M. Merkx - Academia.edu (original) (raw)
Papers by M. Merkx
Objective: A major dilemma in the management of patients with precursor lesions of the oral mucos... more Objective: A major dilemma in the management of patients with precursor lesions of the oral mucosa lies in deciding which lesions will progress into carcinoma. The aim of this study was to evaluate the value of chromosomal instability (CIN) detected by fluorescence in situ hybridization (FISH) for the[for full text, please go to the a.m. URL]
Journal of Oral Pathology & Medicine, 2021
BACKGROUND Guidelines for follow-up after oral cancer treatment are not site-specific and encompa... more BACKGROUND Guidelines for follow-up after oral cancer treatment are not site-specific and encompass the entire head and neck area rather than the oral cavity alone. This one-size-fits-all protocol disregards the differences in aetiology, treatment and differential distribution of new disease between the subsites. With the effectiveness of follow-up in early detection of new disease being put into question, the focus of follow-up programmes might shift to other aspects of survivorship care. Personalization of follow-up is important, considering patient-specific features and needs. Furthermore, the COVID-19 pandemic urges us to rethink our follow-up practice. FINDINGS This paper discusses ways in which routine follow-up in patients treated for oral cancer can be optimised. Patients with a high risk of new disease might benefit from an intensified follow-up regimen, whilst patients with a low risk of new disease, a low chance of cure or limited life expectancy could benefit from a de-intensified follow-up regimen. The latter could include a shorter follow-up period and focus on goals other than early detection of new disease. Education of patients to report new symptoms early is of vital importance as the majority of new disease presents symptomatically. Other health care professionals such as specialist nurses and dentists need to play an important leading role in survivorship care. Remote consultations may be useful to perform more efficient and patient centred follow-up care. CONCLUSION Routine follow-up needs to be seen as an integrated part of an individualized survivorship plan that is provided by the entire multidisciplinary team.
Introduction: To evaluate the long-term (5 years) effects of perioperative briefing and debriefin... more Introduction: To evaluate the long-term (5 years) effects of perioperative briefing and debriefing on team climate. We explored the barriers and facilitators of the performance of perioperative briefing and debriefing to explain its effects on team climate and to make recommendations for further improvement of surgical safety tools. Methods: A mixed-method evaluation study was carried out among surgical staff at a tertiary care university hospital with 593-bed capacity in the Netherlands. Thirteen surgical teams were included. Team climate inventory and a standardised evaluation questionnaire were used to measure team climate (primary outcome) and experiences with perioperative briefing and debriefing (secondary outcome), respectively. Thirteen surgical team members participated in a semi-structured interview to explore barriers and facilitators of the performance of perioperative briefing and debriefing. Results: The dimension 'participative safety' increased significantly 5 years after the implementation of perioperative briefing and debriefing (p = 0.02 (95% confidence interval 1.18-9.25)). Perioperative briefing and debriefing was considered a useful method for improving and sustaining participative safety and cooperation within surgical teams. The positive aspects of briefing were that shared agreements made at the start of the day and that briefing enabled participants to work as a team. Participants were less satisfied regarding debriefing, mostly due to the lack of a sense of urgency and a lack of a safe culture for feedback. Briefing and debriefing had less influence on efficiency. Conclusions: Although perioperative briefing and debriefing improves participative safety, the intervention will become more effective for maintaining team climate when teams are complete, irrelevant questions are substituted by customised ones and when there is a safer culture for feedback. What's already known about this topic? • The operation room is a high-risk environment where adverse events are likely to happen. • Good team climate in surgical teams is required to provide safe care. • Perioperative briefing and debriefing affect team climate positively. What does this article add? • Perioperative briefing and debriefing are considered a useful method for improving and sustaining participative safety and cooperation within surgical teams. • We make recommendations for further improvement of perioperative briefing and debriefing.
