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1.
PLoS One ; 15(1): e0227738, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31945122

RESUMO

OBJECTIVES: Incidence of oral cavity squamous cell carcinomas is rising worldwide, and population characterization is important to follow for future trends. The aim of this retrospective study was to present a large cohort of primary oral cavity squamous cell carcinoma from all four health regions of Norway, with descriptive clinicopathological characteristics and five-year survival outcomes. MATERIALS AND METHODS: Patients diagnosed with primary treatment-naïve oral cavity squamous cell carcinomas at all four university hospitals in Norway between 2005-2009 were retrospectively included in this study. Clinicopathological data from the electronic health records were compared to survival data. RESULTS: A total of 535 patients with primary treatment-naïve oral cavity squamous cell carcinomas were identified. The median survival follow-up time was 48 months (range 0-125 months) after treatment. The median five-year overall survival was found to be 47%. Median five-year disease-specific survival was 52%, ranging from 80% for stage I to 33% for stage IV patients. For patients given treatment with curative intent, the overall survival was found to be 56% and disease-specific survival 62%. Median age at diagnosis was 67 years (range 24-101 years), 64 years for men and 72 years for women. The male: female ratio was 1.2. No gender difference was found in neither tumor status (p = 0.180) nor node status (p = 0.266), but both factors influenced significantly on survival (p<0.001 for both). CONCLUSIONS: We present a large cohort of primary treatment-naïve oral cavity squamous cell carcinomas in Norway. Five-year disease-specific survival was 52%, and patients eligible for curative treatment had a five-year disease-specific survival up to 62%.


Assuntos
Metástase Linfática/patologia , Neoplasias Bucais/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia Adjuvante/métodos , Feminino , Seguimentos , Humanos , Metástase Linfática/terapia , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Mucosa Bucal/cirurgia , Neoplasias Bucais/patologia , Neoplasias Bucais/terapia , Esvaziamento Cervical , Terapia Neoadjuvante/métodos , Estadiamento de Neoplasias , Noruega/epidemiologia , Prognóstico , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
2.
Cir. plást. ibero-latinoam ; 45(3): 323-326, jul.-sept. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-184409

RESUMO

El fibroma osificante es una neoplasia osteogénica benigna que representa el 3.1% de los tumores orales y el 9.6% de las lesiones gingivales. Su tratamiento de elección es la enucleación por curetaje completado hasta márgenes de hueso sano, con una recurrencia de aproximadamente el 7-20% probablemente por remoción incompleta, irritación continua o daño repetido. Presentamos un caso clínico en el que complementamos el tratamiento quirúrgico con métodos adyuvantes para disminuir la recurrencia y acelerar la regeneración ósea mediante uso de nitrógeno líquido y hueso liofilizado cadavérico combinados con plasma rico en plaquetas. En el control postoperatorio a los 6 meses no evidenciamos recurrencia clínica o radiológica y comprobamos regeneración ósea acelerada. Sugerimos el uso en este tipo de lesiones de nitrógeno líquido como adyuvante para la prevención de recurrencia, hueso liofilizado para favorecer la regeneración ósea guiada y plasma rico en plaquetas para acelerar el proceso de curación ósea


Ossifying fibroma is a benign osteogenic neoplasm, representing 3.1% of oral tumors and 9.6% of gingival lesions. Enucleation by curettage is the treatment of choice, completed to healthy bone margins, with a recurrence of approximately 7-20%, probably due to incomplete removal, continued irritation or repeated damage. We describe a clinical case ttreated in combination with adjuvant methods to decrease recurrence and accelerate bone regeneration, with the placement of liquid nitrogen and cadaveric lyophilized bone, combined with platelet-rich plasma. Post-operative control at 6 months showed no clinical or radiological evidence of recurrence and the presence of accelerated bone regeneration. We suggest liquid nitrogen as an adjuvant for the prevention of recurrence and bone regeneration guided with lyophilized bone in conjunction with platelet-rich plasma as a feasible option to accelerate the bone healing process


Assuntos
Humanos , Feminino , Adulto , Fibroma Ossificante/diagnóstico por imagem , Fibroma Ossificante/cirurgia , Terapia Combinada , Neoplasias Gengivais/diagnóstico por imagem , Neoplasias Gengivais/terapia , Retalhos Cirúrgicos , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/terapia , Biópsia/métodos , Soalho Bucal/patologia , Regeneração Óssea
3.
Dtsch Med Wochenschr ; 144(16): 1135-1137, 2019 08.
Artigo em Alemão | MEDLINE | ID: mdl-31416105

