National Cancer Institute®
Last Modified: October 1, 2002
UI - 12211049
AU - Wang YF; Chang SY; Tai SK; Li WY; Wang LS
TI - Clinical significance of interleukin-6 and interleukin-6 receptor expressions in oral squamous cell carcinoma.
SO - Head Neck 2002 Sep;24(9):850-8
AD - Department of Otolaryngology, Taipei-Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan.
BACKGROUND: Recent studies showed that interleukin-6 (IL-6) played a role in tumor development. However, available information about the prognostic significance of IL-6 and IL-6 receptors (IL-6R) for oral squamous cell carcinoma (OSCC) is limited. METHODS: Eighty-six patients with OSCC were enrolled. Immunohistochemical staining was used to determine IL-6R expression and in-situ hybridization for IL-6 mRNA transcripts in surgical specimens. Clinicopathologic correlation was evaluated by chi-square test and survival by log rank test. RESULTS: Expression rates of IL-6R and IL-6 mRNA transcripts in tumor specimens were 73.3% and 54.7%, much higher than those in nontumor mucosa (p <.001). IL-6R overexpression was associated with larger tumors and more advanced histologic grade (p <.05). The presence of IL-6 mRNA transcripts was inversely correlated with distant metastasis, lymph node involvement, and second primary SCC (p <.05) and predicted better survival (p =.007). CONCLUSIONS: IL-6-IL-6R coexpression was rather high in OSCC, and IL-6 mRNA transcript expression might influence patient survival. The biologic role of IL-6-IL-6R coexpression in OSCC needs additional investigation. Copyright 2002 Wiley Periodicals, Inc. Head Neck 24: 850-858, 2002
UI - 12211050
AU - Piyathilake CJ; Bell WC; Oelschlager DK; Heimburger DC; Grizzle WE
TI - The pattern of expression of Mn and Cu-Zn superoxide dismutase varies among squamous cell cancers of the lung, larynx, and oral cavity.
SO - Head Neck 2002 Sep;24(9):859-67
AD - Division of Nutritional Biochemistry and Molecular Biology, University of Alabama at Birmingham, University Station, Birmingham, Alabama 35294, USA. firstname.lastname@example.org
BACKGROUND: Despite the importance of reactive oxygen species (ROS) in the development of smoking-related cancers, little is known about the pattern of expression of ROS scavengers in these cancers. METHODS: In this present study, we examined the expression of manganese superoxide dismutase (Mn-SOD) and copper/zinc superoxide dismutase (Cu-Zn-SOD), which are essential enzymes that eliminate ROS, in squamous cell cancers (SCCs) of the lung (n = 12), larynx (n = 13), and oral cavity (n = 20). RESULTS: SCCs of larynx and oral cavity showed significantly enhanced immuhistochemical expression of Mn-SOD compared with the matched uninvolved epithelium. The higher expression of Mn-SOD was shown to be late and early events in the process of SCC development in the larynx and the oral cavity, respectively. The expression of Mn-SOD in SCCs of the lung was significantly lower compared with luminal cells of the uninvolved epithelium but not compared with basal cells or an average expression of SOD in basal and luminal cells. The expression of both Mn-SOD and cytoplasmic or nuclear Cu-Zn-SOD in bronchial epithelium adjacent to invasive cancer was significantly lower compared with its expression in the uninvolved bronchial epithelium away from cancer. This resulted in a significant difference in SOD expression between cancer and uninvolved bronchial epithelium away from cancer but not between cancer and uninvolved epithelium adjacent to cancer. CONCLUSIONS: There are significant differences in the expression of Mn-SOD and Cu-Zn-SOD among SCCs of the lung, larynx, and oral cavity. The results also suggest that variations in distance between cancer and uninvolved tissues evaluated could contribute to conflicting results of SOD expression. Copyright 2002 Wiley Periodicals, Inc. Head Neck 24: 859-867, 2002
UI - 3734224
AU - De Maubeuge J; Ledoux M; Feremans W; Zissis G; Goens J; Andre J;
TI - Gourdain JM; Menu R; De Wit S; Cran S; et al Oral "hairy" leucoplakia in an African AIDS patient.
SO - J Cutan Pathol 1986 Jun;13(3):235-41
A 34-year-old African patient with AIDS developed a new form of oral leucoplakia closely resembling the "hairy" leucoplakia described by Greenspan in male homosexuals in the San Francisco area. A herpes-like virus was seen on ultrastructural analysis with electron microscopy. This case supplies further evidence suggesting that the syndrome in patients originating in Central Africa is similar to the acquired immunodeficiency syndrome (AIDS) reported in American patients.
UI - 6583042
AU - Gupta PC
TI - Epidemiologic study of the association between alcohol habits and oral leukoplakia.
