Mortality due to oral and oropharyngeal cancer in Uruguay from 1997 to 2014

Abstract Oral and oropharyngeal cancer is considered a public health problem in several countries due to its high incidence and mortality rate. Objective: This study aimed to analyze oral and oropharyngeal cancer mortality in Uruguay from 1997 to 2014 by age, sex and country region. Methodology: A time series ecological study using secondary data was performed. Data on mortality due to oral and oropharyngeal cancers were obtained from the Vital Statistics Department of Uruguay's Ministry of Public Health. Results: The cumulative mortality rate due to oral and oropharyngeal cancer over the study period was of 19.26/100,000 persons in women and 83.61/100.000 in men, with a mean annual rate of 1.75/100,000 in women and 7.60/100,000 in men. Mortality rate from both sites during the study period was 4.34 times higher in men than in women. Malignant neoplasms of other parts of the tongue and base of tongue showed the highest mortality rate. The means of the annual coefficients of deaths were higher for the age groups between 50 and 69 years. Higher mortality rates of oral and oropharyngeal cancer were observed in Artigas (4.63) and Cerro Largo (3.75). Conclusions: Our study described a high mortality rate for oral and oropharyngeal cancer in Uruguay from 1997 to 2014. According to the country's health department, men, tongue cancer, and oral cavity had higher mortality rates, with some variation. Prevention strategies with control of risk factors and early diagnosis are necessary to improve survival in the Uruguayan population.

How pathological criteria can impact prognosis of tongue and floor of the mouth squamous cell carcinoma

Abstract Pathological parameters have been indicated as tumor prognostic factors in oral carcinoma. Objective: The objective of this study was to investigate the impact of pathological parameters on prognosis of patients affected only by tongue and/or floor of the mouth squamous cell carcinoma (SCC). Methodology: In total, 380 patients treated in the Brazilian National Cancer Institute (INCA) from 1999 to 2006 were included. These patients underwent radical resection followed by neck dissection. The clinical and pathological characteristics were recorded. The Kaplan-Meier method and Cox proportional hazards model were used in survival analysis. Overall survival (OS), cancer-specific survival (CSS) and disease-free interval (DFI) were estimated. Cox residuals were evaluated using the R software version 3.5.2. Worst OS, CSS and DFI were observed in patients with tumors in advanced pathological stages (p<0.001), with the presence of perineural invasion (p<0.001) and vascular invasion (p=0.005). Results: Advanced pathological stage and the presence of a poorly differentiated tumor were independent prognostic factors for OS and CSS. However, advanced pathological stage and perineural invasion were independent predictors of a shorter OS, DFI and CSS. Conclusion: Pathological stage and perineural invasion were the most significant pathological variables in survival analysis in tongue and/or floor of the mouth SCC.

Carcinoma epidermoide de la lengua: presentación de un caso / Epidermoid carcinoma of the tongue: report of a case

El carcinoma epidermoide es el cáncer bucal más frecuente que representamás de 90% de todos los tipos de cáncer de la cavidad oral. Se presenta el caso de masculino de 41 años de edad con un carcinoma epidermoide de rápida evolución a nivel de la lengua. Se observó una estomatosis localizada en el borde izquierdo de la lengua caracterizada por una neoformación de bordes elevados indurados, centro ulcerado, de 2 cm de diámetro y friable. Se detectaron adenomegalias del lado izquierdo de 2 cm. El paciente refería dolor a nivel del cuello y a niveldel oído izquierdo. Fumaba hasta dos cajetillas de cigarros al día. El estudio histopatológico reveló un carcinoma epidermoide ulcerado, invasor con áreas moderadamente poco diferenciadas. Se inició tratamientocon radioterapia 25 sesiones y quimioterapia con cisplatino. Se determinó mala tolerancia y respuesta al tratamiento establecido, por lo que éste se suspendió y se optó por tratamientos paliativos. La evolución del paciente fue tórpida y falleció a los 10 meses del diagnóstico. Las neoplasias de la cavidad oral son relativamente poco frecuentes, pero la letalidad alcanza hasta 78 por ciento entre las neoplasias de las vías aerodigestivas superiores y se diagnostican en etapas avanzadasen 65 por ciento de los casos. La prevención es fundamental, sobre todo la supresión del tabaquismo.

