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Udholm S, Sannino-Greve NB, Klug TE. Exploring tonsillar cancer associations in patients with base of tongue cancer: insights from a single-center study. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08830-7. [PMID: 39042171 DOI: 10.1007/s00405-024-08830-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE To explore the prevalence of synchronous and metachronous tonsillar cancer in patients with base of tongue cancer, as well as identifying potential risk factors linked to these secondary malignancies. We aim to answer the following question: Should bilateral tonsillectomy be recommended to patients diagnosed with base of tongue cancer? METHODS A case-series study was conducted at Aarhus University Hospital, including all patients with histologically confirmed base of tongue squamous cell carcinoma treated between January 2012 and December 2021. Data from electronic patient records, including diagnosis of prior, synchronous or metachronous tonsillar cancer, demographics, and clinical features were analysed. Fisher's exact test was performed to assess factors associated with synchronous and metachronous tonsillar cancer. RESULTS Among 198 patients with base of tongue cancer, 5.6% had a history of tonsillar cancer, either prior to (4.5%), synchronous (0.5%), or metachronous (0.5%) to the base of tongue diagnosis. The prevalence of synchronous or metachronous tonsillar cancer among patients without previous bilateral tonsillectomy was 1.2%. Patients with tonsillar cancer were older, had heavier smoking histories, and exhibited less frequent P16-overexpression. CONCLUSION Our findings deepen understanding of tonsillar cancer in patients with base of tongue cancer. The prevalence of synchronous or metachronous tonsillar cancer was found to be relatively low, suggesting that routine tonsillectomy for all base of tongue cancer patients is not warranted.
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Affiliation(s)
- Sebastian Udholm
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus N. University Hospital, Aarhus, DK-8200, Denmark.
| | - Nina B Sannino-Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus N. University Hospital, Aarhus, DK-8200, Denmark
| | - Tejs Ehlers Klug
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus N. University Hospital, Aarhus, DK-8200, Denmark
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2
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Nankivell P, Gaunt P, Gaunt C, Sissons J, Liaskou E, Jefferson Y, Fulton-Lieuw T, Mittal S, Mehanna H. PET-CT-guided, symptom-based, patient-initiated surveillance versus clinical follow-up in head neck cancer patients (PETNECK2): study protocol for a multicentre feasibility study and non-inferiority, randomised, phase III trial. BMC Cancer 2024; 24:823. [PMID: 38987693 PMCID: PMC11234619 DOI: 10.1186/s12885-024-12470-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/03/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Approximately 40% of treated head and neck cancer (HNC) patients develop recurrence. The risk of recurrence declines with time from treatment. Current guidelines recommend clinical follow-up every two months for the first two years after treatment, with reducing intensity over the next three years. However, evidence for the effectiveness of these regimes in detecting recurrence is lacking, with calls for more flexible, patient-centred follow-up strategies. METHODS PETNECK2 is a UK-based multi-centre programme examining a new paradigm of follow-up, using positron emission tomography-computed tomography (PET-CT)-guided, symptom-based, patient-initiated surveillance. This paradigm is being tested in a unblinded, non-inferiority, phase III, randomised controlled trial (RCT). Patients with HNC, one year after completing curative intent treatment, with no clinical symptoms or signs of loco-regional or distant metastasis will be randomised using a 1:1 allocation ratio to either regular scheduled follow-up, or to PET-CT guided, patient-initiated follow-up. Patients at a low risk of recurrence (negative PET-CT) will receive a face-to-face education session along with an Information and Support (I&S) resource package to monitor symptoms and be in control of initiating an urgent appointment when required. The primary outcome of the RCT is overall survival. The RCT also has an in-built pilot, a nested QuinteT Recruitment Intervention (QRI), and a nested mixed-methods study on patient experience and fear of cancer recurrence (FCR). An initial, single-arm feasibility study has been completed which determined the acceptability of the patient-initiated surveillance intervention, the completion rates of baseline questionnaires, and optimised the I&S resource prior to implementation in the RCT. DISCUSSION We hypothesise that combining an additional 12-month post-treatment PET-CT scan and I&S resource will both identify patients with asymptomatic recurrence and identify those at low risk of future recurrence who will be empowered to monitor their symptoms and seek early clinical follow-up when recurrence is suspected. This change to a patient-centred model of care may have effects on both quality of life and fear of cancer recurrence. TRIAL REGISTRATION ISRCTN: 13,709,798; 15-Oct-2021.
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Affiliation(s)
- Paul Nankivell
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Piers Gaunt
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, Edgbaston, Birmingham. B15 2TT, UK
| | - Claire Gaunt
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, Edgbaston, Birmingham. B15 2TT, UK
| | - Julia Sissons
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, Edgbaston, Birmingham. B15 2TT, UK
| | - Evaggelia Liaskou
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, Edgbaston, Birmingham. B15 2TT, UK
| | - Yolande Jefferson
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, Edgbaston, Birmingham. B15 2TT, UK
| | - Tessa Fulton-Lieuw
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Saloni Mittal
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Hisham Mehanna
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
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3
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Eltohami Y, Suleiman A. Survival analysis of Sudanese oral squamous cell carcinoma patients with field of cancerization. BMC Cancer 2024; 24:473. [PMID: 38622532 PMCID: PMC11017610 DOI: 10.1186/s12885-024-12197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/27/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The late presentation and diagnosis of OSCC account for the large number of patients with the advanced form of the disease. In Sudan, cases with delayed presentation, particularly those with risk factors such as Toombak dipping and alcohol consumption, frequently present with extensive lesions and a wide area of Field cancerization which characterized by the presence of genetic and epigenetic changes in histologically normal-appearing tissues, and have increased risk for recurrent and second primary tumors. This necessitates more aggressive treatment and is usually associated with poorer outcomes. The present study aims to investigate the survival of oral squamous cell carcinoma patients with a wide field of cancerization. METHODS This prospective longitudinal study includes ninety-three oral cancer patients with extensive fields of cancerization who underwent surgical treatment at Khartoum Teaching Dental Hospital (KTDH) conducted from 2019 to 2023. These patients were regularly assessed for clinical changes such as recurrence, the development of second primary tumours, and overall survival over a period of one year. RESULTS Out of the 93 patients, 57 (61.3%) were males, and 36 (38.7%) were females. The majority of the patients (82%) had stage IV tumours, and 62.3% had nodal metastasis. Twenty-eight (30%) patients developed recurrences, and 14 (15%) developed second primary tumours. The overall one-year survival rate was 89%, and all deceased patients passed away within 12 months. The survival rate for patients with different types of recurrences varied, with patients who had regional, local, and locoregional recurrences having survival rates of 87%, 74%, and 72%, respectively. Patients who did not experience a recurrence had a one-year survival rate of 92%. Patients who developed second primary tumours had an 86% survival rate. The survival rates for OSCC patients at stages III, IVa, and IVb were 90%, 90%, and 71%, respectively. CONCLUSION In this study, 62% of patients had nodal metastasis, 30% developed recurrence, and 15% developed second primary tumours. The overall one-year survival rate was 89%, although the development of recurrences and second primary tumours had a negative impact on the survival rate.
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Affiliation(s)
- Yousif Eltohami
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan.
| | - Ahmed Suleiman
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
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4
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Lim AE, Moen CM, Montgomery J. National survey sampling exercise on current practice in channelled local anaesthetic biopsy in suspected head and neck cancer. J Laryngol Otol 2024; 138:338-340. [PMID: 37649262 DOI: 10.1017/s0022215123001500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Out-patient channelled endoscopic local anaesthetic biopsy reduces the time to diagnosis and wider use may improve cancer pathway times. This study aimed to assess the practice of ENT surgeons using channelled local anaesthetic biopsy. METHOD A survey was distributed nationally, containing questions about out-patient local anaesthetic biopsy. RESULTS In total, 58 responses were returned; only 12 per cent of respondents (n = 7) used general anaesthetic biopsy. The advantages of local anaesthetic biopsy were: the avoidance of general anaesthetic for patients with poor performance scores (95 per cent, n = 55) and faster cancer pathway times (91 per cent, n = 53). Disadvantages were: clinics running late (29 per cent, n = 17) and complications (24 per cent, n = 14). The main barrier to using local anaesthetic was access to channelled flexible endoscopy (38 per cent, n = 22), with 43 per cent (n = 25) reporting they were not using out-patient channelled endoscopes but would be interested in using them. CONCLUSION Surgeons are interested in using channelled endoscopic local anaesthetic biopsy, but they are limited by access to equipment. Increased use of channelled endoscopes may improve national cancer pathway times and avoid challenging general anaesthetics.
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Affiliation(s)
- Alison E Lim
- Department of Otolaryngology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Christy M Moen
- Department of Otolaryngology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Jenny Montgomery
- Department of Otolaryngology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
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Binmadi N, Subahi G, Alsharif M, Daous Y, Jamal B, Alshinkity H, Salleh Barefah A. Oral squamous cell carcinoma with synchronous follicular lymphoma: A rare case report. SAGE Open Med Case Rep 2024; 12:2050313X241233423. [PMID: 38419799 PMCID: PMC10901051 DOI: 10.1177/2050313x241233423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
The occurrence of oral squamous cell carcinoma synchronously with lymphoma arising primarily in cervical lymph nodes is rare. Here, we report a case representing an infrequent finding. A 66-year-old male who was diagnosed with right mandibular squamous cell carcinoma and was subsequently found to have a nodal follicular lymphoma as a second malignancy. The patient underwent surgical resection for the oral squamous cell carcinoma with right selective neck dissection. The multidisciplinary team's postoperative treatment strategy involved adjuvant radiotherapy for the oral squamous cell carcinoma, while adopting a close follow-up approach for the follicular lymphoma. After an 18-month follow-up, there were no evidence of disease progression. This case report highlights the diagnostic challenges of synchronous primary malignancies occurring in the head and neck region. It also underscores the importance to conduct a comprehensive clinical and histopathological examination to rule out the possibility of synchronous neoplasms.
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Affiliation(s)
- Nada Binmadi
- Department of Oral Diagnostic Sciences, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Ghidaa Subahi
- Department of Oral Diagnostic Sciences, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Maha Alsharif
- Department of Oral Diagnostic Sciences, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Yara Daous
- Department of Anatomic Pathology, King Abdulaziz University Faculty of Medicine, Jeddah, Saudi Arabia
| | - Basem Jamal
- Department of Oral and Maxillofacial Surgery, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Hashim Alshinkity
- Department of Oral and Maxillofacial Surgery, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Ahmed Salleh Barefah
- Department of Hematology, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
- Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Ke RT, Hsiao YH, Tai WC, Li SH, Yao CC, Chuang KH, Lai HH, Chen Y, Chen LC, Lu HI, Chen YH, Lo CM. Similar survival after endoscopic submucosal dissection and esophagectomy in early esophageal cancer and synchronous or metachronous head and neck cancer. J Cardiothorac Surg 2024; 19:52. [PMID: 38311758 PMCID: PMC10840295 DOI: 10.1186/s13019-024-02514-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/28/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Early-stage esophageal cancer is treated using endoscopic submucosal dissection and esophagectomy. Field cancerization in patients with early-stage esophageal cancer affects treatment outcomes and causes synchronous or metachronous head and neck cancers. We hypothesized that esophagectomy could provide better overall and relapse-free survivals in patients with esophageal cancer and synchronous or metachronous head and neck cancer. METHODS We retrospectively identified patients with early esophageal squamous cell carcinoma and synchronous or metachronous head and neck cancers. We separated the patients into endoscopic submucosal dissection and esophagectomy groups to compare overall and relapse-free survivals. RESULTS The study included 106 patients, 25 of whom underwent endoscopic submucosal dissection and 81 underwent esophagectomy. Overall and relapse-free survivals did not show significant differences between the two groups for both synchronous and metachronous head and neck cancers. CONCLUSIONS Endoscopic submucosal dissection could provide similar overall and relapse-free survivals in patients with esophageal cancer and synchronous or metachronous head and neck cancer.