RESUMO

HISTORY AND CLINICAL FINDINGS: In this report, a 60-year old patient with a history of mixed nociceptive and neuropathic chronic pain after successful removal of oral squamous cell cancer is described who received outpatient pain treatment in our clinic. Moreover, the patient presented with a history of alcohol abuse as well as anorexia and weight loss. EXAMINATIONS AND DIAGNOSIS: The patient was in reduced general condition and cachectic nutritional status. In addition, he suffered from oral pain that radiated to both ears and a related loss of appetite. TREATMENT: In the light of progressive cachexia, we started regular medical cannabis (Sativex®, contains i. e. delta-9-tetrahydrocannabinol and cannabidiol). Despite good initial tolerability, medical cannabis was stopped early due to alcohol relapse of the patient. After termination of medical cannabis, the patient regained control of alcohol consumption and achieved sobriety. CONCLUSIONS: We suggest that medical cannabis only be prescribed with particular caution in patients with a history of alcohol abuse.


Assuntos
Alcoolismo/complicações , Abuso de Maconha , Maconha Medicinal , Dor do Câncer/tratamento farmacológico , Humanos , Masculino , Maconha Medicinal/efeitos adversos , Maconha Medicinal/uso terapêutico , Pessoa de Meia-Idade , Neoplasias Bucais/psicologia , Neoplasias Bucais/terapia , Recidiva , Automedicação/psicologia
4.
Int J Oncol ; 55(2): 513-526, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31268163

RESUMO

The receptor tyrosine kinase, recepteur d'origine nantais (RON), is known to be associated with the progression, metastasis, and prognosis of various types of cancers. Nevertheless, the role of RON in human oral squamous cell carcinoma (OSCC) is unclear. This study evaluated whether RON affects oncogenic behavior, oncogenic signaling pathways, and clinical outcomes, including survival, in human OSCC. Reverse transcription­PCR, quantitative PCR, western blotting and immunohistochemical staining were used to determine mRNA and protein expression levels of RON. Cell invasion, migration and apoptosis assays were used to assess the functional effects of small interfering RNA­mediated knockdown of RON or snail family transcriptional repressor 2 (SLUG). RON knockdown suppressed tumor cell invasion and migration and enhanced apoptosis in human OSCC cells. RON knockdown also decreased the phosphorylation of MAPK signaling proteins, such as ERK1/2, JNK and p38. In addition, RON knockdown suppressed the expression of the epithelial mesenchymal transition (EMT)­related transcription factor, SLUG. SLUG knockdown blocked the enhancement of cell invasion and migration induced by macrophage­stimulation protein (MSP)­mediated RON activation in OSCC cells. The cell morphology was changed to spindle­like shape under MSP­mediated RON activation in OSCC cells. RON was overexpressed in both fresh and paraffin­embedded human OSCC tissues. Taken together, these results indicate that RON contributed to tumor progression by regulating the EMT­related factor, SLUG, and the MAPK pathway in OSCC. This study may provide a theoretical basis for the application of RON­targeting agents, currently being studied in various cancer fields, for the treatment of OSCC.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/secundário , Transição Epitelial-Mesenquimal , Sistema de Sinalização das MAP Quinases , Neoplasias Bucais/patologia , Recidiva Local de Neoplasia/patologia , Receptores Proteína Tirosina Quinases/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Apoptose , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/terapia , Movimento Celular , Proliferação de Células , Terapia Combinada , Feminino , Seguimentos , Regulação Neoplásica da Expressão Gênica , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/metabolismo , Neoplasias Bucais/terapia , Invasividade Neoplásica , Recidiva Local de Neoplasia/metabolismo , Recidiva Local de Neoplasia/terapia , Fosforilação , Prognóstico , Receptores Proteína Tirosina Quinases/genética , Taxa de Sobrevida , Células Tumorais Cultivadas
5.
Oncol Res Treat ; 42(9): 448-457, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336372

