OncoLink - Abramson Cancer Center of the University of Pennsylvania

NCI CANCERLIT^® Search: Mouth Cancer - September 2002

National Cancer Institute^®

Uncommon cancers are also important.
Indian doctors defend "unethical" anticancer drug trial.
Clinical research. Hopkins reviews investment in Indian cancer drug trial.
Clinical research. India acts on flawed cancer drug trials.
Altered expression of integrins and basement membrane proteins in malignant and pre-malignant lesions of oral mucosa.
The retinoic acid receptor-beta (RAR-beta) mRNA expression in the oral squamous cell carcinoma associated with betel quid use.
Prediction of delayed neck metastasis in patients with stage I/II squamous cell carcinoma of the tongue.
The role of molecular techniques in preventing oral cancer and improving its poor prognosis: an illusion?
Solitary neurofibroma of the oral mucosa: a previously undescribed variant of neurofibroma.
Smokeless tobacco use and cancer of the upper respiratory tract.
Immunohistochemical localization of growth factors fibroblast growth factor-1 and fibroblast growth factor-2 and receptors fibroblast growth
Prevalence of Epstein-Barr virus in oral squamous cell carcinoma, oral lichen planus, and normal oral mucosa.
Clinical study of disseminated intravascular coagulation in oral and maxillofacial regions--predictors of onset and prognosis.
Sentinel node biopsy, lymphatic pattern and selective neck dissection in oral cancer.
Oral cancer--an underestimated killer.
Myoepithelioma of the palate: a case report.
Magnetic resonance determination of tumor thickness as predictive factor of cervical metastasis in oral tongue carcinoma.
Epstein-Barr virus latent membrane protein-1 (LMP-1) expression in oral squamous cell carcinoma.
Prognostic factors of clinically stage I and II oral tongue carcinoma-A comparative study of stage, thickness, shape, growth pattern, invasive
The addition of mood and anxiety domains to the University of Washington quality of life scale.
Primary neck management among patients with cancer of the oral cavity without clinical nodal metastases: A decision and sensitivity analysis.
Desmoplastic melanoma of the lip.
Coexpression of Ets-1 and p53 in oral carcinomas is associated with P-glycoprotein expression and poor prognosis.
Oral cancer and precancerous lesions.
Tumor angiogenesis as a prognostic factor in oral cavity carcinomas.
Blue rubber bleb nevus syndrome in a patient with ataxia and dementia.
[Value of panendoscopic examinations within the scope of diagnosing the extent of carcinoma of the mouth cavity]
[Prospective phase II study of neoadjuvant radiochemotherapy in advanced operable carcinoma of the mouth cavity. 3-year outcome]
[Effectiveness of neck dissection in metastasizing mouth carcinoma. Uni- and multivariate analysis of factors of influence]
Interaction of collagen-related genes and susceptibility to betel quid-induced oral submucous fibrosis.
Infrequent genetic alterations of the tumor suppressor gene PTEN/MMAC1 in squamous cell carcinoma of the oral cavity.
Lymphangioma involving the mandible: immunohistochemical expressions for the lymphatic proliferation.
Transnasal placement of percutaneous endoscopic gastrostomy with a pediatric endoscope in oropharyngeal obstruction.
Human papillomavirus as a risk factor for oral squamous cell carcinoma: a meta-analysis, 1982-1997.
Microsurgical tongue revascularization following oromandibular cancer resection.
[Prognostic factors in epidermoid carcinoma of the mobile tongue classified as T1-T2]
Epidemiology of oral cancers.
Interventional laser surgery: an effective surgical and diagnostic tool in oral precancer management.
Surgical margins for resection of squamous cell carcinoma of the lower lip.
Expression of type 2 nitric oxide synthase and p21 in oral squamous cell carcinoma.
Lymphoepithelioma-like carcinoma of oral cavity: report of three cases and literature review.
Stomal metastases complicating percutaneous endoscopic gastrostomy: CT findings and the argument for radiologic tube placement.
The association between Viadent use and oral leukoplakia--results of a matched case-control study.
Expression of inducible nitric oxide synthase in human oral premalignant epithelial lesions.
Maryland family physicians' knowledge, opinions and practices about oral cancer.
Intralesional vinblastine vs. 3% sodium tetradecyl sulfate for the treatment of oral Kaposi's sarcoma. A double blind, randomized clinical
Overexpression of extracellular-signal regulated kinases on oral squamous cell carcinoma.
Genetic polymorphisms of drug-metabolizing enzymes and susceptibility to oral cavity cancer.
Prognostic factors in betel and tobacco related oral cancer.
Orofacial rhabdomyosarcoma in neonates and young children: a review of literature and management of four cases.
Minimally differentiated acute myelogenous leukemia (AML-M0) granulocytic sarcoma presenting in the oral cavity.
The histopathological characterization of oral Candida leukoplakias.
Computer assisted analysis of the microvasculature in metastasized and nonmetastasized squamous cell carcinomas of the tongue.
Histopathologic parameters in the evaluation of T1 squamous cell carcinomas of the oral cavity.
Supraomohyoid neck dissection in the management of cervical lymph node metastases of squamous cell carcinoma of the lower lip.
"Tongue sandwich" bolster for skin graft immobilization.
Epithelial cell proliferative activity and oral cancer progression.
Mutations of the cell cycle arrest gene p21WAF1, but not the metastasis-inducing gene S100A4, are frequent in oral squamous cell
Selected parameters of blood coagulation and fibrinolysis prior to and after surgical treatment of squamous cell carcinoma of the oral cavity.
High concentration of beta-defensin-2 in oral squamous cell carcinoma.
Development of Kaposi's sarcoma at the site of a biopsy.
Lingual thyroid carcinoma: a case report and review of the literature.
Systematic review of randomized trials for the treatment of oral leukoplakia.
[Prognostic value of antibodies against p53 in patients with oral squamous cell carcinoma--five years survival rate]
Anti-epidermal growth factor receptor monoclonal antibody 225 upregulates p27(KIP1) and p15(INK4B) and induces G1 arrest in oral
Unilateral cleft lip complicated by a hemangioma.
Development of Kaposi's sarcoma in a surgical wound.
[Quality of life of patients with carcinomas of the mouth cavity]
Vascular endothelial growth factor (VEGF) expression correlates with p53 and ki-67 expressions in tongue squamous cell carcinoma.
Immunohistochemical detection of early-stage carcinogenesis of oral leukoplakia by increased DNA-instability and various malignancy markers.
Telomerase activity detected in oral lichen planus by RNA in situ hybridisation: not a marker for malignant transformation.
The combination of ionizing radiation and expression of a wild type p53 gene via recombinant adenovirus induced a prominent tumour suppressing
Incidence and survival of squamous cell carcinoma of the tongue in Scandinavia, with special reference to young adults.
Neurilemmoma of the hard palate.
Reconstruction of a combined lip-mandible defect by a single fibula flap.
Human papilloma virus DNA detection in oral lesions in the Greek population.
Impact of genomic instability in risk assessment and chemoprevention of oral premalignancies.
[Can you trust on a biopsy from oral mucosa? The lesion can be cancer, after all]
[Factors that increase the risk of oral cancer and cancer-resembling changes of oral mucosa]
Prognostic indicators of occult metastases in oral cancer.
Prognostic indicators of occult metastases in oral cancer.
High-resolution mapping of the 11q13 amplicon and identification of a gene, TAOS1, that is amplified and overexpressed in oral cancer cells.
Multiple head and neck tumors frequently originate from a single preneoplastic lesion.
The effect of retinoids on premalignant oral lesions: focus on topical therapy.
Do it or lose it.
One more time.
Quality of life following surgery for oral and pharyngeal malignancy.
Re: Anderson G, Lewthwaite A, Yeats N. quality of life following surgery for oral and pharyngealmalignancy. Br J Oral maxillofac surg 2001;39:
Decreased expression of Ku70/Ku80 proteins in malignant melanomas of the oral cavity.
Identification of Epstein-Barr virus strain variants in hairy leukoplakia and peripheral blood by use of a heteroduplex tracking
Quantitative real-time PCR identifies a critical region of deletion on 22q13 related to prognosis in oral cancer.
[Oral leukoplakia]
Prognostic value of mandibular involvement in oral cavity cancers.
Early recognition of oral cancer: a team approach.
Early recognition of oral cancer.
Refractory localized "periodontitis".
Cathepsin expression in oral squamous cell carcinoma: relationship with clinicopathologic factors.