SO - Community Dent Oral Epidemiol 1984 Feb;12(1):47-50
In a house-to-house survey in Ernakulam district, Kerala State, 10914 individuals were interviewed for their tobacco and alcohol habits and examined for the presence of oral leukoplakia. Very few females (1.6%) were found to be alcohol users and they were excluded from further analysis. Among 7604 males, 30.4% used alcohol regularly, 25.4% occasionally and 44.2% were non-users. The prevalence of leukoplakia was significantly higher among regular (5.7%) and occasional (3.9%) users than among non-users (2.9%) of alcohol. Alcohol usage was found to be related to age as well as tobacco habits. The prevalence of leukoplakia was higher among alcohol users in each age-group as well as in each tobacco habit category. After age-adjustment the difference between alcohol users and non-users, although reduced, remained significant. For most tobacco habit categories the trend remained similar after age-adjustment except for the mixed habits group, for which there was a reversal of the trend. The alcohol habit may, perhaps, produce discernible effects only in association with other 'weak' etiological risk factors, such as a single tobacco habit of smoking or chewing rather than a 'strong' etiologic factor such as the mixed habits of chewing and smoking.
UI - 11956629
AU - Tanaka M; Hiraki A; Ueoka H; Bessho A; Kiura K; Takigawa N; Kodani T;
TI - Miyatake K; Hamada N; Kishimoto T; Tanimoto M; Harada M Gingival metastasis in lung cancer.
SO - Oncol Rep 2002 May-Jun;9(3):571-4
AD - Department of Medicine II, Okayama University Medical School, Okayama 700-8558, Japan. email@example.com
Gingival metastasis is an extremely rare manifestation of lung cancer, and exhibits rapid growth with various clinical symptoms. Physicians must appropriately manage patients with lung cancer who develop gingival metastasis. Clinical records of patients with lung cancer treated at the Department of Internal Medicine II, Okayama University Hospital, between 1976 and 1998 were retrospectively reviewed. The medical literature was searched by Medline to identify reports of gingival metastasis from lung cancer. Three of 729 (0.41%) lung cancer patients developed gingival metastasis in our hospital between 1976 and 1998, and 9 additional cases of this type of metastasis were found in the literature. All were male, and median age was 57.5 years (range, 47 to 70). There were no clear correlations between development of gingival metastasis and either histologic type or location of the primary lesion. Chemotherapy or radiotherapy was effective for treatment of gingival metastasis, and the quality of life was improved. However, survival after development of gingival metastasis was very short, with median survival of only 4 months.
UI - 11956630
AU - Tirelli G; Sidari L; Giacomarra V; Papanikolla L; Sasso F; Russolo M;
TI - Melato M Do Ki67, S-phase, S + G2M and DNA ploidy, evaluated by flow cytometry, reveal locoregional metastasis in oral cavity and oropharynx carcinomas?
SO - Oncol Rep 2002 May-Jun;9(3):575-80
AD - Department of Otorhinolaryngology, Cattinara Hospital, I-34149 Trieste, Italy.
Tumour cell proliferation is an important biological prognostic parameter to be considered alongside clinical and histopathological parameters. It has been evaluated by immunohistochemistry using proliferative markers (PCNA, Ki67, etc.) and by flow cytometry considering DNA content, growth fraction (S + G2M) and S-phase fraction. Our aim was to evaluate by flow cytometry both Ki67 and S-phase fraction, S + G2M, DNA content in patients surgically treated for oral cavity and/or oropharynx carcinomas. The study, performed on archival material, analysed the significance and prognostic reliability of these biological parameters to reveal locoregional metastasis and evaluated their possible correlation with clinical and histopathological parameters. In conclusion, tumour cell proliferation seems not to be useful in revealing the presence of locoregional metastasis in oral cavity and oropharynx carcinomas. Thus, new approaches are required.
UI - 12069515
AU - Kovacs AF; Schiemann M; Turowski B
TI - Combined modality treatment of oral and oropharyngeal cancer including neoadjuvant intraarterial cisplatin and radical surgery followed by concurrent radiation and chemotherapy with weekly docetaxel - three year results of a pilot study.
SO - J Craniomaxillofac Surg 2002 Apr;30(2):112-20
AD - Department of Maxillofacial Plastic Surgery, Johann Wolfgang Goethe-University Frankfurt Medical School, Frankfurt am Main, Germany. A.Kovacs@em.uni-frankfurt.de
BACKGROUND: A new four-modality treatment of primary oral and oropharyngeal squamous cell carcinomas was evaluated with regard to feasibility, tolerance, and survival. PATIENTS AND METHODS: Seventy three operable patients (100%) with histologically proven untreated stage I to stage IV disease received at least one cycle of neoadjuvant intraarterial chemotherapy with 150 mg/m(2) cisplatin neutralized with sodium thiosulphate, followed by radical operation for the tumour with a simultaneous selective neck dissection (clinically negative neck), or modified radical neck dissection (nodal involvement), followed by adjuvant chemoradiation over 5 weeks (51.9 Gy, systemic docetaxel 25 mg/m(2), once every week). RESULTS: Ninety-six per cent of patients were operated on, 68% had postoperative radiation, 57% concomitant chemotherapy; 44% fulfilled the complete protocol. There have been 11 local or regional recurrences to date, three of which were treated by salvage surgery. Eighteen patients died, in nine of them death was tumour-related. Seventy five per cent lived after a median observation time of 33 months. Cumulative survival was 74% calculated for 4 years. CONCLUSION: The presented multimodality regimen proved feasible and showed better survival for the whole population and for all tumour stages when compared with the treatment-dependent prognosis index of the DOSAK (German-Austrian-Swiss Cooperative Group on tumours of the maxillofacial region). Copyright 2002 Published by Elsevier Science Ltd. on behalf of European Association for Cranio-Maxillofacial Surgery.
