101
|
Viana TSA, Silva PGDB, Pereira KMA, Mota MRL, Alves APNN, de Souza EF, Sousa FB. Prospective Evaluation of Quality of Life in Patients Undergoing Primary Surgery for Oral Cancer: Preoperative and Postoperative Analysis. Asian Pac J Cancer Prev 2017; 18:2093-2100. [PMID: 28843228 PMCID: PMC5697466 DOI: 10.22034/apjcp.2017.18.8.2093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: The purpose of the present study was to compare the preoperative and postoperative health related quality of life (HRQoL) of a sample of patients undergoing primary surgery for oral cancer in 2012-13. Materials and Methods: A cross-sectional, prospective study of 54 patients in a Brazilian population was performed. HRQoL was measured preoperatively (after histopathological diagnosis) and postoperatively (2 months after surgery) using the University of Washington Quality of Life Questionnaire (UW-QOL). Clinicopathological, sociodemographic and lifestyle data were collected. Results: Surgery had a negative impact on most HRQoL domains, but pain, mood and anxiety scores were significantly improved. Most patients rated their health-related and overall postoperative HRQoL as good or very good. Conclusions: The UW-QOL was efficient at measuring HRQoL in our sample of patients with oral cancer. Surgery had a negative impact on HRQoL, especially due to sequelae affecting the stomatognathic system, yet patients classified their postoperative health-related and overall QoL as positive. Qualitative studies are necessary for confirmation of our results and further exploration.
Collapse
Affiliation(s)
- Thales Salles Angelim Viana
- Department of Oral Medicine, School of Dentistry, Federal University of Ceará (UFC), Rua Alexandre Baraúna 949, Rodolfo Teófilo, Fortaleza, Ceará, Brazil.
| | | | | | | | | | | | | |
Collapse
|
102
|
Gane EM, O’Leary SP, Hatton AL, Panizza BJ, McPhail SM. Neck and Upper Limb Dysfunction in Patients following Neck Dissection: Looking beyond the Shoulder. Otolaryngol Head Neck Surg 2017; 157:631-640. [DOI: 10.1177/0194599817721164] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective To measure patient-perceived upper limb and neck function following neck dissection and to investigate potential associations between clinical factors, symptoms, and function. Study Design Cross-sectional. Setting Two tertiary hospitals in Brisbane, Australia. Subjects and Methods Inclusion criteria: patients treated with neck dissection (2009-2014). Exclusion criteria: aged <18 years, accessory nerve or sternocleidomastoid sacrifice, previous neck dissection, preexisting shoulder/neck injury, and inability to provide informed consent (cognition, insufficient English). Primary outcomes were self-reported function of the upper limb (Quick Disabilities of the Arm, Shoulder, and Hand) and neck (Neck Disability Index). Secondary outcomes included demographics, oncological management, self-efficacy, and pain. Generalized linear models were prepared to examine relationships between explanatory variables and self-reported function. Results Eighty-nine participants (male n = 63, 71%; median age, 62 years; median 3 years since surgery) reported mild upper limb and neck dysfunction (median [quartile 1, quartile 3] scores of 11 [3, 32] and 12 [4, 28], respectively). Significant associations were found between worse upper limb function and longer time since surgery (coefficient, 1.76; 95% confidence interval [CI], 0.01-3.51), having disease within the thyroid (17.40; 2.37-32.44), postoperative radiation therapy (vs surgery only) (13.90; 6.67-21.14), and shoulder pain (0.65; 0.44-0.85). Worse neck function was associated with metastatic cervical lymph nodes (coefficient, 6.61; 95% CI, 1.14-12.08), shoulder pain (0.19; 0.04-0.34), neck pain (0.34; 0.21-0.47), and symptoms of neuropathic pain (0.61; 0.25-0.98). Conclusion Patients can experience upper limb and neck dysfunction following nerve-preserving neck dissection. The upper quadrant as a whole should be considered when assessing rehabilitation priorities after neck dissection.
