Oral cancer trends in a single head-and-neck cancer center in the Netherlands; decline in T-stage at the time of admission

Objectives: In this study we evaluated the possible epidemiologic changes of oral cancer patients in the Netherlands between the years 1980-1984 and 2000-2004. We specifically studied the differences in male-female ratio, age, TNM-stage, site distribution, and alcohol and tobacco use. Materials and Methods: Patients from the VU University Medical Center with an oral squamous cell carcinoma of the oral cavity registered in 1980-1984 (n=200), group 1, were compared to patients registered in 2000-2004 (n=184), group 2. Trends in prevalence, site distribution, TNM-stage, alcohol and tobacco use, age and gender were studied. Results: The male-female ratio has decreased from 1.8 to 1.2. There were no differences in age between the two groups of patients. The site distribution was similar in both groups. The most commonly involved sites were the tongue and the floor of mouth. In group 2 more patients were diagnosed with a T1 tumour. There were no differences in tobacco use between the two different groups. There were much more light drinkers (0-2 drinks per day) in group 2 than in group 1, whereas there were more heavy drinkers (>4 per day) in group 1 than in group 2 (p<0.001). This was observed in both male and female patients. Conclusion: In our study there were no significant differences between the patients registered in the years 1980-1984 and 2000-2004 regarding the mean age of the patients, site distribution and smoking habits. The male-female ratio has decreased. In the recent group more patients were staged T1N0 and there was a strong decrease of the patients who were heavy drinkers. © Medicina Oral S. L

Postoperative Daycare as a Safe and Cost-Effective Option for Secondary Alveolar Bone Graft (SABG) Surgery: A Retrospective Comparative Cohort Study

Objective: To evaluate the outcomes of Secondary Alveolar Bone Grafting (SABG) in patients treated either in daycare or with multiple day hospitalization (MDH) in relation to costs and complication rates. Design: Retrospective comparative cohort study. Setting: The data was collected from two settings: Postoperative daycare or MDH after oral cleft surgery in an Academic Medical Center in The Netherlands. Patients: Data of 137 patients with unilateral Cleft lip, alveolus, and palate (CLAP) treated between 2006-2018 were evaluated. Registered clinical variables: age, gender, cleft subtype, bone donor site, type of hospitalization, length of stay, additional surgery, complications, surgeons, and costs. Interventions: Closure of the alveolar cleft with/without closure of the anterior palate. Main outcome measures: Univariate analyses. Results: Of the 137 patients, 46.7% were treated in MDH, and 53.3% in daycare. Total costs for daycare were significantly lower (P <.001). All patients treated in daycare received mandibular symphysis bone, whereas in MDH, 46.9% received iliac crest bone instead. Bone donor site was associated with postoperative care type. Complication rates were slightly but not significantly higher in daycare (26%) vs. MDH (14.1%) (P =.09). Most were Grade I (minor) according to Clavien Dindo classification. Conclusions: Daycare after alveolar cleft surgery is about as safe as MDH, but significantly cheaper

Distribution of personal and practice characteristics by degree of technology use.

<p>*One-way Analysis of Variance with post hoc Tukey HSD test</p><p>^† Kruskal-Wallis H test with post hoc Mann-Whitney U test</p><p>a Low TU- Intermediate TU p<0.05</p><p>b Intermediate TU—High TU p<0.05</p><p>c Low TU—high TU p<0.05.</p><p>Distribution of personal and practice characteristics by degree of technology use.</p

Digital technology use by personal characteristics and practice characteristics.

<p>^†χ² Test</p><p>*Standardized residuals <-2 or >2.</p><p>Digital technology use by personal characteristics and practice characteristics.</p