scholarly journals Low-dose aspirin confers a survival benefit in patients with pathological advanced-stage oral squamous cell carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sheng-Dean Luo ◽  
Shao-Chun Wu ◽  
Wei-Chih Chen ◽  
Ching-Nung Wu ◽  
Tai-Jan Chiu ◽  
...  

AbstractOral squamous cell carcinoma (OSCC) remains one of the most challenging clinical problems in the field due to its high rate of locoregional and distant metastases. However, studies that assess the association between aspirin use and survival in patients with OSCC are limited. Moreover, patients that recruited from those studies might have tumors that arose from different anatomic regions of the head and neck, including the oral cavity, oropharynx, etc. Since tumors within these distinct anatomic regions are unique in the context of epidemiology and tumor progression, we sought to evaluate the association of aspirin use with squamous cell carcinomas located within the oral cavity only. In this 10-year cohort study, we evaluated aspirin use and survival rates in relation to clinical characteristics as well as duration of aspirin use in patients with OSCC. Our findings suggest that OSCC patients with aspirin use for more than 180 days showed improved overall and disease-specific survival rates. Aspirin also improves survival in patients across various stages of OSCC. Cox regression models indicated that aspirin use was associated with a good prognosis. In conclusion, this evidence indicates that aspirin may be potentially used as an adjuvant therapy for OSCC.

2021 ◽  
Author(s):  
Sheng-Dean Luo ◽  
Shao-Chun Wu ◽  
Wei-Chih Chen ◽  
Ching-Nung Wu ◽  
Tai-Jan Chiu ◽  
...  

Abstract Oral squamous cell carcinoma (OSCC) remains one of the most challenging clinical problems in the field due to its high rate of locoregional and distant metastases. However, studies that assess the association between aspirin use and survival in patients with OSCC are limited. Moreover, patients that recruited from those studies might have tumors that arose from different anatomic regions of the head and neck, including the oral cavity, oropharynx, etc. Since tumors within these distinct anatomic regions are unique in the context of epidemiology and tumor progression, we sought to evaluate the association of aspirin use with squamous cell carcinomas located within the oral cavity only. In this 10-year cohort study, we evaluated aspirin use and survival rates in relation to clinical characteristics as well as duration of aspirin use in patients with OSCC. Our findings suggest that OSCC patients with aspirin use for more than 180 days showed improved overall and disease-specific survival rates. Aspirin also improves survival in patients across various stages of OSCC. Cox regression models indicated that aspirin use was associated with a good prognosis. In conclusion, this evidence indicates that aspirin may be potentially used as an adjuvant therapy for OSCC.


2008 ◽  
Vol 139 (6) ◽  
pp. 775-780 ◽  
Author(s):  
Claudio Marchetti ◽  
Angelo Pizzigallo ◽  
Riccardo Cipriani ◽  
Angelo Campobassi ◽  
Giovanni Badiali

Objective We analyzed our experiences with microvascular reconstruction after oncologic resections for oral squamous cell carcinoma. Has microvascular surgery changed the survival rate of these patients? Design Retrospective study. Subjects and Methods Forty-two consecutive patients enrolled from March 1999 to December 2004. Follow-up time ranged from 1 to 94 months. Survival rates were evaluated by the Kaplan-Meier method and compared among different groups with the use of Cox regression. Results The actuarial 5-year survival rate was 41.9% (SD = 9.6%). Survival rates were also analyzed according to T, N, and stage. The survival was significantly related only to N, which showed a 72.4% increase in the risk related to the increase of one N stage. Conclusions A comparison between our study group and those of 3 previous similar studies would not provide definitive statistical evidence, but it could certainly suggest a trend. The comparison seems to support that microvascular free tissue transfer does not change the survival of these patients.


