Oral Cavity Carcinoma Research Articles

Subacute Infarction of Recurrent Artery of Heubner Mimicking CNS Tumor With Correlative Brain MRI and 18F-FDG PET/CT Findings.

A 62-year-old man, previously treated for oral cavity carcinoma, presented with new-onset cognitive-motor symptoms. Brain MRI revealed a periventricular, avidly enhancing lesion in the right anterior basal ganglia and hypothalamus suspicious for a brain tumor, particularly CNS lymphoma. 18F-FDG brain PET/CT showed corresponding uptake suggestive of primary brain tumor, lymphoma, or metastasis. Follow-up MRI showed resolution of enhancement and mass effect favoring an evolving subacute infarct. The diagnosis of an infarct in the recurrent artery of Heubner territory was facilitated by MRI, and recurrent artery of Heubner infarction was noted as a potential cause for false-positive 18F-FDG uptake on PET/CT, mimicking intracranial tumor.

Synthesis and Cytotoxicity Evaluation of Novel C-3 Aminocarbamate Pregnenolone Derivatives

Cancer is one of the leading causes of death worldwide. There are many ongoing studies in the search for new treatments or drugs to combat cancer. Similarly, in this research, twelve 3-aminocarbamate pregnenolones (2a–2l) were designed, synthesized, and evaluated for their cytotoxicity against five cancer cell lines: Human hepatocellular carcinoma (HepG2), Human colon adenocarcinoma (HT-29), Human oral cavity carcinoma (KB), Human breast adenocarcinoma (MCF-7), Murine leukemia (P388), and one normal cell line, African green monkey kidney fibroblast (Vero), using the MTT assay. Notably, 3-aminobenzylcarbamate pregnenolone (2b), 3-diaminoheptylcarbamate pregnenolone (2f), and 3-diaminopropanolcarbamate derivative (2i) were the most potent against these cancer cell lines. Specifically, for P388 cell lines, these compounds were more potent than the positive control drug, vinblastine sulfate salt. Results from the SAR study demonstrated that the length of the alkyl chain of diaminocarbamate derivatives was crucial for their anticancer properties. These findings will be useful in the future research and development of anticancer drugs.

Pattern of Recurrence in Carcinoma Oral Cavity: Prospective Longitudinal Study

Pattern of Recurrence in Carcinoma Oral Cavity: Prospective Longitudinal Study

A prospective observational study of local failures in surgical stage III and IV squamous cell carcinoma of oral cavity

A prospective observational study of local failures in surgical stage III and IV squamous cell carcinoma of oral cavity

Abstract B034: Engineering the tumor microenvironment: Patient-specific microphysiological systems of the head and neck cancer tumor microenvironment

Abstract Introduction: Survival rates in advanced head and neck cancer (HNC) remain poor with no clinically approved biomarkers to predict treatment efficacy. HNC is a highly heterogenous disease and the lack of available models that capture patient heterogeneity and the complexity of the tumor microenvironment (TME) contributes to these poor patient outcomes. Microphysiological systems (MPS) are complex multicellular in vitro models that can recapitulate three-dimensional organ structure and function. The low cell number requirements for MPS permits the creation of patient-specific TME models, where all the cell types can be isolated from a single piece of tumor tissue. These patient-specific MPS represent a promising strategy for elucidating the contribution of the TME to treatment resistance, predicting the best treatment for each patient and improving patient outcomes in HNC. Here, we report a patient-specific MPS that contains multiple TME compartments and recapitulates patient heterogeneity. Methods: Tumor tissue was collected from patients with oral cavity carcinoma undergoing standard of care surgery followed by radiation or chemoradiation. Tissue from each patient was digested and tumor infiltrating leukocytes (TIL) were isolated using CD45 magnetic beads, while epithelial cells and fibroblasts were expanded in culture using specific media formulations. Tissue was also snap frozen for single cell RNA sequencing analysis. To build the MPS, a custom designed microfluidic device was filled with a hydrogel matrix containing patient-matched TIL, fibroblasts and epithelial spheroids to mimic the solid tumor. Lumens molded from the hydrogel were seeded with blood or lymphatic endothelial cells to create vasculature. Multiple replicate MPS can be built from each patient, which are cultured in an optimized media formulation to support the multiple primary cell types. Patient-specific MPS were treated with radiation or cisplatin + radiation to mimic the treatment the patient received. Multiple orthogonal endpoints were measured including tumor cell migration and viability, cytokine secretion and angiogenesis. Single cell sequencing was also performed on the original tumor tissue and matched MPS. Results: We have successfully created patient-specific models of the HNC TME. Single cell RNA sequencing analysis of the MPS suggests that cellular heterogeneity is being retained. Patient characteristics varied between MPS with some patient TME MPS showing highly migratory tumor cells or angiogenic responses. Treatment responses were measured for each patient-specific MPS and ongoing work will characterize the contributions of the TME to treatment resistance. These data demonstrate the feasibility of using patient-specific MPS to investigate the contribution of the TME to treatment response and resistance and lays important groundwork for using MPS to identify patient treatment responses. Citation Format: Adeel Ahmed, Marcos Lares, Fauzan Ahmed, Adam R. Burr, Paul M. Harari, David J. Beebe, Sheena C. Kerr. Engineering the tumor microenvironment: Patient-specific microphysiological systems of the head and neck cancer tumor microenvironment [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor-body Interactions: The Roles of Micro- and Macroenvironment in Cancer; 2024 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(22_Suppl):Abstract nr B034.

