disease-free survival

Study identifies patients best suited to second round of head-and-neck treatment

Source: http://www.oncologynurseadvisor.com/ Author: Delicia Honen Yard A small group of patients with recurrent or second primary head and neck cancer achieved long-term cure after undergoing concomitant chemotherapy with reirradiation. However, the associated risk of severe toxicity demonstrated that only carefully selected patients should undergo treatment readministration. Joseph Salama, MD, formerly with the University of Chicago (Illinois), and colleagues analyzed data from 166 patients with head and neck cancer who had received a first round of radiation followed by a second round plus chemotherapy because their cancer recurred or because they developed a new tumor. After a median follow-up of 53 months among surviving patients, median overall survival was 10.3 months. The 2-year rates for overall survival, disease-free survival, locoregional control, and freedom from distant metastasis were 24.8%, 19.9%, 50.7%, and 61.4%, respectively. Despite yielding a 2-year cure rate of nearly a quarter of the subjects, the second course of treatment was highly toxic: 33 participants (19.9%) died of treatment-related toxicity, and some lost the ability to speak or swallow. The investigators found that certain patients benefited from the second treatment over others: Those who were cancer-free for a longer period of time, did not have chemotherapy with their first course of radiation, were treated with a higher dose of radiation in their second round, and had surgical resection or debulking prior to the second course of radiation were more likely to be cured at 2 years than those who had none or only some of these features. “This can help doctors determine [...]

Oral Cancer Foundation News Team - A2011-07-03T09:12:41-07:00July, 2011|Oral Cancer News|

Comparative prognostic value of HPV16 E6 mRNA compared with in situ hybridization for human oropharyngeal squamous carcinoma

Source: Journal of Clinical Oncology, Vol 27, No 36 (December 20), 2009: pp. 6213-6221 Authors: Wei Shi et al. Purpose: A significant proportion of oropharyngeal squamous cell carcinomas (OSCC) are associated with the human papilloma virus (HPV), particularly HPV16. The optimal method for HPV determination on archival materials however, remains unclear. We compared a quantitative real-time polymerase chain reaction (qRT-PCR) assay for HPV16 mRNA to a DNA in situ hybridization (ISH) method, and evaluated their significance for overall (OS) and disease-free (DFS) survival. Patients and Methods: Matched, archival biopsies from 111 patients with OSCC were evaluated for HPV16 using a qRT-PCR for E6 mRNA and ISH for DNA. Immunohistochemistry for p16, p53, and epidermal growth factor receptor were also performed. Results: HPV16 E6 mRNA was positive in 73 (66%) of 111 samples; ISH was positive in 62 of 106 samples (58%), with 86% concordance. P16 was overexpressed in 72 samples (65%), which was strongly associated with HPV16 status by either method. E6 mRNA presence or p16 overexpression were significantly associated with superior OS; E6 mRNA, HPV16 ISH, or p16 were all significantly associated with DFS. On multivariate analysis adjusted for age, stage, and treatment, positive E6 mRNA was the only independent predictor for superior OS; for DFS, p16 expression or HPV16 status determined by either method was significant. Conclusion: The prevalence of HPV16 in OSCC ranges from 58% to 66%, in a recently treated Canadian cohort. Classification of HPV-positivity by HPV16 E6 mRNA, HPV16 ISH or p16 immunohistochemistry (IHC) is [...]

Oral Cancer Foundation News Team - A2009-12-19T23:04:23-07:00December, 2009|Oral Cancer News|

Does the negative node count affect disease-free survival in early-stage oral cavity cancer?

Source: J Oral Maxillofac Surg, November 1, 2009; 67(11): 2473-5 Authors: FL Ampil, G Caldito, GE Ghali, and RG Baluna Purpose: We performed a retrospective study to determine whether there is a relationship between disease-free survival and negative lymph node count in patients with resected early-stage oral cavity cancers. Materials and Methods: Of the 526 individuals diagnosed with carcinoma of the oral cavity between 1998 and 2005, 52 had undergone primary tumor resection and lymph node dissection of the neck for stage I or II disease. With a mean count of 27 examined negative nodes, these 52 patients were separated into groups with fewer than 27 or > or = 27 uninvolved lymph nodes and compared for disease-free survival. Results: The tumor recurred or progressed in 10 patients (19%) during a median follow-up of 27 months. The 2-year disease-free survival rates were 75% and 78% in individuals with fewer than 27 and > or = 27 uninvolved node counts, respectively (P > .78). Conclusion: The removal of a greater number of regional, uninvolved cervical lymph nodes does not correlate with disease-free survival in this particular cohort of patients. Authors' affiliation: Division of Therapeutic Radiology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA

Oral Cancer Foundation News Team - A2009-10-27T05:15:46-07:00October, 2009|Oral Cancer News|

Surgery effective in achieving local control of tongue cancer

Source: www.docguide.com Author: Louise Gagnon Surgery is effective in achieving local control of tongue cancer, but additional therapy with radiation does not produce a significant advantage in regional disease control, according to a study presented here at the 2nd World Congress of the International Academy of Oral Oncology (IAOO). The review, presented on July 9, identified 282 patients (mean age, 59 years) who were treatment naïve and then received treatment for squamous cell carcinoma of the tongue between 1994 and 2004 at the Princess Margaret Hospital, Toronto, Ontario. "These were newly diagnosed patients who were previously untreated," said David Goldstein, MD, Head and Neck Surgical Oncology, Department of Surgical Oncology, University Health Network and Princess Margaret Hospital and Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Ontario. "We wanted to analyse the outcomes and patterns of failure at our institution." The medical literature suggests a wide variability in outcomes in the management of squamous cell carcinoma of the oral tongue, according to Dr. Goldstein. A total of 268 (95%) were treated primarily with surgery, and 70 patients (26%) received postoperative adjuvant therapy. The majority of patients were in early stages of cancer. Patients were followed for a median of 4.54 years. The mean tumour thickness was 11 mm. The intent was curative, noted Dr. Goldstein. A minority of patients did not receive surgery as primary treatment, noted Dr. Goldstein, pointing out they received chemoradiation. "These patients were not medically fit for surgery or refused surgery as primary [...]

Oral Cancer Foundation News Team - A2009-07-15T04:31:18-07:00July, 2009|Oral Cancer News|