Author(s):  
Asmaa Ali Hussein

Squamous cell carcinoma characterized by poor prognosis due to aggressive tumor growth and dissemination high rate of tumor cell . age ranged of patient case included in the study 40-62 years and mean age 55±99. The sex distribution male/female ratio 1:1. Male case 15 and female 15 of the present study The results of clinical forums showed in the current study was endophytic 10(33.3%) in the same time Exophytic were presented in 20 cases (76.7%). Regarding distribution of the tumors site, the preponderance of them 19 cases 73.3% were located alveolar mucosa, followed by in the tongue 11 cases(36.7%) Tumor stage was analyzed and recorded in Oral squamous cell carcinoma included cases, the preponderance of them were Stage II 11 cases 36.7% followed by stage III 10 cases 33.3% , 9 cases 30.0% were stage I. While Concerning tumor grade, majority of them 15 cases 50% had grade II moderately differentiated SCC, while 11 cases 36.7% had grade III poorly differentiated SCC and 4 cases 13.3% had grade I well differentiated SCC Positive TGF-β3 immunostaining was detected as cell with staining brown color, all tissues sections included show Positive expression based on IHC teqnique. Positive Transforming Growth Factor TGF-β3 Immuno staining was found in all case results and display that 4 samples with percentage 13.3% expressed strong positive 87.67 ± 1.45 expression , 11cases 36.7% showed 51.33 ±0.88 positive expression moderate at the same time 15 samples 50.0% showed positive weak expression.


Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2273
Author(s):  
Lukas Latzko ◽  
Bernd Schöpf ◽  
Hansi Weissensteiner ◽  
Federica Fazzini ◽  
Liane Fendt ◽  
...  

Under aerobic conditions, some cancers switch to glycolysis to cover their energy requirements. Taking advantage of this process, functional imaging techniques such as PET-CT can be used to detect and assess tumorous tissues. The aim of this study was to investigate standardized uptake values and mitochondrial DNA mutations in oral squamous cell carcinoma. A cohort of 57 patients underwent 18[F]FDG-PET-CT and standardized uptake values were collected. In 15 patients, data on mitochondrial DNA mutations of the tumor were available. Kaplan–Meier curves were calculated, and correlation analyses as well as univariate Cox proportional hazard models were performed. Using ROC analysis to determine a statistical threshold for SUVmax in PET investigations, a cut-off value was determined at 9.765 MB/mL. Survival analysis for SUVmax in these groups showed a Hazard Ratio of 4 (95% CI 1.7–9) in the high SUVmax group with 5-year survival rates of 23.5% (p = 0.00042). For SUVmax and clinicopathological tumor features, significant correlations were found. A tendency towards higher mtDNA heteroplasmy levels in high SUVmax groups could be observed. We were able to confirm the prognostic value of SUVmax in OSCC, showing higher survival rates at lower SUVmax levels. Correlations between SUVmax and distinct tumor characteristics were highly significant, providing evidence that SUVmax may act as a reliable diagnostic parameter. Correlation analysis of mtDNA mutations suggests an influence on metabolic activity in OSCC.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hirofumi Tomioka ◽  
Yuko Yamagata ◽  
Yu Oikawa ◽  
Toshimitsu Ohsako ◽  
Takuma Kugimoto ◽  
...  

AbstractThe control of distant metastasis in oral squamous cell carcinoma is an important determinant of improved prognosis. The study aimed to identify risk factors for distant metastasis in patients with locoregionally controlled oral carcinoma. We identified 982 patients with oral squamous cell carcinoma treated at our hospital between January 2008 and December 2017. After excluding patients with distant metastasis at initial treatment, patients with metastasis to the oral cavity, those receiving palliative treatment, and those lacking follow-up data, 941 patients were selected. Finally, among these 941 patients, 887 with locoregionally controlled oral squamous cell carcinoma were included in the study. Among the 887 patients, 36 had confirmed distant metastasis (4.1%), and the lung was the most common site (31/36 patients, 86.1%). Multivariate analysis showed that the incidence of primary intraosseous carcinoma of the mandible, cervical lymph node metastasis at levels IV and V, and the presence of pathological extranodal extension were significant risk factors for distant metastasis. When treating patients with oral squamous cell carcinoma who are positive for the aforementioned risk factors, the possibility of developing distant metastases must be accounted for, and aggressive treatment should be planned accordingly.


