Background:To evaluate the possible association between paediatric head computed tomography (CT) examination and increased subsequent risk of malignancy and benign brain tumour.Methods:In the exposed cohort, 24 418 participants under 18 years of age, who underwent head CT examination between 1998 and 2006, were identified from the Taiwan National Health Insurance Research Database (NHIRD). Patients were followed up until a diagnosis of malignant disease or benign brain tumour, withdrawal from the National Health Insurance (NHI) system, or at the end of 2008.Results:The overall risk was not significantly different in the two cohorts (incidence rate=36.72 per 100 000 person-years in the exposed cohort, 28.48 per 100 000 person-years in the unexposed cohort, hazard ratio (HR)=1.29, 95% confidence interval (CI)=0.90–1.85). The risk of benign brain tumour was significantly higher in the exposed cohort than in the unexposed cohort (HR=2.97, 95% CI=1.49–5.93). The frequency of CT examination showed strong correlation with the subsequent overall risk of malignancy and benign brain tumour.Conclusions:We found that paediatric head CT examination was associated with an increased incidence of benign brain tumour. A large-scale study with longer follow-up is necessary to confirm this result.

BACKGROUND. The number of patients with oral cavity squamous cell carcinoma (OSCC) is increasing. Because the characteristics of patients with OSCC who develop distant metastases (DM) remain uncertain, the authors analyzed potential risk factors. METHODS. For this report, the authors retrospectively reviewed data from 889 consecutive patients with OSCC who underwent radical surgery from January 1996 to November 2004. Patients were divided into 2 groups according to whether they had either achieved locoregional control (Group A; n = 678 patients) or developed a locoregional recurrence (Group B; n = 211 patients). Cox proportional‐hazards models were used to identify independent predictors of the 5‐year DM rate. RESULTS. In the entire study cohort, the 5‐year DM rate was 9.6% (6.6% for Group A and 21.4% for Group B). In Group A, the number of positive lymph nodes (≥5; P = .009) and the presence of extracapsular spread (ECS) (P < .001) were independent risk factors for DM. In Group B, the presence of ECS (P = .008), poor differentiation (P = .040), pathological stage ≥III (P = .036), and the presence of neck recurrence (P = .001) were independent prognosticators. CONCLUSIONS. The current results indicated that different risk factor categories according to locoregional control may be used to facilitate the selection of appropriate management for patients with OSCC after they undergo radical surgery. Cancer 2007. © 2007 American Cancer Society.

BACKGROUND. Relapse of tumors in patients with oral cavity squamous cell carcinoma (OSCC) is associated with a poor prognosis. In addition, salvage therapy may be a significant source of morbidity in patients with relapsing OSCC. The objective of the current study was to determine prognostic factors that predict which patients may benefit from such treatment. METHODS. From 953 patients who underwent primary radical surgery between 1996 and 2005, 272 patients with early‐relapsed OSCC (n = 161) or late‐relapsed OSCC (n = 111) were identified. The optimum cutoff point for relapse was chosen on the basis of 5‐year disease‐specific survival (DSS) and overall survival (OS). RESULTS. The optimal cutoff value for relapse was 10 months. Late relapses were associated with a better prognosis than relapses that occurred within the first 10 months (P < .0001 for both 5‐year DSS and 5‐year OS). Among patients with early‐relapsed OSCC, a primary tumor depth <10 mm was associated significantly and independently with a better 5‐year DSS (P = .014) and OS (P = .011). Among patients with late‐relapsed OSCC, neck recurrence was a significant risk factor for adverse outcomes (P < .001 for both 5‐year DSS and 5‐year OS). CONCLUSIONS. A late relapse was associated with better survival than a relapse that occurred within the first 10 months. Patients with late‐relapsed OSCC may benefit from salvage therapy, especially those who have a local recurrence. Among patients with early‐relapsed OSCC, salvage therapy should be considered for those who have a primary tumor depth <10 mm. Cancer 2008. © 2007 American Cancer Society.

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The association of MDTC with improved outcomes may be potentially explained by a better therapeutic alliance between the patient and the tumor board, and/or a greater thoroughness in clinical management. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1544-E1553, 2016.

Clinical outcome of patients with oral cavity squamous cell carcinoma (OSCC) and contralateral neck recurrence (CLNR) remains poor. We sought to identify factors associated with CLNR and incorporate them into a risk stratification scheme. Between January 1996 and June 2006, a total of 913 consecutive OSCC patients treated by radical surgery were investigated. Postoperative adjuvant therapy was performed in the presence of pathological risk factors. The duration of follow-up was at least 24 months in all surviving patients. Outcome measures were the 5-year CLNR and overall survival rates. In the entire study cohort, the 5-year CLNR rate was 7% (55/913). Specifically, it was 18% (17/132) in patients with local recurrence (LR), and 5% (38/781) in those without (P = 0.0002). In multivariate analysis, extracapsular spread (ECS) was the only independent risk factor for CLNR in patients with LR. Tumor subsite, poor differentiation, and presence of pN + disease were significant predictors of CLNR in patients without LR. We identified two groups of patients with high CLNR rates. The first group consisted of patients with ECS at the initial diagnosis and LR. The second group consisted of subjects with tongue cancer without LR harboring at least two risk factors. We conclude that, in patients who achieved local control, postoperative contralateral neck treatment is recommended for subjects with tongue cancer and at least two risk factors. Once LR occurs, contralateral neck treatment is recommended in patients with ECS.