A 10-year analysis of the oral squamous cell carcinoma profile in patients from public health centers in Uruguay

The aim of this study was to evaluate the demographic, clinical, and therapeutic characteristics and predictive factors of poor prognosis in patients with primary oral squamous cell carcinoma (OSCC) in Uruguay. Medical records of patients with the diagnosis of primary OSCC treated between 2000 and 2010 in Uruguayan public hospitals were selected. Data on demographic characteristics, risk factors, clinical features, treatment, and outcome were collected. Associations of independent variables with outcomes were assessed using Pearson chi-squared and Fisher's tests. Of 200 patients with OSCC, 79.4% were men (3.8:1 male:female ratio), with a mean age of 60.75 ± 11.26 years. Tobacco and alcohol consumption were reported by 85.3% and 63.5% of patients, respectively. The most commonly affected location was the tongue (42.5%), with lesions exhibiting ulcerous aspects in 87.9% of cases and pain at the time of diagnosis in 70.4% of cases. One hundred sixty-one (82.1%) patients had advanced-stage (III/IV) OSCC. Surgery was the most common treatment option, and the overall 5-year survival rate was 58.5%. Univariate analysis showed that the predictors of poor prognosis were clinical aspect, size, regional metastasis, clinical stage, and treatment. In Uruguay, OSCC is diagnosed late, which is associated with a low survival rate. Educational and preventive measures and investment to improve early diagnosis should be undertaken.

Carcinoma base of tongue: Single institution 15 year experiences.

Aims: To report the outcome with radiotherapy and concomitant chemoradiotherapy in patients with locally advanced squamous cell carcinoma base of tongue treated and followed up at single institution over a period of 15 years. Materials and Methods: This study was carried out by auditing the medical records of 103 patients treated at our institution between 1991 and 2006. Mean age with standard deviation of patients in the Radiotherapy only (group I) and chemoradiotherapy (group II) was 55.26 ± 14.16 and 49.81 ± 12.16 years. 46 patients were treated with radiotherapy alone and 57 patients were treated with concurrent chemo radiotherapy using infusion cisplatinum 3 weekly and 5 fluorouracil twice weekly. Mean follow up was 13.35 months. All the patients characteristic and treatment characteristics were recorded. Results: There were 81 men and 22 women in the study. Group I contains 15 and 31 cases of stage III and IV tumors while group II contains 19 and 38 cases of stage III and IV respectively. Group II has shown improved loco regional control rate for the T3 and T4 tumors as compared to group I. Disease free survival and overall survival in the group II is 25.51 months and 22.53 months while group I has 8.67 months and 6.74 months respectively. Grade III mucosal toxicity incidence was higher in group II as compared to group I. Conclusions: In locally advanced squamous cell carcinoma of base of tongue tumors concomitant chemoradiotherapy with infusional cisplatinum and 5 fluorouracil results in higher disease free and overall survival as compared to radiotherapy as single modality. This better tumor response with chemoradiotherapy comes at cost of higher incidence of mucosal toxicity.

Neck recurrence in early carcinoma tongue

To study the efficacy of different locoregional treatment options for tongue cancer in determining the prognosis, with reference to recurrence of disease in neck. This is a retrospective analysis of 80 patients with early [T1/T2] carcinoma tongue who had hemiglossectomy with or without neck surgery and radiotherapy for 14 years. Eighty patients were included in this study, 49 [61.3%] men and 31 [38.8%] women; 36 [45%] patients with T1 lesion and 44 [55%] with T2 lesion. Sixty two patients [77.5%] were staged cN0 and 18 patients had a clinically palpable neck nodes [cN+]. Thirty seven patients were pathologically negative [pN0], whereas 22 were pathologically positive [pN+] and 21 were not operated so they were staged pathologically [pNx] [undissected necks]. Thirty patients received postoperative adjuvant radiotherapy. The median follow-up was 16.5 months with a range of 10-120 months. The over-all rate of recurrence in neck was 32.5% [27 patients]. The rate of recurrence was 23% in T1 and 45.8% in T2 lesion [P-value 0.09] without radiotherapy. The recurrence rates with T1 lesion patients who were given adjuvant radiotherapy did not change significantly whereas with T2 lesions the recurrence rate decreased from 45% to 25% in the group without radiotherapy. Recurrence rate was higher in undissected neck as compared to patients who underwent elective neck dissection having radiotherapy and staged pN0 [P-value 0.009] or pN+ [P-value 0.005]. Patients having therapeutic neck dissection, on comparison of final pathological node staging [i.e. pN0 or pN+] the rate of recurrence in patients pN+ was 56% and in group with pN0 it was 11%, with [P-value 0.046]. We did not find any effect of age, gender and surgically resected margins of primary early tongue tumor on recurrence of disease in neck. There was no significant difference between primary tumor stage T1 and T2 lesions on neck recurrence when treated with surgery alone, but adjuvant radiotherapy further reduced the neck recurrence in T2 groups. Adjuvant radiotherapy also showed a significant reduction in recurrence rates in both pN0 and pN+. Undissected necks have higher incidence of neck recurrence than dissected neck irrespective of pathological status of neck metastasis

