Survival rate trends in oral squamous cell carcinoma
A retrospective hospital-based study that reviewed and evaluated the outcome of 334 patients with oral squamous cell carcinoma (OSCC), aimed to identifying factors affecting the clinical course and survival rate. The analysis revealed a statistically significant relationship among histological Broder's grading of malignancy, tumour size, locoregional involvement, and survival rates, highlighting the importance of tumour differentiation in predicting the clinical course and outcome of OSCC. Dr Paolo Arduino, Associate Professor at the Department of Biomedical Sciences and Human Oncology, University of Turin, Italy, explained the outcomes of the research.
Question: What does the current evidence state about the prognostic factors in OSCC?
Paolo Arduino: Although in recent years different biological and molecular factors have been proposed as prognostic factors in oral cancer, these have so far yet to impact on routine clinical care, and comprehensive histopathological staging of pathological specimens is still a significant determinant of post-operative management and prognosis prediction. TNM stage, the grade and the depth of invasion of the tumour seem to have still an important effect on the course of the disease.
However, it may be stated that the prognostic value of the classical clinicopathological parameters is often uncertain and controversial. Although many risk factors associated with oral cancer have been documented, few clinical studies about this topic have been conducted in Northern Italy. The purpose of this retrospective study was to analyze the outcome of patients with oral cancer, treated by different modalities, and to identify factors that may affect survival rate.
Question: What were the most significant outcomes of your study?
Paolo Arduino: Gender and risk factors seemed not to be related with prognosis, while we found a significant increase in mortality for patients older than 70. Histological grading, size of tumour and neck involvement were related, as independent factors, in predicting survival in patients with OSCC (QM-H>3.9). Gender, age and risk factors had no statistical relationship with cancer histological differentiation, differently from tumour size and neck involvement. Our study revealed the value of grade, size and node involvement as autonomous prognostic factors in predicting survival in patients with OSCC. According to this, histological grade, as originally described by Broders, can still be taken as a useful “prognosticator”, especially because it is simple and well known by pathologists. However, it is still essential for the pathologists and the surgeon to communicate efficiently regarding the histological feeling of the tumours using grading systems as a device to assist in standardizing diagnosis.
Question: How do you hope your study will be used in the treatment and prognostics of OSCC?
Paolo Arduino: Even if the future is still the molecular diagnosis, clinical prognostic factors should be carefully analyzed by a physician working in the field of oral medicine.
Question: Will you conduct further research in this area?
Paolo Arduino: We will continue to research in the field of oral cancer, trying to find predictive prognostic factors, which can improve patients’ survival. Genetic research will certainly be an issue in the future. Future work should analyse the influence of these prognostic factors and the results of therapy in a selective manner for each sub-site of the oral cavity. However, it is possible that, in the future, no solo prognostic factor will be the key, but management should be based on a wide-ranging consideration of multiple combined factors.
Send your comments and questions to
editorial@dental-learninghub.com
Full article
‘Clinical and Histopathologic Independent Prognostic Factors in Oral Squamous Cell Carcinoma: A Retrospective Study of 334 Cases’
Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 8, August 2008, Pages 1570-1579
 |
USA: The purpose of a paper by Professor Joel Epstein from the Department of Oral Medicine and Diagnostic Sciences at the University of Illinois, Chicago, was to review and update advances in stem cell transplant for oral health care providers.
|
 |
Following the success of its inaugural congress in 2007, the International Academy of Oral Oncology will host the Second World Congress in Toronto, Canada on 8-11 July 2009. Registration is now open and abstract submission for oral and poster presentations will be accepted until 1 December 2008.
|
 |
The schools of thought on the treatment of temporomandibular disorders (TMD) focus on the relationship between pain and movement. It remains unclear how the two symptoms influence each other and both the Vicious Cycle Theory and Pain Adaptation Model have limitations and advantages. To address this, researchers from the Faculty of Dentistry at Sydney University, Australia, have created an integrated model that includes elements of both, emphasising individual reaction to pain and a tailored approach towards management. Professor Greg Murray spoke to Dental Learning Hub about the proposed model and how it could benefit the TMD patient.
|
 |
Researchers at the University of Leeds, UK, have discovered a novel method of preventing plaque formation, using photo dynamic therapy (PDT). Delivered through a mouthwash containing an anti-bacterial agent activated by bright light, studies have shown that oral bacteria can be destroyed. According to Dr Simon Wood, clinical trails will start in the next few months to develop this product further. He spoke to Dental Learning Hub about the research and how PDT works.
|
 |
A study to develop mouldable, mechanically strong and in situ hardening calcium phosphate cement (CPC) composite scaffolds for bone regeneration showed positive results with potential applications in various dental, craniofacial, and orthopaedic reconstructions. The CPC scaffolds were strong, tough, macroporous and osteoconductive and showed potential for injection in minimally invasive surgeries, and in delivering osteogenic cells and osteoinductive growth factors to promote bone regeneration. Professor Hockin Xu from the Department of Endodontics, Prosthodontics and Operative Dentistry, at the University of Maryland Dental School in Baltimore, explained why the study is significant.
|
 |
A study designed to investigate the effect of compression with ice and compression alone on pain and quality of life after surgical removal of mandibular third molars, revealed that compression is an effective pain prevention method. The research was based around a prospective, single-blind, randomized controlled study. Although there were no significant differences postoperatively between groups with ice compression and compression alone, both registered a reduction in pain and significantly better quality of life. Dr Tim Forouzanfar from the Department of Oral and Maxillofacial Surgery/Oral Pathology at VU University Medical Center/Academic Centre for Dentistry Amsterdam, The Netherlands, provided some insight into the study.
|
 |
A retrospective hospital-based study that reviewed and evaluated the outcome of 334 patients with oral squamous cell carcinoma (OSCC), aimed to identifying factors affecting the clinical course and survival rate. The analysis revealed a statistically significant relationship among histological Broder's grading of malignancy, tumour size, locoregional involvement, and survival rates, highlighting the importance of tumour differentiation in predicting the clinical course and outcome of OSCC. Dr Paolo Arduino, Associate Professor at the Department of Biomedical Sciences and Human Oncology, University of Turin, Italy, explained the outcomes of the research.
|
 |
Toothbrushes are rapidly contaminated with different microorganisms, which colonize the oral cavity and interdental spaces, which is a risk can for possible infection or reinfection. In a recent study, the ozone experimental effect upon toothbrushes microflora was estimated microbiologically before and after saturation with ozone gas and was found to remove the microbiota following conventional brushing. Professor Eugenia Bezirtzoglou from the Democritus University of Thrace, Greece, explained the significance of the outcomes.
|
 |
In a prospective cohort study on male health professionals, periodontal disease was associated with a small, but significant, increase in overall cancer risk, which persisted in never-smokers. Similar research up till now has suggested that tooth loss and periodontal disease might increase the risk of developing various cancers; however, smoking might have confounded the reported associations. Dental Learning Hub asked Dr Dominique Michaud, reader in cancer epidemiology at the Department of Epidemiology and Public Health at Imperial College London, UK, about the results and why this study is unique.
|