1
UI - 11905796
AU - Dimitrov BD
TI - Uncommon cancers are also important.
SO - Lancet Oncol 2001 Feb;2(2):71-2

2
UI - 11498476
AU - Mudur G
TI - Indian doctors defend "unethical" anticancer drug trial.
SO - BMJ 2001 Aug 11;323(7308):299

3
UI - 11498549
AU - Bagla P; Marshall E
TI - Clinical research. Hopkins reviews investment in Indian cancer drug trial.
SO - Science 2001 Aug 10;293(5532):1024

4
UI - 11577215
AU - Bagla P
TI - Clinical research. India acts on flawed cancer drug trials.
SO - Science 2001 Sep 28;293(5539):2371-3

5
UI - 11860227
AU - Giannelli G; Milillo L; Marinosci F; Muzio LL; Serpico R; Antonaci S
TI - Altered expression of integrins and basement membrane proteins in malignant and pre-malignant lesions of oral mucosa.
SO - J Biol Regul Homeost Agents 2001 Oct-Dec;15(4):375-80
AD - Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Medical School, Italy. g.gianelli@intmed.uniba.it
Integrins are transmembrane receptors that regulate cell-cell and cell-extracellular matrix (ECM) contact. In epithelial tissues, they interact with ECM components of the basement membrane (BM) to maintain the homeostasis and the architecture of the tissue. This interaction controls several cell functions such as adhesion, migration, proliferation, differentiation, and therefore has a key role in cancer development and metastasis. We studied the expression of integrins and ECM components of the BM by immunohistochemistry in frozen specimens of malignant squamous cell carcinoma (SCC), pre-malignant lesions of the oral mucosa (leucoplakia) and oral lichen planus. In invasive SCC, we observed altered polarity and distribution of alpha2beta1, alpha6beta4 and alpha3beta1 integrins, whereas in the in situ carcinoma alpha6beta4 and alpha3beta1 patterns only were altered. Immunostaining for ECM components such as Laminin-1 (Ln-1), Ln-5, and Collagen IV (Coll IV) was discontinuous and interrupted in invasive SCC, whereas it was normal in the in situ carcinoma. In both pre-malignant lesions and lichen planus specimens, integrins were expressed in a polarized manner in the presence of a normal BM, whereas were abnormally distributed in those tissues with altered staining patterns of the ECM components. In conclusion, we suggest that abnormal re-distribution of alpha3beta1 and alpha6beta4 integrins and expression of ECM components such as Ln-5 could play an important role in SCC invasion and metastasis.