Otolaryngology–Head and Neck Surgery, 2020
ObjectiveAn increased interval between symptomatic disease and treatment may negatively influence... more ObjectiveAn increased interval between symptomatic disease and treatment may negatively influence oncologic and/or functional outcomes in head and neck cancer (HNC). This systematic review aims to provide insight into the effects of time to treatment intervals on oncologic and functional outcomes in oral cavity, pharyngeal, and laryngeal cancer.Data SourcesPubMed, EMBASE, and Cochrane library were searched.Review MethodsAll studies on delay or time to diagnosis or treatment in oral, pharyngeal, and laryngeal cancer were included. Quality assessment was performed with an adjusted version of the Newcastle‐Ottawa scale. Outcomes of interest were tumor volume, stage, recurrence, survival, patient‐reported outcome measures (PROMs), toxicity, and functionality after treatment.ResultsA total of 51 studies were included. Current literature on the influence of delay in HNC is inconsistent but indicates higher stage and worse survival with longer delay. The effects on PROMs, toxicity, and fun...
Radiotherapy and Oncology, 2011
Otorhinolaryngolog
Oral Oncology Supplement, 2007
Head & neck, Apr 21, 2015
To report the results of accelerated radiotherapy with concomitant weekly cisplatin in head and n... more To report the results of accelerated radiotherapy with concomitant weekly cisplatin in head and neck cancer. One-hundred-and-six patients received concomitant cisplatin 40 mg/m(2) weekly with accelerated radiotherapy up to a dose of 68 Gy over 5.5 weeks. Ninety-nine percent of the patients received planned radiotherapy and 90% received ≥ 5 cycles of cisplatin. Moist desquamation of skin developed in 45% and confluent mucositis in 82%. Feeding tubes were required in 79% of the patients, and after 12 months in 4%. One patient developed nephrotoxicity. Three-year loco-regional control, disease-free survival and overall survival (OS) were 72%, 54% and 61%, respectively. HPV status was positive on PCR and p16in 11 of 50 tested oropharyngeal carcinoma (OPC) patients. Three-years OS was 81% and 66% in HPV-positive versus HPV-negative OPC patients (ns). Concomitant weekly cisplatin 40 mg/m(2) with accelerated radiotherapy was well tolerated and treatment compliance was high. This article i...
Nederlands tijdschrift voor geneeskunde, 2009
Three patients developed descending necrotizing mediastinitis (DNM): a 44-year-old man due to poo... more Three patients developed descending necrotizing mediastinitis (DNM): a 44-year-old man due to poor dental status; a 54-year-old women due to a throat infection, 6 weeks after a tooth extraction; and a 30-year-old man a few days after a tooth extraction. Presenting symptoms were dyspnoea, fever, trismus, cervical oedema, and pain. The first two patients had multiple drainage of the cervical region and mediastinum in combination with pathogen-specific antibiotics. Both recovered without any complications. The third patient probably had inadequate surgical drainage of the mediastinum directly after diagnosis, and died. If the CT scan is suggestive of DNM, the patient should be referred to a thoracic surgical unit immediately. The optimal treatment consists of vigorous surgical drainage of both the neck and mediastinum with irrigation in combination with pathogen-specific antibiotic therapy. An early diagnosis followed by adequate antibiotic and surgical treatment improves the outcome i...
Head & Neck, 2015
ABSTRACTBackgroundChoosing between a more or less extensive neck dissection implies a tradeoff be... more ABSTRACTBackgroundChoosing between a more or less extensive neck dissection implies a tradeoff between survival, quality of life, and costs. The purpose of this study was to determine if selective neck dissection (level I–III or I–IV) is cost‐effective compared with modified radical neck dissection (level I–V) in patients with cT1–2 oral squamous cell carcinoma (OSCC) with singular nodal disease confined to level I or II.MethodsA decision‐analytic model was developed to model quality‐adjusted life years (QALYs) and costs over a lifetime horizon, based on literature.ResultsThe selective neck dissection strategy resulted in an expected health loss of 0.06 QALY and savings of €1351 per patient compared to modified radical neck dissection. The results were sensitive to differences in regional failure probabilities between the strategies.ConclusionWith the evidence used in this model, selective neck dissection was not cost‐effective compared to modified radical neck dissection. Prospecti...
