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Hua R, Yao HF, Song ZY, Yu F, Che ZY, Gao XF, Huo YM, Liu W, Sun YW, Yang MW, Yang JY, Zhang S, Zhang JF. Evaluation of a new scoring system for assessing nerve invasion in resected pancreatic cancer: A single-center retrospective analysis. Cancer Lett 2024; 603:217213. [PMID: 39244006 DOI: 10.1016/j.canlet.2024.217213] [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: 05/14/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/09/2024]
Abstract
Nerve invasion (NI) is a characteristic feature of pancreatic cancer. Traditional dichotomous statements on the presence of NI are unreasonable because almost all cases exhibit NI when sufficient pathological sections are examined. The critical implications of NI in pancreatic cancer highlight the need for a more effective criterion. This study included 511 patients, who were categorized into a training group and a testing group at a ratio of 7:3. According to the traditional definition, NI was observed in 91.2 % of patients using five pathological slides in our study. The prevalence of NI increased as more pathological slides were used. The criterion of 'two points of intraneural (endoneural) invasion in the case of four pathological slides' has the highest receiver operating characteristic (ROC) score. Based on this new criterion, NI was proved to be an independent prognostic factor for overall survival (OS) and disease-free survival (DFS) and was also correlated with tumor recurrence (P = 0.004). Interestingly, gemcitabine-based chemotherapy regimen is an independent favorable factor for patients with high NI. In the high NI group, patients who received a gemcitabine-based regimen exhibited a better prognosis than those who did not receive the gemcitabine-based regimen for OS (P = 0.000) and DFS (P = 0.001). In conclusion, this study establishes assessment criteria to evaluate the severity of NI in order to predict patient outcomes.
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Affiliation(s)
- Rong Hua
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China
| | - Hong-Fei Yao
- Department of Hepato-Biliary-Pancreatic Surgery, General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, PR China
| | - Zi-Yu Song
- Department of Pathology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China
| | - Feng Yu
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China
| | - Zhao-Yu Che
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China
| | - Xiao-Fang Gao
- Department of Pathology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China
| | - Yan-Miao Huo
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China
| | - Wei Liu
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China
| | - Yong-Wei Sun
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China
| | - Min-Wei Yang
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China.
| | - Jian-Yu Yang
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China.
| | - Shan Zhang
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200240, PR China.
| | - Jun-Feng Zhang
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, PR China; Shanghai Key Laboratory for Cancer Systems Regulation and Clinical Translation, Department of General Surgery, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, PR China.
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Jia Y, Liu Y, Yang H, Yao F. Adenoid cystic carcinoma: insights from molecular characterization and therapeutic advances. MedComm (Beijing) 2024; 5:e734. [PMID: 39263605 PMCID: PMC11387731 DOI: 10.1002/mco2.734] [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: 03/06/2024] [Revised: 08/24/2024] [Accepted: 08/26/2024] [Indexed: 09/13/2024] Open
Abstract
Adenoid cystic carcinoma (ACC) is a malignant tumor primarily originating from the salivary glands, capable of affecting multiple organs. Although ACC typically exhibits slow growth, it is notorious for its propensity for neural invasion, local recurrence, and distant metastasis, making it a particularly challenging cancer to treat. The complexity of ACC's histological and molecular features poses significant challenges to current treatment modalities, which often show limited effectiveness. Recent advancements in single-cell RNA-sequencing (scRNA-seq) have begun to unravel unprecedented insights into the heterogeneity and subpopulation diversity within ACC, revealing distinct cellular phenotypes and origins. This review delves into the intricate pathological and molecular characteristics of ACC, focusing on recent therapeutic advancements. We particularly emphasize the insights gained from scRNA-seq studies that shed light on the cellular landscape of ACC, underscoring its heterogeneity and pathobiology. Moreover, by integrating analyses from public databases, this review proposes novel perspectives for advancing treatment strategies in ACC. This review contributes to the academic understanding of ACC by proposing novel therapeutic approaches informed by cutting-edge molecular insights, paving the way for more effective, personalized therapeutic approaches for this challenging malignancy.
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Affiliation(s)
- Yunxuan Jia
- Department of Thoracic Surgery Shanghai Chest Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Yupeng Liu
- Department of Thoracic Surgery Tumor Hospital Affiliated to Nantong University Nantong Tumor Hospital Nantong China
| | - Haitang Yang
- Department of Thoracic Surgery Shanghai Chest Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Feng Yao
- Department of Thoracic Surgery Shanghai Chest Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
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Mauthe T, Meerwein CM, Holzmann D, Soyka MB, Mueller SA, Held U, Freiberger SN, Rupp NJ. Outcome-oriented clinicopathological reappraisal of sinonasal adenoid cystic carcinoma with broad morphological spectrum and high MYB::NFIB prevalence. Sci Rep 2024; 14:18655. [PMID: 39134604 PMCID: PMC11319476 DOI: 10.1038/s41598-024-69039-6] [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: 07/10/2023] [Accepted: 07/30/2024] [Indexed: 08/15/2024] Open
Abstract
Adenoid cystic carcinoma (AdCC) is a salivary gland neoplasm that infrequently appears in the sinonasal region. The aim of this study was to evaluate the outcome and clinicopathological parameters of sinonasal AdCC. A retrospective analysis was conducted on all cases of AdCC affecting the nasal cavity or paranasal sinuses between 2000 and 2018 at the University Hospital Zurich. Tumor material was examined for morphological features and analyzed for molecular alterations. A total of 14 patients were included. Mean age at presentation was 57.7 years. Sequencing revealed MYB::NFIB gene fusion in 11/12 analyzable cases. Poor prognostic factors were solid variant (p < 0.001), histopathological high-grade transformation (p < 0.001), and tumor involvement of the sphenoid sinus (p = 0.02). The median recurrence-free survival (RFS) and OS were 5.2 years and 11.3 years. The RFS rates at 1-, 5-, and 10-year were 100%, 53.8%, and 23.1%. The OS rates at 1-, 5-, and 10- years were 100%, 91.7%, and 62.9%, respectively. In Conclusion, the solid variant (solid portion > 30%), high-grade transformation, and sphenoid sinus involvement are negative prognostic factors for sinonasal AdCC. A high prevalence of MYB::NFIB gene fusion may help to correctly classify diagnostically challenging (e.g. metatypical) cases.
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Affiliation(s)
- Tina Mauthe
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
| | - Christian M Meerwein
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Simon A Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Ulrike Held
- Department of Biostatistics, at the Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Sandra N Freiberger
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
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Phillips AL, Li C, Liang J, Sheyn A, Rastatter JC, Chelius DC, Orbach D, Richard C. Adenoid cystic carcinoma of the parotid and submandibular glands in children and young adults: A population-based study. Pediatr Blood Cancer 2024; 71:e30928. [PMID: 38418934 PMCID: PMC10959679 DOI: 10.1002/pbc.30928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES This study aims to analyze the behavior and treatment of adenoid cystic carcinoma (AdCC) in the pediatric and young adult population and to identify factors affecting overall survival (OS). MATERIALS AND METHODS The study analyzed salivary gland malignancies in patients aged 0-21 with AdCC histology using the National Cancer Database from 2004 to 2018. RESULTS A total of 72 patients (59.7% parotid, 36.1% submandibular, 1.4% sublingual, 2.8% unspecified) met criteria. Median age was 18 years [range: 0-21]. High-grade dysplasia was present in 67% of cases. Therapy consisted of primary surgery for all cases, regional lymph node dissection (LND) (74%), radiotherapy (71%), chemotherapy (8%), and chemoradiation (7%). The 5-year OS rate was 93.2% [95% confidence interval (CI): 86.9%-99.9%], respectively. Patients who underwent associated LND had improved OS (p = .0083, log-rank test) with a 5-year OS at 82.4% [95% CI: 66.1%-100%] versus 97.6% [95% CI: 93.0%-100%]. A significant difference in OS was found with unfavorable outcomes after positive marginal status: 5-year OS 84.1% [95% CI: 71.0%-99.7%] versus 100% [95% CI: 100%]; p < .001. Adjuvant therapy did not seem to impact the outcome. CONCLUSION This study confirms that AdCC in children and young adults has an overall good prognosis despite frequent high grade. It suggests that cervical LND may be of importance, but the value of systematic adjuvant therapy is not confirmed. These findings emphasize the importance and relevance of population-based studies in shaping clinical practice and informing the design of future prospective investigations.
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Affiliation(s)
- Alisa L Phillips
- University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - Cai Li
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jia Liang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Anthony Sheyn
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
- Division of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jeffrey C Rastatter
- Division of Pediatric Otolaryngology - Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Daniel C Chelius
- Department of Otolaryngology - Head and Neck Surgery, Pediatric Head and Neck Tumor Program, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Celine Richard
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
- Division of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Xu Z, Peng C, Zhang Y, Chen L, Zhai J. Adenoid cystic carcinoma of the retromolar pad region: A case report. Int J Surg Case Rep 2024; 117:109567. [PMID: 38522303 PMCID: PMC10973809 DOI: 10.1016/j.ijscr.2024.109567] [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: 01/04/2024] [Revised: 03/12/2024] [Accepted: 03/16/2024] [Indexed: 03/26/2024] Open
Abstract
INTRODUCTION Adenoid cystic carcinoma (ACC) is one of the most common salivary gland malignancies, mostly occurs in the major and minor salivary glands in the oral and maxillofacial region. The development of ACC in the retromolar pad is extremely rare, which limits establishing proper diagnosis and management. PRESENTATION OF CASE A patient described a 2-month history of finding a mass behind the lower left posterior teeth. Based on the physical examination and radiographic findings, we got an initial impression of a benign mucocele, the nature of which was to be investigated further. Pathological examination of the resected tissue resulted in a diagnosis of ACC. Follow-up visits showed no recurrence during the subsequent 54 months. DISCUSSION In cases with an uncertain diagnosis based on medical history, clinical features and imaging examinations, it is important to proceed carefully with the possibility of a tumor in mind. CONCLUSION ACC in the retromolar pad is rare and can be easily misdiagnosed. Clinical, radiographic, and pathological evidence confirm a definitive diagnosis. Long-term follow-up is important for the full analysis of ACC treatment.
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Affiliation(s)
- Zixian Xu
- Department of Basic Science of Stomatology, School of Stomatology Kunming Medical University, 1168 Chunrong West Road, Chenggong Zone, Kunming 650500, People's Republic of China
| | - Canbang Peng
- Department of Oral and Maxillofacial Surgery, School of Stomatology Kunming Medical University, 1088 Middle Haiyuan Road, High-Tech Zone, Kunming 650106, People's Republic of China
| | - Yuhao Zhang
- Department of Oral Medicine, Stomatological Center of the First People's Hospital of Yunnan Province, 157 Jinbi Road, Xishan Zone, Kunming 650034, People's Republic of China
| | - Lizhong Chen
- Department of Oral Medicine, School of Stomatology Kunming Medical University, 1088 Middle Haiyuan Road, High-Tech Zone, Kunming 650106, People's Republic of China
| | - Jiemei Zhai
- Department of Basic Science of Stomatology, School of Stomatology Kunming Medical University, 1088 Middle Haiyuan Road, High-Tech Zone, Kunming 650106, People's Republic of China.