Collapse
Affiliation(s)
- Elise M. Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Australia
| | - Shaun P. O’Leary
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Physiotherapy Department, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Anna L. Hatton
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Benedict J. Panizza
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Otolaryngology–Head and Neck Surgery Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Steven M. McPhail
- Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Australia
- School of Public Health and Social Work and the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
103
|
García-León FJ, García-Estepa R, Romero-Tabares A, Gómez-Millán Borrachina J. Treatment of Advanced Laryngeal Cancer and Quality of Life. Systematic Review. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017. [DOI: 10.1016/j.otoeng.2017.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
104
|
Treatment of advanced laryngeal cancer and quality of life. Systematic review. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 68:212-219. [PMID: 28351474 DOI: 10.1016/j.otorri.2016.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/28/2016] [Accepted: 11/08/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES The objective was the comparison of the quality of life in patients with advanced laryngeal cancer treated with organ preservation versus surgical treatment. METHODS We performed a systematic review in the databases MedLine, EMBASE, and PubMed (2014 1991) and Web of Science (2012 - 2014). The search terms were: Laryngeal cancer, organ preservation, chemotherapy, laryngectomy, treatment outcomes and quality of life. Systematic reviews, meta-analysis, reports of health technology assessment and comparative studies with control group, published in Spanish, French or English were included. The selection and quality assessment was made by two researchers. The criteria of the Cochrane Collaboration were used to assess the risk of bias and Scottish Intercollegiate Guidelines Network (SIGN) for the level of evidence. RESULTS Of the 208 studies identified in the search, three were included a clinical trial and two observational studies, with a total of 211 patients. Quality and level of evidence was low. The results were contradictory, on occasion they favoured surgery, and on other occasions chemotherapy, but in general there were no statistical differences between the treatments. The studies were heterogeneous, with different methodology, undersized, limitations in quality with high risk of bias and use of different measurement scales. CONCLUSIONS There are not enough studies of quality to establish differences in the quality of life in patients with advanced laryngeal cancer according to the treatment received.
Collapse
|
105
|
Kumar B, Brown NV, Swanson BJ, Schmitt AC, Old M, Ozer E, Agrawal A, Schuller DE, Teknos TN, Kumar P. High expression of myoferlin is associated with poor outcome in oropharyngeal squamous cell carcinoma patients and is inversely associated with HPV-status. Oncotarget 2017; 7:18665-77. [PMID: 26919244 PMCID: PMC4951318 DOI: 10.18632/oncotarget.7625] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/11/2016] [Indexed: 11/25/2022] Open
Abstract
Myoferlin (MYOF) is a member of ferlin family of membrane proteins that was originally discovered as a muscle specific protein. Recent studies have shown that myoferlin is also expressed in other cell types including endothelial cells and cancer cells. However, very little is known about the expression and biological role of myoferlin in head and neck cancer. In this study, we examined expression profile of myoferlin in oropharyngeal squamous cell carcinoma (OPSCC) and assessed its correlation with disease progression and patient outcome. In univariate analyses, nuclear MYOF was associated with poor overall survival (p<0.001) and these patients had 5.5 times increased hazard of death (95% Cl 3.4-8.8). Nuclear myoferlin expression was also directly associated with tumor recurrence (p<0.001), perineural invasion (p=0.008), extracapsular spread (p=0.009), higher T-stage (p=0.0015) and distant metastasis (p<0.001). In addition, nuclear MYOF expression was directly associated with IL-6 (p<0.001) and inversely with HPV status (p=0.0014). In a subgroup survival analysis, MYOF nuclear+/IL-6+ group had worst survival (84.6% mortality), whereas MYOF nuclear-/IL-6- had the best survival. Similarly, patients with HPV-negative/MYOF-positive tumors had worse survival compared to HPV-positive/MYOF-negative. Taken together, our results demonstrate for the first time that nuclear myoferlin expression independently predicts poor clinical outcome in OPSCC patients.