6
UI - 12076325
AU - Kao SY; Tu HF; Chang KW; Chang CS; Yang CC; Lin SC
TI - The retinoic acid receptor-beta (RAR-beta) mRNA expression in the oral squamous cell carcinoma associated with betel quid use.
SO - J Oral Pathol Med 2002 Apr;31(4):220-6
AD - Department of Dentistry, Oral Maxillofacial Surgery, Veterans General Hospital-Taipei/School of Dentistry, National Yang-Ming University, Taipei, Taiwan, R.O.C.
BACKGROUND: Within the abundant retinoids nuclear receptors, abnormally low expression of the RAR-beta has been shown to contribute to neoplastic progression in oral epithelium in western countries. Distinctly different risk factors contributing to oral squamous cell carcinoma (OSCC) in epidemiologically different societies denote the value of exploring the role of RAR-beta expression in OSCC associated with betel quid (BQ) use in our society. METHODS: We examined the cellular expression of RAR-beta using in situ hybridization (ISH) analysis on 38 pairs of surgical specimens of primary OSCC and non-cancerous matched tissues (NCMT) to correlate with their clinico-pathological features including age, sites of tumor, habit of BQ use, stage, size of primary tumor, lymph node metastasis, differentiation. RESULTS: Of all cases analyzed, BQ users were significantly younger than non-BQ users (51.2 +/- 2.1 vs. 60.2 +/- 2.6, P = 0.01). 52% OSCC of BQ users (13/25) and 23% OSCC of non-BQ users (3/13) exhibited the absence of RAR-beta expression. In 17 paired-samples from buccal mucosa (BM), most NCMT and less than half of OSCC exhibited RAR-beta expression (16/17, 94% vs. 8/17, 47%, P = 0.003). The RAR-beta expression was seen in the vast majority of the well-differentiated OSCC and in less than half of the moderately differentiated OSCC only (15/20, 75% vs. 7/18, 39%, P = 0.03). CONCLUSION: A correlation between the loss of RAR-beta expression and more advanced histopathological grade tumors was observed. This study also suggests that the loss of RAR-beta expression is significant in BM OSCC, which preferentially occurs in BQ users.

7
UI - 12076326
AU - Okamoto M; Nishimine M; Kishi M; Kirita T; Sugimura M; Nakamura M;
TI - Konishi N Prediction of delayed neck metastasis in patients with stage I/II squamous cell carcinoma of the tongue.
SO - J Oral Pathol Med 2002 Apr;31(4):227-33
AD - Department of Oral and Maxillofacial Surgery, Nara Medical University, Nara, Japan. masumi8148@hotmail.com
BACKGROUND: The incidence of delayed neck metastasis (DNM) in patients with squamous cell carcinoma (SCC) of the tongue is reported to be 20% to 50%. Although clinically negative cervical lymph nodes (N0) are associated with a good outcome, the prognosis is poor in patients with DNM. The aim of this study was to evaluate the clinicopathological and immunohistochemical parameters associated with DNM in patients with stage I/II SCC. METHODS: Fifty nine patients, with previously untreated stage I/II carcinoma, underwent examination of clinicopathological and immunohistochemical parameters and incidence of DNM. A linear discriminant analysis was used to analyze prognostic factors and to determine the probability of DNM occurring. RESULTS: DNM occurred in 14 (24%) subjects of the 59 study patients, level I to level III, within 5 years. Parameters such as gender and age, disease stage, tumor size and histological grade, tumor location, degree of tumor invasion and expression of VEGF, E-cadherin or Ki-67 showed no significant correlation with the occurrence of DNM; however, factors such as tumor morphology, tumor thickness greater than 4 mm, and Flt-4 expression were significantly associated with development of DNM. CONCLUSIONS: Such factors provide useful information with regard to DNM and the prognosis. We concluded that patients with early SCC whose tumors are > 4 mm in thickness and immunopositive for Flt-4 are particularly at risk of developing DNM.

8
UI - 12076331
AU - Mignogna MD; Fedele S; Ruoppo E; Lo Russo L
TI - The role of molecular techniques in preventing oral cancer and improving its poor prognosis: an illusion?
SO - J Oral Pathol Med 2002 Apr;31(4):246-8; discussion 249-51

9
UI - 12058872
AU - Shimoyama T; Kato T; Nasu D; Kaneko T; Horie N; Ide F
TI - Solitary neurofibroma of the oral mucosa: a previously undescribed variant of neurofibroma.
SO - J Oral Sci 2002 Mar;44(1):59-63
AD - Department of Oral Surgery, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan.
We report a distinct morphologic type of neurofibroma, lipomatous neurofibroma, arising in the oral mucosa, which has not been described previously in the literature. A 25-year-old female patient presented with a solitary mucosal mass on the palatal gingiva. Although the limited biopsy material was diagnosed as a spindle cell lipoma, characteristic light microscopic neurofibromatous areas, intricately admixed with mature fat, were found in the entire resection specimen. Immunohistochemically, many of the spindle cells were positive, either diffusely or focally, for common neural markers, with patchy staining for CD34 and epithelial membrane antigen. S-100 protein was also positive in adipocytes. Ultrastructural examination confirmed the diagnosis of neurofibroma and suggested an intimate relationship between neoplastic neural cells and adipocytes.

10
UI - 12075196
AU - Rodu B; Cole P
TI - Smokeless tobacco use and cancer of the upper respiratory tract.
SO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002 May;93(5):511-5
AD - University of Alabama at Birmingham, AL 35294-0007, USA. rodu@uab.edu
The most recent epidemiologic review of the cancer risks associated with smokeless tobacco use appeared in 1986, when 10 studies were available. This review describes 21 published studies, 20 of which are of the case-control type. We characterize each study according to the specific anatomic sites and according to the type of smokeless tobacco products for which it provides relative risks of cancer. The use of moist snuff and chewing tobacco imposes minimal risks for cancers of the oral cavity and other upper respiratory sites, with relative risks ranging from 0.6 to 1.7. The use of dry snuff imposes higher risks, ranging from 4 to 13, and the risks from smokeless tobacco, unspecified as to type, are intermediate, from 1.5 to 2.8. The strengths and limitations of the studies and implications for future research are discussed.