RESUMO

BACKGROUND: Oral antiproliferative therapies have become increasingly important in the treatment of tumors. To ensure patient safety, medical care is focused on adherence and side effects. OBJECTIVES: To meet increased personnel and time requirements, delegation of tasks to nonmedical specialists (NMS) may be a solution; however, presently, little is known about the options in Germany. METHOD: At least 3,300 members of the German Society for Hematology and Medical Oncology (DGHO), 580 members of the Professional Association of Office-Based Hematologists and Oncologists in Germany (BNHO), and 1,500 members of the Conference on Oncology Nursing and Pediatric Nursing (KOK) were contacted via a web-based survey. The survey focused on the feasibility of oncology nurse consultation as an additional consulting service for patients undergoing oral tumor therapy. RESULTS: In total, 255 (physicians) and 206 (NMS) questionnaires were evaluable; 90.9% of the physicians were hematologists/oncologists, 87.8% advocated oncology nurse consultation, 34.1% had previously implemented/scheduled such consultations, 58.3% of the NMS were nursing staff, 46.1% had advanced training in oral tumor therapy, 94.2% were interested in further qualifications, 37.8% worked at facilities with established/planned nurse consultations, and 62.1% personally conducted/preferred conducting consultations. CONCLUSIONS: Throughout Germany, there seems to exist a group of qualified NMS who are motivated to provide care to patients undergoing oral tumor therapy. Particular physicians actively support these nurse consultations. Extensive implementation of delegation concepts in standard care of patients undergoing oral tumor therapy is not yet underway.


Assuntos
Neoplasias Bucais/enfermagem , Neoplasias Bucais/terapia , Oncologistas , Enfermagem Oncológica/métodos , Encaminhamento e Consulta , Especialização , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Educação em Enfermagem , Estudos de Viabilidade , Feminino , Alemanha , Humanos , Internet , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Segurança do Paciente , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-31350225

RESUMO

OBJECTIVE: The aim of this study was to analyze myopericytoma in the oral and maxillofacial region in terms of clinical appearance, diagnosis, treatment, and outcomes. STUDY DESIGN: Data on 5 new patients with myopericytoma in the oral and maxillofacial region treated at our department were collected and analyzed. RESULTS: There were 2 males and 3 females (age range 10-62 years; mean age 43.8 years). All of the 5 patients presented with masses showing benign biologic behavior. Imaging examinations with use of computed tomography or magnetic resonance imaging showed heterogeneous regions with internal contrast-enhancement or cystic change in 3 cases. All of the patients underwent surgery. Histologic examination showed a broad morphologic spectrum characterized by concentric and perivascular growth of ovoid, plump spindled, and/or round myoid tumor cells. Immunohistochemical examination showed positive staining for vimentin and smooth muscle actin, and negative for CD34 and desmin. During the follow-up period (8-56 months), there was no tumor recurrence. CONCLUSIONS: Myopericytoma in the oral and maxillofacial region always exhibits benign biologic behavior and a heterogeneous region with internal contrast-enhancement or cystic change on imaging examinations. Surgery is the first choice of treatment and results in good clinical outcomes.


Assuntos
Neoplasias Bucais , Miopericitoma , Adolescente , Adulto , Criança , Desmina , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/terapia , Miopericitoma/diagnóstico , Miopericitoma/terapia , Recidiva Local de Neoplasia , Adulto Jovem
7.
Mol Cell Biochem ; 458(1-2): 11-26, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31165315

RESUMO

Dysregulation of microRNAs (miRNAs) has been found to disrupt the progression of oral cancer. However, which miRNAs are most effective against oral cancer and how these miRNAs should be delivered are major unanswered problems. We aimed at investigating if human bone marrow mesenchymal stem cells (hBMSCs)-derived exosomes affect oral cancer development, and the potential regulatory mechanism associated with COL10A1 and miR-101-3p. COL10A1 was upregulated, while miR-101-3p was downregulated in oral cancer, and miR-101-3p targeted COL10A1 as verified by dual-luciferase reporter gene assay. Meanwhile, exosomes derived from hBMSCs were isolated and then co-cultured with oral cancer cells to identify the role of exosomes, and the results suggested that hBMSCs-derived exosomes overexpressing miR-101-3p inhibited oral cancer progression. Furthermore, tumorigenicity assay in nude mice further confirmed the inhibitory effects of hBMSCs-derived exosomes, loaded with miR-101-3p, on oral cancer, which provides a new theoretical basis in the treatment of oral cancer.


Assuntos
Células da Medula Óssea/metabolismo , Movimento Celular , Proliferação de Células , Exossomos/transplante , Células-Tronco Mesenquimais/metabolismo , MicroRNAs/biossíntese , Neoplasias Bucais/terapia , Idoso , Animais , Exossomos/metabolismo , Feminino , Células HEK293 , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Pessoa de Meia-Idade , Neoplasias Bucais/metabolismo , Neoplasias Bucais/patologia , Invasividade Neoplásica , Ensaios Antitumorais Modelo de Xenoenxerto
8.
Oral Dis ; 25(6): 1511-1518, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31165559

