Twenty-seven cases of tongue cancer of stage I or II among highly invasive oral cancer were retrospectively analysed according to each modality. The modality for tongue cancer consisted of excisional biopsy (therapy A), tumor excision with preoperative chemotherapy (therapy B), and therapy B with elective neck dissection (therapy C) . The treatment results according to the modality were as follows:
1. Therapy A was performed in eight patients, consisting of three of T1 + 4C, three of T1 + 4D, one of T2 + 4C, and one of T2 + 4D. None of them had recurrent disease at the primary site. Delayed ipsilateral cervical lymph node metastasis was found in four patients. Absolute survival rate for these eight patients consisting of three of Dc and five of Ao, was 63%.
2. Therapy B was performed in nine patients, consisting of three of T1 + 4C, three of T1 + 4D, one of T2 + 4C, and two of T2 + 4D. One patient with T2 + 4C had recurrent disease at the primary site with cervical lymph node metastasis. Delayed ipsilateral cervical lymph node metastasis was found in seven patients without evidence of recurrent local disease. Absolute survival rate for these nine patients, consisting of three of Dc, two of Do, and four of Ao, was 44%.
3. Therapy C was performed in 10 patients, consisting of two of T1 + 4C, one of T1 + 4D, theree of T2 + 4C, and four of T2 + 4D. Occult cervical metastasis was pathologically confirmed in two patients. Four patients had recurrent disease at the primary site and had recurrent disease of the neck except for one patient. Three patients had recurrent disease of the neck without evidence of recurrent local disease. Absolute survival rate for these 10 patients was 40%, consisting of six of Dc and four of Ao.
4. Absolute survival rate and 5-year cumulative survival rate for all patients were 48% and 52% respectively.

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The therapeutic effects of neo-adjuvant chemotherapy administered by two route infusion of cisplatin and its antidote, sodium thiosulfate, and intravenous infusion of vinblastine and peplomycin were studied on 35 patients with previously untreated squamous cell carcinoma of the oral cavity, maxillary sinus, or oropharynx. The overall response rate to chemotherapy was 91.4%, and complete response rate was 57.1%. When the patients who died of a disease other than tumor were excluded, the cumulative 5-year survival rate was 100% in CR and 87.5% in PR plus NC. This chemotherapy could be carried out in a shorter time period because of the appropriate supporting therapy. Twelve out of 20 CR patients underwent conservative surgery, and they are all free from tumor and have good oral function. These data showed that this chemotherapy may be more effective for treatment of head and neck cancer. The results are preliminary, and additional studies using more patients are needed.

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Forty patients with ameloblastoma were treated during 20 years (1975-1994, male : 19 cases, female : 21 cases) . In this study, the results were as follows :
1) The peak developmental age was 30 to 49 years (m ± S.D.: 36.7 ± 19.8 years old) .
2) Five cases (12.5%) were found in the maxilla, and 35 cases (87.5%) in the mandible.
3) Radiography revealed 18 cases of unilocular, 12 cases of multilocular, and 8 cases of honeycomb.
4) Histologically, 6 cases with following cellular variants (4 acanthomatous type, 1 granular cell type, and 1 desmoplastic type) were seen among 26 follicular pattern cases, and 1 with cellular variant (acanthomatous type) was seen among 14 plexiform pattern cases.
5) Two cases underwent fenestration, 10 cases underwent enucleation followed by removal of adjacent bone, 16 cases underwent enucleation followed by removal of adjacent bone and wound-opening, and 12 cases underwent radical treatment (1 partial maxilloectomy, 2 marginal resection of mandible, 8 partial mandiblectomy.)
6) Recurrence occurred in 5 cases. There were no recurrent cases following radical treatment.
7) Unicystic ameloblastoma (U.A.) were seen in 8 cases out of all 40 cases. The mean age (19.0 ± 8.5y) at diagnosis of U.A. was younger than that of other cases (41.1 ± 18.4y) .
There were no recurrent cases among U.A. cases.

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The prognostic factors, histological malignancy grade, primary tumor size, lymph metastasis, and mode of bone destruction, were analyzed in 80 squamous cell carcinomas of the lower gingiva treated in our clinic from 1978 to 1992. TNM (UICC 1987) classification of these cases was as follows : T1, 5 cases ; T2, 46; T3, 14; T4, 15; N0, 32; N1, 41; N2c, 5 ; N3, 2 ; and M0, 80 cases.
The results were as follows ;
1. The cumulative 5-year survival rates for T1, T2, T3, T4, and all cases were 100%, 80%, 76%, 67%, and 78% respectively.
2. Most of T1 and T2 cases showed low scores of histological malignancy grade.
3. Most of T1 and T2 cases showed no bone destruction or pressure type, and 2/3 of T4 showed moth-eaten type radiographically.
4. The high score group had a tendency to positive lymph metastasis.
5. The cause of death of patients was due to uncontrolled primary tumor except one case with pulmonary metastasis.

