Dietary patterns and risk of oral cancer: a case-control study in São Paulo, Brazil

Abstract

OBJECTIVE:To analyze the association between dietary patterns and oral cancer. METHODS:The study, part of a Latin American multicenter hospital-based casecontrol study, was conducted in São Paulo, Southeastern Brazil, between November 1998 and March 2002 and included 366 incident cases of oral cancer and 469 controls, frequency-matched with cases by sex and age. Dietary data were collected using a food frequency questionnaire. The risk associated with the intake of food groups defined a posteriori, through factor analysis (called factors), was assessed. The first factor, labeled "prudent," was characterized by the intake of vegetables, fruit, cheese, and poultry. The second factor, "traditional," consisted of the intake of rice, pasta, pulses, and meat. The third factor, "snacks," was characterized as the intake of bread, butter, salami, cheese, cakes, and desserts. The fourth, "monotonous," was inversely associated with the intake of fruit, vegetables and most other food items. Factor scores for each component retained were calculated for cases and controls. After categorization of factor scores into tertiles according to the distribution of controls, odds ratios and 95% confidence intervals were calculated using unconditional multiple logistic regression.RESULTS: "Traditional" factor showed an inverse association with cancer (OR=0.51; 95% CI: 0.32; 0.81, p-value for trend 0.14), whereas "monotonous" was positively associated with the outcome (OR=1.78; 95% CI: 1.78; 2.85, p-value for trend <0.001). CONCLUSIONS:The study data suggest that the traditional Brazilian diet, consisting of rice and beans plus moderate amounts of meat, may confer protection against oral cancer, independently of any other risk factors such as alcohol intake and smoking. KEYWORDS

A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

“…groups [40,46,157,169]. However, there have been few studies which showed a significant survival benefit in favor of elective neck dissection in oral carcinoma patients with clinically N0 neck [36,62,76,94,170]. Among prospective randomized trials, only the study by Kligerman et al showed evidence of a statistically significant disease-free survival benefit of elective neck dissection over a policy of observation [79] (Table 5 and Figure 4).…”

“…They however suggested concurrent neck treatment with the surgical extirpation of the primary tumor if the tumor depth is more than 4mm or if the patient cannot be regularly followed-up. However, a few retrospective studies have reported on the survival benefit of elective neck dissection in oral carcinoma with clinical N0 neck [37,62,76,94]. It has also been reported that the survival rate of patients with oral carcinomas will reduce by 50% once there is a palpable cervical lymph node [42,52,87,132].…”

“…Few reports exist on diet which may protect against oral cancers [90,93]. This includes eating of diet rich in fresh fruits and vegetables [91,94]. Epidemiologic evidence has suggested that vitamins A, C and carotenoids (present in fruits and vegetables) may be protective against epithelial cancers [91,94].…”

“…This includes eating of diet rich in fresh fruits and vegetables [91,94]. Epidemiologic evidence has suggested that vitamins A, C and carotenoids (present in fruits and vegetables) may be protective against epithelial cancers [91,94]. A decreased risk of oral cancer associated with vitamin A and C intake has been reported [6].…”

“…Although his description is exhaustive and produced an influential classification but it has been further modified by others to suit the need of clinicians [53,54,94,142]. Clinically, the roughly 300 lymph nodes, 150…”