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At least 253 records · Page 14Linked to original sources
PubMed2005

Efficacy of narrow-margin excision of well-demarcated primary facial basal cell carcinomas.

BACKGROUND: A 4-mm surgical margin of clinically normal skin is the current standard for elliptical excision of basal cell carcinomas (BCCs). However, a 4-mm surgical margin is often not feasible on the face because of cosmetic and functional concerns. As such, facial excisions of BCCs are typically performed with the appropriate margin determined by the surgeon based on clinical features of the tumor. OBJECTIVE: We designed a study to test the efficacy of narrow-margin elliptical excisions for the treatment of small, well-demarcated facial BCCs. METHODS: A total of 134 primary, small (<1 cm), well-demarcated, facial nodular BCCs were excised as an ellipse with 1-, 2-, or 3-mm margins around the visible border of the tumor. The margin used was decided by the dermatologic surgeon based on cosmetic, anatomic, and functional factors, with the goal of clearing the tumor in a single excision. Using the Mohs technique for elliptical specimens, frozen sections were prepared and examined microscopically to provide complete histologic margin control. RESULTS: In all, 134 facial BCCs were included in the study. On average, the tumors measured 0.6 x 0.5 cm. Of these, 27 (20.1%) had positive margins, requiring additional excision. Excisions with 1-, 2-, and 3-mm margins were associated with positive margins in 16%, 24%, and 13% of tumors, respectively. There was no statistically significant difference in the occurrence of positive margins based on tumor size, anatomic location, or the measured margin used. CONCLUSION: Narrow margins (1-3 mm) are inadequate for the excision of small, well-demarcated, primary nodular BCCs of the face. To avoid repetitive operations and the risk of recurrence in anatomically sensitive areas, these tumors should be treated with standard wide margins (eg, 4 mm), or have Mohs micrographic surgery for histologic margin control.

Basal Cell Carcinoma↗
PubMed2007

Impact of recurrence interval on survival of oral cavity squamous cell carcinoma patients after local relapse.

OBJECTIVE: The aim of this study was to investigate whether the recurrence interval influenced the survival of oral cavity squamous cell carcinoma patients after relapse. STUDY DESIGN AND SETTING: Retrospective charts were reviewed at a medical center. METHODS: We retrospectively reviewed 1687 chart records of oral cancer patients. Statistical methods included descriptive statistics, bivariate analyses, Kaplan-Meier survival analyses, and Cox proportional hazard models for investigating the relationship between the recurrence interval and survival of oral cancer patients after relapse. RESULTS: Local recurrence rate was 31.3 percent. Kaplan-Meier survival analyses showed the 5-year overall survival after recurrence was 31.56 percent. Cox proportional hazard model revealed that those with recurrence interval less than 18 months tended to have a higher probability of death than those with recurrence interval greater than or equal to 18 months (relative risk, 1.743; 95% confidence interval, 1.298-2.358). CONCLUSION: The interval from initial treatment to recurrence is an independent prognostic factor for oral squamous cell carcinoma patients. Those with a shorter disease-free interval tend to have a less favorable outcome.

Adult↗
PubMed1984

Reconstruction experience with myocutaneous and osteomyocutaneous skin flaps in oncological surgery of the head and neck.

Our experience in the field of oncological surgery of the head and neck enables us to present 26 cases operated upon, analysing the complications and the results, and suggesting immediate reconstruction using myocutaneous and osteomyocutaneous skin flaps due to their advantages as shown. We also present the different criteria considered in the choice of each of the three different flaps which our department uses.

Bone Transplantation↗
PubMed1995

Computed tomographic evaluation of lymph node metastasis in head and neck carcinomas.

A retrospective study of 53 patients was undertaken to evaluate the efficacy of computer tomography (CT) in the detection of nodal metastases from carcinomas of the head and neck. The CT findings of 53 patients with head and neck carcinomas who underwent a total of 57 neck dissections were compared with the findings of physical examination (PE) and histopathological examination. Using node size larger than 10 mm in the short-axis diameter or the presence of central lucency as the criteria of nodal metastasis CT scanning staged correctly 52 of 57 necks, providing an accuracy of 91%, a sensitivity of 86% and a specificity of 100% in the detection of nodal metastases. There was agreement of PE findings with histology in 43 (74%) of 57 necks, with a sensitivity of 97% and a specificity of 38%, respectively. Because CT scanning was superior to PE in the pre-operative staging of head and neck carcinomas, it should be used for pre-operative evaluation of metastatic neck disease.

Carcinoma, Squamous Cell↗
PubMed2004

Current treatment options in squamous cell carcinoma of the oral cavity.

Oral cavity SCC remains a significant health problem and requires a multidisciplinary approach. Treatment with surgery alone or in combination with adjuvant radiotherapy for more advanced lesions is the standard of care. Major advances have been made in surgical approaches,reconstructive options, and the rehabilitation of patients who have oral cavity SCC. These advances have significantly improved disease-specific outcome and quality of life. The future may lie in the development of treatment regimes that combine early detection with organ preservation and result in improved cure rates and quality of life.

