Survival analysis of recurrent squamous cell carcinoma of the lower oral cavity treated by surgery.

The aim of the present study was to investigate the survival of individuals with squamous cell carcinoma of the lower oral cavity who underwent surgical treatment and experienced recurrence, considering the site of the recurrent disease. A retrospective longitudinal study was conducted, comparing the survival rates of patients with and without recurrence and considering the site of recurrence (local, regional, distant). Statistical analysis was performed with SPSS and a p-value ≤ 0.05 was considered significant. The sample comprised 150 patients, 59 (39.3%) of whom experienced recurrence. Local recurrence occurred in 35 patients (23.4%), regional recurrence in 17 (11.3%), and distant recurrence in seven (4.6%). The average survival of participants with local, regional, and distant recurrence was 12, five, and two months, respectively. Patients with recurrent disease had worse survival than those who did not (P < 0.001). Patients with local recurrence had better survival than those with regional/distant recurrence (P = 0.011). All patients with regional and distant recurrence had deceased by the last follow-up. In conclusion, patients with local recurrence of squamous cell carcinoma of the lower oral cavity treated by surgery have a better survival rate than those with regional and distant recurrence. Local recurrence poses the possibility of curative salvage therapy.

Pigmented lesions of the oral mucosa: A cross-sectional study of 458 histopathological specimens.

OBJECTIVES: To evaluate clinical, demographic, and histopathological characteristics of pigmented lesions of the oral mucosa. MATERIALS AND METHODS: A cross-sectional study was conducted over a 64-year period. Information was collected from medical charts, and all archived histopathological specimens with diagnoses of any pigmented lesion were retrieved. Statistical analysis was performed using SPSS software. RESULTS: A total of 34,127 archived specimens were reviewed, revealing 458 (1.34%) pigmented lesions, of which 230 were melanocytic and 228 nonmelanocytic. Most patients were females (74.2%), white-skinned (49.1%), in the third and seventh decades of life (mean of 45 years). Most lesions were macular (59.8%), followed by plaques and nodules (4.8%), measuring 0-5 mm (41.9%). Cheek mucosa (21.0%), alveolar mucosa (16.6%), and gingiva (11.8%) were the most commonly affected sites. Amalgam tattoo was applied in 212 cases (46.3%), followed by melanotic macule (22.9%) and nevus (20.5%). Other diagnoses included racial pigmentation, exogenous pigmentation, melanotic neuroectodermal tumor of infancy, melanoma, melanoacanthoma, smoker's melanosis, and heavy metal pigmentation. CONCLUSIONS: Pigmented lesions represent an uncommon diagnosis in oral pathology routines. The most frequent entities are amalgam tattoo, melanotic macule, and nevus. Patients are usually middle-aged women presenting a small, long-lasting, macular lesion on the cheek mucosa.

Thioredoxin and metallothionein: Homeostasis-related proteins in lip carcinogenesis.

OBJECTIVE: Thioredoxin (Trx) and metallothionein (MT) are involved in the development of some carcinomas; however, the role of these proteins in labial carcinogenesis has not yet been tested. The aims of the study were to evaluate and to correlate the immunoexpression of Trx and MT in actinic cheilitis, lip squamous cell carcinoma, and normal vermillion lip mucosa. DESIGN: Immunohistochemistry was undertaken for Trx and MT in samples of actinic cheilitis, lip squamous cell carcinoma, and normal lip mucosa. Qualitative and semi-quantitative evaluations were conducted. The proportion of stained cells, intensity of staining, and the cell compartment labeled were evaluated. A quickscore index was also calculated by multiplying the values of extension and intensity of nuclear and cytoplasmic staining, respectively, giving a maximum value of 9. Statistics were performed. RESULTS: A remarkable nuclear Trx staining was seen in normal lip mucosa and cheilitis, not in carcinoma (p<0.05). Cytoplasmic Trx expression was widely detected in all lesions (p>0.05). MT was broadly expressed in nuclei and cytoplasm of carcinoma, but not in normal lip mucosa and cheilitis (p<0.05). Quickscores were in accordance with the qualitative results. CONCLUSIONS: The current study showed a different immunopattern of Trx and MT between normal lip mucosa, actinic cheilitis and lip squamous cell carcinoma. The cellular compartment-based analyses evidenced differences that can be related to the proteins function. Considering the relevant roles of these proteins in cellular homeostasis, they seem to have an important role in lip carcinogenesis.