Carcinoma of the oral cavity: on the prognostic significance of the primary tumour site (by organs) in the oral cavity.

The prognostic significance of so-called organ sites was investigated in 585 cases with carcinoma of the oral cavity and lips. For the subsamples studied the numerical distribution of TNM categories, life tables and life table comparisons were computed. This produced the following results: 1. There is no demonstrable difference in prognosis between identical T catagories in the organs of the oral cavity. 2. In some cases there is a significant difference between identical N categories in organs of the oral cavity. In the No category this is, however, attributable to the substantial differences in the numerical distribution of T categories. By contrast, a logical explanation for the computationally demonstrable significant differences in the Nx category is not available. The problem is currently being investigated. 3. An assessment of identical TN combinations in the "organs" of the oral cavity proved to be impossible on account of the inadequate number of cases available. The so-called "organ localization" of primary tumours in the oral cavity need not - at least for the time being - be accorded any prognostic relevance. The findings should, however, be re-examined on the basis of greater numbers.

[A retrospective study of carcinomas of the oral cavity: a preliminary report (author's transl)]. / Karzinome der Mundhöhle. Vorläufiger Bericht über eine retrospektive Studie.

UNLABELLED: The German-Austrian-Swiss Research Team on Maxillofacial Tumours is investigating a series of 585 carcinomas of the oral cavity, lips and oropharynx by biostatistical methods. The aim of the study is the determination of relevant prognostic symptoms of oral cavity carcinomas, classification of the series on the basis of these symptoms, the determination of therapeutic efficacy and the assessment of collective and individual prognosis. PRELIMINARY RESULTS: 1. Factors of prognostic relevance are probably only tumour size and intensity of regional metastases. 2. The classification of the series becomes problematic due to the lack of relevant prognostic factors.

Carcinoma of the oral cavity: on the prognostic significance of the primary tumour site (by levels and areas).

The prognostic significance of primary tumour site in carcinomas of the oral cavity was investigated in a series of 585 cases. For the subsamples (levels and areas of oral cavity) studied, the numerical distribution of TNM categories, life tables and life table comparisons were computed. This produced the following results: Given an identical extension and analogous metastazising rate, there is no computationally demonstrable difference in prognosis between primary tumours sited at different levels and areas of the oral cavity. The exception are the T1Nx categories, for which a difference exists between precanine and retromolar sites. These results should be re-examined on the basis of a larger series.

TNM-classification of carcinomas of the oral cavity-efficacy of clinically available data (TN).

Using adequate number of cases, the influence of the spread of primary tumour and the degree of regional metastasis on prognosis were investigated. Assuming a practicable classification as a prerequisite for clinico-therapeutic cancer research, experience has shown that the assessment of the spread of primary tumour alone does not suffice for the establishment of comparable homogenous data. The investigation on the importance of the degree of regional metastasis has shown, above all, that the percentage of N3-metastasis within the T-groups contributes essentially to the fact that these show a marked difference in their prognosis. It would therefore appear necessary also to examine the importance of other clinically accessible data in the assessment of prognosis. Only then could we be in a position to judge whether, and to what extent a clinically practicable classification and integration into special groups is possible on the basis of clinically available data. The inclusion of more clinics in the joint investigation is encouraged.

Drug treatment of trigeminal neuralgia with sympatho- and parasympatholytics.

Exciting factors in trigeminal neuralgia known to date are reviewed, and the involvement of the vegetative system in the development of neuralgic pain is documented by clinical observations. Studies of free fatty acids (ffs) and free glycerin (FGly) conducted to assess sympathetic and vegal involvement revealed a sympathetic component to be active in attacks along the distribution of the first and second trigeminal branches, while pain originating from the third branch appears to be mediated by vagal stimuli. Sy,patho- and parasympatholytic therapy is discussed and its effect reviewed in a large group of cases. More than 50% of cases were found to be improved.

The role of the autonomic nervous system in trigeminal neuralgia.

The role of the autonomic nervous system in trigeminal neuralgia is discussed. While the trigeminal nerve is accompanied by both sympathetic and parasympathetic fibers, first and second branch phenomena are predominantly associated with sympathetic stimuli. Third branch phenomena, by contrast, primarily involved a parasympathetic component. Atropine sulfate and beta-receptor blockers are suggested as a therapeutic modality. On ancillary studies involving 30 patients with trigeminal neuralgia an abnormal glucose tolerance and/or increased cholesterol level was found to be present in 28 cases.

[TNM-classification of oral cavity neoplasms the value of clinically measurable factors (TN)]. / TNM-Klassifizierung der Mundhöhlenkarzinome--Wertigkeit klinisch fassbarer Sachverhalte (TN).?19H

Problems associated with the classification of cavum oris and labial carcinomata were discussed with particular reference to patients admitted to and treated in seven different clinical hospitals where identical methods of diagnosis and case history evaluation had been used. Using electronic data processing and biostatistical methods it was possible to study the effects of two clinically detectable factors (growth of primary tumor and degree of regional metastasizing) on both the prognosis and classification according to UICC rules. It was possible to show that a determination of the size of primary tumor (T) alone was not sufficient for three homogeneous, prognostically different collectives of tumors to be satisfactorily classified by the new UICC rules. It has been shown that a classification of three collectives of tumors (new classification according to UICC rules), especially as regards the proportion of N3 metastases within the collectives of tumors, was made possible. Therefore, it will be necessary to study the prognostic influences of additional clinically determinable factors with a view to arriving at a useful and practicable classification of oral cavity carcinomata.