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Sultan Qaboos University Medical Journal Feb 2024This study aimed to analyse the association of tumour budding (TB) and tumour-stroma ratio (TSR) with clinicopathological parameters that can be easily viewed on routine...
OBJECTIVES
This study aimed to analyse the association of tumour budding (TB) and tumour-stroma ratio (TSR) with clinicopathological parameters that can be easily viewed on routine haematoxylin and eosin (H&E)-stained slides to provide an easy and cost-effective method for prognosticating oral squamous cell carcinoma (OSCC).
METHODS
This study was conducted at the ESIC Medical College and Hospital in Faridabad, India, from July 2022 to October 2022. In patients with histologically diagnosed OSCC, TB and TSR were evaluated via routine H&E-stained sections and correlated with clinicopathological parameters. Statistical analysis was performed using Chi-squared test.
RESULTS
A total of 50 patients were included. The mean age of participants was 61 ± 12.72, and the male-to-female ratio was 7.1:1. Most of the tumours were located on the tongue (46%), followed by the buccal mucosa (26%), gingivobuccal sulcus (12%) and retromolar trigone (8%). The palate and alveolus were the other sites involved, constituting 4% each. TB and TSR were both found to be significantly associated with the tumour grade, lymph node metastasis and tumour size. A highly significant correlation was also found between TB and TSR ( = 0.001).
CONCLUSIONS
Both TB and TSR can be easily evaluated on routine H&E sections; they are highly reproducible and were found to be reliable independent prognostic markers in OSCC. Therefore, this simple and cost-effective method of prognostication, which is currently lacking in clinical practice, will help clinicians to identify patients with poor prognosis and thus individualise their treatment plan.
Topics: Humans; Female; Male; Carcinoma, Squamous Cell; Mouth Neoplasms; Squamous Cell Carcinoma of Head and Neck; Hospitals; Head and Neck Neoplasms
PubMed: 38434449
DOI: 10.18295/squmj.9.2023.048 -
Maxillofacial Plastic and... Mar 2024Oral squamous cell carcinoma has a poor prognosis. Therefore, prognostic factors are important to increase the survival rate. This study assessed the survival rate and...
BACKGROUND
Oral squamous cell carcinoma has a poor prognosis. Therefore, prognostic factors are important to increase the survival rate. This study assessed the survival rate and the prognostic factors for survival of patients with oral squamous cell carcinoma.
METHOD
This study included 168 patients who underwent surgery for oral squamous cell carcinoma between January 2006 and December 2021. The survival rate was analyzed with overall survival and disease-specific survival. The patient's age, sex, pTNM stage, primary sites (lip, tongue, mouth of floor, mandibular gingiva, maxillary gingiva, mandibular vestibule, maxillary vestibule, retromolar trigone, palate, buccal mucosa, primary intra-osseous site), smoking and alcohol drinking habits, depth of invasion, perineural and lymphovascular invasion, cell differentiation, and postoperative radiotherapy were evaluated to analyze risk factors. Kaplan-Meier methods were used to estimate the survival rates. Cox regression methods were used to investigate the main independent predictors of survival in univariable and multivariable analysis.
RESULTS
Sixty-eight patients died of oral squamous cell carcinoma during follow-up periods. Their overall survival for 5 years was 51.2%, and the disease-specific survival was 59.2%. In univariable analysis, seven factors which are neck metastasis, depth of invasion, cell differentiation, lymphovascular invasion, postoperative radiotherapy, pTNM stage, and recurrence were significantly associated with survival. In multivariable analysis, pTNM stage and recurrence were significantly associated with survival.
CONCLUSION
In patients with oral squamous cell carcinoma, pTNM stage and recurrence were significant prognostic factors. Neck metastasis, depth of invasion, cell differentiation, lymphovascular invasion, and postoperative radiotherapy were also prognostic factors. These factors serve as markers for obtaining prognosis information in oral squamous cell carcinoma.
PubMed: 38433140
DOI: 10.1186/s40902-024-00410-3 -
Journal of Applied Clinical Medical... May 2024To quantify the impact of treatment planning system beam model parameters, based on the actual spread in radiotherapy community data, on clinical treatment plans and...
A radiotherapy community data-driven approach to determine which complexity metrics best predict the impact of atypical TPS beam modeling on clinical dose calculation accuracy.