Multidisciplinary tumor boards in oral cavity cancer: survival effect due to balancing guideline adherence and treatment delays.

The purpose of the study was to assess the impact of a pretherapeutic Multidisciplinary Tumor Board (MTB) presentation on the prognosis and treatment outcomes in patients with primary oral cavity carcinoma. This single-center study included 630 patients diagnosed with oral cavity carcinoma treated between 2010 and 2020. The study cohort was divided in a group with and without pretherapeutic MTB presentation. Data on patient demographics, tumor characteristics, treatment and the time to treatment initiation (TTI) were collected retrospectively. Primary findings revealed no significant difference in 3-year survival rate (3-YSR) and 3-year disease-free survival rate (3-YDFSR) for the non-MTB and MTB group. The 3-YSR was 73.1% in the non-MTB group and 67.1% in the MTB group (p = 0.112). The 3-YDFSR was 73.8% in the non-MTB group and 76.5% in the MTB group (p = 0.447). Estimated mean 5-year survival (5-YS) and 5-year disease-free survival in (5-YDFS) did not differ significantly between both groups, across the UICC stages I-IV, as well as for the entire cohort. The TTI was significantly longer in the MTB group (33.5 days, CI: 31.3;35.7) compared to the non-MTB group (20.1 days, CI: 17.9;22.4, p < 0.001). The MTB group adhered more frequently to the national guidelines (68% vs. 79.6%, p < 0.01). The results demonstrate both positive and negative side effects of the MTB presentation in patients with oral cavity cancer. Further multicenter studies will be required to assess the impact of TTI and adherence to guidelines on the survival of oral cavity cancer patients.

The Diagnostic And Prognostic Role Of Immunohistochemistry In Head &amp; Neck Tumours Along With Radiological &amp; Histopathological Study

Background: Head &amp; neck tumors are defined as benign, premalignant &amp; malignant tumors above the clavicles, except the tumors of brain, spinal cord and esophagus. This includes tumors of paranasal sinus, nasal cavity, salivary glands, thyroid and upper aerodigestive tract, lymph nodes of neck, skin &amp; its appendages, soft tissue tumors, midline carcinomas &amp; metastatic tumors. Ultrasonography, computed tomography, magnetic resonance imaging were the modalities for initial evaluation. Histopathology was the GOLD standard for diagnosis followed by IHC for confirmation because correct diagnosis &amp; cancer subtyping of the neoplasia is essential for successful therapy and prognosis. Materials &amp; Methods: Study was conducted for 2 years with 100 specimens of head &amp; neck tumors. Thorough Radiological investigation was done followed by Histopathological examination including biopsy &amp; whole resected specimens. IHC markers appropriate to the histopathological diagnosis was done. Results: Among 100 patients of head &amp; neck tumors, most belonged to 5th decade with male: female ratio of 2.3:1. Squamous cell carcinoma (66%) followed by Lymphoma(11%), tumors of salivary glands(8%), metastatic lymphadenopathy(7%) were the lesions present. SCC was most common carcinoma in oral cavity, larynx, nasopharynx and ear with positive p63 marker. 1 case of Basal cell carcinoma with positive BerEP4 &amp; in NHL, salivary gland tumors &amp; Metastatic lymphadenopathy panel of IHC were included for confirmation. Conclusion: Immunohistochemistry has a diagnostic &amp; prognostic role in Head &amp; Neck tumors along with Radiological &amp; histopathological examination.