Surgical Pathology of the Head and Neck, Third Edition, 2008
Oral and Maxillofacial Surgery, 2008
Background In the presence of severe maxillofacial trauma, management of the airway is important ... more Background In the presence of severe maxillofacial trauma, management of the airway is important because this condition poses a significant threat to airway patency. That securing the airway is not always straightforward is described and illustrated in this paper. Case We present the case of a 23-year-old patient who sustained severe maxillofacial injury for which airway control was necessary. A wire-guided percutaneous dilation cricothyrotomy was performed, which was most probably the cause of an acute loss of airway patency. The literature regarding the role of percutaneous techniques in an elective and emergency setting is reviewed.
Radiotherapy and Oncology, 2007
Oral Oncology, 2013
Purpose Despite advances in surgical and other treatment modalities, the prognosis of patients wi... more Purpose Despite advances in surgical and other treatment modalities, the prognosis of patients with oral squamous cell carcinoma (OSCC) remains poor. It is well known that the early detection of OSCC and recurrent lesions is of utmost importance in obtaining disease control. Besides difficulty in visually differentiating between benign and (pre) cancerous lesions, the detection is hampered by the fact that scalpel biopsy is an invasive activity with potential morbidity. It is therefore not recommended to biopsy lesions on a regular basis. An easily performed, non-invasive screening method suitable to monitor lesions over time is urgently needed. In addition, the current histopathological examination suffers from inter- and intra-observer variability. In a previous study we showed the prognostic value of DNA image cytometry (ICM). Aim of the present study is assessment of the possibility to determine ploidy status using an oral brush. Materials and methods This prospective study included 85 (23 premalignancies, 27 stage T1 and 31 stage T2 OSCC) patients who visited the department of Oral and Maxillofacial Surgery at the Radboud University Nijmegen Medical Center, The Netherlands, with a suspected (pre) malignant lesion of the oral cavity. Newly discovered lesions as well as suspected recurrent OSCC were included. Both a brush and biopsy specimen were obtained for each patient. All specimens were analysed using ICM according to a well-established procedure. Results A significant difference was observed between brushes from diploid biopsies and brushes from non-diploid biopsies ( p Conclusions The oral brush biopsy is not suitable to replace the conventional surgical biopsy, however it may be of additional value in monitoring (pre) malignant lesions over time.
![Research paper thumbnail of Corrigendum to “Facial nerve function in carcinoma of the parotid gland” [European Journal of Cancer, 42 (2006) 2744–2750]](https://attachments.academia-assets.com/110427469/thumbnails/1.jpg)
](European Journal of Cancer, 2007
Niets uit deze uitgave mag worden vermenigvuldigd en/of openbaar worden gemaakt middels druk, fot... more Niets uit deze uitgave mag worden vermenigvuldigd en/of openbaar worden gemaakt middels druk, fotokopie, microfilm, geluidsband of op welke andere wijze dan ook, zonder voorafgaande schriftelijke toestemming van de copyrighthouder.
Cancer Research, 2010
A major dilemma in the management of patients with precursor lesions of the oral mucosa lies in d... more A major dilemma in the management of patients with precursor lesions of the oral mucosa lies in deciding which lesions will progress into carcinoma. Because a strong association between histological differentiation and clinical prognosis is lacking, the aim of this study was to evaluate the value of chromosomal instability (CIN) detected by fluorescence in situ hybridization (FISH) for the identification of oral premalignant lesions at risk for progression. We examined a series of premalignant oral mucosa lesions of 106 patients by means of FISH on paraffin-embedded tissue sections using biotin- and digoxigenin-labeled probes specific for the centromeric regions of chromosomes 1 and 7. CIN was indicated by the presence of chromosome imbalances and/or polyploidization for chromosomes 1 and 7. Results were correlated with histopathological data as well as with clinical follow up data. The 5-year progression-free survival rate was 83%. Outcome of routine histopathology did only predict malignant progression when comparing severe dysplasia with lower stage precursor lesions (hyperplasia, mild en moderate dysplasia) (p In conclusion, tumorigenesis of the oral mucosa is associated with the development of CIN, which can reliably identify lesions at risk for progression. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5720.