RESUMO

OBJECTIVE: To evaluate the prognostic values of tumor-related leukocytosis (TRL) as a reliable biomarker predictive of recurrence and survival after definitive surgery for oral cavity squamous cell carcinoma (OSCC). MATERIALS AND METHODS: This retrospective study involved 322 patients who underwent tumor extirpation combined with neck dissection for treatment-naïve OSCC between 2006 and 2014. Multivariate binary logistic regression analyses were used to analyze the relationship between TRL and pathological variables. Cox proportional hazard regression analyses were used to find associations between factors and disease-free survival (DFS) or overall survival (OS). RESULTS: TRL was significantly related to advanced disease status, tumor size, invasion depth, poor differentiation, and T and N classifications, resulting in increased post-treatment recurrence rate, particularly in the distant site. Multivariate logistic regression analyses showed that only the T classification was significantly associated with baseline TRL (p = 0.018). Multivariate analyses also showed that the tumor depth of invasion, pathological N classification, extranodal extension, and TRL remained the independent variables predictive of DFS and OS (all p < 0.05). TRL was related to a more than twofold increased risk of post-treatment recurrence and mortality. CONCLUSIONS: TRL is associated with advanced tumor disease and increased recurrence and mortality in OSCC patients.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Leucocitose , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Recidiva Local de Neoplasia/patologia , Carcinoma de Células Escamosas/terapia , Intervalo Livre de Doença , Humanos , Neoplasias Bucais/terapia , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
9.
Mol Carcinog ; 58(10): 1783-1794, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31206208

RESUMO

Recent findings have shown that dysregulation of circular RNAs (circRNAs) is implicated in various cancers. However, the contribution of circRNAs in oral squamous cell carcinoma (OSCC) remains largely unexplored. We screened circRNA expression profiles using a circRNA microarray in paired OSCC and normal tissues and explored the clinical significance of a downregulated circRNA, circ-PKD2. Moreover, the biological function of circ-PKD2 in OSCC was investigated both in vitro and in vivo. We found that downregulation of circ-PKD2 in OSCC correlated significantly with aggressive characteristics. Further analysis revealed that overexpression of circ-PKD2 inhibited OSCC cell proliferation, migration and invasion, induced apoptosis and cell cycle arrest, which were promoted by knockdown of circ-PKD2. In addition, circ-PKD2 was identified as a sponge for miR-204-3p and upregulated the expression of adenomatous polyposis coli 2 (APC2), which was the functional target of miR-204-3p. Moreover, circ-PKD2 attenuated the oncogenic effects of miR-204-3p-mediated APC2 on OSCC progression via multiple signaling pathways. These results demonstrate that the circ-PKD2/miR-204-3p/APC2 axis represents a novel pathway involved in the pathogenesis of OSCC and may serve as a novel therapeutic target of OSCC.


Assuntos
Carcinoma de Células Escamosas/genética , Proteínas do Citoesqueleto/genética , MicroRNAs/genética , Neoplasias Bucais/genética , Proteínas Quinases/genética , Animais , Apoptose/genética , Carcinogênese/genética , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Linhagem Celular Tumoral , Proliferação de Células , Feminino , Regulação Neoplásica da Expressão Gênica , Xenoenxertos , Humanos , Masculino , Camundongos , Análise em Microsséries , Neoplasias Bucais/terapia , Proteínas Quinases/uso terapêutico , /uso terapêutico , Transdução de Sinais
10.
J Oral Pathol Med ; 48(7): 604-610, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31188490

RESUMO

BACKGROUND: Green tea is heavily consumed on a global basis for its health benefits. The active ingredient, (-)-epigallocatechin gallate (EGCG), is a major polyphenol demonstrated to inhibit the growth of various non-oral cancer cell lines and interfere with the carcinogenic process, including downregulation of the epidermal growth factor receptor (EGFR). Our aim was to determine the phenotypic changes of oral cancer cells treated with EGCG and concurrently assess the effect on EGFR expression and activation. METHODS: Oral cancer cells (H400 and H357) were treated with 10 µg/mL and 20 µg/mL of EGCG for up to 72 hours. Phenotypic changes were assessed by performing cell proliferation analysis and cell migration (Transwell) assays. Expression of EGFR and its phosphorylated form (p-EGFR) was determined by Western blotting. RESULTS: Cell proliferation of both cell lines was significantly reduced at 48hrs when treated with 20 µg/mL EGCG. However, after 72 hours of treatment the effect of EGCG on cell proliferation ceased. Treatment of both cell lines with 10 µg/mL and 20 µg/mL of EGCG resulted in significant reduction in cell migration. Mechanistically, EGFR expression did not change significantly after treatment with EGCG; however, there was a reduction in its phosphorylated form. CONCLUSION: EGCG transiently inhibits both cell proliferation and migration of oral cavity cancer cells. This effect is associated with a decrease in the expression of phosphorylated EGFR. It is possible that more frequent bursts of EGCG could result in a persistent and sustained cancer inhibition, but this requires further research for clarification.


