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Ye YC, Wang YP, Chang TE, Wu PS, Hsin IF, Chen PH, Tai SK, Chu PY, Hou MC, Lu CL. Routine image-enhanced endoscopic surveillance for metachronous esophageal squamous cell neoplasms in head and neck cancer patients. Esophagus 2024; 21:131-140. [PMID: 38194013 DOI: 10.1007/s10388-023-01039-3] [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: 06/06/2023] [Accepted: 12/08/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Esophageal squamous cell neoplasms (ESCNs) are common second primary tumors in patients with head and neck cancer. Image-enhanced endoscopy (IEE) with Lugol chromoendoscopy or magnifying narrow-band imaging both increase the detection of early ESCNs. No evidence-based ESCN surveillance program for head and neck cancer patients without a history of synchronous ESCNs exists. We aimed to evaluate the performance of an IEE surveillance program with magnifying narrow-band imaging endoscopy and Lugol chromoendoscopy. METHODS From April 2016, we routinely used IEE with magnifying narrow-band imaging and Lugol chromoendoscopy to evaluate patients with head and neck cancer history. All patients who were negative for ESCNs at the first surveillance endoscopy and received at least 2 IEEs through December 2019 were included. Demographic profiles, clinical data, cancer characteristics, IEE results and pathology reports were analyzed. RESULTS A total of 178 patients were included. Only 4 patients (2.2%) developed metachronous ESCNs during follow-up, all of whom received curative resection treatment. The interval for the development of metachronous ESCNs was 477 to 717 days. In multivariate Firth logistic regression and Kaplan‒Meier survival curve analysis, Lugol's voiding lesion type C had an increased risk of esophageal cancer development (adjusted odds ratio = 15.71; 95% confidence interval, 1.33-185.87, p = 0.029). Eight patients died during the study period, and none of them had metachronous ESCNs. CONCLUSIONS IEE with magnifying narrow-band imaging and Lugol chromoendoscopy is an effective surveillance program in head and neck cancer patients without a history of ESCNs. Annual surveillance can timely detect early ESCNs with low ESCN-related mortality.
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Affiliation(s)
- Yong-Cheng Ye
- Endoscopy Center For Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Po Wang
- Endoscopy Center For Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan.
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
- Institute of Brain Science, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Tien-En Chang
- Endoscopy Center For Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Shan Wu
- Endoscopy Center For Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - I-Fang Hsin
- Endoscopy Center For Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan
| | - Ping-Hsien Chen
- Endoscopy Center For Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan
- Division of Gastroenterology, Department of Medicine, West Garden Hospital, Taipei, Taiwan
| | - Shyh-Kuan Tai
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pen-Yuan Chu
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- Endoscopy Center For Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Liang Lu
- Endoscopy Center For Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Marijić B, Tudor F, Janik S, Grasl S, Frommlet F, Maržić D, Hadžisejdić I, Vukelić J, Braut T, Velepič M, Erovic BM. Long-Term Care and Follow-Up in Laryngeal Cancer Patients: A Multicenter Retrospective Analysis. J Pers Med 2023; 13:927. [PMID: 37373916 DOI: 10.3390/jpm13060927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE We conducted an outcome analysis on surgically treated laryngeal squamous cell carcinoma (LSCC) patients. METHODS A multicenter retrospective study with 352 patients was analyzed. A new nomogram that incorporates age, T- and N-classification, and treatment was created. RESULTS Recurrence was observed in 65 (18.5%) patients after a mean time of 16.5 months. After 60 months, 91 (25.9%) of patients developed secondary primary tumors (SPT), most commonly in the lungs (n = 29; 8.2%) followed by other head and neck cancers (n = 21; 6.0%). Notably, the mean time to occurrence of secondary head and neck cancers was twice that of lung cancer (101.1 vs. 47.5 months). CONCLUSION Recurrent disease is less common in LSCC patients and appears much earlier than SPT. Because one in every four laryngeal cancer patients develops SPTs within 5-10 years, long-term care and follow-up, including imaging studies, are highly recommended. The nomogram was useful for estimating survival.