UI - 12069517
AU - Rogers SN; Laher SH; Overend L; Lowe D
TI - Importance-rating using the University of Washington quality of life questionnaire in patients treated by primary surgery for oral and oro-pharyngeal cancer.
SO - J Craniomaxillofac Surg 2002 Apr;30(2):125-32
AD - Mossley, Cheshire, UK. firstname.lastname@example.org
BACKGROUND: There are now several validated and widely accepted head and neck cancer questionnaires. These record patients subjective levels of function and dysfunction, as well as symptoms related to their cancer and its treatment. One popular measure is the University of Washington head and neck cancer questionnaire (UW-QOL). Domain importance-ratings were added to the second version of the questionnaire, which was published in 1997. It is unique amongst head and neck cancer questionnaires in this respect. AIM: The purpose of the study was to evaluate UW-QOL with particular reference to domain importance-rating. It was also the intention to investigate how the importance-ratings related to 'quality of life' and comment on the cumulative scoring of the questionnaire. METHODS: Forty-eight patients with previously untreated oral or oro-pharyngeal cancer were recruited. All were treated by primary surgery. Questionnaires were completed pre-operatively, 6 months and 1 year post-operatively. RESULTS: This study demonstrates a wide variation in importance-ratings. Both pre- and post-treatment there was a general lack of correlation between importance-rating and domain scores. At all time points, patients tended to rate speech, chewing and swallowing as more important than the other UW-QOL domains. The cumulative UW-QOL score correlated strongly with the new single item QOL question. CONCLUSION: It remains unclear how best to incorporate importance-ratings into a single UW-QOL total score. However, for individual patients they can assist in setting priorities in treatment strategies. Copyright 2002 European Associaton for Cranio-Maxillofacial Surgery. Published by Elsevier Science Ltd. All rights reserved.
UI - 12142867
AU - Courrier B; Plantier F; Kuffer R
TI - Ulcerated mass of the retromolar area.
SO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002 Jun;93(6):635-9
AD - University of Paris, Cochin Hospital, France. email@example.com
UI - 12142875
AU - Noguchi M; Kinjyo H; Kohama GI; Nakamori K
TI - Invasive front in oral squamous cell carcinoma: image and flow cytometric analysis with clinicopathologic correlation.
SO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002 Jun;93(6):682-7
AD - Department of Oral Surgery, Sapporo Medical University, Hokkaido, Japan. firstname.lastname@example.org
OBJECTIVE: Pathologists have drawn attention to the invasive tumor front (ITF) in the determination of the biologic aggressiveness of oral cancer. We have attempted to discover the prognostic significance of cancer cells with abnormal DNA content at the ITF of oral squamous cell carcinoma. STUDY DESIGN: A comparative DNA analysis by means of image cytometry and flow cytometry was conducted to confirm the usefulness of image cytometry in detecting cancer cells having abnormal DNA content at the ITF. The prognostic value of cancer cells with abnormal DNA content ws examined by a multivariate analysis for 195 patients with oral squamous cell carcinoma. RESULTS: In the comparative DNA analysis, it was suggested that image cytometry is useful for detecting cancer cells with abnormal DNA content (4c exceeding rate [4cER]), which is associated with poor prognosis of patients with oral squamous cell carcinoma. In the multivariate analysis, 3 independent factors were found to significantly influence cause-specific survival. These are, in decreasing order of influence, (1) abnormal DNA content (4cER), (2) clinical stage, and (3) growth type. CONCLUSION: The presence of cancer cells with abnormal DNA content of the ITF in conjunction with clinical findings (clinical stage and growth type) can give additional useful information when selecting treatment strategies for oral cancer patients.
UI - 12173283
AU - De Zinis LO; Ghizzardi D; Casati E; Nicolai P; Antonelli AR
TI - [Salvage surgery in squamous cell carcinoma of the oral cavity]
SO - Acta Otorhinolaryngol Ital 2002 Jun;22(3):135-41
AD - Clinica Otorinolaringoiatrica, Universita di Brescia. email@example.com
The objective of this work was to evaluate the results of salvage surgery in squamous cell carcinoma of the oral cavity. In the period 1983-1998, 127 patients consecutively underwent surgical treatment. Of these, 80 cases had not been treated previously (Group I), while 47 patients had come under our observation after radiotherapy alone or other treatment had failed (Group II). Local recurrence was observed in 29 cases, local/regional in 10 cases, and exclusively regional in eight cases. In both groups, the surgical T-approach was prevalently transoral (55 cases in Group I and 24 in Group II). A transmandibular approach was taken in most of the remaining patients (22 cases in Group I and 16 in Group II). One hundred patients (65 in Group I and 35 in Group II) underwent laterocervical neck dissection. The neoplasms in group I were staged as follows: pT1, 29%; pT2, 37.5%; pT3, 12.5%; pT4, 21%. In group II, the neoplasms were stages as: pT0, 17%; pT1, 21%; pT2, 38%; pT3, 13%; pT4, 11% (Group II). The overall 5-year survival rate was 38% and the overall determinate 5-year survival rate was 45%, distributed as follows in the two groups: 51% of the patients in Group I, 36% of the patients in Group II (p = 0.01). Restricting the analysis to Group II, the difference in the three year survival rate was 54% among the patients at stages I-II and 25% among the patients suffering from a recurrence at stages III-IV (p = 0.04). In patients whose recurrence was limited to the primary tumor, survival at 3 years was 49%; in those whose recurrence also had nodal involvement, survival was 27% (p = 0.05). Lastly, the 5-year survival rate was 45% in the patients whose recurrence had been diagnosed late and only 24% in the 24 patients whose recurrence had been diagnosed within a year of prior treatment (p = 0.09). In conclusion, the life expectancy of patients undergoing salvage surgery for squamous cell carcinoma of the oral cavity is significantly less with respect to patients undergoing first round treatment. This difference appears significant only in patients with a recurrence that was diagnosed at an advanced stage. In accordance with the previously published data, an early recurrence (within a year) and the presence of a recurrence in the neck are unfavorable prognostic factors.
