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Qayyum MU, Keerio AA, Faisal M, Rashid A, Hussain R, Jamshed A. Survival Outcomes and Patterns of Failure in Maxillary Alveolus Squamous Cell Carcinoma. Int Arch Otorhinolaryngol 2023; 27:e559-e564. [PMID: 37876703 PMCID: PMC10593516 DOI: 10.1055/s-0042-1758214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/05/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Squamous cell carcinoma (SCC) of the maxillary alveolus is a relatively rare disease. There is lack of data on this subsite as compared with other sites. The factors that affect survival in cases of maxillary alveolar SCC are tumor stage, local and cervical metastases, histological grading, and the margin status. Objectives To evaluate the overall survival (OS), the disease free survival (DFS), and the complex interaction and effects of margin status, histological differentiation, habits (such as smoking and the use of smokeless tobacco products), and cervical and distant metastases based on clinicopathological data. Methods We examined the electronic database at our hospital from 2003 to 2017. We included all cases with a histopathological diagnosis of SCC of the maxillary alveolus. Tumors originating primarily from the maxillary alveolus were included, while those originating from adjacent subsites, like the hard palate, the buccal mucosa or the maxillary sinus were excluded. We also excluded all the patients who were not operated on with a curative intent. Results More than half of the patients had stage-IV tumors at the time of presentation, while only one fourth of them had nodal metastasis. The rate of recurrence increased in cases of primary tumors in advanced stages and the degree of histological differentiation. The 2-year and 5-year OS rates were of 54.5% (18 patients) and 30.3% (10 patients) respectively. Conclusion Primary tumors in advanced stages, histological grade, and presence of nodal metastasis are poor prognostic markers in terms of long-term survival.
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Affiliation(s)
- Muhammad Umar Qayyum
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
- Department of Maxillofacial Surgery, Combined Military Hospital Lahore, Lahore, Pakistan
| | - Ahmed Ali Keerio
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Muhammad Faisal
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Asma Rashid
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Raza Hussain
- Department of Surgical Oncology–Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Arif Jamshed
- Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
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2
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Mughal MS, Kaur IP, Akbar H, Abbas SH, Angi P. Hard Palate Perforation in an Elderly Man With Dementia. Cureus 2021; 13:e15872. [PMID: 34327097 PMCID: PMC8302451 DOI: 10.7759/cureus.15872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 12/04/2022] Open
Abstract
A 74-year-old male with a history of mild cognitive impairment presented to the emergency department with failure to thrive and generalized weakness. He was having difficulty swallowing leading to 30 pounds of unintentional weight loss in the last three months. His social history was significant for 12.5 pack-year smoking and drinking (two to three glasses of wine/day). The oral cavity examination revealed a large (3 × 2 cm2) defect with the erythematous border that encompassed the mid-palatal structures and emanated from the hard palate into his nasal cavity. Auto-immune work-up was negative. Palatal biopsy showed squamous cell carcinoma (SCC; well-differentiated). A diagnosis of locally advanced (stage IVa) oral cavity squamous cell carcinoma (OSCC) was made based on PET scan findings. A palatal obturator (prosthesis) was placed to improve his eating, prevent regurgitation. The patient opted for palliative care and did not want to pursue further treatment. He was discharged home with a regular follow-up visit.
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Affiliation(s)
- Mohsin S Mughal
- Internal Medicine, Monmouth Medical Center, Long Branch, USA
| | | | - Hafsa Akbar
- Department of Internal Medicine, Abington Jefferson Hospital, Abington, USA
| | - Syed H Abbas
- Pathology, Saint Barnabas Medical Center, Livingston, USA.,Pathology, Monmouth Medical Center, Long Branch, USA
| | - Priya Angi
- Geriatrics, Monmouth Medical Center, Leon Hess Cancer Center, Long Branch, USA
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3
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Chia C, Key S, Hasan Z, Virk S, Riffat F. Systematic review and meta-analysis of cervical metastases in oral maxillary squamous cell carcinoma. Cancer Rep (Hoboken) 2021; 4:e1410. [PMID: 33963809 PMCID: PMC8714539 DOI: 10.1002/cnr2.1410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/05/2021] [Accepted: 03/25/2021] [Indexed: 12/30/2022] Open
Abstract
Background Management of the node‐negative neck in oral maxillary squamous cell carcinoma (SCC), encompassing the hard palate and upper alveolar subsites of the oral cavity, is controversial, with no clear international consensus or recommendation regarding elective neck dissection in the absence of cervical metastases. Aim To assess the occult metastatic rate in patients with clinically node negative oral maxillary SCC; both as an overall metastatic rate, and a comparison of patients managed with an elective neck dissection at index surgery, compared to excision of the primary with clinical observation of the neck. Methods and results A systematic review was performed by two independent investigators for studies relating to oral maxillary SCC and analysed according to PRISMA criteria. Data were extracted from Pubmed, Ovid MEDLINE, EMBASE, and SCOPUS via relevant MeSH terms. Grey literature was searched through Google Scholar and OpenGrey. Five hundred and fifty‐three articles were identified on the initial search, 483 unique articles underwent screening against eligibility criteria, and 29 studies were identified for final data extraction. Incidence of occult metastases in patients with clinically node negative oral maxillary SCC was identified either on primary elective neck dissection or on routine follow up. Meta‐analyses were performed. Of 553 relevant articles identified on initial search, 29 were included for analysis. The pooled overall rate of occult metastases in patients initially presenting with clinically node‐negative disease was 22.2%. There is a statistically significant effect of END on decreasing regional recurrence demonstrated in this study (RR 0.36, 95% CI 0.24, 0.59). Conclusion The results of this systematic review and meta‐analysis suggest elective neck dissection for patients presenting with hard palate or upper alveolar SCC, even in a clinically node negative neck.
