagnostic Sciences, University of Detroit Mercy School of Dentistry, USA.
UI - 21386166
AU - Syme SE; Drury TF; Horowitz AM
TI - Maryland dental hygienists' knowledge and opinions of oral cancer risk factors and diagnostic procedures.
SO - Oral Dis 2001 May;7(3):177-84
AD - Department of Dental Hygiene, University of Maryland, Baltimore Dental School, 21201-1586, USA. firstname.lastname@example.org
OBJECTIVES: To examine Maryland dental hygienists' (DHs) knowledge of oral cancer risk factors and diagnostic procedures, as well as opinions about the currency and adequacy of their oral cancer knowledge, educational preparation, interest in, and preferred types of, continuing education courses. METHODS: Seven hundred DHs were randomly selected from a registry of 2677 Maryland licensed dental hygienists. A mailed survey instrument provided baseline data on 331 (RR = 60%) DHs. Stratified tabular and logistic analytical techniques were employed (alpha level < or =0.05). RESULTS: Most correctly identified tobacco use (99.7%) and alcohol use (89%) as risk factors; however, 31% incorrectly identified poor oral hygiene as a risk factor. 64% of DHs correctly identified older age as a risk factor, yet only 16% identified that the majority of oral cancers are diagnosed in the 60+ year old age group. Nearly 91% correctly identified the examination procedures of the tongue for oral cancer detection; while only 16% of DHs correctly identified erythroplakia and leukoplakia as the conditions most likely associated with oral cancer. CONCLUSIONS: Gaps in knowledge exist and strongly suggest the need for continuing education courses to clarify risk factors and diagnostic procedures associated with earlier oral cancer detection and prevention.
UI - 21386169
AU - Schortinghui J; Hille JJ; Singh S
TI - Intraoral myxoid nerve sheath tumour.
SO - Oral Dis 2001 May;7(3):196-9
AD - Department of Oral and Maxillofacial Surgery, University Hospital Groningen, The Netherlands.
A case of an intraoral myxoid nerve sheath tumour of the dorsum of the tongue in a 73-year-old Caucasian male is reported. This case describes the oldest patient with this pathology to date. Immunoperoxidase staining for neuron-specific enolase (NSE) and epithelial membrane antigen (EMA) expression demonstrated the perineural origin of the lesion.
UI - 21329613
AU - Saha B; Mondal AC; Majumder J; Basu S; Dasgupta PS
TI - Physiological concentrations of dopamine inhibit the proliferation and cytotoxicity of human CD4+ and CD8+ T cells in vitro: a receptor-mediated mechanism.
SO - Neuroimmunomodulation 2001;9(1):23-33
AD - Signal Transduction and Biogenic Amines Lab, Chittaranjan National Cancer Institute, Calcutta, India.
OBJECTIVE: Dopamine, a catecholamine neurotransmitter, influences growth and proliferation of lymphocytes. Pharmacological doses of dopamine have been shown to modulate T cell functions significantly, but no information is available on the effect of physiological concentrations of circulating dopamine on CD4+ and CD8+ T cell functions. This information may be of importance since significantly elevated plasma dopamine levels were observed in humans during uncoping stress, and suppression of T cell functions during stress is a well-known phenomenon. However, the mechanism inducing the suppression of T cell functions during stress is not yet clear. In the present investigation, we evaluated the effect of the dopamine level attained in the plasma of individuals with uncoping stress on the proliferation and cytotoxicity of CD4+ and CD8+ T cells in vitro. METHODS: T cell subpopulations were separated by panning. The effect of dopamine on IL-2-induced cell proliferation in vitro was evaluated by [3H]thymidine incorporation and cytotoxicity by 51Cr release, receptors by radioligand binding, cAMP by an assay kit a