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Zhou J, Li Y, Wei D, Qian Y, Li W, Liu D, Li G, Pan X, Lei D. Overall survival with and without laryngeal function preservation in 580 patients with hypopharyngeal squamous cell carcinoma. Oncol Rep 2016; 34:3196-202. [PMID: 26503600 DOI: 10.3892/or.2015.4313] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 08/14/2015] [Indexed: 11/06/2022] Open
Abstract
The aims of the present study were to review the experience of different surgical reconstruction methods for hypopharyngeal squamous cell carcinoma (HSCC) and compared the survival of patients with and without laryngeal function (LF) preservation. The clinical characteristics of 580 patients were retrospectively obtained and analyzed. Survival curves were analyzed using the Kaplan‑Meier method for survival and Cox models for hazard ratios (HRs) with 95% confidence intervals (CIs). LF was preserved in 403 cases and not preserved in 177 cases. The 3‑ and 5‑year survival rates were 70.9 and 52.7%, respectively, in the LF preservation group and 48.4 and 30.5%, respectively, in the no LF preservation group. Compared with the patients without LF preservation, patients with LF preservation had a significantly reduced risk of overall death (HR=0.63, 95% CI: 0.50-0.80). LF preservation positively affects the prognosis of patients with HSCC.
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Butskiy O, Anderson DW, Prisman E. Management algorithm for failed gastric pull up reconstruction of laryngopharyngectomy defects: case report and review of the literature. J Otolaryngol Head Neck Surg 2016; 45:41. [PMID: 27449235 PMCID: PMC4957331 DOI: 10.1186/s40463-016-0153-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 06/22/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Gastric pull up remains a popular reconstructive option for pharyngoesophagectomy defects extending to thoracic inlet. Gastric necrosis is a dreaded complication of gastric pull up reconstruction and few studies report on management of this complication. MEDLINE, EMBASE, and Web of Science™ databases were searched for publications in the last 25 years on gastric pull up reconstruction following pharyngoesophagectomy. The rates of complications related to gastropharyngeal anastomosis were extracted, and methods of managing gastric necrosis were noted. Forty seven case series were identified reporting on the use of gastric pull up for reconstruction of pharyngoesophageal defects. Mortality rate varied from 0 to 33 % with a weighted average of 8.6 %. In 39 % of patients, mortality was either caused or directly related to failure of the gastropharyngeal anastomosis. The reported rate of gastric necrosis ranged from 0 to 24 % resulting in a 28 % mortality. Options for managing gastric necrosis included: temporary cervical diversion, free jejunum flap, colonic interposition, tubed radial forearm flap, deltopectoralis and pectoralis myocutaneous flaps. CASE PRESENTATION We present the first case of an anterolateral thigh flap rescue of gastric necrosis after gastric pull up reconstruction. The case report is followed by a review of literature on management of gastric pull up failures. CONCLUSION Based on the extracted information, we propose an algorithm for managing gastric pull up failure following pharyngoesophageal reconstruction.
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Affiliation(s)
- Oleksandr Butskiy
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Vancouver General Hospital & University of British Columbia, Vancouver, BC, Canada.
- Gordon & Leslie Diamond Health Care Centre, 4th. Fl. 4299B-2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
| | - Donald W Anderson
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Vancouver General Hospital & University of British Columbia, Vancouver, BC, Canada
| | - Eitan Prisman
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Vancouver General Hospital & University of British Columbia, Vancouver, BC, Canada
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Suzuki H, Matoba T, Hanai N, Nishikawa D, Fukuda Y, Koide Y, Hasegawa Y. Lymph node ratio predicts survival in hypopharyngeal cancer with positive lymph node metastasis. Eur Arch Otorhinolaryngol 2016; 273:4595-4600. [DOI: 10.1007/s00405-016-4170-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 06/23/2016] [Indexed: 10/21/2022]
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De Felice F, Blanchard P, Levy A, Nguyen F, Gorphe P, Janot F, Temam S, Tao Y. Treatment of squamous cell carcinoma of the posterior pharyngeal wall: Radiotherapy versus surgery. Head Neck 2015; 38 Suppl 1:E1722-9. [PMID: 26613802 DOI: 10.1002/hed.24307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 08/12/2015] [Accepted: 09/19/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Treatment strategy in squamous cell carcinoma (SCC) of the posterior pharyngeal wall is still being debated. METHODS We performed a retrospective analysis according to delivered treatment. RESULTS One hundred eighty patients were treated between 1997 and 2011. Eighty-nine patients (49.4%) received surgery +/- radiotherapy (RT), whereas 91 (50.6%) received definitive RT +/- chemoradiotherapy (RT/CRT). Five-year overall survival (OS) was 33.4%. There was a significant 5-year OS benefit in surgical treatment versus RT/CRT (43% vs 24.1%; p = .002). Multivariate analysis showed that current smokers, T3 to T4 classification, well-differentiated SCC, and nonsurgical treatment were associated with reduced OS. Subgroup analysis showed significant survival benefit of surgical treatment compared with RT/CRT in patients with T1 to T2 but not in T3 to T4 disease. CONCLUSION Surgical management translated into a survival benefit, even in early T classification. These results should be interpreted with caution for selection bias. Surgery remains the standard of care in localized posterior pharyngeal wall SCC. Primary CRT should be considered for nonoperable disease. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1722-E1729.
