ABSTRACT
The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan-Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.
Subject(s)
Carcinoma, Squamous Cell , Head and Neck Neoplasms , Mouth Neoplasms , Humans , Male , Female , Aged , Carcinoma, Squamous Cell/pathology , Palate, Hard , Mouth Neoplasms/surgery , Mouth Neoplasms/pathology , Retrospective Studies , Prognosis , Lymphatic Metastasis/pathology , Neoplasm Staging , Neoplasm Recurrence, Local/pathology , Survival Rate , Squamous Cell Carcinoma of Head and Neck/pathology , Alveolar Process/pathology , Head and Neck Neoplasms/pathologyABSTRACT
Abstract: The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan-Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.
ABSTRACT
Introdução: as lesões odontogênicas (LOs) compreendem um grupo heterogêneo de patologias orais e maxilofaciais que apresentam características distintas. O objetivo do presente estudo foi identificar as características clínico--patológicas das LOs diagnosticadas em um hospital da região sul do Brasil. Materiais e métodos: foi realizado um estudo retrospectivo para levantamento dos casos com diagnóstico histopatológico de LOs no período entre 2007 e 2017. Os laudos dos pacientes foram avaliados para extração das características clínico-patológicas e dos diagnósticos histopatológicos de cada caso. Resultados: um total de 255 casos de LOs foram identificados. Destes casos, 197 (77%) cistos odontogênicos e 58 (23%) tumores odontogênicos foram coletados, sendo que somente um caso (0,39%) possuiu o diagnóstico de neoplasia odonto-gênica maligna. Os diagnósticos mais prevalentes foram cisto radicular (32,5%) e cisto dentígero (31,76%), seguidos de ceratocisto odontogênico (10,98%), odontoma (10%) e ameloblastoma (10%). A maioria dos casos acometeu mandíbula (53,7%), com uma discreta predileção pelo sexo feminino (51%). A média de idade foi de 34±20,53 anos. Discussão: os dados apresentados corroboram com a literatura no que se refere à raridade do diagnóstico de tumores odontogênicos. Conclusão: o presente estudo demonstrou as principais características clínico-pato-lógicas de LOs diagnosticadas em um hospital no sul do Brasil, contribuindo para um maior conhecimento do perfil destas lesões.
Introduction: odontogenic lesions (OLs) represent a heterogeneous group of oral and maxillofacial patho-logies presenting distinct characteristics. The present study aimed to identify the clinical and pathological characteristics of OLs diagnosed in a southern Brazilian hospital. Materials and methods: a retrospective study was performed to evaluate cases with histopathological diagnosis of OLs identified in the period between 2007 and 2017. The patient's medical records were evaluated in order to obtain the clinical and pathological charac-teristics and the histopathological diagnosis from each case. Results: a total of 255 cases of OLs were identified. From these, 197 (77%) odontogenic cysts and 58 (23%) odontogenic tumors were surveyed, with only one case (0,39%) of a malignant odontogenic neoplasm. The most prevalent diagnosis were radicular cyst (32.5%) and den-tigerous cyst (31.76%), followed by odontogenic keratocyst (10.98%), odontoma (10%) and ameloblastoma (10%). The majority of the cases affected the mandible (53.7%) with a slight preference by female individuals (51%). The mean age was 34±20.53 years old. Discussion: the presented data are in accordance with the literature regarding the rarity of the diagnosis of odontogenic tumors.Conclusion: the present study demonstrated the main clinical and pathological characteristics of OLs diagnosed in a southern Brazilian hospital, contrib-uting to a better understanding of these injuries profiles.
Subject(s)
Humans , Male , Female , Odontogenic Cysts/epidemiology , Retrospective Studies , Neoplasms/epidemiology , Ameloblastoma , Dentigerous Cyst , Odontoma , Radicular Cyst , Odontogenic Cyst, CalcifyingABSTRACT
Background: Salivary gland cancers (SGC) represent an uncommon group of heterogeneous tumors. We per-formed a retrospective survey of SGC diagnosed in a reference center for treatment of malignant tumors from thesouth of Brazil aiming to determine the prognostic value of demographic, clinic and pathologic features.Material and Methods: Cases diagnosed as SGC between 2006 and 2016 were retrospectively collected. Medicalrecords were examined to extract demographic, clinic, pathologic and follow-up information.Results: One-hundred and seven cases of SGC were identified. The most common SGC were mucoepidermoidcarcinoma (MEC) (n = 39) followed by adenoid cystic carcinoma (AdCC) (n = 29). Among AdCCs, 55.2% of caseswere classified as cribriform, 27.6% as tubular and 17.2% as solid. The tubular subtype had the highest percentageof cases with perineural invasion (p=0.01). Among MEC, 61.5% of cases were classified as low grade, 15.4% asintermediate grade and 19.9% as high grade. Low grade MEC had the lowest percentage of cases with perineuralinvasion (p=0.04). The 5-year survival for loco-regional control, disease-free survival (DFS) and disease-specificsurvival were 75%, 70% and 84%, respectively. The following features were associated with poor DFS: advanced age (p=0.03), rural residency (p=0.01), being a smoker or former smoker (p=0.01), pain (p=0.03), nodal metastasis(p<0.001), need for chemotherapy (p=0.02), neck dissection (p=0.04), perineural invasion (p=0.01), and being diag-nosed with AdCC compared to MEC (p=0.02).Conclusions: The clinco-demographic and pathologic features identified as prognostic factors reveal the profile ofpatients at increased risk of recurrence and who would benefit from closer follow-up.(AU)