Collapse
Affiliation(s)
- Bhavna Kumar
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Nicole V Brown
- Center for Biostatistics, The Ohio State University, Columbus, OH 43210, USA
| | - Benjamin J Swanson
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Alessandra C Schmitt
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA.,Current affiliation: Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Matthew Old
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Amit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - David E Schuller
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Theodoros N Teknos
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Pawan Kumar
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| |
Collapse
|
106
|
Risk factors for aspiration pneumonia after definitive chemoradiotherapy or bio-radiotherapy for locally advanced head and neck cancer: a monocentric case control study. BMC Cancer 2017; 17:59. [PMID: 28095814 PMCID: PMC5241959 DOI: 10.1186/s12885-017-3052-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 01/10/2017] [Indexed: 11/12/2022] Open
Abstract
Background Chemoradiotherapy (CRT) and bio-radiotherapy (BRT) are recognized as standard therapies for head and neck cancer (HNC). Aspiration pneumonia after CRT or BRT is a common late adverse event. Our aim in this study was to evaluate the cause-specific incidence of aspiration pneumonia after CRT or BRT and to identify its clinical risk factors. Methods We performed a retrospective analysis of 305 patients with locally advanced HNC treated by CRT or BRT between August 2006 and April 2015. Results Of these 305 patients, 65 (21.3%) developed aspiration pneumonia after treatment. The median onset was 161 days after treatment. The two-year cause-specific cumulative incidence by CRT or BRT was 21.0%. Multivariate analysis revealed five independent risk factors for aspiration pneumonia, namely, habitual alcoholic consumption, use of sleeping pills at the end of treatment, poor oral hygiene, hypoalbuminemia before treatment, and the coexistence of other malignancies. A predictive model using these risk factors and treatment efficacy was constructed, dividing patients into low- (0–2 predictive factors), moderate- (3–4 factors), and high-risk groups (5–6 factors), the two-year cumulative incidences of aspiration pneumonia of which were 3.0, 41.6, and 77.3%, respectively. Aspiration pneumonia tended to be associated with increased risk of death, although this was not statistically significant (multivariate-adjusted hazard ratio 1.39, P = 0.18). Conclusion The cause-specific incidence and clinical risk factors for aspiration pneumonia after definitive CRT or BRT were investigated in patients with locally advanced HNC. Our predictive model may be useful for identifying patients at high risk for aspiration pneumonia.
Collapse
|
107
|
NBI utility in the pre-operative and intra-operative assessment of oral cavity and oropharyngeal carcinoma. Am J Otolaryngol 2017; 38:65-71. [PMID: 27773561 DOI: 10.1016/j.amjoto.2016.09.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE Despite advances in the surgical management of head and neck squamous cell carcinoma, the identification of synchronous lesions, precancerous lesions around the main tumor, or the unknown primary in the case of neck metastasis remains a problem, as these lesions may be invisible to the naked eye or with standard white light (WL) endoscopy. However, the advent of tools such as narrow-band imaging (NBI) could help the clinician. The purpose of this study was to assess the impact of NBI during the pre-operative and intra-operative stages of management of oral and oropharyngeal cancers. MATERIALS AND METHODS NBI was used pre-operatively in 47 patients with oral or oropharyngeal squamous cell carcinoma to identify the involvement of adjacent subsites, multifocality, synchronous lesions or an unknown primary. NBI was used intra-operatively in 30 patients to better define the tumor limits and guide the resection. The advantage of NBI versus WL endoscopy was analyzed by calculating the true and false positive rate pre-operatively, and the need for resection enlargements, histology of the enlargement, and the rate of clear margins at definitive histology, intra-operatively. RESULTS Pre-operatively, the diagnostic gain of NBI was 8.5%, allowing identification of three synchronous tumors and one unknown primary. Intra-operatively, NBI improved the definition of tumor limits in 67.7% of cases, with resection enlargements showing dysplasia and carcinoma in 8 and 12 patients, respectively; we obtained 74.2% negative margins at histology. CONCLUSIONS NBI could represent an added value in the pre-operative and intra-operative assessment of oral cavity and oropharyngeal carcinoma.
Collapse
|
108
|
Curra M, Salvadori G, Junges R, Filho MS, Hugo FN, Martins MD. Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions. Braz Oral Res 2016; 30:e135. [PMID: 28001243 DOI: 10.1590/1807-3107bor-2016.vol30.0135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 10/26/2016] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to assess the accuracy of clinical diagnosis for lip lesions based on sensitivity and specificity. The retrospective analysis focused on the detection of lesions caused by potentially malignant disorders (PMDs) and malignant lesions (n = 1195). All cases were classified as benign, PMD, and malignant lesions. Concordance between diagnoses based on clinical examination and those based on histopathological analysis was assessed, and accuracy for the identification of PMD and malignant lesions was calculated. Histopathological analysis revealed 44 lesion types; PMD and malignant lesions comprised 8.3% of all cases. Compared with histopathological analysis, clinical examination showed 97.4% accuracy for the identification of non-malignant and potentially malignant/malignant cases. Degrees of specific sensitivity ranged from 34% to 77% for different lesions, and were highest for autoimmune (77%) and reactive (72%) lesions. Positive and negative predictive values for the identification of PMD and malignant lesions were 81.9% and 98.9%, respectively. Clinical examination showed a high degree of accuracy for the detection of PMD and malignant lip lesions, indicating good reliability.