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Affiliation(s)
- Blažen Marijić
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Filip Tudor
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Stefan Janik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, 1090 Vienna, Austria
| | - Stefan Grasl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, 1090 Vienna, Austria
| | - Florian Frommlet
- Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Medical University Vienna, 1090 Vienna, Austria
| | - Diana Maržić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Audiology and Phoniatrics, Clinical Hospital Centre Rijeka, 51000 Rijeka, Croatia
| | - Ita Hadžisejdić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Jelena Vukelić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Audiology and Phoniatrics, Clinical Hospital Centre Rijeka, 51000 Rijeka, Croatia
| | - Tamara Braut
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Marko Velepič
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Boban M Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria
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Afify AY, Ashry MH, Sadeq MA, Elsaid M. Causes of death after laryngeal cancer diagnosis: A US population-based study. Eur Arch Otorhinolaryngol 2023; 280:1855-1864. [PMID: 36357608 PMCID: PMC9989001 DOI: 10.1007/s00405-022-07730-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/26/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Several reports examined the survival of laryngeal cancer (LC) patients, most of these studies only focused on the prognosis of the disease, and just a small number of studies examined non-cancer-related causes of death. The objective of the current study is to investigate and quantify the most common causes of deaths following LC diagnosis. METHODS The data of 44,028 patient with LC in the United States diagnosed between 2000 and 2018 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) program and analyzed. We stratified LC patients according to various demographic and clinical parameters and calculated standardized mortality ratios (SMRs) for all causes of death. RESULTS Over the follow-up period, 25,407 (57.7%) deaths were reported. The highest fatalities (11,121; 43.8%) occurred within 1-5 years following LC diagnosis. Non-cancer causes of death is the leading cause of death (8945; 35.2%), followed by deaths due to laryngeal cancer (8,705; 34.3%), then other cancers deaths (7757; 30.5%). The most common non-cancer causes of death were heart diseases (N = 2953; SMR 4.42), followed by other non-cancer causes of death (N = 1512; SMR 3.93), chronic obstructive pulmonary diseases (N = 1420; SMR 4.90), then cerebrovascular diseases (N = 547; SMR 4.28). Compared to the general population, LC patients had a statistically significant higher risk of death from all reported causes. CONCLUSIONS Non-cancer causes of death is the leading cause of death in LC patients, exceeding deaths attributed to LC itself. These findings provide important insight into how LC survivors should be counselled regarding future health risks.
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Affiliation(s)
| | | | - Mohammed Ahmed Sadeq
- Faculty of Medicine, Misr University for Science and Technology, 6th of October, Giza, Egypt.,Medical Research Platform, Cairo, Egypt
| | - Mohamed Elsaid
- Faculty of Medicine, Misr University for Science and Technology, 6th of October, Giza, Egypt.,Medical Research Platform, Cairo, Egypt
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Huang YW, Wang YP, Lee TL, Chang CF, Hou MC, Tai SK, Chu PY. Image-enhanced endoscopy for detection of second primary esophageal neoplasms in patients with hypopharyngeal cancer: Prevalence, risk factors, and characteristics. J Chin Med Assoc 2021; 84:963-968. [PMID: 34320514 DOI: 10.1097/jcma.0000000000000592] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Esophageal second primary neoplasms (ESPNs) are common in hypopharyngeal squamous cell carcinoma (HPSCC) patients and are associated with poor prognoses. The effectiveness of image-enhanced endoscopy (IEE) has not been well established. METHODS We reviewed the patients between April 2016 and April 2018 with HPSCC receiving ESPNs screening via white-light imaging, narrow-band imaging, and Lugol chromoendoscopy. RESULTS Of 99 eligible patients, ESPNs prevalence was 31%. Of the 69 patients assigned to the follow-up group, 23 with positive findings showed significantly increased previous histories of second primary malignancies in the upper aerodigestive tract. Among them, patients without symptoms at the time of IEE screening showed less advanced T stages and higher percentages of receiving minimal invasive therapy. CONCLUSION The present study represented the clinical utility of routine IEE screening in HPSCC patients and proposed routine surveillance may help identify and properly manage early-stage ESPN.
