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NCI CANCERLIT® Search: Mouth Cancer - March 2002
National Cancer Institute®
Last Modified: March 1, 2002
Table of Contents
1
UI - 11287280
AU - Mignogna MD; Lo Muzio L; Lo Russo L; Fedele S; Ruoppo E; Bucci E
TI -
Clinical guidelines in early detection of oral squamous cell carcinoma
arising in oral lichen planus: a 5-year experience.
SO - Oral Oncol 2001 Apr;37(3):262-7
AD - Department of Oral Medicine and Pathology, Faculty of Medicine, School
of Dentistry, University of Naples Federico II, Via Domenico Fontana 81
pal. 10, 80128, Naples, Italy.mdmig@tin.it
In recent years, studies on the malignant potential of oral lichen
planus (OLP) provided clinical evidence that patients affected by OLP
have an increased risk to develop oral squamous cell carcinoma (OSCC);
nevertheless, controversies still exist as to whether OLP has inherent
predisposition to become malignant, or not. We believe extremely careful
management of OLP patient is mandatory, and the aim of this paper is to
illustrate our clinical guidelines in evaluating the possible risk of
transformation in OLP lesions. Five-hundred and two patients (311 women
and 191 men) affected by OLP regularly undergo follow-up examination in
our Department. Patients' ages range from 18 to 83 years, with a mean of
55.4 years (57.5 for women and 53.9 for men); minimal follow-up period
is 4 months, with a maximum of 12 years. In our group of OLP patients in
the past 5 years we detected 24 carcinomas: excluding three cases in
which diagnoses of OLP and OSCC were synchronous and three patients who
had a history of tobacco use, thus possible malignant transformation of
OLP would appear to be 3.7%. Clinical criteria used in our follow-up
allowed us to detect 28.5% of tumours as in situ OSCC, 38% as
microinvasive OSCC, 28.5% as stage I OSCC and 4.7% as stage II OSCC,
with a remarkable improvement in prognosis compared to our previous
study in which we adopted different criteria.
2
UI - 11740475
AU - Katou F; Shirai N; Kimizuka S; Kamakura S; Echigo S; Motegi K
TI -
Comparison of reliability between the modified groin flap and the
forearm flap in oral reconstruction.
SO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001 Dec;92(6):602-5
AD - Department of Oral and Maxillofacial Surgery I, Tohoku University School
of Dentistry, Sendai, Japan. fkatou@mail.cc.tohoku.ac.jp
OBJECTIVE: The groin flap has the advantage of minimum donor-site
morbidity, while having the disadvantage of short vascular pedicle of
small caliber. Modification of the groin flap has improved the former
disadvantage, but the latter one remains. The purpose of this study was
to compare the reliability of the modified groin flap with the forearm
flap.Study Design: Eleven modified groin flaps and 40 forearm flaps
consecutively performed by a single surgeon in a hospital for patients
with oral cancer were retrospectively reviewed. RESULTS: The rate of
total flap loss in the modified groin flap group (8.3%) was higher than
that in the forearm flap group (2.5%). The rates of partial flap loss in
both flaps were similar to those of total flap loss. The failures of the
modified groin flap and the forearm flap were due to arterial and venous
complications, respectively. CONCLUSION: The modified groin flap appears
to be a little less reliable than is forearm flap; nevertheless, it
could be a good option for patients who desire less conspicuous
postoperative scars.
3
UI - 11740487
AU - Lee SS; Kim HK; Choi SC; Lee JI
TI -
Granulocytic sarcoma occurring in the maxillary gingiva demonstrated by
magnetic resonance imaging.
SO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001 Dec;92(6):689-93
AD - Department of Oral and Maxillofacial Radiology & Dental Research
Institute, College of Dentistry, Seoul National University, Korea.
We report the case of a 43-year-old woman presenting with a painless
swelling that had developed over 8 months in the maxillary labial
vestibule. An oral examination revealed an exophytic, firm,
black-pigmented lesion measuring 3.5 x 1.5 cm that bled on palpation.
Periapical radiographs showed a slightly enlarged periodontal ligament
space of the left central incisor and bone resorption in the region of
the missing lateral incisor. Panoramic and other conventional
radiographs showed no obvious lytic area, and a magnetic resonance
imaging examination demonstrated a low signal intensity lesion on both
the T1-weighted and the T2-weighted images. Therefore, granulocytic
sarcoma was suspected.Granulocytic sarcoma of the oral cavity is a rare
condition, and its diagnosis is usually difficult. Increased awareness
of this entity may minimize misinterpretation of radiographic and
clinical findings and can assist suitable treatment planning that is
essential to this pathosis.
4
UI - 11813674
AU - Forrest JL; Horowitz AM; Shmuely Y
TI -
Dental hygienists' knowledge, opinions, and practices related to oral
and pharyngeal cancer risk assessment.
SO - J Dent Hyg 2001 Fall;75(4):271-81
AD - National Center for Dental Hygiene Research, University of Southern
California School of Dentistry, USA.
METHODS: A pre-tested, validated 62-item survey was mailed to a 1%
national random sample of licensed dental hygienists, (n = 960). Four
complete mailings of the instrument resulted in a 74.4% percent return
rate of which 65% percent were usable (n = 464). Respondents provided
information on their knowledge of oral cancer risk assessment factors,
their use of health history questions to assess patients' oral cancer
risks, how they conduct oral cancer examinations, and their beliefs
about their oral cancer training. Data were analyzed using descriptive
and inferential statistics and evaluated at a significance level of p <
or = 0.05. RESULTS: Based on responses to 14 questions, the average
score on knowledge of oral cancer risk factors was 7.92, with a
significant difference found among age groups and year of graduation, (p
= 0.006). On average, dental hygienists assessed five of eight risk
assessment items with "use of alcohol" receiving the least attention.