Interpreting the patterns of local failure following postoperative volumetric-modulated arctherapy in oral cavity and oropharynx cancers: Impact of the different methods of analysis

PurposeIntensity-modulated radiation therapy or volumetric-modulated arctherapy is nowadays the recommended radiation technique for the treatment of head and neck cancers. However, by providing a significant dose gradient between target volumes and organs at risk, there is a risk of target missing and thus recurrence in case of inadequate delineation. It is therefore necessary to determine the origin of these recurrences to improve clinical practice. Over the past years, different methods have been described for the analysis of recurrences. Using the patterns of failure of patients with oral cavity and oropharynx carcinoma, treated with postoperative volumetric-modulated arctherapy in our institution, the purpose of this work was to analyse the sites of local recurrences and to evaluate the disparity in the classification of recurrences when different methods were used. Material and methodsBetween 2011 and 2019, 167 patients who underwent postoperative volumetric-modulated arctherapy for oral cavity or oropharyngeal cancers were included (60 and 40 % respectively). Two or three dose levels were prescribed (54Gy, 59.4/60Gy±66Gy). Local recurrence occurred in 17 patients (10.2 %). We assessed the patterns of local recurrences according to four methods: 1/ volume-based method using the volume overlap between the recurrence volume and initial target volumes; 2/ volume-based method of overlap between the recurrence volume and the 95 % treatment isodose; 3/ point-based method using the position of the barycentre of the recurrence volume; 4/ combined centroid method classifying recurrences according to both the initial target volumes and dose distribution. Each case was reviewed to make a clinical judgment on these classifications and assessed them as “appropriate”, “possible”, or “inappropriate”. ResultsFor the volume-based method using overlap between the recurrence volume and the initial clinical target volume, this classification was clinically judged as inappropriate in 11 out of 17 cases (65 %). For the volume-based method using overlap between the recurrence volume and the 95 % prescribed isodose, this classification was clinically judged as appropriate in 15 out of 17 cases (88 %). For the point-based method, this classification was clinically judged as appropriate in 14 out of 17 cases (82 %). Thirteen out of 17 local recurrences had the same classification between this point-based method and the volume-based method of overlap between the recurrence volume and the 95 % prescribed isodose. For the combined centroid method, among 17 local recurrences nine were classified as type A, two as type B, two as type C, three as type D and one as type E. This classification was clinically judged as appropriate in 15 out of 17 cases (88 %). Only five out of 17 of the local recurrences were classified the same way according to the four different methods (29 %). ConclusionRecurrences that are “marginal” or “outfield” represent a major challenge for intensity-modulated radiation therapy/volumetric-modulated arctherapy quality assurance and improvement of delineation recommendations. To date, there are no published methods that give complete satisfaction.

Pioneering Clinical Investigation: Beta Defensin Expression in Patients of Squamous Cell Carcinoma of Oral Cavity as a Forward-Looking Validation for Molecular Treatment

Pioneering Clinical Investigation: Beta Defensin Expression in Patients of Squamous Cell Carcinoma of Oral Cavity as a Forward-Looking Validation for Molecular Treatment

Pattern of Recurrence and Metastatic Disease in Post Operative Postradiotherapy Patients of Squamous Cell Carcinoma of Oral Cavity

