Oral and oropharyngeal cancer: time from first symptoms to treatment initiation and associated factors.

The aim of this study was to evaluate the time elapsed from first symptoms to the treatment of oral and oropharyngeal cancer (OOC) and to identify variables associated with treatment delay. This is an observational study with retrospective and prospective data collection. Patients with a diagnosis of OOC seen at the Head and Neck Surgery outpatient clinic of a Brazilian public hospital were included and followed up to treatment initiation. Participants answered a questionnaire for the collection of socioeconomic, demographic, cultural, and clinical information, as well as information about the time elapsed from first symptoms to the first appointment with a head and neck surgeon. Time to treatment was classified into four intervals: 1- first symptoms to first medical appointment; 2- first medical appointment to specialized medical care; 3- specialized medical care to preparation for treatment; and 4- preparation for treatment to treatment initiation. Bivariate statistics were computed. Out of 100 participants, nine died before treatment. Mean time to treatment was 217 days. Highest mean time was observed for interval 2 (94 days), followed by interval 1 (63 days), interval 4 (39 days), and interval 3 (21 days). At interval 1, a longer time was associated with severe alcohol consumption, severe smoking, and family history of cancer. At interval 2, the delay was associated with appointment with a general practitioner, clinical diagnosis of disease other than cancer, and antibiotic prescription. At interval 4, delay in treatment was associated with surgical treatment. Patients with OOC experience delays from symptom onset to treatment initiation. The longest interval was associated with professional delay, followed by patient delay in help-seeking.

Oral and oropharyngeal cancer: time from first symptoms to treatment initiation and associated factors

Abstract The aim of this study was to evaluate the time elapsed from first symptoms to the treatment of oral and oropharyngeal cancer (OOC) and to identify variables associated with treatment delay. This is an observational study with retrospective and prospective data collection. Patients with a diagnosis of OOC seen at the Head and Neck Surgery outpatient clinic of a Brazilian public hospital were included and followed up to treatment initiation. Participants answered a questionnaire for the collection of socioeconomic, demographic, cultural, and clinical information, as well as information about the time elapsed from first symptoms to the first appointment with a head and neck surgeon. Time to treatment was classified into four intervals: 1- first symptoms to first medical appointment; 2- first medical appointment to specialized medical care; 3- specialized medical care to preparation for treatment; and 4- preparation for treatment to treatment initiation. Bivariate statistics were computed. Out of 100 participants, nine died before treatment. Mean time to treatment was 217 days. Highest mean time was observed for interval 2 (94 days), followed by interval 1 (63 days), interval 4 (39 days), and interval 3 (21 days). At interval 1, a longer time was associated with severe alcohol consumption, severe smoking, and family history of cancer. At interval 2, the delay was associated with appointment with a general practitioner, clinical diagnosis of disease other than cancer, and antibiotic prescription. At interval 4, delay in treatment was associated with surgical treatment. Patients with OOC experience delays from symptom onset to treatment initiation. The longest interval was associated with professional delay, followed by patient delay in help-seeking.

Neoplasias mesenquimais benignas da região oral e maxilofacial: um estudo retrospectivo de 1066 casos / Benign mesenchymal neoplasms of the oral and maxillofacial region: a retrospective study of 1066 cases

Neoplasias mesenquimais benignas são diagnósticos relativamente incomuns na região de cabeça e pescoço e constituem um grupo diversificado de tumores com histogênese e etiopatogenia distintos. Considerando que são limitadas as pesquisas sobre a prevalência destas lesões, o objetivo deste trabalho foi avaliar a frequência, características demográficas e clinicopatológicas das neoplasias mesenquimais benignas, que acometem a região oral e maxilofacial, em um serviço de patologia oral. Trata-se de um estudo transversal que abrangeu um período de 66 anos. Todos os laudos histopatológicos com diagnóstico de neoplasias mesenquimais benignas, arquivados no Laboratório de Patologia Oral da Faculdade de Odontologia da Universidade Federal de Minas Gerais, foram recuperados. Dados demográficos (sexo, idade e cor da pele) e clínicos (lesão fundamental, localização, tamanho, coloração, consistência, sintomatologia, envolvimento ósseo, achados radiográficos, diagnóstico clínico e histopatológico) foram coletados a partir dos registros de biópsia. A análise estatística foi realizada no software SPSS. Foram revisados 38.119 registros de biópsias, revelando 1.066 (2,79%) neoplasias mesenquimais benignas, das quais 369 eram tumores fibroblásticos/miofibroblásticos, 250 adiposos, 179 vasculares, 130 neurais, 94 ósseos e cartilaginosos, 19 musculares e 2 tumores fibro-histiocíticos. Os tumores foram predominantes em pacientes do sexo feminino (62,8%), leucodermas (42,3%) e com idade média de 42 anos. A maioria das lesões eram pápulas e nódulos (42,7%) e mediam frequentemente entre 0 a 5 mm (26,4%). A língua (25,2%) foi o sítio mais afetado para neoplasias extraósseas e a mandíbula (67,0%) para os tumores intraósseos. Este é o estudo com a maior amostra de neoplasias mesenquimais benignas da região oral e maxilofacial. Estas lesões foram pouco frequentes no Laboratório estudado, sendo o fibroma de células gigantes, lipomas e hemangiomas as neoplasias mais prevalentes. Apesar de exibirem semelhanças clínicas entre si, a melhor caracterização e diferenciação entre esses tumores, abordadas neste estudo, fornece aos clínicos o conhecimento para diagnosticar com maior precisão essas lesões e conduzir uma abordagem de tratamento adequada para seus pacientes.

Benign mesenchymal neoplasms are relatively uncommon diagnoses in the head and neck region and constitute a group of several tumors with distinct histogenesis and etiopathogenesis. Since researches on the prevalence of these lesions are limited, the aim of this study was to evaluate the frequency, demographic and clinicopathological features of oral and maxillofacial benign mesenchymal neoplasms in an oral pathology service. This is a cross­sectional study conducted over a 66­year period. Archives from the Oral Pathology Service, School of Dentistry, of Universidade Federal de Minas Gerais were reviewed and all histopathological reports with diagnoses of benign mesenchymal neoplasms were recovered. Demographic (sex, age and skin color) and clinical data (lesion appearance, site, size, color, symptoms, bone involvement, radiographic aspects, clinical and histopathological diagnosis) were collected from the biopsy records. Statistical analysis was performed using SPSS software. A total of 38,119 archived specimens were reviewed, revealing 1,066 (2.79%) neoplasms, of which 369 were fibroblastic/myofibroblastic, 250 adipose, 179 vascular, 130 neural, 94 osseous and cartilaginous, 19 muscle and 2 fibrohistiocytic tumors. Tumors were predominant in females (62.8%), white­skinned (42.3%) patients, with mean age of 42 years. Most lesions were papules and nodules (42.7%), and often measure between 0­5 mm (26.4%). Tongue (25.2%) was the most commonly affected site for extraosseous neoplasms and mandible (67.0%) for intraosseous tumors. This is the study with the largest sample of benign mesenchymal neoplasms of the oral and maxillofacial region. These lesions were unusual in the Laboratory studied, with giant cell fibroma, lipomas and hemangiomas being the most prevalent neoplasms. Although they may have similar clinical features, the further characterization and differentiation among these tumors presented in this study, is important to help the clinician in the accurate diagnostic and management of its patients.