• Radiation Oncology Journal
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• v.37 no.2
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• pp.73-81
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• 2019

Purpose: There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC. Materials and Methods: It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated. Results: The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3-102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS. Conclusion: Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.94-94
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• 1993

Squamous cell carcinoma of the oral tongue was reviewed retrospectively for the evaluation of clinical features and for the comparison between treatment modalities. Medical records of 112 patients who underwent treatment between 1916 and 1989 at Yonsei University Severance Hospital were reviewed.22 eases were excluded from this study due to incomplete treatment. Minimum follow up period was 36 months and median follow up was 41 months(range 1 to 135 months). The most common site of the tumor was lateral border of the tongue. 45.6% of the patients showed nodal metastasis. The 5-year survival rate of the patients with stage I, II was 78.8%, and those with III, IV was 20.7%. Over all 5-year survival rate was 58.5% . Survival rate of the patients treated with radiation was 19.7% in contrast to 55.7%, 66.2% in surgery plus radiation and surgery alone. The most common sites of failures were the primary site. Reducing the rate of local recurrence and more radical therapy is desired to improve the survival of this cancer.

• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.142-147
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• 2003

Purpose: Accurate evaluation of metastatic cervical lymph nodes plays a decisive role in the treatment and prognosis of patients with squamous cell carcinoma of the head and neck. The purpose of this study is to investigate the usefulness of FDG-PET for diagnosis of cervical metastasis in the head and neck cancer by comparing with the conventional imaging study. Materials and Methods: The subjects on this study were 30 patients (24 males and 6 females, aged 39 to 76, mean 57.1) diagnosed as pathologic-proven squamous cell carcinomas of the head and neck. All patients underwent preoperative FDG-PET, CT(n=27) or MRI (n=3). Their medical records were reviewed retrospectively. Using pathologic reports as a golden standard, the results of FDG-PET were compared with conventional imaging study (CT/MRI) in the evaluation of cervical metastasis. Results: Thirty patients had five different primary sites which were tongue (11), supraglottis (10), glottis (6), hypopharynx (2) and tonsil (1). A total of 40 neck dissections were performed unilaterally in 20 patients and bilaterally in 10 patients. Of these, 16 showed pathologically positive for lymph node metastasis. The sensitivity and specificity of FDG-PET for the diagnosis of cervical metastasis was 75% and 100% respectively, compared with conventional imaging of 56.3% and 95.8%, respectively. The difference of sensitivity was not statistically significant (p=0.453). Of 5 cases with small metastatic node (<1cm), 3 were detected on PET detected correctly but none were detected by CT. Conclusion: FDG-PET was more accurate than conventional imaging study in the diagnosis of metastatic lymph nodes in squamous cell carcinomas of the head and neck, especially detection of small metastatic node. FDG-PET might be useful adjunct to conventional image in the preoperative evaluation of head and neck squamous cell carcinoma.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3373-3378
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• 2012

Background: Head and neck squamous cell carcinoma (HNSCC) is the 8th most common cancer worldwide. Although older age, male gender, smoking and alcohol consumption are known risk factors, an increasing number of HNSCC patients are without typical risk factors. Our aim was to define demographics of HNSCC in Iran and the potential risk factors related to Iranian ethnicity and lifestyle. Methods: We conducted a cross-sectional analytical study on 262 patients with primary SCC of the larynx, hypopharynx or tongue referred to our pathology department during 1995-2010. Patients' demographics, tumor characteristics and risk factors such as smoking, alcohol consumption and anemia were analyzed and compared in two groups of patients: over 40 years (older group) and 40 years or less (young group); Chi-square and Mann-Whitney analytical tests were employed. Results: 5.7% of patients were young adults. The male to female ratio was 1.5 in the younger group and 5.6 in the older group. In young adults, 40% of tumors were located in larynx and 40% in the tongue. Age >40 was significantly associated with laryngeal location (P<0.001). History of smoking and drinking was significantly associated with age >40 and SCC of larynx in both age groups. Cervical lymph node involvement was significantly correlated with SCC of tongue (P<0.001), however, considering young adults only, SCC of hypopharynx was most frequently accompanied by lymph node involvement (60%). The most prevalent tumor among men was SCC of larynx whereas SCC of hypopharynx was the most prevalent tumor among women (61%), of whom 18.2% were ${\leq}40$. Conclusions: The incidence of HNSCC among young adults seems to be higher in Iran compared to other countries. Reduction in exposure to known risk factors, especially tobacco smoking in forms of cigarettes and bubble pipes, and search for other causative agents of HNSCC in young population is recommended.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.2
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• pp.121-126
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• 2012