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Affiliation(s)
- Ruei-Ti Ke
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung Dist., Kaohsiung, Taiwan
| | - Yu-Hsin Hsiao
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung Dist., Kaohsiung, Taiwan
| | - Wei-Chen Tai
- Department of Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Chien Yao
- Department of Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Kai-Hao Chuang
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung Dist., Kaohsiung, Taiwan
| | - Hsing-Hua Lai
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung Dist., Kaohsiung, Taiwan
| | - Yu Chen
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung Dist., Kaohsiung, Taiwan
| | - Li-Chun Chen
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung Dist., Kaohsiung, Taiwan
| | - Hung-I Lu
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung Dist., Kaohsiung, Taiwan
| | - Yen-Hao Chen
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Ming Lo
- Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung Dist., Kaohsiung, Taiwan.
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Alterio D, Zaffaroni M, Bossi P, Dionisi F, Elicin O, Falzone A, Ferrari A, Jereczek-Fossa BA, Sanguineti G, Szturz P, Volpe S, Scricciolo M. Reirradiation of head and neck squamous cell carcinomas: a pragmatic approach-part I: prognostic factors and indications to treatment. LA RADIOLOGIA MEDICA 2024; 129:160-173. [PMID: 37731151 DOI: 10.1007/s11547-023-01713-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Reirradiation (reRT) of locally recurrent/second primary tumors of the head and neck region is a potentially curative treatment for patients not candidate to salvage surgery. Aim of the present study is to summarize available literature on both prognostic factors and indications to curative reRT in this clinical setting. MATERIALS AND METHODS A narrative review of the literature was performed on two topics: (1) patients' selection according to prognostic factors and (2) dosimetric feasibility of reRT. Postoperative reRT and palliative intent treatments were out of the scope of this work. RESULTS Patient-tumor and treatment-related prognostic factors were analyzed, together with dosimetric parameters concerning target volume and organs at risk. Based on available evidence, a stepwise approach has been proposed aiming to provide a useful tool to identify suitable candidates for curative reRT in clinical practice. This was then applied to two clinical cases, proposed at the end of this work. CONCLUSION A second course of RT in head and neck recurrence/second primary tumors is a personalized approach that can be offered to selected patients only in centers with expertise and dedicated equipment following a multidisciplinary team discussion.
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Affiliation(s)
- Daniela Alterio
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy.
| | - Paolo Bossi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Francesco Dionisi
- Radiotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Andrea Falzone
- Unità Operativa Multizonale di Radiologia Ospedale di Rovereto e Arco, Azienda Sanitaria per i Servizi Provinciali di Trento, Trento, Italy
| | - Annamaria Ferrari
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giuseppe Sanguineti
- Radiotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Petr Szturz
- Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Stefania Volpe
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Echevarria MI, Yang GQ, Chen DT, Kirtane K, Russell J, Kish J, Muzaffar J, Otto K, Padhya T, McMullen C, Patel K, Chung CH, Caudell JJ. Phase 1 Dose Escalation of Stereotactic Body Radiation Therapy and Concurrent Cisplatin for Reirradiation of Unresectable, Recurrent Squamous Cell Carcinoma of the Head and Neck. Int J Radiat Oncol Biol Phys 2023; 117:341-347. [PMID: 37105404 DOI: 10.1016/j.ijrobp.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/27/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE Patients with locoregional recurrence of squamous cell carcinoma of the head and neck (SCCHN) have relatively poor outcomes; therefore, stereotactic body radiation therapy (SBRT) has been investigated for this patient population. We performed a phase 1 clinical trial to establish a maximum tolerated dose of SBRT with concurrent cisplatin in previously irradiated locoregional SCCHN. METHODS AND MATERIALS Patients with recurrent SCCHN who had previously undergone radiation therapy to doses ≥45 Gy to the area of recurrence ≥6 months before enrollment and who were not surgical candidates or refused surgery were eligible. SBRT was delivered every other day for 5 fractions. Starting dose level was 6 Gy × 5 fractions, followed by 7 Gy × 5 fractions and 8 Gy × 5 fractions. Chemotherapy consisted of cisplatin given before every SBRT fraction at a dose of 15 mg/m2. Patients were monitored for dose-limiting toxicities (DLT) that occurred within 3 months from the start of SBRT. Secondary endpoints included locoregional failure, distant metastasis, and overall survival. RESULTS Twenty patients were enrolled, with 18 patients evaluable for endpoints. One patient at dose level 1 (30 Gy) died of unknown causes 2 weeks following completion of treatment. Therefore, an additional 3 patients were accrued to the 30-Gy dose level, with no further DLTs observed. Three patients were then accrued at dose level 2 (35 Gy) and 9 patients at dose level 3 (40 Gy) without DLTs. At a median follow-up of 9.5 months, cumulative incidence of locoregional failure at 2 years was 61% (95% confidence interval [CI], 12%-66%), cumulative incidence of distant metastasis was 11% (95% CI, 74%-100%) at 2 years, and overall survival was 22% (95% CI, 9%-53%) at 2 years. CONCLUSIONS Concurrent cisplatin and reirradiation with an SBRT dose of ≤40 Gy was safe and feasible in patients with locoregionally recurrent or second primary SCCHN.
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Affiliation(s)
| | - George Q Yang
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
| | - Kedar Kirtane
- Department of Head and Neck Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Jeffery Russell
- Department of Head and Neck Oncology, University of Utah Huntsman Cancer Institute, Salt Lake City, Utah
| | - Julie Kish
- Department of Senior Adult Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Jameel Muzaffar
- Department of Head and Neck Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Kristen Otto
- Department of Head and Neck Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Tapan Padhya
- Department of Head and Neck Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Caitlin McMullen
- Department of Head and Neck Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Krupal Patel
- Department of Head and Neck Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Christine H Chung
- Department of Head and Neck Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Jimmy J Caudell
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida
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Amdal CD, Moan JM, Dale E, Falk RS, Johansen S, Bjordal K. Impact of hyperfractionated re-irradiation on quality of life in patients with recurrent or second primary head and neck cancer, a prospective single institutional study. Clin Transl Radiat Oncol 2023; 42:100654. [PMID: 37415638 PMCID: PMC10319815 DOI: 10.1016/j.ctro.2023.100654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/19/2023] [Accepted: 06/17/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose Describe the clinical outcome of hyperfractionated re-irradiation (HFRT) in patients with recurrent or second primary (SP) head and neck cancer (HNC). Methods This prospective observational study included HNC patients eligible for HFRT. Inclusion criteria: age ≥18 years, recurrent or SP HNC, planned re-irradiation and ability to respond to questionnaires. Patients received 1.5 Gy twice daily, five days a week for three (palliative) or four (curative/local control) weeks, total dose 45/60 Gy. Toxicity was scored with CTCAE v3 at baseline, end of treatment, at three, six, 12 and 36 months follow-up. Health-related quality of life (HRQoL) was measured with EORTC QLQ-C30 and EORTC QLQ-H&N35, pre-treatment and eight times until 36 months. In the main outcome (Global quality of life and H&N Pain), a change score of ≥10 was considered clinically significant, and p-values < 0.05 (two-sided) statistically significant. The Kaplan-Meier method was used for survival analyses. Results Over four years from 2015, 58 patients were enrolled (37 recurrent and 21 SP). All, but two patients completed treatment as planned. Toxicity (≥grade 3) increased from pre-treatment to end of treatment with improvement in the follow-up period. The mean Global quality of life (QoL) and H&N Pain scores were stable from pre-treatment to three months. Maintained/ improved Global QoL was reported by 60% of patients at three months and 56% of patients at 12 months. For patients with curative, local control and palliative intent, the median survival (range) was 23 (2-53), 10 (1-66) and 14 (3-41) months respectively. Of those alive, the proportion of disease-free patients at 12 and 36 months, were 58% and 48%, respectively. Conclusion Most HNC patients reported maintained HRQoL at three and 12 months after HFRT despite serious toxicity observed in many patients. Long-term survival can be achieved in a limited proportion of the patients.
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Affiliation(s)
- Cecilie Delphin Amdal
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Jon Magne Moan
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Einar Dale
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | - Safora Johansen
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Oslo Metropolitan University, Faculty of Health Sciences, Oslo, Norway
| | - Kristin Bjordal
- Research Support Services, Oslo University Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
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Abrari A, Tyagi A, Mukherjee U. Leiomyoma of the palatine tonsil - report of a rare and unusual tumor at this site. INDIAN J PATHOL MICR 2023; 66:664-666. [PMID: 37530367 DOI: 10.4103/ijpm.ijpm_708_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A leiomyoma is a remarkably rare cause of a benign, one-side tonsillar enlargement. The diagnosis is essentially histologic and will not normally be suspected clinically. Immunohistochemistry is needed for substantiation of the morphology and confirmation. We submit this illustrative case report.
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Affiliation(s)
- Andleeb Abrari
- Department of Histopathology, The Rotherham NHS Foundation Trust, UK
| | - Aarti Tyagi
- Department of Pathology, Subharti Medical College, Meerut, Uttar Pradesh, India
| | - Urmi Mukherjee
- Department of Histopathology, Max Super Speciality Hospital, New Delhi, India
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11
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Basyuni MA, Altowairqi A, Khan MF, Bahaj AS, Alharbi J, Alessa MA, Abdelmonim SK. Synchronous Nasopharyngeal and Thyroid Malignancies: A Case Report. Cureus 2023; 15:e41674. [PMID: 37575697 PMCID: PMC10412943 DOI: 10.7759/cureus.41674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 08/15/2023] Open
Abstract
This report presents a case of primary non-keratinizing, undifferentiated nasopharyngeal cancer and an oncocytic (Hurthle cell) thyroid carcinoma developing simultaneously. The patient was diagnosed in August 2022 with nasopharyngeal carcinoma. After the staging process and before starting treatment for the patient, he was diagnosed with oncocytic (Hurthle cell) thyroid carcinoma on October 2022. Synchronous primary head and neck malignancies are well-known in the medical field. However, this is a rare case of two primary tumors of mucosal and non-mucosal carcinomas, highlighting the importance of discussing head and neck malignant cases in the multidisciplinary team meeting and performing frequent imaging and endoscopic examination for suspicious cases, especially in elderly patients. This case report describes the cases, the management modalities, and the outcomes, informing clinicians of the importance of considering the possibility of multiple primary malignancies when evaluating patients with head and neck tumors and a better approach to this rare and challenging case to ensure successful management.