International Journal of Oral and Maxillofacial Surgery
Poster presentations and it has been attributed to dietary factors. Dietary Guidelines for Americ... more Poster presentations and it has been attributed to dietary factors. Dietary Guidelines for American Adherence Index (DGAI) 2005 has been developed to evaluate the contribution of diet to chronic disease risk. The aim of this study was to evaluate the association of DGAI 2005 scores and ESCC risk in a high-risk population. Methods: This case-control study was conducted on 47 cases with incident ESCC and 96 hospital controls aged 40 75 years. Dietary data were collected in faceto-face interviews using a validated food frequency questionnaire. DGAI 2005 was used to score the prevailing dietary intakes of participants according to the latest dietary recommendations. SPSS software was used to calculate regression odds ratios for the association of DGAI tertiles and ESCC risk. Results: The mean DGAI score for this population was low (9.54 out of possible 19 scores) and control group scored significantly higher in both healthy choice and food group subscores of DGAI (p < 0.001). Being in the highest tertiles of DGAI score, food intake and healthy choice subscores reduced the ESCC risk by 38%, 42% and 21% respectively. Consuming salty, peppery and sour foods in combination increased the ESCC risk by 7.23, followed by consuming fried/barbecued meals (OR: 3.79) and high temperature food/beverages (OR: 3.68). Conclusion: Consuming a diet in accordance with the latest dietary guidelines might lower the risk of ESCC in a high-risk population. Preventive strategies to reduce ESCC risk should focus on overall dietary patterns and dietary habits instead of individual dietary factors, to be effective.
Journal of Cranio-Maxillofacial Surgery, 1994
Objective: A major dilemma in the management of patients with precursor lesions of the oral mucos... more Objective: A major dilemma in the management of patients with precursor lesions of the oral mucosa lies in deciding which lesions will progress into carcinoma. The aim of this study was to evaluate the value of chromosomal instability (CIN) detected by fluorescence in situ hybridization (FISH) for the[for full text, please go to the a.m. URL]
Journal of Oral Pathology & Medicine, 2021
BACKGROUND Guidelines for follow-up after oral cancer treatment are not site-specific and encompa... more BACKGROUND Guidelines for follow-up after oral cancer treatment are not site-specific and encompass the entire head and neck area rather than the oral cavity alone. This one-size-fits-all protocol disregards the differences in aetiology, treatment and differential distribution of new disease between the subsites. With the effectiveness of follow-up in early detection of new disease being put into question, the focus of follow-up programmes might shift to other aspects of survivorship care. Personalization of follow-up is important, considering patient-specific features and needs. Furthermore, the COVID-19 pandemic urges us to rethink our follow-up practice. FINDINGS This paper discusses ways in which routine follow-up in patients treated for oral cancer can be optimised. Patients with a high risk of new disease might benefit from an intensified follow-up regimen, whilst patients with a low risk of new disease, a low chance of cure or limited life expectancy could benefit from a de-intensified follow-up regimen. The latter could include a shorter follow-up period and focus on goals other than early detection of new disease. Education of patients to report new symptoms early is of vital importance as the majority of new disease presents symptomatically. Other health care professionals such as specialist nurses and dentists need to play an important leading role in survivorship care. Remote consultations may be useful to perform more efficient and patient centred follow-up care. CONCLUSION Routine follow-up needs to be seen as an integrated part of an individualized survivorship plan that is provided by the entire multidisciplinary team.
