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1.
Medicine (Baltimore) ; 100(16): e25507, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879685

RESUMO

BACKGROUND: Long noncoding RNA (lncRNA) is reported to be upregulated in many tumors. Although the expression of lncRNA in oral squamous cell carcinoma has been assessed, the association between lncRNA expression and prognosis or clinicopathological feature still remains controversial. Therefore, we conducted a meta-analysis to verify whether lncRNA expression was related to prognosis or clinicopathological features in patients with oral squamous cell carcinoma. METHODS: We searched Embase, PubMed, Web of Science, Cochrane library, Chinese National Knowledge Infrastructure, and Wanfang databases from inception to February 2021. The language included Chinese and English. The published literature on lncRNA expression and prognosis or clinicopathological characteristics of patients with oral squamous cell carcinoma was statistically analyzed. The combination of hazard ratios (HRs), odds ratios (OR), and 95% confidence intervals (95% CIs) were applied to evaluate the effects of lncRNA on the prognosis and clinicopathological features of oral squamous cell carcinoma. RESULTS: This study could provide a comprehensive review of the available evidence of lncRNA on the prognosis and clinicopathological features of oral squamous cell carcinoma. CONCLUSION: The conclusion of our study will provide the updated evidence to judge the lncRNA on the prognosis and clinicopathological features of oral squamous cell carcinoma.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias Bucais/mortalidade , RNA Longo não Codificante/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Biomarcadores Tumorais/análise , Regulação Neoplásica da Expressão Gênica , Humanos , Metanálise como Assunto , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/genética , Neoplasias Bucais/terapia , Estadiamento de Neoplasias , Prognóstico , RNA Longo não Codificante/análise , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Revisões Sistemáticas como Assunto
2.
Anticancer Res ; 41(4): 2177-2182, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33813430

RESUMO

BACKGROUND/AIM: To investigate the impact of PDZ-binding kinase (PBK) on the clinical outcome of patients with oral squamous cell carcinoma (OSCC) who received radiotherapy. PATIENTS AND METHODS: PBK immunoreactivity of cancer specimens obtained from 179 patients with primary OSCC was analyzed by immunohistochemistry. RESULTS: High PBK expression in tumor cells tended to be associated with advanced N-stage. The 5-year survival rate was greater for patients with high total PBK expression than in those with low PBK expression. After adjustment, high PBK remained associated with a favorable outcome. In subgroups according to tumor stage, the prognostic role was significant in patients with stage III/IV rather than those with stage I/II disease. CONCLUSION: We suggest that PBK expression should be used as an independent prognostic marker for patients with OSCC treated with radiotherapy, especially for those with advanced-stage disease.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/radioterapia , Quinases de Proteína Quinase Ativadas por Mitógeno/metabolismo , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/radioterapia , Idoso , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Imuno-Histoquímica , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Quinases de Proteína Quinase Ativadas por Mitógeno/fisiologia , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia , Análise de Sobrevida , Taiwan/epidemiologia
3.
BMC Cancer ; 21(1): 225, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33663427

RESUMO

BACKGROUND: Our goal was to analyze the incidence of level VI metastasis in previously untreated oral squamous cell carcinoma (SCC) patients and their clinicopathological and prognostic characteristics. METHODS: Oral SCC patients with level VI metastasis were retrospectively enrolled, and their demographic and pathologic features as well as their survival data were descriptively analyzed. RESULTS: A total of 13 cases from 1875 patients were included, all patients had SCC at the floor of mouth (SCCFOM). Eight (61.5%) patients had a pT4 tumor, and all patients had a pathological N3 neck with multiple positive lymph nodes. Adverse pathologic features were present in 100% of the patients. The size of the metastatic foci in level VI ranged from 2.6 cm to 4.5 cm with a mean value of 3.2 cm, and 5 patients showed a soft tissue deposit with no lymph node component. Recurrence occurred in all patients, and 11 patients died of uncontrolled cancer within 5 years after surgery. CONCLUSION: Level VI metastasis in primary oral SCCFOM is rare, and its prognosis is poor.


Assuntos
Soalho Bucal/patologia , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Adulto , Idoso , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade
4.
Int J Mol Sci ; 22(5)2021 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-33673690

RESUMO

Most patients with oral squamous cell cancer (OSCC) have a locally advanced stage at diagnosis. The treatment strategies are diverse, including surgery, radiotherapy and chemotherapy. Despite multimodality treatment, the response rate is unsatisfactory. DNA repair and genetic instability are highly associated with carcinogenesis and treatment outcomes in oral squamous cell cancer, affecting cell growth and proliferation. Therefore, focusing on DNA repair and genetic instability interactions could be a potential target for improving the outcomes of OSCC patients. DNA polymerase-ß (POLB) is an important enzyme in base excision repair and contributes to gene instability, leading to tumorigenesis and cancer metastasis. The aim of our study was to confirm POLB regulates the growth of OSCC cells through modulation of cell cycle and chromosomal instability. We analyzed a tissue array from 133 OSCC patients and discovered that low POLB expression was associated with advanced tumor stage and poor overall survival. In multivariate Cox proportional hazards regression analysis, low POLB expression and advanced lymph node status were significantly associated with poor survival. By performing in vitro studies on model cell lines, we demonstrated that POLB silencing regulated cell cycles, exacerbated mitotic abnormalities and enhanced cell proliferation. After POLB depletion, OSCC cells showed chromosomal instability and aneuploidy. Thus, POLB is an important maintainer of karyotypic stability in OSCC cells.