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Affiliation(s)
| | | | - Zubair Hasan
- Monash Health, Clayton, Victoria, Australia.,Westmead Hospital, Westmead, New South Wales, Australia.,University of Sydney, Camperdown, New South Wales, Australia
| | - Sohaib Virk
- University of New South Wales, Randwick, New South Wales, Australia
| | - Faruque Riffat
- University of Sydney, Camperdown, New South Wales, Australia.,Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.,Macquarie University Hospital, Macquarie University, Macquarie Park, New South Wales, Australia
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4
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Obayemi A, Cracchiolo JR, Migliacci JC, Husain Q, Rahmati R, Roman BR, Cohen MA. Elective neck dissection (END) and cN0 hard palate and upper gingival cancers: A National Cancer Database analysis of factors predictive of END and impact on survival. J Surg Oncol 2019; 120:1259-1265. [PMID: 31549410 DOI: 10.1002/jso.25706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 09/08/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES The reported risk of nodal metastasis in hard palate and upper gingival squamous cell carcinoma (SCC) has been inconsistent with inadequate consensus regarding the utility of neck dissection in the clinically negative (cN0) neck. MATERIALS AND METHODS Using the National Cancer Database, cN0 patients diagnosed with SCC of the head and neck with the subsites of the hard palate and upper gingiva were identified from 2004 to 2014. RESULTS A total of 1830 patients were identified, and END was performed on 422 patients with cN0 tumors. Pathologically positive nodes occurred in 14% (59/422) of patients in this cohort. Higher tumor stage, academic hospital type, and large hospital volume (>28 cancer-specific cases/year) were associated with a higher likelihood of END both in univariate and multivariate analyses (P < .05). Patients >80 years of age were less likely to receive END on multivariate analysis (OR 0.52, 0.32-0.84). No variables, including advanced T stage, predicted occult metastases. Cox proportional hazards regression analysis showed that patients who underwent END demonstrated improved OS over an 11-year period (hazard ratio 0.75, P = .002). On subgroup analysis, this improvement was significant in patients with both stage T1 and T4 tumors. CONCLUSIONS Tumor stage, hospital type, and hospital volume were associated with higher rates of END for patients with cN0 hard palate SCC and after controlling for clinical factors, END was associated with improved overall survival.
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Affiliation(s)
- Adetokunbo Obayemi
- Department of Otolaryngology Head and Neck Surgery, Columbia University Medical Center, New York, New York
| | - Jennifer R Cracchiolo
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jocelyn C Migliacci
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Qasim Husain
- Coastal Ear, Nose, and Throat, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey
| | - Rahmatullah Rahmati
- Department of Otolaryngology Head and Neck Surgery, Columbia University Medical Center, New York, New York
| | - Benjamin R Roman
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc A Cohen
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
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5
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Ikawa H, Koto M, Demizu Y, Saitoh JI, Suefuji H, Okimoto T, Ohno T, Shioyama Y, Takagi R, Hayashi K, Nemoto K, Nakano T, Kamada T. Multicenter study of carbon-ion radiation therapy for nonsquamous cell carcinomas of the oral cavity. Cancer Med 2019; 8:5482-5491. [PMID: 31369213 PMCID: PMC6745861 DOI: 10.1002/cam4.2408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 12/13/2022] Open
Abstract
Background The aim of this study was to evaluate the efficacy and safety of carbon‐ion radiation therapy for nonsquamous cell carcinomas of the oral cavity in a multicenter study. Methods Retrospective analysis of the clinicopathological features and outcomes of 76 patients with oral nonsquamous cell carcinomas with N0‐1 M0 status and were treated with carbon‐ion radiation therapy at four institutions in Japan between November 2003 and December 2014 was performed. Results Salivary gland carcinoma, mucosal melanoma, and three other carcinomas were found in 46, 27, and 3 patients, respectively. T1‐3, T4a, and T4b disease was diagnosed in 27, 18, and 31 patients, respectively. Median follow‐up period was 31.1 months (range, 3‐118 months). Three‐year local control, progression‐free survival, and overall survival of all patients were 86.8%, 63.1%, and 78.4%, respectively. Multivariate analysis showed T classification (T4) to be a significant independent poor prognostic factor for local control. Acute grade 3 mucositis was observed in 38 patients. Grades 3 and 4 late morbidities were observed in 9 and 4 patients, respectively. No grade 5 late toxicity was observed. Conclusions Oral nonsquamous cell carcinomas could be treated effectively, with acceptable toxicity, by carbon‐ion radiation therapy.
