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Squamous cell carcinoma is by far the most common type of cancer of the oral cavity, representing more than 90% of all oral cancers. Despite refinement of surgical techniques and adjuvant therapies, the prognosis for patients with oral squamous cell carcinoma remains poor. Identification of prognostic factors related to tumor biology might improve this assessment. Recently, the human trophoblast cell-surface antigen TROP2 was found to be highly expressed in colorectal cancer, correlating with aggressiveness and poor prognosis. Thus, the aim of this study was to investigate TROP2 expression and its prognostic impact in oral squamous cell carcinoma patients. TROP2 expression was examined by immunohistochemistry in a series of 90 patients on a tissue microarray of paraffin-embedded specimens. Survival was calculated using Kaplan-Meier estimates. Parameters found to be of prognostic significance in univariate analysis were verified in a multivariate Cox regression model. TROP2 overexpression was observed in 52 (58%) of the tumor samples. Kaplan-Meier curves showed that TROP2 overexpression was significantly associated with decreased overall survival (P<0.01). Overall survival gradually worsened with increasing TROP2 scores. By univariate analyses, no correlation with conventional clinicopathological features was found. Multivariate Cox regression analysis revealed TROP2 overexpression to be an independent factor predictive of poor disease outcome (P<0.01). These results demonstrate that TROP2 overexpression is an independent prognostic marker in patients with oral squamous cell carcinoma. TROP2 overexpression was detectable in 58% of the tumor samples, indicating it to be a potential novel therapeutic target in squamous cell carcinoma of the oral cavity.

Purpose: The development of overall survival of a DOSAK (German-Austrian-Swiss Cooperative Group on tumours of the maxillofacial region) clinic's overall population comprising a time period of more than 20 years (1983-2004) should be assessed. At a cutoff date (January 1st, 1997), a change from a primarily surgically based to a consequent multi-modality treatment regimen was implemented. The periods of time before and after that change should be compared., Methods and Patients: The data of the DOSAK registry entries on 1038 patients suffering from primary untreated oral and oropharyngeal carcinomas were updated with respect to follow-up and mortality data to achieve a 100% quality of follow-up. The end point (death) was reached in 67% of the overall population. Statistical analysis was carried out by the Trium Analysis Online corporation, Munich., Results: The portion of female and older tumor patients increased, more than half of all tumor patients were clearly in stage IV of the disease at first referral. The portion of patients operated on persisted approximately (80%), the portion of additional treatment modalities could be increased considerably. The fact of a bony infiltration by the tumor and the operability remained highly significantly relevant for survival in multivariate analysis, despite of multi-modality treatment. The survival rate of the patients remained significantly dependent on the clinical stage of the disease in multivariate analysis but could be improved by 10% in the clinical stages II and III and in the patients who could not be operated on. All in all, the cutoff date was statistically relevant for survival in multivariate analysis, i.[Symbol: see text]e. the change in the treatment regimen had a verifiable positive effect on the survival of a unicentric overall population., Conclusion: Survival improvement in an overall population via change in treatment strategy is possible in relatively short time; the clinical stages II and III and the non-operable patients have the greatest benefit from a multi-modality treatment.

Aim: The prognostic value of the TNM and pTNM classifications currently used for tumours of the oral cavity is unsatisfactory. A better classification should be aimed at as today's definition of T4 leads to overclassification of many tumours and today's definition of N3 results in too few lymph nodes in this group. Until 1987 the grade of fixation of lymph-nodes was part of the N-classification for oral cancer as it is currently used in the N-classification of breast cancer., Methods: From 1987 to 1991 the DOSAK tumour registry has stored 1532 primary cases of cancer of the oral cavity from 23 hospitals. Crosstables were applied to outline the classification rule for clinical and histopathological T and N based on important factors (T: tumour diameter and thickness; N: lymph node diameter and grade of fixation; pT: histopathological tumour diameter and thickness; pN: number of lymph nodes involved by the tumour). A Cox model was calculated and combinations of similar prognostic estimates were summarized to the same clinical and histopathological T and N. It was aimed at separating categories and achieving equivalent clinical and histopathological T classifications and group frequencies. In a final step a clinical and histopathological stage grouping can be proposed., Results: The gradation of the survival rates shows a marked separation between the T, N and stage categories. The distribution of T, N and stage categories was more uniform when applying the new classification.

In eastern Austria, mortality from cancer of the mouth and pharynx, larynx, esophagus and lung between 1960 and 1989 developed differently by site and gender. In males, a decrease in lung cancer contrasted with an increase in mouth/pharynx cancer, while rates for cancer of the larynx and esophagus changed only slightly. At all sites, similar double-wave shaped cohort effects were discernible, with a period of decreasing risk separating two periods of increasing risks. The extents of these cohort effects, especially in the later rise of mouth/pharynx neoplasms, shaped the respective mortality curves. In females, lung cancer was found to increase over the whole period, while mouth/pharynx cancer increased during the last decade with risks increasing from cohort to cohort. Larynx rates became somewhat greater during the last two decades. Esophageal cancer demonstrated a steady decrease. For tobacco-related cancers, deglutitional sites were affected in a growing proportion. The combined topical effects of tobacco and alcohol suggest an increasing influence of the co-factor alcohol upon the occurrence of upper aerodigestive cancers in eastern Austria.