Objective: Oral cavity is one of the common site of cancer in head and neck. They have high cure rate but locoregional failure seen in some cases at primary, nodal or metastatic site. We retrospectively analysed treatment results of oral cavity cancer in our institute and intented to define the prevalence and pattern of failure. Materials and Methods: It is a prospective cohort study. 179 cases of post operative oral cavity cancer between January 2019 to December 2021, who took radiotherapy or chemoradiotherapy treatment in our institute were studied. 79 patients had loss of follow up during and after treatment. Results of study excluded these patients. Results: Median follow up was 24 months (8-40 months). Treatment failure after radiotherapy or chemoradiotherapy at primary site and at nodal site was 22 % and 2 % respectively. In 8% cases recurrence was present at both primary and nodal site. Metastasis at extra nodal site occurred in 4% cases (3% in liver, 1% in bone). Conclusion: Operated case of oral cavity cancer when treated with radiotherapy or chemoradiotherapy has very high cure rate and few locoregional failures at primary and nodal site and rarely at distant site. Recurrence most commonly seen in advanced disease. Therefore, advanced disease patients should be treated with more aggressive treatment to achieve higher cure rate in oral cavity cancer patients. Disease free survival and overall survival was better in early stage than in advanced stage. Node positive disease had more risk of recurrence and metastasis.

Impact of Cancer Localization on Symptom Burden and Quality of Life in Head and Neck Cancers: A Comparative Study.

Background: Head and neck cancer (HNC) is a critical concern in oncology, with notable disparities in survival rates. While the long-term symptom burden in HNC survivors and its impact on quality of life (QoL) has been explored, there is limited understanding of the influence of cancer localizations on these aspects. This study aims to elucidate the role of cancer localizations in shaping long-term outcomes in HNC patients. Methods: A cross-sectional study was conducted at the University Hospital Erlangen's Department of Otolaryngology, exploring the impact of cancer localization on symptom burden and QoL in 138 HNC patients using the University of Washington Quality of Life Questionnaire Version 4. Results: In our study of HNC patients, we investigated symptom burden across different cancer localizations, including oral cavity, oropharyngeal, hypopharyngeal, laryngeal, and cancer of unknown primary (CUP). While we found no significant variations in parameters such as pain, appearance, and activity, notable differences emerged in swallowing, speech, and salivation. Patients with oral cavity and laryngeal carcinomas had significantly higher swallowing and salivation scores compared to those with oropharyngeal carcinoma and CUP, while speech-related symptoms were lower for oral cavity and laryngeal carcinoma patients. Importantly, these symptom differences did not significantly impact health-related and overall QoL. These findings emphasize the nuanced interplay between symptomatology and QoL in different HNC cancer localizations. Conclusion: The research highlights significant disparities in post-treatment symptoms across different HNC localizations and underscores the need for personalized treatment and management strategies to address unique challenges associated with each HNC type, ultimately aiming to enhance post-treatment QoL.

An Integrated Approach of Network Pharmacology, Bioinformatics, Molecular Docking, and Experimental Verification Uncovers Prunellae Spica as the potential Medicine of Prognosis Improvement for Oral Squamous Cell Carcinoma.

Prunellae Spica (PS), the spike from Prunella vulgaris L., is a traditional Chinese medicine that can treat Oral Squamous Cell Carcinoma (OSCC), whereas its molecular mechanisms and effects on the prognosis of patients remain unclear. Our study aimed to identify potential anti-OSCC targets of PS and explore its mechanisms and effects on prognosis through network pharmacology, bioinformatics analysis, molecular docking, and in vitro cell assays. Sixty-two potential targets of 11 active anti-OSCC ingredients of PS were identified, with Quercetin, the core ingredient of PS, exhibiting the most significant number of OSCC-related targets. GO analysis indicated that the primary biological processes involved in OSCC treatment by PS were the cellular response to nitrogen compound, response to xenobiotic stimulus, and cellular response to organonitrogen compound. KEGG analysis revealed that Pathways in cancer were the top highly enriched signaling pathway in the treatment of OSCC by PS. DisGeNET analysis is mainly about Lip and Oral Cavity Carcinoma. More importantly, 6 of the 62 targets were markedly related to prognosis. Molecular docking revealed high affinities between the key component and the prognosis-related target proteins. Treatment of OSCC cell line SCC-25 with Quercetin could inhibit malignant biological behaviors, such as cell proliferation, colony formation, invasion, and migration, as well as affect the targets related to prognosis and promote autophagy. Overall, these results suggest that PS plays a significant role in treating and improving the prognosis of OSCC by directly influencing various processes in OSCC.