Introduction: To evaluate the long-term (5 years) effects of perioperative briefing and debriefin... more Introduction: To evaluate the long-term (5 years) effects of perioperative briefing and debriefing on team climate. We explored the barriers and facilitators of the performance of perioperative briefing and debriefing to explain its effects on team climate and to make recommendations for further improvement of surgical safety tools. Methods: A mixed-method evaluation study was carried out among surgical staff at a tertiary care university hospital with 593-bed capacity in the Netherlands. Thirteen surgical teams were included. Team climate inventory and a standardised evaluation questionnaire were used to measure team climate (primary outcome) and experiences with perioperative briefing and debriefing (secondary outcome), respectively. Thirteen surgical team members participated in a semi-structured interview to explore barriers and facilitators of the performance of perioperative briefing and debriefing. Results: The dimension 'participative safety' increased significantly 5 years after the implementation of perioperative briefing and debriefing (p = 0.02 (95% confidence interval 1.18-9.25)). Perioperative briefing and debriefing was considered a useful method for improving and sustaining participative safety and cooperation within surgical teams. The positive aspects of briefing were that shared agreements made at the start of the day and that briefing enabled participants to work as a team. Participants were less satisfied regarding debriefing, mostly due to the lack of a sense of urgency and a lack of a safe culture for feedback. Briefing and debriefing had less influence on efficiency. Conclusions: Although perioperative briefing and debriefing improves participative safety, the intervention will become more effective for maintaining team climate when teams are complete, irrelevant questions are substituted by customised ones and when there is a safer culture for feedback. What's already known about this topic? • The operation room is a high-risk environment where adverse events are likely to happen. • Good team climate in surgical teams is required to provide safe care. • Perioperative briefing and debriefing affect team climate positively. What does this article add? • Perioperative briefing and debriefing are considered a useful method for improving and sustaining participative safety and cooperation within surgical teams. • We make recommendations for further improvement of perioperative briefing and debriefing.
Otolaryngology–Head and Neck Surgery, 2020
ObjectiveAn increased interval between symptomatic disease and treatment may negatively influence... more ObjectiveAn increased interval between symptomatic disease and treatment may negatively influence oncologic and/or functional outcomes in head and neck cancer (HNC). This systematic review aims to provide insight into the effects of time to treatment intervals on oncologic and functional outcomes in oral cavity, pharyngeal, and laryngeal cancer.Data SourcesPubMed, EMBASE, and Cochrane library were searched.Review MethodsAll studies on delay or time to diagnosis or treatment in oral, pharyngeal, and laryngeal cancer were included. Quality assessment was performed with an adjusted version of the Newcastle‐Ottawa scale. Outcomes of interest were tumor volume, stage, recurrence, survival, patient‐reported outcome measures (PROMs), toxicity, and functionality after treatment.ResultsA total of 51 studies were included. Current literature on the influence of delay in HNC is inconsistent but indicates higher stage and worse survival with longer delay. The effects on PROMs, toxicity, and fun...
Radiotherapy and Oncology, 2011
Otorhinolaryngolog
Oral Oncology Supplement, 2007
Head & neck, Apr 21, 2015
To report the results of accelerated radiotherapy with concomitant weekly cisplatin in head and n... more To report the results of accelerated radiotherapy with concomitant weekly cisplatin in head and neck cancer. One-hundred-and-six patients received concomitant cisplatin 40 mg/m(2) weekly with accelerated radiotherapy up to a dose of 68 Gy over 5.5 weeks. Ninety-nine percent of the patients received planned radiotherapy and 90% received ≥ 5 cycles of cisplatin. Moist desquamation of skin developed in 45% and confluent mucositis in 82%. Feeding tubes were required in 79% of the patients, and after 12 months in 4%. One patient developed nephrotoxicity. Three-year loco-regional control, disease-free survival and overall survival (OS) were 72%, 54% and 61%, respectively. HPV status was positive on PCR and p16in 11 of 50 tested oropharyngeal carcinoma (OPC) patients. Three-years OS was 81% and 66% in HPV-positive versus HPV-negative OPC patients (ns). Concomitant weekly cisplatin 40 mg/m(2) with accelerated radiotherapy was well tolerated and treatment compliance was high. This article i...
