Carcinoma, Squamous Cell ; secondary ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Mouth Neoplasms ; pathology ; Prognosis

Objective:To understand the clinical features of osteonecrosis of the jaw after bisphospho-nates use for therapy of breast cancer patients with bone metastasis.Methods:The cases diagnosed as bisphosphonates-related osteonecrosis of the jaws (BRONJ)were retrospectively analyzed from January 201 1 to August 201 5 in the Peking University School and Hospital of Stomatology,and those breast cancer patients with bone metastasis were selected.The clinical symptoms,imaging characteristics and treatment results were summarized.Results:A total of 1 4 cases of breast cancer patients with bone me-tastasis were selected,with an average age of 60.21 years.The average time of suffering from breast cancer was 9 .77 years,and the average time of bone metastasis and bisphosphonates drugs use was 5 .67 and 3 .29 years individually.There was no patient with systemic application history of hormone therapy, and no history of diabetes.There were 9 patients with tooth extractions history,and the mean time of bone necrosis symptoms was 8.58 months.There were 1 0 cases with bone necrosis occurring on mandi-ble,3 cases on maxilla,and one case with both upper and lower jaws involved.Among the 1 0 patients with surgical treatment,there were 3 cases cured,and 6 cases improved.However,the clinical symp-toms of 2 cases with conservative treatment were significantly aggravated.Conclusion:The medication time between the bisphosphonates use beginning and the occurrence of BRONJ is relatively long.The his-tory of diabetes and long-time hormone use did not exist in this group.Tooth extraction itself does not de-termine the severity of BRONJ.Mandible is the most common site involved by BRONJ.Surgical treatment can alleviate the clinical symptoms of BRONJ with breast cancer to some extent.

OBJECTIVETo investigate the cutoff value and significance of lymph node ratio (LNR) in oral squamous cell carcinoma.

METHODSThis retrospective study included 286 patients with oral cancer and pathological positive lymph nodes. Used time-dependent receiver operating characteristic (ROC) curves to determine which LNR best defines different risk groups of oral squamous cell carcinoma (OSCC) patients. All the variables were subjected to the univariate analysis, then only the variables that had prognostic potential were subjected to multivariate analysis by the COX proportional hazards regression model.

RESULTSThe cutoff value of LNR was 0.092. When LNR was greater than 0.092, the overall survival rate was 24.2%, when LNR was less than 0.092, the overall survival rate was 45.8% (P<0.05).

CONCLUSIONSLymph node ratio is a predictor of outcome in patients with oral squamous cell carcinoma, and the cutoff value is 0.092.

Analysis of Variance ; Carcinoma, Squamous Cell ; mortality ; pathology ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Mouth Neoplasms ; mortality ; pathology ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; ROC Curve ; Retrospective Studies ; Survival Rate

OBJECTIVETo retrospectively analyze the data of the patients with Bisphosphonate-related osteonecrosis of the jaw over the past five years in our hospital.

METHODSTwenty-four patients with bisphosphonate-related osteonecrosis of the jaw treated in our hospital from 2009 to 2013 were included. The medication, bisphosphonate types, clinical signs and symptom, treatment methods and results were also analyzed.

RESULTSOf the 24 cases, 20 cases suffered from malignant tumors and received intravenous infusion of bisphosphonates and 4 cases took oral bisphosphonates. Three of the 4 cases with osteoporosis had history of glucocorticoid (rheumatoid arthritis). All patients had oral clinical symptoms for an average of 11.6 months, and 19 patients had the history of tooth extraction. There were 11 cases with mandible involved, 10 cases with maxilla involved, and 3 cases with both mandible and maxilla involved. After conservative treatment (3 cases) or operation (21 cases), 10 cases had wound healing, 6 cases were stable with bone exposure, and 4 cases with died bone needed reoperation. During the follow-up period, there was one patient died of primary disease (renal carcinoma).

CONCLUSIONSBoth intravenous and oral application routes of bisphosphonates can induce osteonecrosis of the jaw. Bisphosphonate-related osteonecrosis of the jaw can be caused by alveolar trauma. The treatment modality is to relieve the clinical symptoms of bisphosphonate-related osteonecrosis of the jaw.

Bisphosphonate-Associated Osteonecrosis of the Jaw ; complications ; pathology ; therapy ; Bone Density Conservation Agents ; Diphosphonates ; Glucocorticoids ; Humans ; Mandible ; Maxilla ; Osteoporosis ; Retrospective Studies ; Tooth Extraction ; Wound Healing

OBJECTIVETo investigate the application efficacy of three-dimensional tumor mapping technique for diagnosis and treatment of maxillary cancer.

METHODSSeventeen patients (aged from 9 to 74 years with an average age of 44.2 years) diagnosed with maxillary malignant tumors (13 for primary cancer and 4 for recurrent cancer) in Peking University School of Stomatology from December 2012 to October 2014 were reviewed as experimental group, in whom three-dimensional tumor mapping was performed before surgery, and 18 patients underwent traditional surgery in the same period as control group. Three-dimensional tumor imaging was generated with conversion of CT data into DICOM format by a software. Virtual plan of tumor resection and osteotomy was also manipulated according to the three-dimensional position of the tumor. Surgical navigation was used in the operation to confirm the virtual plan. The real position and situation of tumor was evaluated in the operation and compared with the pre-operative design. The frozen section was applied to confirm the margin after tumor resection. All the patients were followed up and the prognosis was evaluated.

RESULTSThe real situation of the tumor in the operation matched well with the result of pre-operative tumor mapping and positive margin was detected only in one case. While in the control group, 2 of 18 patients presented with positive margin in the operation. The mean follow-up time was 14.8 months (range from 2.0 to 22.0 months). Local recurrence occurred in 4 cases of experimental group and in 6 cases of controlled group, and all of them were with advanced malignant tumors.

CONCLUSIONThe three-dimensional tumor mapping technique is a feasible and reliable method for the diagnosis and treatment of maxillary malignant tumor, and use of this technique can significantly improve the clinical outcome.

Adolescent ; Adult ; Aged ; Beijing ; Child ; Humans ; Imaging, Three-Dimensional ; Maxillary Neoplasms ; diagnosis ; surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Osteotomy ; Prognosis ; Treatment Outcome ; Young Adult