Collapse
Affiliation(s)
- Marina Curra
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Gabriela Salvadori
- University of Oslo, Faculty of Dentistry, Department of Oral Biology, Oslo, Norway
| | - Roger Junges
- University of Oslo, Faculty of Dentistry, Department of Oral Biology, Oslo, Norway
| | - Manoel Sant'ana Filho
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Center of Community Dental Health Research, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| |
Collapse
|
109
|
Howard J, Masterson L, Dwivedi RC, Riffat F, Benson R, Jefferies S, Jani P, Tysome JR, Nutting C. Minimally invasive surgery versus radiotherapy/chemoradiotherapy for small-volume primary oropharyngeal carcinoma. Cochrane Database Syst Rev 2016; 12:CD010963. [PMID: 27943254 PMCID: PMC6463943 DOI: 10.1002/14651858.cd010963.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND More than 400,000 cases of oropharyngeal squamous cell carcinoma (OPSCC) are diagnosed each year worldwide and the incidence is rising, partly as a result of human papillomavirus. Human papillomavirus-associated OPSCC affects younger patients and often presents at a higher stage; however, it is associated with a better prognosis.Until recently, first-line management of OPSCC involved chemoradiotherapy, as research had demonstrated comparable survival outcomes when compared with open surgery, with significantly decreased morbidity. However, interventions have now evolved with computerised planning and intensity-modulated radiotherapy, and the advent of endoscopic head and neck surgery, which provide the potential for decreased treatment-associated morbidity.The oropharynx plays an essential role in swallowing, speech and protecting the airway as it is situated at the bifurcation of the respiratory and digestive tracts. Treatment modality recommendations are based on survival outcomes. Given the younger patient demographic, establishing the safety of modalities that potentially have better functional outcome is becoming increasingly important. OBJECTIVES To assess the efficacy of endoscopic head and neck surgery (transoral robotic surgery or transoral laser microsurgery) for small-volume, primary (T1-2, N0-2) oropharyngeal squamous cell carcinoma (OPSCC) in comparison to radiotherapy/chemoradiotherapy. SEARCH METHODS The Cochrane ENT Information Specialist searched the ENT Trials Register; Central Register of Controlled Trials (CENTRAL 2016, Issue 10); PubMed; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 8 November 2016. SELECTION CRITERIA Randomised controlled trials in patients with carcinoma in the oropharynx subsite (as defined by the World Health Organization classification C09, C10). Cancers included were primary squamous cell carcinomas arising from the oropharyngeal mucosa. The tumours were classified as T1-T2 with or without nodal disease and with no evidence of distant metastatic spread. The intervention was transoral, minimally invasive surgery with or without adjuvant radiotherapy or adjuvant chemoradiotherapy. The comparator was primary radiotherapy with or without induction or concurrent chemotherapy for the tumour. The treatments received and compared were of curative intent and patients had not undergone prior intervention, other than diagnostic biopsy. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. Our primary outcomes were overall survival (disease-related mortality was to be studied where possible), locoregional control, disease-free survival and progression-free survival or time to recurrence. All outcomes were to be measured at two, three and five years after diagnosis. Our secondary outcomes included quality of life, harms associated with treatment, patient satisfaction and xerostomia score. MAIN RESULTS No completed studies met the inclusion criteria for the review. Two ongoing trials fulfilled the selection criteria, however neither are complete.'Early-stage squamous cell carcinoma of the oropharynx: radiotherapy versus trans-oral robotic surgery (ORATOR)' is a phase II randomised controlled trial comparing primary radiation therapy with primary transoral robotic surgery for small-volume primary (T1-2, N0-2) OPSCC. It is currently in progress with an estimated completion date of June 2021.'European Organisation for Research and Treatment of Cancer 1420 (EORTC 1420-HNCG-ROG)' is a phase III, randomised study assessing the "best of" radiotherapy compared to transoral robotic surgery/transoral laser microsurgery in patients with T1-T2, N0 squamous cell carcinoma of the oropharynx and base of tongue. It was due to start accrual mid-2016. AUTHORS' CONCLUSIONS The role of endoscopic head and neck surgery in the management of OPSCC is clearly expanding as evidenced by its more overt incorporation into the current National Comprehensive Cancer Network guidelines. Data are mounting regarding its outcomes both in terms of survival and lower morbidity. As confidence increases, it is being used in the management of more advanced OPSCC.Based on this review, there is currently no high-quality evidence from randomised controlled trials regarding clinical outcomes for patients with oropharyngeal cancer receiving endoscopic head and neck surgery compared with primary chemoradiotherapy.