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Affiliation(s)
- Hiroaki Ikawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Masashi Koto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | | | | | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | | | - Ryo Takagi
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Kazuhiko Hayashi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Takashi Nakano
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
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6
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Ikawa H, Koto M, Hayashi K, Tonogi M, Takagi R, Nomura T, Tsuji H, Kamada T. Feasibility of carbon-ion radiotherapy for oral non-squamous cell carcinomas. Head Neck 2019; 41:1795-1803. [PMID: 30676669 PMCID: PMC6590439 DOI: 10.1002/hed.25618] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/30/2018] [Accepted: 12/11/2018] [Indexed: 02/06/2023] Open
Abstract
Background This study evaluated carbon‐ion radiotherapy (C‐ion RT) for oral non‐squamous cell carcinomas (non‐SCC). Methods We retrospectively obtained data from 74 patients who underwent C‐ion RT for oral malignancies between April 1997 and March 2016. The C‐ion RT was administered in 16 fractions at a total dose of 57.6 or 64.0 Gy (relative biological effectiveness). Results Forty‐three patients had salivary gland carcinomas, 29 patients had mucosal melanoma, and 2 patients had other types of pathologies. The tumors were classified as T1‐T3 (24 cases), T4a (21 cases), or T4b (29 cases). The median follow‐up was 49 months. The 5‐year rates were 78.8% for local control, 36.2% for progression‐free survival, and 58.3% for overall survival. Although 10 patients developed grade 3 osteoradionecrosis after C‐ion RT, all patients maintained their mastication and deglutition functions after sequestrectomy and prosthesis placement. Conclusion C‐ion RT was effective for oral non‐SCC and had acceptable toxicities.
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Affiliation(s)
- Hiroaki Ikawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Masashi Koto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Kazuhiko Hayashi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Morio Tonogi
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, Tokyo, Japan
| | - Ryo Takagi
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Takeshi Nomura
- Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
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7
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Schernberg A, Canova C, Blanchard P, Gorphe P, Breuskin I, Mirghani H, Moya-Plana A, Janot F, Bidault F, Chargari C, Bellefqih S, Ruffier A, Even C, Nguyen F, Temam S, Tao Y. Prognostic factors in patients with soft palate squamous cell carcinoma. Head Neck 2019; 41:1441-1449. [PMID: 30636178 DOI: 10.1002/hed.25598] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 10/02/2018] [Accepted: 12/05/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To define the prognostic factors associated with outcome in patients with soft palate squamous cell carcinoma (SCC). METHODS Previously untreated patients with soft palate and uvula SCC treated in our institution between 1997 and 2012 were collected. The prognostic value of clinical, hematological, and treatment characteristics was examined. RESULTS We identified 156 patients, median age 58 years, with 71% drinkers, 91% smokers; 19% had synchronous cancer. Front-line treatment was chemoradiotherapy in 58 (37%), radiotherapy alone in 60 (39%), surgery in 17 (11%), and induction chemotherapy in 21 patients (14%). The 5-year actuarial overall survival (OS) and progression-free survival (PFS) were 41% and 37%, respectively. In univariate analysis, T3-T4 vs T1-T2 stage, N2-N3 vs N0-N1 stage, and neutrophil count >7 g/L were associated with worse OS and PFS (P < .05). CONCLUSION In patients with soft palate SCC, inflammation biomarkers were associated with OS.
