prognosis – Page 3 – Oral Cancer News

Incidence and impact of comorbidity diagnosed after the onset of head and neck cancer

Source: Arch Otolaryngol Head Neck Surg. 2008;134(10):1045-1049 Authors: Katherine C. Yung, MD; Jay F. Piccirillo, MD Objective: To investigate the incidence and prognostic impact of comorbidities diagnosed after the onset of head and neck cancer. Design: Retrospective review of medical records. Patients: One hundred eighty-three patients diagnosed as having head and neck cancer at Washington University School of Medicine from January 1, 1997, through December 31, 1998. Main Outcome Measures: We reviewed medical records for demographic, tumor, treatment, and comorbidity data. Comorbid ailments at diagnosis and last follow-up or death were coded using the Adult Comorbidity Evaluation–27. Results: Of the 183 patients, 53 (29.0%) were found to have a baseline comorbidity score of none; 58 (32.0%) of mild; 53 (29.0%) of moderate; and 19 (10.4%) of severe. At last follow-up or death, scores were none for 30 patients (16.4%), mild for 52 (28.4%), moderate for 43 (23.5%), and severe for 58 (31.7%). Comorbidity scores at baseline (P = .002) and last follow-up (P = .001) were associated with 5-year survival. The prognostic impact of comorbidity scores at baseline and last follow-up were analyzed using Cox proportional hazards analysis. Individual comorbid ailments after diagnosis included myocardial infarction, coronary artery disease/angina, solid tumor, psychiatric disease, chronic obstructive pulmonary disease, hypertension, and alcohol abuse. Conclusions: These findings are consistent with previous research demonstrating that comorbidity at diagnosis is strongly correlated with prognosis. This study also showed that the burden of comorbidity changes after diagnosis. There appeared to be a prognostic gradient based on [...]

Oral Cancer Foundation News Team - A2008-10-21T12:30:55-07:00October, 2008|Oral Cancer News|

Racial disparities exist in head and neck cancer outcomes

Source: www.forbes.com Author: staff Blacks and the poor have worse outcomes when it comes to head and neck cancer, researchers say. In a new study, published in the Nov. 15 issue of Cancer, researchers examined the data on diagnosis, coexisting conditions, and procedures performed among 20,915 cases of head and neck cancer. The found a worse prognosis was associated with race, poverty, age, gender, tumor site and stage, treatment type, and history of smoking and alcohol consumption. Specifically, the survival time among blacks was 21 months after being diagnosed with head and neck cancer, compared to 47 months among Hispanics and 40 months among whites. In addition, blacks were diagnosed at a younger age, were diagnosed with more advanced disease, and were less likely to have undergone surgery (45 percent versus 32 percent), when compared with whites. The treatment type did not seem to be the reason for the disparity in outcomes, however. Even among the patients who had surgery, blacks had a shorter survival time than whites. As for socioeconomic status, the patients who lived in communities where the poverty levels exceeded 15 percent were diagnosed with these cancers at a significantly younger age and with more advanced disease. Additionally, average survival time was shorter in patients who lived in areas of the highest poverty rates, regardless of the type of therapy that was received. The authors of the study concluded that racial disparities continue to exist in head and neck cancer outcomes, and that socioeconomic factors also play [...]

Oral Cancer Foundation News Team - A2008-10-22T11:56:08-07:00October, 2008|Oral Cancer News|

Does Pretreatment Seropositivity to Human Papillomavirus Have Prognostic Significance for Head and Neck Cancers?

Source: Cancer Epidemiology Biomarkers & Prevention 17, 2087-2096, August 1, 2008 Authors: Elaine M. Smith et al. Background: Human papillomavirus (HPV) is a risk factor for head and neck cancers (HNC), yet HPV-associated tumors have better prognosis than HPV-negative tumors. Methods: We evaluated whether pretreatment presence of antibodies to HPV capsids [virus-like particles (VLP)] or to HPV-16 oncoproteins E6 and E7 was a predictor of HPV-positive HNC and clinical outcomes. Sera from 156 HNC patients were tested for antibodies to HPV-16–derived antigens using ELISA. HPV-16 in tumors was evaluated by PCR and DNA sequencing. Results: HPV-16 antibodies were found in 33% with HPV-16 VLP, 21% with HPV-16 E6, and 21% with E7. HPV-16 was detected in 26% of tumors. There was a strong correlation between detection of HPV-16 tumor DNA and antibodies to HPV-16 E6 or E7 ( = 0.7) but not to HPV-16 VLP ( = 0.4). Multivariate analyses showed significantly better disease-specific survival in seropositive HPV-16 VLP [hazard ratio (HR), 0.4; 95% confidence interval (95% CI), 0.1-0.9], HPV-16 E6 (HR, 0.1; 95% CI, 0.02-0.5), and HPV-16 E7 (HR, 0.3; 95% CI, 0.1-0.9) cases. Less disease recurrence occurred among those with antibodies to both E6 and E7 compared with those negative to both (P = 0.003). There was better disease-specific survival in patients who were E6 positive at baseline and remained positive at follow-up compared with individuals who were E6 negative at both time points (P = 0.03; = 0.9). Conclusions: The presence of antibodies to HPV-16 E6 and [...]