Assuntos
Aneuploidia , Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/mortalidade , DNA Polimerase beta/metabolismo , Neoplasias Bucais/mortalidade , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/enzimologia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/secundário , Proliferação de Células , DNA Polimerase beta/antagonistas & inibidores , DNA Polimerase beta/genética , Feminino , Seguimentos , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Mitose , Neoplasias Bucais/enzimologia , Neoplasias Bucais/genética , Neoplasias Bucais/patologia , Prognóstico , Taxa de Sobrevida , Células Tumorais Cultivadas
5.
Am J Clin Oncol ; 44(3): 99-104, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33417322

RESUMO

OBJECTIVES: To investigate the benefit of postoperative radiotherapy (PORT) for low-volume (pN1) nodal disease after resection of oral cavity squamous cell carcinoma. MATERIALS AND METHODS: The National Cancer Database was queried for adults with nonmetastatic squamous cell carcinoma of the oral cavity treated by surgical resection with pathologic stage T1-2 N0-2 (American Joint Committee on Cancer 7th edition) and with the maximal exclusion of standard indications for PORT. Overall survival was compared within pN1 for observation versus PORT and then compared for pN1 versus pN0 and versus pN2 stratified by receipt of observation or PORT. Multivariable Cox regression was used to adjust for potential confounders between PORT and survival, including comorbidity and age. RESULTS: Overall 5017 pN0, 530 pN1, and 253 pN2 patients were identified, of whom 9%, 35%, and 64% received PORT, respectively. Within the pN1 cohort, PORT was associated with improved survival versus observation (adjusted hazard ratio, 0.66; 95% confidence interval, 0.46-0.97; P=0.03). Among observed patients, the prognosis of pN1 was equivalent to pN2 and inferior to pN0; in contrast, among patients treated with PORT, the prognosis of pN1 was equivalent to pN0 and superior to pN2. Without PORT, pN1 remained an adverse risk factor relative to pN0 regardless of the depth of invasion, lymph node size, lymph node location, and extent of lymph node dissection. CONCLUSIONS: PORT was associated with a survival benefit compared with observation. Notably, pN1 was an adverse risk factor relative to pN0 if, and only if, patients did not receive PORT, suggesting pN1 by itself may be an indication for PORT.


Assuntos
Neoplasias Bucais/radioterapia , Neoplasias Bucais/cirurgia , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Idoso , Feminino , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Cuidados Pós-Operatórios/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Análise de Sobrevida
6.
PLoS One ; 15(12): e0244446, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33382762

RESUMO

OBJECTIVES: Oral potentially malignant disorders (OPMDs) encompass histologically benign, dysplastic, and cancerous lesions that are often indistinguishable by appearance and inconsistently managed. We assessed the potential impact of test-and-treat pathways enabled by a point-of-care test for OPMD characterization. MATERIALS AND METHODS: We constructed a decision-analytic model to compare life expectancy of test-treat strategies for 60-year-old patients with OPMDs in the primary dental setting, based on a trial for a point-of-care cytopathology tool (POCOCT). Eight strategies of OPMD detection and evaluation were compared, involving deferred evaluation (no further characterization), prompt OPMD characterization using POCOCT measurements, or the commonly recommended usual care strategy of routine referral for scalpel biopsy. POCOCT pathways differed in threshold for additional intervention, including surgery for any dysplasia or malignancy, or for only moderate or severe dysplasia or cancer. Strategies with initial referral for biopsy also reflected varied treatment thresholds in current practice between surgery and surveillance of mild dysplasia. Sensitivity analysis was performed to assess the impact of variation in parameter values on model results. RESULTS: Requisite referral for scalpel biopsy offered the highest life expectancy of 20.92 life-years compared with deferred evaluation (+0.30 life-years), though this outcome was driven by baseline assumptions of limited patient adherence to surveillance using POCOCT. POCOCT characterization and surveillance offered only 0.02 life-years less than the most biopsy-intensive strategy, while resulting in 27% fewer biopsies. When the probability of adherence to surveillance and confirmatory biopsy was ≥ 0.88, or when metastasis rates were lower than reported, POCOCT characterization extended life-years (+0.04 life-years) than prompt specialist referral. CONCLUSION: Risk-based OPMD management through point-of-care cytology may offer a reasonable alternative to routine referral for specialist evaluation and scalpel biopsy, with far fewer biopsies. In patients who adhere to surveillance protocols, POCOCT surveillance may extend life expectancy beyond biopsy and follow up visual-tactile inspection.