PURPOSE
To quantify the impact of treatment planning system beam model parameters, based on the actual spread in radiotherapy community data, on clinical treatment plans and determine which complexity metrics best describe the impact beam modeling errors have on dose accuracy.
METHODS
Ten beam modeling parameters for a Varian accelerator were modified in RayStation to match radiotherapy community data at the 2.5, 25, 50, 75, and 97.5 percentile levels. These modifications were evaluated on 25 patient cases, including prostate, non-small cell lung, H&N, brain, and mesothelioma, generating 1,000 plan perturbations. Differences in the mean planned dose to clinical target volumes (CTV) and organs at risk (OAR) were evaluated with respect to the planned dose using the reference (50th-percentile) parameter values. Correlation between CTV dose differences, and 18 different complexity metrics were evaluated using linear regression; R-squared values were used to determine the best metric.
RESULTS
Perturbations to MLC offset and transmission parameters demonstrated the greatest changes in dose: up to 5.7% in CTVs and 16.7% for OARs. More complex clinical plans showed greater dose perturbation with atypical beam model parameters. The mean MLC Gap and Tongue & Groove index (TGi) complexity metrics best described the impact of TPS beam modeling variations on clinical dose delivery across all anatomical sites; similar, though not identical, trends between complexity and dose perturbation were observed among all sites.
CONCLUSION
Extreme values for MLC offset and MLC transmission beam modeling parameters were found to most substantially impact the dose distribution of clinical plans and careful attention should be given to these beam modeling parameters. The mean MLC Gap and TGi complexity metrics were best suited to identifying clinical plans most sensitive to beam modeling errors; this could help provide focus for clinical QA in identifying unacceptable plans.
Topics: Humans; Radiotherapy Planning, Computer-Assisted; Radiotherapy Dosage; Radiotherapy, Intensity-Modulated; Organs at Risk; Neoplasms; Particle Accelerators; Algorithms
PubMed: 38427776
DOI: 10.1002/acm2.14318 -
European Archives of... May 2024The involvement of the anterior commissure (AC) is regarded to be a risk factor for poor results after transoral laser microsurgery (TLM) for early glottic cancer. The...
PURPOSE
The involvement of the anterior commissure (AC) is regarded to be a risk factor for poor results after transoral laser microsurgery (TLM) for early glottic cancer. The objective of this study was to determine how AC-related clinical and radiological factors affected oncological outcomes in a cohort of patients with T1 stage early glottic carcinoma involving the anterior commissure who were treated with TLM with negative surgical margins.
METHODS
Retrospective analysis was performed on clinical, radiological, and follow-up data of patients consecutively treated with TLM at a tertiary academic center between November 2011 and August 2021 for T1 glottic squamous cell carcinoma involving the anterior commissure. Recurrence-free survival (RFS), local control with laser alone (LCL), laryngeal preservation (LP), and overall survival (OS) rates (Kaplan-Meier) were the primary outcome metrics.
RESULTS
In our series, 5-year OS probability was 75.1%, RFS was 64.8%, LCL was 73.8%, and LP was 83.4%. OS and RFS were higher in patients with early stages of AC pattern than in patients with advanced stage (p = 0.004, p = 0.034, respectively). Vertical extension ratio was found to be associated with OS and RFS (p = 0.023, p = 0.001, respectively), and thyroid cartilage interlaminar angle with LCL by multiple Cox regression analysis (p = 0.041).
CONCLUSION
TLM remains a valuable treatment option for AC involvement. AC3 type involvement and elevated vertical extension ratio were associated with negative prognosis. There have been signs that thyroid cartilage with a narrow angle increases recurrence. Alternative modalities should be kept in mind in the treatment decision of these cases.
Topics: Humans; Laryngeal Neoplasms; Carcinoma, Squamous Cell; Retrospective Studies; Microsurgery; Glottis; Tongue Neoplasms; Laser Therapy; Head and Neck Neoplasms; Treatment Outcome; Neoplasm Staging; Neoplasm Recurrence, Local
PubMed: 38424299
DOI: 10.1007/s00405-024-08513-3 -
Frontiers in Bioscience (Landmark... Feb 2024Clinical indexes are often selected as relevant factors for constructing prognostic models of tongue squamous cell carcinoma (TSCC) patients, while factors related to...