Collapse
Affiliation(s)
- James Howard
- Cambridge University Hospitals NHS Foundation TrustENT DepartmentHills RoadCambridgeUKCB2 0QQ
| | - Liam Masterson
- Cambridge University Hospitals NHS Foundation TrustENT DepartmentHills RoadCambridgeUKCB2 0QQ
| | - Raghav C Dwivedi
- Cambridge University Hospitals NHS Foundation TrustENT DepartmentHills RoadCambridgeUKCB2 0QQ
| | | | - Richard Benson
- Addenbrooke's HospitalOncology CentreBox 193CambridgeUKCB2 2QQ
| | - Sarah Jefferies
- Cambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Piyush Jani
- Cambridge University Hospitals NHS Foundation TrustENT DepartmentHills RoadCambridgeUKCB2 0QQ
| | - James R Tysome
- Cambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Chris Nutting
- Royal Marsden HospitalHead and Neck UnitFulham RoadLondonUKSW3 6JJ
| | | |
Collapse
|
110
|
Chevalier C, Bertaut A, Quivrin M, Vulquin N, Desandes C, Folia M, Duvillard C, Truc G, Crehange G, Maingon P. Impact of waiting time on nodal staging in head and neck squamous-cell carcinoma treated with radical intensity modulated radiotherapy. Clin Transl Radiat Oncol 2016; 1:27-32. [PMID: 29657991 PMCID: PMC5893481 DOI: 10.1016/j.ctro.2016.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 10/22/2016] [Accepted: 11/14/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE To evaluate the influence of delays for radiotherapy on survival, recurrence and upstaging for head and neck squamous-cell carcinoma (HNSCC) with no nodal involvement treated with intensity modulated radiotherapy (IMRT). MATERIAL AND METHODS This retrospective study included 63 consecutive patients with HNSCC located in the pharynx and larynx and treated with exclusive IMRT with or without chemotherapy. Survival, loco-regional or distant failure and upstaging were analyzed according to the waiting time. RESULTS Mean waiting time for treatment was 62.5 days for the hypopharynx subgroup (range = 37-102), 63 days for the larynx subgroup (range = 19-128) and 58.5 days for the oropharynx subgroup (range = 29-99) (p = 0.725). Nine patients (14%) experienced upstaging. Loco-regional or distant failure occurred in 18 patients. Beyond a delay of 50 days, 19% of patients had local failure, 17% nodal recurrence and 11% distant failure. Within a delay of 50 days, no nodal or distant failure was observed and only 1 patient experienced local recurrence. Upstaging and overall survival were not significantly affected by an increased waiting time. CONCLUSION For N0 patients treated with IMRT for HNSCC, waiting time around 50 days after the diagnosis was not significantly associated with an excessive risk of upstaging or recurrence.
Collapse
Affiliation(s)
- Cédric Chevalier
- Department of Radiation Oncology, Georges François Leclerc Cancer Center, Dijon, France
| | - Aurélie Bertaut
- Department of Statistics, Georges François Leclerc Cancer Center, Dijon, France
| | - Magali Quivrin
- Department of Radiation Oncology, Georges François Leclerc Cancer Center, Dijon, France
| | - Noémie Vulquin
- Department of Radiation Oncology, Georges François Leclerc Cancer Center, Dijon, France
| | - Cédric Desandes
- Department of Radiation Oncology, Georges François Leclerc Cancer Center, Dijon, France
| | - Mireille Folia
- Ear Nose and Throat Department, University Hospital of Dijon, Dijon, France
| | | | - Gilles Truc
- Department of Radiation Oncology, Georges François Leclerc Cancer Center, Dijon, France
| | - Gilles Crehange
- Department of Radiation Oncology, Georges François Leclerc Cancer Center, Dijon, France
| | - Philippe Maingon
- Radiation Oncology Department, GHU La Pitié Salpêtrière, Paris, France
| |
Collapse
|
111
|
Hoekstra J, Vissink A, Raghoebar GM, Visser A. Implant-retained skull prosthesis to cover a large defect of the hairy skull resulting from treatment of a basal cell carcinoma: A clinical report. J Prosthet Dent 2016; 117:690-693. [PMID: 27881310 DOI: 10.1016/j.prosdent.2016.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/23/2016] [Accepted: 08/23/2016] [Indexed: 11/28/2022]
Abstract
Skin carcinoma, particularly basal cell carcinoma, and its treatment can result in large defects of the hairy skull. A 53-year-old man is described who was surgically treated for a large basal cell carcinoma invading the skin and underlying tissue at the top of the hairy skull. Treatment consisted of resecting the tumor and external part of the skull bone. To protect the brain and to cover the defect of the hairy skull, an acrylic resin skull prosthesis with hair was designed to mask the defect. The skull prosthesis was retained on 8 extraoral implants placed at the margins of the defect in the skull bone. The patient was satisfied with the treatment outcome.