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Affiliation(s)
- Francesca De Felice
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France.,Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Pierre Blanchard
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France.,Université Paris-Sud, Faculté de Médecine Kremlin Bicêtre, France
| | - Antonin Levy
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France.,Université Paris-Sud, Faculté de Médecine Kremlin Bicêtre, France
| | - France Nguyen
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - Philippe Gorphe
- Department of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - François Janot
- Department of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - Yungan Tao
- Department of Radiation Oncology, Gustave Roussy, Villejuif, France
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Wang CC, Liu SA, Wu SH, Wang CP, Liang KL, Jiang RS, Lin JC. Transoral robotic surgery for early T classification hypopharyngeal cancer. Head Neck 2015; 38:857-62. [PMID: 26559383 DOI: 10.1002/hed.24160] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND For hypopharyngeal cancer, transoral robotic surgery (TORS) has been reported as a new organ preserving treatment but outcomes are rarely reported. METHODS From 2010 to 2013, 10 patients with early T classification pyriform sinus cancer were selected to receive TORS and conventional neck dissection. The clinical parameters, including rates of adjuvant radiotherapy, survivals, as well as organ and function preservation, were retrospectively analyzed. RESULTS TORS was successful in all 10 patients, and 5 patients received adjuvant radiotherapy. After mean follow-up of 26 months, 1 patient died of distant metastasis and 1 patient died of other malignancy. There was no local recurrence and larynxes were all preserved. Eight surviving patients who were followed up continuously could receive oral intake and had a serviceable voice without tracheostomy or feeding tubes. CONCLUSION TORS is a feasible transoral approach for selected patients with early T classification hypopharyngeal cancer. The reported oncologic/functional outcomes are satisfactory. © 2015 Wiley Periodicals, Inc. Head Neck 38: 857-862, 2016.
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Affiliation(s)
- Chen-Chi Wang
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,School of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shih-An Liu
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shang-Heng Wu
- Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Ping Wang
- School of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kai-Li Liang
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Rong-San Jiang
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jin-Ching Lin
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
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Tumor-suppressive microRNAs (miR-26a/b, miR-29a/b/c and miR-218) concertedly suppressed metastasis-promoting LOXL2 in head and neck squamous cell carcinoma. J Hum Genet 2015; 61:109-18. [PMID: 26490187 DOI: 10.1038/jhg.2015.120] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 09/05/2015] [Accepted: 09/09/2015] [Indexed: 12/19/2022]
Abstract
In spite of considerable advances in multimodality therapy, including surgery, radiotherapy and chemotherapy, the overall survival rate for patients with head and neck squamous cell carcinoma (HNSCC) is very poor (only 15-45%). Understanding the molecular mechanisms of metastatic pathways underlying HNSCC using currently available genomic approaches might improve therapies for and prevention of the disease. Our previous studies showed that three tumor-suppressive microRNAs (miRNAs), miR-26a/b, miR-29a/b/c and miR-218, significantly inhibited cancer cell migration and invasion. Therefore, we hypothesized that these miRNAs-regulated target genes deeply contributed to cancer metastasis. These tumor-suppressive miRNAs directly regulate LOXL2 expression in HNSCC cells by using in silico analysis and luciferase reporter assays. Overexpressed LOXL2 was confirmed in HNSCC clinical specimens, and silencing of LOXL2 inhibited cancer cell migration and invasion in HNSCC cell lines. Our present data showed that tumor-suppressive miRNAs regulation of LOXL2 will provide new insights into the novel molecular mechanisms of HNSCC metastasis.
