survival – Page 7 – Oral Cancer News

Laser microsurgery for tongue cancer is as effective as invasive open surgery, according to new study

Source: www.sciencedaily.com Author: press release Transoral (through-the-mouth) laser surgery to remove cancer at the base of the tongue is as effective as more invasive open surgery and may improve quality of life according to a new study by Rush University Medical Center. The study is published in the July issue of the scientific journal Otolaryngology –Head and Neck Surgery. The study involved a retrospective chart review of 71 patients who underwent transoral laser microsurgery for squamous cell carcinoma of the base of the tongue. At 24 months, overall survival was 90 percent and disease specific survival was 94 percent. Quality-of-life data, obtained for 46 patients, revealed the majority had mild or no pain, minimally impaired to normal swallowing, and normal speech. Historically, the tongue base could only be safely accessed through complicated open surgical approaches through the neck. Delicate structures in the neck, such as the voice box, the trachea, the esophagus, lymph nodes, muscles and large nerves make surgical resection difficult with significant complications including speech and swallowing impairment. Advances in transoral laser microsurgery have transformed the surgeon's ability to treat cancer that was not otherwise amenable to surgical therapy. The surgery is performed through the opening of the mouth using an endoscope with a lighted camera and microscopic lens to view the area. Using a CO-2 laser and micro-staging, surgeons carefully remove the tumor in small pieces minimizing disruption to nearby tissues, thereby reducing complications and the likelihood of infections. With magnification of normal and abnormal tissue the [...]

Oral Cancer Foundation News Team - A2009-07-21T04:17:23-07:00July, 2009|Oral Cancer News|

The prognostic significance of histological features in oral squamous cell carcinoma

Source: J Oral Pathol Med, June 25, 2009 Authors: S R Larsen et al. Background: Different factors predict nodal metastasis, recurrence and survival in oral cancer. The aim was to assess the prognostic value of histological features related to the primary tumour. Methods: A total of 144 patients surgically treated at Odense University Hospital for oral cancer between 1999 and 2004 were included in the study. Postoperative radiation therapy was given in case of close and involved margins or high TNM stages (UICC 1997). Median follow-up time was 38 months. All surgical resections were reviewed and 22 histological characteristics were assessed. Results: The predominant sites were floor of mouth (FOM, 39%) and lateral tongue (35%). Fifty-nine per cent had UICC97 stage I-II disease. Five-year cause-specific survival was observed in 65%. Nodal involvement at diagnosis was observed in 36% which was significantly related to grade, neural and vascular invasion; surgical margins and increasing tumour depth. A cut-off value of 2 mm (4 mm for FOM) separated patients without and with nodal metastasis at the time of diagnosis. However, on multivariate analysis, neck disease was only associated with tumour depth and grade. Cox analysis of local recurrence in the oral cavity over time showed that tumour diameter and surgical margins were significant predictors while cause-specific survival was related to diameter, depth of invasion, surgical margins and extracapsular spread (ECS). Conclusions: Tumour depth and grade were strong prognostic factors for nodal metastasis, independently of other histological features. Tumour diameter and margins independently predict [...]

Oral Cancer Foundation News Team - A2009-07-03T17:40:45-07:00July, 2009|Oral Cancer News|

Pretreatment health behaviors predict survival among patients with head and neck squamous cell carcinoma

Source: Journal of Clinical Oncology, 10.1200/JCO.2008.18.2188 Author: Sonia A. Duffy et al. Purpose: Our prior work has shown that the health behaviors of head and neck cancer patients are interrelated and are associated with quality of life; however, other than smoking, the relationship between health behaviors and survival is unclear. Patients and Methods: A prospective cohort study was conducted to determine the relationship between five pretreatment health behaviors (smoking, alcohol, diet, physical activity, and sleep) and all-cause survival among 504 head and neck cancer patients. Results: Smoking status was the strongest predictor of survival, with both current smokers (hazard ratio [HR] = 2.4; 95% CI, 1.3 to 4.4) and former smokers (HR = 2.0; 95% CI, 1.2 to 3.5) showing significant associations with poor survival. Problem drinking was associated with survival in the univariate analysis (HR = 1.4; 95% CI, 1.0 to 2.0) but lost significance when controlling for other factors. Low fruit intake was negatively associated with survival in the univariate analysis only (HR = 1.6; 95% CI, 1.1 to 2.1), whereas vegetable intake was not significant in either univariate or multivariate analyses. Although physical activity was associated with survival in the univariate analysis (HR = 0.95; 95% CI, 0.93 to 0.97), it was not significant in the multivariate model. Sleep was not significantly associated with survival in either univariate or multivariate analysis. Control variables that were also independently associated with survival in the multivariate analysis were age, education, tumor site, cancer stage, and surgical treatment. Conclusion: Variation in [...]