12
UI - 12075209
AU - Sand LP; Jalouli J; Larsson PA; Hirsch JM
TI - Prevalence of Epstein-Barr virus in oral squamous cell carcinoma, oral lichen planus, and normal oral mucosa.
SO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002 May;93(5):586-92
AD - Goteborg University, Angelholm Hospital, Goteborg, Angelholm, Sweden.
OBJECTIVE: The Epstein-Barr virus (EBV) is associated with both malignant and benign diseases in the head and neck region. In several studies it has also been associated with oral squamous cell carcinoma (OSCC). Oral lichen planus (OLP) is a disease with unknown origin, and viral antigens have been proposed as etiologic agents. Smoking and alcohol habits are known risk factors for oral cancer development. In this study, the prevalence of EBV in OSCC and OLP was investigated, along with the effect of smoking, alcohol use, and age on EBV prevalence. STUDY DESIGN: We examined 29 patients with OSCC, 23 with OLP, and 67 with clinically healthy oral mucosa. For EBV DNA analysis, a nested polymerase chain reaction method was used. RESULTS: The overall EBV prevalence in patients with oral disease was 32.1%. Of the OSCC patients, 37.9% were EBV positive; and of the OLP patients, 26.1% were EBV positive. Both percentages were statistically significant compared with that of control patients (7.3%). The difference in EBV prevalence between the smoking control group and the nonsmoking control group was insignificant. Increased age did not enhance EBV prevalence. CONCLUSIONS: This investigation shows that EBV is present in oral diseases such as OSCC and OLP. Smoking, alcohol use, or age does not seem to be a risk factor for EBV infection. The etiologic role of EBV in OSCC and OLP needs to be examined in a prospective follow-up study.

13
UI - 12117204
AU - Morimoto Y; Ikeuchi M; Yamamoto K; Kirita T; Sugimura M
TI - Clinical study of disseminated intravascular coagulation in oral and maxillofacial regions--predictors of onset and prognosis.
SO - Oral Dis 2001 Sep;7(5):291-5
AD - Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan. ysn-mori@nmu-gw.naramed-u.ac.jp
OBJECTIVES: To examine disseminated intravascular coagulation (DIC) cases in detail to identify the predictors of onset and prognosis. STUDY DESIGN: The clinical records of eight patients with DIC were examined with regard to the patient's background, underlying disease, direct inducers, duration, contents of treatments and outcome. The factors which controlled the onset and prognosis of DIC were examined in cases receiving surgery for malignant neoplasm compared with non-DIC cases. Wilcoxon test was used for statistical analysis. RESULTS: There were seven males and one female, age range from 25 to 93 years. The underlying diseases were six malignant neoplasms, one severe infection, and one case of multiple injuries of the mandible. Seven patients had pretherapeutic complications, and six patients recovered. Reduction in platelet counts immediately after the operation revealed high values up to 36%, and patients with more than two pretherapeutic complications were more susceptible to DIC when major postoperative complications occurred. The operation time and blood loss may also have affected the outcome. CONCLUSION: Change of platelet counts, number of pretherapeutic complications, operation time and blood loss are important for predicting the onset and prognosis of DIC in the oral and maxillofacial regions.

14
UI - 12117209
AU - Chiesa F; Tradati N; Calabrese L
TI - Sentinel node biopsy, lymphatic pattern and selective neck dissection in oral cancer.
SO - Oral Dis 2001 Sep;7(5):317-8

15
UI - 12146119
AU - Bateman C
TI - Oral cancer--an underestimated killer.
SO - S Afr Med J 2002 Jun;92(6):410, 412

16
UI - 11889909
AU - Medici A; Tullio A; Bertolini F; Sesenna E
TI - Myoepithelioma of the palate: a case report.
SO - Acta Biomed Ateneo Parmense 2001;72(3-4):65-8
AD - Department of Maxillofacial Surgery, University Hospital of Parma, Italy. amedic@tin.it
Myoepithelioma is a rare malignant neoplasm, representing about the 1% of all the salivary gland's tumors. It mainly affects women, particularly in the 7th and 8th decade of life. A case of myoepithelioma of the palate in a 70-year-old woman is described. The tumor was completely excised two years ago. Nowadays, there are no signs of local recurrence and/or distant metastasis. The discrepancy between the histological diagnosis of low-grade malignancy and the clinical aggressive behavior of the tumor is discussed.