Assuntos
Neoplasias Bucais , Catequina , Linhagem Celular Tumoral , Proliferação de Células , Humanos , Neoplasias Bucais/terapia , Polifenóis , Chá
11.
J Cancer Res Ther ; 15(3): 582-588, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31169224

RESUMO

Objectives: We sought to determine whether smokers with oral cavity squamous cell carcinoma (OCSCC) have tumors with more adverse pathological features than in nonsmokers and whether or not these are predictive of outcomes. Materials and Methods: We retrospectively identified 163 patients with American Joint Committee on Cancer stages I-IVa OCSCC diagnosed between 2005 and 2015 and treated with curative intent. A pathological risk score (PRS) was calculated using the National Comprehensive Cancer Network adverse risk factors: positive margin, extracapsular extension of lymph node metastases, pT3 or pT4 primary, N2 or N3 nodal disease, perineural invasion, and lymphovascular space invasion. Multivariable models were constructed to determine the independent predictors of overall survival (OS), recurrence-free survival (RFS), and PRS. Results: A total of 108 (66.26%) were smokers and 55 nonsmokers. Three-year actuarial OS and RFS were 62% and 68% in smokers and 81% and 69% in nonsmokers, respectively (P = 0.06 and P = 0.63). Smokers were more likely to have advanced disease stage and tumors with aggressive pathological features than nonsmokers. Smokers had significantly worse PRS (mean ± standard deviation; 2.38 ± 2.19, median; 2.00) than nonsmokers (0.89 ± 1.21, 0.00) (P < 0.001). Older age, higher PRS, and smoking status were independent predictors of OS. Smoking or PRS did not predict for worse RFS. On multivariate analysis, independent predictors of PRS were smoking status and grade (P < 0.001). Conclusion: In patients with OCSCC, smokers have more aggressive disease as evidenced by more adverse pathological features than nonsmokers. Moreover, smoking is an independent predictor of OS but not RFS. The PRS is a significant predictor of OS and needs validation in the future studies.


Assuntos
Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/etiologia , Neoplasias Bucais/patologia , Fumar/efeitos adversos , Adulto , Idoso , Biópsia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/terapia , Terapia Combinada , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Neoplasias Bucais/terapia , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Resultado do Tratamento , Carga Tumoral
12.
J Cancer Res Ther ; 15(3): 604-607, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31169227

RESUMO

Background: The aim of this study was to retrospectively evaluate various patterns of failure in patients with oral squamous cell carcinoma and to estimate overall survival (OS) and disease-free survival (DFS) in failure patterns. Materials and Methods: Retrospective data of 500 patients operated for oral malignancy were obtained from year 2011 to 2014. Incidence of local, regional, and distant failure as well as DFS and OS was calculated. Furthermore, we studied various prognostic factors such as habits and coexistent comorbid conditions, depth of invasion, histological grade of tumor, and primary site of tumor. Results: Average DFS was 13.9 months and average overall survival was 55.77 months. The overall incidence of recurrence was 42.4%. Incidence of local recurrence was 24%, regional recurrence was 11.2%, and distant failure was seen in 7.2% of cases. Conclusion: Despite execution of standard treatment protocol comprising of surgery and chemoradiation, incidence of recurrence remains sententious in oral malignancy.


Assuntos
Neoplasias Bucais/epidemiologia , Adulto , Idoso , Comorbidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Neoplasias Bucais/terapia , Gradação de Tumores , Estadiamento de Neoplasias , Prognóstico , Vigilância em Saúde Pública , Estudos Retrospectivos , Falha de Tratamento
13.
J Cancer Res Ther ; 15(3): 693-695, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31169243

RESUMO

Head-and-neck squamous cell carcinomas are tumors with propensity mostly for locoregional spread. The most frequent sites of metastasis include lung, bone, liver, adrenal, heart, and kidney. Distant metastasis to axillary lymph nodes from buccal mucosa cancer is extremely rare. To the authors' knowledge, this is the first case reported where a gentleman who was treated for carcinoma right buccal mucosa developed left axillary lymph node metastasis at 6th year of follow-up.