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Moriwaki K, Ayani Y, Kuwabara H, Terada T, Higashino M, Kawata R. Differential expression of TRKB tyrosine kinase in the two histological types of parotid salivary duct carcinoma with cancer aggressiveness. Oral Oncol 2024; 151:106751. [PMID: 38479153 DOI: 10.1016/j.oraloncology.2024.106751] [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: 10/18/2023] [Revised: 03/06/2024] [Accepted: 03/06/2024] [Indexed: 04/06/2024]
Abstract
Parotid salivary duct carcinoma (SDC) is a rare and aggressive parotid gland carcinoma (PGC). SDC has two origins: de novo and ex pleomorphic adenoma (SDC ex PA); however, because of its rarity, the clinical and molecular features of the two types of SDC are not sufficiently understood. Here, we studied the differences in their clinicopathological and molecular features using clinical specimens while comparing them to those of adenoid cystic carcinoma (AdCC), an intermediate-grade PGC. Clinicopathological analysis of tissues from patients with PGC revealed significant associations between histological types and malignant phenotypes, including nodal metastasis, recurrence, vascular invasion, and neural invasion, and revealed more malignant phenotypes of de novo SDC than of SDC ex PA. The de novo SDC showed a significantly higher frequency of intra-neural invasion (intra-NI) and vascular invasion than AdCC and SDC ex PA. PGCs with high intra-NI were significantly correlated with malignant phenotypes and survival rates. Recently, we observed the overexpression of tropomyosin receptor kinase B (TRKB), a receptor tyrosine kinase, in PGC cells. Here, immunohistochemical and clinicopathological analyses showed that TRKB was highly expressed in SDC cells, particularly de novo SDC cells, and was significantly associated with poor survival and highly malignant phenotypes, including intra-NI and vascular invasion. Collectively, these data show that TRKB expression is significantly elevated in PGC, particularly in de novo SDC, and can be one of the biomarkers of their aggressiveness.
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Affiliation(s)
- Kazumasa Moriwaki
- Department of Pharmacology, Faculty of Medicine, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan.
| | - Yusuke Ayani
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Hiroko Kuwabara
- Department of Pathology, Faculty of Medicine, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Tetsuya Terada
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Masaaki Higashino
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Ryo Kawata
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
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Liu S, Yang J, Lu H, Wu Y, Yang W, Xu W, Zhang C. Adenoid cystic carcinoma of submandibular gland: Emphasis on locoregional metastasis and prognosis. Oral Dis 2024; 30:1152-1162. [PMID: 36564993 DOI: 10.1111/odi.14478] [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: 10/02/2022] [Revised: 11/30/2022] [Accepted: 12/17/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To analyze the clinicopathological features, locoregional or distant metastasis, and prognosis of adenoid cystic carcinoma of submandibular gland (SMG-AdCC). METHODS The clinicopathological data of 80 patients with SMG-AdCC from January 2005 to December 2017 were analyzed retrospectively, and the relationships between different parameters of SMG-AdCC and its locoregional or distant metastasis or prognosis were analyzed. RESULTS As of December 2019, 41 patients (51.25%) were tumor-free, while 20 patients were found to be living with tumors. The locoregional metastasis rate of grade II-III SMG-AdCC were found to be significantly higher than that of grade I. The five-year DFS and OS rates were 70.8% and 87.1%, respectively. Univariate analysis showed that clinical size, extraglandular extension, pathological grade, pathological node (pN) status, and perineural invasion were correlated with DFS. Multivariate Cox regression analysis showed that pathological grade and extraglandular extension were independent prognostic factors for DFS; pN status and extraglandular extension were independent prognostic factors impacting OS. CONCLUSION The pathological grade is a risk factor for locoregional metastasis of SMG-AdCC. Pathological grade, pN status, and status of extraglandular extension are independent prognostic factors for DFS/OS in SMG-AdCC patients.
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Affiliation(s)
- Shengwen Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Yang
- Department of stomatology, Hangzhou Medical College affiliated Lin'An people's hospital, The first people's hospital of Hangzhou Lin'an district, Hangzhou, China
| | - Hao Lu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yifan Wu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjun Yang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wanlin Xu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chenping Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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8
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Gu B, Chi Y, Wu W, Zhong Y, Zhang J, Zhang J. Prognostic factors of palatal adenoid cystic carcinoma: A single-center analysis of 85 cases. Laryngoscope Investig Otolaryngol 2024; 9:e1236. [PMID: 38525125 PMCID: PMC10960245 DOI: 10.1002/lio2.1236] [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: 07/01/2023] [Revised: 10/06/2023] [Accepted: 02/25/2024] [Indexed: 03/26/2024] Open
Abstract
Objective The purpose of this retrospective study was to describe the clinicopathological characteristics of primary adenoid cystic carcinoma (ACC) of the palate and to identify the factors affecting prognosis. Methods The medical records of 85 patients with primary ACC of the palate treated with surgery, with or without adjuvant radiotherapy/chemotherapy, from 2009 to 2019 were reviewed. The relationship of different clinical parameters with locoregional recurrence (LR), distant metastasis (DM), and overall survival (OS) were analyzed. Results Median follow-up time was 44.6 months. LR and DM rates were 24.7% and 25.9%, respectively, and the 5-year OS and disease-free survival (DFS) rates were 85.9% and 55.1%, respectively. Multivariate analysis showed that positive margins were independently associated with the risk of LR (p < .001). Positive margins (p = .001) and high histological grade (p = .031) were significantly associated with shorter OS. Conclusion Positive surgical margins are a strong adverse prognostic factor affecting LR and OS in patients with ACC; apart from that, high histopathological grade is an independent predictor of poor OS. Level of Evidence Level 3 (Prognosis - Cohort study).
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Affiliation(s)
- Baoxin Gu
- Department of Oral and Maxillofacial SurgeryPeking University School and Hospital of StomatologyBeijingChina
- National Center of StomatologyBeijingChina
- National Clinical Research Center for Oral DiseasesBeijingChina
| | - Yanting Chi
- National Center of StomatologyBeijingChina
- National Clinical Research Center for Oral DiseasesBeijingChina
- Department of Oral PathologyPeking University School and Hospital of StomatologyBeijingChina
| | - Wenjie Wu
- Department of Oral and Maxillofacial SurgeryPeking University School and Hospital of StomatologyBeijingChina
- National Center of StomatologyBeijingChina
- National Clinical Research Center for Oral DiseasesBeijingChina
| | - Yiwei Zhong
- Department of Oral and Maxillofacial SurgeryPeking University School and Hospital of StomatologyBeijingChina
- National Center of StomatologyBeijingChina
- National Clinical Research Center for Oral DiseasesBeijingChina
| | - Jianyun Zhang
- National Center of StomatologyBeijingChina
- National Clinical Research Center for Oral DiseasesBeijingChina
- Department of Oral PathologyPeking University School and Hospital of StomatologyBeijingChina
| | - Jie Zhang
- Department of Oral and Maxillofacial SurgeryPeking University School and Hospital of StomatologyBeijingChina
- National Center of StomatologyBeijingChina
- National Clinical Research Center for Oral DiseasesBeijingChina
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de Morais EF, de Farias Morais HG, de Almeida Freitas R, Coletta RD. Prognostic Significance of Histopathological Parameters for Salivary Gland Adenoid Cystic Carcinoma. Dent J (Basel) 2023; 11:262. [PMID: 37999026 PMCID: PMC10670021 DOI: 10.3390/dj11110262] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor that accounts for approximately 1% of all head and neck cancers. Despite its initial indolent behavior, long-term survival is poor due to locoregional recurrence in approximately 40% and distant metastasis in up to 60% of patients who undergo radical treatment. The histological parameters of ACC and the combination of these parameters in histopathological grading systems provide valuable prognostic information about the clinical course of the disease. Within this context, this review aims to analyze the impact of histopathological parameters, individual or combined in histopathological grading systems of malignancy, on ACC prognosis. Individual histopathological parameters such as solid pattern, presence of tumor necrosis, high-grade transformation, dominance of the epithelial component, presence of perineural and lymphovascular invasion, and positive surgical margins have negative impacts on the survival of patients with ACC. There are currently four histopathological grading systems for ACC; however, few studies have validated these systems and most of them explored small cohorts with short follow-up. Considering that the application of grading systems has been associated with ACC prognosis, a broader validation will allow not only their use for prognostic prediction but also assist in treatment planning.
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Affiliation(s)
- Everton Freitas de Morais
- Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba 13414-018, SP, Brazil;
| | - Hannah Gil de Farias Morais
- Postgraduate Program in Oral Science, Federal University of Rio Grande do Norte, Natal 59000-000, RN, Brazil; (H.G.d.F.M.); (R.d.A.F.)
| | - Roseana de Almeida Freitas
- Postgraduate Program in Oral Science, Federal University of Rio Grande do Norte, Natal 59000-000, RN, Brazil; (H.G.d.F.M.); (R.d.A.F.)
| | - Ricardo D. Coletta
- Department of Oral Diagnosis and Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba 13414-018, SP, Brazil
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Na'ara S, Subramaniam N, Deganello A, Shinnawi S, Billan S, Mattavelli D, Ferrari M, Balasubramanian D, Thankappan K, Iyer S, Gil Z. Primary Tumor Staging for Oral Cancer and a Proposed Modification Incorporating Perineural Invasion: An International Multicenter Study. Adv Biol (Weinh) 2023; 7:e2300162. [PMID: 37415540 DOI: 10.1002/adbi.202300162] [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: 04/26/2023] [Revised: 06/02/2023] [Indexed: 07/08/2023]
Abstract
The objective of this study is to determine if the incorporation of perineural invasion (PNI) into the T-classification would improve the prognostic performance of TNM-8. An international, multicenter study of 1049 patients with oral cavity squamous cell carcinoma that were treated from 1994 to 2018 is performed. Various classification models are developed within each T-category and evaluated using the Harrel-concordance index (C-index), Akaike-information criterion (AIC), and visual inspection. Stratification into distinct prognostic categories, with internal validation, is performed using bootstrapping analysis (SPSS and R-software). Through multivariate analysis, PNI is significantly associated with disease-specific survival (p < 0.001). PNI integration into the staging system results in a significantly improved model compared with the current T category alone (lower AIC, p < 0.001). The PNI-integrated model is superior in predicting differential outcomes between T3 and T4 patients. A new model for T-classification of oral cavity squamous cell carcinoma is proposed, which is based on incorporating PNI into the staging system. These data can be used for future evaluations of the TNM staging system.
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Affiliation(s)
- Shorook Na'ara
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, 94158, USA
- Department of Otolaryngology Head and Neck Surgery, The Head and Neck Center, Rambam Healthcare Campus, Rappaport School of Medicine, Technion - Israel Institute of Technology, Haifa, 3109601, Israel
| | - Narayana Subramaniam
- Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, 682041, India
| | - Alberto Deganello
- Otolaryngology Head and Neck Surgery, Department of IRCCS National Cancer Institute (INT), Milan, 20133, Italy
- Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
| | - Shadi Shinnawi
- Department of Otolaryngology Head and Neck Surgery, The Head and Neck Center, Rambam Healthcare Campus, Rappaport School of Medicine, Technion - Israel Institute of Technology, Haifa, 3109601, Israel
| | - Salem Billan
- Oncology Department, The Head and Neck Center, Rambam Healthcare Campus, Haifa, 3109601, Israel
| | - Davide Mattavelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, 25123, Italy
| | - Marco Ferrari
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, 25123, Italy
| | - Deepak Balasubramanian
- Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, 682041, India
| | - Krishnakumar Thankappan
- Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, 682041, India
| | - Subramania Iyer
- Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, 682041, India
| | - Ziv Gil
- Head and Neck Center, Holy Family Hospital, Nazareth, 1641100, Israel
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11
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Locati LD, Ferrarotto R, Licitra L, Benazzo M, Preda L, Farina D, Gatta G, Lombardi D, Nicolai P, Vander Poorten V, Chua MLK, Vischioni B, Sanguineti G, Morbini P, Fonseca I, Sozzi D, Merlotti A, Orlandi E. Current management and future challenges in salivary glands cancer. Front Oncol 2023; 13:1264287. [PMID: 37795454 PMCID: PMC10546333 DOI: 10.3389/fonc.2023.1264287] [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: 07/20/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
Salivary gland cancers (SGCs) are rare, accounting for less than 5% of all malignancies of the head and neck region, and are morphologically heterogeneous. The diagnosis is mainly based on histology, with the complementary aid of molecular profiling, which is helpful in recognizing some poorly differentiated, borderline, or atypical lesions. Instrumental imaging defines the diagnosis, representing a remarkable tool in the treatment plan. Ultrasound and magnetic resonance are the most common procedures used to describe the primary tumour. The treatment of SGCs is multimodal and consists of surgery, radiotherapy, and systemic therapy; each treatment plan is, however, featured on the patient and disease's characteristics. On 24 June 2022, in the meeting "Current management and future challenges in salivary gland cancers" many experts in this field discussed the state of the art of SGCs research, the future challenges and developments. After the meeting, the same pool of experts maintained close contact to keep these data further updated in the conference proceedings presented here. This review collects the insights and suggestions that emerged from the discussion during and after the meeting per se.