Nederlands tijdschrift voor geneeskunde, 2009
Three patients developed descending necrotizing mediastinitis (DNM): a 44-year-old man due to poo... more Three patients developed descending necrotizing mediastinitis (DNM): a 44-year-old man due to poor dental status; a 54-year-old women due to a throat infection, 6 weeks after a tooth extraction; and a 30-year-old man a few days after a tooth extraction. Presenting symptoms were dyspnoea, fever, trismus, cervical oedema, and pain. The first two patients had multiple drainage of the cervical region and mediastinum in combination with pathogen-specific antibiotics. Both recovered without any complications. The third patient probably had inadequate surgical drainage of the mediastinum directly after diagnosis, and died. If the CT scan is suggestive of DNM, the patient should be referred to a thoracic surgical unit immediately. The optimal treatment consists of vigorous surgical drainage of both the neck and mediastinum with irrigation in combination with pathogen-specific antibiotic therapy. An early diagnosis followed by adequate antibiotic and surgical treatment improves the outcome i...
Head & Neck, 2015
ABSTRACTBackgroundChoosing between a more or less extensive neck dissection implies a tradeoff be... more ABSTRACTBackgroundChoosing between a more or less extensive neck dissection implies a tradeoff between survival, quality of life, and costs. The purpose of this study was to determine if selective neck dissection (level I–III or I–IV) is cost‐effective compared with modified radical neck dissection (level I–V) in patients with cT1–2 oral squamous cell carcinoma (OSCC) with singular nodal disease confined to level I or II.MethodsA decision‐analytic model was developed to model quality‐adjusted life years (QALYs) and costs over a lifetime horizon, based on literature.ResultsThe selective neck dissection strategy resulted in an expected health loss of 0.06 QALY and savings of €1351 per patient compared to modified radical neck dissection. The results were sensitive to differences in regional failure probabilities between the strategies.ConclusionWith the evidence used in this model, selective neck dissection was not cost‐effective compared to modified radical neck dissection. Prospecti...
Surgical Pathology of the Head and Neck, Third Edition, 2008
Oral and Maxillofacial Surgery, 2008
Background In the presence of severe maxillofacial trauma, management of the airway is important ... more Background In the presence of severe maxillofacial trauma, management of the airway is important because this condition poses a significant threat to airway patency. That securing the airway is not always straightforward is described and illustrated in this paper. Case We present the case of a 23-year-old patient who sustained severe maxillofacial injury for which airway control was necessary. A wire-guided percutaneous dilation cricothyrotomy was performed, which was most probably the cause of an acute loss of airway patency. The literature regarding the role of percutaneous techniques in an elective and emergency setting is reviewed.
Radiotherapy and Oncology, 2007
Oral Oncology, 2013
Purpose Despite advances in surgical and other treatment modalities, the prognosis of patients wi... more Purpose Despite advances in surgical and other treatment modalities, the prognosis of patients with oral squamous cell carcinoma (OSCC) remains poor. It is well known that the early detection of OSCC and recurrent lesions is of utmost importance in obtaining disease control. Besides difficulty in visually differentiating between benign and (pre) cancerous lesions, the detection is hampered by the fact that scalpel biopsy is an invasive activity with potential morbidity. It is therefore not recommended to biopsy lesions on a regular basis. An easily performed, non-invasive screening method suitable to monitor lesions over time is urgently needed. In addition, the current histopathological examination suffers from inter- and intra-observer variability. In a previous study we showed the prognostic value of DNA image cytometry (ICM). Aim of the present study is assessment of the possibility to determine ploidy status using an oral brush. Materials and methods This prospective study included 85 (23 premalignancies, 27 stage T1 and 31 stage T2 OSCC) patients who visited the department of Oral and Maxillofacial Surgery at the Radboud University Nijmegen Medical Center, The Netherlands, with a suspected (pre) malignant lesion of the oral cavity. Newly discovered lesions as well as suspected recurrent OSCC were included. Both a brush and biopsy specimen were obtained for each patient. All specimens were analysed using ICM according to a well-established procedure. Results A significant difference was observed between brushes from diploid biopsies and brushes from non-diploid biopsies ( p Conclusions The oral brush biopsy is not suitable to replace the conventional surgical biopsy, however it may be of additional value in monitoring (pre) malignant lesions over time.