Oral Cancer Foundation News Team - A2008-08-15T21:40:30-07:00August, 2008|Oral Cancer News|

Disease-Free Period Predicts Response to Salvage Therapy for Oral Cancer

Source: Abkhazia (www.abkhazia.com) Author: Ramaz Mitaishvili In patients with locally recurrent carcinomas of the oral cavity and oropharynx, a disease-free interval of more than 1 year and tumor tissue negative for EGFR (epidermal growth factor receptor) expression predict a good response to salvage surgery. That's the conclusion of physicians in Brazil who studied the outcomes of 111 patients following salvage surgery for locally recurrent squamous cell carcinomas of the oral cavity and oropharynx at Hospital A. C. Camargo in Sao Paulo. Local recurrence in such patients carries a poor prognosis, and clinical factors alone are insufficient for identifying those who would benefit from further treatment, Dr. Luiz Paulo Kowalski and associates note in their paper in the July issue of the Archives of Otolaryngology--Head and Neck Surgery. They therefore analyzed the prognostic significance of EGFR, matrix metalloproteinases 2 and 9, and vascular endothelial growth factor expression. In multivariate analysis, disease-free survival and EGFR expression status were the only variables associated with an independent significantly high risk of death. Patients with a disease-free interval of less than 1 year (hazard ratio 1.97) and those with overexpression of EGFR (HR 4.20) had the worst prognosis. In their suggested treatment algorithm for patients with resectable local recurrence, Dr. Kowalski's group recommends surgery for all patients with a disease-free interval of > 1 year and for those with clinical stage I or II. They also believe that surgery is worthwhile for patients with higher stage tumors if they are EGFR-negative. They suggest other options [...]

Oral Cancer Foundation News Team - A2008-08-01T05:05:07-07:00August, 2008|Oral Cancer News|

Nervous Tissue Involvement May Predict Progression of Oral Carcinomas: Presented at AHNS

Source: Doctor's Guide (www.docguide.com) Author: Arushi Sinha Among patients with early-stage squamous cell carcinomas, those with perineural involvement appear to have lower survival rates compared with patients who have no perineural involvement, according to research presented here at the American Head and Neck Society (AHNS) 7th International Conference on Head and Neck Cancer. While it is known that perineural invasion by the carcinoma has a negative impact on prognosis for squamous cell carcinomas in general, there is less information on the impact for early-stage oral cancers. "With perineural invasion, there is a possibility that even very small tumours can be very aggressive," explained Raquel Moysés, MD, Head and Neck Surgery Department, Sao Paulo University Medical School, Sao Paulo, Brazil. The retrospective study, presented in a poster session on July 22, examined the progress of 42 patients diagnosed with early-stage squamous cell carcinoma of the oral tongue or of the floor of the mouth. The tumours were stage I or II with no nodal involvement (N0). There were 16 patients with perineural invasion and 26 patients without. The average follow-up time was 49 months. Study endpoints included clinical and pathological characteristics as well as an analysis of treatment regimens and outcomes data. When compared with those without perineural involvement, patients with perineural invasion were found to have significantly larger tumour diameter (P = .046) and thickness (P = .002). They also had a higher rate of disease-specific death (P = .015) and lower global survival (P = .019), despite having a [...]

Oral Cancer Foundation News Team - A2008-07-23T19:22:12-07:00July, 2008|Oral Cancer News|

Presence of Human Papillomavirus Infection Has No Prognostic Value in Tongue Cancer Patients: Presented at AHNS

Source: Doctors Guide (www.docguide.com) Author: Arushi Sinha The presence of human papilloma virus (HPV) infection does not appear to have any prognostic effect in patients treated for base-of-tongue (BoT) cancer, according to research presented here at the American Head and Neck Society (AHNS) 7th International Conference on Head and Neck Cancer. Investigator Mary Reid, PhD, Department of Epidemiology, Roswell Park Cancer Institute, Buffalo, New York, presented the findings in a poster session on July 20. According to Dr. Reid, HPV has been shown to be associated with oral and laryngeal carcinomas. Therefore, the research team conducted the study to identify characteristics of patients diagnosed with BoT carcinomas and outcomes in patients with or without HPV infection. The researchers studied patient charts for 87 patients with BoT; the majority of patients comprised Caucasians (93%) and males (87%). The average age of the study cohort was 59 years. Forty-seven percent of the study population were smokers, 29% were former smokers, and 24% had never smoked at the time of diagnosis. In addition, 24% of patients reported heavy alcohol use. Of the group, 98% were diagnosed with squamous cell carcinoma and 74% had advanced stage IV disease. The researchers identified a smaller subset of 30 patients for whom tissue samples were used to detect the presence of HPV, specifically the HPV 16 strain, using polymerase chain reaction techniques. Twenty of the 30 patients (66%) tested positive for HPV infection. There were similarities among tested and nontested patients with respect to alcohol consumption, race, [...]

Oral Cancer Foundation News Team - A2008-07-23T19:06:18-07:00July, 2008|Oral Cancer News|