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Affiliation(s)
- Laura D. Locati
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
- Medical Oncology Unit, Istituti Clinici Scientifici Maugeri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Pavia, Italy
| | - Renata Ferrarotto
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Lisa Licitra
- Head and Neck Medical Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) National Cancer Institute, Milano, Italy
- University of Milan, Milano, Italy
| | - Marco Benazzo
- Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department of Otorhinolaryngology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
| | - Lorenzo Preda
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
- Radiology Institute, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
| | - Davide Farina
- Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, Division of Radiology and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) National Cancer Institute, Milano, Italy
| | - Davide Lombardi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Study, Brescia, Italy
| | - Piero Nicolai
- Unit of Otorhinolaryngology - Head and Neck Surgery, University of Study, Padova, Italy
| | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery, Leuven Cancer Institute, University Hospital of Leuven, Leuven, Belgium
- Department of Oncology, Section Head and Neck Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Melvin Lee Kiang Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Barbara Vischioni
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
| | - Giuseppe Sanguineti
- Department of Radiotherapy, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Regina Elena National Cancer Institute, Roma, Italy
| | - Patrizia Morbini
- Unit of Pathology, Department of Molecular Medicine, University of Pavia, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
| | - Isabel Fonseca
- Anatomia Patológica, Instituto Português de Oncologia Francisco Gentil, University of Lisbon, Lisbon, Portugal
| | - Davide Sozzi
- Department of Medicine and Surgery, School of Medicine University of Milano-Bicocca, Monza, Italy
- Maxillofacial Surgery Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Gerardo dei Tintori, Monza, Italy
| | - Anna Merlotti
- Department of Radiation Oncology, Santa Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Ester Orlandi
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
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12
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Kalaitsidou I, Pasteli N, Venetis G, Poulopoulos A, Antoniades K. Immunohistochemical Expression of Epithelial Cell Adhesion Molecule (EpCAM) in Salivary Gland Cancer: Correlation with the Biological Behavior. Diagnostics (Basel) 2023; 13:2652. [PMID: 37627911 PMCID: PMC10453306 DOI: 10.3390/diagnostics13162652] [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: 07/19/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Salivary gland neoplasms comprise a diverse group of tumors with different biological behaviors and clinical outcomes. Understanding the underlying molecular alterations associated with these malignancies is critical for accurate diagnosis, prognosis, and treatment strategies. Among the many biomarkers under investigation, epithelial cell adhesion molecule (EpCAM) has emerged as a promising candidate in salivary gland cancer research. This article aims to provide a comprehensive overview of the differential expression of EpCAM in salivary gland cancer and its potential correlation with the biological behavior of these tumors. The clinical characteristics of 65 patients with salivary gland malignancy of different histopathological subtypes were included. We report the differential expression of EpCAM and the relationship between the clinical and histopathologic features of these tumors. Regarding the evaluation of the effect of EpCAM expression on survival, in our study, we showed that tumors with high EpCAM expression had reduced disease-free survival (DFS) and overall survival (OS) (p < 0.001) compared to patients with cancers with low EpCAM expression. In addition, the concurrent presence of perineural invasion and positive EpCAM expression appeared to be associated with shorter disease-free survival and overall survival. In conclusion, our study confirmed the prognostic value of detecting perineural invasion and EpCAM expression.
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Affiliation(s)
- Ioanna Kalaitsidou
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (G.V.)
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
| | - Nikoleta Pasteli
- Pathology Department, G. Papanikolaou Hospital, 57010 Thessaloniki, Greece
| | - Gregory Venetis
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (G.V.)
| | - Athanasios Poulopoulos
- Department of Oral Medicine and Maxillofacial Pathology, Aristotle University, 54124 Thessaloniki, Greece;
| | - Konstantinos Antoniades
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (G.V.)
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13
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Schiavo Lena M, Gasparini G, Crippa S, Belfiori G, Aleotti F, Di Salvo F, Redegalli M, Cangi MG, Taveggia C, Falconi M, Doglioni C. Quantification of perineural invasion in pancreatic ductal adenocarcinoma: proposal of a severity score system. Virchows Arch 2023; 483:225-235. [PMID: 37291275 DOI: 10.1007/s00428-023-03574-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/02/2023] [Accepted: 05/27/2023] [Indexed: 06/10/2023]
Abstract
Perineural invasion (PNI) is a common feature in pancreatic ductal adenocarcinoma (PDAC) and correlates with an aggressive tumor behavior already at early stages of disease. PNI is currently considered as a "present vs. absent" feature, and a severity score system has not yet been established. The aim of the present study was thus to develop and validate a score system for PNI and to correlate it with other prognostic features. In this monocentric retrospective study, 356 consecutive PDAC patients (61.8% upfront surgery patients, 38.2% received neoadjuvant therapy) were analyzed. PNI was scored as follows: 0: absent; 1: the presence of neoplasia along nerves < 3 mm in caliber; and 2: neoplastic infiltration of nerve fibers ≥ 3 mm and/or massive perineural infiltration and/or the presence of necrosis of the infiltrated nerve bundle. For every PNI grade, the correlation with other pathological features, disease-free survival (DFS), and disease-specific survival (DSS) were analyzed. Uni- and multivariate analysis for DFS and DSS were also performed. PNI was found in 72.5% of the patients. Relevant trends between PNI score and tumor differentiation grade, lymph node metastases, vascular invasion, and surgical margins status were found. The latter was the only parameter statistically correlated with the proposed score. The agreement between pathologists was substantial (Cohen's K 0.61). PNI severity score significantly correlated also with decreased DFS and DSS at univariate analysis (p < 0.001). At multivariate analysis, only the presence of lymph node metastases was an independent predictor of DFS (HR 2.235 p < 0.001). Lymph node metastases (HR 2.902, p < 0.001) and tumor differentiation grade (HR 1.677, p = 0.002) were independent predictors of DSS. Our newly developed PNI score correlates with other features of PDAC aggressiveness and proved to have a prognostic role though less robust than lymph nodes metastases and tumor differentiation grade. A prospective validation is needed.
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Affiliation(s)
- Marco Schiavo Lena
- Pathology Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, 20132, Milan, Italy.
| | - Giulia Gasparini
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, Milan, Italy
| | - Stefano Crippa
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, Milan, Italy
| | - Giulio Belfiori
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, Milan, Italy
| | - Francesca Aleotti
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, Milan, Italy
| | - Francesca Di Salvo
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, Milan, Italy
| | - Miriam Redegalli
- Pathology Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, 20132, Milan, Italy
| | - Maria Giulia Cangi
- Pathology Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, 20132, Milan, Italy
| | - Carla Taveggia
- Axo-Glial Interaction Unit, Division of Neuroscience, San Raffaele Research Hospital, Milan, Italy
| | - Massimo Falconi
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, Milan, Italy
| | - Claudio Doglioni
- Pathology Unit, Pancreas Translational and Clinical Research Center, San Raffaele Research Hospital, 20132, Milan, Italy
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14
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Tang YF, An PG, Gu BX, Yi S, Hu X, Wu WJ, Zhang J. Transcriptomic insights into adenoid cystic carcinoma via RNA sequencing. Front Genet 2023; 14:1144945. [PMID: 37152992 PMCID: PMC10160386 DOI: 10.3389/fgene.2023.1144945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/10/2023] [Indexed: 05/09/2023] Open
Abstract
Background: The aim of this study was to investigate the underlying mechanisms of adenoid cystic carcinoma (ACC) at the transcriptome level. Materials and methods: We obtained paired tumor and normal salivary gland tissues from 15 ACC patients, which were prepared for RNA sequencing. Results: Gene enrichment analysis revealed that the upregulated pathways were mainly involved in axonogenesis, and the downregulated pathways were mainly related to leukocyte migration, the adaptive immune response, lymphocyte-mediated immunity, and the humoral immune response. T-cells, B-cells and NK cells showed low infiltration in ACC tissues. In addition to the gene fusions MYB-NFIB and MYBL1-NFIB, a new gene fusion, TVP23C-CDRT4, was also detected in 3 ACC tissues. PRAME was significantly upregulated in ACC tissues, while antigen-presenting human leukocyte antigen (HLA) genes were downregulated. Conclusion: We found a new gene fusion, TVP23C-CDRT4, that was highly expressed in ACC. PRAME may be an attractive target for ACC immunotherapy.
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Affiliation(s)
- Yu-Fang Tang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
- Department of Stomatology, Xinqiao Hospital (the Second Affiliated Hospital), Army Medical University, Chongqing, China
| | - Pu-Gen An
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Bao-Xin Gu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Shu Yi
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiao Hu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wen-Jie Wu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
- *Correspondence: Wen-Jie Wu, ; Jie Zhang,
| | - Jie Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
- *Correspondence: Wen-Jie Wu, ; Jie Zhang,
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15
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Macri C, Juniat V, Davis G, Selva D. Intraorbital and intracranial extension of adenoid cystic carcinoma without clinical or radiological lacrimal gland involvement. Orbit 2022; 41:797-801. [PMID: 34107855 DOI: 10.1080/01676830.2021.1939731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
Adenoid cystic carcinoma (AdCC) is a rare epithelial neoplasm of the head and neck, most commonly found in the salivary glands. Orbital AdCC is an uncommon clinical entity arising from the lacrimal glands, however primary orbital AdCC has been previously described in a small number of case reports. The exact origin of the neoplasm with uninvolved lacrimal gland in the orbit is unknown, however it may arise from ectopic lacrimal or salivary gland tissue, or extension from nearby epithelial structures. We describe the clinical characteristics, investigations and management of a 55-year-old man presenting with vertical diplopia, found to have left posterior orbital AdCC invading the skull base with intracranial extension involving the inferotemporal fossa, pterygopalatine fossa, left carotid artery, cavernous sinus and temporal lobe dura, without clinical or radiological lacrimal gland involvement or systemic metastases.