Collapse
Affiliation(s)
- Jitske Hoekstra
- Dentist, Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Arjan Vissink
- Professor and Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Gerry M Raghoebar
- Professor and Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Anita Visser
- Assistant Professor, Maxillofacial Prosthodontist, Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| |
Collapse
|
112
|
Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP. Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2016; 116:663-740. [PMID: 28236412 DOI: 10.1016/j.prosdent.2016.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
STATEMENT OF PROBLEM It is clear the contemporary dentist is confronted with a blizzard of information regarding materials and techniques from journal articles, advertisements, newsletters, the internet, and continuing education events. While some of that information is sound and helpful, much of it is misleading at best. PURPOSE This review identifies and discusses the most important scientific findings regarding outcomes of dental treatment to assist the practitioner in making evidence-based choices. This review was conducted to assist the busy dentist in keeping abreast of the latest scientific information regarding the clinical practice of dentistry. MATERIAL AND METHODS Each of the authors, who are considered experts in their disciplines, was asked to peruse the scientific literature published in 2015 in their discipline and review the articles for important information that may have an impact on treatment decisions. Comments on experimental methodology, statistical evaluation, and overall validity of the conclusions are included in many of the reviews. RESULTS The reviews are not meant to stand alone but are intended to inform the interested reader about what has been discovered in the past year. The readers are then invited to go to the source if they wish more detail. CONCLUSIONS Analysis of the scientific literature published in 2015 is divided into 7 sections, dental materials, periodontics, prosthodontics, occlusion and temporomandibular disorders, sleep-disordered breathing, cariology, and implant dentistry.
Collapse
Affiliation(s)
- Terence E Donovan
- Professor, Biomaterials, University of North Carolina School of Dentistry, Chapel Hill, N.C.
| | | | | | - David R Cagna
- Professor, Advanced Prosthodontics University of Tennessee Health Sciences Center, Memphis, Tenn
| | | | | | | | | |
Collapse
|
113
|
Hartmann S, Grandis JR. Treatment of head and neck cancer in the elderly. Expert Opin Pharmacother 2016; 17:1903-21. [DOI: 10.1080/14656566.2016.1220540] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
114
|
Kularatna S, Whitty JA, Johnson NW, Jayasinghe R, Scuffham PA. A comparison of health state utility values associated with oral potentially malignant disorders and oral cancer in Sri Lanka assessed using the EQ-5D-3 L and the EORTC-8D. Health Qual Life Outcomes 2016; 14:101. [PMID: 27402015 PMCID: PMC4940840 DOI: 10.1186/s12955-016-0502-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 06/29/2016] [Indexed: 11/22/2022] Open
Abstract
Background It has been suggested that the EQ-5D-3 L preference-based measure of health outcome lacks sensitivity to discriminate between health states in cancer patients. An alternative approach is to use a disease (cancer) specific preference-based measure, such as the EORTC-8D. A limited number of comparisons have been made between generic and disease specific preference-based measures. The aim of this study was to compare the utility scores from the EQ-5D-3 L and the EORTC-8D in a group of patients with oral cancer or with oral potentially malignant disorders (OPMD). Methods Patients (n = 151) with OPMD or oral cancer were recruited consecutively from six hospitals in Sri Lanka. All participants completed both the EQ-5D-3 L and the EORTC's QLQC-30 instrument. The Sri Lankan EQ-5D-3 L and EORTC-8D scoring algorithms were employed to estimate utility scores. The utility scores from the two instruments were compared for discrimination, responsiveness and correlation. Results There were significant differences across the two utility scores. The EQ-5D-3 L showed better discrimination than EORTC-8D with higher effect sizes. There were higher ceiling effects observed in the EQ-5D-3 L. There was poor correlation between the dimensions of the two instruments except for the mobility and physical functions. Conclusion The two instruments captured different aspects of quality of life. The EQ-5D-3 L demonstrated better discrimination than the EORTC-8D. In mild conditions EORTC-8D was more responsive and we recommend further validation of this instrument in diverse cancer conditions.
