ABSTRACT
OBJECTIVES: HPV16-positive oropharyngeal cancer (OPC) patients experience better outcomes compared to HPV16-negative patients. Currently, strategies for treatment de-escalation are based on HPV status, smoking history and disease stage. However, the appropriate cut-point for smoking and the role of other non-clinical factors in OPC survival remains uncertain. MATERIALS AND METHODS: We examined factors associated with OPC outcome in 321 patients recruited in a large European multi-center study. Seropositivity for HPV16 E6 was used as a marker of HPV16 positive cancer. Hazard ratios (HR) and confidence intervals (CI) were estimated using Cox proportional models adjusted for potential confounders. RESULTS: Overall 5-year survival following OPC diagnosis was 50%. HPV16-positive OPC cases were at significantly lower risk of death (aHRâ¯=â¯0.51, 95% CI: 0.32-0.80). A significant effect on OPC survival was apparent for female sex (aHR 0.50: 95% CI: 0.29-0.85) and being underweight at diagnosis (aHR: 2.41, 95% CI: 1.38-4.21). A 10 pack year smoking history was not associated with overall survival. Higher stage at diagnosis appeared as the only factor significantly associated with OPC recurrence (aHR: 4.88, 95% CI: 2.12-11.21). CONCLUSION: This study confirms that HPV16 status is an independent prognostic factor for OPC survival while female sex lowers risk of death and being underweight at diagnosis increases the risk of death. Smoking was not an independent predictor of OPC survival.
Subject(s)
Oropharyngeal Neoplasms/pathology , Survival Analysis , Alphapapillomavirus/isolation & purification , Body Mass Index , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Oropharyngeal Neoplasms/virology , Retrospective Studies , Risk Factors , Smoking , Tumor Virus Infections/pathology , Tumor Virus Infections/virologyABSTRACT
OBJECTIVES: Orofacial granulomatosis has mostly been described in reports of very small numbers of cases. Few large case groups have been described. The aim of this study was to describe the demographics, symptoms, clinical features and laboratory findings in a large cohort of cases. SUBJECTS AND METHODS: Clinical and laboratory data for 119 cases of orofacial granulomatosis who attended oral medicine clinics in Dublin, Ireland, were examined for demographic characteristics at the time of first presentation. The male/female ratio was approximately 1:1, with a median age (and range) of 28 (5-84) years. RESULTS: Symptoms had been present for a median duration of 12 weeks. A food association was suspected by 30% of patients. The predominant complaint was lip swelling (77%) with only 15% reporting facial swelling, while 8% complained of both. Almost all patients had clinical evidence of lip or facial swelling (95%). Other common extra-oral manifestations were lip fissuring (30%), angular cheilitis (28%) and perioral erythema (28%). Common intra-oral manifestations were cobblestoning of the buccal mucosa (63%), ulcers (36%), granulomatous gingivitis (33%), mucosal tags (29%) and fissured tongue (17%). Over half of the biopsies (56%) performed were reported as typical of orofacial granulomatosis. CONCLUSION: This is one of the largest cohorts of orofacial granulomatosis patients to have been described in detail.
Subject(s)
Granulomatosis, Orofacial/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Blood Cell Count , Blood Chemical Analysis , Cheilitis/epidemiology , Child , Child, Preschool , Cohort Studies , Edema/epidemiology , Erythema/epidemiology , Facial Paralysis/epidemiology , Female , Gingivitis/epidemiology , Humans , Hypersensitivity/epidemiology , Ireland/epidemiology , Lip Diseases/epidemiology , Male , Middle Aged , Oral Ulcer/epidemiology , Retrospective Studies , Sex Factors , Tongue, Fissured/epidemiology , Young AdultABSTRACT
We report a case of gingival T cell non-Hodgkin's lymphoma that responded initially to chemotherapy, recurred at another site a year later, but regressed spontaneously after incisional biopsy. We are not aware of any other reports about spontaneous regression of T cell lymphomas in the oral cavity.
Subject(s)
Gingival Neoplasms , Lymphoma, T-Cell, Peripheral , Gingival Neoplasms/blood , Gingival Neoplasms/pathology , Gingival Neoplasms/therapy , Humans , Lymphoma, T-Cell, Peripheral/blood , Lymphoma, T-Cell, Peripheral/pathology , Lymphoma, T-Cell, Peripheral/therapy , Male , Middle Aged , Remission, SpontaneousABSTRACT
Report on an unusual case of uremic stomatitis mimicking oral hairy leukoplakia. The similarities of the two lesions are discussed, and the differential diagnosis reviewed.
Subject(s)
Kidney Failure, Chronic/complications , Leukoplakia, Hairy/diagnosis , Stomatitis/diagnosis , Stomatitis/etiology , Uremia/complications , Diagnosis, Differential , Humans , Male , Middle Aged , Uremia/diagnosisABSTRACT
We report a case of intravenous talcosis in a 36 year old woman. Although she initially denied drug abuse clinical suspicion was aroused by the finding of obliterated peripheral veins, a pleural rub and a peripheral nodular lesion on chest x-ray. Diagnosis of intravenous talcosis was confirmed by finding birefringent particles on transbronchial biopsy. Confronted with this evidence the patient admitted long-standing drug abuse, including intravenous injection of crushed methadone tablets which contain talc filler.