Brachytherapy↗
PubMed2003

[Brachytherapy in head and neck cancers].

Experience accumulated over several decades with radiation of Head and Neck tumours by irradiation has demonstrated the need for a high tumour dose to achieve local control. With external beam irradiation alone, it is difficult to spare adjacent normal tissues, resulting in undesirable late effects on the salivary glands, mandible, and muscles of mastication. Interstitial implantation is ideally suited to deliver a high dose limited to the volume of the primary tumor, thus minimizing sequels. A large experience has been accumulated with low dose rate (LDR) brachytherapy in treatment of carcinoma of oral cavity, oropharynx, and nasopharynx. Recent analysis of large clinical series provided data indicating that modalities of low dose rate brachytherapy should be optimized in treating these tumors for increasing therapeutic ratio. Low dose rate brachytherapy is now challenged by high dose rate (HDR) brachytherapy and pulsed dose rate (PDR) brachytherapy. Preliminary results obtained with these two last modalities are discussed regarding to those of low dose rate brachytherapy.

Brachytherapy↗
PubMed2001

Surgical management of cutaneous squamous cell carcinoma of the head and neck.

A retrospective audit was made of histological records and hospital case notes of patients who had cutaneous squamous cell carcinomas excised from the head and neck region at the Maxillofacial Units at St Richard's Hospital, Chichester and Southlands Hospital, Shoreham-By-Sea, UK. A total of 227 lesions were excised from 183 patients over a 5-year period between 1990 and 1995. The local recurrence rate was 4% (9/227) and 12 (7%) of the patients presented with or developed regional nodal metastases. Of the 183 patients, 177 (97%) were cured. These rates compare favourably with those of other published series of cutaneous squamous cell carcinoma managed by surgical techniques that did not follow the micrographical technique of Mohs. Certain characteristics may aid in the prediction of those cancers that may be more aggressive. It is important to evaluate each case in terms of histological grade and site and to design management plans to deal with each lesion in the most appropriate way.

Aged↗
PubMed1990

[Incidence of epithelial neoplasms in the head and neck area in non-Hodgkin's lymphomas].

There is an increased risk of malignancy in patients with genetically determined or acquired immunosuppression. The authors report a case of a 70-year-old patient with a lymphoplasmocytic immunocytoma who developed 19 squamous-cell carcinomas (SCC) and nine basal-cell carcinomas (BCC) over a three-year period. This was the reason to review 100 cases of malignant lymphomas for evidence of additional malignancies. Of these patients, 15% had one or more SCC or BCC in the head and neck area. The age range was 59 to 79 years (mean, 71.7 years) and the male:female ratio 11:4. One or more SCC arose in 93% of these patients, 36% developed an additional one or more BCC, and BCC alone occurred in 7%. The usual ratio of BCC:SCC is 10:1; in the authors' patients, by contrast, this ratio was 6:14. In 12 cases, SCC and BCC were located on the skin. The remaining cases of SCC developed in the oral mucosa, the tonsils and the hypopharynx. In 13 cases, low-grade malignant lymphomas were found and in two cases high-grade malignant lymphomas were found. The SCC were clinically aggressive. Thirty-six percent of the patients had recurrent lesions, 43% multiple neoplasms, and 50% metastases. Histologically, the SCC showed moderate to poor differentiation, a high degree of cell polymorphism and mitotic activity, and deep tissue infiltration. There are several explanations for the increased incidence of neoplasms in patients with immunodeficiency disorders. The surveillance function of the immune system may be impaired due to the disease itself or due to the treatment for immunosuppression. Immunosuppressive and cytotoxic agents are potential carcinogens.(ABSTRACT TRUNCATED AT 250 WORDS)

Basal Cell Carcinoma↗
PubMedDate not supplied

Morphometric study of desmosomes from oral squamous cell carcinoma.

The authors studied ultrastructural characteristics of desmosomes from oral squamous cell carcinoma, reporting the cellular differentiation and size of the desmosomes. The length of the desmosome profiles was measured with a Zeiss KS-300. The desmosomes were grouped according to their size and the tumor histological grading. Statistical analysis indicated a significant correlation (p < .001) between the size of the desmosomes and the histological grading group of the malignancy. The comparison of the desmosome size among the tumor histological grading groups also showed significant difference (p < .001). A multiple comparisons test indicated homogeneity in the size of desmosomes within the histological grading groups: 100% in the well differentiated, 95.2% in the moderately differentiated, and 50% in the poorly differentiated group. The preliminary data strongly suggest that the homogeneity of length of the desmosome profiles may be exploited for diagnostic strategies.

Carcinoma, Squamous Cell↗