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PURPOSE Head and neck squamous cell carcinoma (HNSCC) incidence is high in South America, where recent data on survival are sparse. We investigated the main predictors of HNSCC survival in Brazil, Argentina, Uruguay, and Colombia. METHODS Sociodemographic and lifestyle information was obtained from standardized interviews, and clinicopathologic data were extracted from medical records and pathologic reports. The Kaplan-Meier method and Cox regression were used for statistical analyses. RESULTS Of 1,463 patients, 378 had a larynx cancer (LC), 78 hypopharynx cancer (HC), 599 oral cavity cancer (OC), and 408 oropharynx cancer (OPC). Most patients (55.5%) were diagnosed with stage IV disease, ranging from 47.6% for LC to 70.8% for OPC. Three-year survival rates were 56.0% for LC, 54.7% for OC, 48.0% for OPC, and 37.8% for HC. In multivariable models, patients with stage IV disease had approximately 7.6 (LC/HC), 11.7 (OC), and 3.5 (OPC) times higher mortality than patients with stage I disease. Current and former drinkers with LC or HC had approximately 2 times higher mortality than never-drinkers. In addition, older age at diagnosis was independently associated with worse survival for all sites. In a subset analysis of 198 patients with OPC with available human papillomavirus (HPV) type 16 data, those with HPV-unrelated OPC had a significantly worse 3-year survival compared with those with HPV-related OPC (44.6% v 75.6%, respectively), corresponding to a 3.4 times higher mortality. CONCLUSION Late stage at diagnosis was the strongest predictor of lower HNSCC survival. Early cancer detection and reduction of harmful alcohol use are fundamental to decrease the high burden of HNSCC in South America.

O presente estudo tem como objetivo a identificação de eventos climáticos na cidade de Bagé/RS a partir de registros de precipitação pluvial no período 1970 a 2016. Nesse intuito, foi efetuada uma análise espectral da distribuição tempo-frequência da série. Tal análise ajusta a resolução do espectrograma por estimativas local da curtose generalizada por estatística de alta ordem- high-order statistics ( HOS ). Objetivando melhor caracterizar os trechos onde as incertezas são mais relevantes, cálculos do grau de entropia foram avaliados. Os resultados são apresentados via densidade espectral de potência do sinal, espectrograma e perfil de curtose relativos aos registros da série pluvial, mostrando-se eficientes no reconhecimento dos padrões climáticos avaliados. Além disso, especificações sobre a mudança no regime de chuvas foram observadas, identificando períodos mais secos no clima da região na década de 80.

This study investigates the effectiveness of a time-frequency analysis of photovoltaic signals with transients caused by shading on the solar panel. The prototype experiment for the signals acquisition was performed by simulating the desired disturbances on the photovoltaic panel. In this direction, the signals were analyzed by a scheme called variable short-time Fourier transform, that has a varying window size over time that is adjusted by local kurtosis given by the fourth normalized cumulant. Thus, a large window size is applied in regions where the kurtosis is relatively high, improving the resolution of time-frequency image. The technique was used on a synthetic signal and current-voltage photovoltaic signals. The results showed that the variable short-time Fourier transform was able to identify transients and classify them over time.

Moderator: Eugene N Myers, MD; Parotidectomy for nonsalivary tumors-Claudio R Cernea, MD; Recurrent pleomorphic adenomas-Jacob Kligerman, MD; Prognostic factors of salivary gland cancers-Roberto A Lima, MD; Intraoperative decisions about the facial nerve-Pavel Dulguerov, MD; Reflexions about the adenoid cystic carcinoma-Ronald H Spiro, MD; Treatment of the neck in cancer of the salivary glands-Fernando L. Dias, MD.

Objectives: Analyze the factors influencing lymph nodes metastasis in parotid malignant epithelial tumors. Methods: We retrospectively reviewed the files of 150 patients treated in our institution and by the authors, from 1974 to 1998. Twenty-three patients were excluded of this study because of nonsurgical treatment. The remaining 126 patients were treated with surgery and 75 patients had postoperative radiotherapy. Thirty-four patients were treated with parotidectomy plus neck dissection. The mean age was 49-years-old. According the UICC/1997 TNM Classification, we classified 49 patients as Stage I, 27 as Stage II, 22 as Stage III, and 28 as Stage IV. The influence of those factors on the presence of neck metastasis was analyzed using the chi-square method and multivariate analysis. Results: Forty patients had mucoepidermoid carcinoma, 18 patients had adenocarcinoma NOS, 18 patients had acinic cell carcinoma, 15 patients had adenoid cystic carcinoma, 11 patients had malignant mixed tumor, 11 patients had salivary duct carcinoma, 3 patients had basal cell adenocarcinoma, 3 patients had epithelial-myoepitelial carcinoma, 2 patients had malignant myoepithelioma, 2 patients had anaplastic carcinoma, 1 patient had primary squamous cell carcinoma, 1 patient had terminal duct adenocarcinoma, and 1 patient had papillary cystadenocarcinoma. Twenty-four patients had recurrences, 17 local recurrences, 4 patients had neck recurrences, and 3 locoregional recurrences. Seventeen patients had distant metastasis. The presence of neck metastasis was influenced by 4 factors in univariate analysis, age (P 0.05), tumor classification (P 0001), grade (P 03), and histology (P 003), and in multivariate analysis, Grade (P 01) and tumor classification (P 0001). Conclusions: The tumor classification and grade are an important factor to predict neck metastasis.

Objectives: The aim of this study is to demonstrate the prevalence and patterns of regional metastases in Stage I-II squamous cell carcinoma (SCC) of the tongue and floor of the mouth. Methods: From January 1987 through December 1997, 339 previously untreated patients with TI-II N0 M0 SCC of the tongue and floor of the mouth underwent primary surgical treatment in our institution with 245 neck dissections. A retrospective review of the pathology reports and outcome of these patients was made to ascertain the prevalence and distribution of neck metastases (NM) by neck level, according to the primary site and the time of neck dissection (elective versus subsequent therapeutic). Results: Overall incidence of NM was 43.4% (24.8% TIN0M0 and 52.75% TIIN0M0). Occult NM at elective neck dissection ocurred in 22.2% of patients (15.5% TIN0M0 and 25.6% TIIN0M0). Clinically N+ metastases occurred in 21.2% of patients at subsequent neck dissection (9.3% TIN0M0 and 27.1% TIIN0M0). Level II was the most frequent site of NM in all sites in both END and SND groups. Neck level IV nodes were involved in only 1.3% of patients in END group vs 23.7% in SND group. Level V was always always associated withnodal metastases in other neck levels, occurring in only 8.7% in SND group. Of all patients, only 1.8% presented “skip metastases” in the neck. Conclusions: Based on our series of 339 patients with early cancer of the oral cavity, we found levels I, II, and III to be at great risk for the development of nodal metastases.