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Objectives: (1) To determine the prognosis of patients with squamous cell carcinoma (SCC) of the oral cavity and (2) to determine whether a relationship exists between koilocytosis and tumour grade, stage, and prognosis in these patients., Methods: Retrospective study of patients with SCC of the oral cavity at McGill University in the last 5 years followed by a pathology review of available cases. The data extracted were age at diagnosis, risk factors, tumour stage and grade, koilocytosis, treatment, and outcome. Deoxyribonucleic acid (DNA) extraction was done, followed by polymerase chain reaction (PCR) to detect the presence of human papillomavirus (HPV)., Results: One hundred ninety-nine patients were identified. There was an overall 13% mortality rate over the follow-up period of 5 years. Pathology material was available for 146 patients. Koilocytosis was found in 67% of patients. More specifically, koilocytosis was present in 67.2% of well-differentiated lesions, 65.2% of moderately differentiated lesions, and 68.4% of poorly differentiated lesions. Koilocytosis was evenly distributed among tumour stages (I, 73%; II, 68%; III, 68%; IV, 69%). PCR was positive in only one sample., Conclusion: Mortality rates in this series are similar to those published in the literature. There is a high prevalence of koilocytosis in SCC of the oral cavity, which appears to be associated with better tumour differentiation and poorly differentiated equally and also evenly distributed among tumour. Because HPV is negative, we do not know if koilocytosis is a marker of HPV. We could not determine the relationship between HPV and prognosis.

Background: Serum proteomics has enormous potential in the identification of biomarkers and the development of new therapies for oral cancer. Current efforts are limited by the lack of a control subject. The human-mouse chimeric model offers a solution., Objectives: To develop and test two orthotopic xenograft mouse models of human oral squamous cell carcinoma for research in serum proteomics., Methods: Advanced human oral cancer from three patients was implanted orthotopically into the tongues of 19 SCID and 4 RAG2/gamma(c) knockout (KO) mice. Adjacent normal tissue from each patient was also implanted into nine SCID and 4 RAG2/gamma(c) KO mice. The models were compared for tissue take, the presence of metastasis, and histologic invasiveness. Mouse serum was preserved for studies in serum proteomics., Results: Tumour tissue was successfully implanted into SCID and RAG2/gamma(c) mice, and the invasiveness was confirmed pathologically. Three of the control mice demonstrated the persistence of normal tissue more than 1 month after implantation. This is the first time that this has been reported. The larger size of the RAG2/gamma(c) KO mouse facilitated serum collection for serum proteomics., Conclusions: Both RAG2/gamma(c) KO and SCID mouse are able to reliably engraft human oral cancer. Engraftment of normal oral tissue was less reliable. This is the first in vivo model allowing identification of proteins released from the tumour microenvironment.

This feasibility study aimed at comparing psychosocial outcomes in head and neck cancer patients receiving the Nucare program with a group of control subjects receiving no intervention. A prospective, nonrandomized study design was used. The Nucare program, a short-term psychoeducational coping strategies intervention, was the test intervention. Control subjects were matched to intervention subjects by cancer stage and time since cancer diagnosis. Outcomes were quality of life and depressive symptoms evaluated at baseline and 3 to 4 months later. One hundred thirty-eight subjects were recruited, and outcome data were available on 101 subjects. At outcome evaluation, compared with their baseline scores, the intervention group had improved physical and social functioning, global quality of life, fatigue, sleep disturbance, and depressive symptoms; the control group showed no changes in quality of life or depressive symptoms. The results suggest that the Nucare program may improve quality of life and reduce depressive symptoms in head and neck cancer patients.

Introduction: Mucoepidermoid carcinoma is the most common salivary gland malignancy, representing up to 30% of all cases. Despite attempts to correlate histopathologic grades to clinical outcomes, some histologically "low"-grade lesions continue to behave aggressively despite appropriate treatment., Objective: This preliminary study will attempt to evaluate the use of immunohistochemical markers HER2/neu and Ki-67 as prognostic markers of biologic aggressiveness for mucoepidermoid carcinoma of the salivary glands., Design and Methods: A retrospective chart review of 42 patients with mucoepidermoid carcinoma of major and minor salivary glands treated between 1970 and 1995 was conducted. A combination of primary resection with or without postoperative irradiation was used. Histologic grading and correlation with outcome analyses are provided., Results: In the current study, positive HER2/neu staining and strong Ki-67 staining occurred in patients with high-grade mucoepidermoid carcinoma, whereas low-grade carcinoma was correlated with negative or weak staining., Conclusion: These preliminary results indicate that, overall, the overexpression of both the HER2/neu and the Ki-67 oncoproteins may serve as prognostic markers for poor outcome in salivary gland mucoepidermoid carcinoma.

Thyroid cancer accounted for about 2.5% of all new cancers among Canadian females in the year 2000. The surgical management of well-differentiated thyroid cancer remains controversial. We reviewed 100 consecutive cases of total thyroidectomy for thyroid masses suspicious for malignancy done between 1998 and 1999. When feasible, a capsular dissection was performed using only the bipolar cautery for hemostasis. The accuracy of preoperative diagnosis and complications of surgery are evaluated. We suggest that total thyroidectomy can be performed, without excessive morbidity. If performed for all suspicious thyroid nodules, it will eliminate the need for completion thyroidectomies and high ablative does of 131I.

Squamous cell carcinoma of the nasal vestibule is a rare disease. Most advocate radiotherapy as a primary treatment for early tumours, with surgery reserved for salvage. For advanced disease, combined therapy with surgery and postoperative radiotherapy is generally recommended. Fourteen patients with squamous cell carcinoma of the nasal vestibule were reviewed. A classification of early versus late lesions was used. We achieved a 78% local regional control rate (minimum follow-up 3 years) in patients with early disease, with either radiotherapy or surgery as a primary modality of treatment. All patients with late disease recurred, requiring further surgical and/or radiation treatment. Only 20% of these patients were disease free at 2 years. Recurrent disease in either group, whether local or regional, carried a grave prognosis, with a 25% disease-free survival at 3 years.

Objective: The primary aim of this article is to provide surgeons with a "how to do it" approach to surgically increase the widest diameter of the nasal valve., Method: An approach utilizing a composite graft from the aural concha to the nasal floor is described, with a brief report of the postoperative results in 13 cases., Results: An objective, measurable improvement in nasal-valve aperture was demonstrated in 77% of operated cases, with 77% of patients indicating a good to excellent rating in satisfaction with the procedure., Conclusion: With minimal scarring and no excisions of supporting structures involved, this method has proved to be effective in the repair of nasal-valve narrowing.

A retrospective study of 126 patients who underwent total laryngectomy during a 10-year period was carried out. The incidence of post-laryngectomy pharyngo-cutaneous fistula was 19%. Pre-operative radiotherapy appears to be a risk factor when surgery is performed within three months of completion of radiotherapy. Intra-operative blood transfusion is strongly associated with fistula development. Fistula formation has an important effect on patient morbidity and mortality post-operatively. It remains a relatively frequent complication following total laryngectomy and may be able to be reduced in incidence if surgery is delayed post radiotherapy and blood transfusion is avoided whenever possible.