Oral Cancer Foundation News Team - A2009-03-17T17:07:20-07:00March, 2009|Oral Cancer News|

What is the adequate margin of surgical resection in oral cancer?

Source: Oral Surg Oral Med Oral Pathol Oral Radiol Endod, January 23, 2009 Authors: Richard W Nason et al. Objective: The "adequate surgical margin" has always remained an enigma in the minds of head and neck surgeons. This study systematically analyses the impact of the width of the clear surgical margin on survival in oral cancer. Study Design: A historical cohort of 277 surgically treated patients with oral cancer were followed for a median period of 36 months. Cox proportional hazard models were used to determine the independent effect of the clear surgical margin, in millimeters, on 5-year survival. Results: Patients with margins of 5 mm or more had a 5-year survival rate of 73% when compared to those with margins of 3 to 4 mm (69%) , 2 mm or less (62%), and involved margins (39%, P = .000). After controlling for confounding variables (age, gender, stage) each 1-mm increase in clear surgical margin decreased the risk of death at 5 years by 8% (HR 0.92; 95% CI 0.86, 0.99; P = .021). Based on this model, patients with positive surgical margins had a 2.5-fold increase in risk of death at 5 years and those with close (

Oral Cancer Foundation News Team - A2009-02-01T22:30:19-07:00February, 2009|Oral Cancer News|

Head and neck cancer worse in blacks

Source: www.curetoday.com Author: staff African Americans and economically disadvantaged patients face a worse prognosis than other patients with head and neck cancer, according to a report in the journal Cancer. "The head and neck cancer manuscript is the first in a series of manuscripts we have written to examine disparities in cancer," Dr. Michael Cheung told Reuters Health. "We have observed disparities in a number of different cancers," including those of the esophagus and the reproductive organs. Cheung and colleagues at the University of Miami Miller School of Medicine, sought to determine the impact of race and socioeconomic status on outcomes for almost 21,000 patients with cancers of the head and neck diagnosed between 1998 and 2002. Typical survival times were significantly higher for whites (40 months) than for African Americans (21 months), for Hispanics (47 months) than for non-Hispanics (37 months), and for women (41 months) than for men (36 months), the authors report. Patients living in communities with poverty rates above 15 percent were diagnosed with head and neck cancer at a significantly earlier age, and survival times were decreased across all age groups in such communities. Consistent with previous research, alcohol and tobacco use also adversely affected survival in patients with head and neck cancer, the report indicates. Other predictors of survival included the location and stage of the tumor as well as the surgical, medical, and radiology treatments used. The inequalities seen in the study are "not explained completely by demographics, (other medical) conditions, or undertreatment [...]

Oral Cancer Foundation News Team - A2009-01-01T17:08:51-07:00January, 2009|Oral Cancer News|

Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours

Source: The Lancet Oncology. 2008;9:629-635 Authors: Prado CMM et al. Body composition appears to be of key importance when it comes to surviving cancer, as researchers have found that cancer patients with more lean muscle mass live longer. The study of 250 obese cancer patients revealed that patients with depleted muscle mass a recently recognized condition known as sarcopenic obesity lived, on average, for 10 months less than obese patients with more muscle mass. Participants with sarcopenic obesity were also more likely to be bedridden. Study leader Professor Vickie Baracos says muscle mass could even effect how patients respond to chemotherapy. The authors concluded: ³This study provides evidence of the great variability of body composition in patients with cancer and links body composition, especially sarcopenic obesity, to clinical implications such as functional status, survival, and potentially, chemotherapy toxicity.² Authors: Prado CMM, Lieffers JR, McCargar LJ, et al. Source: "Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study". The Lancet Oncology. 2008;9:629-635.