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Affiliation(s)
- Mohammed A Basyuni
- ENT Head and Neck Surgery, Otolaryngology-Head and Neck Surgery, King Abdullah Medical City, Makkah, SAU
| | - Abdulaziz Altowairqi
- Otolaryngology-Head and Neck Surgery, King Abdulaziz Specialist Hospital, Taif, SAU
| | - Meshal F Khan
- Otolaryngology-Head and Neck Surgery, Al-Noor Specialist Hospital, Makkah, SAU
| | - Ahmed S Bahaj
- Otolaryngology-Head and Neck Surgery, King Abdullah Medical City, Makkah, SAU
| | - Jabir Alharbi
- Otolaryngology-Head and Neck Surgery, King Abdullah Medical City, Makkah, SAU
- Otolaryngology, Majmaah University, Majmaah, SAU
| | - Mohammad A Alessa
- Head, Neck and Skull Base Health Center, King Abdullah Medical City, Makkah, SAU
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Chen X, Kioi M, Hayashi Y, Koizumi T, Koike I, Yamanaka S, Hata M, Mitsudo K. Efficacy of concurrent chemoradiotherapy with retrograde super selective intra-arterial infusion combined with cetuximab for synchronous multifocal oral squamous cell carcinomas. Radiat Oncol 2023; 18:90. [PMID: 37237293 DOI: 10.1186/s13014-023-02282-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The incidence of multicentric oral cancer is increasing. However, treatment encounters difficulty if each tumor needs to be treated simultaneously. The objective of this clinical case report is to highlight the effect of concurrent chemoradiotherapy with retrograde superselective intra-arterial infusion combined with systemic administration of cetuximab on synchronous multifocal oral squamous cell carcinomas. CASE PRESENTATION A 70-year-old man presented to the hospital with multiple tumors and oral pain. Three independent tumors were found in the right dorsal tongue, left edge of the tongue, and left lower lip. Based on the characteristic appearance of the lesions and further evaluation, clinical diagnoses of right tongue cancer "T3", left tongue cancer "T2" and lower left lip cancer "T1", N2cM0 were made. Treatment was initiated with systemic administration of cetuximab, followed by intra-arterial chemoradiotherapy. Treatment results were complete response on all three local lesions, and left neck dissection was performed following the initial treatment. The patient showed no evidence of recurrence during the 4 years follow-up period. CONCLUSIONS This novel combination treatment seems to be a promising strategy for patients with synchronous multifocal oral squamous cell carcinoma.
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Affiliation(s)
- Xuefei Chen
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Mitomu Kioi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Yuichiro Hayashi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Toshiyuki Koizumi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Izumi Koike
- Department of Radiation Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Masaharu Hata
- Department of Radiation Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
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What is the Incidence of Oral Cancer Recurrence in Patients Reconstructed With a Microvascular Free Flap, Endosseous Implants, and an Oral Prosthesis and How Does the Timing of Implant Placement Influence Recurrence? J Oral Maxillofac Surg 2023; 81:120-128. [PMID: 36209893 DOI: 10.1016/j.joms.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/26/2022] [Accepted: 09/06/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE In patients with malignant oral disease, there is concern that immediate implant placement at the time of ablative and microvascular free flap surgery can contribute to tumor recurrence or delay the diagnosis of recurrence. The purpose of this study is to 1) estimate the incidence of recurrence in patients with malignant disease treated with immediate microvascular free flap reconstruction, endosseous implants, and an oral prosthesis, 2) measure and compare the timing of implant placement, immediate versus delayed, and the time to complete oral rehabilitation, and 3) measure the association between the timing of implant placement and tumor recurrence. MATERIALS AND METHODS This is a retrospective cohort study utilizing medical record analysis involving patients with malignant oral cancer undergoing tumor resection and immediate microvascular reconstruction from 1996 to 2019 at the Mayo Clinic, Rochester, MN by the Division of Oral and Maxillofacial Surgery. Additional inclusion criteria comprised of immediate or delayed endosseous implant placement, the fabrication of an oral prosthesis, and a minimum of 2-year follow-up. Data on patient demographics, tumor characteristics, timing of implant placement and prosthesis loading, type of prosthesis, tumor recurrence, or second primary tumor events were analyzed. RESULTS Thirty-three patients with a mean follow-up of 6.4 years were included. Twenty-four patients (72.7%) were diagnosed with squamous cell carcinoma with 3 patients experiencing tumor recurrence. Fifteen patients had immediate implant placement while 18 patients had delayed implant placement. The mean number of days to prosthetic loading of the implants was 680.4 days and 330.1 days for the delayed implant group and immediate implant group, respectively, which was statistically significant (P = .004). The timing of implant placement and the event of a recurrence were not statistically significant (P = .075). CONCLUSION The incidence of recurrence in patients with malignant oral cancer treated with microvascular reconstruction, endosseous implants, and an oral prosthesis was 12.5% with one recurrence occurring beneath the oral prosthesis. Delayed implant placement resulted in a statistically significant delay in the completion of oral rehabilitation compared to immediate implant placement. There was no difference in the incidence of recurrence in the immediate implant group compared to the delayed implant group.
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Association between postoperative radiotherapy for young-onset head and neck cancer and long-term risk of second primary malignancy: a population-based study. J Transl Med 2022; 20:405. [PMID: 36064552 PMCID: PMC9446763 DOI: 10.1186/s12967-022-03544-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background Second primary malignancy (SPM) represents the leading long-term cause of death among patients with index head and neck squamous cell carcinoma (HNSCC). We aimed to quantify the association between postoperative radiotherapy (PORT) and the risk of SPM development for index HNSCC among adolescent and young patients, who are particularly vulnerable to radiation-associated impacts due to their increased tissue susceptibilities and longer life expectancies. Methods This study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database to collect the data of 5 year survivors of index young-onset HNSCC from 1975 to 2011. The outcome of interest was SPM, a new, metachronous malignancy after the index HNSCC. Standardized incidence ratios (SIRs) and excess absolute risks (EARs) were used to quantify the PORT-associated risks externally, and relative risks (RRs) were estimated by the multivariate Poisson regression analysis to quantify the PORT-associated risks internally. Results Of the included 2771 5 year survivors with index young-onset HNSCCs, the receipt of PORT (37.6%) was associated with higher risk of SPMs (RR, 1.23; 95% CI 1.07 to 1.43). PORT-associated risks were elevated for the majority of sites, including head and neck (RR, 1.19; 95% CI 0.95 to 1.50) and lung (RR, 1.67; 95% CI 1.18 to 2.34). With regarding to the subsites of head and neck, RRs were above unity in oral cavity squamous cell carcinoma (SCC) (RR, 1.68; 95% CI 1.39 to 2.03) and laryngeal SCC (RR, 1.02; 95% CI 0.73 to 1.43). A relatively greater RR was observed for patients younger than 35 years (RR, 1.44, 95% CI 0.37 to 5.57) and those diagnosed with localized diseases (RR, 1.16, 95% CI 0.9 to 1.5). PORT-associated risks were increased remarkably after 15 years of follow-up (RR, 1.24; 95% CI 0.97 to 1.58). Conclusions An association was discovered between PORT treatment and increased long-term risk of SPM among patients with index young-onset HNSCC. The findings suggest long-term follow-up surveillance for these patients, particularly those with oral cavity SCC or laryngeal SCC. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03544-y.
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Parra-Medina R, Rocha F, Castañeda-González JP, Moreno-Lucero P, Veloza L, Romero-Rojas AE. Synchronous or collision solid neoplasms and lymphomas: A systematic review of 308 case reports. Medicine (Baltimore) 2022; 101:e28988. [PMID: 35838994 PMCID: PMC11132339 DOI: 10.1097/md.0000000000028988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/13/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The presence of a lymphoma associated with a solid synchronous neoplasm or collision neoplasm has been rarely in the literature, and a detailed characterization of these cases is lacking to date. OBJECTIVE To describe the main clinicopathological features of synchronous/collision tumors. METHODS A systematic search in PubMed, Scielo, and Virtual Health Library literature databases for cases or case series of synchronous or collision lymphoma and other solid neoplasms reported up to March 2021 was performed. Three reviewers independently screened the literature, extracted data, and assessed the quality of the included studies. The systematic review was performed following the Preferred Reporting Items for Systematic Meta-Analyses guidelines. RESULTS Mean age of patients was 62.9 years (52.9% men). A total of 308 cases were included (62% synchronous and 38% collision). The most frequent location of both synchronous and collision tumors was the gastrointestinal tract with the most common solid neoplasm being adenocarcinoma, and the most frequent lymphoma diffuse large B-cell lymphoma (21.7%) and mucosa-associated lymphoid tissue lymphoma (20.4%). Of the total number of mucosa-associated lymphoid tissue lymphomas and gastric adenocarcinomas, the presence of Helicobacter pylori infection was documented in 47.3% of them. Only 2% of all cases had a previous history of lymphoma. Thus, in most cases (98%), lymphoma was discovery incidentally. In addition, nodal lymphoma was associated with metastasis in 29 (9.4%) cases as collision tumor, most commonly (90%) in locoregional lymph nodes of the solid neoplasm. CONCLUSIONS The frequent association of some type of B-cell lymphoma and adenocarcinoma in synchronous/collision tumors of the gastrointestinal tract points to common pathogenic mechanisms in both neoplasia, particularly related to chronic inflammation in this location. In most cases, lymphoma identified in locoregional lymph nodes or distant of a carcinoma seems to represent an incidental finding during the carcinoma diagnostic/therapeutic approach. A synergy between carcinoma and lymphoma (involving inflammation and immunosuppression mechanisms) may favor tumor progression and dissemination. A better understating of the interactions lymphoma/carcinoma in the setting of synchronous/collision tumors may help to improve patient management and prognosis.
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Affiliation(s)
- Rafael Parra-Medina
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
- Research Institute, Fundación Universtaria de Ciencias de la Salud, Bogotá, Colombia
- Department of Pathology, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Franky Rocha
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
| | | | - Paula Moreno-Lucero
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
| | - Luis Veloza
- Institute of Pathology, Lausanne University Hospital, Lausanne University, Lausanne, Switzerland
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Linz C, Brands RC, Hackenberg S, Hartmann S, Iring T, Hohm J, Haug L, Kertels O, Kircher M, Dierks A, Buck AK, Brumberg J, Lapa C. [18F]FDG-PET/CT improves the detection of synchronous malignancies at primary staging of oral squamous cell carcinoma – A retrospective study. J Craniomaxillofac Surg 2022; 50:671-676. [DOI: 10.1016/j.jcms.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/01/2022] [Accepted: 06/11/2022] [Indexed: 11/24/2022] Open
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Occurrence and Prognosis of Secondary Lung Cancer in Patients with Primary Nasal Cavity and Sinus Squamous Cell Carcinoma. Adv Ther 2022; 39:2533-2543. [PMID: 35357667 DOI: 10.1007/s12325-022-02107-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 02/28/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION There is an increasing focus on the burden of long-term survivors of secondary malignant neoplasms (SMNs) after the appearance of the primary tumor. Our goal was to describe the occurrence and prognosis of secondary lung cancer (SLC) in patients suffering from primary nasal cavity and sinus squamous cell carcinoma (NSSCC). METHODS Patients with NSSCC who reported to the Surveillance, Epidemiology and End Results (SEER) program between 1973 and 2017 were selected for our analysis. The Kaplan-Meier analysis was employed to predict the overall prevalence of SMNs and survival rates after the development of SMN. Standardized incidence ratios (SIRs) of SMNs have also been assessed after the development of the primary NSSCC. RESULTS A total of 5354 patients were diagnosed with NSSCC. The type and date of diagnosis of the first malignancy were included in the records. In total 419 patients were reported to have developed SMNs within a median duration of 36 months from the time of the primary to the secondary tumor diagnosis. The reported cumulative incidence of SMNs was 14% after 10 years from the primary tumor diagnosis and 32% after 20 years. Among the solid SMNs, secondary lung cancer was the most common malignancy, with cumulative incidences of 12.4% after 20 years. The SIR of SMNs after the primary NSSCC compared with that of the general population was 1.65 and the 5-year overall survival (OS) rate following SMNs was 30%. The SMN lung cancer exhibited a SIR of 3.21 and was associated with a short-term median survival of only 11 months. CONCLUSIONS NSSCC survivors are at a high risk of developing SMNs, relative to baseline individuals. Lung cancer is one of the most common SMNs, and it has a poor outcome.