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Affiliation(s)
- Antoine Schernberg
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,INSERM1030, Gustave Roussy Cancer Campus, Paris, France
| | - Charles Canova
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Pierre Blanchard
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,Faculté de Médecine du Kremlin-Bicetre, Université Paris Sud, Université Paris Saclay, Paris, France
| | - Philippe Gorphe
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Ingrid Breuskin
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Haitham Mirghani
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Antoine Moya-Plana
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - François Janot
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Francois Bidault
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Cyrus Chargari
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,INSERM1030, Gustave Roussy Cancer Campus, Paris, France.,French Military Health Services Academy, Paris, France.,Institut de Recherche Biomédicale des Armées, Paris, France
| | - Sara Bellefqih
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Amandine Ruffier
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Caroline Even
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - France Nguyen
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Stéphane Temam
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Yungan Tao
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,INSERM1030, Gustave Roussy Cancer Campus, Paris, France
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8
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Cariati P, Cabello-Serrano A, Monsalve-Iglesias F, Fernadez-Solis J, Martinez-Lara I. Is a "watch and wait strategy" safe to manage clinically N0 squamous cell carcinoma of the upper jaw? Curr Probl Cancer 2018; 43:336-343. [PMID: 30447879 DOI: 10.1016/j.currproblcancer.2018.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 10/11/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE The main aim of the present study is to analyze the behavior of squamous cell carcinoma (SCC) of maxillary gingiva, alveolus, and hard palate and to determine the utility of selective neck dissection in clinically N0 patients at early stages. MATERIAL AND METHOD Twenty-nine previously untreated patients with SCC of maxillary gingiva, alveolus, and hard palate were diagnosed and treated with at least a tumorectomy and selective neck dissection at HUVN and included in the study. RESULTS A total of 34.4% of patients (10/29) showed nodal involvement at postoperative histopathologic exam. Several pathologic features such as N involvement, N stage, T stage, and locoregional failure all have a negative impact on overall survival. DISCUSSION SCC of maxillary gingiva, alveolus, and hard palate shows an aggressive behavior that is comparable with other oral cavity cancers. A more aggressive treatment is thus required for improving locoregional control and overall survival. Supraomohyoid neck dissection may be useful in cT2N0M0.
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9
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Alonso JE, Han AY, Kuan EC, Strohl M, Clair JMS, St John MA, Ryan WR, Heaton CM. The survival impact of surgical therapy in squamous cell carcinoma of the hard palate. Laryngoscope 2018; 128:2050-2055. [PMID: 29399797 DOI: 10.1002/lary.27080] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 11/10/2017] [Accepted: 12/04/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To describe the incidence and determinants of survival of patients with squamous cell carcinoma of the hard palate (SCCHP) between the years of 1973 to 2014 using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS Retrospective, population-based cohort study of patients in the SEER tumor registry who were diagnosed with SCCHP from 1973 to 2014. Outcomes and measures included overall survival (OS) and disease-specific survival (DSS). RESULTS A total of 1,489 cases of primary SCCHP were identified. Of those, 53.2% were females and 47.8% presented with stage IV disease. The mean age at diagnosis was 69.8 years. Overall survival at 2, 5, and 10 years was 44%, 33%, and 21%, respectively. A total of 66.2% of patients underwent surgery (with or without radiation therapy [RT]); 20.1% received RT; and 22.4% had both surgical and RT. On multivariate analysis, RT, advanced age, stage, and grade were associated with worse OS and DSS (P < 0.05). Surgical therapy (with or without radiation) was an independent favorable predictor of OS and DSS (P < 0.05). CONCLUSION SCCHP is relatively infrequent tumor that portends an overall poor prognosis when advanced stage and a greater prognosis when early stage. Surgical therapy was found to be an independent predictor for improved OS and DSS, whereas RT was associated with reduced OS and DSS. LEVEL OF EVIDENCE 4. Laryngoscope, 128:2050-2055, 2018.
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Affiliation(s)
- Jose E Alonso
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Albert Y Han
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Edward C Kuan
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Madeline Strohl
- UCSF Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, San Francisco
| | - Jon Mallen-St Clair
- UCSF Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, San Francisco
| | - Maie A St John
- UCSF Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, San Francisco.,Jonsson Comprehensive Cancer Center, Los Angeles, California, U.S.A.,UCLA Head and Neck Cancer Program, Ronald Reagan UCLA Medical Center, Los Angeles, California, U.S.A
| | - William R Ryan
- UCSF Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, San Francisco
| | - Chase M Heaton
- UCSF Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, San Francisco
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10
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Clinical outcomes with high-dose-rate surface mould brachytherapy for intra-oral and skin malignancies involving head and neck region. J Contemp Brachytherapy 2017; 9:242-250. [PMID: 28725248 PMCID: PMC5509977 DOI: 10.5114/jcb.2017.66773] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 02/08/2017] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The literature and experience of high-dose-rate (HDR) surface mould brachytherapy (SMB) in head and neck cancer is sparse. We report our institutional experience of SMB for such tumours. MATERIAL AND METHODS Thirty-five patients with malignant localized early T1/T2, N0 (21 intra-oral and 14 skin) tumours treated with SMB during 2008-2014 were analyzed. Treatment was delivered using HDR 192Ir source to a median dose of 49 Gy (range, 38.5-52.5 Gy) as radical brachytherapy and 18 Gy (range, 15.5-30 Gy) as boost with 3-4 Gy/fraction twice daily using customized surface mould. RESULTS Median follow-up was 52 months (range, 6 to 98 months). Local control (LC) for skin tumours and intra-oral malignancies at 5 years were 92% and 76%, respectively. Five-year cause specific survival was 92%. For T1 and T2 tumours, 5 year LC was 94.2% and 68.2%, respectively. T stage (p < 0.04) and dose/fractions (p < 0.003) were the only significant prognostic factors for LC on univariate analysis. CONCLUSIONS Surface mould brachytherapy results in excellent LC rates for skin tumours and T1 intraoral tumours when considered as radical treatment, and preferable to consider it as a boost for T2 intraoral tumours. Surface mould brachytherapy results in excellent organ and function preservation.
