Addition of the tumour-stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma.

AIMS: One of the objectives of current research is to customise the treatment of cancer patients. The achievement of this objective requires stratification of patients based on the most significant prognostic factors. The aims of this study were to evaluate the prognostic value of the tumour-stroma ratio (TSR), defined as the proportion of tumour cells relative to surrounding stroma, in patients with oral tongue squamous cell carcinoma (OTSCC), and to develop a prognostic nomogram based on the most significant clinicopathological features. METHODS AND RESULTS: Clinicopathological data of 211 patients treated at 'Ospedali Riuniti' General Hospital (Ancona, Italy) for OTSCC were collected. One hundred and thirty-nine patients were restaged according to the 8th edition American Joint Committee on Cancer (AJCC) staging system. Evaluation of the TSR was performed on haematoxylin and eosin-stained slides, and correlation with survival outcomes was evaluated. In addition, with the aim of integrating the independent value of the TSR with the 8th edition AJCC staging system, a prognostic nomogram for OTSCC has been developed. OTSCC with a low TSR (i.e. a high proportion of stroma and a low proportion of tumour cells) was shown to have negative prognostic value in terms of disease-specific survival, with a hazard ratio (HR) of 1.883 and a 95% confidence interval (CI) of 1.033-3.432 (P = 0.039), and overall survival (HR = 1.747, 95% CI 0.967-3.154; P = 0.044), independently of other histological and clinical parameters. For the cohort of 139 patients restaged according to the 8th edition AJCC staging system, variables correlating with a poor prognosis were: the TSR, perineural invasion, and sex. The nomogram built on these parameters showed good predictive capacity, outperforming the 8th edition AJCC staging system in stratifying disease-specific survival in OTSCC patients. CONCLUSIONS: Including the TSR in the predictive model could improve risk stratification of OTSCC patients and aid in making treatment decisions.

Dentistry in the centuries: a historical overview.

The began of the dentistry as medicine's concept has a long history dating back to 7000 BCE, making it one of the earliest medical specialties. In its early days, dental diseases were often attributed to supernatural causes like "evil spirits" and "tooth worms." However, today, dentistry leverages cutting-edge technologies, including artificial intelligence, for diagnosis and treatment. This journey reflects the remarkable progress made in the field. Despite these advancements, there is still room for improvement in integrating dental knowledge and skills with medical science and engineering backgrounds. Bridging these disciplines could lead to even greater advancements in the diagnosis and maintenance of oral health. Thus, over time, it has transformed from a primitive form of medicine into a modern field that emphasizes preventative dental care, advanced diagnostics, and state-of-the-art treatment.

Education during the COVID-19 pandemic: the perception of Italian dental and medical students.

BACKGROUND: During COVID-19 pandemic many dental and medical students continued their education from home. From several studies it emerges that students prefer face-to-face teaching, due to the better interaction with teachers, the least number of distractions and due to the negative effect of social isolation on the psychological aspect. The aim of this study was to evaluate the perception of Italian dentistry and medicine students about teaching and training in this scenario. METHODS: Two online questionnaires were sent to medical and dental students of all Italian universities to investigate the limits and advantages of distance learning and the experience regarding the internship. A chi-square test was used to assess the association between gender, year of the course and region of residence (P<0.05). RESULTS: One thousand one hundred thirty-eight students answered the first survey, and 292 the second one. Most students preferred face-to-face teaching due to the difficult to maintain attention during online lessons. Many students reported that the online internship was not adequate for their education. CONCLUSIONS: Distance learning disadvantages are the greater number of sources of distraction, low level of interaction, and absence of the relationship with the patient during the practical training. Furthermore, isolation has strongly affected psychosocial balance of the students. The advantages are the greater comfort, the reduction of transport costs, the decrease in pollution, and the possibility of reviewing the lessons. Most Italian students considered appropriate to provide distance learning during the pandemic but believed that the best teaching method was teaching in presence.

High PD-L1 expression in the tumour cells did not correlate with poor prognosis of patients suffering for oral squamous cells carcinoma: A meta-analysis of the literature.

OBJECTIVES: Oral cancer represents one of the most common malignancies in humans. Its prognosis is still poor, despite the most recent improvements in therapies. An increasing attention is placed on the role of programmed death ligand 1 (PD-L1) in the tumour immunity and its potential function as a marker for tumour prognosis. Whether PD-L1 expression is a prognostic factor for the poor outcomes in oral squamous cell carcinoma is still controversial. This study aimed to investigate, through a meta-analysis, a potential correlation between PD-L1 expression and the prognostic outcomes in patients with oral squamous cell carcinoma. MATERIALS AND METHODS: The studies were identified by searching PubMed, SCOPUS, Web of Science and were assessed by two of the authors. After the selection process, 11 articles met eligibility criteria and were included in the meta-analysis. Quality assessment of studies was performed according to the REMARK guidelines, and the risk of biases across studies was investigated through Q and I2 tests. Meta-analysis was performed to investigate the association between the PD-L1 expression either overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), gender and lymph node metastasis. RESULTS: A total of 1060 patients were analysed in the 11 studies included in the meta-analysis. Pooled analysis revealed that the expression of PD-L1 did not correlate with poor OS (HR, 0.60; 95% CI: [0.33, 1.10]; P = 0.10), DFS (HR, 0.62; 95% CI: [0.21, 1.88]; P = 0.40), DSS (HR, 2.05; 95% CI: [0.53, 7.86]; P = 0.29 and lymph node metastasis (HR, 1.15; 95% CI: [0.74, 1.81]; P = 0.53). Furthermore, results of the meta-analysis showed that high expression of PD-L1 is two times more frequent in female patients (OR, 0.5; 95% CI: [0.36, 0.69]; P < 0.0001) compared to males. For all the three outcomes analysed, a high rate of heterogeneity was detected (I2  > 50%). DISCUSSION: High PD-L1 expression did not correlate with poor prognosis of patients suffering for oral squamous cell carcinoma. Studies published on the topic showed a significant variation in results, limiting the use of PD-L1 expression by immunohistochemistry as prognostic biomarker in clinical practice.