EP-1203 Characterization of DCE-MRI parameters associated with advanced mandibular osteonecrosis
Notice bibliographique
Résumé
Purpose or ObjectiveOutcomes of oral cavity squamous cell carcinoma (OSCC) tend to be worse than other head and neck squamous cell carcinomas (HNSCC) despite modern surgical and radiation techniques and the use of postoperative concurrent chemotherapy in high risk OSCC.Anecdotal evidence has suggested that OSCC patients under the age of 40 have aggressive disease.We evaluated the outcomes of OSCC patients <40 treated in the modern IMRT era at our institution. Material and MethodsAfter obtaining REB and institutional approval, OSCC patients under 40 were identified from our prospectively collected database.Details were collected in relation to tumor and treatment factors.Oncologic outcomes including overall survival, disease free survival, and locoregional control were determined for this sub-set.Overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan Meier method and loco-regional control was evaluated using competing risk analysis. ResultsFrom 1183 consecutive patients with OSCC treated with curative intent between 2005 and 2017, 57 patients (5%) under the age of 40 were identified.The median age was 33 years (range 18-39).In the study cohort 42% of patients were female and 58% male; 61% of patients were lifelong non-smokers, with only 23% current smokers, and 16% exsmokers; 44% were non-drinkers.ECOG performance status was 0-1 in 92.9% ( one 2, 3 missing data).Surgery was to the primary lesion only in 26%, to the primary with an ipsilateral neck dissection in 53%, and 21% had surgery to the primary with bilateral neck dissections.Only 5% of patients had positive microscopic resection margins.Lymph node involvement with extra-nodal extension was seen in 17% of patients, 5% had LVI and 37% had PNI.Almost 60% received definitive surgery alone, while in 40% surgery was followed by adjuvant radiotherapy; among these, 65% received concurrent chemotherapy.The adjuvant radiotherapy dose received ranged from 56Gy in 40 fractions to 70.72Gy in 35 fractions; 26% of patients received 60Gy in 30 fractions, and 52% receiving 66Gy in 33 fractions.Almost half, 44%, had stage I disease, 10.5% stage II, 16% stage III, 28% stage IV; 1 patient's biopsy showed CIS despite a large tumor.Serious comorbidity was present in 8 patients: 6 with previous malignancies (10.5%), 1 with Fanconi's Anaemia, and 1 with severe SLE causing renal failure.With a median follow-up of 4.27 (5.03 in survivors) years, 1-year OS was 94% (0.88-1), 3-year OS 84% (0.75-0.95) and 5-year OS 82% (0.71-0.93).DFS was 84% (0.74-0.94) at one year, and 66% (0.54-0.81) at 5 years.Event free survival was 87% at 1 year (94-74), 79% at 3 years (88-65) and 74% at 5 years (84-57) . ConclusionThe clinical impression of poor outcomes for patients aged under 40yrs may represent recall bias.Such treated curatively for OSCC in our institution appear to have acceptable OS and DFS.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».