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11
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Treatment-related determinants of survival in early-stage (T1-2N0M0) oral cavity cancer: A population-based study. Head Neck 2017; 39:876-880. [DOI: 10.1002/hed.24679] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2016] [Indexed: 01/22/2023] Open
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12
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Os ADV, Karakullukcu B, Leemans CR, Halmos GB, Roodenburg JLN, Weert SV, Karagozoglu KH, Witjes MJH. Management of the clinically N0 neck in squamous cell carcinoma of the maxillary alveolus and hard palate. Head Neck 2016; 38:1794-1798. [DOI: 10.1002/hed.24511] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/26/2016] [Accepted: 05/05/2016] [Indexed: 02/05/2023] Open
Affiliation(s)
- Alejandra D. van Os
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital; Amsterdam The Netherlands
| | - Baris Karakullukcu
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital; Amsterdam The Netherlands
| | - C. René Leemans
- Department of Otolaryngology - Head and Neck Surgery; VU University Medical Centre and Cancer Center; Amsterdam The Netherlands
| | - Gyorgy B. Halmos
- Department of Otorhinolaryngology / Head and Neck Surgery; University of Groningen, University Medical Center Groningen; The Netherlands
| | - Jan L. N. Roodenburg
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; The Netherlands
| | - Stijn van Weert
- Department of Otolaryngology - Head and Neck Surgery; VU University Medical Centre and Cancer Center; Amsterdam The Netherlands
| | - K. Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center; Amsterdam The Netherlands
| | - Max J. H. Witjes
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; The Netherlands
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13
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Zhang WB, Peng X. Cervical metastases of oral maxillary squamous cell carcinoma: A systematic review and meta-analysis. Head Neck 2016; 38 Suppl 1:E2335-42. [PMID: 26890607 DOI: 10.1002/hed.24274] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 07/17/2015] [Accepted: 09/12/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Wen-Bo Zhang
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Haidian District Beijing China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery; Peking University School and Hospital of Stomatology; Haidian District Beijing China
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Clinicopathological Characteristics and Outcome Predictors in Squamous Cell Carcinoma of the Maxillary Gingiva and Hard Palate. J Oral Maxillofac Surg 2015; 73:1429-36. [DOI: 10.1016/j.joms.2014.12.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 12/18/2014] [Accepted: 12/23/2014] [Indexed: 12/16/2022]
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15
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Abstract
PURPOSE Minor salivary gland cancers are rare and account for roughly 2% to 3% of all head and neck tumors. This is a retrospective review in a modern cohort of patients treated for this rare cancer with surgery and adjuvant radiation therapy. MATERIALS AND METHODS Between February 1990 and December 2010, 98 patients with cancer of the minor salivary glands were identified and treated at a single institution. The median radiation dose was 63 Gy. Outcomes assessed included local control (LC), locoregional control (LRC), and overall survival (OS). Toxicity was graded using the Common Terminology Criteria for Adverse Events, version 3.0. Competing-risk analysis using the Gray test was performed, with death as the competing risk. OS was calculated by the Kaplan-Meier method. RESULTS With a median follow-up of 7.3 years, the 5- and 10-year LC and LRC rates were 87.9% and 83%, and 80.5% and 73.7%, respectively. Higher T stage and adenocarcinoma histology were the significant negative prognostic factors for both LC and LRC. Freedom from distant metastasis at 5 and 10 years were 83% and 63%, respectively. The median OS was 19.6 years. Overall, no grade 4 or 5 toxicities occurred, and 20% of the cohort experienced an acute grade 3 toxicity, and 6% with a grade 3 late toxicity. CONCLUSIONS In a modern cohort treated with surgery and radiotherapy, excellent outcomes can be achieved with lower toxicity rates compared with older published series.