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Mutagen sensitivity and risk of second cancer in younger adults with head and neck squamous cell cancer: 15-year results. Strahlenther Onkol 2022; 198:820-827. [PMID: 35357513 PMCID: PMC9402516 DOI: 10.1007/s00066-022-01917-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/22/2022] [Indexed: 11/05/2022]
Abstract
Purpose To evaluate the mutagen sensitivity phenotype on the risk of second primary cancer (SPC) in patients with head and neck squamous cell carcinoma (HNSCC), and to estimate the long-term rate of SPC and the outcome with SPC. Methods A survey was made regarding SPC among 124 younger (≤ 50 years) adults with HNSCC who were enrolled in a pretreatment mutagen sensitivity investigation during 1996–2006. Mutagen sensitivity was assessed by exposing lymphocytes to bleomycin in vitro and quantifying the bleomycin-induced chromatid breaks per cell (b/c). Patients were classified as hypersensitive (> 1 b/c) or not hypersensitive (≤ 1 b/c). Results Mean follow-up time for all patients was 68 months (range: 5–288 months), and the 15-year cancer-specific survival was 15%. Twenty patients (16%) developed a SPC (15-year estimated rate: 41%), and half of them was hypersensitive. The crude rate of SPC for hypersensitive (n = 65) or not hypersensitive (n = 59) patients were 15 and 17%, respectively (p = 0.4272). The 15-year estimated rate of SPC for hypersensitive and not hypersensitive patients was 36 and 48%, respectively (p = 0.3743). Gender, UICC stages, anatomical sites of index cancer did not prove to be a significant risk factor for SPC. Forty-five percent of SPC developed after the 10-year follow-up. The 3‑year cancer-specific survival was 23% with SPC. Conclusion According to our findings, mutagen hypersensitivity was not associated with an increased SPC risk in HNSCC patients. Patients are at a lifelong risk of developing a SPC. Survival with SPC is very poor.
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Clinical characteristics and prognosis of patients with hypopharyngeal cancers with multiple primary cancers: A propensity score matched analysis. Am J Otolaryngol 2022; 43:103297. [PMID: 34894448 DOI: 10.1016/j.amjoto.2021.103297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/05/2021] [Accepted: 11/28/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE This study aimed to identify the clinical characteristics of hypopharyngeal squamous cell carcinoma (HPSCC) patients with multiple primary cancers (MPCs) and to compare differences between patients with metachronous and synchronous MPCs. MATERIAL AND METHODS This study included 219 patients with HPSCC treated at our center between 2008 and 2020; the clinical characteristics and prognosis of 66 patients with MPCs were analyzed. Propensity score matching (PSM) was used to balance the factors between patients with synchronous and metachronous MPCs. RESULTS Sixty-six patients with HPSCC (66/219, 30.1%) experienced MPCs, of which 29 were synchronous and 37 were metachronous. The esophagus (n = 39, 59.1%), lung (n = 10, 15.2%), and oropharynx (n = 4, 6.1%) were the three most common sites of MPCs in both the synchronous and metachronous groups. More patients with synchronous MPCs were stage T1-2 (82.8% vs. 59.5%, P = 0.041) compared to those with metachronous MPCs. Among the 24 pairs of patients after PSM, patients with metachronous MPCs had higher 3-year progression-free survival (PFS) (52.5% vs. 16.3%, P < 0.001) and overall survival (OS) (58.5% vs. 22.1%, P = 0.001) than those with synchronous cancers. Multivariate Cox analysis showed that patients with synchronous MPCs had shorter PFS (HR 4.45, 95% CI 1.819-10.885, P = 0.001) and OS (HR 3.918, 95% CI 1.591-9.645, P = 0.003). CONCLUSION MPCs are common among patients with HPSCC, and patients with metachronous MPCs had better survival than those with synchronous MPCs. Clinicians should be aware of the possibility of MPCs in patients with HPSCC and optimize treatment to improve outcomes.
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Uddin M, Lim LC, Goodall A, Padaki P, Anjum K. Synchronous mucosal and intraosseous oral cavity carcinomas: a case of rare occult second primary malignancy. Ann R Coll Surg Engl 2021; 104:e150-e152. [PMID: 34841900 DOI: 10.1308/rcsann.2021.0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Secondary primary malignancies within the head and neck region are well documented. Within this group, synchronous tumours with an index oral cancer are usually found in the oropharyngeal or laryngeal sites. We present a rare case of an index squamous cell carcinoma in the tongue with a synchronous primary intraosseous squamous cell carcinoma. We discuss the challenges associated with investigation, diagnosis and subsequent management. Treatment aims remain the same; namely, eradicating the disease using surgery, radiotherapy, chemotherapy or a combination of these modalities. It is important to acknowledge the unpredictable pattern of tumour presentation and the need to maintain a high index of suspicion.
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Affiliation(s)
- M Uddin
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - L C Lim
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - A Goodall
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - P Padaki
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - K Anjum
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
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Tanaka A, Uemura H, Masui T, Ota I, Kimura T, Akioka H, Adachi S, Kitahara T. Surgical technique for the prevention of tracheal necrosis following total pharyngolaryngectomy. MEDICINE INTERNATIONAL 2021; 1:18. [PMID: 36698531 PMCID: PMC9829085 DOI: 10.3892/mi.2021.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/25/2021] [Indexed: 01/28/2023]
Abstract
Total pharyngolaryngectomy with cervical esophagectomy (TPLCE) is an invasive procedure with various post-operative complications. Tracheal necrosis (TRN) is a fatal complication of TPLCE. The present study aimed to identify a surgical technique which may be used to prevent TRN. The post-operative complications of 48 patients who underwent TPLCE from January, 2010 to December, 2019 were retrospectively investigated. The incidence of TRN was examined and measures against TRN were reviewed. The results revealed that 3 patients (6%) experienced TRN within 1 week following surgery. In addition, 2 patients required the surgical debridement of the necrotic tissue and tracheoplasty. The other patient underwent conservative treatment. Stomal recurrence developed in 1 patient (2%). On the whole, the present study demonstrates that the incidence of TRN following TPLCE is lower than that observed in previous reports, and only one stomal recurrence was reported. Preserving the blood supply to the trachea is essential for the prevention of TRN. The eight surgical processes used herein effectively preserved the blood supply. Further investigations however, are necessary in order to confirm the present findings and to ensure effective measures are found with which to prevent TRN following TPLCE.
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Affiliation(s)
- Akihisa Tanaka
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan,Correspondence to: Dr Akihisa Tanaka, Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Hirokazu Uemura
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Takashi Masui
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Ichiro Ota
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Takahiro Kimura
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Hiroshi Akioka
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Shiori Adachi
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Tadashi Kitahara
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
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Bollen H, van der Veen J, Laenen A, Nuyts S. Recurrence Patterns After IMRT/VMAT in Head and Neck Cancer. Front Oncol 2021; 11:720052. [PMID: 34604056 PMCID: PMC8483718 DOI: 10.3389/fonc.2021.720052] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/30/2021] [Indexed: 01/04/2023] Open
Abstract
Purpose Intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT), two advanced modes of high-precision radiotherapy (RT), have become standard of care in the treatment of head and neck cancer. The development in RT techniques has markedly increased the complexity of target volume definition and accurate treatment delivery. The aim of this study was to indirectly investigate the quality of current TV delineation and RT delivery by analyzing the patterns of treatment failure for head and neck cancer patients in our high-volume RT center. Methods Between 2004 and 2014, 385 patients with pharyngeal, laryngeal, and oral cavity tumors were curatively treated with primary RT (IMRT/VMAT). We retrospectively investigated locoregional recurrences (LRR), distant metastases (DM), and overall survival (OS). Results Median follow-up was 6.4 years (IQR 4.7–8.3 years) during which time 122 patients (31.7%) developed LRR (22.1%) and DM (17.7%). The estimated 2- and 5-year locoregional control was 78.2% (95% CI 73.3, 82.3) and 74.2% (95% CI 69.0, 78.8). One patient developed a local recurrence outside the high-dose volume and five patients developed a regional recurrence outside the high-dose volume. Four patients (1.0%) suffered a recurrence in the electively irradiated neck and two patients had a recurrence outside the electively irradiated neck. No marginal failures were observed. The estimated 2- and 5-year DM-free survival rates were 83.3% (95% CI 78.9, 86.9) and 80.0% (95% CI 75.2, 84.0). The estimated 2- and 5-year OS rates were 73.6% (95% CI 68.9, 77.8) and 52. 6% (95% CI 47.3, 57.6). Median OS was 5.5 years (95% CI 4.5, 6.7). Conclusion Target volume definition and treatment delivery were performed accurately, as only few recurrences occurred outside the high-dose regions and no marginal failures were observed. Research on dose intensification and identification of high-risk subvolumes might decrease the risk of locoregional relapses. The results of this study may serve as reference data for comparison with future studies, such as dose escalation or proton therapy trials.
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Affiliation(s)
- Heleen Bollen
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium.,Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Julie van der Veen
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium.,Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Annouschka Laenen
- Leuven Biostatistics and Statistical Bioinformatics Center, KU Leuven, Leuven, Belgium
| | - Sandra Nuyts
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium.,Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
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Incidental uptake of fluorodeoxyglucose in the Waldeyer's ring and risk of oropharyngeal malignancy. Eur Arch Otorhinolaryngol 2021; 279:2657-2664. [PMID: 34570264 PMCID: PMC8986689 DOI: 10.1007/s00405-021-07089-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/12/2021] [Indexed: 10/27/2022]
Abstract
PURPOSE Fluorodeoxyglucose (FDG) positron emission tomography (PET) is increasingly used to diagnose and stage malignancy. The aim of this article is to investigate the significance of incidental FDG uptake in the Waldeyer's ring and to assess its value in predicting clinically occult oropharyngeal malignancy. METHODS All FDG-PET/CT scans performed in Imperial College NHS Foundation Trust, UK between January 2012 and November 2018 were included. Patients with known or suspected oropharyngeal malignancy or lymphoma were excluded. Minimum follow-up was 12 months. RESULTS A total of 724 scans revealed oropharyngeal uptake of FDG. Of these, 102 were included in the study. Most patients (62.1%) were scanned as part of staging for other malignancies. Oropharyngeal FDG uptake was asymmetrical in 57.3% of the cases. Uptake was more common in the tonsils (56.3%), followed by the tongue base (31.1%) and both sites (12.6%). In 41.7% of reports, appearance was described as likely physiological; however, 52.4% of reports advised direct visualisation, clinical correlation or ENT opinion. Only 24.3% (25/102) of patients were referred and seen by ENT, 14.6% (15/102) of which had an interval PET scan and 8.7% (9/102) proceeded to tissue diagnosis. There was one oropharyngeal cancer identified and one unexpected metastasis from esophageal cancer. CONCLUSION Incidental uptake on PET/CT in the oropharynx is common. However, malignancy is rare (1.9%) and, when present, is associated with high SUVmax and asymmetrical uptake. Imaging results must be correlated clinically. These patients should be seen by an ENT specialist yet most may not require further investigations.
