Despite early diagnosis and treatment, almost 20% of patients with early-stage (cT1-cT2N0) oral tongue squamous cell carcinoma (OTSCC) still die of their disease. The prognosis of OTSCC patients is influenced by several demographic, clinical, and histopathologic factors. The aim of this multicenter international study was to find which of the factors age, gender, stage, grade, lymphocytic host response, perineural invasion, worst pattern of invasion, or depth of invasion has the strongest prognostic power in early-stage OTSCC. Patient data of 479 patients with early-stage (cT1-2N0) OTSCC in Finland, Brazil, and the USA were retrieved and analyzed using Cox proportional hazards regression models. Our results indicate that depth of invasion (DOI) and worst pattern of invasion (WPOI) are the strongest pathological predictors for locoregional recurrence, with a hazard ratio (HR) for 4 mm DOI of 1.67 (95% confidence interval (CI) 1.07-2.60) and HR for WPOI of 1.46 (95% CI 0.95-2.25). In addition, mortality from early OTSCC was also predicted by DOI (HR 2.44, 95% CI 1.34-4.47) and by WPOI (HR 2.34, 95% CI 1.26-4.32). We suggest that clinically early-stage oral tongue carcinomas 4 mm or deeper, or with a growth pattern of small cell islands or satellites, should be considered as high-risk tumors which require multimodality treatment.
Our results demonstrated that immunodetection of activin A can be useful for prognostication of oral tongue SCC, revealing patients with occult lymph node metastasis and lower overall survival.
Background
Mucoepidermoid carcinoma is the most common malignant tumor of salivary glands. Apoptosis plays an important role in organogenesis of glandular structures, and aberrations of apoptotic mechanisms is associated with a wide array of pathologic conditions.
Methods
The immunoexpression of proteins associated with apoptosis and proliferation was evaluated in 40 mucoepidermoid carcinoma cases.
Results
Par‐4, Survivin, MUC1, PHLDA1, Fas, and Ki‐67 were predominantly expressed in mucoepidermoid carcinoma. FasL was rarely expressed, and Caspase‐3 expression was observed in almost 50% of the cases. SPARC expression was associated with low‐grade tumors, and Ki‐67 expression was associated with lymph node metastasis. Expression of Fas and decreased expression of Ki‐67 and Caspase‐3 were associated with better overall cancer‐specific survival rates.
Conclusions
The association of SPARC and Ki‐67 expression with pathological features and the association of Fas, Caspase‐3, and Ki‐67 with survival probabilities suggest that these proteins may be useful prognostic markers for mucoepidermoid carcinoma.
A mucosite oral é uma complicação comum e dose-limitante do tratamento oncológico. A mucosite grave pode tornar necessária a alteração ou até mesmo a interrupção do tratamento com sérias conseqüências na resposta tumoral e sobrevida do paciente, aumentando o risco de infecções local e sistêmica. As lesões aparecem mais comumente na mucosa não-queratinizada. Os sinais e os sintomas variam desde um leve desconforto até lesões ulcerativas graves, comprometendo a nutrição e a ingestão hídrica do paciente. O laser de baixa intensidade tem sido proposto para o tratamento da mucosite oral, com resultados satisfatórios dos pontos de vista clínico e funcional, acelerando o processo de cicatrização das feridas e diminuindo o quadro doloroso. Este artigo, ilustrado por dois casos clínicos realizados no Hospital do Câncer de Pernambuco, tem como objetivo relatar a eficiência do laser de baixa potência no tratamento da mucosite oral induzida pela radioterapia.
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