Cáncer de la lengua. Manejo del cuello en etapa temprana I T1 NO MO / Management of the neck in early cancer of the tongue

Quince enfermos con cáncer de la lengua oral, etapas I T1 NO MO y etapa II T2 NO MO. Atendidos entre enero de 1990 y enero de 1999, fueron tratados con gloscectomía y disección supraomohioidea ipsilateral que se convierte a disección radical modificada si el estudio transoperatorio de los ganglios linfáticos es positivo para metástasis. En caso de ruptura capsular o ganglios N2 se da tratamiento con radioterapia externa al cuello. El 66 por ciento de estos pacientes están vivos y sin actividad tumoral por cuando menos 3 años. Se discuten los factores que influyen en este resultado y se compara con la información pertinente de la literatura médica

Carcinoma espinocelular en borde de lengua / Espinocellular carcinoma in the lateral edge of the tonque

Se presenta el caso clínico de un paciente del sexo masculino , edad 17 años, raza blanca por lesión ubicada en el borde lateral de la lengua de aspecto verrugoso, ulcerada, cubierta por una capa blanquecina, no dolorosa. Lo más resaltante en este caso es que el paciente no presentaba ningún tipo de habito es decir no fumaba y no ingería alcohol, tampoco tenia ningún antecedente familiar que involucrara esta patología. Ante las características de la lesión se tomo la decisión de realizar una biopsia incisional para determinar la naturaleza de la misma, el diagnóstico reportado fue el de carcinoma espinocelular. Por lo tanto hubo que hacer el tratamiento integral mediante un equipo multidisciplinario. El odontólogo debe saber como se inicia el cáncer por tal razón es un hecho que comprobamos diariamente que la Facultad de Odontología de la Universidad Central de Venezuela pone todo su empleño en incorporar al Odontólogo en la lucha contra el cáncer, porque ya se ha superado la etapa en que el profesional de la salud bucal solamente se ocupe del tratamiento de las lesiones dentarias, para llegar a ser lo que es hoy en día un verdadero estomatólogo con capacidad y preparación para atender toda la patología de la boca y sus anexos

Cancer de la Lengua y del Suelo de la Boca. Reporte de 52 casos / Cancer of the tongue and of the floor of the mouth. Report on 52 cases

Se realizo un estudio de 52 pacientes que presentaban neoplasias malignas de la lengua y del suelo de la boca vistos en el servicio de Cirugia Maxilofacial del Hospital Provincial Clinicoquirurgico Docente de Cienfuegos "Gustavo Aldereguia". La pesquisa abarco el periodo comprendido de enero de 1987 a diciembre de 1994, con el proposito de describir las mas frecuentes, el estadio tumoral y la terapeutica utilizada. Se revisaron todas las historias clinicas; los casos en tratamiento fueron reevaluados, se analizo el estadio tumoral, las modalidades terapeuticas y los resultados histopatologicos. La principal neoplasia maligna fue el carcinoma espinocelular bien diferenciado, el mayor numero de enfermos estaban en el estado III y IV y la terapeutica de mayor uso fue la cirugia, ademas se analizaron nuevas modalidades terapeuticas

Neurolinoma bucomaxilofacial / Buccomaxillofacial neurilemmoma

Reportamos un caso clínicoquirúrgico de Neurilemoma primitivo del nervio lingual