1132: Adjuvant Intensity Modulated Radiation Therapy in Oral Cavity Carcinomas with Pedicled Flap

1132: Adjuvant Intensity Modulated Radiation Therapy in Oral Cavity Carcinomas with Pedicled Flap

Local Flap Reconstructions in Oral Cavity Defects: An Insight from 104 Cases.

Resection of oral cavity carcinoma often leads to complex defects causing functional and aesthetic morbidity. Providing optimum reconstruction with free flaps becomes challenging in a high-volume center setting with constrained resources. Hence, understanding the local flap technique for reconstructing oral cancer defects is prudent. This study is a retrospective analysis of prospectively operated cases of oral cavity resections which were subsequently reconstructed using local flaps from 2019 to 2022. Patients who underwent reconstruction with either melolabial flap, islanded facial artery myomucosal (FAMM) flap, submental flap, supraclavicular artery island flap, infrahyoid flap, or platysma myocutaneous flap (PMF) were included in this analysis. Eligible patients were followed up to evaluate functional outcomes like oral feeding and to analyze the Performance Status Scale for Head and Neck Cancer. The study included 104 patients. The tongue was the most common subsite, resulting in most hemiglossectomy defects, which were reconstructed using the melolabial flap procedure. Buccal mucosa defects in our series were reconstructed using the supraclavicular flap, whereas the submental flap procedure was the choice for lower lip-commissure defects. Complications such as partial and total flap loss, deep neck infection, and donor site complications like infection and gaping, oral cutaneous fistula, parotid fistula, and seroma were analyzed; the supraclavicular flap presented with a majority of complications. Local flaps are an alternative to free flap reconstruction in select cases with optimum functional outcomes and minimal donor site morbidity. This article comprehensively reviews the surgical steps for various local flap procedures in oral cancer defects.

Assessment of Pattern of Cervical Lymph Node Metastasis in Squamous Cell Carcinoma of Oral Cavity

Objective: Cervical lymph node involvement is crucial for prognostic factor for oral squamous cell carcinomas, and understanding nodal metastasis pattern is essential for optimal neck dissection, oncological control, and minimizing morbidity. This study reviews nodal involvement and skip metastasis in 316 oral SCC patients to determine the extent of neck dissection. Methods: The retrospective study analysed 316 patients with oral cancer diagnosed between 2017 and 2020, including those with primary oral cavity cancer who underwent neck dissection. A comprehensive assessment of patient data was used to determine the extent and size of the lesion and lymph node involvement. Preoperative staging was confirmed using various imaging techniques, including OPG, CT MRI, and biopsies. Histological examination results were used to categorize carcinomas based on differentiation levels and to identify nodal involvement patterns. Results: The most common subsite for 316 patients was the tongue (62%), followed by the buccal mucosa (19%), lower alveolus (10.2%), hard palate (3.2%), retro molar trigone (2.8%), floor of the mouth (1.6%), upper alveolus (0.9%), and lower lip (0.3%). Nodal metastasis were more common in Levels II and Ib, with less involvement in Level III and beyond. Tumour with a DOI greater than 10 mm showed higher nodal metastasis frequency, with an increased occurrence in Levels IA, IB, II, III, and IV. Conclusion: Nodal metastasis in oral cancer are common in Levels II and Ib, with variations based on subsite. Alveolus and buccal mucosa malignancies involve fewer lymph nodes beyond Level III, while tongue malignancies show greater involvement in lower levels Level IV involvement is more frequent with greater DOI, and skip metastasis are rare.

Frequency and involvement of lymph nodes in squamous cell carcinoma of oral cavity in cross sectional population.