Oral Cancer Foundation News Team - A2008-12-22T13:12:12-07:00December, 2008|Oral Cancer News|

Other ailments can affect survival of head and neck cancer

Source: record.wustl.edu Author: Gwen Ericson Current estimates for head and neck cancer survival are largely inaccurate because they widely disregard many of the most common diseases such patients have in addition to their primary cancer, said Jay Piccirillo, M.D., a head and neck specialist at the School of Medicine, the Siteman Cancer Center and Barnes-Jewish Hospital. This highlights a broader problem with cancer survival statistics, which generally don't take into account the effect of coexisting conditions or comorbidities, Piccirillo said. In a recent study, Piccirillo, professor of otolaryngology and director of the Clinical Outcomes Research Office at the School of Medicine, showed that the risk of death increased up to sevenfold when patients with head and neck cancer developed new or more severe coexisting ailments such as heart problems, diabetes or lung disorders after cancer diagnosis. The study, published in the October issue of the Archives of Otolaryngology, Head and Neck Surgery, is the first to look at comorbidities in head and neck cancer patients in the period following diagnosis. "For decades, we have used a cancer-staging system based on tumor size, lymph node involvement and whether cancer has spread to other parts of the body when estimating a patient's survival while mostly ignoring how sick patients are from other diseases," Piccirillo said. "In fact, national databases used to estimate cancer survival don't account for comorbidities, and, as a result, we don't have very accurate estimates of how long patients are likely to survive their cancers." Some past studies of [...]

Oral Cancer Foundation News Team - A2008-12-12T10:59:26-07:00December, 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 [...]

Oral Cancer Foundation News Team - A2008-11-22T08:09:13-07:00November, 2008|Oral Cancer News|

Survival of head and neck cancer patients is greatly affected by coexisting ailments

Source: mednews.wustl.edu Author: Gwen Ericson Current estimates for head and neck cancer survival are largely inaccurate because they widely disregard many of the most common diseases such patients have in addition to their primary cancer, says Jay Piccirillo, M.D., a head and neck specialist at Washington University School of Medicine in St. Louis, the Siteman Cancer Center and Barnes-Jewish Hospital. This highlights a broader problem with cancer survival statistics, which generally don't take into account the effect of co-existing conditions, or comorbidities, according to Piccirillo. In a recent study, Piccirillo, director of the Clinical Outcomes Research Office at Washington University School of Medicine and professor of otolaryngology, showed that the risk of death increased up to seven-fold when patients with head and neck cancer developed new or more severe co-existing ailments such as heart problems, diabetes or lung disorders after cancer diagnosis. The study, published in the October issue of the Archives of Otolaryngology, Head and Neck Surgery, is the first to look at comorbidities in head and neck cancer patients in the period following diagnosis. "For decades, we have used a cancer staging system based on tumor size, lymph node involvement and whether cancer has spread to other parts of the body when estimating a patient's survival while mostly ignoring how sick patients are from other diseases," Piccirillo says. "In fact, national databases used to estimate cancer survival don't account for comorbidities, and as a result, we don't have very accurate estimates of how long patients are likely to [...]

Oral Cancer Foundation News Team - A2008-11-21T14:36:13-07:00November, 2008|Oral Cancer News|

Does surgical resection of pulmonary metastases of head and neck cancer improve survival?

Source: Annals of Surgical Oncology 15:2915-2926 (2008) Author: Hauke Winter, MD et al. Background: The prognosis of patients with metastasized head and neck cancer is poor. Limited experience exists with the benefit of resection of lung metastases and systematic mediastinal and hilar lymph node dissection on survival of patients with head and neck carcinoma. Methods: Eighty patients undergoing metastasectomy for pulmonary metastases of primary head and neck cancer entered the study. Multivariate analysis was performed by Cox regression analysis. Survival differences between patients operated and those not operated on were analyzed by matched pair analysis. Results: From 1984 until 2006, pulmonary metastases were diagnosed in 332 patients treated for head and neck cancer; 80 of these were admitted to our department for resection. Metastases of the primary head and neck tumor were confirmed histologically in 67 patients. The median overall survival after resection of lung metastases was 19.4 months and was statistically significantly better compared with patients who were not operated on (P < .001). The multivariate analysis after metastasectomy revealed that incomplete resection of pulmonary lesions, complications associated with surgery, and adjuvant therapy of the primary tumor are independent negative prognostic factors for survival. We observed a trend to improved survival in patients without hilar or mediastinal lymph node metastases. Conclusion: The survival rate of patients operated on was statistically significantly higher than that of patients with conservative treatment. Even patients with multiple or bilateral pulmonary lesions after curative treatment of a primary tumor should be operated on if [...]

Oral Cancer Foundation News Team - A2008-11-13T16:05:15-07:00November, 2008|Oral Cancer News|