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The effect of diagnosis delay on the prognosis of oral cancer
P218
OtolaryngologyHead and Neck Surgery August 1999
Scientific Posters
of therapy/no intervention, and again after another 6 to 8 weeks. Analysis was conducted using SPSS(X). Results: Voice therapy improved self-rated (F = 12.2, P = 0.001), and expert-rated voice quality (F = 17.5, P < 0.001). Therapy also improved one acoustic analysis parameter-shimmer (amplitude perturbation: F = 5.9, P < 0.01); however, this effect was not sustained at follow-up. There were no differences between the groups in psychological distress or quality of life over time. Conclusion: (1) Voice therapy for dysphonia is an effective treatment in terms of subjective reports. (2) Most objective acoustic parameters showed poor correlation with global reports of voice quality. (3) Voice therapy had surprisingly little impact on psychological distress or general health status. 51 Auricular Pseudocysts: A Treatment with CU-VAC PAKPOOM SUPIYAPHUN MD; WITHAYA DECHA MD; VIRACHAI KEREKHANJANARONG MD; PRAKOBKIAT HIRUNWIWATKUL MD; Bangkok Thailand; Bangkok Thailand; Bangkok Thailand; Stanford CA
Objectives: A new Chulalongkorn-vacuum device (CUVAC) is described. The efficacy and safety of the simple aspiration plus CU-VAC application are prospectively evaluated in treating the auricular pseudocysts. Methods: Twenty patients with auricular pseudocysts were treated with simple aspiration plus CU-VAC application for 5 days. The cure rate of the procedure was evaluated in 17 patients on days 5, 10, and 15. The appropriate descriptive statistics were used. Results: A complete resolution of the lesions (cure rate) on day 15 was obtained in 15 patients (88.2%). No complication existed in our series. Conclusion: A new treatment for auricular pseudocysts with needle aspiration plus CU-VAC application is described. Because of its simplicity efficacy and safety, the procedure may be an option in treating these lesions. 52 The Effect of Diagnosis Delay on the Prognosis of Oral Cancer MARTA SANDOVAL MD; MANUEL DICENTA MD PHD; ANTONIO MONNER MD; XAVIER CASTELLSAGUE MD PHD; MANUEL MANOS PUJOL MD PHD; AMPARO JUAN MD; JULIO NOGUES MD; RAFAELVERA MD; Barcelona Spain
Objectives: The diagnostic delay and advanced clinical stage at diagnosis are not conclusive as to be related to disease progression. However, convincing evidence is still lacking, and little is known about which factors might be related to these parameters.
Methods: To assess whether diagnostic delay and clinical stage are associated with disease progression and survival, we analyzed preliminary data from an ongoing prospective study of 89 incident cases of oral cancer (70% oral cavity and 30% oropharynx). Results: Diagnostic delay was present in 68.5% of the cases. Twenty-two percent of cases had early stage (stage III), and 78% had advanced stage (stage Ill-IV). Diagnostic delay was not related to clinical stage (P = 0.8). After 1-year follow-up 70% of patients were alive and disease free, 17% were dead of disease, 5% were dead without evidence of disease, and 6% had recurrence. Patients with diagnostic delay or advanced disease had a poorer prognosis than patients with no diagnostic delay or early stage. However, these differences did not reach statistical significance. Conclusion: Our preliminary data show that there is no evidence for an association between clinical stage or diagnostic delay and disease progression in oral cancer patients.
53 Marijuana-Associated p53 Mutations in Head and Neck Carcinomas LISA MOLIN MD; PAULJ DONALD MD; Sacramento CA
Objectives: The tumor suppressor gene p53 is involved in the regulation of cell growth and development. Benzo(a)pyrene (BaP) is a carcinogen found in large quantities in cigarette smoke, and it causes characteristic p53 mutations in patients who develop head and neck carcinomas. Our hypothesis is that p53 mutations in head and neck carcinoma of marijuana smokers will have similar mutations due to the high concentration of BaP in marijuana smoke. Methods: Eighteen archival specimens of head and neck carcinomas from young patients aged 18 to 41 years with known marijuana use were available for molecular study. Immunohistochemical staining was used to identify mutant p53, and the DNA of 7 positive samples were extracted and amplified using PCR. Single-strand conformational polymorphism of exons 4 through 10 was done followed by DNA sequencing for identification of base pair changes. Results: Abnormal DNA migration patterns of exons 4 through 10 were noted from our specimens. Two demonstrated an abnormality in exons 5 and 6, 1 in exon 10, and 3 in exon 7. Three of our samples demonstrated base pair changes resulting in amino acid changes. These occurred at codons 151 (Pro-Ser), 160 (Met-Arg), and 237 (Met-Ile). Conclusion: Characteristic mutations have been identified in p53 that implicate carcinogens from tobacco smoke, namely BaP, as an etiology of head and neck carcinomas. Our preliminary results demonstrate similar mutations in p53. Further studies and sample evaluations will be necessary to confirm these results.
