Candida oral colonization and infection in Brazilian patients undergoing head and neck radiotherapy: a pilot study.

Objective: The aim of this study was to verify the profile of Candida species responsible for colonizing and infecting the oral cavity of Brazilian patients undergoing radiotherapy (RT).

Study Design: Saliva samples were collected from 21 patients before, during, and immediately after RT. Each sample was distributed in agar Sabouraud dextrose/chlorophenicol and incubated at 37 degrees C for 18 hours.

Management of extensive osteoradionecrosis of the mandible with radical resection and immediate microvascular reconstruction.

Purpose: Osteoradionecrosis (ORN) is a severe and devastating late complication of radiotherapy in patients with head and neck cancer. Management of ORN remains controversial and the current approach has been focused on debridement, systemic antibiotics, and eventually hyperbaric oxygen therapy for small and limited ORN. However, this conservative approach is ineffective in controlling extensive bone and soft-tissue necrosis.

Dietary patterns and risk of oral cancer: a case-control study in São Paulo, Brazil.

Objective: To analyze the association between dietary patterns and oral cancer.

Methods: The study, part of a Latin American multicenter hospital-based case-control study, was conducted in São Paulo, Southeastern Brazil, between November 1998 and March 2002 and included 366 incident cases of oral cancer and 469 controls, frequency-matched with cases by sex and age. Dietary data were collected using a food frequency questionnaire.

Comorbidity is a prognostic factor in elderly patients with head and neck cancer.

Background: The number of aged patients with head and neck cancer is increasing. Comorbidities are common in this population. It is necessary to evaluate the effect of comorbidities as measured with the ACE-27 index on recurrence and survival of elderly patients with head and neck cancer, adjusting by other prognostic factors as age, clinical stage and functional status index.

Clinicopathological and immunohistochemical evaluation of oral squamous cell carcinoma in patients with early local recurrence.

Early local recurrence is one of the main causes of treatment failure after definitive therapy of oral squamous cell carcinoma (OSCC), contributing significantly for the relative low survival rates of this neoplasia. The aim of this study was to investigate the clinical, histological and molecular factors involved in early local recurrence of OSCC, which may lead to better risk assessment in some specific cases. Twenty-seven patients with early recurrent OSCC were matched with 54 patients with the same clinical stage and tumor site but without local recurrence, in a pair-matched study design.

Adenoid cystic carcinoma and mucoepidermoid carcinoma of the maxillary sinus: report of a 44-year experience of 25 cases from a single institution.

Purpose: The aim of this study was to analyze the clinicopathologic characteristics of all cases of adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma (MEC) arising in the maxillary sinuses treated in a single institution.

Patients And Methods: From 1953 to 1997, 18 ACCs and 7 MECs from the maxillary sinus were studied. Clinical data were obtained from the medical records and microscopic slides were reviewed.

Voice and vocal self-assessment after thyroidectomy.

Background: Voice alterations after thyroidectomy can be found even with preserved function of laryngeal nerves. The purpose of this study was to evaluate voice before and after thyroid surgery and the role of orotracheal intubation on voice changes.

Methods: We conducted a prospective nonrandomized study of patients who underwent thyroid surgery and compared the results with a control group of patients who underwent breast surgery.

Salvage for cervical recurrences of head and neck cancer with dissection and interstitial high dose rate brachytherapy.

Salvage therapy in head and neck cancer (HNC) is a controversy issue and the literature is scarce regarding the use of interstitial high-dose rate brachytherapy (I-HDR) in HNC. We evaluated the long-term results of a treatment policy combining salvage surgery and I-HDR for cervical recurrences of HNC. Charts of 21 patients treated from 1994 to 2004 were reviewed.

Neck dissection: then and now.

