[A retrospective study on the importance of preoperative control in the prognosis of spinocellular carcinoma of the oral cavity]. / Studio retrospettivo sull'importanza del controllo prechirurgico nella prognosi del carcinoma spinocellulare del cavo orale.

Surgical treatment of advanced forms of spinocellular carcinoma of the oral cavity (stages 3-4) has been integrated for a number of years with cycles of chemo- and/or radiotherapy both before and after surgery. This chemo-radio-surgical therapeutic protocol consists of four distinct stages, separated by precise treatment-free intervals, which enable the best efficacy to be achieved through synergy. A total of 60 patients were treated by our Ward using this protocol during the period March 1988-June 1992. At the time of surgery a complete negative outcome in the histological picture (pTO) was observed in 40% of cases; lesions had not regressed on only 16% of patients. A retrospective type study has been carried out using Kaplan-Meier's statistical analysis to evaluate the prognostic factors in this population: a significant correlation was found between disease-free time and survival, calculated at 40 months from the completion of the protocol, and histopathological TNM. Non correlation was found with clinical TNM: therefore, rather than the extent of the lesion at the time of diagnosis, its control during preoperative stages appears to be the major prognostic factor.

[Extracapsular lymph node metastasis in squamous cell carcinoma of the oral cavity after chemo-radio-surgical treatment protocol]. / Metastasi linfonodali extracapsulari nel carcinoma spinocellulare del cavo orale dopo protocollo terapeutico chemio-radio-chirurgico.

A total of 134 cases of spinocellular carcinoma of the oral cavity were treated by our division during the period March 1988-June 1992. This carcinoma histotype has a predominantly local evolution with rare long-distance hematic metastases. On the other hand, there are more frequent reports of metastases along the lymphatic route with an incidence which varies according to the site of tumour onset. Among the 134 patients treated a group of 77 were selected and admitted to a chemo-radio-surgical protocol consisting of four stages. During surgery patients in this group showed a marked reduction of both intracapsular and extracapsular lymph node involvement in almost all sites examined.

[Multidisciplinary treatment in advanced stages of spinocellular carcinoma of the oral cavity. Initial results]. / Trattamento multidisciplinare degli stadi avanzati di carcinoma spinocellulare del cavo orale. Primi risultati.

As in almost all forms of tumour, the best therapeutic results for those of the oral cavity is obtained following the first treatment which must be incisive and appropriate because it often represents the sole decisive possibility of recovery. In advanced forms (stages III and IV) it is best to establish a close collaboration between surgeon, cancer specialist and radiotherapist: this paper reports the authors' experience over the past 5 years with regard to advanced stages of spinocellular carcinoma of the oral cavity treated according to a chemoradiosurgical therapeutic protocol. Of the 134 cases treated by our unit, 77 were included in the protocol showing a 78% actuarial survival rate over 40 months.