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This is a report on the reconstruction of the mandible using hydroxyapatite porous block (hereafter apatite) after resection of ameloblastoma.
This material has been used in clinical settings to support the jaw morphologically or structurally by uniting it with the callus from the residual mandible and providing the base for ossification.
The formulae for apatite material for reconstruction of the mandible include 1) intraosseous implantation after partial resection, 2) bridge implantation after segmental resection, and 3) implantation connecting a free bone stump of the unilaterally resected mandible. Since apatite material is not strong enough mechanically to fix the mandible by itself, titanium plate, newly developed for the reconstruction of the mandible with apatite, is used with it. This plate compresses and binds a residual mandibular stump by screwing during bridge implantation. Of five patients who received this procedure, four were supported structually, three with bridge implantation and one with intraosseous implantation, and one was supported morphologically. Titanium plate of mandibular reconstruction using hydroxyapatite porous block was used in two of the five patients.

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Relationship of prognosis to clinicopathological findings and treatment procedures was investigated in 24 cases with mandibular ameloblastoma.
Of 24 cases, numbers of unilocular, multilocular and honeycomb types were 12, 9, and 3 respectively. Six out of 9 anterior cases (incisor-premolar region) were multilocular or honeycomb type, whereas 9 of 15 posterior cases (molar-ramus region) were unilocular type. On the other hand, the rate of the lesions with impacted teeth was higher in the posterior cases (10/15) than in the anterior cases (2/9) . Histopathological examination was performed according to the criteria of WHO, and the number of follicular, plexiform, and acanthomatous types were 6, 16, and 1 respectively, with the majority of the posterior cases being plexiform type.
Two cases received marginal resection of the mandible, and recurrence was not seen in either of these cases. Enucleation followed by curettage was performed in 21 cases, and recurrence was noted in 4 cases. The rate of recurrence was higher in multilocular and honeycomb types (3/12) than in unilocular type (1/12) . The recurrence rate was also higher in the follicular type (3/6) than in the plexiform type (1/16) . Expression of proliferating cell nuclear antigen (PCNA) was investigated in 12 cases, and the mean labeling index was 22.3 %, which ranged from 3.3 % to 42.1 %. However, no significant relationship was noted between the labeling index and the rate of recurrence.

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A retrospective analysis of 45 patients with previously untreated squamous cell carcinoma of the oral cavity was performed in order to elucidate the ultrasonographic findings predicting lymph node metastasis.
Seventy-nine (75.2 %) out of 105 lymph nodes, which were examined by ultrasonography, were clinically identified as no tumor or tumor eradication, and 26 other nodes (24.8 %) were histologically identified as tumor metastases by neck dissection.
Ultrasonography was performed using an electric linear scanner with a 7.5 MHz probe. When lymph nodes in the neck were depicted, 5 items were evaluated : longest diameter, shortest diameter, border, internal echo, and ratio of lymph node diameter.
All of them and nodal metastasis were found to be related by the x² test and student-t test. The contributions to nodal metastasis of each finding were, in descending order, shortest diameter of lymph node, internal echo, border, longest diameter, and ratio of lymph node diameter by quantification theory type II. The discrimination ratio between microscopic positive and negative lymph nodes was 89.5 %.
Multivariate analytical results closely correlated with nodal status and appears to be a valid indicator for prediction of nodal metastasis.

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Two patients with oral cavity malignancies, which showed excellent responses to chemotherapy with UFT, are reported. One patient was a 71-year-old female who had undergone radical surgical resection of cancer of the tongue (T2N0M0) . However, after 4 years and 7 months the malignancy recurred at the resected margin on the floor of the mouth. The patient refused a second radical resection, so UFT was p.o, administered at a dose of 600 mg/day. The tumor showed a tendency to shrink beginning from the 2nd week of UFT therapy, and by the 4th week the tumor had been clinically disappeared. Histopathological examination also indicated a complete response (CR) . The second patient was an 83-year-old male who had a mandibular gum carcinoma (T1N0M0) with a complication of asthma. Therefore, in consideration of the patient's quality of life, a combination of UFT at 600 mg/day and ubenimex (Bestatin) at 30 mg/day was p.o. administered. The tumor began to shrink from about the 3rd month of treatment, and it had clinically disappeared by the 6th month. The histopathological findings also indicated CR. Both of these patients are disease-free, and they are still under observation.

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The adenomatoid odontogenic tumor has been thought to be rare, but the number of reported cases is gradually increasing. However, various things concerning it have not been clarified in detail. A case of adenomatoid odontogenic tumor in a 23-year-old female was experienced. Radiographic examination revealed a cystic lesion with an unerupted canine in the incisal region of the mandible and the lesion was clinically diagnosed as a dentigerous cyst in the mandibular anterior region. The lesion was extirpated and the pathological diagnosis was adenomatoid odontogenic tumor. Histological examination revealed many cysts, duct-like structures lined with columnar epithelial cells, some deposition of eosinophilic material, and a few calcified masses.
Of the 152 cases of the adenomatoid odontogenic tumors reported in Japan, 66 were in the mandible. They were clinicostatistically reviewed. Fifty-one were in females, and the lesion was found most frequently at the age of 10 to 19 years. The most frequent region was from the lower incisal portion to the lower molar portion and the most frequent preoperative diagnosis was dentigerous cyst. Radiographically, calcification was found in 36 cases accounting for more than half of all the cases.

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