Assuntos
Técnicas de Apoio para a Decisão , Assistência Odontológica/organização & administração , Neoplasias Bucais/diagnóstico , Sistemas Automatizados de Assistência Junto ao Leito/organização & administração , Lesões Pré-Cancerosas/diagnóstico , Biópsia/economia , Biópsia/estatística & dados numéricos , Tomada de Decisão Clínica , Simulação por Computador , Análise Custo-Benefício , Procedimentos Clínicos/economia , Procedimentos Clínicos/organização & administração , Assistência Odontológica/economia , Clínicas Odontológicas/economia , Clínicas Odontológicas/organização & administração , Clínicas Odontológicas/estatística & dados numéricos , Diagnóstico Diferencial , Feminino , Humanos , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Neoplasias Bucais/prevenção & controle , Sistemas Automatizados de Assistência Junto ao Leito/economia , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/terapia , Encaminhamento e Consulta/economia , Encaminhamento e Consulta/organização & administração , Encaminhamento e Consulta/estatística & dados numéricos , Medição de Risco/métodos
7.
Aging (Albany NY) ; 13(2): 2379-2396, 2020 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-33318296

RESUMO

FOXD2 adjacent opposite strand RNA 1 (FOXD2-AS1) plays an important role in the pathogenesis of some cancers. However, its functional role in oral squamous cell carcinoma (OSCC) remains largely unknown. In this study, we conducted expressional and functional analyses of FOXD2-AS1 using data from the Cancer Genome Atlas (TCGA) and in vitro OSCC assays. FOXD2-AS1 dysregulation was remarkably associated with radiation therapy, anatomic location, high histologic grade, and lymphovascular invasion (P < 0.05). A nomogram based on FOXD2-AS1 expression was constructed for use as a diagnostic indicator for OSCC patients, and multivariate cox regression analysis showed that FOXD2-AS1 expression was an independent prognostic factor for OSCC patients. KEGG, gene set enrichment analysis, and immune infiltration evaluations indicated that FOXD2-AS1 was involved in tumor progression via epithelial-to-mesenchymal transition and cell cycle regulation and was negatively associated with mast cell, DCs, iDCs, and B cells. FOXD2-AS1 silencing suppressed the proliferation and migration of Cal27 cells. Our findings showed that an aberrantly high FOXD2-AS1 expression predicts poor prognosis in OSCC; FOXD2-AS1 may act as an oncogenic protein by regulating cell proliferation and migration and may suppress adaptive immunity by modulating the number and function of antigen-presenting cells.


Assuntos
Movimento Celular/genética , Proliferação de Células/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Bucais/metabolismo , RNA Longo não Codificante/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Ciclo Celular/genética , Progressão da Doença , Transição Epitelial-Mesenquimal/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca/metabolismo , Boca/patologia , Neoplasias Bucais/genética , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Prognóstico , RNA Longo não Codificante/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia
8.
PLoS One ; 15(9): e0238420, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32931492

RESUMO

BACKGROUND: Patients diagnosed with Oral Floor Squamous Cell Carcinoma (OFSCC) face considerable challenges in physiology and psychology. This study explored prognostic signatures to predict prognosis in OFSCC through a detailed transcriptomic analysis. METHOD: We built an interactive competing endogenous RNA (ceRNA) network that included lncRNAs, miRNAs and mRNAs. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to predict the gene functions and regulatory pathways of mRNAs. Least absolute shrinkage and selection operator algorithm (LASSO) analysis and Cox regression analysis were used to screen prognosis factors. The Kaplan-Meier method was used to analyze the survival rate of prognosis factors. Risk score was used to assess the reliability of the prediction model. RESULTS: A specific ceRNA network consisting of 56 mRNAs, 16 miRNAs and 31 lncRNAs was established. Three key genes (HOXC13, TGFBR3, KLHL40) and 4 clinical factors (age, gender, TNM, and clinical stage) were identified and effectively predicted the for survival time. The expression of a gene signature was validated in two external validation cohorts. The signature (areas under the curve of 3 and 5 years were 0.977 and 0.982, respectively) showed high prognostic accuracy in the complete TCGA cohort. CONCLUSIONS: Our study successfully developed an extensive ceRNA network for OFSCC and further identified a 3-mRNA and 4-clinical-factor signature, which may serve as a biomarker.