Aberrations on the short arm of chromosome 8 (8p) are frequently observed in several human cancers. In this study, 20 squamous cell carcinoma (SCC) specimens from the tongue were examined in order to evaluate the role of 8p in SCC of the tongue. Microsatellite analysis using 14 markers demonstrated two commonly deleted regions (CDRs) on 8p. Reverse transcription-polymerase chain reaction (RT-PCR) revealed frequent down-regulation of the FEZ1 gene, mapped to 8p22, and frequent over-expression of the cathepsin B gene, mapped to 8p-21-22. These results suggested that genetic aberrations are involved in the development of SCC of the tongue. However, no significant relationship was observed to be established between the genetic alterations and clinicopathological features. Thus, further investigation is necessary in order to clarify the clinical role of 8p in carcinoma of the tongue.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.2
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• pp.97-100
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• 2014

We experienced a case of dental treatment under general anesthesia in a 22-year-old female patient with dysphagia and dental phobia following partial glossectomy. She was diagnosed of squamous cell carcinoma of tongue and received surgical, radiation treatment two years ago. We report the experiences of anesthetic management for dental treatment in a patient with dysphagia and dental phobia following partial glossectomy.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1251-1254
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• 2016

Background: Oral squamous cell carcinoma (OSCC), the most common malignancy of the oral cavity, shows geographical variation with respect to the age, sex, site and habits of the population. The histolopathologic grade of the tumor is closely related to its tissue of origin. This study was conducted to establish the prevalence of OSCC in relation to patient sex, age, habits and sites of lesions. Materials and Methods: A total of 130 cases of histopathologically diagnosed OSCC were selected for the study, out of which 66, 38 and 26 were well (WD), moderately (MD)and poorly differentiated (PD), respectively. Sections were stained with haematoxylin and eosin and graded according to a modified Borders's system. Then statistically analyzed different grades of OSCC for correlations with other variables. Results: In our study the majority cases of OSCC were found in the 5th to 7th decades of life, males acconting for 53%. The most common site was the buccal mucosa and most cases had habit of tobacco use either in the form of chewing or smoking or both. When the different grades of OSCC were compared with different sites a statistically significant value was observed (P=0.029). Conclusions: The incidence of high grade PD is very much less in female patients but in males such lesions were common. In our location population the buccal mucosa is the most common site due to the tobbaco habits of the patients and majority cases of the buccal mucosa are WD whereas in tongue, floor of the mouth and palate PD are common.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.1
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• pp.69-75
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• 2006

Head and neck squamous cell carcinoma(HNSCC) is the sixth most common cancer among men in the developed world affecting the tongue, pharynx, larynx and oral cavity. HNSCC is thought to represent a multistep process whereby carcinogen exposure leads to genetic instability in the tissue and accumulation of specific genetic events, which result in dysregulation of proliferation, differentiation, and cell loss and the acquisition of invasive capacity. Despite therapeutic and diagnostic progress in oncology during the past decades, the prognosis of HNSCC remains poor. Thus it seems that finding a biological tumor markers which will increase the early diagnosis and treatment monitoring rates, is of paramount importance in respect to improving prognosis. In an effort to identify gene expression signatures that may serve as biomarkers, this study several genes were selected, such as H3,3A, S100A7, UCHL1, GSTP1, PAI-2, PLK, TGF${\beta}$1 and bFGF, and used 7 HNSCC cell lines that were established various anatomical sites, and also 17 other cancer cell lines were used for control group using real-time quantitative RT-PCR and immunocytochemical analysis with a monoclonal antibody. In this study, S100A7 showed a clearly restricted occurrence in tongue originated cell line, and GSTP1 expression level in the pharynx originated cell line was very increased, relative to corresponding other cell lines. These results suggest that S100A7 and GSTP1 genes' expression can occur during tongue and pharynx originated head and neck tumorigenesis and that genetic change is an important driving force in the carcinogenesis process. This data indicate that S100A7 and GSTP1 expression pattern in HNSCC reflect both diagnostic clue and biological marker. And this is provides a foundation for the development of site-specific diagnostic strategies and treatments for HNSCC.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.261-276
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• 2009