Author(s):  
Nattinee Charoen ◽  
Kitti Jantharapattana ◽  
Paramee Thongsuksai

Objective: Programmed cell death ligand 1 (PD-L1) and mammalian target of rapamycin (mTOR) are key players in host immune evasion and oncogenic activation, respectively. Evidence of the prognostic role in oral squamous cell carcinoma (OSCC) is conflicting. This study examined the associations of PD-L1 and mTOR expression with 5-year overall survival in OSCC patients. Material and Methods: The expressions of PD-L1 and mTOR proteins were immunohistochemically evaluated on tissue microarrays of 191 patients with OSCC who were treated by surgery at Songklanagarind Hospital, Thailand from 2008 to 2011. Cox regression analysis was used to determine independent prognostic factors. Results: PD-L1 expression was observed in 14.1% of cases while mTOR expression was present in 74.3% of cases. Females were more likely to have tumors with PD-L1 (p-value=0.007) and mTOR expressions (p-value=0.003) than males. In addition, lower clinical stage and well differentiated tumor are more likely to have mTOR expression (p-value= 0.038 and p-value<0.001, respectively). Cox regression analysis showed that age, tumor stage, nodal stage, combined surgical treatment with radiation or chemoradiation therapy, surgical margin status, PD-L1 expression and mTOR expression are independent prognostic factors. High PD-L1 expression (hazard ratio (HR) 3.14, 95% confidence interval (CI), 1.26–7.79) and high mTOR expression (HR 1.69, 95% CI, 1.00–2.84) are strong predictors of poor outcome. Conclusion: A proportion of OSCC expressed PD-L1 and mTOR proteins. Expression of PD-L1 and mTOR proteins are strong prognostic factors of OSCC.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17536-e17536
Author(s):  
Hsueh-Ju Lu ◽  
Szu-Wen Tseng ◽  
Chih-Yu Peng ◽  
Hsien-Chun Tseng ◽  
Chung-Han Hsin ◽  
...  

e17536 Background: Early progression, usually defined disease-free interval (DFI) less than six months after completing adjuvant platinum-based chemoradiotherapy (CRT), has very poor outcome for oral cavity squamous cell carcinoma (OCSCC). But there are no biomarkers to predict such early progression. Methods: Locally advanced OCSCC patients, after complete surgical resection and followed-up platinum-based adjuvant CRT, were retrospectively enrolled from Chung Shan Medical University Hospital (CSMUH, training cohort) and Taipei Veterans General Hospital (TPE-VGH, validating cohort) in Taiwan. Clinicopathologic variables of patients with DFI < or ≥ 6 months were compared by using the χ2 test. The Cox proportional hazards model was applied to identify independent factors for DFI. Survival was estimated using the Kaplan-Meier method and log-rank test. Results: A total of 350 high-risk OCSCC patients were enrolled, including 146 patients in training cohort and 204 in validating cohort. In multivariate Cox regression, pN > 0, extracapular spread, and depth of invasion ( ≥ 1cm) were independent factors for DFI in training cohort. If each factor scored one point, the scoring system could effectively predict early progression that sensitivity/specificity/area under curve (AUC) of training and validating cohort were 57.7%/91.2%/0.771 and 58.1%/83.9%/0.730, respectively (the cutoff level ≤ 2 or > 2). DFI between lower- (score 0–2) and high- (score 3) risk groups were also significantly different in both training (median DFI, 59.6 vs. 4.5 months, P < 0.001) and validating cohorts (NA vs. 9.3 months, P < 0.001). Conclusions: The established score system was effective to predict early progression after adjuvant CRT for locally advanced OCSCC.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15548-e15548
Author(s):  
Ritvi K Bagadia ◽  
Vishal Uchila Shishir Rao ◽  
Ajay Balakrishnan ◽  
Abhijith George ◽  
Prashant Kumar