Assuntos
Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/genética , Neoplasias Bucais/genética , RNA Neoplásico/genética , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Bases de Dados de Ácidos Nucleicos , Feminino , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Ontologia Genética , Redes Reguladoras de Genes , Proteínas de Homeodomínio/genética , Humanos , Estimativa de Kaplan-Meier , Masculino , MicroRNAs/genética , Pessoa de Meia-Idade , Soalho Bucal , Neoplasias Bucais/mortalidade , Proteínas Musculares/genética , Prognóstico , Proteoglicanas/genética , RNA Longo não Codificante/genética , RNA Mensageiro/genética , Receptores de Fatores de Crescimento Transformadores beta/genética , Fatores de Risco
9.
Med. oral patol. oral cir. bucal (Internet) ; 25(5): e599-e607, sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-196515

RESUMO

BACKGROUND: TORS has become one of the latest surgical alternatives in the treatment of oropharynx squamous cell carcinomas (OPSCC) and has become increasingly accepted by surgeons as a treatment option. Surgical robots were designed for various purposes, such as allowing remote telesurgery, and eliminating human factors like trembling. The study aimed to compare systematic review of the available literature in order to evaluate the safety and efficacy of Transoral Robotic Surgery (TORS) compared with open surgery. MATERIAL AND METHODS: We performed a systematic review of the available literature in order to evaluate the safety and effectiveness of TORS compared with open surgery. We compared TORS and open surgery based on 16 outcomes divided in to 3 groups: intraoperative complications, post-operative complications, and functional and oncologic outcomes. An electronic search of observational studies was carried out using the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Oral Health Group Trials Register, and Scielo. Data analysis was carried out in accordance to Preferred Reporting Items for Systematic Reviews and Metanalysis (PRISMA) and the quality of the studies were evaluated using the Newcastle-Ottawa Scale. No language restrictions were imposed. RESULTS: From the 4 studies identified (Newcastle-Ottawa Scale mean score 6.5), 371 patients were revised (186 patients were treated with TORS and 185 with conventional surgery). Overall, TORS, when compared with open surgery, appears to have better functional results (less hospital time, decannulation) and fewer intraoperative and post-operative complications. There is no significant difference when assessing the oncological outcomes (positive margins, survival rate) when comparing both techniques. CONCLUSIONS: TORS has an overall better functional outcome, and less intraoperative and postoperative complications with no difference in positive margins and survival rate when compared with conventional therapy


No disponible


Assuntos
Humanos , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias Bucais/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/mortalidade , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias Bucais/mortalidade , Procedimentos Cirúrgicos Robóticos/mortalidade , Resultado do Tratamento , Taxa de Sobrevida
10.
PLoS One ; 15(8): e0237465, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785290

RESUMO

BACKGROUND: Tumor-infiltrating lymphocytes include tumor-reactive lymphocytes and regulatory T-cells. However, the prognostic value of tumor-infiltrating lymphocytes in oral squamous cell carcinoma (OSCC) remains unclear. METHODS: We used immunohistochemistry to evaluate the presence of tumor-infiltrating FoxP3⁺ T-cells and CTLA-4⁺ cells in four distinct histological compartments (tumor parenchyma and stroma at the tumor center, and parenchyma and stroma at the invasive front) and assessed the association between the prevalence of these cells and the histopathological status of 137 patients with OSCC. RESULTS: Five-year overall survival, disease-specific survival, and recurrence-free survival were favorable in patients with high numbers of FoxP3⁺ T-cells in the parenchyma of the invasive front. Recurrence-free survival and metastasis-free survival were decreased in patients with high numbers of CTLA-4⁺ cells in the parenchyma of the invasive front. CONCLUSIONS: The presence of FoxP3⁺ T-cells in the parenchyma of the invasive front may be a useful prognostic factor. Our results indicate that FoxP3⁺ T-cells may exert site-specific anti-tumor effects but may not play an immunosuppressive role in OSCC. In addition, our results suggest that CTLA-4+ cells suppress the function of FoxP3+ T-cells and promote anti-tumor immunity in OSCC.


Assuntos
Antígeno CTLA-4/metabolismo , Carcinoma de Células Escamosas/patologia , Fatores de Transcrição Forkhead/metabolismo , Neoplasias Bucais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/mortalidade , Feminino , Humanos , Imuno-Histoquímica , Linfócitos do Interstício Tumoral/citologia , Linfócitos do Interstício Tumoral/imunologia , Linfócitos do Interstício Tumoral/metabolismo , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/metabolismo , Neoplasias Bucais/mortalidade , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Taxa de Sobrevida , Linfócitos T Reguladores/citologia , Linfócitos T Reguladores/metabolismo
11.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e523-e531, jul. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-196506

