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Background: The development and progression of cancer depend on its genetic characteristics as well as on the interactions with its microenvironment. Understanding these interactions may contribute to diagnostic and prognostic evaluations and to the development of new cancer therapies. Aiming to investigate potential mechanisms by which the tumor microenvironment might contribute to a cancer phenotype, we evaluated soluble paracrine factors produced by stromal and neoplastic cells which may influence proliferation and gene and protein expression., Methods: The study was carried out on the epithelial cancer cell line (Hep-2) and fibroblasts isolated from a primary oral cancer. We combined a conditioned-medium technique with subtraction hybridization approach, quantitative PCR and proteomics, in order to evaluate gene and protein expression influenced by soluble paracrine factors produced by stromal and neoplastic cells., Results: We observed that conditioned medium from fibroblast cultures (FCM) inhibited proliferation and induced apoptosis in Hep-2 cells. In neoplastic cells, 41 genes and 5 proteins exhibited changes in expression levels in response to FCM and, in fibroblasts, 17 genes and 2 proteins showed down-regulation in response to conditioned medium from Hep-2 cells (HCM). Nine genes were selected and the expression results of 6 down-regulated genes (ARID4A, CALR, GNB2L1, RNF10, SQSTM1, USP9X) were validated by real time PCR., Conclusions: A significant and common denominator in the results was the potential induction of signaling changes associated with immune or inflammatory response in the absence of a specific protein.

Objective: Salvage surgery is the first therapeutic option for recurrent tumors of the mouth and oropharynx, mainly in early stage tumors. This study intends to evaluate the disease free survival interval after salvage treatment for recurrent tumors of the mouth and oropharynx., Methods: Retrospective analysis of 276 patients with squamous cell carcinoma of the mouth and oropharynx treated with surgery. One hundred and twenty seven patients developed loco-regional recurrence. Ninety-seven were staged as early tumors and 178 as advanced ones. The tumor site was the lip in 25 cases, oral cavity in 173 and oropharynx in 78. Postoperative radiotherapy was indicated in 121 cases with a mean dose of 60.8Gy., Results: Eighty-nine patients underwent salvage treatment (surgery in 76 patients). Loco-regional recurrences were treated with salvage surgery in 65% of cases. Disease free survival after salvage surgery was 13% in cases with recurrences diagnosed up to 6 months and 48% in those who recurred after 12 months of follow-up (p=0.0009). Modality of salvage treatment and the disease free interval were independent variables of survival in the multivariate analysis., Conclusion: In cases clinically staged as I and II, the disease free survival in five years after salvage treatment was 70%.

Background: Squamous cell carcinoma (SCC) of the oral cavity occurs mainly in the male population. The objective of the study is to identify the main clinical and epidemiological differences of the oral SCC between men and women., Methods: Retrospective analysis of the charts of 228 cases of SCC of the oral cavity in women treated at the Head & Neck Surgery Service, Heliopolis Hospital, São Paulo, Brazil from 1977 to 1996. The clinical and epidemiological characteristics of these cases were compared with those of 849 male patients., Results: The mean age of women was 60.7 years (ranging 2 to 100 years) and in the male group was 55.6 years (p<0.00001). In cases where the alcohol intake and tobacco use were absent, the tumors ocurred in older patients. The isolated tobacco use didn't affect the distribuction by age but for the alcohol intake (alone or combined with tobacco) the patients were younger. On the alcohol intake, 71% of the women and 8% of the man used no alcohol. The most common sites of tumors were tongue and floor of the mouth but in the women group the incidence of tumors in these sites were 43% compared with 61% in the men., Conclusions: The highest incidence of SCC the of oral cavity occurs later in women, than in men. This could be explained by a lesser exposure to alcohol and tobacco in women. Other factors seem to be involved in this issue.