UI - 12221671
AU - Bayani N; Rugina M; Haddad-Vergnes L; Lelong F
TI - High-titer acquired factor V inhibitor responsive to corticosteroids and cyclophosphamide in a patient with two malignant tumors.
SO - Am J Hematol 2002 Sep;71(1):33-6
AD - Hematology Laboratory, Creteil Intercommunal Hospital Center, France. firstname.lastname@example.org
We report a 79-year-old man with two simultaneous malignant tumors (buccal epidermoid carcinoma and prostatic adenocarcinoma) who developed a severe bleeding complication at the site of the buccal tumor as well as a massive cerebral hematoma after a skull trauma. Laboratory findings showed the presence of a high-titer specific factor V inhibitor. The patient failed to respond to intravenous immunoglobulins, but both clinical and laboratory improvement was obtained after treatment with corticosteroids and cyclophosphamide. Copyright 2002 Wiley-Liss, Inc.
UI - 12234999
AU - Kresty LA; Mallery SR; Knobloch TJ; Song H; Lloyd M; Casto BC; Weghorst
TI - CM Alterations of p16(INK4a) and p14(ARF) in patients with severe oral epithelial dysplasia.
SO - Cancer Res 2002 Sep 15;62(18):5295-300
AD - Division of Environmental Health Sciences, School of Public Health, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA.
A number of genetic aberrations have been reported in end-stage squamous cell carcinoma of the head and neck, including p16(INK4a) and p14(ARF) (INK4a/ARF) inactivation rates of 70-85%. Still, the cell cycle-regulatory genes p16(INK4a) and p14(ARF) remain poorly understood in oral cavity premalignant lesions. This study evaluated INK4a/ARF locus alterations in 26 patients (28 samples) deemed to be at increased risk for malignant transformation to squamous cell carcinoma due to the diagnosis of severe oral epithelial dysplasia. Microscopically confirmed dysplastic oral epithelium and matching normal tissue were laser capture-microdissected from paraffin sections, DNA was isolated, and molecular techniques were used to evaluate p16(INK4a) and p14(ARF) gene deletion, mutation, loss of heterozygosity (LOH), and hypermethylation events. Deletion of exon 1beta, 1alpha, or 2 was detected in 3.8%, 11.5%, and 7.7% of patients, respectively. INK4a and ARF mutations were detected in 15.4% and 11.5% of patients with severe dysplasia of the oral epithelium. All identified mutations occurred in the INK4a/ARF conserved exon 2. Allelic imbalance was assessed using three markers previously reported to show high LOH rates in head and neck tumors. LOH was found in 42.1%, 35.0%, and 82.4% of patients for the markers IFNalpha, D9S1748, and D9S171, respectively. Hypermethylation of p16(INK4a) and p14(ARF) was detected in 57.7% and 3.8% of patients, respectively, using nested, two-stage methylation-specific PCR. The highest rates of p16(INK4a) hypermethylation occurred in lesions of the tongue and floor of the mouth. In addition, p16(INK4a) hypermethylation was significantly linked to LOH in two or more markers. These data support that INK4a/ARF locus alterations are frequent events preceding the development of oral cancer and that p16(INK4a) inactivation occurs to a greater extent in oral dysplasia than does p14(ARF) inactivation.
UI - 9643608
AU - Townend J
TI - Combined radial forearm and pharyngeal flaps for soft palate reconstruction.
SO - Br J Oral Maxillofac Surg 1998 Apr;36(2):156-7
UI - 12074233
AU - Flaitz CM
TI - Acquired vascular lesion of the lower lip.
SO - Am J Dent 2002 Feb;15(1):67-8
AD - Department of Stomatology, University of Texas-Houston Health Science Center, 77030-3402, USA. Catherine.M.Flaitz@uth.tmc.edu
UI - 12092993
AU - Flaitz CM
TI - Firm enlargement of the dorsolateral tongue.
SO - Am J Dent 2002 Apr;15(2):139-40
AD - Department of Diagnostic Sciences, UT-Houston Dental Branch, TX 77030-3402, USA. Catherine.M.Flaitz@uth.tmc.edu
UI - 12210962
AU - Chiarini L; De Santis G; Bedogni A; Nocini PF
TI - Lining the mouth floor with prelaminated fascio-mucosal free flaps: clinical experience.
SO - Microsurgery 2002;22(5):177-86
AD - Section of Dentistry, Department of Neurosciences, Head and Neck and Rehabilitation, Faculty of Medicine, University of Modena and Reggio Emilia, Italy.
