Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma: Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients.

BACKGROUND: The National Comprehensive Cancer Network guidelines recommend that patients with oral cavity squamous cell carcinoma (OSCC) and cT4b disease should be either included in clinical trials or treated with a nonsurgical approach. However, surgery may be feasible in selected patients with adequate safety margins. Using the nationwide Taiwanese Cancer Registry Database, we examined the prognosis of cT4b OSCC patients in relation to their treatment approach. METHODS: Of the 18,910 patients with previously untreated first primary OSCC identified between 2004 and 2010, 492 (2.6 %) had cT4b tumors. Of them, 327 (66 %) received initial treatment with surgery, whereas 165 (34 %) were initially treated with a nonsurgical approach. Of the latter group, 78 patients subsequently underwent surgery. A 5-year disease-specific survival (DSS) ≥45 % was considered as a favorable outcome. RESULTS: Better 5-year DSS and overall survival (OS) rates were observed in cT4b patients initially treated with surgery (vs. nonsurgery; DSS, 51 vs. 38 %; OS, 43 vs. 27 %, respectively, p < 0.001). Of the participants initially treated with surgery, patients with cN0-2 disease had better 5-year survival rates (DSS: cN0, 59 %; cN1, 53 %; cN2, 46 %; OS: cN0, 49 %; cN1, 50 %; cN2, 37 %) than those with cN3 disease (DSS: 0 %; OS: 0 %). Among cT4b patients who initially received a nonsurgical treatment, subjects who subsequently underwent surgery showed better outcomes. CONCLUSIONS: Primary surgery is performed in approximately two-thirds of cT4b OSCC patients, with cN0-2 cases showing a good prognosis. Patients who initially received a nonsurgical approach can subsequently be treated with surgery and achieve favorable outcomes.

Lowered risk of nasopharyngeal carcinoma and intake of plant vitamin, fresh fish, green tea and coffee: a case-control study in Taiwan.

BACKGROUND: A case-control study was conducted to evaluate the role of adult diet on nasopharyngeal carcinoma (NPC) in Taiwan. METHODS: A total of 375 incident NPC cases and 327 controls matched to the cases on sex, age, and residence were recruited between July 1991 and December 1994. A structured questionnaire inquiring complete dietary history, socio-demographic characteristics, and other potential confounding factors was used in the personal interview. Unconditional logistic regression analysis was used to estimate multivariate-adjusted odds ratio (OR(adj)) with 95% confidence interval (CI) after accounting for known risk factors. RESULTS: Fresh fish (OR(adj), 0.56; 95% CI, 0.38-0.83 for the highest vs. lowest tertile of intake), green tea (OR(adj), 0.61; 95% CI, 0.40-0.91 for drinking ≥1 times/week vs. never) and coffee (OR(adj), 0.56; 95% CI, 0.37-0.85 for drinking ≥0.5 times/week vs. never) were inversely associated with the NPC risk. No association with NPC risk was observed for the intake of meats, salted fish, fresh vegetables, fruits and milk. Intake of vitamin A from plant sources was associated with a decreased NPC risk (OR(adj), 0.62; 95% CI, 0.41-0.94 for the highest vs. lowest tertile). CONCLUSION: The study findings suggest that certain adult dietary patterns might protect against the development of NPC.

Application of unsedated transnasal esophagogastroduodenoscopy in the diagnosis of hypopharyngeal cancer.

BACKGROUND: This study evaluates the efficacy of unsedated transnasal esophagogastroduodenoscopy (EGD) in the diagnosis of hypopharyngeal cancer and screening of esophageal lesions. METHODS: Twenty-seven patients with newly diagnosed hypopharyngeal cancer were evaluated by transnasal EGD without conscious sedation. RESULTS: Twenty-two hypopharyngeal cancers arose from the pyriform sinus, and the other 5 tumors were from the posterior hypopharyngeal wall. Seventeen tumors were classified as T3-T4. Twenty-four hypopharyngeal tumors were pathologically proved malignancy by this technique. Regarding simultaneous esophageal lesions, esophageal dysplasia was noted in 4 patients and esophageal cancer occurred in 6 patients. The procedures were performed without difficulty except in 1 patient with huge posterior wall tumor. The mean procedure time was 22 minutes. All patients tolerated the procedure well, without significant bleeding or respiratory distress during examination. CONCLUSION: Unsedated transnasal EGD is a safe, tolerable, and accurate endoscopic technique for diagnosis of hypopharyngeal cancer and screening of simultaneous esophageal cancer.

The development of magnetic degradable DP-Bioglass for hyperthermia cancer therapy.

In this study, a novel magnetic degradable material was developed by adding Fe ions into DP-Bioglass (Na(2)O-CaO-P(2)O(5)-SiO(2)) as thermoseed for hyperthermia cancer therapy under an alternating magnetic field. We have investigated the properties of developed magnetic DP-Bioglass including morphology, chemical composition, and magnetism. The degradability was conducted by measuring the released concentrations of Na, Ca, Si, P, and Fe ions. The biocompatibility was analyzed by biological assays, and the functional hyperthermia effect to cancer cells was evaluated by in vitro cell culture test. In the results, the morphology of synthesized magnetic DP-Bioglass was revealed in sphere and rod shape with particle size around 50-100 nm. From the hysteresis loop analysis, it showed that the group of Fe/Bioglass = 0.2 possessed the maximum magnetization property. When cultured with fibroblasts, the magnetic DP-Bioglass had no significant influence on cell viability and mediated low cytotoxicity. The thermal-induced property demonstrated that after exposure to an alternating magnetic field, the cell number of human Caucasian lung carcinoma cells (A549) was significantly decreased when temperature was increasing to 45 degrees C. In brief, successfully incorporated with Fe ions by sol-gel method, this magnetic degradable DP-Bioglass possessed the potential and properties of hyperthermia effect to lung carcinoma cells.