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Affiliation(s)
- Carmelo Macri
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
| | - Valerie Juniat
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
- The South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Garry Davis
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
- The South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Dinesh Selva
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
- The South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
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16
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Gola M, Sejda A, Godlewski J, Cieślak M, Starzyńska A. Neural Component of the Tumor Microenvironment in Pancreatic Ductal Adenocarcinoma. Cancers (Basel) 2022; 14:5246. [PMID: 36358664 PMCID: PMC9657005 DOI: 10.3390/cancers14215246] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/04/2022] [Accepted: 10/25/2022] [Indexed: 10/15/2023] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive primary malignancy of the pancreas, with a dismal prognosis and limited treatment options. It possesses a unique tumor microenvironment (TME), generating dense stroma with complex elements cross-talking with each other to promote tumor growth and progression. Diversified neural components makes for not having a full understanding of their influence on its aggressive behavior. The aim of the study was to summarize and integrate the role of nerves in the pancreatic tumor microenvironment. The role of autonomic nerve fibers on PDAC development has been recently studied, which resulted in considering the targeting of sympathetic and parasympathetic pathways as a novel treatment opportunity. Perineural invasion (PNI) is commonly found in PDAC. As the severity of the PNI correlates with a poorer prognosis, new quantification of this phenomenon, distinguishing between perineural and endoneural invasion, could feature in routine pathological examination. The concepts of cancer-related neurogenesis and axonogenesis in PDAC are understudied; so, further research in this field may be warranted. A better understanding of the interdependence between the neural component and cancer cells in the PDAC microenvironment could bring new nerve-oriented treatment options into clinical practice and improve outcomes in patients with pancreatic cancer. In this review, we aim to summarize and integrate the current state of knowledge and future challenges concerning nerve-cancer interactions in PDAC.
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Affiliation(s)
- Michał Gola
- Department of Human Histology and Embryology, Collegium Medicum, School of Medicine, University of Warmia and Mazury, 10-082 Olsztyn, Poland
| | - Aleksandra Sejda
- Department of Pathomorphology and Forensic Medicine, Collegium Medicum, School of Medicine, University of Warmia and Mazury, 18 Żołnierska Street, 10-561 Olsztyn, Poland
| | - Janusz Godlewski
- Department of Human Histology and Embryology, Collegium Medicum, School of Medicine, University of Warmia and Mazury, 10-082 Olsztyn, Poland
| | - Małgorzata Cieślak
- Department of Pathomorphology and Forensic Medicine, Collegium Medicum, School of Medicine, University of Warmia and Mazury, 18 Żołnierska Street, 10-561 Olsztyn, Poland
| | - Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland
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Du Y, Zeng Y. Analysis of postoperative radiotherapy for non-metastatic head and neck adenoid cystic carcinoma based on SEER data. J Int Med Res 2022; 50:3000605221115151. [PMID: 35929027 PMCID: PMC9358576 DOI: 10.1177/03000605221115151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The postoperative role of adjuvant radiotherapy in non-metastatic head and neck adenoid cystic carcinoma (ACC) remains controversial. We analyzed adjuvant radiotherapy's effect on surgical patient survival. METHODS Patients diagnosed with ACC from 2004 to 2015 in the Surveillance, Epidemiology, and End Results database were analyzed. The overall survival (OS) and disease-specific survival (DSS) of patients after adjuvant radiotherapy were assessed using the Kaplan-Meier and multivariate Cox methods. Propensity score matching (PSM) was performed to adjust confounders between patients with or without adjuvant radiotherapy; a forest plot was generated by subgroup analysis. RESULTS The study included 742 patients. In the PSM cohort, adjuvant radiotherapy did not improve OS or DSS. Radiotherapy was not a protective factor for OS or DSS in the univariate and multivariate Cox proportional hazard models. In the subgroup analysis, postoperative radiotherapy improved the OS of female and N1-stage patients and those with oropharyngeal tumors or over 79 years and the DSS of N1-stage patients. CONCLUSIONS Postoperative radiotherapy showed different benefits in ACC patients, and postoperative radiotherapy recommendations should be individualized. Female and N1-stage ACC patients and those with oropharyngeal tumors or patients over 79 years without distant metastases postoperatively could benefit from adjuvant radiotherapy.
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Affiliation(s)
- Yan Du
- Department of Oncology, Dujiangyan People’s Hospital, Dujiangyan Sichuan, China
| | - Yong Zeng
- Department of Oncology, Dujiangyan People’s Hospital, Dujiangyan Sichuan, China
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18
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Fang Y, Peng Z, Wang Y, Gao K, Liu Y, Fan R, Zhang H, Xie Z, Jiang W. Current opinions on diagnosis and treatment of adenoid cystic carcinoma. Oral Oncol 2022; 130:105945. [PMID: 35662026 DOI: 10.1016/j.oraloncology.2022.105945] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
Adenoid cystic carcinoma (ACC) is a rare malignant tumor derived mainly from the salivary glands, representing approximately 1% of all headandneck carcinomasand 10% of all salivary gland neoplasms. ACC displays a paradoxical behavioral combination of an indolent growth pattern but an aggressive progression, with local recurrence and distant metastasis. The propensity of ACC of the head and neck (ACCHN) for perineural invasion and its anatomical location, especially if it extends to the nasal cavity and paranasal sinuses, facilitates tumor involvement in the surrounding structures, such as the orbit, pterygopalatine fossa, Meckel'scave, and cavernous sinus, which can lead to skull base involvement and intracranial extension. Despite advances in molecular mechanisms and diagnostic imaging, ACC treatment remainschallenging due to the lack ofconsensuson treatment patterns. In this review, we aimed toprovideanupdatedinsight intothe understanding of ACCHN by focusing on clinical behavior, imaging diagnosis, pathological features, and therapeutic strategies. We reviewed the molecular mechanisms, especially in ACCHN with perineural invasion, and elaborated on treatment options, including chemotherapy, targeted therapies, and immunotherapy, to establish a comprehensive understanding of ACC to arrive at a policy for proper diagnosis, preoperative evaluation, and therapeutic strategies.
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Affiliation(s)
- Yan Fang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zhouying Peng
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Yumin Wang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Kelei Gao
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan 410008, China; Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Yalan Liu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Ruohao Fan
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Hua Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zhihai Xie
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Weihong Jiang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
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19
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Michaelides I, Fest S, Berszin M, Wiegand S, Bohr C, Künzel J, Dietz A, Pirlich M, Wichmann G. [Pembrolizumab and Cetuximab as therapeutic options for ACC in head and neck]. Laryngorhinootologie 2022; 101:736-740. [PMID: 35576974 DOI: 10.1055/a-1830-8298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ioannis Michaelides
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Leipzig, Leipzig, Deutschland.,Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Sandra Fest
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Leipzig, Leipzig, Deutschland
| | - Michael Berszin
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Leipzig, Leipzig, Deutschland
| | - Susanne Wiegand
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Leipzig, Leipzig, Deutschland
| | - Christopher Bohr
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Julian Künzel
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Andreas Dietz
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Leipzig, Leipzig, Deutschland
| | - Markus Pirlich
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Leipzig, Leipzig, Deutschland
| | - Gunnar Wichmann
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Leipzig, Leipzig, Deutschland
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20
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Biau J, Nutting C, Langendijk J, Frédéric-Moreau T, Thariat J, Piram L, Bellini R, Saroul N, Pham Dang N, O'Sullivan B, Giralt J, Blanchard P, Bourhis J, Lapeyre M. Radiographic-anatomy, natural history and extension pathways of parotid and submandibular gland cancers. Radiother Oncol 2022; 170:48-54. [DOI: 10.1016/j.radonc.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 01/27/2022] [Accepted: 03/06/2022] [Indexed: 11/16/2022]
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21
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Ouatassi N, Elguerch W, Bensalah A, Maaroufi M, Alami MN. Unusual presentation of parotid gland adenoid cystic carcinoma : A case presentation and literature review. Radiol Case Rep 2022; 17:344-349. [PMID: 34887973 PMCID: PMC8637004 DOI: 10.1016/j.radcr.2021.10.043] [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: 07/20/2021] [Revised: 10/20/2021] [Accepted: 10/20/2021] [Indexed: 11/20/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) represents approximately 10% of all epithelial salivary neoplasms and most commonly involves the parotid gland. We report CT and MRI finding of a 38-year-old young man presented to our ENT department with 02 years history of an external auditory canal stenosis. Physical examination revealed bilateral parotid gland swelling with a complete stenosis of the left external auditory canal. Temporal bone contrast enhanced CT-SCAN revealed is an isodense enhancing mass measuring 4 cm involving posterior and inferior external auditory canal wall, and invading the superficial lobe of the homolateral parotid gland. No bone erosion was noted. MRI investigation has shown a tumor process highly suspicious of malignancy centered on the left EAC involving the superficial lobe of the homolateral parotid gland. Adenoid cystic carcinoma (ACC) of the parotid gland was the final diagnosis, after surgical biopsy and histopathological examination. The Pre-operative check-up demonstrated multiple round shape lung lesions suggestive of multiple metastases. Considering the metastatic stage of the tumor, a collegial decision to adopt a palliative treatment approach based on chemotherapy was taken by the multidisciplinary oncology board.
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Affiliation(s)
- N. Ouatassi
- Department of ENT, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, BP. 1893; Km 2.200, Sidi Hrazem Road, Fez 30000, Morocco
| | - W. Elguerch
- Department of ENT, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, BP. 1893; Km 2.200, Sidi Hrazem Road, Fez 30000, Morocco
- Corresponding author.
| | - A. Bensalah
- Department of Radiology, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Morocco
| | - M. Maaroufi
- Department of Radiology, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Morocco
| | - MN. Alami
- Department of ENT, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, BP. 1893; Km 2.200, Sidi Hrazem Road, Fez 30000, Morocco
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22
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Xuan L, Yuan J, Zhang H, Zhang Y, Liu H. Dominant cell type analysis predicts head and neck adenoid cystic carcinoma outcomes. Ann Diagn Pathol 2021; 56:151867. [PMID: 34826781 DOI: 10.1016/j.anndiagpath.2021.151867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/11/2021] [Indexed: 11/01/2022]
Abstract
Traditional histological grading for predicting adenoid cystic carcinoma (ACC) outcomes is challenging and unreliable. We explored the relationship between dominant cell type (DCT) and outcomes for ACC of the head and neck to develop a new approach to predicting prognosis. Clinicopathological data were obtained from a retrospective cohort of 167 patients with primary ACC of the head and neck. Using immunohistochemistry markers to determine DCT, tumors were subclassified into three distinct subtypes, epithelial-predominant (E-ACC), myoepithelial-predominant (M-ACC), and conventional (C-ACC). Differences in clinicopathological parameters and clinical outcomes among these subtypes were then analyzed. Compared to that of M-ACC and C-ACC, E-ACC exhibited more aggressive clinicopathological features with predominantly solid components, high-grade transformation, lymphovascular invasion, tumor necrosis (TN), Ki-67 ≥ 30%, and advanced stage of disease. Both E-ACC and M-ACC could present as solid morphological forms, but E-ACC had a significantly worse prognosis than M-ACC. DCT, TN, and disease stage were independent predictors of recurrence-free survival. DCT, TN, age ≥ 50 years, and disease stage were independent predictors for overall survival. In conclusion, DCT was an independent prognostic indicator for both recurrence-free and overall survival for ACC. Our results provide a new approach to predicting prognosis in ACC and a strong pathological basis for clinically optimizing treatment.
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Affiliation(s)
- Lanlan Xuan
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, NO. 1, Dongjiaominxiang Street, Beijing 100730, China; Department of Pathology, Anqing Hospital, Anhui Medical University, Anqing Municipal Hospital, NO. 87, Tianzhushandong Street, Anqing 246003, China
| | - Jianwei Yuan
- Department of Oncology Surgery, Anqing Hospital, Anhui Medical University, Anqing Municipal Hospital, NO. 87, Tianzhushandong Street, Anqing 246003, China
| | - Hong Zhang
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, NO. 1, Dongjiaominxiang Street, Beijing 100730, China
| | - Ying Zhang
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, NO. 1, Dongjiaominxiang Street, Beijing 100730, China
| | - Honggang Liu
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, NO. 1, Dongjiaominxiang Street, Beijing 100730, China.
