Pablo Ignacio Varela Centelles

Early oral cancer diagnosis: The Aarhus statement perspective. A systematic review and meta-analysis.

Mortality is linked to diagnostic intervals in certain cancers. As symptom perception is conditioned by tumor site, a specific study on oral cancer is needed.

Neurological adverse events related to lip biopsy in patients suspicious for Sjögren’s syndrome: a systematic review and prevalence meta-analysis

OBJECTIVE The aim of this study was to compare the prevalence of neurological complications related to lip biopsy for SS diagnosis using conventional vs minimally invasive techniques. METHODS We performed a systematic review and prevalence meta-analysis using the search strategy [(salivary gland biopsy OR labial biopsy OR lip biopsy) AND (Sjögren)] in the MEDLINE, EMBASE and Web of Science Conference Proceedings Citation Index databases. Studies were selected if they included original data for minor salivary gland biopsy, sample size, exposure of interest (technique description), number of complications and number of affected patients. The prevalence of total and permanent neurological adverse effects was calculated. Both fixed-effects and random-effects pooled estimates were assessed. Heterogeneity was calculated using an adaptation of the DerSimonian and Laird Q test. RESULTS Sixteen articles were selected for the study. In the minimally invasive group (n = 3), the pooled prevalence of total adverse events is almost four times higher than that in the linear incision group (n = 12) (4.73% vs. 1.20%). In contrast, the pooled prevalence of the permanent or potentially permanent neurological adverse events is 8.5 times lower in the minimally invasive technique group than in the studies using linear incisions (0.17% vs. 1.45%). CONCLUSION With the limitations intrinsic to the potential biases in the studies included in this meta-analysis, we conclude that the minimally invasive lip biopsy technique for SS diagnosis induces fewer permanent neurological complications than conventional approaches with large linear incisions in the lower lip.

Timing of Oral Cancer Diagnosis: Implications for Prognosis and Survival

Oral cancer has become a global health problem (Parkin, 2005; Gillison, 2007) and its increasing incidence and mortality rates are particularly relevant in certain parts of Europe (France, Hungary, Spain and Croatia), Brazil, and South-Eastern Asia (Sri Lanka, Pakistan, Bangladesh and India) (Warnakulasuriya, 2009). These geographical variations seem to reflect disparities in tobacco, areca nut and alcohol consumption (Warnakulasuriya, 2009). Worldwide, oral cancer has one of the lowest survival rates that remains unaltered despite recent therapeutic advances. Young adults seem to be growingly affected by tongue cancer in Brazil, several European countries and USA (Llewellyn, 2004). However, current reports describe a trend –more marked for tongue carcinomastowards improved survival at each stage and at all ages but ≥75 years (Pulte, 2010).