We report a comparison between upper gastrointestinal fiberscopy (GIF) and ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for screening of upper gastrointestinal double cancer in patients with oral cancer.
Between September 2006 and August 2009, 133 patients with oral cancer underwent GIF and FDG-PET/CT before treatment. Five patients (3.8%) had synchronous double cancer in the esophagus or stomach using GIF. There were early-stage cancers in all cases. However, FDG-PET/CT could detect double cancer (esophageal cancer) in only one patient, and the sensitivity and specificity were 20% and 100%, respectively. This study proved the usefulness and necessity of GIF for screening in the upper gastrointestinal regions before treatment in patients with oral cancer.

View full abstract

The purpose of the present study was to examine the effect of Daikenchuto (DKT) on postoperative intestinal function and nutritional status of patients.
The subjects were 40 patients who had undergone immediate reconstruction with free tissue graft for the defect after radical surgery for advanced oral cancer from March 2008 to May 2013. Twenty patients were administered 15g DKT a day from postoperative day 1, while the other 20 patients served as controls without DKT administration. Intestinal function such as peristaltic sound, passage of flatus and bowel movement, start of enteral nutrition (EN), and amount and rate of body weight loss 2 weeks after surgery were evaluated. Peristaltic sound (p < 0.001), passage of flatus (p < 0.005), bowel movement (p < 0.005), and start of EN (p < 0.01) were observed earlier in the DKT group. The amount (p < 0.05) and rate (p < 0.05) of body weight loss were also smaller in the DKT group. Preoperative chemoradiotherapy or surgical stress did not affect these indexes. These results suggest that DKT is effective for the improvement of intestinal function and weight maintenance after reconstruction with free tissue graft in patients with advanced oral cancer.

View full abstract

Patients over 80 years old accounted for 7.6% of the total of 670 patients with primary oral squamous cell carcinoma who were treated in our department from April 1998 to March 2011. These elderly patients were clinically investigated and compared with the patients under 80 years old.
These elderly patients consisted of 24 males and 27 females; the ratio of females among patients over 80 years old was significantly higher than that among patients under 80 years old (P = 0.035). The most frequent region of the primary tumor was the gingiva (20 cases: 39.2%), followed by tongue (19 cases: 37.3%). As clinical stage classification, 17 cases were stage I (33.3%), 21 cases were stage II (41.2%), 5 cases were stage III (9.8%), and 8 cases were stage IV (15.7%). Of the patients over 80 years old, 90.9% had systemic disease, and this ratio was significantly higher than that of the patients under 80 years old (P = 0.026). As for the treatment manner, radical treatment was performed for 43 cases (84.3%) and palliative treatment was performed for 8 cases (15.7%), and the ratio of radical treatment among the patients over 80 years old was significantly lower than that among the patients under 80 years old (P < 0.001). The cause-specific 5-year survival rates of the radical treatment group among the patients over 80 years old and those under 80 years old were 79.4% and 82.1%, respectively. The cause-specific 5-year survival rates between these two groups were approximately equal. However, the ratio of deaths due to oral cancer in the elderly patients group was only 52.6%; about half of the patients over 80 years old died of other diseases.

View full abstract