RESUMO

BACKGROUND: Low socioeconomic status, increasing age, and poor lifestyle behaviors are associated with poor survival in patients with oral cavity squamous cell carcinoma (OCSCC). To determine the overall survival (OS) and the risk of OCSCC death by tumor subsite. MATERIAL AND METHODS: A retrospective cohort study of OCSCC patients diagnosed from 2007 to 2009 and treated at a single cancer center in Rio de Janeiro, Brazil. Patient information was obtained from the Hospital Cancer Registry (HCR) database and complemented by individual search of physical and electronic medical records. Descriptive statistics of population characteristics were computed. OS was estimated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards regression analyses were used to estimate the risk of death by tumor subsite. RESULTS: Seven hundred and three patients with OCSCC were identified. Most patients were men (77.4%) with low levels of education (67.5%), who drank (73.9%) and smoked (79.7%). The most prevalent tumor site was the tongue (45.4%), 73.4% of patients had advanced (clinical stage III or IV) OCSCC at diagnosis and 74.1% died during follow-up. For the entire cohort, the OS was 39.1% at two years and 27.9% at five years. The median survival time was 1.4 years (95% CI: 1.2-1.5). Non-operative treatment (HR: 3.11; 95% CI: 2.26-4.29; p < 0.001), advanced stage (HR 2.14; 95% CI 1.68-2.74; p < 0.001), and age > 60 years at diagnosis (HR: 1.37; 95% CI: 1.15-1.64; p < 0.001) were independently associated with the risk of death. However, these factors varied by tumour subsite.CONCLUSION: Analysis of specific subsites of the oral cavity revealed substantial differences in prognostic factors associated with poor survival in OCSCC


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Carcinoma de Células Escamosas/mortalidade , Neoplasias Bucais/mortalidade , Estudos Retrospectivos , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Estimativa de Kaplan-Meier , Fatores de Risco , Prognóstico , Fatores Socioeconômicos , Modelos de Riscos Proporcionais , Brasil/epidemiologia
12.
Br J Radiol ; 93(1112): 20190825, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32520585

RESUMO

OBJECTIVES: High throughput pre-treatment imaging features may predict radiation treatment outcome and guide individualized treatment in radiotherapy (RT). Given relatively small patient sample (as compared with high dimensional imaging features), identifying potential prognostic imaging biomarkers is typically challenging. We aimed to develop robust machine learning methods for patient survival prediction using pre-treatment quantitative CT image features for a subgroup of head-and-neck cancer patients. METHODS: Three neural network models, including back propagation (BP), Genetic Algorithm-Back Propagation (GA-BP), and Probabilistic Genetic Algorithm-Back Propagation (PGA-BP) neural networks were trained to simulate association between patient survival and radiomics data in radiotherapy. To evaluate the models, a subgroup of 59 head-and-neck patients with primary cancers in oral tongue area were utilized. Quantitative image features were extracted from planning CT images, a novel t-Distributed Stochastic Neighbor Embedding (t-SNE) method was used to remove irrelevant and redundant image features before fed into the network models. 80% patients were used to train the models, and remaining 20% were used for evaluation. RESULTS: Of the three supervised machine-learning methods studied, PGA-BP yielded the best predictive performance. The reported actual patient survival interval of 30.5 ± 21.3 months, the predicted survival times were 47.3 ± 38.8, 38.5 ± 13.5 and 29.9 ± 15.3 months using the traditional PCA. Combining with the novel t-SNE dimensionality reduction algorithm, the predicted survival intervals are 35.8 ± 15.2, 32.3 ± 13.1 and 31.6 ± 15.8 months for the BP, GA-BP and PGA-BP neural network models, respectively. CONCLUSION: The work demonstrated that the proposed probabilistic genetic algorithm optimized neural network models, integrating with the t-SNE dimensionality reduction algorithm, achieved accurate prediction of patient survival. ADVANCES IN KNOWLEDGE: The proposed PGA-BP neural network, integrating with an advanced dimensionality reduction algorithm (t-SNE), improved patient survival prediction accuracy using pre-treatment quantitative CT image features of head-and-neck cancer patients.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Redes Neurais de Computação , Neoplasias da Língua/mortalidade , Algoritmos , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Humanos , Aprendizado de Máquina , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Análise de Componente Principal , Probabilidade , Prognóstico , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X , Língua/diagnóstico por imagem , Neoplasias da Língua/diagnóstico , Neoplasias da Língua/diagnóstico por imagem , Neoplasias da Língua/patologia
13.
Ann Otol Rhinol Laryngol ; 129(12): 1215-1220, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32546006

