Predictors of Survival After Head and Neck Squamous Cell Carcinoma in South America: The InterCHANGE Study.

PURPOSE: Head and neck squamous cell carcinoma (HNSCC) incidence is high in South America, where recent data on survival are sparse. We investigated the main predictors of HNSCC survival in Brazil, Argentina, Uruguay, and Colombia. METHODS: Sociodemographic and lifestyle information was obtained from standardized interviews, and clinicopathologic data were extracted from medical records and pathologic reports. The Kaplan-Meier method and Cox regression were used for statistical analyses. RESULTS: Of 1,463 patients, 378 had a larynx cancer (LC), 78 hypopharynx cancer (HC), 599 oral cavity cancer (OC), and 408 oropharynx cancer (OPC). Most patients (55.5%) were diagnosed with stage IV disease, ranging from 47.6% for LC to 70.8% for OPC. Three-year survival rates were 56.0% for LC, 54.7% for OC, 48.0% for OPC, and 37.8% for HC. In multivariable models, patients with stage IV disease had approximately 7.6 (LC/HC), 11.7 (OC), and 3.5 (OPC) times higher mortality than patients with stage I disease. Current and former drinkers with LC or HC had approximately 2 times higher mortality than never-drinkers. In addition, older age at diagnosis was independently associated with worse survival for all sites. In a subset analysis of 198 patients with OPC with available human papillomavirus (HPV) type 16 data, those with HPV-unrelated OPC had a significantly worse 3-year survival compared with those with HPV-related OPC (44.6% v 75.6%, respectively), corresponding to a 3.4 times higher mortality. CONCLUSION: Late stage at diagnosis was the strongest predictor of lower HNSCC survival. Early cancer detection and reduction of harmful alcohol use are fundamental to decrease the high burden of HNSCC in South America

E-cadherin as a potential biomarker of malignant transformation in oral leukoplakia: a retrospective cohort study

Submitted by Luciana Ferreira ([email protected]) on 2018-10-26T14:50:19Z No. of bitstreams: 2 Artigo - Sandra Lúcia Ventorin von Zeidler - 2014.pdf: 935206 bytes, checksum: f95eb6d90870c787a7f5d9f938d78525 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2018-10-29T11:14:10Z (GMT) No. of bitstreams: 2 Artigo - Sandra Lúcia Ventorin von Zeidler - 2014.pdf: 935206 bytes, checksum: f95eb6d90870c787a7f5d9f938d78525 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2018-10-29T11:14:10Z (GMT). No. of bitstreams: 2 Artigo - Sandra Lúcia Ventorin von Zeidler - 2014.pdf: 935206 bytes, checksum: f95eb6d90870c787a7f5d9f938d78525 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2014Background: Numerous attempts have been made to establish and develop tumor markers that could determine the susceptibility of normal tissues to transform into cancerous ones. To determine whether altered expression patterns of E-cadherin could be an early event in the progression of potentially malignant disorders to oral squamous cell carcinoma, this study aimed to assess the relationship between the immunoexpression of E-cadherin and the different degrees of epithelial dysplasia in oral leukoplakia. Methods: Surgically excised specimens from patients with oral leukoplakia (n = 31), oral cavity squamous cell carcinoma with cervical lymph node metastasis (n = 12) and normal oral mucosa (n = 9) were immunostained for E-cadherin. Oral leukoplakia samples were distributed into low and high risk group according to a binary system for grading oral epithelial dysplasia. Comparative analyses between E-cadherin expression and microscopic features (WHO histological grading and epithelial dysplasia) were performed by Pearson Chi-square test (P < 0.05). Results: Differences in E-cadherin expression were observed between normal oral mucosa and low risk oral leukoplakia (P = 0.006), low and high risk oral leukoplakia (P = 0.019), and high risk oral leukoplakia and oral cavity squamous cell carcinoma with cervical lymph node metastasis (P = 0.0001). In addition, as epithelia undergo dysplastic changes, the risk of malignant transformation increases, and there is a reduction or loss of E-cadherin expression by keratinocytes. Reduced E-cadherin expression was an early phenomenon and it was observed in moderate-severe dysplasia, showing that the loss of epithelial cohesion may be an indicator of progression to oral cavity squamous cell carcinoma. Conclusions: E-cadherin could be used as a novel biomarker to identify lesions with potential risk for malignant transformation, which may provide opportunities for prophylactic interventions in high risk patient groups

Polymorphisms in methylenetetrahydrofolate reductase and cystathionine beta-synthase in oral cancer - a case-control study in southeastern Brazilians