Although nearly 100% percent agreed that oral cancer examinations for
adults 40 years of age or older should be provided annually, only 66%
percent reported doing so for patients on their initial appointment.
Seventy-four percent believed they were adequately trained to provide
oral cancer examinations, while only 27 percent agreed that they were
prepared to provide tobacco cessation counseling. There was no
significant correlation between knowledge of oral cancer risk factors
and probing these risk factors when conducting a health history.
CONCLUSIONS: Results from this study indicate that interventions are
needed to increase dental hygienists' knowledge of oral cancer risk
factors, correct misinformation, and close the gap between their
knowledge and its application in providing prevention and early
detection services. The majority believed that they are not as
knowledgeable as they could be and are interested in attending an oral
cancer continuing education (CE) course.
5
UI - 10615198
AU - Walton GM
TI -
Complications of percutaneous gastrostomy in patients with head and neck
cancer--an analysis of 42 consecutive patients.
SO - Ann R Coll Surg Engl 1999 Jul;81(4):272-6
AD - University Department of Oral and Maxillofacial Surgery, Manchester
Royal Infirmary, UK.
A total of 42 patients, who underwent insertion of a percutaneous
gastrostomy tube prior to resection for oral squamous cell carcinoma,
were investigated to examine the incidence and severity of complications
associated with use of this technique. The team performing the procedure
and the grade of operator was noted together with any subsequent
complications and their outcome. Previously reported complication rates
were 2.7-2.8% and 6-7.1% for major and minor complications,
respectively, but, in this series, a major complication rate of 22.5%
and minor complication rate of 17.5% were identified. The findings of
this study have led to the introduction of a further prospective audit
of this technique in the maxillofacial unit and a more selective policy
of PEG prescription for patients undergoing resection for head and neck
cancer.
6
UI - 11780476
AU - Zhou H; Gu X
TI -
[Surgical treatment of cervical lymph nodes in 301 patients with oral
squamous cell carcinoma]
SO - Zhonghua Kou Qiang Yi Xue Za Zhi 2000 Mar;35(2):108-9
AD - Department of Oral Maxillofacial Surgery, College of Stomatology, Fourth
Military Medical University, Xi'an 710032, China.
OBJECTIVE: To evaluate cervical lymph metastases and its surgical
treatment of oral carcinoma with regard to primary location and TNM
classification. METHODS: 301 previously untreated patients were included
in the follow-up study to calculate the rate of histopathologically
positive lymph metastasis and the rate of recurrences in untreated necks
and after FND (functional neck dissection). RESULTS: Lymph node
pathologic positive rates were N0 7.4%, N1 14.7%, N2 76.2%. Recurrences
occurred in 32.1% untreated necks and 14.7% necks after FND of
carcinomas of tongue, buccal, lower-gingiva and oral floor, while rarely
in necks of carcinomas of palate and upper-gingiva. CONCLUSIONS: TNM
classification is useful to estimate lymph metastasis. Application of
elective neck dissection needs to expand in carcinomas of the above four
sites. It should be careful when choose FND.
7
UI - 11776869
AU - Gao Y; Liu X; Han Z
TI -
[Type IV collagen and C-erbB-2 expression in oral candidal leukoplakia]
SO - Zhonghua Kou Qiang Yi Xue Za Zhi 1999 Nov;34(6):325-7
AD - School of Stomatology, Beijing Medical University, Beijing 100081.
OBJECTIVE: To investigate type IV collagen and C-erbB-2 expression in
oral candidal leukoplakia. METHODS: 27 cases of oral candidal
leukoplakia were studied by immunohistochemistry. RESULTS: In normal and
simple hyperplastic epithelia type IV collagen was noted as brown linear
staining along the basement membrane. The most obvious change in the
staining pattern was that the linear staining became very thin or
discontinued in dysplastic epithelia. C-erbB-2 was demonstrated in 25
cases(78%). The positive staining, as a reticular pattern, was located
at cell membrane, and not correlated with epithelial dysplasia.
CONCLUSION: The results indicate that type IV collagen expression
changed in candidal leukoplakia with epithelial dysplasia. This kind of
change may be related to basement membrane destruction. The
immunohistochemically expression of C-erbB-2 has no correlation with
epithelial dysplasia.
8
UI - 11776870
AU - Yao H; Wu B; Wu Q
TI -
[Study and detection of telomerase activity in oral squamous cell
carcinomas and precancerous lesions]
SO - Zhonghua Kou Qiang Yi Xue Za Zhi 1999 Nov;34(6):328-30
AD - Department of Stomatology, First Affiliated Hospital of Zhejiang Medical
University, Hangzhou 310003.
OBJECTIVE: To find out the expression of telomerase activity in oral
squamous cell carcinomas (SCC) and oral precancerous lesions. METHODS:
Telomerase activity was examined by telomerase PCR ELISA assay and
telomere repeat amplification protocol (TRAP) electrophoresis. 60 fresh
oral specimens were selected, including 20 oral SCC, 30 oral
precancerous lesions (10 oral leukoplakia, LK, 20 oral lichen planus,
LP) and 10 normal mucosa (NM). RESULTS: Telomerase activity detected in
SCC (0.128) was highest among all of the tissues(LK: 0.054, LP: 0.0094,
NM: 0.0014). Statistical difference was notable between SCC and LK, LP,
NM (P < 0.01). A little difference was detected between LK, LP and NM.