RESUMO

BACKGROUND: Oral cavity carcinomas individually are the fifth-leading cause of overall cancer mortality in the Northern Mariana Islands, which is likely a representative statistic for many other betel-nut-endemic Pacific islands. Factors associated with survival have been minimally evaluated in this region. The purpose of this study is to further characterize oral cavity carcinoma outcomes and associated prognostic factors in the United States commonwealth of the Northern Mariana Islands (CNMI). METHODS: A single-institution retrospective review was undertaken for 81 patients diagnosed with head and neck cancers at the CNMI's only regional hospital complex from 2005 to 2019. A subset of patients diagnosed with oral cavity carcinoma was further evaluated for survival outcomes. Cox proportional hazard regressions were performed to evaluate for variables associated with survival. RESULTS: A majority of patients had cancer of the oral cavity (64/81, 79%). Fifty-five of these patients had sufficient data for review. The average age at the time of diagnosis was 48 and over half were diagnosed with stage IV disease (29/55, 53%). Five-year overall survival (OS) was 49.5% (95% CI, 33.3-63.7%). Factors associated with worse OS were lymph node metastases at presentation (P = .031), higher overall stage (III or IV vs I or II, P = .016), and higher T-stage (III or IV vs I or II, P = .027). Those who used betel nut were diagnosed at a significantly younger age than those who did not (47.2 vs 55.4, P = .001). CONCLUSIONS: The head and neck cancer burden in the CNMI is dominated by betel nut related oral cavity disease that is characterized by delayed presentations in younger patients and decreased OS. Future studies are indicated to improve health literacy as well as to investigate the potential for screening programs.


Assuntos
Antineoplásicos/uso terapêutico , Areca , Carcinoma/terapia , Neoplasias Bucais/terapia , Procedimentos Cirúrgicos Otorrinolaringológicos , Radioterapia , Adulto , Carcinoma/mortalidade , Carcinoma/patologia , Intervalo Livre de Doença , Feminino , Humanos , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Micronésia/epidemiologia , Pessoa de Meia-Idade , Mucosa Bucal , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Estadiamento de Neoplasias , Grupo com Ancestrais Oceânicos , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Uso de Tabaco/epidemiologia , Adulto Jovem
14.
Oral Oncol ; 109: 104849, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32599499

RESUMO

OBJECTIVE: Surgery is the preferred treatment modality for oral squamous cell carcinoma (OSCC). However, due to limited resources, re-assessment of treatment paradigms in the wake of the Coronavirus Disease 2019 (COVID-19) pandemic is urgently required. In this rapid review, we described contemporary oncological outcomes for OSCC using non-surgical modalities. METHODS: A systematic literature search was conducted for articles published between January 1, 2010 and April 1, 2020 on MEDLINE and Cochrane CENTRAL. Studies were included if they contained patients with OSCC treated with either neoadjuvant, induction, or definitive radiotherapy, chemotherapy, immunotherapy, or combination thereof, and an outcome of overall survival. RESULTS: In total, 36 articles were included. Definitive radiotherapy or chemoradiotherapy were the focus of 18 articles and neoadjuvant chemotherapy or chemoradiotherapy were the focus of the other 18 articles. In early stage OSCC, definitive radiotherapy, with or without concurrent chemotherapy, was associated with a significantly increased hazard of death compared to definitive surgery (HR: 2.39, 95% CI: 1.56-3.67, I2: 63%). The hazard of death was non-significantly increased with definitive chemoradiotherapy in studies excluding early disease (HR: 1.98, 95% CI: 0.85-4.64, I2: 84%). Two recent randomized control trials have been conducted, demonstrating no survival advantage to neoadjuvant chemotherapy. CONCLUSION: This review suggests that primary radiotherapy and chemoradiotherapy are inferior to surgical management for OSCC. Strategies for surgical delay warranting consideration are sparse, but may include several neoadjuvant regimens, recognizing these regimens may not offer a survival benefit over definitive surgery alone.


Assuntos
Antineoplásicos/uso terapêutico , Quimiorradioterapia , Infecções por Coronavirus/epidemiologia , Neoplasias Bucais/terapia , Terapia Neoadjuvante , Pneumonia Viral/epidemiologia , Radioterapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Antineoplásicos Imunológicos/uso terapêutico , Betacoronavirus , Assistência à Saúde , Gerenciamento Clínico , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/terapia , Recursos em Saúde , Humanos , Mortalidade , Neoplasias Bucais/mortalidade , Pandemias , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade
15.
Medicine (Baltimore) ; 99(23): e20575, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32502026

RESUMO

BACKGROUND: Recently, many studies have suggested that the aberrant expression of c-erbB-2 existed in oral cancer (OC) patients and had a correlation with poor clinical features across OC patients. Considering the inconsistent results among published articles, we performed the meta-analysis to assess the prognostic and clinical effect of c-erbB-2 expression on oral tumors. METHODS: Web of Science, Embase, and PubMed were retrieved to acquire relevant publications based on selection criteria, up to February 8, 2020. Pooled odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) were applied to evaluate the associations between c-erbB-2 expression and overall survival (OS), disease specific survival, disease-free survival as well as clinicopathology of OC. RESULTS: A total of 30 literatures with 1499 patients for survival of OC were enrolled in this meta-analysis. The results indicated that c-erbB-2 overexpression was significantly associated with poor OS (HR = 2.40, 95% CI = 1.53-2.55, P < .05), disease specific survival (HR = 2.60, 95% CI = 1.11-4.10, P < .05) and disease-free survival (HR = 2.22, 95% CI = 1.46-2.99, P < .05). Subgroup analysis based on race showed that the significant prognostic value of c-erbB-2 in OC was found both in Caucasians and Asians (OS of Caucasians, HR = 2.90, 95% CI = 1.50-4.31, P < .05; OS of Asians, HR = 1.90, 95% CI = 1.27-2.53, P < .05). Moreover, OC patients with enhanced c-erbB-2 expression were prone to male (OR = 1.97, 95% CI = 1.22-3.19, P < .05), advanced TNM stage (OR = 1.84, 95% CI = 1.17-2.88, P < .05), lymph node metastasis (OR = 2.23, 95% CI = 1.47-3.36, P < .05) and advanced grade (OR = 1.98, 95% CI = 1.30-3.01, P < .05), but not associated with distant metastasis (OR = 1.65, 95% CI = 0.98-3.04, P > .05). CONCLUSIONS: c-erbB-2 may be a potential indicator in the prediction of prognosis and clinicopathological features in OC patients.