Collapse
Affiliation(s)
- Sanjeewa Kularatna
- Centre for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University , 170 Kessels Road, Nathan, 4111, Queensland, Australia. .,Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
| | - Jennifer A Whitty
- Centre for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University , 170 Kessels Road, Nathan, 4111, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Queensland, Australia.,School of Pharmacy, The University of Queensland, Queensland, Australia
| | - Newell W Johnson
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Ruwan Jayasinghe
- Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Paul A Scuffham
- Centre for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University , 170 Kessels Road, Nathan, 4111, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| |
Collapse
|
115
|
Cancer Stem Cells: The Potential Targets of Chinese Medicines and Their Active Compounds. Int J Mol Sci 2016; 17:ijms17060893. [PMID: 27338343 PMCID: PMC4926427 DOI: 10.3390/ijms17060893] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 05/28/2016] [Accepted: 05/30/2016] [Indexed: 12/27/2022] Open
Abstract
The pivotal role of cancer stem cells (CSCs) in the initiation and progression of malignancies has been rigorously validated, and the specific methods for identifying and isolating the CSCs from the parental cancer population have also been rapidly developed in recent years. This review aims to provide an overview of recent research progress of Chinese medicines (CMs) and their active compounds in inhibiting tumor progression by targeting CSCs. A great deal of CMs and their active compounds, such as Antrodia camphorate, berberine, resveratrol, and curcumin have been shown to regress CSCs, in terms of reversing drug resistance, inducing cell death and inhibiting cell proliferation as well as metastasis. Furthermore, one of the active compounds in coptis, berbamine may inhibit tumor progression by modulating microRNAs to regulate CSCs. The underlying molecular mechanisms and related signaling pathways involved in these processes were also discussed and concluded in this paper. Overall, the use of CMs and their active compounds may be a promising therapeutic strategy to eradicate cancer by targeting CSCs. However, further studies are needed to clarify the potential of clinical application of CMs and their active compounds as complementary and alternative therapy in this field.
Collapse
|
116
|
Tirelli G, Piovesana M, Gatto A, Torelli L, Boscolo Nata F. Is NBI-Guided Resection a Breakthrough for Achieving Adequate Resection Margins in Oral and Oropharyngeal Squamous Cell Carcinoma? Ann Otol Rhinol Laryngol 2016; 125:596-601. [PMID: 27056557 DOI: 10.1177/0003489416641428] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Obtaining free resection margins is the main goal of oncological surgeons. Narrow-band imaging (NBI) has been recently used to help define resection margins in transoral laser microsurgery for laryngeal carcinoma. The aim of this study was to evaluate the effect of intraoperative NBI in defining the surgical resection margins of oral and oropharyngeal cancers. METHODS Between January 2014 and March 2015, NBI was used intraoperatively after an initial definition of resection margins with white light in 26 patients (group A). The rate of superficial positive margins at definitive histology was compared with that of a historical cohort of 44 patients (group B) previously managed without the use of intraoperative NBI. RESULTS A statistically significant reduction in the rate of positive superficial margins was observed at definitive histology in group A (P = .028). NBI helped to identify the presence of dysplasia and cancer around the visible tumor not otherwise detectable with visual examination alone. CONCLUSIONS NBI could be a useful tool for obtaining free resection margins in oral and oropharyngeal carcinoma.
Collapse
Affiliation(s)
| | - Marco Piovesana
- ENT Clinic, Head and Neck Department, University of Trieste, Italy
| | - Annalisa Gatto
- ENT Clinic, Head and Neck Department, University of Trieste, Italy
| | - Lucio Torelli
- Department of Mathematics and Earth Science, University of Trieste, Italy
| | | |
Collapse
|