Epidermoid carcinoma is the most frequent oral cancer (90% of alloral cancer). We present the case of a 41-year-old man with oralcancer on the tongue. The lesion was localized on the left side of thetongue and was characterized by an ulcerated tumor with induratedborders, 2 cm of diameter. Lymph node metastasis was detected onthe neck. The patient had left ear pain and also a pain in the neck.He smoked two packs of cigarettes per day. The histopathologic studyrevealed an epidermoid carcinoma with poor and well-diff erentiatedareas. Radiotherapy and chemotherapy with cisplatin on were started.The patient did not tolerate and had a poor response, so the treatmentwas suspended. The patient died 10 months after the diagnosis. Oralcarcinoma is not frequent but the mortality is high, 78%, between thecarcinomas of the aerodigestive tract and frequently it is diagnosedwhen in advanced stages in 65% of the cases. The most important arethe prevention, mostly, tobacco consumption.

Carcinoma espinocelular de lengua: estudio de sobrevida a 5 años / Squamous cell carcinoma of the tongue: A five-year survival study

El carcinoma espinocelular (CEC) es el cáncer oral más prevalente dentro de la población, representando aproximadamente el 90% de todas las neoplasias orales, y la lengua se alza como el sitio más común del CEC. El objetivo de este estudio fue determinar la sobrevida a los 5 años de los pacientes diagnosticados de CEC de lengua. Se realizó un estudio retrospectivo con los datos obtenidos en fichas de la Universidad Mayor de 44 pacientes diagnosticados con CEC de lengua. Los datos de sobrevida en relación con el género, grupos etarios, hábitos y grado de diferenciación histopatológica se realizó mediante el análisis de Kaplan-Meier. El resultado de sobrevida global a los 5 años fue 45,5%. La sobrevida por carcinoma espinocelular de lengua en Chile presenta un porcentaje menor comparado con los resultados de otros países, tales como Estados Unidos.

Squamous cell carcinoma is the most prevalent oral cancer in the population, accounting for approximately 90% of all oral cancers, with the tongue being the most common location of SCC. The aim of this study was to determine the five-year survival rate of patients diagnosed with SCC of tongue. A retrospective study was performed on 44 patients of the Universidad Mayor (Chile) diagnosed with SCC of the tongue. The survival data in relation to gender, age groups, habits, degree of histopathological differentiation, was performed using the Kaplan-Meir analysis. The overall survival rate at five years was 45.5%. The survival rate for squamous cell carcinoma of tongue in Chile is lower than the results found in other countries, such as the United States.

Valor prognostico da metastase regional no carcinoma epidermoide de lingua e soalho bucal / Prognostic value of regional metastasis in squamous cell carcinoma of the tongue and floor of mouth

A presença da metástase linfonodal é um fator limitante da sobrevida no câncer da boca. OBJETIVO: Avaliar as causas de falha no tratamento dos carcinomas de língua e soalho de boca em função do estadiamento. MÉTODO: Foram analisados 365 casos de carcinoma epidermoide de boca, tratados de 1978 a 2007, sendo 48 T1, 156 T2, 98 T3 e 63 T4, dos quais 193 foram pNo e 172 pN+. RESULTADOS: Entre os casos pN+, foram observados 17/46 recidivas (36,9%) nos casos não irradiados e 46/126 (36,5%) nos casos irradiados. Quanto aos resgates, nos casos pN0, obtivemos 16/51 (31,3%) e, nos pacientes pN+, de 3/77 (3,9%). CONCLUSÃO: O sucesso dos resgates é menor em pacientes com pN+, com maior recidiva local e menor sobrevida. .

The presence of metastatic nodes is a survival-limiting factor for patients with mouth tumors. OBJECTIVE: To evaluate the causes of treatment failure in carcinomas of the tongue and floor of the mouth due to staging. METHOD: This study included 365 patients with squamous cell carcinoma of the mouth treated from 1978 to 2007; 48 were staged as T1, 156 as T2, 98 as T3, and 63 as T4, of which 193 were pNo and 172 pN+. RESULTS: Among the pN+ cases, 17/46 (36.9%) of the patients not treated with radiation therapy had relapsing tumors, against 46/126 (36.5 %) of the patients who underwent radiation therapy. Success rates in the group of subjects submitted to salvage procedures were 16/51 (31.3%) for pN0 patients and 3/77 (3.9%) for pN+ patients. CONCLUSION: Salvage procedure success and survival rates are lower for pN+ patients; pN+ individuals also have more relapsing local disease. .