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Th1-, Th2-, and Th17-associated cytokine expression in hypopharyngeal carcinoma and clinical significance. Eur Arch Otorhinolaryngol 2015; 273:431-8. [DOI: 10.1007/s00405-015-3779-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 02/16/2015] [Indexed: 12/22/2022]
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Synthesis and Properties of Flexible Polyurethane Using Ferric Catalyst for Hypopharyngeal Tissue Engineering. BIOMED RESEARCH INTERNATIONAL 2015; 2015:798721. [PMID: 26236737 PMCID: PMC4506851 DOI: 10.1155/2015/798721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/05/2015] [Accepted: 06/14/2015] [Indexed: 12/03/2022]
Abstract
Biodegradable polyurethane is an ideal candidate material to fabricate tissue engineered hypopharynx from its good mechanical properties and biodegradability. We thus synthesized a hydrophilic polyurethane via reactions among polyethylene glycol (PEG), e-caprolactone (e-CL) and hexamethylene diisocyanate (HDI), and thrihydroxymethyl propane (TMP). The product possessed a fast degradability due to its good wettability and good mechanical parameters with the elongations at break (137 ± 10%) and tensile strength (4.73 ± 0.46 MPa), which will make it a good matrix material for soft tissue like hypopharynx. Its biological properties were evaluated via in vitro and in vivo tests. The results showed that this hydrophilic polyurethane material can support hypopharyngeal fibroblast growth and owned good degradability and low inflammatory reaction in subcutaneous implantation. It will be proposed as the scaffold for hypopharyngeal tissue engineering research in our future study.
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60
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Kucur C, Durmus K, Dziegielewski PT, Ozer E. Transoral robot-assisted carbon dioxide laser surgery for hypopharyngeal cancer. Head Neck 2015; 37:743-5. [DOI: 10.1002/hed.23860] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/07/2014] [Accepted: 09/12/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Cuneyt Kucur
- Department of Otolaryngology - Head and Neck Surgery; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University Wexner Medical Center; Columbus Ohio
- Department of Otolaryngology; Dumlupinar University; Kutahya Turkey
| | - Kasim Durmus
- Department of Otolaryngology - Head and Neck Surgery; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University Wexner Medical Center; Columbus Ohio
| | - Peter T. Dziegielewski
- Department of Otolaryngology - Head and Neck Surgery; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University Wexner Medical Center; Columbus Ohio
- Department of Otolaryngology; University of Florida; Gainesville Florida
| | - Enver Ozer
- Department of Otolaryngology - Head and Neck Surgery; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University Wexner Medical Center; Columbus Ohio
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Synthesis and characterization of biodegradable polyurethane for hypopharyngeal tissue engineering. BIOMED RESEARCH INTERNATIONAL 2015; 2015:871202. [PMID: 25839041 PMCID: PMC4369943 DOI: 10.1155/2015/871202] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 01/18/2015] [Accepted: 02/13/2015] [Indexed: 11/17/2022]
Abstract
Biodegradable crosslinked polyurethane (cPU) was synthesized using polyethylene glycol (PEG), L-lactide (L-LA), and hexamethylene diisocyanate (HDI), with iron acetylacetonate (Fe(acac)3) as the catalyst and PEG as the extender. Chemical components of the obtained polymers were characterized by FTIR spectroscopy, (1)H NMR spectra, and Gel Permeation Chromatography (GPC). The thermodynamic properties, mechanical behaviors, surface hydrophilicity, degradability, and cytotoxicity were tested via differential scanning calorimetry (DSC), tensile tests, contact angle measurements, and cell culture. The results show that the synthesized cPU possessed good flexibility with quite low glass transition temperature (T g , -22°C) and good wettability. Water uptake measured as high as 229.7 ± 18.7%. These properties make cPU a good candidate material for engineering soft tissues such as the hypopharynx. In vitro and in vivo tests showed that cPU has the ability to support the growth of human hypopharyngeal fibroblasts and angiogenesis was observed around cPU after it was implanted subcutaneously in SD rats.