17
UI - 12148854
AU - Iwai H; Kyomoto R; Ha-Kawa SK; Lee S; Yamashita T
TI - Magnetic resonance determination of tumor thickness as predictive factor of cervical metastasis in oral tongue carcinoma.
SO - Laryngoscope 2002 Mar;112(3):457-61
AD - Department of Otorhinolaryngology, Kansai Medical University, Osaka, Japan. iwai@takii.kmu.ac.jp
OBJECTIVES: To establish an accurate and reproducible means of measuring tumor thickness as a preoperative prognostic factor for cervical metastasis in oral tongue carcinoma. STUDY DESIGN: Retrospective review. METHODS: Charts from 30 patients were reviewed, and the correlation between histopathological and magnetic resonance imaging (MRI) findings of actual tumor thickness or reconstructed tumor thickness measured between a reconstructed mucosal line and the deepest extent of the tumor was investigated. Magnetic resonance images were acquired on a 1.5 T-scanner with a T2-weighted sequence in the axial plane using 3-mm-thick sections and a 256 x 256 matrix. The correlation between N stage and tumor thickness acquired by histopathological scrutiny or MRI was also assessed. RESULTS: The correlation between histopathological and MRI examinations was more significant in terms of reconstructed than actual tumor thickness. No cervical metastasis was detected in patients with tumors of less than 6 mm of reconstructed thickness in the MRI examination. The difference in cervical metastasis between the two groups, namely, less than 6 or more than 6 mm, was statistically significant (P = .0051). CONCLUSIONS: Magnetic resonance imaging examination provides useful data for prognostic assessment and planning strategies with which to treat oral tongue carcinoma. The preoperative decision as to whether to attempt neck dissection could be based on a tumor thickness of 6 mm for patients with oral tongue carcinoma.

18
UI - 12148858
AU - Gonzalez-Moles MA; Gutierrez J; Rodriguez MJ; Ruiz-Avila I;
TI - Rodriguez-Archilla A Epstein-Barr virus latent membrane protein-1 (LMP-1) expression in oral squamous cell carcinoma.
SO - Laryngoscope 2002 Mar;112(3):482-7
AD - Department of Oral Medicine, School of Dentistry, University of Granada, Spain. magonzal@ugr.es
OBJECTIVES: Epstein-Barr virus (EBV) is frequently associated with malignant cell transformation through the action of the oncoprotein latent membrane protein-1 (LMP-1). The present study aimed to determine the presence of EBV in oral squamous cell carcinomas (OSCCs) and the expression of LMP-1 in neoplastic cells of EBV-positive OSCCs. STUDY DESIGN/METHODS: In a retrospective study of 78 OSCCs, we investigated the presence of the DNA of EBV by polymerase chain reaction, the expression of the oncoprotein LMP-1 by immunohistochemistry, and the presence of EBV-encoded RNA (EBER) by in situ hybridization. RESULTS: EBV DNA was detected in 19.2% of the cases. Expression of LMP-1 in neoplastic cells was found in 85.7% of the EBV-positive OSCCs. EBV presence was significantly more frequent (P <.05) in OSCCs localized on the lateral tongue. EBV-positive OSCCs more frequently presented (P <.05) greater nuclear atypia. CONCLUSION: EBV can appear in latent form in OSCC and express its main oncoprotein, LMP-1.

19
UI - 12112547
AU - Po Wing Yuen A; Lam KY; Lam LK; Ho CM; Wong A; Chow TL; Yuen WF; Wei WI
TI - Prognostic factors of clinically stage I and II oral tongue carcinoma-A comparative study of stage, thickness, shape, growth pattern, invasive front malignancy grading, Martinez-Gimeno score, and pathologic features.
SO - Head Neck 2002 Jun;24(6):513-20
AD - Department of Otorhinolaryngology, Queen Mary Hospital, Pokfulam Road, Hong Kong, China. pwyuen@hkucc.hku.hk
PURPOSE: This study aims at evaluation of the different prognostic models, including stage, tumor thickness, shape, malignancy grading of tumor invasive front, Martinez-Gimeno score, and pathologic features in the prediction of subclinical nodal metastasis, local recurrence, and survival of early T1 and T2 oral tongue squamous cell carcinoma. The results will have important implication for the management of patients. PATIENTS AND METHODS: Seventy-two clinically T1 and T2 glossectomy specimens of oral tongue carcinoma were serially sectioned in 3-mm thickness for the evaluation of various pathologic features. The prognostic value in the prediction of subclinical nodal metastasis, local recurrence, and survival of different models were compared. RESULTS: Among all the tumor parameters and predictive models being evaluated, tumor thickness was the only significant factor that had significant predictive value for subclinical nodal metastasis, local recurrence, and survival. With the use of 3-mm and 9-mm division, tumor of up to 3-mm thickness has 8% subclinical nodal metastasis, 0% local recurrence, and 100% 5-year actuarial disease-free survival; tumor thickness of more than 3 mm and up to 9 mm had 44% subclinical nodal metastasis, 7% local recurrence, and 76% 5-year actuarial disease-free survival; tumor of more than 9 mm had 53% subclinical nodal metastasis, 24% local recurrence, and 66% 5-year actuarial disease-free survival. CONCLUSIONS: Tumor thickness should be considered in the management planning of patients with early oral tongue carcinoma. Copyright 2002 Wiley Periodicals, Inc.

20
UI - 12112548
AU - Rogers SN; Gwanne S; Lowe D; Humphris G; Yueh B; Weymuller EA Jr
TI - The addition of mood and anxiety domains to the University of Washington quality of life scale.
SO - Head Neck 2002 Jun;24(6):521-9
AD - Consultant and Honorary Reader, Regional Maxillofacial Unit, University Hospital Aintree, Fazakerley, Liverpool L9 1AL United Kingdom. snrongers@globalnet.co.uk
BACKGROUND: There are numerous head and neck specific quality of life questionnaires, each having its own merits and disadvantages. The University of Washington questionnaire has been widely used and is notable by the inclusion of a shoulder dysfunction domain, domain importance ratings, and patient free text. It is short, simple to process, and provides clinically relevant information. However, it has lacked any psychological dimension of quality of life. The aim of this study was to report the inclusion of two psychological domains (mood, anxiety) to the most recent refinement of the questionnaire (version 3). Questionnaires were sent to 183 patients alive and disease free after surgery for oral and oro-pharyngeal malignancy. Replies were received from 145 patients (79% response rate). RESULTS: The new domains (mood and anxiety) correlated significantly with the emotional functioning domains from the EORTC C30 and with the pain and appearance domains of UW-QOL. There were also significant correlations between the "global quality of life" item and the two new domains. Mood (p =.005) and anxiety (p <.001) scores were associated with patient age but with no other clinicodemographic variable. CONCLUSION: The addition of mood and anxiety domains makes the UW-QOL version 4 a single broad measure suitable for effective health-related quality of life evaluation in the routine clinical setting. Copyright 2002 Wiley Periodicals, Inc.