No difference was found between LK, and LP (P > 0.05). CONCLUSION:
Telomerase may play an important role during oncogenesis of oral
precancerous lesions, and may be a good molecular biomarker for
observing the cancerization ability of precancerous lesion and
estimating its prognosis.
9
UI - 11776894
AU - Gao Y; Liu J; Pang S
TI -
[Alteration of CD44v3 and CD44v6 expression in oral premalignant
epithelia]
SO - Zhonghua Kou Qiang Yi Xue Za Zhi 1999 Sep;34(5):286-8
AD - School of Stomatology, Beijing Medical University, Beijing 100081.
OBJECTIVE: To investigate the expression of CD44v3 and CD44v6 in oral
premalignant epithelia and its relationship to the carcinogenesis of
oral mucosa. METHODS: 85 normal, hyperplastic, dysplastic and malignant
oral epithelia were studied by immunohistochemistry. RESULTS: Normal and
hyperplastic epithelia showed strong CD44v3, v6 staining on cell
membrane. Cells in the deep layers of moderate and severe dysplastic
epithelia showed remarkably reduced staining intensity or no positive
staining as compared with normal and hyperplastic epithelia. This
down-regulation of CD44v3, v6 expression was noted in all 12 cases of
severe dysplasia. In invasive front of squamous cell carcinoma and some
metastases to lymphnode CD44v3 and v6 staining were also weak or
negative. CONCLUSION: Low level expression of CD44v3 and v6 exists in
moderate and severe epithelial dysplasia. This may be related to the
reduction of cellular adhesion and thereby facilitates the infiltration
of basement membrane by dysplastic cells.
10
UI - 11776896
AU - Zhang T; Lai Q; Du D
TI -
[Expression of metastasis suppressor gene nm23-H1 in oral squamous cell
carcinoma and its relation to tumor prognosis]
SO - Zhonghua Kou Qiang Yi Xue Za Zhi 1999 Sep;34(5):292-4
AD - Department of Stomatology, Peking Union Medicine College Hospital,
Chinese Academy of Medical Science and Peking Union Medicine College,
Beijing 100730.
OBJECTIVE: To study the relation between the expression level of nm23-H1
protein and prognosis of oral squamous cell carcinoma (OSCC). METHODS:
The expression of nm23-H1 protein in 75 cases of OSCC, 27 cases of oral
mucosa, 9 cases of cervical lymph-node metastases by immunohistochemical
technique (SABC), and the relation between nm23-H1 protein expression
level and prognosis of OSCC was evaluated by chi-test and single-factor,
multi-factor Cox proportional hazards regression model analysis.
RESULTS: These immunoreactivities of nm23-H1 protein were mostly in the
cytoplasm of tumor and epithelial cells. There was a significant
difference of nm23-H1 protein expression level between three-year
survival and seven-year survival group (P < 0.05), and there was a
relation between nm23-H1 protein expression level and prognosis of OSCC
in single-factor Cox analysis. But no relation was found between nm23-H1
protein expression level and prognosis in multi-factor Cox analysis.
CONCLUSION: nm23-H1 protein expression level was probably not a valuable
predictor of OSCC patients' prognosis. It may indirectly affect OSCC
prognosis through its effect on OSCC metastasis.
11
UI - 11793916
AU - Kollbrunner J; Zbaren P; Quack K
TI -
[Quality of life stress in patients with large tumors of the mouth. 3:
Indications for preoperative assessment of individual coping capacity]
SO - HNO 2001 Dec;49(12):1008-18
AD - Universitatsklinik fur HNO, Hals-Kiefer- und Gesichtschirurgie,
Inselspital, CH-3010 Bern, Schweiz. juerg.kollbrunner@insel.ch
A three-part empirical study investigated in detail the effects of
illness and therapy on patients with large tumors of the oral cavity (n
= 50). Part 1 compared the limitations of quality of life (LQL) of these
patients with those of patients after total laryngectomy (n = 34) and
with a group of patients "without cancer" (n = 40). Part 2 dealt with
the individual coping strategies applied by the patients. The aim of
this third part was to evaluate those biopsychosocial variables which
could serve preoperatively in determining whether a planned surgical
intervention could benefit the patient's quality of life. For this
purpose a dependent variable ("subjective burden of illness and
therapy") was defined as the weighted sum of 9 scores (including
"duration of survival" and LQL). 51 variables (19 medical, 7 demographic
and many psychological) were chosen as potentially explanatory
variables. 7 of the 8 exploratory variables correlating most strongly
with the dependent variable had an emotional content: depressive
personality, intensified preoperative anxiety and depression, emotional
indifference, reinforced control of emotions, reservation and
compulsiveness. The somatic variables with the highest correlations to
the dependent variable were "more pronounced preoperative dysfunction"
(4th place) and "extent of primary tumor" (9th place). The findings
suggested that the primary reason for a delay (postponement of the first
medical consultation) often resulting in a poorer prognosis is not the
growth of the tumor in the meantime but the fact that the delay
represents an existing resignation. This resignation and the reduced
self-esteem generally underlying it would then be concomitant causes of
poorer courses of the illness. The opportunities for the surgeon to
support the patient's self-esteem are discussed.