Objective: To find out the frequent site of squamous cell carcinoma of oral cavity and pattern of neck node involvement in cross sectional population. Study Design: Prospective Study. Setting: Department of Otorhinolaryngology Head and Neck Surgery, Abbasi Shaheed Hospital Karachi and Karachi Medical and Dental College. Period: 01-06-2023 to 31-12-2023. Methods: Patients who biopsy proven squamous cell carcinoma of oral cavity visited ENT department Abbasi Shaheed Hospital were include in this study. Proforma was made in which detail history and examination were noted. Oral cavity examined to see the size and site of tumor. Neck was palpated to see palpable cervical lymph node. CT scan head and neck with contrast was done. Those patients who fulfilled the inclusion and exclusion criteria included in this. Result: 56 patients were selected in this study who fulfill the inclusion criteria. Male were 37 (66%). Maximum number of patients were between the 41-50 years of age, 24 patients (42.8%). Most common site of carcinoma was buccal mucosa 27 (48.2%). Highest number of patients presented with T3 stage 22 patients (39.2%). The frequency of lymph node involvement noted in 35 (62.5%) patients while 21 (37.5%) came with no lymph node. Level I was the most frequent level involved, it was involved in 28 patients (50%). Conclusion: Oral squamous cell carcinoma usually reported late. Early referral to otorhinolaryngologist and educate patient to consult Otorhinolaryngologist as earliest for early diagnosis and appropriate treatment plan.

Turbocharging of Deep to Superficial Venous System for Vessel Depleted Neck in Radial Forearm Free Flap: A Case Report of One Neck Vein for Drainage of Both Venous Systems

Dual venous anastomosis in radial forearm free flap surgery increases chances of flap survival as compared to anastomosing only the superficial system. A 48-year-old male patient who had received three previous microsurgical reconstructions and radiotherapy presented with recurrent oral cavity carcinoma. Two of these reconstructions were anastomosed to the left side neck vessels. The recurrence was in the left half of the soft palate. The left neck and underlying vessels were severely scarred and fibrotic, and only 2 cm of the left internal jugular vein (IJV) could be circumferentially mobilized for anastomosis, allowing for only one venous anastomosis. The radial forearm free flap was harvested and a tributary of the cephalic vein was preserved in the proximal part to act as a conduit for drainage of one of the venae comitantes. The cephalic vein was anastomosed end-to-side to the IJV and one venae comitantes to the preserved tributary in end-to-end fashion. The flap survived and the patient was discharged in a week. This novel method helps to drain both venous systems through one available neck vein.

Clinical Implications of EMT in HNSCC: A Review of the Factors and Pathways at Play

_Background: _Epithelial-mesenchymal transition (EMT) is a biological process where epithelial cells acquire mesenchymal traits. Epithelial cells are characterized by tight cell-cell adhesions and apical-basal polarity, whereas mesenchymal cells are generally elongated in appearance with loose cell-cell interactions, allowing increased cell migration. Many studies have been done on EMT pathways in oral cavity carcinoma, but there are few studies about the possible clinical implications. _Aims_ _&amp;_ _Objectives:_ This systematic review was carried out to find the clinical implications of EMT in HNSCC and bring together the molecular, genetic, and epigenetic pathways found to be acting on the cadherin switch. _Materials &amp; Methods: _An extensive search for relevant papers was made on PubMed, Medline, and Google Search. Only good-quality studies pertaining to epithelial–mesenchymal transition in oral cavity cancers in humans were selected. Furthermore, all selected papers were assessed for their clinical relevance. _Results: EMT has role in prognostication, diagnostic dilemma, margin assessment, mandibular preservation, making OSCC more prone to systemic therapies and planning risk reduction in strategies. _The cadherin switch is regulated by transcription factors like Snail, SLUG, ZEB1, and ZEB2. It is also acted on by epigenetic modifiers. These transcription factors are regulated by multiple pathways like Wnt/β–catenin, PI3K/AKT, MAPK, etc. These pathways are in turn regulated by molecular and external agents like NNK from tobacco smoke, hypoxia, the DDB2 gene, reactive oxygen species (ROS), and melatonin.