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Lee HJ, Kim J, Woo HY, Kang WJ, Lee JH, Koh YW. 18F-FDG PET-CT as a supplement to CT/MRI for detection of nodal metastasis in hypopharyngeal SCC with palpably negative neck. Laryngoscope 2015; 125:1607-12. [DOI: 10.1002/lary.25136] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 11/13/2014] [Accepted: 12/01/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Ho-Joon Lee
- Department of Radiology; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Jinna Kim
- Department of Radiology; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Ha Young Woo
- Department of Pathology; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Won Jun Kang
- Department of Nuclear Medicine; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Jae-Hoon Lee
- Department of Nuclear Medicine; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology; Severance Hospital, Yonsei University College of Medicine; Seoul Republic of Korea
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Feasibility and Clinical Outcomes of Transoral Robotic Surgery and Transoral Robot-Assisted Carbon Dioxide Laser for Hypopharyngeal Carcinoma. J Craniofac Surg 2015; 26:235-7. [DOI: 10.1097/scs.0000000000001185] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Antoniou AJ, Marcus C, Subramaniam RM. Value of Imaging in Head and Neck Tumors. Surg Oncol Clin N Am 2014; 23:685-707. [DOI: 10.1016/j.soc.2014.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Shin NY, Lee JH, Kang WJ, Koh YW, Sohn B, Kim J. Clinical usefulness of [18F]FDG PET-CT and CT/MRI for detecting nodal metastasis in patients with hypopharyngeal squamous cell carcinoma. Ann Surg Oncol 2014; 22:994-9. [PMID: 25201502 DOI: 10.1245/s10434-014-4062-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this study was to investigate whether pretreatment imaging modalities, including [18F]fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) and CT/magnetic resonance imaging (MRI) are helpful for the selection of patient groups requiring contralateral neck dissection in patients with hypopharyngeal squamous cell carcinoma (SCC). METHODS A total of 72 consecutive patients with histologically proven hypopharyngeal SCC who underwent both PET-CT and CT/MRI preoperatively were recruited. To assess the diagnostic accuracy of each imaging modality, the neck was divided into levels based on the imaging-based nodal classification, and the histopathologic results of the surgical specimen were used as a standard reference. RESULTS Fifty-one (70.8%) of the 72 patients had neck metastasis, and 12 (26.7%) had contralateral metastatic nodes. The sensitivities of PET-CT and CT/MRI for detecting nodal metastasis in the contralateral neck were significantly lower than those in the ipsilateral neck (60.0 and 53.3 vs. 89.1 and 84.8%, respectively; p < 0.001). Among the patients who underwent bilateral neck dissection (n = 45), three (13.0%) of the 23 patients with a palpably negative neck on the ipsilateral side showed occult contralateral lymph node metastasis, while none of the 11 patients without ipsilateral metastatic nodes on imaging studies had contralateral neck metastasis. CONCLUSIONS With accurate assessment of ipsilateral neck metastasis in hypopharyngeal SCC patients, PET-CT and CT/MRI may be helpful in identifying patients at high risk of contralateral neck metastasis. Elective contralateral neck treatment is not necessary in hypopharyngeal SCC patients who do not show evidence of ipsilateral neck metastasis on preoperative imaging studies.