The significance of metastatic disease in the lymph nodes of the neck as a critical independent prognostic factor in head and neck cancer has long been appreciated. Although 19th century surgeons attempted to remove involved cervical lymph nodes at the time of resection of the primary cancer, a systematic approach to en bloc removal of cervical lymph node disease, described in detail by Jawdyński in 1888 and popularized and illustrated by Crile in the early 20th century, provided consistent and more effective treatment, and forms the basis of our current techniques. During the first half of the 20th century, developments included preservation of the accessory nerve in selected cases, elective neck dissection performed in association with resection of various primary tumors, bilateral neck dissection and limited neck dissection.

Brazilian-Portuguese validation of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer.

Background: The University of Washington Quality of Life (UW-QOL) questionnaire is an English-language survey instrument used worldwide to assess the quality of life of patients with head and neck cancer. To be used in other cultures, such instruments require careful translation and psychometric validation in other languages.

Methods: The translation and cultural adaptation of the questionnaire were performed following accepted international guidelines.

Oral verrucous carcinoma: a retrospective study in São Paulo Region, Brazil.

Oral verrucous carcinoma (OVC) is a rare variant of squamous cell carcinoma with a characteristic morphology and specific behavior. To date, few studies are available focusing the prevalence and clinicopathologic features of the oral verrucous carcinoma in Brazilian population. A total of 3,500 primary oral well-differentiated squamous cell carcinoma surgically excised in the A.

Class distinction between follicular adenomas and follicular carcinomas of the thyroid gland on the basis of their signature expression.

Background: Nodules of the thyroid gland are observed frequently in patients who undergo ultrasound studies. The majority of these nodules are benign, corresponding to goiters or adenomas, and only a small fraction corresponds to carcinomas. Among thyroid tumors, the diagnosis of follicular adenocarcinomas by preoperative fine-needle aspiration biopsy is a major challenge, because it requires inspection of the entire capsule to differentiate it from adenoma.

Clinicopathologic and immunohistochemical study of intraoral mucoepidermoid carcinoma.

Objective: The purpose of this study is to assess the clinicopathologic and immunohistochemical features of intraoral mucoepidermoid carcinomas and its relationship with the prognosis.

Study Design And Setting: From 1953 to 1993, 27 patients with intraoral mucoepidermoid carcinomas surgically treated were selected for this study. Clinical data were obtained from the medical records, the microscopic slides were reviewed, the tumors were graded, and immunohistochemical analysis for p53, PCNA, cerbB-2, and CEA were carried out.

Epithelial lacrimal gland tumors: a clinicopathological study of 18 cases.

Objective: The aim of this study was to report the clinicopathological features of 18 epithelial tumors of the lacrimal gland treated in a single institution.

Study Design And Setting: Clinical data and treatment were recorded and histological features reviewed.

Results: Twelve tumors (66.

Craniofacial resection for malignant melanoma of the skull base: report of an international collaborative study.

Objective: To report postoperative mortality, complications, and outcomes in a subset of patients with the histologic diagnosis of malignant melanoma extracted from an existing database of a large cohort of patients accumulated from multiple institutions.

Design: Retrospective outcome analysis.

Setting: Seventeen international tertiary referral centers performing craniofacial surgery for malignant skull base tumors.

Socioeconomic effects of and risk factors for disability in long-term survivors of head and neck cancer.

Objective: To evaluate the socioeconomic effect of and risk factors for work-related disability due to head and neck cancer and its treatment.

Design: Cross-sectional analysis of a consecutive series of patients.

Setting: Tertiary cancer center hospital.

H19-DMR allele-specific methylation analysis reveals epigenetic heterogeneity of CTCF binding site 6 but not of site 5 in head-and-neck carcinomas: a pilot case-control analysis.

Aberrant methylation of seven potential binding sites of the CTCF factor in the differentially methylated region upstream of the H19 gene (H19-DMR) has been suggested as critical for the regulation of IGF2 and H19 imprinted genes. In this study, we analyzed the allele-specific methylation pattern of CTCF binding sites 5 and 6 using methylation-sensitive restriction enzyme PCR followed by RFLP analysis in matched tumoral and lymphocyte DNA from head-and-neck squamous cell carcinoma (HNSCC) patients, as well as in lymphocyte DNA from control individuals who were cancer-free. The monoallelic methylation pattern was maintained in CTCF binding site 5 in 22 heterozygous out of 91 samples analyzed.