Morphometric Analysis of Nucleus and Nucleolar Organizer Regions (NORs) in Tongue Squamous Cell Carcinoma (SCC) / Análisis Morfométrico de Núcleos y Regiones del Organizador Nucleolar (NORs) en Carcinomas de Células Escamosas de la Lengua (SCC)

The tongue is one of the most likely places for the primary squamous cell carcinoma (SCC) to arise in the western world.This work intends to do a morphometric evaluation of the cellular nucleus, as well as a morphometric analysis of the nucleolar organizer regions (NORs). The biopsy specimen was removed from patients with tongue SCC, staged T2N0M0, before they underwent treatment. They were, then, subject to hemiglossectomy and supraomohyoid neck dissection (SOHND) and presented different clinical evolution. According to that, they were subdivided in three groups: Group A, control group, formed by patients without tongue neoplasm (the histopathologic specimen was obtained from the Department of Pathology at Hospital de Base and Faculdade de Medicina de Sao José do Rio Preto - FAMERP-HB); Group B, T2N0M0+ hemiglossectomy + SOHND, survival of only 36 months; Group C, T2N0M0 + hemiglossectomy + SOHND, survival of 5 years. The morphometric analysis included the study of larger diameter, smaller diameter, medium diameter, the relation between larger/smaller diameters, perimeter, area, volume, the relation between volume/area, idiosyncrasy, shape coefficient and the nuclear contour index of the tumor cells from patients with tongue SCC, as well as the same measurements of the nucleolar organizer regions. The analysis was aleatory and double-blind. All the morphometric data were compiled and statistically evaluated by the Kruskall-Wallis test and by the ANOVA test, and a 5% alpha error rate was adopted.

La lengua es probablemente, el lugar en donde más frecuentemente surge el carcinoma primario de células escamosas (SCC), en el mundo occidental. Este estudio propone realizar la evaluación morfométrica del núcleo celular, así como el análisis morfométrico de las regiones de los organizadores nucleolares (NORs). La muestra de biopsia fue removida de pacientes con SCC de lengua, etapificado en T2N0M0, antes de recibir tratamiento. Los pacientes fueron sometidos a una hemiglosectomía y una disección supraomohiodea del cuello (SOHND) y presentaron diferente evolución clínica. De acuerdo a esto, fueron subdividos en tres grupos: Grupo A, grupo control formado por pacientes sin neoplasia de lengua (la muestra fue obtenida del Departamento de Patología del Hospital Base de la Facultad de Medicina de Sao José do Rio Preto - FAMERP-HB, Brasil); Grupo B, T2N0M0 + hemiglosectomía + SOHND, sobrevida de 36 meses; Grupo C, T2N0M0 + hemiglosectomía + SOHND, sobrevida 5 años. El estudio morfométrico incluyó los análisis del diámetro mayor, diámetro menor, diámetro medio, la relación entre el diámetro mayor/menor, perímetro, área, volumen, relación volumen/área, idiosincrasia, coeficiente de forma y el índice de contorno nuclear de células tumorales en pacientes con SCC de lengua, así también las mismas mediciones de las regiones nucleolares organizadas. El análisis fue aleatorio y doble ciego. Todos los datos morfométricos fueron recopilados y evaluados estadísticamente con el test de Kruskall-Wallis y el Test ANO VA, con un valor alfa de un 5%.

Condrossarcoma primário de língua em cão / Primary chondrosarcoma in the tongue of a dog

A 10 year old female Boxer was taken dead to veterinary hospital for a necropsy without any clinical history, showing a growth on the dorsal part of the tongue. Based on the histopathological findings mesenchymal chondrosarcoma was diagnosed. This report describes the first case of chondrosarcoma on the base of the tongue in veterinary medicine.

Cáncer avanzado de lengua: evolución y resultados a 5 años / Advanced cancer of the tongue: evolution and 5 years late results

Se analizó la evolución a largo plazo de 135 enfermos portadores de cáncer epidermoide de lengua Estadios III y IV. La llegada tardía a la consulta ha significado que sólo el 21.7% pudiera ser pasible de tratamiento. Predominó el Estadio IV en casi 2/3 de la población y el sexo masculino en una relación 4.86:1. La mayor incidencia se registró en la 6a y 7a década de la vida y juntas representaron más del 50%. La supervivencia global fue del 9.5% a 5 años, observándose que los únicos factores que incidieron en forma estadísticamente significativa fueron el tamaño del primario, la presencia de adenopatías metastásicas y el grado de diferenciación celular. En cambio el sexo, la edad y la topografía no alcanzaron significación pronóstica. Los mejores resultados terapéuticos se obtuvieron con cirugía, complementada con telecobaltoterapia en Estadio III. La quimioterapia neoadyuvante no contribuyó a mejorar la supervivencia ni prolongar los períodos libres de enfermedad. La gran proporción de lesiones avanzadas conduce a divulgar los factores de riesgo a nivel popular y producir una mayor información en el pregrado universitario