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Can BRONJ be Prevented by Relaxin Administration? A Pilot Study

2012, Journal of Oral and Maxillofacial Surgery

Abstract

stratified by race, gender and anatomic sub-site. Outcomes were measured by number of occurrences per 100,000 people. Results: The overall incidence of OOC was stable over time. Males had higher incidence of OOC with a marked difference between Black males and females (11.72 and 3.82 respectively). In a collective analysis there was a decreased incidence (18.39 to 9.21) among Blacks 40-64. There was increased incidence of tongue cancer among Whites in particular age groups; 3.84 to 5.65 in the 40-64 and 8.45 to 10.6 in the 65ϩ. Blacks had an interval decrease of tongue cancer; 6.63 to 4.06 in the 40-64 age cohort. There was a significant decrease in the incidence of FOM cancer in all races (1.49 to 0.65). The incidence of gingival cancer was stable over time, however it was significantly decreased in Blacks 40-64 (6.02 to 2.31). White females Ͼ65 had a higher incidence of gingival cancer than Black females of the same age; 7.54 versus 5.32. Oropharyngeal cancer had the lowest incidence among the measured sub-sites; however, Blacks demonstrated an increased trend in both the 40-64 and 65 ϩ cohorts. The overall 3 and 5-year observed survival (OS) rates for all sub-sites improved over time. Older age groups demonstrated a 34% mean improvement in survival. Blacks demonstrated the poorest OS irrespective of age, gender and sub-site. The mean difference in survival between Blacks and Whites ranged 10-30%. The disease specific mortality has decreased over time in tongue, gingival and FOM cancer. Whites and Blacks had proportionate decreases in mortality in ages 40-64. Whites aged 65 ϩ had a greater decrease in mortality compared to Blacks; 30% reduction versus 21%. Increased mortality was noted for oropharyngeal cancer; Blacks 65 ϩ had a 110% increase compared to 40% in Whites of the same age. Conclusions: This study was designed to raise awareness among practitioners of OOC trends. The data confirms known trends with respect to gender and age and will serve as a framework to develop early diagnostics and focus therapeutics in high-risk demographic subsites such as Black males, White males with tongue cancer and females with gingival cancer. Overall disease specific survival has improved in both Blacks and Whites, but less so for Blacks. Mortality for oropharyngeal cancers increased twofold. These points re-emphasize the importance of potential etiologic factors other than smoking and alcohol abuse, such as HPV. Further investigations will focus on factors that contribute to these differences in an effort to improve outcomes.