Tumor-stroma contact ratio - a novel predictive factor for tumor response to chemoradiotherapy in locally advanced oropharyngeal cancer

The growth pattern of oropharyngeal squamous cell carcinomas (OPSCC) varies from compact tumor cell aggregates to diffusely infiltrating tumor cell-clusters. The influence of the growth pattern on local tumor control and survival has been studied mainly for surgically treated oral cavity carcinomas on a visual basis. In this study, we used multiplex immunofluorescence staining (mIF) to examine the antigens pan-cytokeratin, p16INK4a, Ki67, CD271, PD-L1, and CD8 in pretherapeutic biopsies from 86 OPSCC. We introduce Tumor-stroma contact ratio (TSC), a novel parameter, to quantify the relationship between tumor cells in contact with the stromal surface and the total number of epithelial tumor cells. mIF tumor cores were analyzed at the single-cell level, and tumor-stromal contact area was quantified using the R package "Spatstat". TSC was correlated with the visually assessed invasion pattern by two independent investigators. Furthermore, TSC was analyzed in relation to clinical parameters and patient survival data to evaluate its potential prognostic significance.Higher TSC correlated with poor response to (chemo-)radiotherapy (r = 0.3, p < 0.01), and shorter overall (OS) and progression-free (PFS) survival (median OS: 13 vs 136 months, p < 0.0001; median PFS: 5 vs 85 months, p < 0.0001). Visual categorization of growth pattern according to established criteria of tumor aggressiveness showed interobserver variability increasing with more nuanced categories (2 categories: k = 0.7, 95 %-CI: 0.55 - 0.85; 4 categories k = 0.48, 95 %-CI: 0.35 - 0.61).In conclusion, TSC is an objective and reproducible computer-based parameter to quantify tumor-stroma contact area. We demonstrate its relevance for the response of oropharyngeal carcinomas to primary (chemo-)radiotherapy.

Photodynamic therapy in treatment of squamous cell carcinoma of oral cavity with chlorine e6 photosensitizer with long-term follow up

Photodynamic therapy is an effective method for treating superficial forms of malignant neoplasms, characterized by a minimal risk of damage to normal tissues. In this study, we presented our experience of treating cancer of the oral mucosa using photodynamic therapy, and analyzed the immediate and long-term results of treatment. 38 patients with squamous cell carcinoma of oral cavity mucosa, with a depth of invasion no more than 7 mm, were included in the study. All patients underwent photodynamic therapy with chlorine e6 based photosensitizer. Photosensitizers were administered intravenously 3 hours before irradiation, at a dosage of 1 mg/kg of the patient’s weight. Photodynamic therapy was performed with the following parameters: P – 1.0 W, Ps – 0.31 W/cm2, E – 300 J/cm2. The area of one irradiation field ranged 1.0-2.0 cm2. Treatment effect was evaluated by RECIST 1.1. Overall survival, cancer-specific survival, and disease-free survival were calculated using Kaplan-Meier curves. Evaluation of adverse events was made by .TCAE 5.0 criteria. At 35 (92.1%) out of 38 cases, complete regression was observed after photodynamic therapy. Among them in 3 out of 35 patients relapse was diagnosed in 11.5 to 43.2 months. The total number of patients who didn’t respond to treatment was 6 (15.8%). Follow-up period was 4.2-87.3 months. (mean 42.9). 34 (89.5%) out of 38 patients are alive, 1 (2.6%) died from progression, and three died from other causes. The 5-year overall survival rate was 82.1%, cancer-specific survival rate was 97.0%, and disease-free survival rate was 81.1%. Among the factors significantly (p &lt; 0.05) influencing relapse-free survival: depth of invasion &lt; 5 mm (p – 0.013) and the presence of leukoplakia (p – 0.007). When assessing cancer-specific survival, factors worsening the prognosis were: age &gt;70 years (p – 0.034) and the presence of leukoplakia (p – 0.007). Photodynamic therapy is an alternative treatment method of oral cancer superficial lesions, in case of proper assessment of primary lesion and in case of possibility of full irradiation of the tumor. Moreover, after using photodynamic therapy, the underlying connective-muscular structures are preserved, which promotes rapid healing with minimal scarring, the functions of the affected organ remain intact, and cosmetic defects do not form.