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16
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Park HJ. Is elective neck dissection needed in clinically N0 neck in maxillary cancer? J Korean Assoc Oral Maxillofac Surg 2014; 40:101-2. [PMID: 25045635 PMCID: PMC4095808 DOI: 10.5125/jkaoms.2014.40.3.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Hong-Ju Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju, Korea
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17
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Kato H, Kanematsu M, Makita H, Kato K, Hatakeyama D, Shibata T, Mizuta K, Aoki M. CT and MR imaging findings of palatal tumors. Eur J Radiol 2014; 83:e137-46. [DOI: 10.1016/j.ejrad.2013.11.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 11/26/2013] [Accepted: 11/27/2013] [Indexed: 01/19/2023]
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18
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Dalal AJ, McLennan AS. Cervical metastases from maxillary squamous cell carcinoma: retrospective analysis and review of the literature. Br J Oral Maxillofac Surg 2013; 51:702-6. [DOI: 10.1016/j.bjoms.2013.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 08/18/2013] [Indexed: 10/26/2022]
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19
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Li Q, Wu D, Liu WW, Li H, Liao WG, Zhang XR, Liu ZM, Guo ZM, Liu XK. Survival impact of cervical metastasis in squamous cell carcinoma of hard palate. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:23-7. [DOI: 10.1016/j.oooo.2013.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 12/23/2012] [Accepted: 01/04/2013] [Indexed: 10/27/2022]
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20
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Eskander A, Givi B, Gullane PJ, Irish J, Brown D, Gilbert RW, Hope A, Weinreb I, Xu W, Goldstein DP. Outcome predictors in squamous cell carcinoma of the maxillary alveolus and hard palate. Laryngoscope 2013; 123:2453-8. [PMID: 23553191 DOI: 10.1002/lary.24079] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 01/22/2013] [Accepted: 02/05/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Hard palate and maxillary alveolus are two commonly grouped oral cavity subsites due to their anatomic contiguity and oncologic disease behavior. Few studies have been conducted investigating clinical presentation, staging, prevalence of cervical metastases, and outcomes in this population. The primary objective of this study was to analyze predictors of disease-free survival (DFS) in surgically treated patients, particularly as it relates to the role of neck dissection. STUDY DESIGN Cohort study with planned data collection. METHODS This cohort study used planned data collection over 15 years (1994-2008) at a large tertiary care cancer center to study all patients presenting with squamous cell carcinoma of the maxillary alveolus and hard palate treated surgically. Univariate and multivariate Cox regression analyses were used to identify predictors of DFS. RESULTS Ninety-seven patients met the inclusion criteria (54 male, 56%). The majority of patients (54, 56%) presented with locally advanced disease (cT3, cT4). Occult nodal metastases were noted in 26% (17 of 65) of patients clinically staged as N0. The 3-year DFS was 70% (95% confidence interval = 59%-78%) with a median time to failure of 1.1 years (range = 0.3-9.7 years). Cox regression multivariate model demonstrated that advanced pathologic T stage, hard palate tumor site, and poorly differentiated tumor grade were each independent predictors of DFS. CONCLUSIONS A significant portion of the patients with hard palate and maxillary alveolus tumors harbor occult cervical metastases. Elective neck dissection in the high-risk patients may potentially be beneficial in providing more accurate staging and improving DFS. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
- Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Wharton Head and Neck Program, University Health Network, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
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21
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Pugazhendi SK, Thambiah L, Venkatasetty A, Thangaswamy V. Elective neck dissection versus "wait and watch" policy in tongue carcinoma. J Pharm Bioallied Sci 2012; 4:S226-9. [PMID: 23066257 PMCID: PMC3467864 DOI: 10.4103/0975-7406.100212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/02/2012] [Accepted: 01/26/2012] [Indexed: 11/25/2022] Open
Abstract
Aim: To evaluate the efficacy of elective neck dissection versus the “wait and watch” policy in the treatment of early squamous cell carcinoma of tongue. Materials and Methods: This is a retrospective study of 21 patients with surgical treatment between April 2009 and July 2011. The patients were divided into two groups, with Group 1 consisting of patients who underwent wide excision glossectomy with elective neck dissection and Group 2 consisting of patients who underwent glossectomy without the neck being surgically addressed. The selection of patients was done by the random double-blinded method and the review was done by a single reviewer. All patients were examined for an average period of 1 year postoperatively. Results: Twenty-one cases were treated, among which there were 17 T1 and 4 T2 carcinomas. All the patients had primary carcinoma involving only the tongue with no clinical neck palpable neck nodes. Eleven patients underwent wide excision of primary tumor with elective neck dissection (Group 1) and 10 patients underwent only resection of primary tumor without the neck being surgically addressed (Group 2). In Group 1, there were no recurrences, and in Group 2, there were two patients who developed subsequent cervical node metastasis with one patient undergoing further surgery to address the positive neck and the other patient was lost to follow-up. Conclusions: Regional recurrence was the most common cause of failure after surgical treatment of oral tongue carcinoma. Elective neck dissection significantly reduced mortality due to regional recurrence and also increased the overall survival. Our study suggests that elective neck dissection is a treatment strategy of choice for stages I and II carcinoma of the oral tongue. A prospective, randomized study is worthwhile to further evaluate the benefit of elective neck dissection in the treatment of early carcinoma of the tongue with a larger pool of patients and a lengthier follow-up period.
