Cervical Metastasis in Squamous Cell Carcinoma of the Hard Palate and Maxillary Alveolus

2016 ◽  
Vol 95 (10-11) ◽  
pp. E6-E25 ◽  
Author(s):  
Yekaterina Koshkareva ◽  
Jefrey C. Liu ◽  
Miriam Lango ◽  
Tomas Galloway ◽  
John P. Gaughan ◽  
...  

We conducted a retrospective study to determine the incidence and treatment outcomes of neck metastases in patients with squamous cell carcinoma (SCC) of the hard palate and/or maxillary alveolus after surgical excision of the primary tumor. We also sought to identify any risk factors for recurrence. Our study population was made up of 20 patients—9 men and 11 women, aged 46 to 88 years (mean: 72.6)—who had undergone excision of an SCC of the hard palate and/or maxillary alveolus at a tertiary care cancer center over a 7-year period. Half of all patients were former tobacco users. Of the 20 tumors, 10 involved the maxillary alveolus, 4 involved the hard palate, and 6 involved both sites. Three patients were clinically categorized as T1, 9 as T2, 6 as T3, and 2 as T4; pathologically, 8 tumors were categorized as T4a. In addition to maxillectomy, a neck dissection was performed in 7 patients—4 therapeutically and 3 electively. Eight of 20 patients experienced a recurrence: 4 local, 6 regional, and 2 distant (several patients had a recurrence at more than one site). Univariate analysis identified perineural invasion (p = 0.04) as a statistically significant risk factor for recurrence. Of 14 patients with a clinicopathologically negative neck, 5 (36%) developed a cervical recurrence, and 4 of them died of their disease. An advanced stage (T4 vs. <T4) was not significantly correlated with the risk of regional metastasis (p = 0.58). The rate of occult nodal metastasis in clinically and radiologically N0 necks was high. Clinical and radiologic understaging was common, and regional recurrences frequently resulted in death. We conclude that elective nodal evaluation and treatment of the neck warrants strong consideration for most patients with cancer of the hard palate and/or maxillary alveolus.

2020 ◽  
pp. 000348942097777
Author(s):  
Katie M. Mingo ◽  
Adeeb Derakhshan ◽  
Neelab Abdullah ◽  
Deborah J. Chute ◽  
Shlomo A. Koyfman ◽  
...  

Objectives: To analyze characteristics, treatment outcomes, and prognostic factors of sarcomatoid squamous cell carcinoma of the head and neck. Study Design: Retrospective chart review. Setting: Tertiary care center. Subjects and Methods: Fifty-five patients were treated for sarcomatoid squamous cell carcinoma of the head and neck between 1996 and 2018. Data collection included clinical history, tumor characteristics, pathology, treatment modality, and outcomes. Mean follow up was 17.1 months. Cox univariate analysis was used to evaluate for associations with locoregional recurrence, distant metastasis, and overall survival. Results: Most patients were white males with a smoking history and median age 66 years (range 41-92) at diagnosis. Twenty-two percent had prior head and neck radiation. Tumor site was most frequently oral cavity (41.8%), followed by larynx (29.1%), and oropharynx (16.4%). Half presented with early T stage disease (15.5% T0, 12.7% T1, 30.9% T2) and the remainder with late stage disease (16.4% T3, 34.5% T4). Locoregional recurrence rate was 60.0%, metastatic recurrence was rate 21.8%, with median time to recurrence of 4 months and mean overall survival of 20 months. Presence of lymphovascular space invasion was statistically associated with locoregional recurrence ( P = .018, HR 3.55 [95% CI 1.24, 10.14]) and poorer overall survival ( P = .015, HR 2.92 [95% CI 1.23, 4.80]). Treatment with multimodality therapy was associated with decreased locoregional recurrence ( P = .039, HR 0.39 [95% CI 0.16, 0.95]) but did not impact overall survival. Conclusion: Sarcomatoid squamous cell carcinoma remains a rare and aggressive disease variant with high recurrence rates and high mortality. High risk features such as lymphovascular space may indicate the need for more aggressive therapy.


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.


1987 ◽  
Vol 97 (3) ◽  
pp. 308-312 ◽  
Author(s):  
William W. Shockley ◽  
Fred J. Stucker

Squamous cell carcinoma of the external ear can be a potentially lethal lesion. Although it is the most common cancer involving the pinna, the variables that have the greatest impact on prognosis are still in question. We reviewed 75 cases of squamous cell carcinoma of the external ear to determine patterns of occurrence and treatment failure. Forty patients had adequate follow-up for determination of cancer control rates. Local control was successful with initial treatment in 85% of the cases. The incidence of lymph node metastases was 10%, whereas distant metastasis occurred in only one patient (2.5%). This series differs from others in that most patients were unselected and most of the lesions treated were early (less than 1 cm). The significance of positive margins after surgical excision is also analyzed.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P43-P44
Author(s):  
Sundip H Patel ◽  
Mike Yao ◽  
Tara Brennan

Objective 1) The primary goal of this study was to evaluate the incidence of radionecrosis among patients treated with radiation therapy for oral cavity & oropharynx squamous cell carcinoma at our institution. Many patients with oral cavity & oropharyngeal cancers receive radiation to preserve the tongue, knowing the risks of post-treatment radionecrosis. However, recent protocols have intensified chemo-radiotherapy in an effort to improve local control while possibly increasing risk. 2) Among those patients with radionecrosis, we also analyzed their cancer treatment regimen, associated risk factors, the severity of the radionecrosis and the resulting treatment they recieved. Methods We performed a retrospective review of all adult patients at our tertiary care facility with biopsy proven squamous cell carcinoma of the oral cavity & oropharynx from 1999 to 2007 who completed a full course of radiotherapy at our facility with at least 6 months follow-up. Medical charts were reviewed for the presence of radionecrosis as well as for other corresponding, pertinent data. Results After reviewing 241 patients, a total of 107 patients were included. 5 of 65 with oropharynx disease had radionecrosis, revealing an incidence of 7.7%. Among the oral cavity group there were 8 out of 42 patients with radionecrosis, revealing an incidence of 19%. The overall incidence among our treatment group was 12.1%. Conclusions Radiation-induced necrosis of the oral cavity & oropharynx is still a significant complication in the treatment of head and neck cancer and poses a higher risk in the oral cavity than the oropharynx.


