Socio-demographic factors in the prognosis of oral cancer patients.

The aim of this study was to determine the survival rate of oral cancer patients treated in a medical center in central Taiwan and to investigate whether socio-demographic factors influence their survival. We retrospectively reviewed 1010 chart records of oral cancer patients. Survival was analyzed by the Kaplan-Meier method and Cox proportional hazard model was used for investigating the relationship between socio-demographic factors and survival. The overall 5-year survival rate was 63.24%. Multivariate analysis revealed that those without religious belief tended to have higher probability of death than those who had religious belief (relative risk (RR): 2.057, p<0.001). In addition, those who were single, widow/widower or divorced/separated had a poorer prognosis than those who were married (RR: 1.528, p=0.008). Apart from clinical features, socio-demographic factors also significantly influenced the survival of oral cancer patients. Therefore, care providers should take socio-demographic issues into consideration aside from ordinary clinical health care.

Nutritional factors and survival of patients with oral cancer.

BACKGROUND: Our objective was to determine the survival rate of patients with oral cancer who were treated at a medical center in central Taiwan. Furthermore, we attempted to investigate whether nutritional factors influence the survival. METHODS: We carried out a retrospective review of 1010 chart records of patients with oral cancer. We used the Kaplan-Meier method for survival analysis and the Cox proportional hazard models to investigate the prognosticators. RESULTS: Kaplan-Meier survival analysis showed an overall 5-year survival rate of 63.24%. The Cox proportional hazard model revealed that those with a preoperative body mass index (BMI) of <22.8 kg/m(2) tended to have a higher probability of death (relative risk [RR] = 1.292, p = .022). In addition, those with a preoperative serum albumin level of <4.15 g/dL were generally associated with a poorer prognosis (RR = 1.313, p = .016). CONCLUSIONS: Apart from clinical features, nutritional factors also had a significant influence on the survival of patients with oral cancer. Therefore, good nutritional status is crucial for patients with oral cancer in improving their survival.

Microvascular density and vascular endothelial growth factor immunoreactivity as predictors of regional lymph node metastasis from betel-associated oral squamous cell carcinoma.

PURPOSE: Neovascularization has profound effects on tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is a mitogen that acts exclusively on endothelial cells. The roles of miscrovascularity density (MVD) and VEGF expression in the progression of oral squamous cell carcinoma (OSCC) have been controversial. The purpose of the present study was to measure the MVD and VEGF expression in a cohort of patients with betel-associated OSCC and to evaluate for possible clinicopathologic correlations. PATIENTS AND METHODS: The paraffin sections from 49 subjects with OSCC were subjected to immunohistochemical studies to measure the highest MVD (h-MVD) and cytoplasmic immunoreactivity of VEGF. The findings in the tissue samples were analyzed with regard to the patients' risk factors and clinical course. RESULTS: The OSCC samples had an average h-MVD score of 27.7/mm(2). VEGF immunoreactivity was positive in 75.5% of samples. Both h-MVD and VEGF immunoreactivity were statistically associated with lymph node metastasis (P =.012 and.037, respectively). A marginally significant association was also noted between the h-MVD and patient survival (P =.056). The age and oral habits of patients, as well as the tumor site and size, did not appear to be correlated with h-MVD or VEGF immunoreactivity. CONCLUSION: The data suggest that both h-MVD and VEGF immunoreactivity may be useful predictors for the progression of a subset of OSCC associated mostly with betel use. Antiangiogenesis therapy might have a role in reducing regional metastasis.

The molecular markers for prognostic evaluation of areca-associated buccal squamous cell carcinoma.

BACKGROUND: Buccal squamous cell carcinoma (BSCC) is the most frequently occurring oral cancer in Asians due to the popularity of areca use in this area. The aim of the present study was to evaluate the survival of areca-associated BSCC associated with multiple molecular markers. METHODS: Using immunohistochemistry, we evaluated the survival of a cohort of 55 patients with BSCC being followed long term, as correlated to the expression of variable markers. RESULTS: We found that p53, p21, Rb, cyclin D1 (CCD1), MDM2, and gamma-catenin were positive in 81, 60, 70, 31, 88, and 44% of patients, respectively. Subjects with -ve immunoreactivity for CCD1, and +ve immunoreactivity for MDM2 and gamma-catenin had significantly better survival than subjects with the opposite immunoreactive pattern. KAPLAN-meier survival curves confirmed this association. CONCLUSION: The data indicate that expression of CCD1, MDM2, and gamma-catenin might serve as potential prognostic markers for BSCC in areca-using patients.