Computer-aided individual prognoses (CIP) is a software-package developed on the basis of an empirical study and can be installed on any IBM-compatible personal computer. The project which went into the making of CIP was called "Prospective DOSAK-study on squamous cell carcinomas of the lips, oral cavity and oropharynx". In the course of the study 1485 patients were treated between 1977 and 1982, and followed up through 1985. CIP facilitates individual prognoses and comparisons of independent patient groups with parallel groups from the data of the above-mentioned study. In practical clinical work individual prognoses allow exact and reliable judgements on individual patients. In clinical cancer research it provides the information about prognostic factors required for controlled clinical studies. The comparison of independent patient populations allows for an ongoing qualitative control of the patients in each clinical institution. In clinical cancer research such a comparison means that certain characteristics of the patient, the tumor and of the disease can be given higher prognostic value. The same is true of the clinical testing of therapeutic measures which is typically carried out during phase-II-studies. Due to its menu-based organization CIP does not presuppose any specialist knowledge on the part of its users and can be regarded as particularly user-friendly.

Eastern Austrian regional mortality patterns of oral cancer (oral cavity, pharynx and larynx) and oesophageal, lung and urinary bladder cancer were compared to smoker rates and to liver cirrhosis mortality by type of residence: Vienna (1.7 x 10(6) inhabitants), middle towns (50,000-100,000 and 10,000-50,000 inhabitants), small towns (2000-10,000 inhabitants) and rural areas categorized by agrarian quota less than or equal to 10%, 10%-20% and greater than 20%. The study area (Vienna, Lower Austria and Burgenland) covers 23,600 km2 with 3.23 x 10(6) inhabitants. In men, liver cirrhosis correlated negatively with smoker rates (r = 0.74, P = 0.1). Deaths from oral cancer and oesophageal cancer correlated significantly with deaths from liver cirrhosis (r = 0.81, P = 0.03; r = 0.78, P = 0.04, respectively) but not with smoker rates; lung cancer and bladder cancer correlated significantly with smoker rates (r = 0.91, P = 0.01; r0.83, P = 0.04, respectively), but not with liver cirrhosis. In women, similar urban-rural gradients for all parameters resulted in a positive correlation between liver cirrhosis and smoker rates (r = 0.59, P = 0.22) and a significant correlation of lung cancer with liver cirrhosis (r = 0.75, P = 0.05). Oral cancer correlated significantly with liver cirrhosis (r = 0.83, P = 0.02), but not with smoker rates; lung cancer correlated more significantly with smoker rates (r = 0.92, P = 0.01) than with liver cirrhosis; bladder cancer correlated positively with smoker rates (r = 0.70, P = 0.12). Geographical distribution of oral and oesophageal cancer in Eastern Austria seems thus to be highly subject to the prevalence of heavy drinking. Sociocultural influences upon the occurrence of these cancers seem to be mediated through drinking habits rather than through smoking habits alone.

In a multicentric, retrospective observational study on carcinomas of the oral cavity including the lips and the oropharynx a data material of 1021 patients has been analyzed. The specific goals of this study were: Review of existing proposals for classification; Analysis of prognostically relevant factors of the tumor disease; Construction of a prognostic index for the determination of individual and collective prognoses. The following results were gained: None of the TNM-classifications of oral cavity carcinomas does the necessary criteria justice not even approximately. The multivariate analyses of prognostically relevant factors were performed with and without taking therapeutical factors into account. The results unequivocally show that reliable prognoses are only possible under consideration of various treatment modalities. This led to the construction of the treatment-dependent prognostic index TPI, which will be eligible for the use within the clinical-therapeutical cancer research and within the clinical practice.

In a multicentre, retrospective observational study on carcinomas of the oral cavity, including the lips and oropharynx, data material of 1021 patients has been analysed. The specific goals of this study were: Review of existing proposals for classification. Analysis of prognostically relevant factors of the tumour disease. Construction of a prognostic index for the determination of individual and collective prognoses. The following results were achieved: ad 1: All existing TNM-Classifications of oral cavity carcinomas so far fail to meet the requirements of the necessary criteria. ad 2: The multivariate analyses of prognostically relevant factors were performed with and without taking therapeutic factors into account. The results show unequivocally that reliable prognoses are only possible if various treatment modalities are considered. ad 3: This led to the construction of the treatment-dependent prognostic index TPI, which will be eligible for use in clinical-therapeutic cancer research and in clinical practice.

Any statement regarding the frequency of cancer in the Federal Republic of Germany must be based on the mortality index. Data on the frequency of malignant tumors of the oral mucosa were collected and compared with the international statistics. The focus of the DOSAK study (German-Austrian-Swiss study group for tumors of the maxillofacial region0, which has concerned itself with epidermiologic and clinical studies since 1966, was discussed. Retrospective studies of documentation and prospective studies of therapy for carcinoma of the oral mucosa were discussed in particular.