2021 ◽  
pp. 000348942110556
Author(s):  
Alexandra E. Quimby ◽  
Pagona Lagiou ◽  
Bibiana Purgina ◽  
Martin Corsten ◽  
Stephanie Johnson-Obaseki

Objective: To determine the persistence of human papillomavirus (HPV) infection following treatment of HPV-positive oropharyngeal squamous cell carcinoma (HPV + OPSCC). Methods: A cross-sectional study was undertaken at The Ottawa Hospital (Ottawa, ON, Canada), a tertiary academic hospital and regional cancer center. Adult patients who were diagnosed with HPV + OPSCC between the years of 2014 and 2016 and treated with curative intent, and who were alive and willing to consent were eligible for inclusion. A saliva assay was used to test for the presence of HPV DNA in a random sample of patients. qPCR was used to amplify DNA from saliva samples. Results: Saliva samples were obtained from 69 patients previously treated with HPV + OPSCC. All patients had a minimum of 2 years of follow-up. 5 patients tested positive for HPV: 2 were positive for HPV-16, 2 for HPV-18, and 1 “other” HPV type. No patient in our study cohort had suffered recurrence post-treatment. Conclusions: This study is the first to demonstrate the prevalence of persistent oncogenic HPV DNA in saliva following treatment for HPV + OPSCC. This prevalence appears to be low, despite the fact that persistent HPV infection is a precursor for the development of HPV + OPSCC. This finding raises questions about what factors influence the clearance or persistence of HPV DNA in saliva after treatment for HPV + OPSCC, and may add to our understanding about the longitudinal effects of HPV infection in these cancers.


2021 ◽  
Vol 8 (3) ◽  
pp. 364-368
Author(s):  
Ishani Gupta ◽  
Rekha Rani ◽  
Jyotsna Suri

Oral cancer is one of a major health problem in some parts of the world especially in the developing countries. Oral cancer is the sixth most common cancer in the world whereas in India it is one of the most prevalent cancer. Oral cavity lesions are usually asymptomatic. Accurate diagnosis of the lesion is the first step for the proper management of patients and histopathology is considered as the gold standard. The objective is to study the different patterns of oral cavity lesions seen in a tertiary care hospital of Jammu: One year retrospective study. Post graduate department of pathology.: It was a retrospective study carried out in a tertiary care centre for a period of one year from March 2020 to Feb 2021. 148 cases of oral cavity lesions were included in this study. The parameters that were included in the study were sociodemographic data, site of the lesion, clinical features and histological diagnosis. Data collected was analysed.148 cases of oral lesions were identified during the period of study. The age of patients varied from 5 to 78years and Male to Female ratio was 2.2:1. Buccal mucosa (30%) was the most common site involved which was followed by tonsil (19%). Out of 148 cases 70 cases were malignant, 10 cases pre malignant and 21 cases were benign. Squamous cell carcinoma (33.7%) was the most common lesion present in our study. Oral cavity lesions have a vast spectrum of diseases which range from tumour like lesions to benign and malignant tumours. Our study concluded that squamous cell carcinoma was the most common malignant lesion of oral cavity. Histological typing of the lesion is important for confirmation of malignancy and it is essential for the proper management of the patient.


Author(s):  
M. Prasanna Lakshmi ◽  
P. Veena ◽  
R.V. Suresh Kumar ◽  
D. Rani Prameela ◽  
K. Jagan Mohan Reddy

Background: Bovine ocular squamous cell carcinoma also called cancer eye, represents the most economically important neoplasm in large animals. Hereditary factors, environmental factors (e.g: latitude, altitude, exposure to sunlight), lack of eyelid pigmentation, age and dietary habits have all been reported to play a role in the etiopathogenesis of bovine ocular squamous cell carcinoma. In addition, in cattle the etiology has been linked to a number of viral agents, especially bovine papilloma virus and bovine herpes virus type 1 and 5. Nevertheless, ultraviolet light, viruses and circumocular pigmentation are the major epidemiologic risk factors for the development of the tumor. The efficacy of different treatment modalities for eye cancer in bovines was studied.Methods: All the animals were divided in to four groups of six animals each. Surgical excision, intra lesion BCG vaccine, surgery with auto vaccine and surgery with mitomycin was the treatment protocols followed. Immunohistochemical studies were conducted to know the rate of proliferation of bovine ye cancer. Immunopositive reaction was observed against Vascular Endothelial Growth Factor and Epidermal Growth Factor Receptor in all the cases.Result: The benefits of different treatment modalities depended on nature, type, location and extensiveness of tumor. Early detection and aggressive treatment were essential in the successful management of these tumors. A multimodal treatment approach was recommended with surgery, immunotherapy and chemotherapy in providing 100% disease free interval.


Head & Neck ◽  
2012 ◽  
Vol 35 (2) ◽  
pp. 265-269 ◽  
Author(s):  
James S. Brown ◽  
Fazilet Bekiroglu ◽  
Richard J. Shaw ◽  
Julia A. Woolgar ◽  
Simon N. Rogers

Sign in / Sign up

Export Citation Format

Share Document