The prognosis of patients with oral cancer who had extranodally spreading neck metastases was extremely poor. Postoperative radiotherapy has been performed for those patients since 1992.
A retrospective study was made to ascertain the effect of postoperative radiotherapy for patients who had neck metastasis with extranodal invasion, and the following results were obtained.
1) There were no significant differences except time of treatment between background factors of 17 patients who underwent postoperative radiotherapy (RT+group) and those of 12 who did not undergo radiotherapy (RT-group) .
2) There were no significant differences between neck control rate or survival rate of RT+group and that of RT-group.
3) An average time of survival of RT+group was a little longer than that of RT-group, but the duration of hospitalization of the former was also longer than of the latter.
4) These findings failed to show the usefulness of radiotherapy for those who had lymph node metastasis with extranodal invasion.

View full abstract

The aim of this study was to evaluate the usefulness of magnetic resonance imaging for the preoperative measurement of depth of tumor invasion in 45 patients with tongue cancers. The depth of tumor area as determined by MR imaging was compared with the area where the tumor was really invading in the histopathological section prepared from the corresponding surgical material.
Lesion detectability was compared among the following 3 types of image : T1-weighted spin echo imaging, T1WI-group; T2-weighted spin echo imaging, T2WI-group; enhanced MRI-group. The T2WI-group showed highest accuracy in detecting the tumor among the three groups. In each sample the tumor area detecting in the histopathological tissue sections was measured and size reduction rate through histopathological processing was calculated. The depth of corrected histopathological tumor area was calculated by revising with reduction rate. The depth of corrected histopathological tumor area showed statistically significant correlation with the depth of tumor area of MRI. Type of growth, mode of invasion did not show any significant difference between the classified groups. The correlation coefficient between tumor depth of MRI and histopathology showed significant value in the case where lympho-plasmocytic infiltration was slight or none. On the other hand, the correlation coefficient was not significant in the case where lympho-plasmocytic infiltration was marked or moderate. The present result suggests that the depth of tumor area diagnosed by MRI well correlates with actual tumor depth in generally, however, careful diagnosis is required when stromal lymphocyte infiltration is strong.

View full abstract

The aim of this study is to demonstrate changes in oral surgeons' attitudes toward telling the oral cancer patient in Japan.
The survey populations consisted of 103 departments (Depts.) of oral & maxillof acial surgery in Kyushu/Okinawa, Kinki and Chubu. All subjects received on 15-item structured questionnaire through the mail, which covered oral surgeons' and their departements' attitude and practice toward the oral cancer patient.
From 90 Depts. (87.4%), the questionnaire was returned. Fourty four Depts. (48.9%) usually or often disclose patients the diagnosis of oral cancer. On the other hand, 27 Depts. (30%) disclose that after the permission of patient's family. Seventy three Depts. (81.1%) answered that in the near future, the full disclosure of cancer diagnosis would be common in Japan. Fifty seven Depts. (63.3% ) thought that the disturbance of full disclosure of oral cancer for patients is caused with the inadequate psychological support system within the medical field for those patients whom received terminal diagnosis in Japan.
In answer to a questionnaire administered in this study, 49% of responder indicated a preference for telling the oral cancer patient his diagnosis. In Tomita's survey of 234 oral surgeons in Japan 1994, 70% generally did not inform patients about their cancer. There appears to have been a change in oral surgeons' attitudes concerning telling patients their diagnosis of cancer.
Based on the results of this study, the full disclosure of oral cancer become furthermore usually. However, the psychological support system within the medical field for those patients whom received terminal diagnosis is needed in Japan.

View full abstract

Infantile f ibrosarcoma is very rare, comprising only 0.4% of all infant tumors, and it most often develops in the soft tissue of a limb. Reported oral cases of this tumor include 3 cases occurring in soft tissue and 1 case occurring in mandibular bone. Infantile f ibrosarcoma develops more rapidly than adult form, with faster tumor growth. Its metastatic rate is 7.3% to 8.3%, although there is a high degree of resorption of bony tissue (which is normally associated with aggressively metastatic tumors) . Surgery is considered the best treatment option, because local recurrence after extensive resection is qutie rare. The five-year survival rate of this tumor is 50% to 85%, although is differs with age at onset. A nine year-old girl with intaosseous maxillary tumor was treated with Interleukin-2 (Imunace^®, Shionogi, Osaka, Japan ; 7×10⁵ JRU/day), and underwent radical resection of the maxilla ( both sides of which contained impacted canines) under general anesthesia. After wound healing, her occlusal disturbance and facial def omity were improved by maxillf acial prosthesis. Five years after treatment, her progress was good, without recurrence or metastasis.

View full abstract

Purpose: The purpose of this study was to determine the usefulness of maginetic resonance (MR) imaging for the preoperative measurement of the area of tumor invasion in tongue cancer.
Patients and Methods : Forty five cases with tongue cancer were reviewed and analyzed in the present study from the file from 1990 to 2000 in our department. The tumor area determined by MR imaging was compared with the area where the tumor was really invading in the histopathological sections prepared from surgical material lesion detectability was compared among the following 3 type of images : T1-weighted spin echo imaging, T1WI-group ; T2-weighted spin echo imaging, T2WI-group ; enhanced MRI-group.
Result : Lesion detectability was compared among the following 3 type of images : T2WI-group showed higher sensitivity than T1WI-group. The T2WI and enhanced MRI group showed similar lesion detectability, which was better than in the T1WI-group. The rate of tumor depth invasion of the diagnostic imaging accord with histopathological findings. The correlation coefficient between tumor area by MRI and histopathology generally showed high in over 20 mm group.
Conclusion : The present study revealed that T2WI group showed high sensitivity in detecting tumor. The correlation coefficient between tumor area by MRI and histopathology generally showed high in over 20 mm group. T2WI group was superior to other group in demonstrating the lesion.

View full abstract