Soft-tissue defects of the mouth floor need thin, foldable, and pliable tissues able to preserve local anatomy as well as chewing, phonation, and deglutition. The oral mucosa is made of a stratified, nonkeratinized, epithelium-secreting mucus, which lubricates the oral cavity and facilitates tongue movements. No flap exists that can reproduce the physiology of the oral mucosa better than the oral mucosa itself. Prefabrication of mucosal flaps may represent the best solution. Therefore, 10 consecutive cases of mouth floor cancer were treated with prelamination of the fascia antibrachialis with mucosal grafts obtained from the healthy cheek, and with subsequent transplantation 3 weeks later. A significant increase in mucosal graft surface was seen in all cases, with a mean size twice the original. All flaps healed uneventfully. Follow-up time ranged between 2-60 months (average, 26.6 months). Morphological and functional results were excellent. Tongue motility, speech intelligibility, and swallowing were reestablished in all treated cases. Mucosal prelamination of the forearm fascia is feasible and allows physiological reconstruction of oral cavity defects up to 6 x 4 cm. Copyright 2002 Wiley Liss, Inc.
UI - 12185786
AU - Gassler N; Helmke B; Schweigert HG; Hassfeld S; Otto HF; Flechtenmacher
TI - C [Carcinoma cuniculatum of the oral cavity. A contribution to the differential diagnosis of potentially malignant papillary lesions of mouth mucosa]
SO - Pathologe 2002 Jul;23(4):313-7
AD - Pathologisches Institut der Universitat Heidelberg, Im Neuenheimer Feld 220/221, 69120 Heidelberg. Nikolaus_Gassler@med.uni-heidelberg.de
Although carcinoma cuniculatum clinically appears to be malignant, histological evaluation often results in a false diagnosis of a benign papillomatous lesion or pseudoepitheliomatous hyperplasia, because the tumor usually displays a well differentiated tissue. In this report morphological and immunohistological features in a rare case of carcinoma cuniculatum of the oral cavity are described. Both clinical features and histomorphological evaluation must be taken into consideration when diagnosing the tumor.
UI - 12220214
AU - Azizzadeh B; Enayati P; Chhetri D; Maghami E; Larian B; Blackwell KE;
TI - Abemayor E; Calcaterra TC Long-term survival outcome in transhyoid resection of base of tongue squamous cell carcinoma.
SO - Arch Otolaryngol Head Neck Surg 2002 Sep;128(9):1067-70
AD - Division of Head and Neck Surgery, UCLA School of Medicine, 62-132 CHS, 10833 Le Conte Ave, Los Angeles, CA 90095-1624, USA.
BACKGROUND: The transhyoid approach for the resection of squamous cell carcinoma (SCC) of the base of the tongue continues to evolve and remains controversial. We previously reported that the functional outcome of this operation is superior to that of the traditional transmandibular approaches. OBJECTIVE: To report our long-term survival rates for T1, T2, and select T3 SCCs of the base of the tongue using the transhyoid approach. PATIENTS AND METHODS: Twenty-eight patients with SCC of the base of the tongue were treated using a transhyoid approach at the University of California, Los Angeles, Medical Center between 1981 and 1998. RESULTS: All 28 patients underwent simultaneous neck dissection, and 27 patients underwent postoperative radiation therapy. The majority of the patients had advanced stage III or IV SCC. Twenty-five of the 28 patients had clear margins in the final pathologic specimen. The overall 3- and 5-year patient survival rates were 88.5% and 80.0%, respectively. Tumor-specific 5-year survival rates were 80.0%, 84.6%, and 50.0% for T1, T2, and T3 tumors, respectively. Stage-specific 5-year survival rates were 60.0%, 100.0%, and 80.0% for stages II, III, and IV, respectively. CONCLUSIONS: The advantages of the transhyoid approach to SCC of the base of the tongue in conjunction with neck dissection and postoperative radiation therapy include excellent long-term patient survival, improved swallowing and speech function, outstanding tumor exposure, and minimal cosmetic deformity.
UI - 12365373
AU - Ionna F; Chiesa F; Longo F; Manola M; Villano S; Calabrese L; Lastoria
TI - S; Mozzillo N Prognostic value of sentinel node in oral cancer.
SO - Tumori 2002 May-Jun;88(3):S18-9
AD - Istituto Nazionale Tumori, Fondazione Pascale, Naples.
AIMS AND BACKGROUND: In stage I oral squamous cell carcinoma, clinical examination and imaging techniques are unable to identify 60-90% of patients at risk of micrometastasis, while the sentinel node biopsy technique allows to avoid the morbidity of elective neck dissection in patients not actually affected by micrometastases. MATERIALS AND METHODS: Forty-one T1-T2N0 patients underwent lymphoscintigraphy after peritumoral injection of human albumin labeled with 99Tc. Focal areas of radiotracer uptake were marked on the skin preoperatively. The sentinel lymph node (SLN) was identified by the combined use of blue dye and gamma probe and subsequently removed. Complete neck dissection was then performed in all patients and the histological findings were compared with those of SLN biopsy. RESULTS: The SLN was identified in 95% of the patients; in four cases (10%) two SLNs were isolated. In 18% of our patients the SLNs were located outside the expected drainage area. When the histology of the negative SLNs was compared with the pathological status of the neck dissection specimens no false negatives were found. Five SLNs in four patients contained micrometastases and were the only positive lymph nodes. CONCLUSIONS: SLN biopsy can be a valuable staging technique in T2 and T2 oral cancer with uninvolved neck in patients whose lymphatic drainage of the neck has not been altered by previous surgery or radiotherapy. It provides reliable detection of micrometastasis, indicating which level(s) should be removed ipsilaterally or contralaterally, and allows the surgeon to accurately plan neck dissection, taking into consideration the pattern of lymphatic drainage of each individual patient. In this way unnecessary neck dissection and its morphofunctional sequelae can be avoided in a considerable number of patients.
