Liposarcoma: outcome based on the Scandinavian Sarcoma Group register

BACKGROUND.

The aim was to study the clinicopathological characteristics, treatment, and outcome of liposarcoma in an unselected, population‐based patient sample, and to establish whether treatment was according to the Scandinavian Sarcoma Group (SSG) treatment guidelines.

METHODS.

The SSG Pathology Board reviewed 319 liposarcoma cases reported between 1986 and 1998. After the review, 237 patients without metastasis were analyzed for local recurrence rate in relation to surgical margins, radiotherapy, occurrence of metastasis, and survival.

RESULTS.

Seventy‐eight percent of the patients were primarily operated on at a sarcoma center, 45% with wide margins. All patients operated on outside the center had nonwide margins. Low‐grade lesions constituted 67% of cases. Despite nonwide surgery, only 58% of high‐grade lesions were treated with postoperative radiotherapy. The risk of local recurrence after nonwide surgery, without irradiation, was 47% for high‐grade lesions. The estimated 10‐year, local recurrence‐free and metastasis‐free survival in the low‐grade group was 87% and 95%, respectively. In the high‐grade group, it was 75% and 61%, respectively. Independent adverse prognostic factors for local recurrence were surgery outside a sarcoma center and histological type dedifferentiated liposarcoma. For metastases, they were old age, large tumor size, high grade, and histological type myxoid liposarcoma with a round cell component. Radiotherapy showed significant effect on local recurrence rate for the same grade and margin.

CONCLUSIONS.

Patients with liposarcoma should be treated at specialized centers. Postoperative radiotherapy decreases the local recurrence rate. To maintain quality and provide support for further trials, reporting to quality registers is crucial. Cancer 2008. © 2008 American Cancer Society.     

Impact of traumatic dental injuries with unmet treatment need on daily life among Albanian adolescents: a case–control study

Abstract – Background: Traumatic dental injuries (TDI) are common in children and adolescences. Neglected or inadequate treatment may lead to psychosocial distress during late adolescence. Aim: To investigate the potential impact of traumatic dental injuries (TDI) with unmet treatment need, on the quality of life of 16–19 year‐olds in Tirana, Albania. Material and methods: A case–control survey (1:2) was conducted in public high schools in Albania, comprising 95 subjects affected by TDI with unmet treatment need based on objective clinical signs. Controls (n = 190) with no history of TDI were matched by age, sex and belonging to the same school class and group of friends as the respective case. The Oral Impact on Daily Performances (OIDP) index was used to measure the impacts. DMFT, Community Periodontal Index and the Aesthetic Component of the Index of Orthodontic Treatment Need as well as social parameters were recorded. Results: The response rate was 98%. Overall, the impact prevalence of OIDP was 88.4% among the cases, and 58.9% among the controls (P < 0.001). The most prevalent OIDP impact was ‘smiling and showing teeth without embarrassment’: cases had significantly higher values than controls (78.9% vs 31.6%). Multiple conditional logistic regression analysis was used to disclose the effect of TDI with unmet treatment need on quality of life by adjusting for possible confounders. Compared to the control group, TDI cases with unmet treatment need are at greater overall risk of impacts measured as OIDP, with an odds ratio of 3.9 (95% CI: 1.6–9.1). Conclusion: TDI with unmet treatment need in this sample of adolescents is associated with reduced OHRQoL. Compared to adolescents with no history of TDI, those affected by TDI with unmet treatment need are at greater risk of suffering impacts on OHRQoL in the form of OIDP.     

Trends in reasons for tooth extractions in Norway from 1968 to 1998

The aims of this study were (i) to determine the reasons for extraction of permanent teeth in Norway in 1998 and (ii) to describe changes in reasons for extraction in time-trend and quasi-longitudinal perspectives over 30 years based on three cross-sectional studies. The 1998 data were obtained from questionnaires distributed to a national random sample of 1,500 dentists, of whom 1,008 responded (67%). A total of 1,495 teeth were extracted for 1,164 patients (age 10±92 years) during a period of 2 weeks. Caries accounted for 40% of the extractions and periodontal diseases for 24%. Caries was the primary reason in patients 10±45 years old, while periodontal diseases dominated among adults >45 years old. In a time-trend perspective, among patients ≤21 years, a significant decrease in the proportion of extractions because of caries was observed between 1968 and 1988, while non-significant changes were found between 1988 and 1998. Extractions because of periodontal disease accounted for about 26% in all surveys. Followed longitudinally, the three cohorts born 1923±32, 1933±42, 1943±52 showed a decrease in the proportion of extractions due to caries, and an increase in the proportion of periodontal extractions during the period, more so between 1968 and 1988 than between 1988 and 1998. The three cohorts showed a variable trend of change, which may indicate that period and age effects do not necessarily operate in the same direction.     

The Composite Quality Score (CQS) as a trial appraisal tool: inter-rater reliability and rating time

Clinical Oral Investigations - To establish the CQS inter-rater reliability and rating time and to compare both against that of the Jadad scale and Cochrane’s Risk of Bias Tool (ROBT). Four...     

Level and predictors of agreement between patients and their dentists concerning need for replacement of teeth at the time of extraction

The aims were to determine the level of agreement between patient and dentist about the need for a replacement of teeth at the time of extraction, and to identify and assess the effect of predictor variables on the level of agreement. Data were obtained from questionnaires. A systematic random sample of 1,500 Norwegian general dental practitioners were contacted, 67% of them responded and 75% of their patients. The final sample consisted of 427 patients (16-92 years old) and 224 dentists. Overall agreement was 62% of the cases and agreement about replacement 26%. Multiple logistic regression analysis with overall agreement as dependent variable identified tooth type (OR = 2.7 for anterior teeth versus molars, 95% CI: 1.3; 5.6 and OR = 1.9 for molars versus premolars, 95% CI: 1.2; 3.2), service sector, dentist's age and patient gender as significant predictors. Tooth type (OR = 36.0 for anterior teeth versus molars, 95% CI: 12.5; 104.0 and OR = 5.8 for premolars versus molars, 95% CI: 2.7; 12.3), service sector (OR = 7.0, 95% CI: 2.3; 21.1), the number of teeth extracted and the number of remaining natural teeth affected the likelihood of agreement about the need for replacement of extracted teeth. Predictors of no need for replacement were tooth type (OR = 6.7 for molars versus premolars, 95% CI: 3.3; 13.7) and the dentist's age (OR = 2.1, 95% CI: 1.2; 3.6). Clinical factors were the most important predictors of patients' and dentists' likelihood to agree about replacement, but service sector, dentist's age and patient's gender had also a significant impact on the level of agreement.