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Lakshminarasimman P, Pai PS, Mehta S, Patil P. Is Direct Laryngoscopy Obsolete? "Trans Nasal Oesophagoscopy" the Complete Endoscopic Solution in Head Neck Practice. Indian J Otolaryngol Head Neck Surg 2021; 73:310-314. [PMID: 34471618 DOI: 10.1007/s12070-021-02368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022] Open
Abstract
Direct laryngoscopy (DL) is the standard of care for the evaluation of suspicious lesions in the larynx and hypo pharynx but requires general anaesthesia and a dedicated operation theatre. While DL offers us the ability to map the lesion adequately and take a biopsy, it requires workup for anaesthesia well as rigid oesophagoscopy for assessing the oesophagus with its associated complications. Sixty-nine patients underwent TNE under topical anaesthesia. The lesions were mapped and biopsies taken. Those patients who had an inadequate evaluation on TNE or negative biopsy underwent direct laryngoscopy. Completeness of evaluation, adequacy of biopsy, presence of synchronous oesophageal lesions and the modified Gloucester Comfort Score for patient comfort was documented. Amongst 69 cases enrolled for TNE evaluation, 97% of cases had an adequate mapping of disease extent, and 100% adequacy of biopsy material. General anaesthesia could be avoided in 92.75% of patients. TNE took a median time of 8 min. Synchronous oesophageal tumours were seen in 5.8% of patients. There were no complications and 74% patients did not experience any discomfort. TNE appears to be simple, safe, efficient office based diagnostic procedure. TNE has the potential to be the new standard of care making DL obsolete.
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Affiliation(s)
- P Lakshminarasimman
- Department of Head and Neck Surgery (Surgical Oncology), Sri Ramachandra Medical College and Research Institute, No. 1, Ramachandra Nagar, Porur, Chennai, 600116 India
| | - Prathamesh S Pai
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, 400012 India
| | - Shaesta Mehta
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, 400012 India
| | - Prachi Patil
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, 400012 India
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Boscolo Nata F, Gardenal N, Giudici F, Tirelli G. The role of NBI with flexible video-endoscope in the follow-up of head and neck cancer patients: a prospective study. Eur Arch Otorhinolaryngol 2021; 279:2133-2141. [PMID: 34304298 DOI: 10.1007/s00405-021-07016-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE Narrow band imaging (NBI) enhances mucosal vasculature and could help in the identification of recurrences. We assessed the effectiveness of NBI with flexible video-endoscope in the early detection of recurrence after treatment of head and neck squamous cell carcinoma, its diagnostic advantage over high-definition white-light (HD WL) endoscopy, also in relation to recurrence site, and the influence of previous radiotherapy (RT) or chemotherapy (CT). Moreover, we investigated the association between index tumor site and the risk of developing recurrence, and the relation between index tumor site and recurrence site. METHODS From January 2018 to November 2020, 160 patients previously treated with surgery and/or RT ± CT were evaluated using NBI with flexible video-endoscope. Sensitivity, specificity, positive/negative predictive value, and accuracy were calculated for NBI and HD WL, and compared using the McNemar test. The Fisher exact test was used to compare the other associations investigated. RESULTS The difference between NBI and HD WL sensitivity was statistically significant (p < 0.001). The NBI diagnostic advantage was 62.5%, highest in the hypopharynx (p = 0.05), and was not influenced by previous RT or CT (p = 0.49). Index tumor site statistically related with recurrence site (p < 0.001), but not with the risk of developing recurrence (p = 0.81). CONCLUSION NBI with flexible video-endoscope could represent a valid option to detect recurrence early during the follow-up, especially in a difficult-to-visualize site such as the hypopharynx.
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Affiliation(s)
- Francesca Boscolo Nata
- ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy.
| | - Nicoletta Gardenal
- ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy
| | - Fabiola Giudici
- Unit of Biostatistics, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Giancarlo Tirelli
- ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy
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McMillan RA, Van Abel KM, Yin LX, Routman DM, Ma DJ, Neben Wittich MA, Price DL, Kasperbauer JL, Price KR, Chintakuntlawar AV, Moore EJ. Second Primary Tumors in Patients Presenting With Unilateral HPV-Associated Tonsillar Squamous Cell Carcinoma. Laryngoscope 2021; 132:332-338. [PMID: 34236086 DOI: 10.1002/lary.29741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/31/2021] [Accepted: 06/26/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To describe and compare rates of metachronous and synchronous second primaries of the contralateral tonsil in patients with primary HPV(+) tonsillar squamous cell carcinoma (SCC). STUDY DESIGN Retrospective cohort study. MATERIALS AND METHODS This is a single tertiary care center retrospective case series, from 2006 to 2019, of HPV(+) tonsillar SCC patients who underwent primary surgical resection with unilateral wide-field tonsillectomy or bilateral tonsillectomy for diagnostic or therapeutic purposes. A metachronous second primary is one diagnosed >6 months after completion of surgical treatment. A synchronous second primary is one diagnosed during bilateral tonsillectomy for unilateral HPV(+) tonsillar SCC. Rates of second primary and patient characteristics were compared using chi-square tests. RESULTS About 303 patients underwent unilateral surgical resection +/- adjuvant therapy for HPV(+) tonsillar SCC. One (0.3%) developed a metachronous second primary in the contralateral tonsil 11.9 years following treatment. Fifty-seven patients with HPV(+) tonsillar SCC underwent bilateral tonsillectomy, and 37/57 (65%) had no clinical signs for contralateral disease. Of these, only 1/37 (2.7%) was incidentally found to have a synchronous second primary. Twenty patients underwent bilateral tonsillectomy due to clinical concern for contralateral disease. Of these, 3/20 (15%) were found to have a synchronous HPV(+) SCC in the contralateral tonsil. CONCLUSIONS The prevalence of metachronous second primary after appropriate treatment of HPV(+) tonsillar SCC is very low (0.3%) and so is the chance of incidentally discovering a synchronous second primary during bilateral tonsillectomy (2.7%). We do not recommend bilateral tonsillectomy as a part of the routine algorithm in the surgical management of these patients. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Ryan A McMillan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Kathryn M Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Linda X Yin
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - David M Routman
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Daniel J Ma
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, U.S.A
| | | | - Daniel L Price
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Jan L Kasperbauer
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Katharine R Price
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, U.S.A
| | | | - Eric J Moore
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
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Dissemination patterns and chronology of distant metastasis affect survival of patients with head and neck squamous cell carcinoma. Oral Oncol 2021; 119:105356. [PMID: 34034098 DOI: 10.1016/j.oraloncology.2021.105356] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/25/2021] [Accepted: 05/16/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To define metastatic categories based on their prognostic significance. We hypothesized that oligometastasis in patients with head and neck squamous cell carcinoma (HNSCC) is associated with better post-distant metastasis disease specific survival (post-DM DSS) compared to patients with polymetastasis. Furthermore, the impact on survival of synchronous versus metachronous distant metastasis (DM) occurrence was assessed. MATERIALS AND METHODS Retrospective cohort study in which patients with DM were stratified into three groups: oligometastasis (maximum of 3 metastatic foci in ≤2 anatomic sites), explosive metastasis (≥4 metastatic foci at one anatomic site) and explosive-disseminating metastasis (spread to ≥3 anatomic sites or >3 metastatic foci in 2 anatomic sites). In addition, patients were divided into synchronous versus metachronous DM. RESULTS Between January 1, 2006 and December 31, 2013, a total of 2687 patients with HNSCC were identified, of which 324 patients developed DM. In this group, 115 (35.5%) patients had oligometastasis, 64 (19.8%) patients had explosive metastasis and 145 (44.8%) patients had explosive-disseminating metastasis. Their median post-DM DSS were 4.7 months, 4.1 months and 1.7 months respectively (p < .001). Synchronous DM was associated with more favorable survival rates in univariable and multivariable analyses than metachronous DM with recurrence of the index tumor (6-month post-DM DSS probability of 0.51 vs 0.17, p < .001). CONCLUSION Oligometastasis in HNSCC signifies a better prognosis than a polymetastatic pattern. Metachronous DM occurrence with recurrence of the primary index tumor is associated with an unfavorable prognosis.
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Frequency and Localization of Second Primary Tumors in Patients with Oropharyngeal Carcinoma-The Influence of the Human Papilloma Virus. Cancers (Basel) 2021; 13:cancers13081755. [PMID: 33916999 PMCID: PMC8067739 DOI: 10.3390/cancers13081755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/25/2021] [Accepted: 04/03/2021] [Indexed: 12/29/2022] Open
Abstract
Simple Summary Human papillomavirus (HPV) infection, smoking, and excessive alcohol consumption have been established as risk factors for the development of oropharyngeal squamous cell carcinoma (OPSCC). While the HPV epidemic has led to an increasing incidence of OPSCC, HPV-negative OPSCC cases associated with smoking and alcohol remain stable. As HPV-positive and -negative OPSCC present two distinct etiological, clinical, and prognostic entities, different treatment and follow-up strategies are being discussed. Still, specific surveillance strategies for HPV-positive OPSCC are lacking, as the risk of second primary tumors (SPT) in the era of HPV-associated OPSCC has not been comprehensively assessed. Our study investigated the frequency and localization of SPT of HPV-positive OPSCC, as well as their prognostic impact. We find that the SPT of HPV-positive OPSCC are less frequent than those of HPV-negative OPSCC, and they are also associated with higher survival rates. The localization of SPT of HPV-positive OPSCC did not differ from the localization of SPT of HPV-negative OPSCC. Abstract Purpose: To investigate the frequency, localization, and survival of second primary tumors (SPT) of oropharyngeal squamous cell carcinoma (OPSCC) depending on human papillomavirus (HPV) status. Methods: We performed a retrospective chart analysis of 107 OPSCC patients treated at the Zurich University Hospital from 2001 to 2010. Rate and localization of SPT after an index OPSCC were stratified according to smoking and HPV infection status. Results: In total, 57/91 (63%) included patients showed an HPV-associated OPSCC. Of these, 37/57 (64.9%) patients with an HPV-positive and 32/34 (94.1%) patients with an HPV-negative OPSCC were smokers. The median age at diagnosis of the SPT was 59.54 years (interquartile range 52.7–65.6). In addition, 8/57 (14%) HPV-positive and 13/34 (38.2%) HPV-negative patients developed SPT. The rate of SPT in patients with HPV-positive index tumors was significantly lower than in patients with HPV-negative OPSCC (p-value 0.01). Smokers showed significantly more SPT in the head and neck area than outside. The development of an SPT led to a significantly lower survival time in HPV-negative patients, while it did not significantly affect the survival time of HPV-positive patients. Conclusions: Patients with HPV-positive index tumors had a significantly lower risk of developing SPT than patients with HPV-negative tumors. If SPT developed, survival was significantly shorter in patients with HPV-negative tumors than with HPV-positive tumors.
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Ho SY, Tsang RKY. Value of oesophagoscopy and bronchoscopy in diagnosis of synchronous malignancies in patients with head and neck squamous cell carcinomas. BMC Cancer 2020; 20:1172. [PMID: 33256662 PMCID: PMC7706228 DOI: 10.1186/s12885-020-07681-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/23/2020] [Indexed: 11/22/2022] Open
Abstract
Background Routine screening of patients with head and neck squamous cell carcinomas (HNSCCs) for synchronous malignancies using oesophagoscopy and bronchoscopy had been controversial. The aim of this study is therefore to find out the rate of synchronous malignancies in patients with primary HNSCCs, the risk factors for its occurrence and the effectiveness of oesophagoscopy and bronchoscopy from a 10-year experience in a single centre. Methods A retrospective review of medical records was conducted from July 2008 to June 2018 in a tertiary referral centre in Hong Kong. All patients with newly diagnosed HNSCCs were screened with oesophagoscopy and bronchoscopy at the time of diagnosis and therefore all patients were included in the study. The incidence of synchronous malignancies along the aerodigestive tract and the yield of oesophagoscopy and bronchoscopy were studied. Results Of the 702 patients included in the study, the overall rate of synchronous malignancies was 8.3% (58/702), with the rate of synchronous oesophageal and lung malignancies being 5.8% (41/702) and 0.85% (6/702) respectively. Fourteen out of the 41 oesophageal malignancies were only detectable with oesophagoscopy. Only one of the synchronous lung malignancies was detectable by bronchoscopy. Risk factors for synchronous malignancies include male gender, smokers, drinkers and primary hypopharyngeal cancer. Conclusions Oesophagoscopy is essential for detecting synchronous oesophageal malignancies in patients with HNSCCs especially in male patients, smokers and drinkers, and it is most valuable in primary hypopharyngeal cancer patients among all primary subsites. Bronchoscopy had a low yield for synchronous lung malignancies and can be potentially replaced by imaging techniques.