21
UI - 12112556
AU - Kaneko S; Yoshimura T; Ikemura K; Shirasuna K; Kusukawa J; Ohishi M;
TI - Shiba R; Sunakawa H; Tominaga K; Sugihara K; Shinohara M; Katsuki T; Yanagisawa S; Kurokawa H; Mimura T; Ikeda H; Yamabe S; Ozeki S Primary neck management among patients with cancer of the oral cavity without clinical nodal metastases: A decision and sensitivity analysis.
SO - Head Neck 2002 Jun;24(6):582-90
AD - Department of Clinical Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan. stkaneko@ncc.go.jp
BACKGROUND: A standardized neck management strategy for oral cancer patients without clinical nodal metastases remains to be established. Consequently, a decision and sensitivity analysis of two neck management protocols, involving either prophylactic neck dissection or careful observation, was conducted using the Oral Cancer Registry of Kyushu, Japan. METHODS: We calculated probabilities of subclinical nodal metastases and 5-year survival using the registry data. A two-way sensitive analysis was conducted using the probabilities and parameters of the complete nodal metastasis resection rate (x) and a utility rating that describes the health state induced by dissection (y) compared with the neck condition in a careful-observation group. RESULTS: We solved the threshold curve for y and x for the expected utility between the two groups. The results showed that prophylactic neck dissection must guarantee a complete resection of subclinical nodal metastases with no disadvantage to health state to be evaluated as equally satisfactory as careful observation. CONCLUSIONS: Careful observation involving standardized systematic preoperative and postoperative screening of the neck seems preferable to prophylactic neck dissection for oral cancer patients without subclinical nodal metastases. Copyright 2002 Wiley Periodicals, Inc.

22
UI - 12112559
AU - Hessel AC; Byers RM
TI - Desmoplastic melanoma of the lip.
SO - Head Neck 2002 Jun;24(6):605-8
AD - Department of Head and Neck Surgery, Box 441, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA.
BACKGROUND: This retrospective study looks at the prognosis of desmoplastic melanoma of the lip, correlating it with the clinical course, treatment, and patterns of failure. METHOD: Twenty-two patients with desmoplastic melanoma of the lip were seen at the University of Texas M. D. Anderson Cancer Center from 1965 to 1998. RESULTS: Three disease groups: (I) untreated tumor (3 patients), (II) excisional scar (10 patients), and (III) locoregional recurrence (9 patients). Group I had two cures and one failure. In group II six had no recurrences, and there were four failures. In group III, all patients failed. Ten patients (45%) had no evidence of disease, of which three (30%) had an initial misdiagnosis. Twelve patients (55%) died of disease or were living with disease, of which eight (67%) had an initial misdiagnosis. CONCLUSIONS: Desmoplastic melanoma of the lip is often misdiagnosed and, therefore, inappropriately treated with multiple recurrences and poor prognosis. Accurate diagnosis and combined treatment may improve local control and survival. Copyright 2002 Wiley Periodicals, Inc.

23
UI - 12073053
AU - Soni S; Pande P; Shukla NK; Ralhan R
TI - Coexpression of Ets-1 and p53 in oral carcinomas is associated with P-glycoprotein expression and poor prognosis.
SO - J Cancer Res Clin Oncol 2002 Jun;128(6):336-42
AD - Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
PURPOSE: To determine the association between the expression of P-gp with Ets-1 and p53 proteins in oral squamous cell carcinomas (SCCs). MATERIALS AND METHODS: Immunohistochemical analysis of Ets-1, P-glycoprotein (P-gp), and p53 proteins was carried out in 40 formalin-fixed, paraffin-embedded tissue sections from oral SCCs using specific antibodies for these proteins. RESULTS: Expression of Ets-1 protein was observed in 27/40 (68%) cases, P-gp was overexpressed in 27/40 (68%) cases, and p53 accumulation was observed in 26/40 (65%) cases. Twenty-two of 27 (82%) SCCs showed concomitant overexpression of Ets-1 and P-gp underpinning an association between the expression of these two proteins ( P=0.007). Twenty-one of 27 (78%) Ets-1 overexpressing oral SCCs showed accumulation of p53 protein ( P=0.015). Nineteen of the 27 (70%) P-gp expressing tumours showed p53 accumulation. Concomitant Ets-1 and P-gp overexpression was significantly associated with poor prognosis ( P=0.002). In multivariate analysis using Cox's proportional hazards model, P-glycoprotein emerged as the most significant adverse predictor of disease-free survival (HR=6.2, P=0.003). The hallmark of the study was the significant association between the expression of Ets-1, P-gp, and p53 proteins in oral SCCs and their association with poor prognosis. Oral cancer patients showing concomitant expression of Ets-1, P-gp, and p53 proteins had shorter disease-free survival (median time of no recurrence=18 months) and worst prognosis ( P=0.001) as compared to the cases overexpressing any of these proteins. CONCLUSION: Concomitant expression of Ets-1, P-gp, and p53 proteins adversely affects the clinical outcome in oral SCCs.