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22
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Long-term treatment outcome of minor salivary gland carcinoma of the hard palate. Oral Oncol 2012; 48:456-62. [DOI: 10.1016/j.oraloncology.2011.12.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 12/10/2011] [Accepted: 12/14/2011] [Indexed: 11/20/2022]
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23
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Poeschl PW, Seemann R, Czembirek C, Russmueller G, Sulzbacher I, Selzer E, Nuhic D, Ewers R. Impact of elective neck dissection on regional recurrence and survival in cN0 staged oral maxillary squamous cell carcinoma. Oral Oncol 2012; 48:173-8. [DOI: 10.1016/j.oraloncology.2011.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 09/08/2011] [Accepted: 09/10/2011] [Indexed: 10/17/2022]
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24
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Beltramini GA, Massarelli O, Demarchi M, Copelli C, Cassoni A, Valentini V, Tullio A, Giannì AB, Sesenna E, Baj A. Is neck dissection needed in squamous-cell carcinoma of the maxillary gingiva, alveolus, and hard palate? A multicentre Italian study of 65 cases and literature review. Oral Oncol 2012; 48:97-101. [DOI: 10.1016/j.oraloncology.2011.08.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 08/12/2011] [Accepted: 08/17/2011] [Indexed: 02/06/2023]
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25
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Ogawa T, Matsuura K, Shiga K, Tateda M, Katagiri K, Kato K, Saijo S, Kobayashi T. Surgical treatment is recommended for advanced oral squamous cell carcinoma. TOHOKU J EXP MED 2011; 223:17-25. [PMID: 21187696 DOI: 10.1620/tjem.223.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Oral squamous cell carcinoma is one of the most frequent types of head and neck cancers in Japan. Although recent reports have shown positive results of non-surgical treatment for advanced head and neck squamous cell carcinoma, including tongue cancer, no clear treatment strategies have been established for oral cancers, except for tongue cancer. To assess appropriate therapies, we conducted a retrospective chart review of 114 Japanese patients with oral cancers that were pathologically diagnosed as squamous cell carcinoma, excluding tongue cancers. The overall and the disease specific 5-year survival rates were 53% and 61%, respectively. Univariate and multivariate analyses revealed a lower stage (I, II, or III) and non-surgical treatment as good and poor prognostic factors of oral squamous cell carcinoma, respectively, based on their hazard ratios of 0.17 (95% CI 0.045-0.60, p = 0.0061) and 5.3 (95% CI 2.7-11, p < 0.0001). Furthermore, impact of surgery was well documented in the operable stage IVa cancers (p = 0.00015). The surgical treatment consisted of the wide resection of the primary tumor and the neck dissection for stage III or IV tumors. The present data also suggest that adjunctive therapy, such as post-operative radiation therapy or post-operative chemo-radiation therapy, shows no survival benefit compared to the surgery alone. We therefore recommend the surgical treatment for advanced oral squamous cell carcinoma in Japanese patients. These results would be helpful in future clinical trials, especially in non-surgical treatment studies of oral squamous cell carcinoma in Japan.
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Affiliation(s)
- Takenori Ogawa
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan.
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Surgery alone provides long-term survival rates comparable to those of surgery plus postoperative radiotherapy for patients with adenoid cystic carcinoma of the palate. Oral Oncol 2011; 47:170-3. [DOI: 10.1016/j.oraloncology.2010.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Revised: 12/21/2010] [Accepted: 12/21/2010] [Indexed: 11/24/2022]
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27
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Montes DM, Carlson ER, Fernandes R, Ghali GE, Lubek J, Ord R, Bell B, Dierks E, Schmidt BL. Oral maxillary squamous carcinoma: An indication for neck dissection in the clinically negative neck. Head Neck 2010; 33:1581-5. [DOI: 10.1002/hed.21631] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 08/13/2010] [Accepted: 09/06/2010] [Indexed: 11/07/2022] Open
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28
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Abstract
Maxillary cancers include neoplasms arising in both maxillary sinus and oral cavity (upper alveolar ridge, hard palate) according to the American Joint Committee on Cancer. Although it is universally accepted that the combination of surgery and radiotherapy seems to be the treatment of choice, there is no accordance about the treatment of clinically negative neck. We retrospectively analyzed 20 patients with maxillary sinus cancer and 37 with an upper alveolar ridge or hard palate cancer, evaluating the incidence of N-disease and the recurrence at local site. On the basis of our findings, we can affirm that elective treatment of the neck in maxillary carcinoma is not recommended. Considering only squamous cell carcinoma, cervical node metastases are most frequent in case of tumors staged as T1 o T2. High-grade squamous cell carcinomas seem to be related to a higher incidence of nodal involvement. T recurrence has demonstrated to be the most frequent neoplastic event, so that radical surgery is considered one of the most important prognostic factors. Nevertheless, other prospective studies are necessary.