ABSTRACT INTRODUCTION: Oral squamous cell carcinoma (OSCC) is a serious public health problem, due to its high mortality rate and worldwide rising incidence. OSCC susceptibility is mediated by interactions between genetic and environmental factors. Studies suggest that genetic variants encoding enzymes involved in folate metabolism may modulate OSCC risk by altering DNA synthesis/repair and methylation process. OBJECTIVE: The goals of this study were to evaluate the association of three genotypic polymorphism (MTHFR C677T, MTHFR A1298C and CBS 844ins68) and oral cancer risk in southeastern Brazilians and evaluate the interactions between polymorphisms and clinical histopathological parameters. METHODS: This case-control study included 101 cases and 102 controls in the state of Espírito Santo, Brazil. MTHFR genotyping was done by PCR-RFLP (polymerase chain reaction - restriction fragment length polymorphism) and CBS genotyping by PCR (polymerase chain reaction) analysis. RESULTS: MTHFR C677T polymorphism was associated with lymph node involvement. Genotype CT + TT acted as a protective factor. MTHFR A1298C AC + CC genotype was associated with tumor differentiation, and possibly with a better prognosis. In risk analysis, no correlation was observed between genotypes and OSCC. CONCLUSION: We concluded that MTHFR C677T, MTHFR A1298C and CBS 844ins68 polymorphisms were not associated with OSCC risk in southeastern Brazilians; however, we suggest a prognosis effect associated with MTHFR C677T and A1298C polymorphisms in OSCC

Altered β-catenin expression in oral mucosal dysplasia: a comparative study

Objective The current study aimed to investigate the β-catenin expression in oral leukoplakia (OL) with different degrees of epithelial dysplasia and normal oral mucosa.Material and Methods Formalin-fixed, paraffin-embedded tissue samples of 39 OL (mild dysplasia n=19, moderate dysplasia n=13, and severe dysplasia n=7), and 10 normal oral mucosa (control group) were submitted to immunohistochemical reactions to anti-β-catenin primary antibody. A qualitative β-catenin analysis was performed based on the percentage of positive cells. The cellular location and the epithelial layer were also considered. The Chi-square test and the Fisher’s exact test were used to verify possible differences in the β-catenin expression among the OL groups. A p-value o

Atypical esthesioneuroblastoma invading oral cavity: a case report and review of the literature

Submitted by Luciana Ferreira ([email protected]) on 2018-10-26T13:29:43Z No. of bitstreams: 2 Artigo - Sandra Lúcia Ventorin von Zeidler - 2014.pdf: 1740154 bytes, checksum: 44459b8a28bc98d1167e89c248bc9d2e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2018-10-29T11:09:38Z (GMT) No. of bitstreams: 2 Artigo - Sandra Lúcia Ventorin von Zeidler - 2014.pdf: 1740154 bytes, checksum: 44459b8a28bc98d1167e89c248bc9d2e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2018-10-29T11:09:38Z (GMT). No. of bitstreams: 2 Artigo - Sandra Lúcia Ventorin von Zeidler - 2014.pdf: 1740154 bytes, checksum: 44459b8a28bc98d1167e89c248bc9d2e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2014-01Esthesioneuroblastoma is an uncommon tumour of neuroectodermal origin. The authors describe a rare presentation of an atypical esthesioneuroblastoma invading oral cavity. The clinical presentation, aetiology, diagnosis, and management of this condition are discussed. The patient developed significant swelling in the right anterosuperior alveolar mucosa and had moderate tooth mobility. Conventional x-rays and computed tomography revealed a large osteolytic lesion, with imprecise limits. Histological findings along with immunohistochemical staining results and clinical features led to the diagnosis of high-grade esthesioneuroblastoma. Local recurrences and neck metastasis were detected. The rare oral findings produced delayed in diagnosis which may lead to a compromise in planning and execution of further radical management and thus a poor prognosis

Mechanical Response of PEKK and PEEK As Frameworks for Implant-Supported Full-Arch Fixed Dental Prosthesis: 3D Finite Element Analysis

Objective ?Polymeric framework represent an innovative approach for implant-supported dental prostheses. However, the mechanical response of ultra-high performance polymers as frameworks for full-arch prostheses under the all-on-four concept remains unclear. The present study applied finite element analysis to examine the behavior of polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) prosthetic frameworks. Materials and Methods ?A three-dimensional maxillary model received four axially positioned morse-taper implants, over which a polymeric bar was simulated. The full-arch prosthesis was created from a previously reported database model, and the imported geometries were divided into a mesh composed of nodes and tetrahedral elements in the analysis software. The materials were assumed as isotropic, elastic, and homogeneous, and all contacts were considered bonded. A normal load (500 N magnitude) was applied at the occlusal surface of the first left molar after the model was fixed at the base of the cortical bone. The microstrain and von-Mises stress were selected as criteria for analysis. Results ?Similarities in the mechanical response were observed in both framework for the peri-implant tissue, as well as for stress generated in the implants (263-264 MPa) and abutments (274-273 MPa). The prosthetic screw and prosthetic base concentrated more stress with PEEK (211 and 58 MPa, respectively) than with PEKK (192 and 49 MPa), while the prosthetic framework showed the opposite behavior (59 MPa for PEEK and 67 MPa for PEKK). Conclusion ?The main differences related to the mechanical behavior of PEKK and PEEK frameworks for full-arch prostheses under the all-on-four concept were reflected in the prosthetic screw and the acrylic base. The superior shock absorbance of PEKK resulted in a lower stress concentration on the prosthetic screw and prosthetic base. This would clinically represent a lower fracture risk on the acrylic base and screw loosening. Conversely, lower stress concentration was observed on PEEK frameworks