24
UI - 12139232
AU - Neville BW; Day TA
TI - Oral cancer and precancerous lesions.
SO - CA Cancer J Clin 2002 Jul-Aug;52(4):195-215
AD - Department of Stomatology, College of Dental Medicine, Medical University of South Carolina, Charleston, USA.
In the United States, cancers of the oral cavity and oropharynx represent approximately three percent of all malignancies in men and two percent of all malignancies in women. The American Cancer Society estimates that 28,900 new cases of oral cancer will be diagnosed in 2002, and nearly 7,400 people will die from this disease. Over 90 percent of these tumors are squamous cell carcinomas, which arise from the oral mucosal lining. In spite of the ready accessibility of the oral cavity to direct examination, these malignancies still are often not detected until a late stage, and the survival rate for oral cancer has remained essentially unchanged over the past three decades. The purpose of this article is to review the clinical features of oral cancer and premalignant oral lesions, with an emphasis on early detection.

25
UI - 11876537
AU - Lopez-Graniel CM; Tamez de Leon D; Meneses-Garcia A; Gomez-Ruiz C;
TI - Frias-Mendivil M; Granados-Garcia M; Barrera-Franco JL Tumor angiogenesis as a prognostic factor in oral cavity carcinomas.
SO - J Exp Clin Cancer Res 2001 Dec;20(4):463-8
AD - Surgical Oncology Division, Instituto Nacional de Cancerologia, Mexico City, Mexico. iceberg1@prodigy.net.mx
Currently, lymph node metastasis and thickness of the tumor are the gold standard as a predictor of survival in patients with oral cavity squamous cell carcinoma (OSCC). However, there is a significant correlation between microvessel density and the development of cervical metastases or recurrence. Previous studies have demonstrated that head and neck cancers are able to induce an angiogenic response in experimental models. This factor shows a strong correlation with regional recurrence. In this study we propose to use angiogenesis as an independent prognostic indicator of recurrence. We evaluated the expression of tumor angiogenesis in OSCC and determinated its possible usefulness as a prognostic factor. Thirty-three cases with diagnosis of Neck Department of the Instituto Nacional de Cancerologia in Mexico City. These cases were analyzed retrospectively for a minimum period of six months. All of them received a conventional complete treatment to the primary tumor and lymph node metastasis. Paraffin-embedded tumor specimens were available in all patients. The tumors were scanned and the areas of highest microvessel density (MVD) were immunostained for CD-34 using QBEnd/10 antibody. Statistical analysis included descriptive statistics, Wilcoxon test curves, and Cox's proportional hazards model for multivariate analysis. We identified 33 patients with OSCC, 16 were men and 17 women. The mean age among all patients was 58.9 years old. Based on tumor size 33.3% were T1, 27.3% T2, 12.1% T3, and 27.3% T4. The median microvessel count was 32.5. The mean percentage of MVD was 37 in patients with regional recurrence and in those patients without regional metastasis was 29 (p<0.05). 57.9% of the patients who presented recurrence had vessel counts over the median (p<0.01). In fact, 6 patients (46%) who showed more than 20% of angiogenesis expression and higher MVD presented with recurrence. Only 3 patients (23%) who had less than 20% of angiogenesis expression and lower MVD developed recurrence (p<0.01). Higher MVD was seen with increasing T and N stages; however, it did not show correlation with survival. In this study, angiogenesis expression demonstrated to be an independent factor of recurrence in patients with OSCC. It is suggested that it should be used as an independent prognostic indicator. In concordance with previous reports, we observed a significant correlation between MVD determination and recurrence of the tumor, followed by lymph node metastases and tumor size.

26
UI - 11936246
AU - Vig EK; Brodkin KI; Raugi GJ; Gladstone H
TI - Blue rubber bleb nevus syndrome in a patient with ataxia and dementia.
SO - J Geriatr Psychiatry Neurol 2002 Spring;15(1):7-11
AD - Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, USA.
Blue rubber bleb nevus syndrome (BRBNS), an uncommon disorder characterized by cavernous hemangiomas, most often of the skin and gastrointestinal tract, is usually diagnosed during childhood and young adulthood. We made this diagnosis in an octogenarian referred to a geriatric medicine clinic because of concerns about his ability to live independently. Ataxia, dementia, focal neurologic signs, and bluish/purplish vascular nodules on his lips, buccal mucosa, tongue, chest, and neck were noted on physical examination. Magnetic resonance imaging (MRI) revealed an old left parietal infarction, multiple cavernous hemangiomas most densely concentrated in the subcortical structures and cerebellum, and areas of hemosiderin deposition. Skin biopsy findings were consistent with hemangioma. The physical examination, MRI, and skin biopsy made a diagnosis of BRBNS likely. The patient's ataxia, dementia, and other neurologic signs can be explained by previous hemorrhage from the vascular malformations in his brain. Blue rubber bleb nevus syndrome is an uncommon cause of a relatively common geriatric syndrome presentation.