OtolaryngologyHead and Neck Surgery August 1999
Scientific Posters
of therapy/no intervention, and again after another 6 to 8 weeks. Analysis was conducted using SPSS(X). Results: Voice therapy improved self-rated (F = 12.2, P = 0.001), and expert-rated voice quality (F = 17.5, P < 0.001). Therapy also improved one acoustic analysis parameter-shimmer (amplitude perturbation: F = 5.9, P < 0.01); however, this effect was not sustained at follow-up. There were no differences between the groups in psychological distress or quality of life over time. Conclusion: (1) Voice therapy for dysphonia is an effective treatment in terms of subjective reports. (2) Most objective acoustic parameters showed poor correlation with global reports of voice quality. (3) Voice therapy had surprisingly little impact on psychological distress or general health status. 51 Auricular Pseudocysts: A Treatment with CU-VAC PAKPOOM SUPIYAPHUN MD; WITHAYA DECHA MD; VIRACHAI KEREKHANJANARONG MD; PRAKOBKIAT HIRUNWIWATKUL MD; Bangkok Thailand; Bangkok Thailand; Bangkok Thailand; Stanford CA
Objectives: A new Chulalongkorn-vacuum device (CUVAC) is described. The efficacy and safety of the simple aspiration plus CU-VAC application are prospectively evaluated in treating the auricular pseudocysts. Methods: Twenty patients with auricular pseudocysts were treated with simple aspiration plus CU-VAC application for 5 days. The cure rate of the procedure was evaluated in 17 patients on days 5, 10, and 15. The appropriate descriptive statistics were used. Results: A complete resolution of the lesions (cure rate) on day 15 was obtained in 15 patients (88.2%). No complication existed in our series. Conclusion: A new treatment for auricular pseudocysts with needle aspiration plus CU-VAC application is described. Because of its simplicity efficacy and safety, the procedure may be an option in treating these lesions. 52 The Effect of Diagnosis Delay on the Prognosis of Oral Cancer MARTA SANDOVAL MD; MANUEL DICENTA MD PHD; ANTONIO MONNER MD; XAVIER CASTELLSAGUE MD PHD; MANUEL MANOS PUJOL MD PHD; AMPARO JUAN MD; JULIO NOGUES MD; RAFAELVERA MD; Barcelona Spain
Objectives: The diagnostic delay and advanced clinical stage at diagnosis are not conclusive as to be related to disease progression. However, convincing evidence is still lacking, and little is known about which factors might be related to these parameters.
Methods: To assess whether diagnostic delay and clinical stage are associated with disease progression and survival, we analyzed preliminary data from an ongoing prospective study of 89 incident cases of oral cancer (70% oral cavity and 30% oropharynx). Results: Diagnostic delay was present in 68.5% of the cases. Twenty-two percent of cases had early stage (stage III), and 78% had advanced stage (stage Ill-IV). Diagnostic delay was not related to clinical stage (P = 0.8). After 1-year follow-up 70% of patients were alive and disease free, 17% were dead of disease, 5% were dead without evidence of disease, and 6% had recurrence. Patients with diagnostic delay or advanced disease had a poorer prognosis than patients with no diagnostic delay or early stage. However, these differences did not reach statistical significance. Conclusion: Our preliminary data show that there is no evidence for an association between clinical stage or diagnostic delay and disease progression in oral cancer patients.
53 Marijuana-Associated p53 Mutations in Head and Neck Carcinomas LISA MOLIN MD; PAULJ DONALD MD; Sacramento CA
Objectives: The tumor suppressor gene p53 is involved in the regulation of cell growth and development. Benzo(a)pyrene (BaP) is a carcinogen found in large quantities in cigarette smoke, and it causes characteristic p53 mutations in patients who develop head and neck carcinomas. Our hypothesis is that p53 mutations in head and neck carcinoma of marijuana smokers will have similar mutations due to the high concentration of BaP in marijuana smoke. Methods: Eighteen archival specimens of head and neck carcinomas from young patients aged 18 to 41 years with known marijuana use were available for molecular study. Immunohistochemical staining was used to identify mutant p53, and the DNA of 7 positive samples were extracted and amplified using PCR. Single-strand conformational polymorphism of exons 4 through 10 was done followed by DNA sequencing for identification of base pair changes. Results: Abnormal DNA migration patterns of exons 4 through 10 were noted from our specimens. Two demonstrated an abnormality in exons 5 and 6, 1 in exon 10, and 3 in exon 7. Three of our samples demonstrated base pair changes resulting in amino acid changes. These occurred at codons 151 (Pro-Ser), 160 (Met-Arg), and 237 (Met-Ile). Conclusion: Characteristic mutations have been identified in p53 that implicate carcinogens from tobacco smoke, namely BaP, as an etiology of head and neck carcinomas. Our preliminary results demonstrate similar mutations in p53. Further studies and sample evaluations will be necessary to confirm these results.