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23
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Cantù G. Adenoid cystic carcinoma. An indolent but aggressive tumour. Part B: treatment and prognosis. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2021; 41:296-307. [PMID: 34533533 PMCID: PMC8448184 DOI: 10.14639/0392-100x-n1729] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/03/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Giulio Cantù
- Former Director of Otorhinolaryngology and Cranio-Maxillo-Facial Unit, Fondazione I.R.C.C.S. Istituto Nazionale dei Tumori, Milano, Italy
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24
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Zhang M, Xian HC, Dai L, Tang YL, Liang XH. MicroRNAs: emerging driver of cancer perineural invasion. Cell Biosci 2021; 11:117. [PMID: 34187567 PMCID: PMC8243427 DOI: 10.1186/s13578-021-00630-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 06/14/2021] [Indexed: 02/07/2023] Open
Abstract
The perineural invasion (PNI), which refers to tumor cells encroaching on nerve, is a clinical feature frequently occurred in various malignant tumors, and responsible for postoperative recurrence, metastasis and decreased survival. The pathogenesis of PNI switches from 'low-resistance channel' hypothesis to 'mutual attraction' theory between peripheral nerves and tumor cells in perineural niche. Among various molecules in perineural niche, microRNA (miRNA) as an emerging modulator of PNI through generating RNA-induced silencing complex (RISC) to orchestrate oncogene and anti-oncogene has aroused a wide attention. This article systematically reviewed the role of microRNA in PNI, promising to identify new biomarkers and offer cancer therapeutic targets.
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Affiliation(s)
- Mei Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology (Sichuan University), No.14, Sec. 3, Renminnan Road, Chengdu, 610041, China
| | - Hong-Chun Xian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Pathology, West China Hospital of Stomatology (Sichuan University), No.14, Sec. 3, Renminnan Road, Chengdu, 610041, China
| | - Li Dai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology (Sichuan University), No.14, Sec. 3, Renminnan Road, Chengdu, 610041, China
| | - Ya-Ling Tang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Pathology, West China Hospital of Stomatology (Sichuan University), No.14, Sec. 3, Renminnan Road, Chengdu, 610041, China.
| | - Xin-Hua Liang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology (Sichuan University), No.14, Sec. 3, Renminnan Road, Chengdu, 610041, China.
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25
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Dos Santos ES, Rodrigues-Fernandes CI, Speight PM, Khurram SA, Alsanie I, Costa Normando AG, Prado-Ribeiro AC, Brandão TB, Kowalski LP, Silva Guerra EN, Lopes MA, Vargas PA, Santos-Silva AR, Leme AFP. Impact of tumor site on the prognosis of salivary gland neoplasms: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 162:103352. [PMID: 33991662 DOI: 10.1016/j.critrevonc.2021.103352] [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: 10/29/2020] [Revised: 01/28/2021] [Accepted: 05/08/2021] [Indexed: 01/05/2023] Open
Abstract
In numerous types of cancer, the primary tumor site can show a correlation with disease behavior and survival outcomes. In salivary gland tumors (SGTs) this association remains controversial. This study assessed the association between primary sites of SGTs and prognosis. Studies from five databases were assessed and a meta-analysis was performed using studies that presented 95 % confidence interval (95 % CI), hazard ratio (HR) and survival analysis. Gathered information from 46,361 patients showed that site had a prognostic impact on SGTs. Tumors involving minor salivary glands showed worse overall survival (HR = 1.60; 95 % CI = 1.17-2.19; p = 0.003), disease-specific survival (HR=1.63; 95 % CI = 1.12-2.37; p = 0.01), and cause-specific survival (HR=2.10; 95 % CI = 1.72-2.55; p = 0.00001). Tumors from major salivary glands showed better recurrence-free survival (HR=2.31; 95 % CI = 1.77-3.02; p = 0.00001), and locoregional control of disease (HR=2.66; 95 % CI = 1.20-5.91; p = 0.02). Our results showed that the primary site of SGTs has an impact on patient prognosis.
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Affiliation(s)
| | | | - Paul M Speight
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Ibrahim Alsanie
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom; Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Ana Carolina Prado-Ribeiro
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Head and Neck Surgery Department, University of Sao Paulo Medical School and Department of Head and Neck Surgery and Otorhinolaryngology A C Camargo Cancer Center, São Paulo, Brazil
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Adriana Franco Paes Leme
- Brazilian Bioscience National Laboratory, Brazil Center of Research in Energy and Materials, Campinas, Brazil
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26
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Amit M, Bell D, Hunt PJ, Hanna E, Su SY, Kupferman M, Aashiq M, Takahashi H, Gidley PW, Nader ME, DeMonte F, Raza SM. Surgical management of carcinomas of the infratemporal fossa and skull base: patterns of failure and predictors of long-term outcomes. J Neurosurg 2021; 134:1392-1398. [PMID: 32534492 DOI: 10.3171/2020.3.jns192630] [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: 09/23/2019] [Accepted: 03/31/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Infratemporal fossa (ITF) tumors are unique in histological characteristics and difficult to treat. Predictors of patient outcomes in this context are not known. The objective of this study was to identify independent predictors of outcome and to characterize patterns of failure in patients with ITF carcinoma. METHODS All patients who had been surgically treated for anterolateral skull base malignancy between 1999 and 2017 at the authors' institution were retrospectively reviewed. Patient demographics, preoperative performance status, tumor stage, tumor characteristics, treatment modalities, and pathological data were collected. Primary outcomes were disease-specific survival (DSS) and local progression-free survival (LPFS) rates. Overall survival (OS) and patterns of progression were secondary outcomes. RESULTS Forty ITF malignancies with skull base involvement were classified as carcinoma. Negative margins were achieved in 23 patients (58%). Median DSS and LPFS were 32 and 12 months, respectively. Five-year DSS and OS rates were 55% and 36%, respectively. The 5-year LPFS rate was 69%. The 5-year overall PFS rate was 53%. Disease recurrence was noted in 28% of patients. Age, preoperative performance status, and margin status were statistically significant prognostic factors for DSS. Lower preoperative performance status and positive surgical margins increased the probability of local recurrence. CONCLUSIONS The ability to achieve negative margins was significantly associated with improved tumor control rates and DSS. Cranial base surgical approaches must be considered in multimodal treatment regimens for anterolateral skull base carcinomas.
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Affiliation(s)
- Moran Amit
- 1Department of Head and Neck Surgery, Division of Surgery
| | | | - Patrick J Hunt
- 3Baylor College of Medicine; and
- 4Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ehab Hanna
- 1Department of Head and Neck Surgery, Division of Surgery
| | - Shirley Y Su
- 1Department of Head and Neck Surgery, Division of Surgery
| | | | - Mohamed Aashiq
- 1Department of Head and Neck Surgery, Division of Surgery
| | | | - Paul W Gidley
- 1Department of Head and Neck Surgery, Division of Surgery
| | | | - Franco DeMonte
- 4Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shaan M Raza
- 4Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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27
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Wang W, Li L, Chen N, Niu C, Li Z, Hu J, Cui J. Nerves in the Tumor Microenvironment: Origin and Effects. Front Cell Dev Biol 2021; 8:601738. [PMID: 33392191 PMCID: PMC7773823 DOI: 10.3389/fcell.2020.601738] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/30/2020] [Indexed: 12/12/2022] Open
Abstract
Studies have reported the vital role of nerves in tumorigenesis and cancer progression. Nerves infiltrate the tumor microenvironment thereby enhancing cancer growth and metastasis. Perineural invasion, a process by which cancer cells invade the surrounding nerves, provides an alternative route for metastasis and generation of tumor-related pain. Moreover, central and sympathetic nervous system dysfunctions and psychological stress-induced hormone network disorders may influence the malignant progression of cancer through multiple mechanisms. This reciprocal interaction between nerves and cancer cells provides novel insights into the cellular and molecular bases of tumorigenesis. In addition, they point to the potential utility of anti-neurogenic therapies. This review describes the evolving cross-talk between nerves and cancer cells, thus uncovers potential therapeutic targets for cancer.
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Affiliation(s)
- Wenjun Wang
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Lingyu Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Naifei Chen
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Chao Niu
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Zhi Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Jifan Hu
- Cancer Center, The First Hospital of Jilin University, Changchun, China.,VA Palo Alto Health Care System and Stanford University Medical School, Palo Alto, CA, United States
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, Changchun, China
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28
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Mu X, Peng X. Reply to the letter to the Editor by Cantu. Head Neck 2020; 43:1016-1018. [PMID: 33295670 DOI: 10.1002/hed.26567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 11/18/2020] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xiaoli Mu
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xingchen Peng
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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29
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Cantù G. Letter to Editor. Head Neck 2020; 43:1014-1015. [PMID: 33295686 DOI: 10.1002/hed.26558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/18/2020] [Indexed: 11/07/2022] Open
Affiliation(s)
- Giulio Cantù
- Head and Neck Surgery Department, National Cancer Institute, Milan, Italy
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30
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Liu X, Yang X, Zhan C, Zhang Y, Hou J, Yin X. Perineural Invasion in Adenoid Cystic Carcinoma of the Salivary Glands: Where We Are and Where We Need to Go. Front Oncol 2020; 10:1493. [PMID: 33014792 PMCID: PMC7461905 DOI: 10.3389/fonc.2020.01493] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/13/2020] [Indexed: 12/25/2022] Open
Abstract
Adenoid cystic carcinoma of the salivary gland (SACC) is a rare malignant tumors of the head and neck region, but it is one of the most common malignant tumors that are prone to perineural invasion (PNI) of the head and neck. The prognosis of patients with SACC is strongly associated with the presence of perineural spread (PNS). Although many contributing factors have been reported, the mechanisms underlying the preferential destruction of the blood-nerve barrier (BNB) by tumors and the infiltration of the tumor microenvironment by nerve fibers in SACC, have received little research attention. This review summarizes the current knowledge concerning the characteristics of SACC in relation to the PNI, and then highlights the interplay between components of the tumor microenvironment and perineural niche, as well as their contributions to the PNI. Finally, we provide new insights into the possible mechanisms underlying the pathogenesis of PNI, with particular emphasis on the role of extracellular vesicles that may serve as an attractive entry point in future studies.