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Affiliation(s)
- Shi Yeung Ho
- Department of Ear, Nose and Throat, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong
| | - Raymond King Yin Tsang
- Division of Otorhinolaryngology, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong.
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Experience of a Portuguese radiation therapy department in the treatment of synchronous and metachronous head, neck, and oesophageal cancers. Porto Biomed J 2020. [DOI: 10.1097/j.pbj.0000000000000092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Alterio D, Turturici I, Volpe S, Ferrari A, Russell-Edu SW, Vischioni B, Mardighian D, Preda L, Gandini S, Marvaso G, Augugliaro M, Durante S, Arculeo S, Patti F, Boccuzzi D, Casbarra A, Starzynska A, Santoni R, Jereczek-Fossa BA. Carotid blowout syndrome after reirradiation for head and neck malignancies: a comprehensive systematic review for a pragmatic multidisciplinary approach. Crit Rev Oncol Hematol 2020; 155:103088. [PMID: 32956946 DOI: 10.1016/j.critrevonc.2020.103088] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/30/2020] [Accepted: 08/17/2020] [Indexed: 12/18/2022] Open
Abstract
AIM To provide a literature review on risk factors and strategies to prevent acute carotid blowout (CBO) syndrome in patients who underwent reirradiation (reRT) for recurrent head and neck (HN) malignancies. PATIENTS AND METHODS Inclusion criteria were: 1) CBO following reRT in the HN region, 2) description on patient-, tumor- or treatment-related risk factors, 3) clinical or radiological signs of threatened or impending CBO, and 4) CBO prevention strategies. RESULTS Thirty-five studies were selected for the analysis from five hundred seventy-seven records. Results provided indications on clinical, radiological and dosimetric parameters possibly associated with higher risk of CBO. Endovascular procedures (artery occlusion and stenting) to prevent acute massive hemorrhage in high risk patients were discussed. CONCLUSION Literature data are still scarce with a low level of evidence. Nevertheless, the present work provides a comprehensive review useful for clinicians as a multidisciplinary pragmatic tool in their clinical practice.
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Affiliation(s)
- Daniela Alterio
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Irene Turturici
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Stefania Volpe
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
| | - Annamaria Ferrari
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Barbara Vischioni
- National Center of Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy
| | | | - Lorenzo Preda
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Department of Radiology, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, Italy
| | - Sara Gandini
- Department of Experimental Oncology, IEO European Institute of Oncology IRCSS, Milan, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Matteo Augugliaro
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Durante
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Simona Arculeo
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Filippo Patti
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Dario Boccuzzi
- Diagnostic Radiology Residency School, University of Pavia, Pavia, Italy
| | - Alessia Casbarra
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Anna Starzynska
- Department of Oral Surgery, Medical University of Gdansk, Poland
| | - Riccardo Santoni
- Radiation Oncology Department, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Li X, Guo K, Feng Y, Guo Y. Analysis of chemotherapy effect on the second primary malignancy for head and neck cancer patients by a nomogram based on SEER database. Cancer Med 2020; 9:8029-8042. [PMID: 32931661 PMCID: PMC7643691 DOI: 10.1002/cam4.3442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022] Open
Abstract
Second primary malignancy (SPM) ranks the second leading cause of death in patients with head and neck cancer (HNC), while studies exploring the risk factors for SPM are limited. To clarify this, we investigated the relationship between the chemotherapy and SPM using the Surveillance, Epidemiology, and End Results (SEER) database. 11 345 patients initially diagnosed with HNC between 1998 and 2016 were selected from the SEER database. First, these patients were divided into two groups according to chemotherapy or not. With Fine and Gray model, the subdistribution hazard ratio (sHR) of chemotherapy was calculated based on Propensity Score Matching (PSM). Second, the 11 345 cases were randomized into a training set and a validation set. Based on the training set, the different cumulative incidence of SPMs between the patients with and without chemotherapy was estimated respectively in the high‐ and low‐risk group according to the scores derived from a nomogram. Chemotherapy was negatively correlated to the SPMs (sHR: 0.847, 95% CI: 0.733‐0.977, P = .023) by conducting competing risk analysis. With chemotherapy, forest plots showed subgroups of squamous cell carcinoma (SCC, sHR: 0.815, 95% CI: 0.7‐0.948, P = .008), 50‐64 years old (sHR:0.794, 95% CI: 0.655‐0.962, P = .019), male (sHR:0.828, 95% CI: 0.703‐0.974, P = .023), and well/moderate histological grade (sHR:0.828, 95% CI: 0.688‐0.996, P = .045) were negatively correlated to SPMs; the nomogram showed the high‐risk population characterized as SCC, elder age, male, and well/moderate histological grade also tended to have lower incidence of SPMs (sHR: 0.805, 95% CI: 0.669‐0.969, P = .022). Despite HNC patients with characteristics of SCC, increased age, male, and well/moderate histological grade had higher risk of a SPM, they were also more likely to be benefitted from chemotherapy to avoid it.
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Affiliation(s)
- Xinrong Li
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, P. R. China
| | - Kaibo Guo
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, P. R. China
| | - Yuqian Feng
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, P. R. China
| | - Yong Guo
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, P. R. China
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Weber L, Blachutzik O, Vielsmeier V, Andorfer K, Matthias C, Künzel J. [Evaluation of oesophagoscopy for staging and restaging of head and neck squamous cell carcinoma]. Laryngorhinootologie 2020; 100:111-119. [PMID: 32590847 DOI: 10.1055/a-1197-6978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Oesophagoscopy is important in diagnostic and follow up investigation in patients with head and neck squamous cell carcinoma (HNSCC). Second primary malignancies of the oesophagus have major impact on therapy of the primary tumour. Considering the low incidence of oesophageal second primaries and the serious complication of oesophageal perforation routine oesophagoscopy is being discussed. MATERIAL AND METHODS Incidence of oesophageal second primaries and complication rates in oesophagoscopy were identified in a systematic review. A retrospective analysis was performed in our own patient collective. To evaluate the current practice at German ENT Clinics a survey was conducted. RESULTS 1053 oesophagoscopies in 800 patients were analysed. In 800 patients seven (0.9 %) synchronous secondary malignancies of the oesophagus occurred. In 253 follow up oesophagoscopies five (2 %) metachronous secondary malignancies were discovered. 14 (1.3 %) complications were detected; oesophageal perforation was only detected in one case (0.1 %). There was no association of certain risk factors with the incidence of secondary malignancies. The review of literature showed an incidence of secondary malignancies for Europe/USA of 1.8 % and for Asia of 4.1 %. Incidence of oesophageal perforation was 0-0.2 %. Survey results showed routine oesophagoscopy in staging (100 %) and regularly in follow up (65.3 %). CONCLUSIONS Oesophagoscopy is a convenient method to detect secondary malignancies of the oesophagus. To allow a selection of patients developing secondary malignancies according to risk profiles further prospective multicentre studies are required.
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Affiliation(s)
- Lena Weber
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Germany
| | - Oliver Blachutzik
- Hals-Nasen-Ohrenklinik und Poliklinik, Johannes-Gutenberg-Universität Mainz, Germany
| | - Veronika Vielsmeier
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Germany
| | - Kornelia Andorfer
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Germany
| | - Christoph Matthias
- Hals-Nasen-Ohrenklinik und Poliklinik, Johannes-Gutenberg-Universität Mainz, Germany
| | - Julian Künzel
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Germany
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Kuhlin B, Kramer B, Nefas V, Rotter N, Aderhold C. Indicators for secondary carcinoma in head and neck cancer patients following curative therapy: A retrospective clinical study. Mol Clin Oncol 2020; 12:403-410. [PMID: 32257195 PMCID: PMC7087480 DOI: 10.3892/mco.2020.2004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 11/21/2019] [Indexed: 12/28/2022] Open
Abstract
Patients with head and neck squamous cell carcinoma (HNSCC) are at risk for local and regional relapse, as well as for occurrence of synchronous or metachronous secondary carcinoma. The aim of this retrospective study was to evaluate the frequency of secondary malignancies amongst HNSCC patients and their association with age, sex and TNM classification, as well as smoking and alcohol abuse. Data from 394 patients with HNSCC who were treated at the Department of Otorhinolaryngology-Head and Neck Surgery of the University Hospital Mannheim between 2011 and 2015 were retrieved and analyzed using t-tests and P≤0.05 was considered statistically significant. Of the 394 patients, 50 (12.7%) developed a secondary carcinoma. In this cohort, >70% of secondary malignancies were diagnosed using clinical inspection or microlaryngoscopy. The majority of secondary malignancies were identified in the oropharynx, with men being more often affected overall. Continued abuse of carcinogenic substances appeared to increase the incidence of secondary carcinoma, whereas the localization of the primary tumor, age, sex or TNM classification were not identified as significant indicators of the occurrence of a secondary carcinoma. The purpose of the present study was to emphasize the importance of intensive follow-up to ensure early detection of secondary malignancies. The aim was to help predict numbers and occurrence within smaller cohorts, and to evaluate the quality of data collected during the establishment of a certified tumor center. To fully evaluate the role of continued exposure to noxious substances and other possible contributing factors, and in order to improve the rate of early diagnosis and establish preventive strategies, multicentered studies with larger cohorts are required.
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Affiliation(s)
- Beatrice Kuhlin
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Mannheim, D-68167 Mannheim, Germany
| | - Benedikt Kramer
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Mannheim, D-68167 Mannheim, Germany
| | - Vytis Nefas
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Mannheim, D-68167 Mannheim, Germany
| | - Nicole Rotter
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Mannheim, D-68167 Mannheim, Germany
| | - Christoph Aderhold
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Mannheim, D-68167 Mannheim, Germany
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I Awad B, Melibari B, Safadi N, Al-Garni M, Al-Hakami HA. Triple Head and Neck Carcinoma: Case Report and Literature Review. Cureus 2020; 12:e7082. [PMID: 32226683 PMCID: PMC7093913 DOI: 10.7759/cureus.7082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Synchronous cancers are multiple cancers that develop within six months of the initial diagnosis while metachronous cancers are those that develop more than six months after the initial diagnosis. A combination of three cancers is seen with several patients, which leads to a bad prognosis, and that of synchronous cancers is worse than that of metachronous cancers. Herein, we describe the case of a 62-year-old woman with multiple metachronous head and neck cancers.
