Survival and clinicopathological characteristics of cT4b oral squamous cell carcinoma based on different treatment modalities: A single-center retrospective study.

INTRODUCTION: Primary surgical treatment for oral squamous cell carcinoma (OSCC) is reserved for T1 to T4a tumors, but not for T4b tumors, according to the present National Comprehensive Cancer Network clinical practice guidelines. In this retrospective study, we aimed to determine the association between the clinicopathological characteristics and different treatment modalities for T4b OSCC based on whether patients received primary surgical treatment. Therefore, we conducted a survival analysis based on different treatment modalities. METHODS: This retrospective cohort study enrolled 125 patients with clinical stage T4b OSCC who received treatment and were followed up at Changhua Christian Hospital between January 1, 2008 and December 31, 2018. RESULTS: Overall, 81 patients received primary surgical treatment and 44 received primary nonsurgical treatment. Comparison of the clinicopathological characteristics between those who did and did not undergo surgery revealed no significant differences in age at tumor diagnosis, tumor location, clinical N stage, and involved tumor area based on computed tomography or magnetic resonance imaging, or stratified Charlson Comorbidity Index scores. In the survival analysis, Kaplan-Meier curves revealed that patients who received treatment modalities including surgery exhibited better survival than those who received treatment modalities that did not include surgery. CONCLUSIONS: In the present study, patients with T4b OSCC treated with primary surgery had a better overall survival rate than those who received nonsurgical treatment. In the future, it will be necessary for clinicians worldwide to report the treatment outcomes of patients with T4b OSCC based on the common criteria.

Impact on patients with oral squamous cell carcinoma in different anatomical subsites: a single-center study in Taiwan.

The incidence of oral cavity squamous cell carcinoma (OSCC) is particularly high in South Asia. According to the National Comprehensive Cancer Network, OSCC can arise in several subsites. We investigated survival rates and the clinical and pathological characteristics of OSCC in different anatomical subsites in the Taiwanese population. We retrospectively analyzed data for 3010 patients with OSCC treated at the Changhua Christian Hospital. Subsequently, we compared clinical and pathological features of OSCC in different subsites. Pathological T4 stage OSCCs occurred in the alveolar ridge and retromolar trigone in 56.4% and 43.7% of cases, respectively. More than 25% of patients with tongue OSCC and 23.4% of those with retromolar OSCC had lymph node metastasis. The prognosis was worst for hard palate OSCC (hazard ratio 1.848; p < 0.001) and alveolar ridge OSCC (hazard ratio 1.220; p = 0.017). Retromolar OSCC recurred most often and tongue OSCC second most often. The risk for cancer-related mortality was highest for hard palate OSCC, followed by alveolar ridge and retromolar OSCC. We found distinct differences in survival among the different subsites of OSCC. Our findings may also help prompt future investigations of OSCC in different subsites in Taiwanese patients.

Effects of short-term acupuncture treatment on occlusal force and mandibular movement in patients with deep-bite malocclusion.

BACKGROUND/PURPOSE: Acupuncture is well known to be effective for pain relief and muscle relaxation, and hence it is feasible that acupuncture treatment could change the occlusal forces and mandibular movements in subjects with deep-bite malocclusion. The purpose of this research was to determine the distribution of occlusal force and the border movement of the mandible in patients with deep-bite malocclusion before and after acupuncture treatment. MATERIALS AND METHODS: This study involved 17 volunteers with deep-bite malocclusion and aged 20-30 years. Before and after acupuncture treatment, the distribution of the occlusal-force percentage at each tooth was measured and the percentage biting force in the first molar area during maximal clenching was recorded. Additionally, the mandibular movements including the maximum mouth opening and maximum lateral border movement were also evaluated. All of the data were analyzed statistically using the Wilcoxon signed-rank test. RESULTS: The percentage biting force at the first molar differed significantly between before and after the acupuncture treatments (P = 0.017). However, no treatment effects were seen for the maximum mouth opening and the maximum lateral border movement. Conclusion: Although the mandibular border movements did not change significantly, this study has confirmed that acupuncture treatment may become an alternative choice on improving the occlusal force of deep-bite patients.