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Affiliation(s)
- Xiaohao Liu
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaojun Yang
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chaoning Zhan
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yan Zhang
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jin Hou
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xuemin Yin
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
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31
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Pyatigorskaya N, De Laroche R, Bera G, Giron A, Bertolus C, Herve G, Chambenois E, Bergeret S, Dormont D, Amor-Sahli M, Kas A. Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous 18F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer? AJNR Am J Neuroradiol 2020; 41:1888-1896. [PMID: 32972956 DOI: 10.3174/ajnr.a6764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 06/21/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE PET/MRI with 18F-FDG has demonstrated the advantages of simultaneous PET and MR imaging in head and neck cancer imaging, MRI allowing excellent soft-tissue contrast, while PET provides metabolic information. The aim of this study was to evaluate the added value of gadolinium contrast-enhanced sequences in the tumor delineation of head and neck cancers on 18F-FDG-PET/MR imaging. MATERIALS AND METHODS Consecutive patients who underwent simultaneous head and neck 18F-FDG-PET/MR imaging staging or restaging followed by surgery were retrospectively included. Local tumor invasion and lymph node extension were assessed in 45 head and neck anatomic regions using 18F-FDG-PET/MR imaging by 2 rater groups (each one including a radiologist and a nuclear medicine physician). Two reading sessions were performed, one without contrast-enhanced sequences (using only T1WI, T2WI, and PET images) and a second with additional T1WI postcontrast sequences. The results were compared with the detailed histopathologic analysis, used as reference standard. The κ concordance coefficient between the reading sessions and sensitivity and specificity for each region were calculated. RESULTS Thirty patients were included. There was excellent agreement between the contrast-free and postgadolinium reading sessions in delineating precise tumor extension in the 45 anatomic regions studied (Cohen κ = 0.96, 95% CI = [0.94-0.97], P < .001). The diagnostic accuracy did not differ between contrast-free and postgadolinium reading sessions, being 0.97 for both groups and both reading sessions. For the 2 rater groups, there was good sensitivity for both contrast-free (0.83 and 0.85) and postgadolinium reading sessions (0.88 and 0.90, respectively). Moreover, there was excellent specificity (0.98) for both groups and reading sessions. CONCLUSIONS Gadolinium chelate contrast administration showed no added value for accurate characterization of head and neck primary tumor extension and could possibly be avoided in the PET/MR imaging head and neck workflow.
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Affiliation(s)
- N Pyatigorskaya
- From Assistance Publique Hôpitaux de Paris Neuroradiology Department (N.P., E.C., D.D., M.A.-S.)
- Sorbonne University (N.P., D.D.), Pierre and Marie Faculty of Medicine, Paris, France
| | - R De Laroche
- Nuclear Medicine Department (R.D.L.), Morvan Hospital, Brest, France
| | - G Bera
- Nuclear Medicine Department (G.B., S.B., A.K.), Pitié-Salpêtrière-Charles Foix Hospital, Paris, France
| | - A Giron
- Sorbonne University (A.G., A.K.), Laboratoire d'Imagerie Biomédicale, Paris, France
| | - C Bertolus
- Sorbonne University, Maxillo-Facial Surgery Department (C.B.)
- CIMI Sorbonne University UPMC (C.B.), Paris, France
| | - G Herve
- Pathology Department (G.H.), Pitié Salpêtrière-Charles Foix Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - E Chambenois
- From Assistance Publique Hôpitaux de Paris Neuroradiology Department (N.P., E.C., D.D., M.A.-S.)
| | - S Bergeret
- Nuclear Medicine Department (G.B., S.B., A.K.), Pitié-Salpêtrière-Charles Foix Hospital, Paris, France
| | - D Dormont
- From Assistance Publique Hôpitaux de Paris Neuroradiology Department (N.P., E.C., D.D., M.A.-S.)
- Sorbonne University (N.P., D.D.), Pierre and Marie Faculty of Medicine, Paris, France
| | - M Amor-Sahli
- From Assistance Publique Hôpitaux de Paris Neuroradiology Department (N.P., E.C., D.D., M.A.-S.)
| | - A Kas
- Nuclear Medicine Department (G.B., S.B., A.K.), Pitié-Salpêtrière-Charles Foix Hospital, Paris, France
- Sorbonne University (A.G., A.K.), Laboratoire d'Imagerie Biomédicale, Paris, France
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Bastian T, D'Heygere V, Deuß E, Lax H, Wittig A, Sauerwein W, Arweiler-Harbeck D. [Results of surgical and radiotherapeutic treatment of adenoid cystic carcinoma of the salivary glands]. HNO 2020; 68:678-687. [PMID: 32821981 DOI: 10.1007/s00106-020-00913-1] [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] [Indexed: 12/11/2022]
Abstract
Surgical treatment in patients with rare adenoid cystic carcinoma (ACC) of the salivary glands is considered to be the state of the art. With respect to an additional radiotherapy there are different approaches regarding the type of radiotherapy and timing. In this study the overall survival and recurrence-free survival in 52 individuals with salivary gland ACC who were treated at the University Hospital in Essen and received irradiation with fast neutrons and photons (mixed beam technique) either A) immediately following surgical treatment or B) only after the appearance of local recurrence were compared. Group A (n = 28, first diagnosis, FD September 1991-September 2009) received adjuvant radiotherapy immediately postoperative, group B (n = 24, FD June 1979-November 2001) underwent primarily surgical tumor resection according to the treatment regimen at that time and were irradiated only on the appearance of a local recurrence. In comparison to group B, patients in group A showed a lower recurrence rate and a significantly longer local relapse-free survival. Group B, however, showed a significantly higher overall survival. The frequency of distant metastasis occurred equally in both groups but the onset of distant metastasis was significantly earlier in group A. In general, overall survival was negatively influenced by distant metastasis. The local recurrence rate was very high after primary surgical treatment only. The immediate adjuvant high-linear energy transfer (LET) radiotherapy reduced the local recurrence rates. Irradiation after the appearance of a recurrence had a positive influence on overall survival. Overall, definitive high-LET radiotherapy in the mixed beam technique enabled high local control rates both primarily postoperative and also locoregional recurrences.
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Affiliation(s)
- T Bastian
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - V D'Heygere
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - E Deuß
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - H Lax
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - A Wittig
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Jena, Deutschland
| | - W Sauerwein
- Klinik für Strahlentherapie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - D Arweiler-Harbeck
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
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Mu X, Li Y, He L, Guan H, Wang J, Wei Z, He Y, Liu Z, Li R, Peng X. Prognostic nomogram for adenoid cystic carcinoma in different anatomic sites. Head Neck 2020; 43:48-59. [PMID: 32864833 DOI: 10.1002/hed.26443] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/13/2020] [Accepted: 08/14/2020] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xiaoli Mu
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Yan Li
- Department of Head and Neck, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Ling He
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Hui Guan
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Jingjing Wang
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Zhigong Wei
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Yan He
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Zheran Liu
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Ruidan Li
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Xingchen Peng
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
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Sun M, Qu Y, Wang K, Wu R, Zhang Y, Zhang S, Xiao J, Yi J, Gao L, Xu G, Huang X, Luo J. Long-term outcomes of patients in different histological subtypes of primary nasopharyngeal adenocarcinoma: A single-center experience with 71 cases. Oral Oncol 2020; 111:104923. [PMID: 32795912 DOI: 10.1016/j.oraloncology.2020.104923] [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: 04/15/2020] [Revised: 06/17/2020] [Accepted: 07/19/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study is aimed to evaluate the long-term outcomes and management approaches in different histological subtypes of primary nasopharyngeal adenocarcinoma (NPAC). MATERIALS AND METHODS 71 patients with NPAC at our institution between 1984 and 2016 were reviewed, including adenoid cystic carcinoma (ACC) in 43 patients, mucoepidermoid carcinoma (MEC) in 17 patients, and primary traditional adenocarcinoma (AC) in 11 patients. 37 patients received primary radiotherapy and 34 patients underwent primary surgery. RESULTS The median time of follow-up was 77 months. The 5-year overall survival rate (OS), locoregional failure-free survival rate (LRFFS) and distant metastasis failure-free survival rate (DFFS) were 69.9%, 67.1% and 77.9%, respectively. Patients who received combined modality therapy had better 5-year OS (73.7% vs 66.2%, p = 0.065) and LRFFS (73.1% vs 64.5%, p = 0.047) than patients receiving single modality therapy. Regarding the different histological subtypes, the survival rates of patients with ACC undergoing primary radiotherapy and primary surgery were similar (5-year OS 82.3% vs 68.8%, LRFFS 70.0% vs 70.8%, p>0.05). As to patients with MEC and AC, those who underwent primary surgery achieved better 5-year OS (75.6% vs 45.5%, p = 0.001) and LRFFS (70.6%% vs 57.1%, p = 0.014) than those who received primary radiotherapy. Multivariate analyses indicated that histological subtypes and radiotherapy technique were independent factors for OS. CONCLUSIONS The optimal treatment policy for NPAC remained the combination of radiotherapy and surgery. For patients with ACC, radiotherapy could be considered as the primary treatment. Surgery was suggested to be the primary treatment in patients with MEC and AC.
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Affiliation(s)
- Meng Sun
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yuan Qu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Kai Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Runye Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ye Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shiping Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jianping Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Junlin Yi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Li Gao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Guozhen Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xiaodong Huang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
| | - Jingwei Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
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de Morais EF, da Silva LP, Moreira DGL, Mafra RP, Rolim LSA, de Moura Santos E, de Souza LB, de Almeida Freitas R. Prognostic Factors and Survival in Adenoid Cystic Carcinoma of the Head and Neck: A Retrospective Clinical and Histopathological Analysis of Patients Seen at a Cancer Center. Head Neck Pathol 2020; 15:416-424. [PMID: 32779101 PMCID: PMC8134621 DOI: 10.1007/s12105-020-01210-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/03/2020] [Indexed: 12/25/2022]
Abstract
Adenoid cystic carcinoma (AdCC) is a rare malignancy that accounts for approximately 1% of all head and neck cancers. This neoplasm is characterized by slow but often relentless growth and dissemination. Our aim was to retrospectively evaluate the clinical-pathological features of patients diagnosed with head and neck AdCC and to identify possible prognostic factors. This retrospective observational study analyzed 87 cases of AdCC of the head and neck. Clinical parameters (tumor size, lymph node and distant metastasis, clinical stage, and survival) were obtained from the records. Survival curves were constructed using the Kaplan-Meier method. A p value ≤ 0.05 was considered significant. There was a slight predominance of cases diagnosed in female patients (54%). The mean age at diagnosis was 51.5 years. Analysis using Cox's proportional hazards model considering 10-year disease-specific survival identified histologic pattern and presence of perineural invasion as independent prognostic variables. Primary tumor size and distant metastasis were prognostic predictors of 5- and 10-year disease-free survival. Detailed analysis of the association between clinical-pathological parameters and prognosis can assist professionals with cancer treatment planning and adequate patient management. Considering the long-term aggressive behavior of AdCC, rigorous patient follow-up is important to identify possible locoregional or distant recurrences.
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Affiliation(s)
- Everton Freitas de Morais
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Leorik Pereira da Silva
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil ,grid.411181.c0000 0001 2221 0517Health and Biotechnology Institute, Federal University of Amazonas-UFAM, Coari, AM Brazil
| | - Deborah Gondim Lambert Moreira
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Rodrigo Porpino Mafra
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Larissa Santos Amaral Rolim
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Edilmar de Moura Santos
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Lélia Batista de Souza
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Roseana de Almeida Freitas
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
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Soares CD, de Cáceres CVBL, Rodrigues-Fernandes CI, de Lima Morais TM, de Almeida OP, de Carvalho MGF, Fonseca FP. Prognostic importance of RUNX1 expression for head and neck adenoid cystic carcinoma. Oral Dis 2020; 27:266-276. [PMID: 32609408 DOI: 10.1111/odi.13522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE In the present study, we aimed to investigate the prognostic value of RUNX1 expression in 76 patients with adenoid cystic carcinoma (ACC). MATERIALS AND METHODS All cases were arranged in tissue microarray blocks and submitted to immunohistochemistry against RUNX1. These results were statistically correlated with clinicopathologic features, including age, gender, tumour site, tumour size, lymph node status, AJCC clinical stage, distant metastasis, treatment, recurrences, follow-up, histologic pattern, vascular and neural invasion, all of which obtained from patient's medical records. RESULTS RUNX1 was expressed in the nuclei of tumour cells, with a mean of 18.1% of positivity. Nuclear RUNX1 expression was significantly associated with AJCC clinical stage (p < .0001), solid histologic pattern (p < .0001), vascular invasion (p < .0001) and presence of local recurrence (p < .0001). Using univariate and multivariate analyses, RUNX1 nuclear expression was significantly associated with a lower disease-free survival (p < .0001 and p = .028, respectively) and disease-specific survival (p < .0001 and p = .018, respectively) rates. CONCLUSION In summary, RUNX1 nuclear expression may represent an indicator of unfavourable outcome for patients affected by head and neck ACC.