12
UI - 11793924
AU - Kollbrunner J; Zbaren P; Quack K
TI -
[Quality of life stress in patients with larger tumors of the mouth. A
descriptive study of psychosocial effects of illness and primary surgery
therapy in 3 parts--1: Quantity and quality of life]
SO - HNO 2001 Dec;49(12):985-97
AD - Universitatsklinik fur HNO, Hals-Kiefer- und Gesichtschirurgie,
Inselspital, CH-3010 Bern, Schweiz. uerg.kollbrunner@insel.ch
Up to about 40 years ago, the therapy of large tumors of the oral cavity
often resulted in severe disfigurement and dysfunctions. Modern
resection and reconstruction techniques now enable tumors of this type
to be removed in such a way that virtually normal eating and speech
functions are restored and traces of the extensive surgery are barely
noticeable in many patients. After rehabilitation, most of these
patients seem objectively to have a high quality of life, but it is less
clear whether their subjective experience is the same. In a three-part
empirical study the "limitations of quality of life" (LQL) of 50
patients with large tumors of the oral cavity were investigated at four
points of time: preoperatively as well as 1, 4 and 12 months
postoperatively. Our self constructed questionnaire for LQL includes 241
questions covering 19 fields of limitation. The results were compared
with those of a group of patients after total laryngectomy (n = 34) and
a group of patients "without cancer" (n = 40). One year after surgery
the limitations of quality of life of patients with large tumors of the
oral cavity are still large but seem less so than those of patients
after total laryngectomy. However, objectively marginal problems such as
a change of body image through a minor disfigurement, slightly
indistinct articulation, or a prolonged period of accustomization to
dentures are experienced as a severe strain by many patients. The
apparent hypersensitivity of many patients to minor discomfort is seen
as an effect of the demands made by modern society for fast, subtle
adaptive processes. The second part of the study deals with the coping
strategies applied by patients, and the third part is focused on a
search for variables which could serve as preoperative indicators of the
individual ability to bear the burden of illness and therapy.
13
UI - 11793925
AU - Kollbrunner J; Zbaren P; Quack K
TI -
[Quality of life stress in patients with large tumors of the mouth. 2:
Dealing with the illness: coping, anxiety and depressive symptoms]
SO - HNO 2001 Dec;49(12):998-1007
AD - Universitatsklinik fur HNO, Hals-Kiefer- und Gesichtschirurgie,
Inselspital, CH-3010 Bern, Schweiz. juerg.kollburnner@insel.ch
The psychosocial effects of disfigurements and dysfunctions after
combined surgical and radio-oncological therapy of patients with large
tumors of the oral cavity (n = 50) are investigated in a three-part
study. Part 1 compared the "limitations of quality of life" (LQL) of
these patients with those of patients after total laryngectomy (n = 34)
and with a group of patients "without cancer" (n = 40). This second part
records the coping strategies of the three groups of patients and
relates them to the following variables: anxiety (STAI), depression
(D-S'), despair (H-scale), self-image (GT), locus of control (KKG),
intellectual capacity (shortend SPM) and psychosocial burden in early
childhood (new questionnaire). The coping strategies of "compliance" and
"self-encouragement" were used most often. Patients with a higher
psychosocial burden in early childhood often chose defensive strategies
(distrust, cognitive avoidance, distraction, reinforced control of
emotions). Only few patients used strategies of healthy regression
("coasting values", A. Maslow). It seems that no specific single coping
strategy (in particular not the frequently recommended "positive
thinking") but an individualized selection of different strategies is of
special value to patients. The self-esteem of the patient was identified
as a crucial factor in increasing the effectiveness of coping
strategies. The surgeon can support patients in their self-esteem by
showing a genuine interest not only in their state of health but also in
their personal background. The third part of the study is focused on a
search for variables which could serve as preoperative indicators of the
individual ability to bear the burden of illness and therapy.
14
UI - 11813154
AU - Mazeron JJ; Noel G; Simon JM
TI -
Head and neck brachytherapy.
SO - Semin Radiat Oncol 2002 Jan;12(1):95-108
AD - Centre des Tumeurs, Groupe Hospitalier Pitie-Salpetriere, Paris, France.
Experience accumulated over several decades in the treatment of head and
neck tumors by irradiation has demonstrated the need for a high tumor
dose to achieve local control. With external beam irradiation alone, it
is difficult to spare adjacent normal tissues, resulting in undesirable
late effects on the salivary glands, mandible, and muscles of
mastication. Interstitial implantation is ideally suited to deliver a
high dose limited to the volume of the primary tumor, thus maximizing
tumor control while minimizing complications. A large experience has
been accumulated with low dose rate (LDR) brachytherapy in treatment of
carcinoma of oral cavity, oropharynx, and nasopharynx. Recent analysis
of large clinical series provided data indicating that modalities of LDR
brachytherapy should be optimized in treating these tumors for
increasing therapeutic ratio. LDR brachytherapy is now challenged by
high dose rate (HDR) brachytherapy and pulsed dose rate (PDR)
brachytherapy. Preliminary results obtained with these 2 last modalities
will be discussed. Copyright 2002 by W.B. Saunders Company
15
UI - 11781145
AU - Beppu M; Ikebe T; Shirasuna K
TI -
The inhibitory effects of immunosuppressive factors, dexamethasone and
interleukin-4, on NF-kappaB-mediated protease production by oral cancer.
SO - Biochim Biophys Acta 2002 Jan 2;1586(1):11-22
AD - Department of Oral and Maxillofacial Surgery, Graduate School of Dental
Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582,
Fukuoka, Japan.
