ABSTRACT
The German-Swiss-Austrian Group on Maxillofacial Tumors (DOSAK) has been performing observational studies in oral cancer. Since 1989, approximately 1600 cases of tumor of the head and neck per years has been collected in a central tumor registry. The database consists of more than 16,000 patients from 71 clinics; almost two-thirds are primary cases of squamous cell carcinoma. The data show great differences in patho-anatomical findings, therapy concepts, and five-year survival rates among the hospitals.
Subject(s)
Carcinoma, Squamous Cell/mortality , Facial Neoplasms/mortality , Jaw Neoplasms/mortality , Mouth Neoplasms/mortality , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/surgery , Facial Neoplasms/diagnosis , Facial Neoplasms/surgery , Germany , Humans , Jaw Neoplasms/diagnosis , Jaw Neoplasms/surgery , Mouth Neoplasms/diagnosis , Mouth Neoplasms/surgery , Prognosis , Registries/statistics & numerical data , Survival RateABSTRACT
A fifteen-year-old boy with osteogenesis imperfecta (OI) and dentinogenesis imperfecta also had a big cyst in the mandible and needed surgical therapy. Six months postoperatively we saw a complete regeneration of the bone-structures. We came to the conclusion that cysts which appear independently from the disease of OI can heal after surgical intervention.
Subject(s)
Dental Care for Chronically Ill , Mandibular Diseases/surgery , Osteogenesis Imperfecta/complications , Radicular Cyst/surgery , Adolescent , Humans , Incisor , Male , Mandibular Diseases/etiology , Osteogenesis Imperfecta/classification , Radicular Cyst/etiologyABSTRACT
AIM: The prognostic value of the TNM and pTNM classifications currently used for tumours of the oral cavity is unsatisfactory. A better classification should be aimed at as today's definition of T4 leads to overclassification of many tumours and today's definition of N3 results in too few lymph nodes in this group. Until 1987 the grade of fixation of lymph-nodes was part of the N-classification for oral cancer as it is currently used in the N-classification of breast cancer. METHODS: From 1987 to 1991 the DOSAK tumour registry has stored 1532 primary cases of cancer of the oral cavity from 23 hospitals. Crosstables were applied to outline the classification rule for clinical and histopathological T and N based on important factors (T: tumour diameter and thickness; N: lymph node diameter and grade of fixation; pT: histopathological tumour diameter and thickness; pN: number of lymph nodes involved by the tumour). A Cox model was calculated and combinations of similar prognostic estimates were summarized to the same clinical and histopathological T and N. It was aimed at separating categories and achieving equivalent clinical and histopathological T classifications and group frequencies. In a final step a clinical and histopathological stage grouping can be proposed. RESULTS: The gradation of the survival rates shows a marked separation between the T, N and stage categories. The distribution of T, N and stage categories was more uniform when applying the new classification.
