Adjuvant therapy may improve survival in patients with early stage oral tongue cancer

Source: www.docguide.com Author: Louise Gagnon Patients with earlier stage oral tongue cancer disease may benefit from adjuvant combined modality therapy after surgery, according to a retrospective study presented at the 2nd World Congress of the International Academy of Oral Oncology (IAOO). The study looked at 50 patients with squamous cell carcinoma (SCC) of the oral tongue, 38 of whom were newly diagnosed with the condition. The patients were all treated between 1999 and 2007 at the University of Colorado, Denver, Colorado. Of the 38 patients who were recently diagnosed, 13 had either stage I or II cancer, and 25 had more advanced stage III or IV disease. All but 1 of the 50 patients was initially treated with surgery, with the 1 patient who refused surgery being treated with chemoradiation as the primary modality. "Most of the patients received adjuvant therapy after surgery," said one of the study's authors Changhu Chen, MD, Department of Radiation Oncology, University of Colorado, at an oral abstract session here on July 9. Of the 50 patients, 42 received adjuvant radiation or chemoradiation. Seven patients with stage I or II disease did not receive adjuvant therapy. Patients were followed for a median of 29 months (range, 4-95 mo). Investigators reported that 2-year locoregional control was 58%, and freedom from distant relapse was 83%. While 2-year survival for patients with stage I or stage II oral tongue cancer was 77%, compared with 52% for patients more advanced disease, stages III or IV, the rate of 2-year [...]

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 [...]

Improved oral tumor surgery reduces disfigurement

Source: taiwanjournal.nat.gov.tw Author: staff Traditional oral cancer surgeries involve entering the affected area through the lower lip, causing the patient's lower lip to be disfigured in some cases. The patient may suffer from strange sensations as well as losing balance on both sides of the lower lip, making it impossible for them to fully purse their lips. A modified oral cancer surgery technique applied by the Department of Ear, Nose and Throat Medicine at the Dalin Branch of the Buddhist Tzu Chi General Hospital in Chiayi County requires no cutting into the patient's lower lip, and thus leaves no disfigurement to the upper and lower lips of the patient. This wonderful news is sure to bring a smile to patients. The Dalin Buddhist Tzu Chi General Hospital says that oral cancer ranks fourth of the 10 most prevalent cancers among males in Taiwan, and the number of patients with this type of cancer is increasing each year. The hospital noted that 50% of the patients who had undergone the traditional surgical method were not able to fully close their lips, making other patients on the surgery list less likely to go through with such treatment. But their faces will be relatively less disfigured if the modified surgical technique is adopted. Dr. Lee Qing-chi says that the modified surgical technique calls for making a surgical incision under the chin and then excising the tumor from this angle. Cosmetic surgeons will follow through to reconstruct the skin flap in the area, which [...]

Robotic tongue cancer surgery

Source: kaaltv.com Author: staff Fighting cancer is not easy. Chemotherapy, radiation and surgery can be very hard on your body. Take head and neck cancers, for example. These tumors are often hard to reach. Doctors have to cut through bones such as your jaw to reach them. Now, doctors at Mayo Clinic are using robots to access these cancers leaving face bones intact. Roger Combs may be having a tough time beating his wife Gloria at a game of gin rummy. But he's winning a much tougher battle; a fight against cancer that formed at the base of his tongue. "I really didn't feel badly. I had some difficulty swallowing," he says. Roger's doctors told him the cancer had to be removed. "But the tongue and tonsillar area is a very hard area to get to," says Dr. Eric Moore. Dr. Moore says traditional surgery often involves splitting the jawbone open to access the tumor. "And obviously that's disfiguring, interferes with speech and swallowing and it takes a lot of time to recover, " he says. So instead, Dr. Moore used a robot to remove Roger's cancer. The operation involves lowering the robotic equipment through Roger's mouth to the site of the tumor. While seated at a control panel Dr. Moore then guides the robot as it removes the cancer without damaging surrounding structures. After Roger healed from the operation, he went through radiation and chemotherapy - both of which were not easy. "We've had some ups and downs as [...]