Prognostic factors in salvage surgery for recurrent oral and oropharyngeal cancer.

Background: Therapeutic decisions in recurrent oral and oropharyngeal squamous carcinoma (SCC) remain controversial.

Methods: Two hundred forty-six consecutive patients who underwent salvage surgery for recurrent squamous cell carcinoma (SCC) of the oral cavity and oropharynx were studied. The tumor sites were lip, 33 cases; oral cavity, 143; oropharynx, 70.

The importance of long-term follow-up of head and neck cancer patients for reliable survival analysis.

Objective: Analyze the influence of patients lost to follow-up in estimated survival rates calculated by the Kaplan-Meier method.

Study Design: Only patients with previously untreated squamous cell carcinoma of the upper aerodigestive tract were selected. For the patients lost to follow-up anytime, the last medical evaluation date was collected to calculate the "estimate A" survival time.

Prognostic factors in head and neck adenoid cystic carcinoma.

The aim of this study was to analyse the clinical, histological and immunohistochemical prognostic factors of a large series of adenoid cystic carcinoma, using univariate and multivariate survival analyses. All cases of head and neck ACC (n = 129) treated in a single institution in Brazil, between 1955 and 1997, were selected for the study. Univariate survival analysis revealed that age older than 45 years (p = 0.

Planned neck dissection following chemoradiotherapy for advanced head and neck cancer: is it necessary for all?

In the absence of large-scale randomized trials evaluating dissection versus observation of the involved neck after neoadjuvant chemoradiotherapy, there is a need to collect data that will either support or ultimately refute a role for planned posttreatment neck dissection. A significant percentage of patients with extensive (N2 or N3) neck disease who demonstrate a complete response to chemoradiation therapy may harbor residual occult metastases, and identification of this subset of patients remains a clinical challenge. Because surgical salvage rates are greatly diminished when occult nodal disease becomes clinically manifest, planned posttreatment neck dissection is advocated but may not be necessary in all patients.

Sublingual salivary gland tumors: clinicopathologic study of six cases.

Objective: The aim of this study was to assess the clinical and histologic features of 6 cases of sublingual salivary gland tumors treated in a single institution.

Study Design: The clinical data were obtained from the medical records, and the histopathologic slides were reviewed.

Results: Four cases were adenoid cystic carcinoma (ACC) and 2 were mucoepidermoid carcinoma (MEC).

Expression of PCNA, p53, Bax, and Bcl-X in oral poorly differentiated and basaloid squamous cell carcinoma: relationships with prognosis.

Background: The aim of this study was to compare the clinical features and proliferating cell nuclear antigen (PCNA), p53, Bcl-X, and Bax expression in primary oral basaloid squamous cell carcinoma (BSCC) and poorly differentiated squamous cell carcinoma (PDSCC) matched by stage and site and to assess the possible prognostic significance of these variables.

Methods: Seventeen cases of oral BSCC were compared with 27 PDSCCs matched by stage and tumor site. In addition, PCNA, p53, Bax, and Bcl-X expression in both carcinomas were evaluated in relation to their clinicopathologic features and prognostic values using the Kaplan-Meier method and Cox regression models.

Interstitial high-dose-rate brachytherapy combined with cervical dissection on head and neck cancer.

Background: The literature is scarce regarding the use of interstitial high-dose-rate brachytherapy (I-HDR) as adjuvant treatment of the cervical region, and most reports are focused on primary tumors of the mobile tongue and oropharynx. We evaluated the outcome and morbidity related to an institutional treatment policy, using I-HDR as the sole adjuvant treatment or in combination with external beam radiotherapy (EBRT) at the Departments of Radiation Oncology and Head and Neck Surgery, Hospital do Cancer, Sao Paulo, Brazil.

Methods: From October 1994 to December 2003, charts of 42 patients who had biopsy-proven cervical head and neck cancer, with a median follow-up of 36 months (range, 8-111 months), were reviewed.