UI - 12353339
AU - Su WF; Chen SG; Sheng H
TI - Speech and swallowing function after reconstruction with a radial forearm free flap or a pectoralis major flap for tongue cancer.
SO - J Formos Med Assoc 2002 Jul;101(7):472-7
AD - Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
BACKGROUND AND PURPOSE: The tongue plays a more significant role in English than in Mandarin, both in apical-palatal consonant production and tense-lax distinction. Theoretically, the same surgical intervention may produce a less significant impact on postoperative Mandarin production. The impact of tongue reconstruction on Mandarin articulation has not been reported. This study compared the tongue function outcome obtained using two methods of tongue reconstruction, radial forearm free flap transfer and pectoralis major flap transfer. METHODS: Twenty-five patients with carcinoma of the tongue underwent tumor resection. The surgical defects were reconstructed using a pectoralis major flap in six patients and a radial forearm flap in 19 patients. Swallowing and speech function were evaluated 6 months to 5 years after the reconstruction. Speech intelligibility and a Mandarin articulation test were used to evaluate the articulation proficiency before and after surgery. Clinical evaluation of deglutition included a questionnaire on dietary habits and a swallowing rating of 1 to 7. RESULTS: Clinical evaluation showed that patients with free flap reconstruction had more intelligible speech (p = 0.014) even after total glossectomy. Assessment of data obtained by clinical questionnaire showed no significant difference between the two groups in swallowing function. Motility due to flap pliability increased speech intelligibility but had little effect on swallowing function. CONCLUSION: Our results suggest that radial forearm flap transfer is better than pectoralis major flap transfer in preserving speech function and that there is no significant difference between the two methods of reconstruction in their impact on swallowing function.
UI - 12122624
AU - Kocaturk S; Ozdemir N; Erkam U; Uzun H; Babila A; Ozturk E
TI - [Evaluation of occult lymph node metastasis in lower lip cancers and approach to N(0) neck metastasis]
SO - Kulak Burun Bogaz Ihtis Derg 2002 Jan-Feb;9(1):41-5
AD - 2nd Department of Otolaryngology, SSK Training Hospital, Ankara, Turkey. email@example.com
OBJECTIVES: In this study, we evaluated the incidence of occult lymph node metastasis and the approach to N0 necks in carcinoma of the lower lip. PATIENTS AND METHODS: Sixty-eight patients who underwent surgery for squamous cell carcinoma of the lower lip were monitored for a minimum period of three years. All the patients were males (mean age 54 years; range 36 to 69 years). Preoperatively, 15 and 53 patients had N+ and N0 necks, respectively. Depending on the tumor localization, unilateral or bilateral suprahyoid neck dissections were performed. Nine patients underwent radical neck dissection following detection of metastasis on histopathologic examination. RESULTS: Histopathologic examination revealed metastasis in four patients (4/15; 26%) with N+ necks and in five patients (5/53; 9.4%) with N0 necks. Four patients (6.7%) developed late cervical lymph node metastasis at level 3. No evidence of neck disease was encountered in 93% of patients. CONCLUSION: Suprahyoid neck dissection appears to be effective in detecting occult lymph node metastasis. With improved surgical and histopathologic techniques and consideration of skip metastasis, more aggressive treatment approaches may be employed and better survival rates may be obtained.
UI - 12132296
AU - Lischner S; Rosien F; Eiling S; Haacke TC; Hauschild A
TI - [Lipoma of the lip. A rare differential diagnosis]
SO - Hautarzt 2002 Jun;53(6):400-2
AD - Klinik fur Dermatologie, Venerologie und Allergologie, Christian-Albrechts-Universitat zu Kiel.
We report on a 49 year-old female patient with a cherry-sized tumor of the lower lip, which over several years had steadily increased in size. The patient was psychologically affected by the appearance of the tumor and had difficulties to eat. We excised the tumor in local anaesthesia. Histology confirmed the clinical suspicion of lipoma. A total of four lipomas at this location have been reported world-wide.
UI - 12140643
AU - Kitano H; Asada Y; Hayashi K; Inoue H; Kitajima K
TI - The evaluation of dysphagia following radical surgery for oral and pharyngeal carcinomas by cine-magnetic resonance imaging (Cine-MRI).