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Affiliation(s)
- Na-Young Shin
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Identification of tumour suppressive microRNA-451a in hypopharyngeal squamous cell carcinoma based on microRNA expression signature. Br J Cancer 2014; 111:386-94. [PMID: 24918822 PMCID: PMC4102946 DOI: 10.1038/bjc.2014.293] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/23/2014] [Accepted: 04/30/2014] [Indexed: 01/05/2023] Open
Abstract
Background: Hypopharyngeal squamous cell carcinoma (HSCC) has a very poor prognosis because of its high rates of regional and distant metastasis. Identification of differentially expressed miRNAs and their regulated molecular targets in tumour cells might enhance our understanding of the molecular mechanisms of metastasis in human cancers. Methods: A HSCC miRNA signature was constructed by array-based methods. Functional studies of microRNA-451a (miR-451a) and target genes were performed to investigate cell proliferation, migration and invasion by cancer cell lines. To identify miR-451a-regulated molecular targets, we adopted gene expression analysis and in silico database analysis. Results: Our miRNA signature revealed that miR-451a was significantly downregulated in HSCC. Restoration of miR-451a in cancer cell lines revealed that this miRNA significantly inhibited cancer cell migration and invasion. Our data demonstrated that the gene coding for endothelial and smooth muscle cell-derived neuropilin-like molecule (ESDN/DCBLD2) was a direct target of miR-451a regulation. Silencing of ESDN inhibited cell migration and invasion by cancer cells. Conclusions: Loss of tumour suppressive miR-451a enhanced cancer cell migration and invasion in HSCC through direct regulation of ESDN. Our miRNA signature and functional analysis of targets regulated by tumour suppressive miR-451a provide new insights into the potential mechanisms of HSCC oncogenesis and metastasis.
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Chung EJ, Lee SH, Baek SH, Park IS, Cho SJ, Rho YS. Pattern of cervical lymph node metastasis in medial wall pyriform sinus carcinoma. Laryngoscope 2014; 124:882-7. [PMID: 23832757 DOI: 10.1002/lary.24299] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 05/15/2013] [Accepted: 06/18/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS The aim of this study was to analyze the prevalence and distribution of histologic cervical lymph node metastases in medial wall pyriform sinus squamous cell carcinoma (SCC). STUDY DESIGN Retrospective study of medical records. METHODS We reviewed the medical records of 68 medial wall pyriform sinus SCC patients who underwent bilateral neck dissection for primary treatment with curative intent. Thirty-nine patients underwent central compartment neck dissection. Primary tumor was removed using conservative laryngeal surgery with partial pharyngectomy in 39 cases, near total/total laryngectomy with partial pharyngectomy in 24 cases, and total laryngopharyngectomy in five cases. RESULTS The overall N(+) contralateral lymph nodes rate on pathology was 14.7%. The rate of contralateral occult cases was 5.2%. Advanced primary (T3-4) and nodal (N2b-3) disease, and primary lesion across the midline were correlated with contralateral nodal metastasis. Multivariate analysis revealed that a primary lesion across the midline was an independent factor for contralateral neck nodal metastasis. The rate of level VI node metastasis was 16.2%. The disease-specific survival rate was significantly different according to level VI node metastasis (71% vs. 40%). Pyriform sinus apex invasion and extralaryngeal spread were correlated with level VI nodal metastasis. Multivariate analysis revealed that pyriform sinus apex invasion was an independent factor for level VI nodal metastasis. CONCLUSIONS Contralateral nodal metastasis was less frequent than expected. Bilateral neck dissection is mandatory for primary lesion across the midline. Ipsilateral level VI lymph node should be removed in pyriform sinus apex invasion cases. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Eun-Jae Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Institute of Head and Neck Cancer, Hallym University, College of Medicine, Seoul, Korea
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Skeletal muscle regeneration on protein-grafted and microchannel-patterned scaffold for hypopharyngeal tissue engineering. BIOMED RESEARCH INTERNATIONAL 2013; 2013:146953. [PMID: 24175281 PMCID: PMC3794632 DOI: 10.1155/2013/146953] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 08/27/2013] [Indexed: 11/18/2022]
Abstract
In the field of tissue engineering, polymeric materials with high biocompatibility like polylactic acid and polyglycolic acid have been widely used for fabricating living constructs. For hypopharynx tissue engineering, skeletal muscle is one important functional part of the whole organ, which assembles the unidirectionally aligned myotubes. In this study, a polyurethane (PU) scaffold with microchannel patterns was used to provide aligning guidance for the seeded human myoblasts. Due to the low hydrophilicity of PU, the scaffold was grafted with silk fibroin (PU-SF) or gelatin (PU-Gel) to improve its cell adhesion properties. Scaffolds were observed to degrade slowly over time, and their mechanical properties and hydrophilicities were improved through the surface grafting. Also, the myoblasts seeded on PU-SF had the higher proliferative rate and better differentiation compared with those on the control or PU-Gel. Our results demonstrate that polyurethane scaffolds seeded with myoblasts hold promise to guide hypopharynx muscle regeneration.
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