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Affiliation(s)
- Ciro Dantas Soares
- Department of Oral Diagnosis, Area of Pathology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.,Private Pathology Service, Natal, Rio Grande do Norte, Brazil
| | | | | | - Thayná Melo de Lima Morais
- Department of Oral Diagnosis, Area of Pathology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Area of Pathology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Alkhadar H, Macluskey M, White S, Ellis I. Perineural invasion in oral squamous cell carcinoma: Incidence, prognostic impact and molecular insight. J Oral Pathol Med 2020; 49:994-1003. [PMID: 32533593 DOI: 10.1111/jop.13069] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The objective of this study was to characterise the incidence and prognostic correlation of perineural invasion (PNI) in oral squamous cell carcinoma and determine whether nerve growth factor and its receptor tyrosine Kinase A expression could be used as biological markers for PNI. METHODS A retrospective review of pathology reports of 430 patients with oral squamous cell carcinoma who were treated from 1992 to 2014 in Tayside, Scotland, was carried out. The expression of nerve growth factor and tyrosine kinase A was assessed with immunohistochemistry in 132 tissue sections of oral squamous cell carcinoma. RESULTS Perineural invasion was identified in 17.4% of oral squamous cell carcinomas. High expression of nerve growth factor and tyrosine kinase A was seen in 84% and 92% of oral squamous cell carcinoma, respectively. Tumours with PNI expressed nerve growth factor and tyrosine kinase A with a greater frequency than tumours without PNI. PNI and high expression of nerve growth factor were significantly associated with pain. PNI was significantly associated with stage IV tumours and poor disease-specific survival. CONCLUSIONS A higher level of expression of nerve growth factor and tyrosine kinase A may predict PNI and therefore may be considered as biological markers for PNI in oral squamous cell carcinoma. PNI and nerve growth factor overexpression may contribute to the pain generation in oral cancer patients. PNI and nerve growth factor expression can predict the aggressiveness and prognosis of oral squamous cell carcinoma patients.
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Affiliation(s)
- Huda Alkhadar
- Department of Oral Surgery, Medicine and Pathology, Dundee Dental School, University of Dundee, Dundee, UK
| | - Michaelina Macluskey
- Department of Oral Surgery, Medicine and Pathology, Dundee Dental School, University of Dundee, Dundee, UK
| | - Sharon White
- Department of Oral Surgery, Medicine and Pathology, Dundee Dental School, University of Dundee, Dundee, UK
| | - Ian Ellis
- Unit of Cell and Molecular Biology, Dundee Dental School, University of Dundee, Dundee, UK
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Cao Y, Deng S, Yan L, Gu J, Li J, Wu K, Cai K. Perineural invasion is associated with poor prognosis of colorectal cancer: a retrospective cohort study. Int J Colorectal Dis 2020; 35:1067-1075. [PMID: 32179991 DOI: 10.1007/s00384-020-03566-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE Perineural invasion (PNI) is associated with poor prognosis in a variety of cancers. Our aim was to determine the clinicopathological factors associated with PNI in colorectal cancer (CRC) and its impact on patient survival. MATERIAL AND METHODS The clinical data of 1412 patients diagnosed with CRC from July 2013 to July 2016 were retrospectively collected. PNI was determined based on hematoxylin-eosin staining. The relationships of PNI with various clinicopathological factors and prognosis were analyzed. RESULTS The incidence of PNI in the entire cohort was 21.5%. PNI was significantly more common in patients with lower tumor differentiation, higher tumor stage, vascular invasion, TNM stage, tumor diameter, MMR/KRAS/NRAS/BRAF mutation, and more positive lymph nodes. Logistic regression analysis showed that T stage, vascular invasion, tumor diameter, and MMR were the main influencing factors of PNI. Cox regression analysis showed that poor tumor differentiation, N stage, TNM stage, PNI, and BRAF status were independent prognostic factors for OS. The OS, CSS, and PFS rate of the PNI (-) group was higher than that of the PNI (+) group, and the difference was statistically significant (P < 0.001). CONCLUSION PNI in patients with colorectal cancer is significantly associated with T stage, TNM stage, vessel invasion, tumor diameter, MMR status, and BRAF mutation. PNI status is an independent prognostic factor for CRC. Assessing the postoperative PNI status may help predict prognosis and determine further treatment options for these patients.
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Affiliation(s)
- Yinghao Cao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China
| | - Shenghe Deng
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China
| | - Lizhao Yan
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China
| | - Junnan Gu
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China
| | - Jiang Li
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China
| | - Ke Wu
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China.
| | - Kailin Cai
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China.
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Lancione PJ, Kumar B, Zhao S, Mroz EA, Brock G, Rocco JW, Carrau RL, Agrawal A, Seim N, Kang SY, Ozer E, Old MO. A potential protective effect of metformin in adenoid cystic carcinoma. Oral Oncol 2020; 107:104726. [PMID: 32388409 DOI: 10.1016/j.oraloncology.2020.104726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Peter J Lancione
- The Ohio State University College of Medicine, 370 W 9(th) Ave, Columbus, OH 43210, USA.
| | - Bhavna Kumar
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Songzhu Zhao
- Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University, 320 Lincoln Tower, 1800 Cannon Drive, Columbus, OH 43210, USA.
| | - Edmund A Mroz
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Guy Brock
- Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University, 320 Lincoln Tower, 1800 Cannon Drive, Columbus, OH 43210, USA
| | - James W Rocco
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Ricardo L Carrau
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Amit Agrawal
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Nolan Seim
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Stephen Y Kang
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Enver Ozer
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Matthew O Old
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
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Cao Y, Yang M, Yan L, Deng S, Gu J, Mao F, Wu K, Liu L, Cai K. Colon metal stents as a bridge to surgery had no significant effects on the perineural invasion: a retrospective study. World J Surg Oncol 2020; 18:77. [PMID: 32321517 PMCID: PMC7178988 DOI: 10.1186/s12957-020-01845-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 03/25/2020] [Indexed: 02/08/2023] Open
Abstract
Purpose The long-term oncological effects of self-expandable metallic stent (SEMS) as a “bridge to surgery” are contradictory, and perineural invasion was supposed to be enhanced by the stenting. In this retrospective study, we compared the perineural invasion and the oncological outcomes between the stent as a bridge to surgery (SBTS)- and emergency surgery (ES)-treated patients to evaluate the results of stenting on the perineural invasion. Methods The clinical data of patients with acute intestinal obstruction caused by colorectal cancer from January 2013 to January 2017 were retrospectively collected. Forty-three patients underwent semi-elective curative resection after endoscopic SEMS insertion, and sixty-three underwent ES. The adverse events and long-term follow-up outcomes were assessed. The clinicopathological characteristics, perineural invasion rates, and survival rates were compared between the two patient groups. Results Stent insertion resulted in significantly lower stoma rate (32.6% vs 46%; P = 0.03), post-operative overall complication rate (11.6% vs 28.6%, P = 0.038), and total hospital stay (17.07 ± 5.544 days vs 20.48 ± 7.372 days, P = 0.042). Compared with the ES group, there was no significant increase in the incidence of peripheral invasion in the SBTS group (39.5% vs 47.6%, P = 0.411). No significant difference was noted in the survival rate and long-term prognosis between the SEMS and ES groups (P = 0.964). The technical success rate was 95.6%, and the clinical success rate was 97.7%. Conclusions Preoperative colon stenting was an effective transitional method for colorectal cancer patients with complete obstruction. Short-term stent implantation had no significant effect on perineural invasion in patients with CRC.
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Affiliation(s)
- Yinghao Cao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Ming Yang
- Department of Pathology, Union Hospital, Tongji Medical, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Lizhao Yan
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Shenghe Deng
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Junnan Gu
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Fuwei Mao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Ke Wu
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Li Liu
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
| | - Kailin Cai
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
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Abstract
Perineural invasion (PNI) is a prominent characteristic of multiple solid tumors and indicates poor prognosis. Previous data concerning the impact of PNI on prognosis of patients with colorectal cancer (CRC) are conflicting, and little is known about risk factors of PNI. The aim of our study was to reveal the clinical implication of PNI on survival outcome and identify risk factors for the poor prognosis in patients with CRC.We retrospectively reviewed 627 patients who were diagnosed with CRC and underwent curative surgical resection. The differences in several clinicopathologic characteristics were compared between PNI positive and PNI negative groups. Multivariate logistic regression analysis was performed to identify predictors of CRC with PNI. Five-year overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method, and the difference in survival rate was assessed by the log-rank test. The variables that had prognostic potential, as indicated by univariate analyses, were subjected to multivariate analyses with the Cox proportional hazards regression model.PNIs were identified in 79 patients (12.6%). Age, T classification, N classification, M classification, UICC classification, and lymphovascular invasion were significantly associated with PNI. Multivariate logistic regression analysis demonstrated that only lymphovascular invasion was a predictor of PNI. Pathologic evidence of PNI was not associated with survival outcome (the 5-year OS [P = .560] and DFS [P = .083]). Cox proportional hazards regression model revealed that age and N2/3 classification were independent prognostic factors for poorer OS and DFS. M1 stage (95% confidence interval [CI] = 0.228-0.585, P = .000), III/IV stage (95% CI = 0.335-0.920, P = .022), and number of sampled lymph nodes (95% CI = 0.951-0.987, P = .001) were independently prognostic for poorer OS, while history of other malignancy (95% CI = 1.133-2.813, P = .012) was identified as an independent prognostic factor for poorer DFS.Our study indicates that PNI is not an independent poor prognostic factor in patients with CRC and those patients with PNI may not benefit from postoperative adjuvant chemotherapy.
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Adenoid Cystic Carcinoma of Salivary Gland: A Ten-Year Single Institute Experience. CURRENT HEALTH SCIENCES JOURNAL 2020; 46:56-65. [PMID: 32637166 PMCID: PMC7323724 DOI: 10.12865/chsj.46.01.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 02/02/2020] [Indexed: 12/13/2022]
Abstract
Adenoid cystic carcinoma is a rare tumor, accounting for about 7.5% of all salivary gland neoplasms. More frequent developing in minor salivary gland, this is a slow-growing tumor with a long-lasting natural evolution, quite aggressive locally, but which has a tendency toward local recurrence and even for distant metastasis. We conducted a retrospective study limited to a period of 10 years in a single medical institution to investigate the morphoclinical profile of this tumor. Thus, we have established that about 60% of the tumors developed in men, with near 40% of the cases in patients in the sixth decade and, most common, the pathology affected the parotid and minor salivary glands from the hard palate mucosa. Histopathologically, prevailed the solid variant, with 72% cases presenting perineural invasion, and 41% cases showing positive surgical resection margins. Most cases had a long-standing asymptomatic evolution, so that at the time of diagnosis, more than two thirds of the patients were at least in stage II-pTNM, and in one-fifth of the cases histopathology showed lymph nodes disseminations.
