ABSTRACT
Abstract. BACKGROUND/PURPOSE: The clinical significance of minor risk factors remins uncertain in oral squamous cell carcinoma (OSCC) patients. The purpose of this study was to investigate the clinical impact of minor risk factors in OSCC patients. MATERIALS AND METHODS: The cases of OSCC patients that underwent surgery were retrospectively analyzed. Patients with major risk factors for recurrence, such as positive surgical margins or extracapsular spread, were excluded. The impact of possible minor risk factors on treatment outcomes was analyzed. One hundred and seventy-five patients with primary OSCC that underwent surgery were included in this study. RESULTS: The 5-year overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) rates were 81.2%, 91.0%, and 72.4%, respectively. In multivariate analyses, RFS exhibited a significant association with the pattern of invasion (grade 4 vs. grades 1-3: hazard ratio: 3.096, 95% confidence interval: 1.367-6.884, pâ¯<â¯0.01), OS exhibited a tendency towards associations with the pattern of invasion and perineural invasion, and CSS displayed a tendency towards an association with perineural invasion. The prognosis of the patients with ≥2 minor risk factors was significantly worse than that of the patients with 0 or 1 minor risk factor(s) (OS: 91.6% vs. 64.5%, respectively, pâ¯<â¯0.01; CSS: 98.9% vs. 78.9%, respectively, pâ¯<â¯0.001; and RFS: 81.2% vs. 58.5%, respectively pâ¯<â¯0.05). CONCLUSION: Grade 4 invasion and perineural invasion might be significant minor risk factors in OSCC patients. The presence of ≥2 minor risk factors might be a predictor of a poor prognosis in OSCC patients.
ABSTRACT
OBJECTIVES: The purpose of this study was to investigate the treatment outcomes and prognostic factors of medication-related osteonecrosis of the jaw (MRONJ) in Japanese patients. PATIENTS AND METHODS: Among 409 cases, treatment outcomes and prognostic factors were investigated in 275 patients. In statistical analyses, the 1-year cumulative curative rate was calculated with the Kaplan-Meier method, and significance was examined with the Wilcoxon test. Cox's proportional hazards regression analysis was used for the multivariate analysis. RESULTS: Resolution of the disease was achieved in 137 out of 275 MRONJ patients (49.8%). One-year cumulative curative rates were 39.8% in stage 1 patients, 26.3% in stage 2, and 19.0% in stage 3. The 1-year cumulative curative rates of treatment interventions were 17.2% for conservative treatment, 34.5% for sequestrectomy, and 40.7% for extended surgery including bone resection and segmental resection. As the prognostic factors of treatment outcomes, the type of medication, stage of MRONJ, and type of surgical intervention were identified as independent factors in a multivariate analysis. CONCLUSION: These results suggest that surgical interventions may lead to a good prognosis in MRONJ patients. CLINICAL RELEVANCE: This study indicated that surgical intervention for MRONJ might lead to improvement of prognosis and quality of life in MRONJ patients.