Matrix metalloproteinase-9 (MMP-9) produced by tumor cells is known to
be implicated in the invasion of squamous cell carcinoma (SCC). In the
process of searching for agents to inhibit MMP-9 in cancer,
immunosuppressive factors, dexamethasone (DEX) and interleukin-4 (IL-4)
were found to inhibit protein production as well as gene expression of
MMP-9 in tumor necrosis factor alpha (TNFalpha)-stimulated SCC cells.
DEX and IL-4 could also suppress the expression of urokinase type
plasminogen activator (uPA) to prevent the conversion from the proenzyme
form of MMP-9 to its active form. Regarding their mechanisms to inhibit
the expression of MMP-9 and uPA, DEX and IL-4 had no effect on the cell
surface levels of TNFalpha receptors, but inhibited the activation of
NF-kappaB and NF-kappaB-dependent gene expression. DEX, but not IL-4,
could strongly augment the TNFalpha-induced expression of IkappaBalpha
in SCC cells. These results suggest that DEX and IL-4 suppress not only
immunological reactions, but also tumor invasion by targeting NF-kappaB.
16
UI - 11807224
AU - Palefsky JM; Berline J; Greenspan D; Greenspan JS
TI -
Evidence for trafficking of Epstein-Barr virus strains between hairy
leukoplakia and peripheral blood lymphocytes.
SO - J Gen Virol 2002 Feb;83(Pt 2):317-21
AD - Department of Stomatology, School of Dentistry, and the Oral AIDS
Center, University of California San Francisco, 505 Parnassus Avenue,
San Francisco, CA 94143-0126, USA. joelp@medicine.ucsf.edu
Hairy leukoplakia (HL), an epithelial lesion found on the side of the
tongue in immunocompromised individuals, is characterized by high-level
replication of Epstein-Barr virus (EBV) and multiple EBV strains. The
source of these strains and their relationship to peripheral blood
lymphocyte (PBL) strains has not previously been characterized. Using
matched pairs of HL scrapings and PBL from 16 HIV-positive men,
variation in EBV strain identity was characterized by detection of a 30
nucleotide deletion of the EBV latent membrane protein (LMP)-1 gene,
variation in the LMP-1 repeat region and typing for Epstein-Barr nuclear
antigen (EBNA)-2. Multiple EBV strains were found in both the HL and PBL
specimens, but 13 of 16 (81%) patients showed evidence of strain
identity for at least one strain and analysis of two patients suggested
that EBV strains from HL could infect the PBL. Our data are consistent
with active trafficking of EBV between these two compartments.
17
UI - 11852733
AU - Kovacic M
TI -
Reconstruction of total lower lip, labial commissure and palatomaxillary
defect with composite island cheek flap.
SO - Acta Med Croatica 2001;55(3):135-9
AD - ENT Department, General Hospital, 23000 Zadar, Croatia.
Functional and cosmetic restoration of total lower lip, labial
commissure, and palatomaxillary defects can be achieved by using
multiform flaps. The possibility of reconstruction of these areas with
composite island cheek flap is presented. The flap was used in three
patients who were surgically treated between 1993 and 1998. In one
female patient, total lower lip and chin defect was restored with a
small contralateral platysma muscle cutaneous flap. The functional and
cosmetic result was achieved with composite island cheek flap. In the
other two cases, reconstruction was performed without another flap.
Composite island cheek flap is supplied with bloody by the facial artery
and vein, and contains mucous membrane, muscle and skin of the cheek. In
two cases, the flap was formed by the anterior part of the buccal
muscle, and in the case with the reconstruction of labial commissure,
the greater and lesser zygomatic muscles with levator muscle of the
angle of mouth were used. By freeing the blood vessels from the
surrounding structures, isolation and transsection of minor vessel
branches allowed straightening of the tortuous main vessels. With this
technique, excellent functional and satisfactory cosmetic results were
achieved in a single act, with minimal morbidity for labial commissure,
and total lower lip or palatomaxillary defect reconstruction.
18
UI - 11858401
AU - Chang S H; Lee K F; Chan C P; Kuo S B
TI -
Myxoma of the gingiva: a case report and literature review.
SO - Chang Gung Med J 2001 Dec;24(12):826-31
AD - Department of Periodontics, Chang Gung Memorial Hospital, Taoyuan,
Taiwan, ROC.
Soft tissue myxomas of the oral and para-oral tissue are extremely rare.
Only two cases of myxoma of gingiva have been reported in the
literature. The histogenesis of these lesions remains obscure. We report
a case of gingival myxoma in a 37-year-old man. A firm ovoid soft tissue
mass measuring 1.5 x 1.2 x 1 cm in size was noted at the mesio-lingual
gingiva of a partially impacted right mandibular third molar.
Radiographic examination revealed an impacted mandibular third molar
with normal radiographic bony consistency of the mandible. Excisional
biopsy was performed with no evidence of recurrence after 8 months.
Histological examination showed stromal mass composed of myxoid-like
fluid in fibrovascular stroma and scanty inflammatory cell infiltration,
suggesting myxomas of the oral soft tissues and jaws.
Immunohistochemical stains with S-100 protein, desmin and smooth muscle
specific actin yielded negative results, and those with alcian blue,
periodic-acid-Schiff, mucicarmine, vimentin and reticulin were positive.
Tumor cells of mesenchymal origin without neurogenic or muscular
derivations and myxoid matrix composed of acid mucopolysaccharides in
this lesion further confirmed the diagnosis of myxoma. Periodontal
ligament origin cannot be completely excluded due to tumor location and
its association with an impacted molar. However, further study is
necessary to clarify the origin and histogenesis of these lesions.
