RESUMEN
BACKGROUND: There is an ongoing need to identify pathologic prognosticators in early-stage oral cavity squamous cell carcinoma (OCSCC) to aid selection of patients who may benefit from adjuvant treatment. The objective of this study was to evaluate the prognostic ability of worst pattern of invasion-5 (WPOI-5) defined by the presence of satellite nodules, extratumoural perineural invasion (PNI) and/or extratumoural lymphovascular space invasion (LVI) in low-stage, node negative OCSCC. METHODS: This was a retrospective study of 160 patients with T1/T2N0 tumours staged using TNM7 treated surgically. Histology of the primary tumour was re-reviewed as appropriate to assess for the presence of WPOI-5 parameters. Univariate and multivariate analysis assessing impact of pathological features on survival outcomes was performed. RESULTS: On univariate analysis, WPOI-5 and its 3 constituent components of satellite nodules, extratumoural PNI and extratumoural LVI were all significantly associated with disease-specific survival (DSS) and overall survival (OS). On multivariate analysis, satellite nodules (odds ratio 6.61, 95% CI 2.83-15.44, p < 0.0001) and extratumoural LVI (odds ratio 9.97, 95% CI 2.19-45.35, p = 0.003) were independently associated with OS. Postoperative radiotherapy (odds ratio 0.40, 95% CI 0.19-0.87, p = 0.02) and non-tongue subsite (odds ratio 3.03, 95% CI 1.70-5.39, p = 0.0002) were also significantly associated with OS on multivariate analysis. CONCLUSION: Satellite nodules and extratumoural LVI correlated significantly with survival outcomes in our early-stage OSCC cohort. Further study is required to investigate the benefit of adjuvant treatment in these cases and to ascertain if WPOI-5 parameters including satellite nodules should be mandatory reporting data elements.
Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Humanos , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Estudios Retrospectivos , Neoplasias de la Boca/patología , Carcinoma de Células Escamosas/patología , Pronóstico , Invasividad Neoplásica/patología , Neoplasias de Cabeza y Cuello/patología , Estadificación de NeoplasiasRESUMEN
<b>Background and Objective:</b> <i>Demodex</i> mites are considered to play a pathogenic role in facial dermatoses as <i>Acne vulgaris</i>. In this study the association between <i>Acne vulgaris</i> and <i>Demodex</i> spp. intensity, kind and activity were investigated. <b>Materials and Methods:</b> Two degrees of acne was included, mild acne (30 cases) and moderate to severe acne (30 cases), besides 30 healthy subjects as a control. Deep skin scraping followed by direct microscopic detection was applied to diagnose demodicosis. <b>Results:</b> All the detected mites in moderate to severe acne were <i>D. folliculorum</i> which was observed in a highly dynamic status with their entire life cycle stages with intensity >5 mites per cm<sup><a href="2246157_ja">2</a></sup>. While very few inactive <i>D. brevis</i> mites were detected in the 2 subjects related to the control group<i>. </i>Despite that females comprised the majority of acne cases, males encompassed a statistically higher number than females among positive demodicosis cases. Itching and hair loss were the significant clinical signs within positive cases. Regarding risk factors, oily skins, repeated exposure to the sun, stressful lifestyle plus defective use of facial cleansers were found to be statistically significant. <b>Conclusion:</b> These results attained an association between moderate to severe acne and energetic <i>D. folliculorum</i> entire population. Thus, this study recommended lifestyle's modification for those cases suffering from <i>Acne vulgaris</i> with deep facial cleaning to avoid such infestation that worsens acne condition. Accordingly, once acne treatments are ineffective, consideration of <i>Demodex</i> mites with the needed acaricidal therapy is necessary.