Assuntos
Neoplasias Bucais/genética , Receptor ErbB-2/metabolismo , Biomarcadores Tumorais/metabolismo , Intervalo Livre de Doença , Feminino , Regulação da Expressão Gênica , Humanos , Metástase Linfática/genética , Masculino , Neoplasias Bucais/mortalidade , Intervalo Livre de Progressão , Fatores Sexuais
16.
Anticancer Res ; 40(6): 3071-3080, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487601

RESUMO

BACKGROUND/AIM: Head and neck squamous cell carcinoma affects nearly 500,000 people annually. Augmenting PPARγ functional activation is linked with multiple anti-carcinogenic processes in aerodigestive cell lines and animal models. PPARγ/RXRα heterodimers may be key partners in this activation. MATERIALS AND METHODS: CA 9-22 and NA cell lines were treated with the PPARγ agonist ciglitazone and/or the RXRα agonist 9-cis-retinoic acid. PPARγ functional activation, cellular proliferation, apoptosis activity, and phenotype were subsequently analyzed. RESULTS: Ciglitazone and 9-cis-retinoic acid independently activated PPARγ and down-regulated the carcinogenic phenotype in vitro. Combination treatment significantly augmented these effects, further decreasing proliferation (p<0.0001), and increasing PPARγ functional activation (p<0.0001), apoptosis (p<0.05), and adipocyte differentiation markers (p<0.0001). CONCLUSION: The efficacy of the combination of ciglitazone and 9-cis-retinoic acid afforded lowering treatment concentrations while maintaining desired therapeutic outcomes, optimistically supporting the feasibility and practicality of this novel treatment option.


Assuntos
Neoplasias Bucais/tratamento farmacológico , PPAR gama/metabolismo , Retinoides/uso terapêutico , Tiazolidinedionas/uso terapêutico , Humanos , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Retinoides/farmacologia , Taxa de Sobrevida , Tiazolidinedionas/farmacologia
17.
Med. oral patol. oral cir. bucal (Internet) ; 25(3): e375-e382, mayo 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-196325

RESUMO

BACKGROUND: The objective of this study was to evaluate the influence of clinical-pathological and sociodemographic factors on the prevalence of distant metastasis (DM) and overall survival in patients with oral cavity and oropharynx squamous cell carcinoma (OOSCC). MATERIAL AND METHODS: Cross-sectional study based on the records of 404 OOSCC patients evaluated for DM, covering the period 2000-2014. We analysed the influence of age, sex, level of schooling, primary tumor subsite, treatment, marital status, family history of cancer, history of smoking and alcohol consumption, type of health care coverage (private vs. public) and overall survival. Findings were submitted to Fisher's exact test, Pearson's chi-squared test, Mantel-Cox log-rank testing and multinomial and Cox regression analysis (SPSS V. 20.0; p < 0.05). RESULTS: The prevalence of DM was 5.4% (22/404). The respiratory tract was the most affected DM site (n=9; 40.9%). Male sex (p = 0.049), oropharyngeal primary tumor (p = 0.008), stage T3-4 (p = 0.022), lymph node metastasis (N+) (p < 0.001) and palliative treatment (p = 0.005) were directly associated with DM. Patients with oral primary tumours (p = 0.343) and primary oropharyngeal tumours (p = 0.242) did not differ significantly with regard to the prevalence of DM. N+ was an independent risk factor for DM (p = 0.017). Five variables independently reduced overall survival: male sex (p = 0.035), age >65 years (p = 0.046), indigenous/brown racial type (p = 0.045), palliative treatment (p = 0.035) and DM (p = 0.048). CONCLUSIONS: Lymph node metastasis independently increased the prevalence of DM and, along with male sex, older age, brown racial type and palliative treatment, was independently associated with poor prognosis in patients with OOSCC