19
UI - 11776903
AU - Wu Y; Tu G; Tang P
TI -
[Cervical management in the N0 squamous cell carcinoma of the tongue]
SO - Zhonghua Kou Qiang Yi Xue Za Zhi 1999 Jul;34(4):199-201
AD - Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of
Medical Sciences, Beijing 100021.
OBJECTIVE: To assess whether the elective neck dissection would be
beneficial as a routine management in the N0 squamous cell carcinoma of
the tongue. METHODS: Cox regression model was used for analysis of
tongue cancer cases treated by our hospital in a period from 1958 to
1996. RESULTS: Size of primary tumor and preoperative radiation showed
significant difference in relation to cervical lymph node recurrence or
metastasis. Neck dissection in the series was not a factor to influence
the rate of cervical recurrence or survival. 5-years survival was 73.5%
versus 69.3% in patients who underwent elective neck dissection and
those without neck dissection (difference not statistically
significant). CONCLUSION: We suggest that elective neck dissection would
be avoided in T1 or T2 patients who have no neck node metastases.
20
UI - 11776905
AU - Zhang Y; Zhang J; Yu G
TI -
[Long-term complications associated with immediate plate reconstruction
for mandibular defect following tumor-surgery]
SO - Zhonghua Kou Qiang Yi Xue Za Zhi 1999 Jul;34(4):205-7
AD - School of Stomatology, Beijing Medical University, Beijing 100081.
OBJECTIVE: To assess the long-term complications associated with the
application of reconstruction plate. METHODS: Ninety-seven patients
underwent immediate repair by using bendable reconstruction plate for
maintainance of space and contour following mandibular segmental
resection. Of them, 68 cases were followed up for the final outcomes.
RESULTS: Skin or mucosa perforation occurred 6 cases, instabilization of
screws in 22 cases, and broken of plate in 3 cases. The reasons for skin
or mucosa perforation was possibly associated with circulatory
disturbance due to postoperative irradiation. The bone absorption and
screw loosening occured most frequently in bone defect involving
mandibular angle and chin. CONCLUSION: High concentration of
unrationable stress and irradiation were recognised to be the factors
responsible for the perforation of covering tissue and screw loosening.
The broken of plate was brought about possibly by stress loading and
fatigue weakness of plates.
21
UI - 11835547
AU - Gardiner KJ; Irvine BW; Murray A
TI -
Anomalous relationship of the spinal accessory nerve to the internal
jugular vein.
SO - Clin Anat 2002 Jan;15(1):62-3
AD - Department of Otolaryngology, Head and Neck Surgery, Stobhill Hospital,
Glasgow, UK.
A patient with an early cancer of the tongue and undergoing a staging
neck dissection was noted to have an anomalous relationship of the
internal jugular vein and spinal accessory nerve. At the upper end of
the dissection (level II, Memorial Sloan-Kettering classification), the
internal jugular vein was observed to divide above and reconstitute
below the spinal accessory nerve. Although apparently not previously
described in the literature, this finding may be encountered by other
surgeons who operate in this area, and it is important that these
anatomical variations are borne in mind to prevent inadvertent injury.
Copyright 2002 Wiley-Liss, Inc.
22
UI - 11848477
AU - D'Ambrosio SM; Gibson-D'Ambrosio RE; Wani G; Casto B; Milo GE; Kelloff
TI -
GJ; Steele VE
Modulation of Ki67, p53 and RARbeta expression in normal, premalignant
and malignant human oral epithelial cells by chemopreventive agents.
SO - Anticancer Res 2001 Sep-Oct;21(5):3229-35
AD - The Ohio State University School of Medicine and Public Health and
Comprehensive Cancer Center, Columbus 43210, USA. dambrosio.1@osu.edu
BACKGROUND: Aberrant expression of Ki67, p53 and RARbeta are
characteristic of many tumor types including those of the oral cavity.
Chemopreventive agents may act by modulating their expression to more
normal levels. MATERIALS AND METHODS: The effects of 21 chemopreventive
agents on the expression of Ki67, p53 and RARbeta were determined using
a human in vitro model of normal, premalignant and malignant oral
epithelial cell lines. RESULTS: Ki67 and mutant p53 (mtp53) were
overexpressed in both the premalignant and malignant cell lines, whereas
expression of RARbeta was high in the normal, low in the premalignant
and not detectable in the malignant cell lines. Most of the agents
selectively inhibited the expression of Ki67 in the premalignant and
malignant cell lines. Eight of the 21 agents increased, while four
agents decreased, the levels of mtp53 protein in the premalignant cell
line. In the malignant cell line, five of the agents increased, while
ten agents decreased mtp53 protein levels. The agents increased RARbeta
expression to near normal levels in the premalignant cell line.
CONCLUSION: The data suggest that the suppression of Ki67 and mtp53 are
good indicators of the effectiveness of agents in premalignant and
malignant oral cells, whereas the enhancement of RARbeta is a measure of
effectiveness in premalignant oral cells.
23
UI - 11835890
AU - Gutierrez Abad D; Sastre Valera J; Ganado Diaz T; Lopez Chumillas A;
TI -
Diaz-Rubio E
[Cystic lesion in chest wall in a patient with epidermoid carcinoma of
the base of the tongue]
SO - Rev Clin Esp 2001 Dec;201(12):729-30
AD - Servicio de Oncologia Medica, Hospital Clinico Universitario San Carlos,
Madrid, Spain.