Assuntos
Carcinoma/diagnóstico , Linfonodos/patologia , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico , Axila , Biópsia , Carcinoma/terapia , Terapia Combinada , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/terapia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Resultado do Tratamento
14.
Clin Ter ; 170(3): e216-e222, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31173053

RESUMO

BACKGROUND: Early detection of oral cancer improves survival after treatment and the quality of life. The adoption of standardized methodological protocols of screening has increased the possibilities for early identification and appropriate treatment. The informed consent must be obtained by patients before any treatment and/or surgical procedure. The clinical and surgical details must be discussed with the patient, as well as potential risks and benefits. Consent must be documented in the medical record and consent forms may serve to document the physician's discussion with the patient. OBJECTIVES: all dentists are trained to detect the early signs of oral cancer. The health professional have a key role in identify the early signs of oral cancer in order to plan the treatment and management of the disease. The work aims to provide simple practical information to collect the patient's consent and encouraging him to improve healthy behaviors. MATERIALS AND METHODS: are analyzed the critical issues of clinical practice in order to improve the management of oral cancer. RESULTS AND CONCLUSIONS: Identify effective information approaches documented in the medical record as a tool of close communication between the patient and the physician.


Assuntos
Tomada de Decisão Clínica , Neoplasias Bucais/terapia , Qualidade de Vida , Comunicação , Humanos , Consentimento Livre e Esclarecido , Registros Médicos , Relações Médico-Paciente , Médicos/organização & administração
15.
BMC Anesthesiol ; 19(1): 92, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31153379

RESUMO

BACKGROUND: Oral cavity and oropharyngeal cancer impose significant threat to airway management. Head and neck radiotherapy (HNRT) may further increase the difficulty of tracheal intubation. We hypothesized that a history of HNRT would be associated with a high rate of difficult tracheal intubation. METHODS: Adult patients with a history of HNRT were identified. Non-HNRT controls were case-matched by age, sex and body mass index. The tracheal intubation status between the two patient groups (treated vs. untreated with HNRT) was compared. The t test was used to evaluate differences in continuous variables between the 2 groups. Fisher's exact test or a chi-square test was used to test for associations between radiation status and patient characteristics that may be associated with difficult tracheal intubation. Odds ratio and its confidence interval were used to assess the effect of radiation status on intubation status. RESULTS: The final cohort of 472 matched patients in age, sex and body mass index consisted of 236 patients who had HNRT before surgery and 236 who had upfront surgery without HNRT. The percentage of patients who had restricted neck range of motion in the HNRT group was significantly higher than in the control group (22.3% vs. 11.0%; p = 0.001). The proportion of patients with trismus (p = 0.11) or difficult tracheal intubation (p = 0.73) did not differ significantly between the 2 groups. 12.7% patients in the study had difficult tracheal intubation. Patients who had mallampati scores of 3 or 4 had significantly higher rate of difficult tracheal intubation than did patients with mallampati scores of 1 or 2 (17.8% vs. 8.7%; p = 0.004). Multivariate logistic regression model showed no difference between HNRT and intubation status after adjusting neck range of motion and mallampati score (OR = 0.91, 95% CI: 0.510 to1.612). CONCLUSIONS: Previous treatment with HNRT was not associated with additional risk of difficult tracheal intubation. Mallampati score may be a sensitive measurement for difficult tracheal intubation in this patient population.


Assuntos
Manuseio das Vias Aéreas/métodos , Análise de Dados , Intubação Intratraqueal/métodos , Laringoscopia/métodos , Neoplasias Bucais/terapia , Neoplasias Orofaríngeas/terapia , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/epidemiologia , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/epidemiologia , Estudos Retrospectivos
16.
Auris Nasus Larynx ; 46(6): 882-888, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31176493

RESUMO

OBJECTIVE: The present study aimed to retrospectively analyze the long-term efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin and S-1 for head and neck squamous cell carcinoma. METHODS: The study enrolled 53 patients (23 with stage II disease, 13 with stage III disease, and 17 with stage IV disease). S-1 was administered orally twice a day for 14 days, followed by a two-week rest period. Nedaplatin was intravenously administered on day 4. Where possible, two courses of chemotherapy were performed. Radiotherapy was started with the administration of S-1. We analyzed the clinical response, survival rate, acute adverse events, and late swallowing toxicity. RESULTS: The complete response rates for the primary tumor and neck lymph node metastases were 94.3% and 79.3%, respectively. The five-year overall survival rate was 79.5%, the five-year disease-specific survival rate was 84.8%, and the five-year relapse-free survival rate was 73.7%. The main acute adverse events were leukopenia, neutropenia, mucositis, and dermatitis. No patient had severe nephrotoxicity. Late swallowing toxicity was observed in 13 patients. CONCLUSIONS: The low toxicity, and low nephrotoxicity of chemoradiotherapy with nedaplatin and S-1 have a positive impact on long-term survival. The combination of nedaplatin and S-1 can be used instead of cisplatin and 5-fluorouracil as a safer regimen, especially in patients with some complications and those requiring treatment in an outpatient setting.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia/métodos , Neoplasias de Cabeça e Pescoço/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Combinação de Medicamentos , Feminino , Humanos , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/terapia , Compostos Organoplatínicos/administração & dosagem , Ácido Oxônico/administração & dosagem , Neoplasias Faríngeas/terapia , Tegafur/administração & dosagem , Resultado do Tratamento
17.
PLoS One ; 14(6): e0218833, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31247007