European Journal of Cancer, 2007
Niets uit deze uitgave mag worden vermenigvuldigd en/of openbaar worden gemaakt middels druk, fot... more Niets uit deze uitgave mag worden vermenigvuldigd en/of openbaar worden gemaakt middels druk, fotokopie, microfilm, geluidsband of op welke andere wijze dan ook, zonder voorafgaande schriftelijke toestemming van de copyrighthouder.
Cancer Research, 2010
A major dilemma in the management of patients with precursor lesions of the oral mucosa lies in d... more A major dilemma in the management of patients with precursor lesions of the oral mucosa lies in deciding which lesions will progress into carcinoma. Because a strong association between histological differentiation and clinical prognosis is lacking, the aim of this study was to evaluate the value of chromosomal instability (CIN) detected by fluorescence in situ hybridization (FISH) for the identification of oral premalignant lesions at risk for progression. We examined a series of premalignant oral mucosa lesions of 106 patients by means of FISH on paraffin-embedded tissue sections using biotin- and digoxigenin-labeled probes specific for the centromeric regions of chromosomes 1 and 7. CIN was indicated by the presence of chromosome imbalances and/or polyploidization for chromosomes 1 and 7. Results were correlated with histopathological data as well as with clinical follow up data. The 5-year progression-free survival rate was 83%. Outcome of routine histopathology did only predict malignant progression when comparing severe dysplasia with lower stage precursor lesions (hyperplasia, mild en moderate dysplasia) (p In conclusion, tumorigenesis of the oral mucosa is associated with the development of CIN, which can reliably identify lesions at risk for progression. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5720.
International Journal of Oral and Maxillofacial Surgery
Poster presentations and it has been attributed to dietary factors. Dietary Guidelines for Americ... more Poster presentations and it has been attributed to dietary factors. Dietary Guidelines for American Adherence Index (DGAI) 2005 has been developed to evaluate the contribution of diet to chronic disease risk. The aim of this study was to evaluate the association of DGAI 2005 scores and ESCC risk in a high-risk population. Methods: This case-control study was conducted on 47 cases with incident ESCC and 96 hospital controls aged 40 75 years. Dietary data were collected in faceto-face interviews using a validated food frequency questionnaire. DGAI 2005 was used to score the prevailing dietary intakes of participants according to the latest dietary recommendations. SPSS software was used to calculate regression odds ratios for the association of DGAI tertiles and ESCC risk. Results: The mean DGAI score for this population was low (9.54 out of possible 19 scores) and control group scored significantly higher in both healthy choice and food group subscores of DGAI (p < 0.001). Being in the highest tertiles of DGAI score, food intake and healthy choice subscores reduced the ESCC risk by 38%, 42% and 21% respectively. Consuming salty, peppery and sour foods in combination increased the ESCC risk by 7.23, followed by consuming fried/barbecued meals (OR: 3.79) and high temperature food/beverages (OR: 3.68). Conclusion: Consuming a diet in accordance with the latest dietary guidelines might lower the risk of ESCC in a high-risk population. Preventive strategies to reduce ESCC risk should focus on overall dietary patterns and dietary habits instead of individual dietary factors, to be effective.
Journal of Cranio-Maxillofacial Surgery, 1994