24
UI - 11865002
AU - Cruz I; Napier SS; van der Waal I; Snijders PJ; Walboomers JM; Lamey PJ;
TI -
Cowan CG; Gregg TA; Maxwell P; Meijer CJ
Suprabasal p53 immunoexpression is strongly associated with high grade
dysplasia and risk for malignant transformation in potentially malignant
oral lesions from Northern Ireland.
SO - J Clin Pathol 2002 Feb;55(2):98-104
AD - Department of Oral and Maxillofacial Surgery/Oral Pathology, Academic
Centre for Dentistry Amsterdam, University Hospital Vrije Universiteit,
De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. geus@xs4all.nl
AIMS: No good predictive marker for the malignant transformation of
potentially malignant oral lesions (PMOLs) is currently available. This
study re-evaluated the value of p53 immunoexpression to predict
malignant transformation of PMOLs after discounting possible confounding
factors. METHODS: PMOLs from 18 patients who showed progression to
carcinoma, 16 of the respective carcinomas, and PMOLs from 18 matched
controls were evaluated by immunohistochemistry (IHC) for p53
expression. A mouse monoclonal antibody that detects wild-type and
mutant forms of human p53 was used. The p53 immunostaining pattern was
also correlated with the degree of dysplasia. RESULTS: Suprabasal p53
staining was significantly associated with high grades of dysplasia (p <
0.01). The specificity and positive predictive value (PPV) for malignant
transformation of suprabasal p53 staining were superior to the
assessment of dysplasia, but sensitivity was inferior. All carcinomas
derived from PMOLs with suprabasal p53 showed strong p53 immunostaining.
However, the absence of suprabasal p53 staining and/or dysplastic
changes did not preclude malignant transformation in a considerable
proportion of PMOLs. CONCLUSIONS: This study confirms and extends
previous findings that suprabasal p53 immunoexpression has a high PPV
for malignant transformation of PMOLs and can be used as a specific
marker for lesions that are at high risk for malignant transformation.
The absence of suprabasal p53 staining (that is, absence of, or basal,
p53 staining) is non-informative for prognostic purposes. Because of its
limited sensitivity, p53 IHC is not a substitute for the assessment of
dysplasia in the evaluation of PMOLs. Instead, p53 IHC emerges as a
clinically useful supplement of histopathological assessment in the
prognosis of PMOLs.
25
UI - 11856702
AU - Tomura N; Watanabe O; Kato K; Takahashi S; Watarai J; Sageshima M;
TI -
Yokomizo M
Irradiated carcinoma of the tongue: correlation of MR imaging findings
with pathology.
SO - AJR Am J Roentgenol 2002 Mar;178(3):705-10
AD - Department of Radiology, Akita University School of Medicine, 1-1-1,
Hondo, Akita City, Akita, 010-8543, Japan.
OBJECTIVE: MR imaging was prospectively correlated with pathologic
findings to study whether MR imaging can differentiate viable from
nonviable tumor tissue in the irradiated carcinoma of the tongue.
SUBJECTS AND METHODS: MR examinations were performed after radiation
therapy in 21 patients with carcinoma of the tongue. All patients
underwent either a total glossectomy or hemiglossectomy after radiation
therapy. Specimens were examined microscopically. Radiation changes were
histologically graded into four groups (I, minimal cellular changes; II,
presence of cellular changes and partial destruction of the tumor; III,
only nonviable tumor cells; IV, no tumor cells). MR examinations
included T2-weighted imaging, unenhanced T1-weighted imaging, dynamic
contrast-enhanced imaging, and contrast-enhanced T1-weighted imaging.
RESULTS: On unenhanced T1-weighted images, the lesion was hypointense,
except for two patients with histologic grade III. On T2-weighted
images, the lesion appeared hyperintense in 12 of 14 patients with
viable tumor cells (grades I and II); however, the lesion was
hypointense in four, and isointense in two of seven patients with
nonviable tumor cells (grades III or IV). Contrast-enhanced T1-weighted
images showed that the degree of contrast enhancement of the lesion was
equal to or lower than that of a normal salivary gland in 18 of 21
patients. For the time of maximal enhancement of the lesion on dynamic
imaging, there was no substantial difference between viable (grades I
and II) and nonviable (grades III and IV) tumor tissue. CONCLUSION: The
present study shows that T2-weighted imaging is feasible for
differentiating viable from nonviable tumor tissue in irradiated
carcinoma of the tongue.
26
UI - 11869018
AU - Altinyollar H; Berberoglu U; Celen O
TI -
Lymphatic mapping and sentinel lymph node biopsy in squamous cell
carcinoma of the lower lip.
SO - Eur J Surg Oncol 2002 Feb;28(1):72-4
AD - Ankara Oncology Teaching and Research Hospital, Department of Surgery,
Demetevler, Ankara, Turkey.