BACKGROUND
Clinical indexes are often selected as relevant factors for constructing prognostic models of tongue squamous cell carcinoma (TSCC) patients, while factors related to therapeutic targets are less frequently included. As Apigenin (API) shows anti-tumor properties in many tumors, in this study, we construct a novel prognostic model for TSCC patients based on Apigenin-associated genes through transcriptomic analysis.
METHODS
The effect of Apigenin (API) on the cell characteristics of TSCC cells was measured by several phenotype experiments. RNA-seq was executed to ensure differentially expressed genes (DEGs) in squamous cell carcinoma-9 (SCC-9) cells after API treatment. Furthermore, reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry were performed to verify the expression of API-related genes. Then, combined with the gene expression data and relevant individual information of TSCC samples acquired from The Cancer Genome Atlas (TCGA), an API-related model was built through Lasso regression and multivariate Cox regression. A receiver operating characteristic (ROC) curve and a nomogram and calibration curve were created to forecast patient outcomes to improve the clinical suitability of the API-related signature. The relationships between the two risk groups and function enrichment, immune infiltration characteristics, and drug susceptibility were analyzed.
RESULTS
We demonstrated that API could inhibit the malignant behavior of TSCC cells. Among API-related genes, TSCC cells treated with API, compared to the control group, have higher levels of transmembrane protein 213 (TMEM213) and G protein-coupled receptor 158 (GPR158), and lower levels of caspase 14 (CASP14) and integrin subunit alpha 5 (ITGA5). An 7 API-associated gene model was built through Lasso regression and multivariate Cox regression that could direct TSCC prognostic status and tumor immune cell infiltration. In addition, we acquired 6 potential therapeutic agents for TSCC based on the prognostic model.
CONCLUSIONS
Our research suggested the inhibition effect of API on TSCC cells and provided a novel prognostic model combined with therapeutic factors that can guide the prognosis of TSCC and clinical decision-making in TSCC.
Topics: Humans; Tongue Neoplasms; Carcinoma, Squamous Cell; Apigenin; Prognosis; Tongue
PubMed: 38420803
DOI: 10.31083/j.fbl2902065 -
Journal of the Korean Association of... Feb 2024There are very few case reports of the diagnosis and management of concurrent oral cavity and parapharyngeal space tumors. We present a case involving a 49-year-old...
There are very few case reports of the diagnosis and management of concurrent oral cavity and parapharyngeal space tumors. We present a case involving a 49-year-old female who presented with oral cavity squamous cell carcinoma confirmed by biopsy. Initial diagnostic workup revealed a concurrent parapharyngeal mass. Diagnostic studies and surgical therapy were tailored to account for both pathological entities. The patient was treated with a combination of surgery and adjuvant therapy. The surgical strategy was designed to address both lesions simultaneously. One year post-surgery, the patient had good response to therapy with no evidence of persistent or recurrent disease. This report discusses the outcome and treatment of a rare case of concurrent squamous cell carcinoma with a complicating parapharyngeal space tumor. It explores the diagnostic process, comprehensive workup, and the surgical management.
PubMed: 38419522
DOI: 10.5125/jkaoms.2024.50.1.56 -
BMC Oral Health Feb 2024Tongue squamous cell carcinoma (TSCC) is the most common oral cavity cancer, and p16 immunohistochemistry is an exact and available tool in the prognostic and predictive...
BACKGROUND
Tongue squamous cell carcinoma (TSCC) is the most common oral cavity cancer, and p16 immunohistochemistry is an exact and available tool in the prognostic and predictive characterization of squamous cell cancers in the head and neck. Microorganisms have a close relationship with the development of TSCC. However, the association between oral bacteria and p16 status has not been well defined in the case of TSCC. Compared with traditional clinical microbial collection methods, formalin-fixed paraffin-embedded (FFPE) tissue samples have several advantages.
METHODS
To compare the microbiota compositions between p16-positive and p16-negative patients with TSCC, we performed a small pilot study of microbiological studies of TSCC by paraffin tissue. DNA from FFPE tissue blocks were extracted and microbiomes were profiled by sequencing the 16 S-rRNA-encoding gene (V1-V2/V3-V4/V4 regions). Alterations in the functional potential of the microbiome were predicted using PICRUSt, Tax4Fun, and BugBase.