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Affiliation(s)
- Baraa I Awad
- Otolaryngology-Head & Neck Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, SAU
| | | | - Nabeel Safadi
- Radiation Oncology, King Abdulaziz Medical City, Jeddah, SAU
| | - Mohammed Al-Garni
- Otolaryngology-Head & Neck Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Hadi Afandi Al-Hakami
- Otolaryngology - Head and Neck Surgery, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, SAU
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A nationwide population-based study to access the risk of metachronous esophageal cancers in head and neck cancer survivors. Sci Rep 2020; 10:884. [PMID: 31964952 PMCID: PMC6972960 DOI: 10.1038/s41598-020-57630-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/02/2020] [Indexed: 12/29/2022] Open
Abstract
How long esophageal screening should be performed for, and on which sub-groups of head and neck cancer (HNC) survivors, remains uncertain. This retrospective study analyzed data from the Taiwan National Health Insurance Research Database from 1999 to 2013. A total of 68,131 newly- diagnosed HNC patients were enrolled. Subjects who received esophageal endoscopic screening within 6 months after their diagnosis date of index HNC were identified. The incidence trends of secondary primary EC were analyzed using a Cochran-Armitage trend test. Among the 9,707 patients who received index esophageal endoscopy screening, 101 (1.0%) cases of synchronous EC were diagnosed. The 5- and 10-year cumulative incidence rates of metachronous ECs were 1.4% and 2.7%, respectively in those with an initial negative index endoscopic finding. Patients with oropharynx or hypopharynx cancers were at significantly higher risk of developing metachronous ECs compared with those with oral or larynx cancers (10-year incidence rate: 3.3% vs. 0.9%, respectively; hazard ratio: 2.15; 95% confidence intervals: 1.57-2.96). Metachronous EC continues to develop in patients with HNC even at 10-years after treatment for primary HNC. HNC patients, especially those with oropharynx or hypopharynx cancer, may require long-term endoscopic surveillance.
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Bjerkli IH, Jetlund O, Karevold G, Karlsdóttir Á, Jaatun E, Uhlin-Hansen L, Rikardsen OG, Hadler-Olsen E, Steigen SE. Characteristics and prognosis of primary treatment-naïve oral cavity squamous cell carcinoma in Norway, a descriptive retrospective study. PLoS One 2020; 15:e0227738. [PMID: 31945122 PMCID: PMC6964975 DOI: 10.1371/journal.pone.0227738] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/28/2019] [Indexed: 01/04/2023] Open
Abstract
Objectives Incidence of oral cavity squamous cell carcinomas is rising worldwide, and population characterization is important to follow for future trends. The aim of this retrospective study was to present a large cohort of primary oral cavity squamous cell carcinoma from all four health regions of Norway, with descriptive clinicopathological characteristics and five-year survival outcomes. Materials and methods Patients diagnosed with primary treatment-naïve oral cavity squamous cell carcinomas at all four university hospitals in Norway between 2005–2009 were retrospectively included in this study. Clinicopathological data from the electronic health records were compared to survival data. Results A total of 535 patients with primary treatment-naïve oral cavity squamous cell carcinomas were identified. The median survival follow-up time was 48 months (range 0–125 months) after treatment. The median five-year overall survival was found to be 47%. Median five-year disease-specific survival was 52%, ranging from 80% for stage I to 33% for stage IV patients. For patients given treatment with curative intent, the overall survival was found to be 56% and disease-specific survival 62%. Median age at diagnosis was 67 years (range 24–101 years), 64 years for men and 72 years for women. The male: female ratio was 1.2. No gender difference was found in neither tumor status (p = 0.180) nor node status (p = 0.266), but both factors influenced significantly on survival (p<0.001 for both). Conclusions We present a large cohort of primary treatment-naïve oral cavity squamous cell carcinomas in Norway. Five-year disease-specific survival was 52%, and patients eligible for curative treatment had a five-year disease-specific survival up to 62%.
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Affiliation(s)
- Inger-Heidi Bjerkli
- Department of Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Olav Jetlund
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital—Rikshospitalet, Oslo, Norway
| | - Gunnhild Karevold
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital—Rikshospitalet, Oslo, Norway
| | - Ása Karlsdóttir
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Ellen Jaatun
- Department of Otorhinolaryngology, St. Olavs University Hospital, Trondheim, Norway
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Uhlin-Hansen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway
| | - Oddveig G. Rikardsen
- Department of Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elin Hadler-Olsen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sonja E. Steigen
- Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway
- * E-mail:
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Anekpuritanang T, Pongsapich W, Watcharadilokkul T, Ngaotepprutaram P, Pithuksurachai P, Bunbanjerdsuk S. Notch Intracellular Domain (NICD) Expression and Clinical Manifestations of Second Primary Tumor at Esophagus in Patients with Head and Neck Squamous Cell Carcinoma. Onco Targets Ther 2019; 12:11175-11181. [PMID: 31908484 PMCID: PMC6925551 DOI: 10.2147/ott.s227745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 12/02/2019] [Indexed: 12/01/2022] Open
Abstract
Introduction Second primary tumor (SPT) is a major factor that affects the survival of head and neck squamous cell carcinoma (HNSCC) patients, and the esophagus is a common site. Detection of SPT is essential for optimal HNSCC treatment planning and follow-up. Mutation of the NOTCH1 gene is common in head and neck cancer. However, details relating to Notch signaling and clinical outcomes among different primary tumors are still inconclusive. This study aimed to identify the role of the Notch signaling pathway in HNSCC, and to compare NOTCH1 expression in HNSCC compared between those with and without SPT at esophagus while focusing on the Notch intracellular domain (NICD). Methods Twenty-three cases of esophageal SPT and 47 non-SPT controls that were treated at Siriraj Hospital during 2006–2017 were included. Patient information and clinical outcomes were analyzed. NICD expression demonstrated by immunohistochemistry technique in formalin-fixed paraffin-embedded specimens was studied. Results Mean age of SPT and non-SPT was 55.13 and 62.09 years, respectively, and 94.3% of patients were male. Regarding SPT detection, 82.6% were synchronous and 17.4% were metachronous. There was significantly more active smoking among SPT than among non-SPT (87.0% vs 51.1%, p=0.01). Active alcohol use was also significantly greater among SPT than among non-SPT (87.0% vs 61.7%; p=0.04). Hypopharynx was the most common primary tumor site among SPT. Three-year and 5-year survival among SPT patients was 38.0% and 25.3%, respectively. NICD expression was absent in 52.2% of SPT, and in 53.3% of non-SPT. NICD expression intensity was mostly weak or moderate. Conclusion Active smoking and alcohol use were found to be significantly associated with SPT development. A high percentage of NICD inactivation was noted in HNSCC with no significant difference between groups. The Notch signaling pathway is involved in HNSCC tumorigenesis, but may not be a suitable molecular marker for SPT development.
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Affiliation(s)
- Tauangtham Anekpuritanang
- Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Warut Pongsapich
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tanasarun Watcharadilokkul
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Premyot Ngaotepprutaram
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Paveena Pithuksurachai
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sacarin Bunbanjerdsuk
- Section for Translational Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Coca-Pelaz A, Rodrigo JP, Suárez C, Nixon IJ, Mäkitie A, Sanabria A, Quer M, Strojan P, Bradford CR, Kowalski LP, Shaha AR, de Bree R, Hartl DM, Rinaldo A, Takes RP, Ferlito A. The risk of second primary tumors in head and neck cancer: A systematic review. Head Neck 2019; 42:456-466. [PMID: 31750595 DOI: 10.1002/hed.26016] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/22/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Second primary tumors (SPTs) are a common cause of reduced life expectancy in patients treated for head and neck cancer (HNC). This phenomenon forms an area to be addressed during posttreatment follow-up. METHODS We conducted a systematic review of literature following PRISMA guidelines, from 1979 to 2019, to investigate incidence of SPTs, synchronous, and metachronous, in HNC population. RESULTS Our review includes data of 456 130 patients from 61 articles. With a minimum follow-up of 22 months, mean incidence of SPTs was 13.2% (95% CI: 11.56-14.84): 5.3% (95% CI: 4.24-6.36) for synchronous SPTs and 9.4% (95% CI: 7.9-10.9) for metachronous SPTs. The most frequent site for SPTs was head and neck area, followed by the lungs and esophagus. CONCLUSION Although with wide variations between studies, the rate of SPTs in HNC patients is high. Given the impact in the prognosis, we must develop strategies for the early diagnosis of SPTs.
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Affiliation(s)
- Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias-University of Oviedo, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Oviedo, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias-University of Oviedo, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Oviedo, Spain
| | - Carlos Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Oviedo, Spain
| | - Iain J Nixon
- Ear, Nose and Throat Department, NHS Lothian, University of Edinburgh, Edinburgh, UK
| | - Antti Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia, CEXCA. Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia
| | - Miquel Quer
- Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Carol R Bradford
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Luiz P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
| | - Ashok R Shaha
- Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dana M Hartl
- Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France.,Laboratoire de Phonétique et de Phonologie, Paris, France
| | | | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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Comparison of 18F-FDG PET/MRI, MRI, and 18F-FDG PET/CT for the detection of synchronous cancers and distant metastases in patients with oropharyngeal and hypopharyngeal squamous cell carcinoma. Eur J Nucl Med Mol Imaging 2019; 47:94-104. [PMID: 31606831 DOI: 10.1007/s00259-019-04510-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/23/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE In this prospective study, we sought to compare the clinical utility of fluorodeoxyglucose PET/MRI, MRI, and PET/CT in the detection of synchronous cancers and distant metastases in patients with oropharyngeal and hypopharyngeal squamous cell carcinoma (OHSCC). METHODS We examined 198 consecutive patients with biopsy-proven OHSCC who agreed to receive chemoradiation. All patients underwent pretreatment PET/MRI and PET/CT on the same day. Patients were followed-up for a minimum of 12 months or until death. The McNemar's test and receiver-operating characteristic (ROC) curves were used to compare sensitivity/specificity and the diagnostic capabilities of PET/MRI, MRI, and PET/CT, respectively. RESULTS We identified 55 patients (27.7%) who had synchronous cancers and/or distant metastases (number of involved sites: 83). The results of site-based analysis revealed that the sensitivity of PET/MRI was 15.7% higher than that of MRI (73.5% versus 57.8%, p < 0.001) and 3.6% higher compared with PET/CT (73.5% versus 69.9%, p = 0.083), whereas the sensitivity of PET/CT was 12.1% higher than that of MRI (69.9% versus 57.8%, p = 0.012). On a patient-basis, ROC curve analysis demonstrated that PET/MRI yielded a greater area under curve than MRI (0.930 versus 0.905, p = 0.023). There were no significant differences in terms of diagnostic capability between MRI and PET/CT (0.905 versus 0.917, p = 0.469) and between PET/MRI and PET/CT (0.930 versus 0.917, p = 0.062). CONCLUSIONS In our cohort, PET/MRI showed a significantly higher diagnostic capability than MRI and no significant difference compared with PET/CT for the detection of synchronous cancers or distant metastases in patients with OHSCC.
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41
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Bisht N, Singh S, Sarin A, Gupta S, Singh HP, Kapoor A, Mulajker D, Joshi R, Purkayastha A, Mishra PS, Shelly D. The Conundrum of Dual Primary Malignancies: Four Years’ Experience of a Single Tertiary Care Institute in India. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_69_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Encountering more than one malignancy in a cancer patient is no longer uncommon; this increasing incidence is mostly attributable to the improvements in life expectancy, awareness, and diagnostic facilities. This article aims to highlight this institute’s experience in diagnosis and treatment of patients of multiple primary malignancies and a comprehensive review of literature. Materials and Methods: This is a descriptive study of retrospectively collected data of a single institution over 4 years from 2013 to 2016. Known cases of cancer who were diagnosed with a second primary malignancy were included in the study. Various details such as age, sex, site of disease, temporal relation of two cancers (synchronous or metachronous), family history, tobacco use, treatment given, and survival at 1 year were recorded, organized in a tabular form, analyzed, and described. Results: A total of 29 cases of dual malignancies comprising 0.74% of a total of 3879 patients of cancer were encountered. Seventy-two percent of the cases were metachronous and 5 years was the mean time interval between tumors. There was a female preponderance, and the average age was 56 years. Breast was the most common site of malignancy. At 1 year from diagnosis of second primary, 69% of the patients were alive and 27% were disease-free. Conclusion: Second primary in a patient of cancer is becoming increasingly common and the suspicion of the same should always be borne in mind during follow-up. Prognosis as well as intent of treatment depends on respective stages of the two malignancies.