AIMS: The risk of metastases to the submandibular and submental lymph
nodes in squamous cell carcinoma (SCC) of the lower lip is closely
related to the primary tumour size and the differentiation of the
tumour. In order to determine the feasibility of the technique and the
possible metastatic lymph nodes in SCC of the lower lip, intraoperative
lymphatic mapping and sentinel lymph node biopsy was performed in
patients with tumour size greater than 2 cm (T2) and clinically
non-palpable regional lymph nodes (N0). METHODS: Intraoperative
lymphatic mapping with patent blue dye was performed in 20 patients with
SCC of the lower lip. The stained lymph node (sentinel) was identified
in each patient and sent for frozen section analysis in order to verify
tumour metastasis. All patients had undergone bilateral suprahyoid neck
dissection at the same stage. RESULTS: Three of the patients were female
and 17 were male. The median age was 66. Sentinel lymph nodes were
identified in 18 of the patients (90%). Intraoperative or post-operative
histopathologic examination of the sentinel lymph node showed tumour
metastasis in three of the patients (16.6%). The histopathologic
examination of the remaining 15 patients whose sentinel lymph nodes were
free of metastasis, showed no metastasis in the non-sentinel lymph
nodes. In two of the three patients with metastatic sentinel lymph
nodes, non-sentinel lymph nodes were free of metastases. There were no
false negative results and no local or systemic complications of the
technique were seen among the patients. CONCLUSIONS: Intraoperative
lymphatic mapping and sentinel lymph node biopsy is feasible in patients
with SCC of the lower lip who have large tumour size and non-palpable
regional lymph nodes. The technique may help to avoid neck dissection
when the patient has negative sentinel lymph node and when positive
provides useful information for more effective radical treatment.
Copyright Harcourt Publishers Limited.
27
UI - 11870505
AU - Kovacs AF; Obitz P; Wagner M
TI -
Monocomponent chemoembolization in oral and oropharyngeal cancer using
an aqueous crystal suspension of cisplatin.
SO - Br J Cancer 2002 Jan 21;86(2):196-202
AD - Clinic for Maxillofacial Plastic Surgery, Johann Wolfgang
Goethe-University Medical School, Theodor-Stern-Kai 7, 60590 Frankfurt
am Main, Germany. A.Kovacs@em.uni-frankfurt.de
Intensification of intra-arterial chemotherapy with high-dose cisplatin
and concomitant reduction of toxicity under the conditions of the head
and neck was aimed at by combination of antineoplastic activity and
embolizing effect in the same pharmacon. A cisplatin suspension in
normal saline (5 mg in 1 ml) with precipitation of microembolizing
cisplatin crystals was prepared. No additional pharmacons. Cisplatin
dosage was 150 mg m(-2), maximum absolute dose 300 mg, maximum amount of
fluid 60 ml. Thirty patients (UICC-Classification of tumours: I/2
patients, II/6, III/2; IV/20) were treated in a neoadjuvant setting with
superselective chemoembolization using the cisplatin suspension. A
control group (n=30) with the same tumour and nodal staging was treated
with a usual cisplatin solution (150 mg m(-2) dissolved in 500 ml
saline). In both groups, parallel intravenous infusion of sodium
thiosulphate (9 g m(-2)). Endpoints were toxicity and response.
Continuation of treatment by surgery or radiation. Overall remission was
70% in the study group and 46.7% in the control group after one cycle
respectively. Systemic side-effects were very low (grade I WHO) in both
groups. Side-effects were found to be similar to post-embolization
syndrome (swelling, mild to moderate pain, leucocytosis without fever)
in the study group. Chemoembolization in the head and neck area can be
carried out routinely using this method. Copyright 2002 The Cancer
Research Campaign
28
UI - 11605010
AU - Lee BK; Diebel E; Neukam FW; Wiltfang J; Ries J
TI -
Diagnostic and prognostic relevance of expression of human telomerase
subunits in oral cancer.
SO - Int J Oncol 2001 Nov;19(5):1063-8
AD - Department of Oral and Cranio-Maxillofacial Surgery, University of
Erlangen, D-90541 Erlangen, Germany.
Telomerase activity (TA) is associated with most malignant human tumors
but is not detected in normal somatic cells with a few exceptions. Three
major subunits (hTR, hTP1 and hTERT) of telomerase have been identified.
To investigate the clinical implications of the mRNA detection of these
components as useful diagnostic and prognostic markers in oral cancer,
we examined TA, hTR, hTP1 and hTERT mRNA expressions in 46 oral squamous
cell carcinomas (OSCC) and 15 normal oral mucosal tissues from healthy
volunteers using a highly sensitive TRAP assay and RT PCR. In all
specimens hTR and hTP1 mRNA were detected regardless whether TA was
expressed or not. On the contrary, a significant correlation between
hTERT expression and TA was shown indicating that the activity of
telomerase could be regulated by the extent of hTERT transcription. In
addition, hTERT expression showed close association to malignancies.
None of the normal mucosal specimens expressed the hTERT subunit, but
76% (35/46) of the tumor specimens did. None of other
clinico-pathological and prognostic parameters showed significant
relationship with TA or hTERT expression. These results suggest that the
detection of hTERT expression may be another useful diagnostic marker,
especially for early detection of OSCC, and for distinguishing healthy
tissues from neoplastically transformed ones.
29
UI - 11840592
AU - de Luis Roman D; Izaola O; Aller R
TI -
[24-hour oral intake in patients with upper aerodigestive tumors]
SO - Nutr Hosp 2001 Nov-Dec;16(6):280-3
AD - Seccion de Endocrinologia y Nutricion Clinica, Hospital del Rio Hortega
Valladolid, Espana. ddlr@pulso.com
BACKGROUND: A lot of works have shown, alterations in oral intake of
micro and macronutrients, in patients with upper aerodigestive tumors.
The main aim of our work was to compare the daily intake in a group of
patients with upper aerodigestive tumors versus a control group.
METHODS: A group pf 35 patients with upper aerodigestive tumors were
studied (8 oral cavity and 27 larynx). A group of 35 subjects were use
as control group. In all patients the next parameters were taken; age,
sex, smoking and alcohol co
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