SO - Dysphagia 2002 Summer;17(3):187-91
AD - Department of Otolaryngology, Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan. firstname.lastname@example.org
Cine-magnetic resonance imaging (cine-MRI) creates moving pictures by a video system and turbo-flash method that allow for high-speed MRI. This report describes our experience using this new technique for dynamic imaging using the fast spoiled GRASS (SPGR) sequence to study swallowing in patients with dysphagia following radical surgery for oral cancer. We defined two new parameters, laryngeal elevation and the angle of the epiglottis, to quantify swallowing ability by cine-MRI. These variables were markedly different in patients with dysphagia than they were in healthy controls. Cine-MRI not only provides dynamic images of swallowing but can generate objective measures of swallowing ability as well.
UI - 12140418
AU - Landa LE; Kathju S; Nepomuceno-Perez MC; Gordon C; Sotereanos GC
TI - Tuberculous granuloma and adenoid cystic carcinoma presenting as a single buccal space mass.
SO - J Craniofac Surg 2002 Jul;13(4):533-7
AD - Division of Plastic, Reconstructive & Maxillofacial Surgery, Oral and Maxillofacial Fellow, University of Pittsburgh and Hospital Metropolitano, Craniomaxillofacial Surgery Unit, Valencia, Venezuela. email@example.com
We report an unusual case of a 58-year-old man with a "collision lesion" of the buccal space. Initially diagnosed as tuberculoma, the patient showed only partial response to an extensive course of antibiotics, prompting more vigorous investigation. This revealed the presence of a concomitant malignancy, specifically adenoid cystic carcinoma. Definitive treatment was then achieved by surgical resection and flap reconstruction with postoperative radiation therapy.
UI - 12189573
AU - Mancusi G; Susani M; Kornfehl J; Girsch W; Kautzky M
TI - [Adenosquamous carcinoma of the palate]
SO - Laryngorhinootologie 2002 Aug;81(8):568-72
AD - Univ. Klinik fur Hals-, Nasen- und Ohrenkrankheiten, Germany.
A rare case of adenosquamous carcinoma in a 74 year-old man is reported. Presenting as a nodule on the soft palate, diagnosis was prolonged because of the benign macroscopic aspect. CT-scan and MR-tomography showed an encapsulated lesion but biopsy and histologic examination revealed the typical features of adenosquamous carcinoma. The tumour consisted of adenocarcinoma and squamous cell carcinoma in close proximity to minor salivary glands of which the tumour seemed to have its origin. This entity, although rare in the head and neck region has been documented to be very aggressive with early regional and hematogenic metastasis. Therefore it has to be distinguished from other tumours, especially from mucoepidermoid carcinomas of the salivary glands, which have a better prognosis. Adenosquamous carcinoma is considered to have poor radiosensitivity and chemotherapeutic approaches have also not been successful in the literature. In our case radical surgical therapy was performed by excision of the whole soft palate and bilateral neck dissection. This resulted in total removal of the tumour but revealed bilateral lymph node metastases. Vital functions were saved by reconstruction of the palate with a free vascularized tensor-fasciae-latae-perforator-flap. For the first time in a case of adenosquamous carcinoma carcinoembryonic antigen in serum was monitored. A pretherapeutical 29-fold elevation resulted in a marked decrease after surgery, but supranormal values indicated remaining tumour burden which was found in metastases in the lung. Because of the limitations in therapy, early histologic diagnosis is most important in this highly malignant tumour.
UI - 12189574
AU - Riechelmann H
TI - [Occupational exposure and cancer of the oral cavity and pharynx]
SO - Laryngorhinootologie 2002 Aug;81(8):573-9
AD - Univ. HNO-Klinik Ulm, Germany. firstname.lastname@example.org
BACKGROUND: Occupational risk factors for the development of laryngeal cancer are well accepted, whereas the etiologic relationship between occupational exposure to various noxious influences and the development of cancer of the oral cavity and pharynx remain a matter of debate. Based on published data, occupational risk factors for cancer of the oral cavity and pharynx should be evaluated. METHODS: Publications since 1990 listed in the National Library of Medicine, textbooks and data obtained from the German Employer's Liability Insurance Association were evaluated. RESULTS: In several tobacco- and alcohol-adjusted case-control and cohort studies, an association with occupation in construction and metalworking industries, as painters, carpenters and machine operators was consistently found. The relative risks or standardized mortality rates ranged between 1.5 and 3. Some recent investigations found an association for workers in the paper and rubber industry. The results in regard to the textile and woodworking industry were inconclusive. CONCLUSION: In cases with moderate isolated tobacco or moderate isolated alcohol consumption, the risk attributable to occupational factors and smoking or drinking are of similar magnitude. According to German jurisdiction, a partial compensation of the acquired disability is then justified. In pronounced combined tobacco and alcohol consumption, the non-occupational risk factors increase exponentially and occupational risks attain marginal weight.
UI - 12196250
AU - Chua MS; Veness MJ
TI - Mycosis fungoides involving the oral cavity.
SO - Australas Radiol 2002 Sep;46(3):336-9
AD - Department of Radiation Oncology, Westmead Hospital, Sydney, Australia.
Mycosis fungoides is a malignant T-cell lymphoproliferative disease with a predilection for cutaneous involvement. Extracutaneous disease is uncommon and oral mucosal involvement is rare. We describe a case of mycosis fungoides involving the hard palate treated with radiotherapy. The relevant literature on this topic is reviewed.