e15548 Background: Around 90% of cancer-related mortalities are caused by tumor metastasis. CTC clusters, which constitute an intermediate stage of metastasis, have not been studied extensively in head & neck cancers. The mortality rate of oral cancers remains alarmingly high, despite multimodality treatment. The aim of the study is to identify the presence of CTC clusters in patients with Oral Squamous Cell Carcinoma (OSCC) and to correlate their presence with clinical and pathological factors. Methods: Fifty patients diagnosed with histologically proven OSCC, treatment naïve, and underwent surgery at HCG Cancer Centre, Bangalore, were consented and enrolled in the study. An IRB-approved protocol allowed for the collection of 10 ml of blood from central (jugular) and peripheral veins intra-operatively, prior to tumor removal. The culturing of CTC clusters was done using ellipsoidal microwell plates maintained at hypoxic conditions, at the Institute of Bioinformatics, Bangalore. After fourteen days of culturing, the cells were fixed and stained for DAPI, Pan-CK and CD45. The CTC clusters were classified into Loose, Tight and very Tight based on the median gray values obtained from DAPI staining on ImageJ software. Clinical data was collected from patient records and subjected to analysis using Descriptive statistics. Results: From the 50 patients included in the study, 22 (44%) patients exhibited tight clusters in central blood, while only 13 (26%) patients exhibited tight clusters in peripheral blood. A higher clinical stage was observed in a greater percentage of patients with tight clusters in central blood (early: 45.5% versus late: 54.5%), but the same findings could not be inferred with pathological staging (early stage: 59.1% versus late stage: 40.1%). No significant correlation with adverse pathological features was noted. Conclusions: This observational study provides an insight into the varying biological behaviours of similarly grouped cancers, which is based on the standard TNM staging. The study forms the basis for the hypothesis of tight clusters in the central and peripheral circulation, correlating with loco-regional and distant metastasis respectively, thus leading to poorer disease-free and overall survival rates.


2021 ◽  
Author(s):  
Yu-jie Liang ◽  
Xue-ying Mei ◽  
Bin Zeng ◽  
Si-en Zhang ◽  
Le Yang ◽  
...  

Abstract Background: The relationship between cancer and coagulation has been intensively studied in recent years; however, the effects of coagulation factors on oral squamous cell carcinoma (OSCC) have rarely been reported. This study aimed to investigate the relationship between preoperative D-dimer (DD), fibrinogen (FIB), platelets (PLT) and OSCC, as well as the prognostic value of DD, FIB and PLT in OSCC. Methods: We retrospectively investigated a total of 202 patients with OSCC treated at Guanghua Hospital of Stomatology, Sun Yat-sen University. Baseline demographic and clinicopathological information as well as both preoperative and postoperative DD, FIB and PLT results were collected from each patient, and patients with primary OSCC were followed up for disease progression, death or the end of the study. The correlations between preoperative DD, FIB, PLT and other clinical features, as well as the therapeutic effect and PFS were analysed statistically, and postoperative DD and surgical parameters were also analysed. Results: Preoperative DD was significantly correlated with T stage, N stage, clinical stage and relapse of OSCC ( P =0.000, 0.001, 0.000 and 0.000, respectively). Univariate Cox regression analyses showed that high preoperative DD predicted poor prognosis in patients with OSCC (HR=2.1, P =0.033), while FIB and PLT showed no prognostic values. Postoperative DD was significantly correlated with preoperative DD and surgical type but not the duration of surgery ( P =0.005, 0.001 and 0.244, respectively). Conclusion: In this study, we suggested that high preoperative DD level may serve as an indicator for synchronous neck dissection in patients with T 1, 2 OSCC, and the elevated DD level might be the marker of disease progression in patient follow up.


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