RESUMO

BACKGROUND: Oral cancer (OC) is one of the common malignant neoplasm resulting in a range of debilitating symptoms. Patient reported outcome measures (PROMs) could provide a valuable insight into the impact of OC on patients' quality of life (QoL). Selecting an adequate instrument among available PROMs for OC has been challenging for clinicians due to lack of information on their psychometric quality. This systematic review provides an extensive overview of methodological quality of all currently available PROMs for OC. METHOD: A systematic search was performed in PubMed, Scopus, Web of Science and CINAHL for relevant literature until 10th January 2019 and data was extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the identified studies was assessed per measurement property according to the COnsensus-based Standards for the selection of health Measurements Instruments (COSMIN) checklist. RESULTS: Seven studies were found evaluating 6 health-related QoL PROMs. Among six, there were 1 disease-specific and 5 generic PROMs. Information regarding important measurement properties was often incomplete. The evidence for the quality of measurement properties was found to be variable, none of the instruments performed sufficient on all measurement properties. Considering results of this review, QOL-OC appeared to have adequate COSMIN measurement properties. CONCLUSION: QOL-OC can be implemented in future studies to better understand symptoms and expectations of OC patients and help inform clinicians to formulate treatment strategies as per patients' needs.


Assuntos
Neoplasias Bucais/terapia , Medidas de Resultados Relatados pelo Paciente , Feminino , Humanos , Masculino , Neoplasias Bucais/patologia , Neoplasias Bucais/fisiopatologia , Saúde Bucal , Qualidade de Vida
18.
Cancer Immunol Immunother ; 68(7): 1133-1141, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31139925

RESUMO

Advanced oral squamous cell carcinomas (OSCC) have limited therapeutic options. Although immune therapies are emerging as a potentially effective alternative or adjunct to chemotherapies, the therapeutic efficacy of combination immune chemotherapies has yet to be determined. Using a 4-nitroquinolone-N-oxide (4NQO) orthotopic model of OSCC in immunocompetent mice, we evaluated the therapeutic efficacy of single- and combined-agent treatment with a poly-epitope tumor peptide vaccine, cisplatin and/or an A2AR inhibitor, ZM241385. The monotherapies or their combinations resulted in a partial inhibition of tumor growth and, in some cases, a significant but transient upregulation of systemic anti-tumor CD8+ T cell responses. These responses eroded in the face of expanding immunoregulatory cell populations at later stages of tumor progression. Our findings support the need for the further development of combinatorial therapeutic approaches that could more effectively silence dominant immune inhibitory pathways operating in OSCC and provide novel, more beneficial treatment options for this tumor.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Vacinas Anticâncer/uso terapêutico , Imunoterapia/métodos , Neoplasias Bucais/terapia , Neoplasias Experimentais/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , 4-Nitroquinolina-1-Óxido/toxicidade , Animais , Cisplatino/uso terapêutico , Terapia Combinada/métodos , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Neoplasias Bucais/induzido quimicamente , Neoplasias Bucais/imunologia , Neoplasias Bucais/patologia , Neoplasias Experimentais/induzido quimicamente , Neoplasias Experimentais/imunologia , Neoplasias Experimentais/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/induzido quimicamente , Carcinoma de Células Escamosas de Cabeça e Pescoço/imunologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Resultado do Tratamento , Triazinas/uso terapêutico , Triazóis/uso terapêutico , Vacinas de Subunidades/uso terapêutico
19.
JAMA Oncol ; 5(7): 985-992, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31046104