2008-12-11T13:29:12-07:00December, 2008|Oral Cancer News|

Early-stage head and neck cancer in patients 80 years of age or older highly treatable

Source: professional.cancerconsultants.com Author: staff Researchers from France have reported that patients 80 years of age or older with Stage I-II head and neck cancer have good outcomes following surgery or radiation therapy. The details of this study appeared in an early online publication in Cancer on October 17, 2008.[1] Although most cancers occur in older individuals, this patient population is not proportionately represented in current clinical trials. In fact, many trials specifically exclude older patients on the assumption that they will not tolerate the protocol therapies. Thus, the results of many clinical trials are only applicable to the minority of younger patients with a specific type of cancer. In a recent study, researchers affiliated with ECOG looked at 53 patients with head and neck cancers who were 70 years or older. These patients were entered on two randomized trials and represented only 13% of the study group. However, the median age of patients with head and neck cancer is over the age of 65 years. This shows that a disproportionate number of younger patients are included in these trials. However, in this study the results in elderly patients were as good as for younger patients but with more treatment-related toxicities. This study looked at the outcomes of 316 patients with head and neck cancer who were 80 years of age or older treated in a single institution from 1987 to 2006. Thirty-one percent of patients received surgery, and 57% received definitive radiotherapy. Patients with Stage I-II head and neck cancer [...]

2008-11-22T08:09:13-07:00November, 2008|Oral Cancer News|

Sweetest word for a mother to hear

Source: www.journallive.co.uk Author: Neil MacKay It is a memorable moment in any mother’s life when her child utters their first word. But when Daniel Sewell said “Mam” for the first time it was an extra special for his mum Alison. For Daniel was given a “new” tongue during pioneering surgery for mouth cancer at Newcastle’s Royal Victoria Infirmary more than three years ago, and doctors warned Alison that he may never talk properly. Surgeons had to take out three-quarters of his tongue and replace it with muscle from his abdominal lining. Now, after three years in remission, four-year-old Daniel is a happy, talkative primary school pupil. Both he and Alison, 43, of Coronation Street, Crook, County Durham, are backing the British Dental Health Foundation’s Mouth Cancer Action Week, which runs next week. Daniel’s father Richard spotted his badly swollen tongue when he was 13 months old and his quick action saved the tot’s life – early detection of oral cancer means a survival chance of 90%. Alison said: “I was just as ignorant as anyone about mouth cancer. I always presumed it was about the older generation and was linked with smoking and the like. “When we found out Daniel had cancer, we had the shock of our lives. It was so hard for the first few weeks and we didn’t know which way it was going to go. If we hadn’t noticed when we did I really don’t think he would have made it. Mouth cancer is a silent [...]

2008-11-16T07:46:00-07:00November, 2008|Oral Cancer News|

Current concepts in management of oral cancer – Surgery

Source: Oral Oncol, July 30, 2008 Authors: Jatin P Shah and Ziv Gil Oral cancer is the sixth most common cancer worldwide, with a high prevalence in South Asia. Tobacco and alcohol consumption remain the most dominant etiologic factors, however HPV has been recently implicated in oral cancer. Surgery is the most well established mode of initial definitive treatment for a majority of oral cancers. The factors that affect choice of treatment are related to the tumor and the patient. Primary site, location, size, proximity to bone, and depth of infiltration are factors which influence a particular surgical approach. Tumors that approach or involve the mandible require specific understanding of the mechanism of bone involvement. This facilitates the employment of mandible sparing approaches such as marginal mandibulectomy and mandibulotomy. Reconstruction of major surgical defects in the oral cavity requires use of a free flap. The radial forearm free flap provides excellent soft tissue and lining for soft tissue defects in the oral cavity. The fibula free flap remains the choice for mandibular reconstruction. Over the course of the past thirty years there has been improvement in the overall survival of patients with oral carcinoma largely due to the improved understanding of the biology of local progression, early identification and treatment of metastatic lymph nodes in the neck, and employment of adjuvant post-operative radiotherapy or chemoradiotherapy. The role of surgery in primary squamous cell carcinomas in other sites in the head and neck has evolved with integration of multidisciplinary treatment approaches [...]

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