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29
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Squamous cell carcinoma of the maxillary gingiva, alveolus, and hard palate: is there a need for elective neck dissection? Br J Oral Maxillofac Surg 2010; 48:345-8. [DOI: 10.1016/j.bjoms.2009.07.012] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2009] [Indexed: 11/23/2022]
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30
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Wang TC, Hua CH, Lin CC, Tsou YA, Tseng HC, Tsai MH. Risk factors affect the survival outcome of hard palatal and maxillary alveolus squamous cell carcinoma: 10-year review in a tertiary referral center. ACTA ACUST UNITED AC 2010; 110:11-7. [DOI: 10.1016/j.tripleo.2009.11.035] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2009] [Revised: 11/06/2009] [Accepted: 11/20/2009] [Indexed: 11/16/2022]
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31
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Lin HW, Bhattacharyya N. Survival impact of nodal disease in hard palate and maxillary alveolus cancer. Laryngoscope 2009; 119:312-5. [DOI: 10.1002/lary.20054] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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32
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Oral Maxillary Squamous Cell Carcinoma: Management of the Clinically Negative Neck. J Oral Maxillofac Surg 2008; 66:762-6. [DOI: 10.1016/j.joms.2007.12.017] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Revised: 10/06/2007] [Accepted: 12/10/2007] [Indexed: 11/15/2022]
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33
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Binahmed A, Nason RW, Hussain A, Abdoh AA, Sándor GKB. Treatment outcomes in squamous cell carcinoma of the maxillary alveolus and palate: a population-based study. ACTA ACUST UNITED AC 2008; 105:750-4. [PMID: 18299238 DOI: 10.1016/j.tripleo.2007.09.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2007] [Revised: 09/06/2007] [Accepted: 09/07/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This population-based historical cohort study evaluates the treatment outcomes of primary squamous cell carcinoma of the maxillary alveolus and hard palate. METHODS A historical cohort of 37 cases of previously untreated biopsy-proven squamous cell carcinoma of the upper jaw registered in the Province of Manitoba from January 1975 to January 2004 was analyzed. RESULTS The tumor epicenter involved the maxillary alveolus in 26 patients and the hard palate in 11 patients. The mean age of the study population was 72.8 years and 67% were women with a documented tobacco use rate of 50%. Forty-one percent had stage I or II disease, 51% stage III or IV, and 8% could not be staged. Treatment included radiotherapy as a single modality (13.5%), surgery (38%), surgery and radiotherapy (24%), and palliative treatment (24%). Local recurrence was observed in 10 patients with 6 failing at the primary site. The absolute and disease-free survival at 5 years was 33% and 62% respectively. The 5-year disease-free survival was 82% for stage I and II and 48% for stage III and IV (P = .056). No patient treated with radiotherapy as a single treatment modality survived 5 years. Disease-free survival for patients treated with surgery, and surgery +/- radiotherapy, was 69% and 73% at 5 years, respectively (P = .001). CONCLUSIONS Squamous cell carcinoma of the maxillary alveolus and palate differs from other oral cancers in that the patients are relatively older with a slight female predilection. Treatment with surgery, with or without radiotherapy, appears to improve disease control.
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Affiliation(s)
- Abdulaziz Binahmed
- Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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34
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Zwetyenga N, Miquel L, Garuet A, Ricard AS, Majoufre-Lefebvre C, Demeaux H, Siberchicot F. Prise en charge du carcinome épidermoïde de la gencive supérieure et du palais dur. ACTA ACUST UNITED AC 2006; 107:80-5. [PMID: 16738512 DOI: 10.1016/s0035-1768(06)76993-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this retrospective study was to determine a rational of treatment of squamous-cell carcinoma of the upper gum and hard palate. PATIENTS AND METHOD We analyzed retrospectively a series of 34 patients treated over a period of 11 years. RESULTS There were 19 women (76%); mean age was 67.3 years; 76% had advanced tumors; 28% had neck nodes. The 5-year survival rate was 33.7%; patients without node involvement had better prognosis (p=0.034). The 5-year rate of recurrence-free survival was 61%; patients without node involvement had better prognosis (p = 0.032). At the end of the study, only 42% of patients were still alive. DISCUSSION This type of tumor is different from those of other locations in the oral cavity or oropharynx. At the present time, surgery associated or not with post-operative radiotherapy seems to be optimal curative treatment. The question of whether neck dissection should be performed remains debated for patients without clinically nodes.
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Affiliation(s)
- N Zwetyenga
- Service de Chirurgie Maxillo-faciale et Stomatologie, CHU de Bordeaux.
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