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Li H, Yang Z, Wang W, Wang J, Zhang J, Liu J, Yang T, Yang Y, Wei J, Lei D, Yang X. NT-3/TrkC Axis Contributes to the Perineural Invasion and the Poor Prognosis in Human Salivary Adenoid Cystic Carcinoma. J Cancer 2019; 10:6065-6073. [PMID: 31762816 PMCID: PMC6856580 DOI: 10.7150/jca.33635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 08/25/2019] [Indexed: 12/19/2022] Open
Abstract
The present study was aimed to investigate the role and mechanism of neurotrophin-3 (NT-3) and its specific receptor tropomyosin receptor kinase C (TrkC) in the perineural invasion (PNI) process of the salivary adenoid cystic carcinoma (SACC). The co-cultured system between SACC cells and Schwann cells (SCs) was employed to detect the expression of NT-3 and TrkC. The results of ELISA, qRT-PCR and western blot showed that NT-3 was noticeably elevated in the co-cultured SACC-83 cells, while TrkC was increased in the co-cultured SCs. The results of scratch wound healing, migration, and 3D co-culture assays showed that the directional migration abilities of the co-cultured SACC-83 cells and SCs were significantly increased. Under the stimulation of NT-3, the directional motor ability of SACC-83 cells and SCs was significantly improved, and the apoptosis of SACC-83 cells and SCs were obviously inhibited. In addition, blocking TrkC by its specific inhibitor AZD7451 could significantly inhibit these effects. Immunohistochemistry staining showed that the positive expression of NT-3 (88.5%) and TrkC (92.3%) was significantly correlated with the PNI in SACC specimens (P < 0.05). Additionally, the high expression of NT-3 was significantly associated with the poor prognosis of SACC patients (P < 0.05). The present study indicated that NT-3/TrkC axis contributed to the PNI progression and the poor prognosis of SACC via regulating the interaction between SACC cells and SCs. Interruption of the interaction between SACC cells and SCs by blocking the NT-3/TrkC axis might be an effective strategy for anti-PNI therapy in SACC.
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Affiliation(s)
- Huan Li
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Zihui Yang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Weiqi Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Jun Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Jianying Zhang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Junye Liu
- Department of Radiation Medicine, Fourth Military Medical University, Xi'an 710032, China
| | - Tao Yang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Yaowu Yang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Jianhua Wei
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Delin Lei
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Xinjie Yang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
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Fan J, Yang J, Qiao W, Liu W, Xing C. LAPTM4B-35 expression is associated with pathological grades and clinical stages in salivary adenoid cystic carcinoma. Oncol Lett 2019; 19:317-322. [PMID: 31897144 PMCID: PMC6924106 DOI: 10.3892/ol.2019.11124] [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: 04/01/2019] [Accepted: 09/09/2019] [Indexed: 11/06/2022] Open
Abstract
Salivary adenoid cystic carcinoma is one of the most common malignancies of the head and neck. The lysosome-associated protein transmembrane-4β gene (LAPTM4B) is a novel oncogene that has been found overexpressed in a number of clinically aggressive cancers. This study aimed to investigate the expression of the LAPTM4B-35 protein in normal salivary gland and salivary adenoid cystic carcinoma, a relatively indolent malignancy, and explore its clinicopathological significance in this malignancy. By immunohistochemical analysis, LAPTM4B-35 expression was evaluated in 106 cancer tissues, their adjacent non-cancerous tissues and five normal salivary glands. The correlation of LAPTM4B-35 expression with clinicopathological parameters was assessed using Chi-square or Fisher's exact test. The level of LAPTM4B-35 expression varied among different cell types of normal salivary glands. It was expressed at a fairly low level in serous and mucous acini, at low level in intercalated duct and excretory duct cells and moderately in secretory/striated ducts. In 50% of high grade tumor tissues tested, LAPTM4B-35 was markedly overexpressed. LAPTM4B-35 levels were significantly associated with histological grade and clinical stage. LAPTM4B-35 plays an important role in salivary adenoid cystic carcinoma and may serve as a diagnostic marker and a target for individualized therapy.
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Affiliation(s)
- Jianlin Fan
- Department of Stomatology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Jianxin Yang
- Department of Stomatology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Weiping Qiao
- Department of Stomatology, Wuzhong People's Hospital, Suzhou, Jiangsu 215100, P.R. China
| | - Wei Liu
- Department of Pathology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Chungen Xing
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
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Qian ZJ, Chen MM, Divi V, Megwalu UC. Impact of lymph node sampling on survival in cN0 major salivary gland adenoid cystic carcinoma. Head Neck 2019; 41:1903-1907. [PMID: 30620437 PMCID: PMC7202936 DOI: 10.1002/hed.25628] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/27/2018] [Accepted: 12/13/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The role of elective neck dissection in the management of major salivary gland adenoid cystic carcinoma is unclear. METHODS Data were retrospectively extracted from the National Cancer Center Database. The study cohort included 1504 patients with adenoid cystic carcinoma of major salivary glands with clinical N0 necks who were treated with surgery between 2004 and 2014. The cohort was divided into four groups based on number of lymph nodes (LNs) examined on pathology: 0, 1-8, 9-17, and ≥18 LNs. RESULTS The rate of occult nodal metastasis was 9.0%. Number of LNs removed was not associated with survival (Reference, 0 LNs; HR = 0.98, 95% CI 0.73-1.32 for 1-8 LNs; HR = 1.22, 95% CI 0.80-1.88 for 9-17 LNs; HR = 0.94, 95% CI 0.61-1.46 for ≥18 LNs) after adjusting for important covariates. CONCLUSIONS LN sampling is not associated with survival in cN0 major salivary gland ACC.
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Affiliation(s)
- Zhen Jason Qian
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Michelle M Chen
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Vasu Divi
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Uchechukwu C Megwalu
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
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46
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Su W, Yang HY. [Treatment plan and prognosis of salivary adenoid cystic carcinoma with lung metastasis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:214-219. [PMID: 31168990 DOI: 10.7518/hxkq.2019.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Salivary adenoid cystic carcinoma (SACC) is a common malignant tumor in the oral and maxillofacial region and accounts for approximately 3%-5% of all head and neck carcinomas. SACC always occurs in the palatal salivary gland and parotid gland. The tumor has the characteristics of strong invasion, perineural invasion, high hematogenous metastasis, and low lymph node metastasis rate. The biological characteristics of SACC determine the specificity of clinical treatment. Thus far, few clinical trials have investigated the efficacy of systemic therapy owing to the rarity of SACC with lung metastasis. Moreover, long-term results are poor, and no consensus on standard treatment has been reached yet. This systematic review aims to provide a retrospective analysis of treatment options and prognosis for SACC with lung metastasis and evidence for future clinical treatment.
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Affiliation(s)
- Wen Su
- Dept. of Stomatology, Anhui Medical University, Hefei 230032, China;Dept. of Oral and Maxillofacial Surgery, Shenzhen Hospital, Peking University, Shenzhen 518036, China
| | - Hong-Yu Yang
- Dept. of Stomatology, Anhui Medical University, Hefei 230032, China;Dept. of Oral and Maxillofacial Surgery, Shenzhen Hospital, Peking University, Shenzhen 518036, China
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Andreasen S, Kiss K, Mikkelsen LH, Channir HI, Plaschke CC, Melchior LC, Eriksen JG, Wessel I. An update on head and neck cancer: new entities and their histopathology, molecular background, treatment, and outcome. APMIS 2019; 127:240-264. [PMID: 30811708 DOI: 10.1111/apm.12901] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022]
Abstract
The head and neck region harbor numerous specialized tissues of all lineages giving rise to a plethora of different malignancies. In recent years, new types and subtypes of cancer has been described here due to the recognition of their histological and molecular characteristics. Some have been formally accepted in the most recent classifications from the World Health Organization (WHO) and American Joint Committee on Cancer (AJCC) as distinct diseases due to characteristics in clinical presentation, outcome, and treatment. In particular, this applies to malignancies of the salivary gland, sinonasal tract, and oropharynx. In this overview, we present the most recent developments in the classification, histopathological characteristics, and molecular features of head and neck cancer. The clinical and radiological characteristics, outcome, and treatment options including perspectives for targeted therapies, are discussed.
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Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.,Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Katalin Kiss
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Lauge Hjorth Mikkelsen
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark.,Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark
| | - Hani Ibrahim Channir
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Irene Wessel
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
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Pretreatment quantitative 18F-FDG PET/CT parameters as a predictor of survival in adenoid cystic carcinoma of the salivary glands. Clin Imaging 2019; 53:17-24. [DOI: 10.1016/j.clinimag.2018.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/11/2018] [Accepted: 09/25/2018] [Indexed: 12/15/2022]
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Mays AC, Hanna EY, Ferrarotto R, Phan J, Bell D, Silver N, Mulcahy CF, Roberts D, Abdelmeguid ASA, Fuller CD, Frank SJ, Raza SM, Kupferman ME, DeMonte F, Su SY. Prognostic factors and survival in adenoid cystic carcinoma of the sinonasal cavity. Head Neck 2018; 40:2596-2605. [PMID: 30447126 DOI: 10.1002/hed.25335] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 03/01/2018] [Accepted: 04/19/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Optimal treatment and prognostic factors affecting long-term survival in patients with sinonasal adenoid cystic carcinoma (ACC) have yet to be clearly defined. METHODS We conducted a retrospective review of patients treated with curative intent from 1980-2015 at MD Anderson Cancer Center. RESULTS One hundred sixty patients met inclusion criteria, including 8 who were treated with radiotherapy alone. Median follow-up time was 55 months. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 67.0% and 49.0%, respectively. The 10-year OS and DFS rates were 44.8% and 25.4%, respectively. Factors that portended for poor survival on multivariate analysis were recurrent disease, any solid type histology, epicenter in the sinus cavity, the presence of facial symptoms, or the original disease not treated with surgery. There was no association between surgical margin status or nodal status and survival. CONCLUSION In this large cohort of patients with sinonasal ACC with extended follow-up, long-term survival is better than reported in prior literature. Future research should target patients with adverse risk factors.
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Affiliation(s)
- Ashley C Mays
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Renata Ferrarotto
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Diana Bell
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Natalie Silver
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Collin F Mulcahy
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dianna Roberts
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shaan M Raza
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael E Kupferman
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Franco DeMonte
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shirley Y Su
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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50
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Practical clinical guidelines for contouring the trigeminal nerve (V) and its branches in head and neck cancers. Radiother Oncol 2018; 131:192-201. [PMID: 30206021 DOI: 10.1016/j.radonc.2018.08.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 01/15/2023]
Abstract
PURPOSE The trigeminal nerve (V) is a major route of tumor spread in several head and neck cancers. However, only limited data are currently available for its precise contouring, although this is absolutely necessary in the era of intensity-modulated radiation therapy (IMRT). The purpose of this article is to present practical clinical guidelines for contouring the trigeminal nerve (V) in head and neck cancers at risk of spread along this nerve. METHOD The main types of head and neck cancers associated with risks of spread along the trigeminal nerve (V) and its branches were comprehensively reviewed based on clinical experience, literature-based patterns of failure, anatomy and radio-anatomy. A consensus for contouring was proposed based on a multidisciplinary approach among head and neck oncology experts including radiation oncologists (JBi, ML, MO, VG and JB), a radiologist (VD) and a surgeon (CS). These practical clinical guidelines have been endorsed by the GORTEC (Head and Neck Radiation Oncology Group). RESULTS We provided contouring and treatment guidelines, supported by detailed figures and tables to help, for the trigeminal nerve and its branches: the ophthalmic nerve (V1), the maxillary nerve (V2) and the manidibular nerve (V3). A CT- and MRI-based atlas was proposed to illustrate the whole trigeminal nerve pathway with its main branches. CONCLUSION Trigeminal nerve (V) invasion is an important component of the natural history of various head and neck cancers. Recognizing the radio-anatomy and potential routes of invasion is essential for optimal contouring, as presented in these guidelines.
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