RESUMO

Importance: Detection of persistent oral human papillomavirus (HPV) DNA may be associated with recurrence of HPV-positive head and neck squamous cell carcinoma (HNSCC). Objective: To evaluate the dynamics of oral HPV DNA detection and associations with disease outcomes in patients with HPV-positive and HPV-negative HNSCC. Design, Setting, and Participants: This prospective, 2-institution, tertiary referral center study of 396 patients with newly diagnosed oral cavity or oropharyngeal HNSCC was performed from July 11, 2011, to May 7, 2016. Oral rinse samples were prospectively collected at diagnosis and at completion of primary therapy. Weekly oral rinse samples were collected during radiotherapy. Purified tumor and oral rinse sample DNA were evaluated for 37 HPV types, and viral load was quantified by type-specific real-time polymerase chain reaction. Cancers were stratified by tumor HPV status, and HPV was classified as tumor type if identical to that detected in the tumor or nontumor type. Main Outcomes and Measures: Prevalence of HPV DNA before, during, and after therapy. Associations between tumor-type and nontumor-type oral HPV DNA detection and recurrence-free and overall survival were evaluated. Results: Of the 396 patients (median age, 59 years [range, 19-96 years]; 295 [74.5%] men; and 354 [89.4%] white race/ethnicity), 217 had oropharyngeal cancer; 170, oral cavity cancer; and 9, unknown primary HNSCC. The prevalence of oral HPV detection at diagnosis was higher among patients with HPV-positive compared with HPV-negative HNSCC (24 of 194 [84.2%] vs 170 of 202 [12.4%]; P < .001). Oral HPV-16 DNA had an 81% sensitivity and 100% specificity for HPV-16-positive HNSCC. The prevalence and load of tumor-type HPV decreased significantly during primary therapy with odds ratio for probability of infection with each increasing month after diagnosis (0.41; 95% CI, 0.33-0.52; P < .001), whereas those of nontumor types did not (1.01; 95% CI, 0.97-1.06; P = .62). Current smoking was significantly associated with a reduced clearance of tumor-type HPV DNA (hazard ratio [HR], 0.54; 95% CI, 0.32-0.93). Two-year overall survival was significantly lower among the HPV-positive patients with persistent detection of tumor-type HPV after therapy than among those without detectable tumor-type DNA after therapy (68% vs 95%; adjusted HR, 6.61; 95% CI, 1.86-23.44; P = .003), as was recurrence-free survival (55% vs 88%; adjusted HR, 3.72; 95% CI, 1.71-8.09; P < .001). No associations were observed for nontumor type HPV DNA among patients with HPV-positive or HPV-negative HNSCC. Conclusions and Relevance: Prevalence and viral load of tumor-type HPV DNA decreased rapidly with therapy, and persistent detection was associated with increased risk of recurrence and death. Analysis of tumor type HPV DNA has considerable promise as a biomarker for treatment response and risk of progression.


Assuntos
Papillomavirus Humano 16 , Neoplasias Bucais/virologia , Boca/virologia , Recidiva Local de Neoplasia/virologia , Neoplasias Orofaríngeas/virologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , DNA Viral/análise , Progressão da Doença , Feminino , Papillomavirus Humano 16/genética , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/terapia , Neoplasias Orofaríngeas/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Carga Viral , Adulto Jovem
20.
J Surg Oncol ; 120(2): 101-108, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31095734

RESUMO

BACKGROUND AND OBJECTIVES: The management of the clinically N0 (cN0) neck is controversial for early stage squamous cell carcinoma of the oral cavity (OSCC). This paper represents a single institution series analyzing the efficacy of sentinel lymph node biopsy (SNB) for early stage oral cavity cancers. METHODS: From 2005 to 2017, 108 patients with cN0 OSCC were treated with primary resection and SNB. Patients with positive biopsy results proceeded to neck dissection with or without adjuvant chemoradiotherapy. Mean follow-up for the entire cohort was 50.8 months (range: 8-147 months). Clinically, 56 patients were T1N0, 49 patients were T2N0, and three patients were T3N0 or greater. RESULTS: Disease-specific survival was 93% within the entire cohort. Sentinel lymph nodes were identified in 95.4% of patients. Twenty one patients had a positive biopsy. There were seven false-negative biopsies. The overall rate of nodal disease was 26%. Accuracy of node biopsy was 93%, with sensitivity of 75%, and negative predictive value of 91%. Recurrence rate was 19% (20/108), with an overall survival of 60% in this subgroup. CONCLUSION: SNB is a safe, effective, and well tolerated method for staging cN0 OSCC.


Assuntos
Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/terapia , Neoplasias Bucais/patologia , Neoplasias Bucais/terapia , Esvaziamento Cervical , Biópsia de Linfonodo Sentinela , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Quimiorradioterapia Adjuvante , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Recidiva Local de Neoplasia/epidemiologia , Estadiamento de Neoplasias , Seleção de Pacientes , Sensibilidade e Especificidade , Taxa de Sobrevida , Adulto Jovem
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