RESULTS
A total of 60 patients with TSCC were enrolled in the study, however, some challenges associated with DNA damage in FFPE tissues existed, and only 27 (15 p16-positive and 12 p16-negative) passed DNA quality control. Nevertheless, we have tentatively found some meaningful results. The p16 status is associated with microbiota diversity, which is significantly increased in p16-positive patients compared with p16-negative patients. Desulfobacteria, Limnochordia, Phycisphaerae, Anaerolineae, Saccharimonadia and Kapabacteria had higher abundances among participants with p16-positive. Moreover, functional prediction revealed that the increase of these bacteria may enhance viral carcinogenesis in p16-positive TSCC.
CONCLUSIONS
Bacterial profiles showed a significant difference between p16-positive TSCC and p16-negative TSCC. These findings may provide insights into the relationship between p16 status and the microbial taxa in TSCC, and these bacteria may provide new clues for developing therapeutic targets for TSCC.
Topics: Humans; Carcinoma, Squamous Cell; Pilot Projects; Paraffin Embedding; Tongue Neoplasms; Formaldehyde; DNA; Microbiota; Tongue; Papillomavirus Infections
PubMed: 38419008
DOI: 10.1186/s12903-024-04051-w -
American Journal of Otolaryngology 2024The epidemiology and management of oral cavity cancer have changed considerably in recent decades. This study examines epidemiological and management trends in oral...
INTRODUCTION
The epidemiology and management of oral cavity cancer have changed considerably in recent decades. This study examines epidemiological and management trends in oral cavity squamous cell carcinoma (OCSCC).
METHODS
A retrospective cohort study of data from the National Cancer Registry of Ireland between 1994 and 2014.
RESULTS
A total of 2725 patients were identified. The most common subsites were the tongue (34 %, n = 1025), lip (19 %, n = 575), floor of mouth (FOM) (18 %, n = 550), and retromolar trigone (RMT) (6 %, n = 189). The incidence of OCSCC remained largely unchanged (3.14 cases/100000/year) during the study period. 5-year disease-specific survival (DSS) was 58.6 % overall, varying between subsites (lip 85 %, RMT 62.9 %, tongue 54.7 %, and FOM 47.3 %). DSS improved over the study period (p = 0.03), in particular for tongue primaries (p = 0.007). Primary surgery significantly improved DSS versus radiotherapy (HR 0.28, p < 0.0001). Survival of T4 disease managed surgically was superior to that of T1 disease managed with radiotherapy. In node positive patients, chemotherapy improved overall survival (HR 0.8 p = 0.038) but not DSS (HR 0.87 p = 0.215).
CONCLUSION
Primary surgery remains the standard of care in the management of OCSCC. Prognosis has improved in line with an increase in the use of primary surgery in the same time frame, though the incidence remains unchanged.
Topics: Humans; Male; Ireland; Female; Retrospective Studies; Mouth Neoplasms; Middle Aged; Aged; Carcinoma, Squamous Cell; Incidence; Registries; Survival Rate; Adult; Neoplasm Staging; Aged, 80 and over; Cohort Studies
PubMed: 38417262
DOI: 10.1016/j.amjoto.2024.104235 -
Cureus Feb 2024Nodular fasciitis (NF) is a benign, self-limiting condition that is often misdiagnosed due to its resemblance to other lesions. Although NF is common, its occurrence in...
Nodular fasciitis (NF) is a benign, self-limiting condition that is often misdiagnosed due to its resemblance to other lesions. Although NF is common, its occurrence in the oral cavity is rare and particularly challenging for both clinicians and pathologists. To date, no case has been reported in the retromolar area of the oral cavity.A 49-year-old male patient presented with a painless, rapidly growing, firm nodule in the right retromolar area. Histopathological examination revealed spindle cell proliferation with characteristics of NF and immunohistochemical analysis confirmed the diagnosis. The lesion was treated by conservative surgical excision, without recurrence at a one-year follow-up. In the current case, 54 cases of oral nodular fasciitis (ONF) have been documented. The majority of ONF-affected individuals are in their 40s, with a 1:1 male-to-female ratio. The buccal mucosa was the most commonly involved site followed by the tongue and labial mucosa. Histopathologically, the most prominent features were the proliferation of uniform spindle-shaped cells within a myxomatous and/or fibrotic background. A positive smooth muscle actin (SMA) stain was a consistent finding. Complete local excision remains the preferred treatment method, and no recurrences have been reported. This report underscores the importance of considering NF in the differential diagnosis of oral spindle cell lesions and emphasizes the need for a comprehensive evaluation to guide appropriate management.
PubMed: 38405650
DOI: 10.7759/cureus.54803