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Carcinoma de Células Escamosas/secundário , Neoplasias Orofaríngeas/patologia , Neoplasias Bucais/patologia , Metástase Neoplásica , Estudos Transversais , Metástase Linfática , Carcinoma de Células Escamosas/mortalidade , Neoplasias Orofaríngeas/mortalidade , Neoplasias Bucais/mortalidade , Fatores Socioeconômicos , Estimativa de Kaplan-Meier , Medição de Risco , Fatores de Risco , Distribuição por Idade e Sexo , Brasil/epidemiologia
18.
Med. oral patol. oral cir. bucal (Internet) ; 25(3): e403-e409, mayo 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-196329

RESUMO

BACKGROUND: To analyze the trends of oral and oropharyngeal cancer mortality in Uruguay between 1997 and 2014 according to sex and age groups and its possible association with sociodemographic factors. MATERIAL AND METHODS: A time-series ecological study using secondary data was performed. The data about mortality due to oral and oropharyngeal cancers were obtained from the Statistics Vitals Department of the Public Health Ministry of Uruguay. To estimate the mortality trends of the historical series, by sex, anatomical site and age groups, linear regressions generated by the Prais-Winsten procedure were used. RESULTS: The analysis of mortality trends for oral cavity and oropharyngeal cancers in Uruguay indicated that the global mortality rate was stable over the studied period. The women's mortality rate increased from 0.51 per 100,000 in 1997 to 0.65 per 100,000 in 2014 while for men, rates per 100,000 went from 3.22 in 1997 to 2.20 per 100,000 in 2014. Mortality from oral cancer in men decreased between 1997 and 2014. Mortality by oropharyngeal cancer, irrespective of sex, remained stable. Analysis by cancer site revealed decreasing trends tumors situated in the base of the tongue and gum. Years of education, unemployment, smoking and Gini index were not associated with mortality trends. CONCLUSIONS: The overall mortality from oral and oropharyngeal cancer in Uruguay has remained constant in the period between 1997 and 2014. Oral cancer mortality decreased in men and increased in women and decreased at the base of the tongue. It's necessary to continue monitoring the behavior of these diseases


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Bucais/mortalidade , Neoplasias Orofaríngeas/mortalidade , Estudos de Séries Temporais , Distribuição por Idade e Sexo , Modelos Lineares , Mortalidade/tendências , Uruguai/epidemiologia , Fatores de Tempo
19.
Int J Pediatr Otorhinolaryngol ; 134: 110033, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32302884

RESUMO

The aim of this study was to integrate the available data regarding pediatric Burkitt's lymphoma (BL) of the oral cavity. A systematic review was conducted following PRISMA guidelines, through a specific search strategy. Twenty-nine publications were included in this study, resulting in a total of 144 cases. Oral BL was predominantly found in males (75.7%). The mandible was the most involved site (37.5%), and all cases clinically exhibited a swelling. Presence of EBV was observed in 33.3% of the cases, and 4 cases reported HIV-positive patients (33.3%). Chemotherapy was the leading treatment choice for oral BL (94.9%), and the overall 5-year survival was 54.3%. Regarding the quality assessment of the studies, most (19 studies; 65.5%) were classified as an overall moderate risk of bias. In conclusion, the clinicopathological characteristics of oral BL in the pediatric population comprise the sporadic and intermediate subtypes. Despite its aggressiveness, this malignancy presents a moderate overall survival.


Assuntos
Linfoma de Burkitt/diagnóstico , Linfoma de Burkitt/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Adolescente , Linfoma de Burkitt/mortalidade , Linfoma de Burkitt/terapia , Criança , Pré-Escolar , Terapia Combinada , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Neoplasias Bucais/mortalidade , Neoplasias Bucais/terapia , Prognóstico , Análise de Sobrevida , Adulto Jovem
20.
Head Neck ; 42(6): 1173-1178, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32329953

RESUMO

BACKGROUND: The coronavirus infection is rapidly spreading, putting a strain on health care services across the globe. Patients with oral cancer are susceptible often immunosuppressed due to the disease and/or the treatment received. METHODS: We performed a simulation of the currently available data using a multistate and hazards model to provide an objective model for counseling and decision making for health care workers. RESULTS: Stage IV patients with oral cancer who did not receive treatment had progression of disease and an increased mortality rate compared to patients who receive treatment but did not contract COVID-19. The patients who received treatment and got affected with COVID-19 had a far worse impact and higher mortality rate than all other groups. CONCLUSION: Isolation and deferring treatment for stage IV patients with oral cancer, so as to avoid hospital visits and contraction of COVID-19, is an advisable strategy based on this model.


Assuntos
Causas de Morte , Tomada de Decisão Clínica/métodos , Infecções por Coronavirus/epidemiologia , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Simulação por Computador , Infecções por Coronavirus/prevenção & controle , Gerenciamento Clínico , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Neoplasias Bucais/mortalidade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Seleção de Pacientes , Pneumonia Viral/prevenção & controle , Modelos de Riscos Proporcionais , Medição de Risco , Análise de Sobrevida , Estados Unidos
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