UI - 12216485
AU - Suvorova IuV; Tarazov PG; Korytova LI; Sokurenko VP; Khazova TV
TI - [Arterial chemoembolization in the combined treatment of malignant tumors of the tongue and maxilla: preliminary results]
SO - Vestn Rentgenol Radiol 2002 Mar-Apr;(2):23-8
AD - Central Research Roentgenoradiological Institute, Ministry of Health of the Russian Federation, Saint Petersburg.
The authors made a clinical evaluation of the efficiency of regional bolus chemotherapy and embolization as a stage of combined therapy in patients with inoperable cancer of the tongue and maxilla complicated by bleeding episodes. Carotid angiography by attempting to make chemoembolization was performed in 15 patients. The procedure could not be done in full in 2 (13%) patients due to transient vascular and neurological disorders. The remaining 13 (87%) patients had successful chemoembolization of tumor-supplying arteries with 5-fluorouracil (700 mg/m2) and methotrexate (40 mg/m2) in combination with finely cut hemostatic sponge and fragments of metallic spirals (n = 12) or regional bolus injection of a cytostatic (n = 1) without arterial occlusion. After embolization, bleeding episodes ceased in all the patients. Full (n = 1) and partial (n = 6) responses to treatment or stabilization of the process (n = 5) were noted in 12 (92%) cases, progression was only in 1 (8%) case. The study suggests that chemoembolization of the branches of the external carotid artery in patients with cancer of the tongue and maxilla contributes to the arrest of chronic tumorous bleeding and to the reduction in the risk for acute A combination of systemic multidrug therapy, radiation therapy, and chemoembolization stabilizes a tumorous process in most patients.
UI - 12237917
AU - Mendez E; Cheng C; Farwell DG; Ricks S; Agoff SN; Futran ND; Weymuller
TI - EA Jr; Maronian NC; Zhao LP; Chen C Transcriptional expression profiles of oral squamous cell carcinomas.
SO - Cancer 2002 Oct 1;95(7):1482-94
AD - Department of Otolaryngology: Head and Neck Surgery, University of Washington, Seattle, Washington, USA.
BACKGROUND: Currently, the classification of oral squamous cell carcinoma (OSCC) depends heavily on the clinical and pathologic examination of tissue. This system can lead to the classification of potentially heterogeneous tumors into single groups when they may have different degrees of aggressiveness. No system to date has incorporated genetic changes as a factor by which to classify OSCC tumors. METHODS: To test the hypothesis that OSCC has a genome-wide genetic expression profile that differs from normal oral tissue and that transcriptional expression profiling can be used to characterize the heterogeneity among tumors, the authors examined the genetic expression profiles of 26 invasive squamous cell carcinomas of the oral cavity and oropharynx, 2 premalignant lesions, and 18 normal oral tissue samples using oligonucleotide arrays that contained probes representing approximately 7000 full-length human genes. RESULTS: Using hierarchical clustering analysis, the data show that oral carcinomas are distinguishable from normal oral tissue based on genome-wide transcriptional expression patterns. However, there is genetic expression profile heterogeneity among tumors of a particular histopathologic grade and stage. In addition, using a statistical approach that integrated normalization and regression analysis, the authors found 314 genes that were expressed differentially in the OSCC samples with statistical significance (P
UI - 12360690
AU - Abbott PV
TI - Unusual periapical pathosis--adenoid cystic carcinoma.
SO - Aust Endod J 2001 Aug;27(2):73-5
UI - 12006539
AU - Ha PK; Pai SI; Westra WH; Gillison ML; Tong BC; Sidransky D; Califano JA
TI - Real-time quantitative PCR demonstrates low prevalence of human papillomavirus type 16 in premalignant and malignant lesions of the oral cavity.
SO - Clin Cancer Res 2002 May;8(5):1203-9
AD - Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA.
PURPOSE: Human papillomavirus (HPV) type-16 has been associated with invasive squamous cell carcinoma of the head and neck. This study examines the role of HPV-16 in the progression of oral head and neck cancer by determining the quantity of HPV-16 DNA in premalignant and malignant lesions, using real-time quantitative PCR, to more accurately determine the role of HPV-16 in oral head and neck squamous cell carcinogenesis. EXPERIMENTAL DESIGN: We examined 102 microdissected premalignant head and neck lesions (85 from the oral cavity), 34 invasive oral cavity squamous cell carcinomas, as well as 18 invasive tumors known to be HPV positive by traditional molecular technology for the presence of HPV-16 DNA using real-time quantitative PCR. RESULTS: HPV DNA was detected in 1 of 102 premalignant lesions (0.98%), 1 of 34 (2.9%) invasive oral cavity carcinomas, and 14 of 18 (78%) known HPV-positive tumors. CONCLUSIONS: HPV-16 infection and integration is seldom found in oral premalignant lesions and invasive carcinoma, and therefore rarely contributes to malignant progression in the oral cavity. Furthermore, quantitative PCR is a useful technique that reliably excludes contaminated samples and those with minimal HPV DNA content that is unlikely to be significant in carcinogenesis.
UI - 11893452
AU - Kuropkat C; Venkatesan TK; Caldarelli DD; Panje WR; Hutchinson J;
TI - Preisler HD; Coon JS; Werner JA Abnormalities of molecular regulators of proliferation and apoptosis in carcinoma of the oral cavity and oropharynx.