Circulating Tumour Cells in the Prediction of Bone Metastasis.

Bone is the most common organ for the development of metastases in many primary tumours, including those of the breast, prostate and lung. In most cases, bone metastasis is incurable, and treatment is predominantly palliative. Much research has focused on the role of Circulating Tumour Cells (CTCs) in the mechanism of metastasis to the bone, and methods have been developed to isolate and count CTCs from peripheral blood. Several methods are currently being used in the study of CTCs, but only one, the CellSearchTM system has been approved by the United States Food and Drug Administration for clinical use. This review summarises the advantages and disadvantages, and outlines which clinical studies have used these methods. Studies have found that CTC numbers are predictive of bone metastasis in breast, prostate and lung cancer. Further work is required to incorporate information on CTCs into current staging systems to guide treatment in the prevention of tumour progression into bone.

Oral cancer in Australia: Rising incidence and worsening mortality.

BACKGROUND: Oral cancer, predominantly squamous cell carcinoma (SCC), is a lethal and deforming disease of rising incidence. Although largely preventable by eliminating harmful tobacco and alcohol risk factor behaviour, 5-year survival rates remain around 50%, primarily due to late presentation of advanced stage disease. Whilst low socio-economic status, regional and remote location and indigenous status are associated with head and neck cancer in general, detailed incidence and demographic data for oral SCC in Australia are limited. This study aimed to characterise the Queensland population at risk of oral SCC development. METHODS: Following ethical approval, the Queensland Cancer Register (QCR) dataset was analysed to determine patterns of incidence, anonymised patient demographics, clinical presentation and outcome data for oral SCC cases diagnosed between 1982 and 2018. RESULTS: Data from 9887 patients were obtained. Mean age at diagnosis was 64.55 years, with a male-to-female ratio of 2.51:1; males were diagnosed at a younger age (p < 0.001). At study census date, 59% of patients had died, with females demonstrating longer mean survival (p < 0.001). Clinicopathological data confirmed that SCC most commonly arose from tongue sites (49%) and, whilst tumours were predominantly moderately differentiated in nature (63%), patients with poorly differentiated carcinomas exhibited shortest survival times (p < 0.05). Over the 36-year study period, the number of diagnoses increased 4.49-fold, whilst the number of deaths increased 19.14-fold. CONCLUSION: Oral SCC poses a significant and growing healthcare problem in Queensland. In the absence of national screening, characterising the high-risk oral SCC population facilitates pragmatic opportunities to raise disease awareness, to deliver targeted screening and effective primary prevention strategies, and to provide early interventional treatment intervention to reduce disease mortality and morbidity.