27
UI - 12017873
AU - Hoffmann J; Scheiderbauer H; Krimmel M; Grund KE; Reinert S
TI - [Value of panendoscopic examinations within the scope of diagnosing the extent of carcinoma of the mouth cavity]
SO - Mund Kiefer Gesichtschir 2002 Mar;6(2):111-6
AD - Klinik und Poliklinik fur Mund-, Kiefer- und Gesichtschirurgie, Universitatsklinikum Tubingen, Osianderstrasse 2-8, 72076 Tubingen. juergen.hoffmann@uni-tuebingen.de
BACKGROUND: In our department panendoscopic examinations of the tracheobronchial system, the epi-, meso,- and hypopharynx, and the upper gastrointestinal tract are obligatory with regard to the staging of oral squamous cell carcinomas, the main interest being the exclusion of synchronous secondary carcinomas. The aim of this study was to present the pathological findings in 160 panendoscopies of patients with previously untreated oral squamous cell carcinomas. STUDY: A total of 17 synchronous carcinomas were found in 13 (8.2%) of all cases studied. They were situated in the esophagus (n = 9), the stomach (n = 1), the duodenum (n = 1), the hypopharynx (n = 1), the trachea (n = 1), and the lung (n = 4). Multiple carcinomas were found in three patients. The survival time of patients with a secondary carcinoma proved to be significantly worse than that of the other patients. The abuse of alcohol and tobacco causes a high amount of inflammatory changes in the aerodigestive system. In 27 cases (17%) ulcers of the stomach or duodenum were found, although the majority of the patients had large inflammatory mucosal alterations. In 49 cases (34.5%) a chronic tracheobronchitis could be found. DISCUSSION: In our opinion there is an absolute indication for panendoscopic examinations of patients with oral squamous cell carcinomas. In cases with dysplastic mucosal findings these endoscopies have to be repeated on a regular basis.

28
UI - 12017874
AU - Eckardt A; Rades D; Rudat V; Hofele C; Dammer R; Dietl B; Wildfang I;
TI - Karstens JH [Prospective phase II study of neoadjuvant radiochemotherapy in advanced operable carcinoma of the mouth cavity. 3-year outcome]
SO - Mund Kiefer Gesichtschir 2002 Mar;6(2):117-21
AD - Klinik fur Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover. eckardt.andre@mh-hannover.de
PURPOSE: The purpose of simultaneous chemoradiotherapy is to increase local-regional control and to decrease the incidence of distant metastases. Regimens containing cisplatin/5-FU chemotherapy are widely accepted as standard treatment in advanced head and neck cancer. Most studies reported promising response and survival data, but also severe mucosal toxicity. In recent years the newly developed drug Taxol demonstrated interesting activity in head and neck cancer as a single agent as well as in combination drug regimens. In the present outpatient phase II trial, we investigated the combination of Taxol/carboplatin with 40 Gy radiotherapy in a neoadjuvant setting of operable stage III/IV squamous cell carcinoma of the oral cavity and oropharynx. PATIENTS AND METHODS: Fifty-three patients were enrolled in this trial weekly of Taxol (40 mg/m2) and carboplatin (AUC 1.5) with conventional radiotherapy (40 Gy). Within 3-4 weeks after chemoradiotherapy resection of the primary tumor and the regional neck nodes was performed. RESULTS: Fifty-two patients were evaluable for toxicity and response. Complete response was observed in 31 of 52 patients (CR 60%), and partial remission was seen in 21 of 52 patients (PR 40%). In 30 of 52 patients complete pathologic response (pCR 58%) was documented in the resection specimens. The 1-, 2-, and 3-year overall survival rate was calculated as 84%. CONCLUSION: Our present results demonstrated impressive clinical and pathological response rates of concurrent Taxol/carboplatin and radiotherapy as a preoperative treatment modality in advanced oral and oropharyngeal cancer.

29
UI - 12017879
AU - Kokemuller H; Brachvogel P; Eckardt A; Hausamen JE
TI - [Effectiveness of neck dissection in metastasizing mouth carcinoma. Uni- and multivariate analysis of factors of influence]
SO - Mund Kiefer Gesichtschir 2002 Mar;6(2):91-7
AD - Klinik und Poliklinik fur Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover. mkg-chirurgie@mh.hannover.de
BACKGROUND: The purpose of this study was to evaluate the oncologic effectiveness of radical and different types of modified neck dissections with preservation of n. accessorius, v. jugularis interna, and m. sternocleidomastoideus and to identify prognostic factors for regional control and survival in univariate and multivariate analysis. METHODS: This retrospective study included 373 patients with squamous cell carcinoma of the oral cavity who underwent 401 neck dissections Maxillofacial Surgery, Hanover Medical School. RESULTS: The 5-year regional control was estimated at 87%. Relapse occurred only within the first 2 years after neck dissection. The number of positive nodes, metastases without lymphatic tissue, preparation of metastases from the carotid artery and cranial base, and preoperative radiochemotherapy were analyzed as prognostic factors with significant influence. The grade of metastases, extracapsular spread, lymphangiosis carcinomatosa, and postoperative radiation showed no prognostic significance. DISCUSSION: The comparison of recurrent metastases after radical and modified neck dissection demonstrated that as the extent of neck disease increased there was a tendency toward improved regional control after radical neck dissection.

30
UI - 12101112
AU - Chiu CJ; Chang ML; Chiang CP; Hahn LJ; Hsieh LL; Chen CJ
TI - Interaction of collagen-related genes and susceptibility to betel quid-induced oral submucous fibrosis.
SO - Cancer Epidemiol Biomarkers Prev 2002 Jul;11(7):646-53
AD - Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei 100, Taiwan.
Oral submucous fibrosis (OSF) is a precancerous condition of the oral cavity.It is a collagen-related disorder induced by betel quid chewing, a habit that is common in Taiwan. However, the cumulative exposure to betel quids varies in OSF patients. It seems that there is individual susceptibility to betel quid-induced OSF. This study compared the association of OSF and polymorphisms of six collagen-related genes, collagen 1A1 and 1A2 (COL1A1 and COL1A2), collagenase-1 (COLase), transforming growth factor beta1 (TGF-beta1), lysyl oxidase

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