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Affiliation(s)
- Niharika Bisht
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Sankalp Singh
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Arti Sarin
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Samir Gupta
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Harinder Pal Singh
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Amul Kapoor
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Deepak Mulajker
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Richa Joshi
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Abhishek Purkayastha
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | | | - Divya Shelly
- Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India
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42
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Ng SP, Pollard C, Kamal M, Ayoub Z, Garden AS, Bahig H, Gunn GB, Frank SJ, Skinner HD, Phan J, Berends J, Morrison WH, Johnson JM, Ferrarotto R, Sturgis EM, Mohamed ASR, Lai SY, Fuller CD, Rosenthal DI. Risk of second primary malignancies in head and neck cancer patients treated with definitive radiotherapy. NPJ Precis Oncol 2019; 3:22. [PMID: 31583278 PMCID: PMC6764977 DOI: 10.1038/s41698-019-0097-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 09/10/2019] [Indexed: 12/31/2022] Open
Abstract
Second primary malignancy (SPM) may occur after index head and neck cancer (HNC) treatment. This study evaluated the prevalence and outcome of SPM in patients with HNC treated with definitive radiotherapy. Eligible patients include those with index mucosal HNC treated with definitive radiotherapy between 2000 and 2010. SPM was defined as an invasive cancer at a noncontiguous site diagnosed at least 6 months after completion of radiotherapy. Clinical data were collected, and the Kaplan–Meier method was used to estimate overall survival. In total, 1512 patients were studied. The majority of patients had index oropharyngeal cancer (86%). In all, 130 (9%) patients developed a SPM. The risk of SPM increased exponentially with time with 5-, 10-, and 15-year rates of 4, 10, and 25%. Half of SPMs were within the head and neck or thoracic regions. SPM rates were significantly higher (p < 0.0001) in current smokers and former smokers than never smokers with 5-, 10-, and 15-year risk being: never smoker (2, 4, 14%), former smokers with <10-pack year (5, 10, 23%), former smokers with ≥10-pack year (5, 14, 35%), and current smokers (6, 18, 32%). In total, 102 (78%) had subsequent curative-intent therapy. The 5-year overall survival from SPM was 44%. The majority of SPMs were in those with significant smoking history reflecting the same risk factor as for the index mucosal HNC. Nearly one in two patients with SPMs were salvaged underscoring the importance of regular surveillance for SPMs.
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Affiliation(s)
- Sweet Ping Ng
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA.,2Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria Australia
| | - Courtney Pollard
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Mona Kamal
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Zeina Ayoub
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Adam S Garden
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Houda Bahig
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - G Brandon Gunn
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Steven J Frank
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Heath D Skinner
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Jack Phan
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Joel Berends
- 3The University of Texas Health Science Center, San Antonio, TX USA
| | - William H Morrison
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Jason M Johnson
- 4Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Renata Ferrarotto
- 5Department of Thoracic Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Erich M Sturgis
- 6Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Abdallah S R Mohamed
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Stephen Y Lai
- 6Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Clifton D Fuller
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - David I Rosenthal
- 1Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
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Haremza C, Baert M, Pascual C, Biet-Hornstein A, Page C. Head and neck squamous cell carcinoma and metachronous second primaries. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:367-372. [PMID: 31208879 DOI: 10.1016/j.anorl.2019.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To assess the rate of second (or more) primaries after treatment for head and neck squamous cell carcinoma (HNSCC), and survival compared to patients with a single head and neck cancer. MATERIAL AND METHOD A single-center retrospective study was performed in a University Hospital Center in 541 patients between 2002 and 2010. RESULTS One hundred and forty-one patients (26.06%) presented 172 metachronous cancers. Overall 5-year survival was 20.3% with and 38.1% without metachronous cancer. Median and mean survival were respectively 21.9 and 51 months in patients with a single cancer, versus 13.9 and 26.5 months in case of metachronous cancer. Specific survival was comparable to overall survival. All-cause and specific survival were significantly poorer in metachronous cancer (P=0.001; log-rank α=0.05). CONCLUSION At least a quarter of HNSCC patients go on to develop a metachronous second primary. These are of poor prognosis, whatever their location.
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Affiliation(s)
- C Haremza
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France
| | - M Baert
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France
| | - C Pascual
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France
| | - A Biet-Hornstein
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France
| | - C Page
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France.
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44
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Mirkheshti N, Mohebtash M. A rare case of bilateral breast lobular carcinoma coexisting with primary breast follicular lymphoma. J Community Hosp Intern Med Perspect 2019; 9:155-158. [PMID: 31061694 PMCID: PMC6487443 DOI: 10.1080/20009666.2019.1579611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 01/31/2019] [Indexed: 11/25/2022] Open
Abstract
CLINICAL PRACTICE POINTS ● Co-existence of breast cancer and lymphoma is a rare condition. A few cases of synchronous breast ductal carcinoma and lymphoma have been reported in the literature. However, to our knowledge this is the first case report of a bilateral breast lobular carcinoma co-presenting with follicular lymphoma. ● Little is known about the pathophysiology of synchronous cancers of different tumor types, especially solid tumors co-existing with hematologic malignancies. In-depth review of these cases can shed light on underlying mechanism leading to synchronous cancer development.
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Affiliation(s)
- Nooshin Mirkheshti
- Department of Internal Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Mahsa Mohebtash
- MedStar Franklin Square Cancer Center at Loch Raven Campus, Baltimore, MD, USA
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45
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van de Goor RMGE, Hardy JCA, van Hooren MRA, Kremer B, Kross KW. Detecting recurrent head and neck cancer using electronic nose technology: A feasibility study. Head Neck 2019; 41:2983-2990. [PMID: 31012533 PMCID: PMC6767436 DOI: 10.1002/hed.25787] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 02/19/2019] [Accepted: 04/09/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The aim of this feasibility study was to assess the diagnostic performance of an electronic nose (e-nose) as a noninvasive diagnostic tool in detecting locoregional recurrent and/or second (or third) primary head and neck squamous cell carcinoma (HNSCC) after curative treatment. METHODS Using an e-nose (Aeonose, The eNose Company, Zutphen, The Netherlands), breath samples were collected from patients after curative treatment of an HNSCC with a locoregional recurrence or second (or third) primary tumor (N = 20) and from patients without evidence of recurrent disease (N = 20). Analyses were performed utilizing artificial neural networking based on patterns of volatile organic compounds. RESULTS A diagnostic accuracy of 83% was observed in differentiating follow-up patients with locoregional recurrent or second (or third) primary HNSCC from those without evidence of disease. CONCLUSION This study has demonstrated the feasibility of using an e-nose to detect locoregional recurrent and/or second (or third) primary HNSCC.
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Affiliation(s)
- Rens M G E van de Goor
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Otorhinolaryngology, Head and Neck Surgery, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Joey C A Hardy
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michel R A van Hooren
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bernd Kremer
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kenneth W Kross
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
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Kishimoto Y, Harada H, Funakoshi M, Miyamoto SI, Suehiro A, Kitamura M, Muto M, Tateya I, Omori K. Endoscopic laryngo-pharyngeal surgery for elderly patients. Auris Nasus Larynx 2019; 46:279-284. [DOI: 10.1016/j.anl.2018.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/08/2018] [Accepted: 08/13/2018] [Indexed: 12/24/2022]
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47
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Toratani S, Ogawa I, Sasahara H, Yoshioka Y, Kanda T, Tani R, Okamoto T. Pathological factors involved in local failure in squamous cell carcinoma of the oral cavity: retrospective study and proposal of a new clinical classification. Int J Oral Maxillofac Surg 2019; 48:143-151. [DOI: 10.1016/j.ijom.2018.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 04/03/2018] [Accepted: 07/06/2018] [Indexed: 01/28/2023]
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48
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Chest radiography or chest CT plus head and neck CT versus 18F-FDG PET/CT for detection of distant metastasis and synchronous cancer in patients with head and neck cancer. Oral Oncol 2019; 88:109-114. [DOI: 10.1016/j.oraloncology.2018.11.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 11/13/2018] [Accepted: 11/18/2018] [Indexed: 12/18/2022]
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49
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Prognosis associated with synchronous or metachronous multiple primary malignancies in patients with completely resected non-small cell lung cancer. Surg Today 2018; 49:343-349. [PMID: 30417262 DOI: 10.1007/s00595-018-1738-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 10/27/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate the influence of multiple primary malignancies (MPMs) on the prognosis of patients with completely resected non-small cell lung cancer (NSCLC). METHODS The subjects of this retrospective study were 521 patients who underwent complete curative pulmonary resection for NSCLC. Patients were divided into two groups: those with and those without MPMs. RESULTS The 521 NSCLC patients included 184 patients (35.3%) with MPMs and 337 patients without MPMs. The overall 5-year survival rates for patients with vs those without MPMs were 66.1 and 75.6%, respectively (p = 0.0061). According to multivariate analysis, MPMs, age, gender, pathological stage, and interstitial pneumonia were independent predictors of prognosis. The 47 patients with synchronous MPMs and the 82 patients with metachronous MPMs found within the last 5 years had significantly poorer prognoses than patients without MPMs (p = 0.0048 and p = 0.0051, respectively). However, the prognoses of the 55 patients with metachronous MPMs that had been present for over 5 years did not differ from those of the patients without MPMs. CONCLUSIONS NSCLC patients with synchronous MPMs or metachronous MPMs diagnosed within the last 5 years had poor prognoses. Decisions about the best therapeutic strategies require comprehensive consideration of the organ location, malignant potential, recurrence, and prognosis of the MPMs. In contrast, decisions about the best therapeutic strategies for NSCLC patients with metachronous MPMs present for over 5 years should be based solely on the NSCLC.
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50
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Adeel M, Siddiqi MI. Metachronous second primary malignancy in head and neck cancer patients: is five years of follow-up sufficient? J Korean Assoc Oral Maxillofac Surg 2018; 44:220-224. [PMID: 30402413 PMCID: PMC6209691 DOI: 10.5125/jkaoms.2018.44.5.220] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/17/2017] [Accepted: 03/02/2018] [Indexed: 11/07/2022] Open
Abstract
Objectives The aim of this study was to determine the incidence and characteristics of second primary malignancy (SPM) in patients with head and neck squamous cell carcinoma treated at a tertiary care hospital. Materials and Methods We retrospectively reviewed the medical records of 221 patients who underwent surgery with or without adjuvant treatment for head and neck cancer from 2000 to 2002. Data of age, sex, risk factors, sites of primary and SPM, TNM stage of primary tumor, incidence of SPM, and survival were collected from medical charts. Results Eighteen patients developed SPM during a median follow-up of 67 months, with an overall incidence of 8.14%. In addition, 77.7% of SPMs occurred in the oral cavity, followed by 11% in the lungs. The 5-year overall survival after the diagnosis of SPM in the head or neck was 70%, compared to 30% for SPM in other body regions. Conclusion Considering a high incidence of SPM, i.e., 8.14%, in a mean follow-up period of 67 months suggests the need for long-term follow-up. Since treatment of SPM has shown an acceptable survival rate, early detection and curative therapy should be emphasized.
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Affiliation(s)
- Mohammad Adeel
- Department of Surgical Oncology, Section of Head and Neck Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan
| | - Moghira Iqbal Siddiqi
- Department of Otolaryngology & Head and Neck Surgery, The Aga Khan University Hospital, Karachi, Pakistan
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