Lactacystin, a microbial natural product synthesized by Streptomyces, has been commonly used as a selective proteasome inhibitor in many studies. Proteasome inhibitors is known to be preventing the proliferation of cancer cells in vivo as well as in vitro. Furthermore, proteasome inhibitors, as single or combined with other anticancer agents, are suggested as a new class of potential anticancer agents. This study was undertaken to examine in vitro effects of cytotoxicity and growth inhibition, and the molecular mechanism underlying induction of apoptosis in SCC25 human tongue sqaumous cell carcinoma cell line treated with lactacystin. The viability of SCC25 cells, human normal keratinocytes (HaCaT cells) and human gingiva fibroblasts (HGF-1 cells), and the growth inhibition of SCC25 cells were assessed by MTT assay and clonogenic assay respectively. The hoechst staining, hemacolor staining and TUNEL staining were conducted to observe SCC25 cells undergoing apoptosis. SCC25 cells were treated with lactacystin, and Western blotting, immunocytochemistry, confocal microscopy, FAScan flow cytometry, MMP activity, and proteasome activity were performed. Lactacystin treatment of SCC25 cells resulted in a time- and does-dependent decrease of cell viability and a does-dependent inhibition of cell growth, and induced apoptotic cell death. Interestingly, lactacytin remarkably revealed cytotoxicity in SCC25 cells but not normal cells. And tested SCC25 cells showed several lines of apoptotic manifestation such as nuclear condensation, DNA fragmentation, the reduction of MMP and proteasome activity, the decrease of DNA contents, the release of cytochrome c into cytosol, the translocation of AIF and DFF40 (CAD) onto nuclei, the up-regulation of Bax, and the activation of caspase-7, caspase-3, PARP, lamin A/C and DFF45 (ICAD). Flow cytometric analysis revealed that lactacystin resulted in G1 arrest in cell cycle progression which was associated with up-regulation in the protein expression of CDK inhibitors, $p21^{WAF1/CIP1}$ and $p27^{KIP1}$. We presented data indicating that lactacystin induces G1 cell cycle arrest and apoptois via proteasome, mitochondria and caspase pathway in SCC25 cells. Therefore our data provide the possibility that lactacystin could be as a novel therapeutic strategy for human tongue squamous cell carcinoma.

• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.147-160
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• 2011

Eugenol (4-allyl-2-methoxyphenol) is a natural phenolic constituent extensively used in dentistry as a component of zinc oxide eugenol cement and is applied to the mouth environment. Chios gum mastic (CGM) is a resinous exudate obtained from the stem and the main leaves of Pistacia lenticulus tree native to Mediterranean areas. This study was undertaken to investigate the synergistic apoptotic effect of co-treatment with a natural product, CGM and natural phenolic compound, eugenol on SCC25 human tongue squamous cell carcinoma cell line. To investigate whether the co-treatment with eugenol and CGM compared to each single treatment efficiently reduces the viability of SCC25 cells, MTT assay was conducted. Induction and augmentation of apoptosis were confirmed by Hoechst staining, TUNEL staining and DNA hypoploidy. Westen blot analysis and immunofluorescent staining were performed to study the alterations of the expression level and the translocation of apoptosis-related proteins in co-treatment. In this study, co-treatment of with eugenol and CGM on SCC25 cells showed several lines of apoptotic manifestation such as nuclear condensations, DNA fragmentation, the increase and decrease of Bax and Bcl-2, decrease of DNA content, the release of cytochrome c into cytosol, translocation of AIF and DFF40 (CAD) onto nuclei, and activation of caspase-3, caspase-6 caspase-7, caspase-9, PARP, Lamin A/C and DFF45 (ICAD) whereas each single treated SCC25 cells did not show or very slightly these patterns. Although the single treatment of 40 ${\mu}g$/ml CGM and 0.5 mM eugenol for 24 h did not induce apoptosis, the co-treatment of these reagents prominently induced apoptosis. Therefore our data provide the possibility that combination therapy with CGM and eugenol could be considered as a novel therapeutic strategy for human oral squamous cell carcinoma.