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Affiliation(s)
- Yu-Wen Huang
- Department of Otolaryngology, Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yen-Po Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Tsung-Lun Lee
- Department of Otolaryngology, Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chia-Fan Chang
- Department of Otolaryngology, Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shyh-Kuan Tai
- Department of Otolaryngology, Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Pen-Yuan Chu
- Department of Otolaryngology, Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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5
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Ben Arie G, Shafat T, Belochitski O, El-Saied S, Joshua BZ. Treatment Modality and Second Primary Tumors of the Head and Neck. ORL J Otorhinolaryngol Relat Spec 2021; 83:420-427. [PMID: 34587611 DOI: 10.1159/000513617] [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: 01/20/2020] [Accepted: 12/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Second primary tumors (SPTs) in head and neck cancer are thought to occur from premalignant lesions that are present at the time of the primary tumor diagnosis. The association of the modality used to treat the primary lesion with SPT occurrence is not clear. OBJECTIVE The aim of the study was to assess the incidence of SPTs in patients with head and neck malignancies, according to treatment modality. METHODS We conducted a retrospective cohort study. All patients who were treated at Soroka Medical Center between 2000 and 2013 for a head and neck squamous cell carcinoma were assessed. Data analysis included tumor site of the primary and second primary and treatment modality of the primary tumor. In addition, demographics as well as habits were recorded as well. RESULTS Of the 184 patients included in the cohort, SPT developed in 31 patients (17%) with a median time to diagnosis of 4.3 years. Smoking was reported in 74% of those with SPT and 78% of those without. The most common site for SPT was the lungs, with 13 cases, 42% of the total SPTs. Among patients who developed an SPT, for 12 of those with an index tumor in the oral cavity or oro-hypopharynx, 8 (67%) developed an SPT in the same location; for 18 of those with an index tumor in the larynx, 11 (61%) developed a SPT in the lungs and bronchi (p = 0.001). On multivariate analysis, the treatment modality used was not found to be associated with the occurrence of SPTs and the radiotherapy showed no protective or harmful effect (HR 0.64 p = 0.24). CONCLUSION Treatment modality used for head and neck cancer does not seem to be associated with the occurrence of SPTs.
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Affiliation(s)
- Gal Ben Arie
- Department of Medical Imaging, Soroka University Medical Center, Beer- Sheva, Israel
| | - Tali Shafat
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Olga Belochitski
- Department of Oncology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Sabri El-Saied
- Department of Otolaryngology and Head and Neck Surgery, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ben-Zion Joshua
- Department of Otolaryngology and Head and Neck Surgery, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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6
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Bugter O, van Iwaarden DLP, van Leeuwen N, Nieboer D, Dronkers EAC, Hardillo JAU, Baatenburg de Jong RJ. A cause-specific Cox model for second primary tumors in patients with head and neck cancer: A RONCDOC study. Head Neck 2021; 43:1881-1889. [PMID: 33655596 PMCID: PMC8247881 DOI: 10.1002/hed.26666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/12/2021] [Accepted: 02/19/2021] [Indexed: 12/11/2022] Open
Abstract
Background The aim of this study was to identify risk factors for the development of second primary tumors (SPTs) in the head and neck region, lungs, and esophagus in patients with head and neck cancer. Methods We collected data from 1581 patients. A cause‐specific Cox model for the development of an SPT was fitted, accounting for the competing risks residual/recurrent tumor and mortality. Results Of all patients, 246 (15.6%) developed SPTs. Analysis showed that tobacco and alcohol use, comorbidity, and the oral cavity subsite were risk factors for SPTs. The C‐index, the discriminative accuracy, of the model for SPT was 0.65 (95% confidence interval, 0.61–0.68). Conclusions Our results show that there is potential to identify patients who have an increased risk to develop an SPT. This might increase their survival chances and quality of life. More research is needed to provide head and neck clinicians with definitive recommendations.
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Affiliation(s)
- Oisín Bugter
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dirk L P van Iwaarden
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nikki van Leeuwen
- Department of Public Health, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Center for Medical Decision Making, Rotterdam, The Netherlands
| | - Daan Nieboer
- Department of Public Health, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Center for Medical Decision Making, Rotterdam, The Netherlands
| | - Emilie A C Dronkers
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - José A U Hardillo
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Henrys C, Slaughter T, Bernard A, Perry C, Porceddu S, Panizza B. Primary pharyngolaryngectomy with jejunal free flap reconstruction: a single centre's evolving experience. ANZ J Surg 2020; 90:1965-1969. [PMID: 32356604 DOI: 10.1111/ans.15930] [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: 09/24/2019] [Revised: 03/25/2020] [Accepted: 04/09/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Head and neck squamous cell carcinoma, and in particular hypopharyngeal squamous cell carcinoma, has long been associated with disfiguring treatment options, significant morbidity and limited long-term survival outcomes. Total pharyngolaryngectomy (TPL) with free flap reconstruction followed by post-operative radiation therapy or chemoradiotherapy is a widely accepted treatment of choice for advanced disease of the hypopharynx. METHODS Our unit undertook a 11-year review of all primary TPL patients aiming to provide an update on survival outcomes, morbidity, post-operative complications and evolving management strategies. We report one of the largest single-centre series to date with 89 patients undergoing primary TPL between 2003 and 2013, and compare these outcomes to 180 patients undergoing TPL at the same facility in the previous 23 years. RESULTS Between study periods, we saw a shift in patient population towards higher stage disease (T-stage 3 or 4 97% 2003-2013; 68% 1979-2002) and increased nodal involvement (node positive 88% 2003-2013; 70% 1979-2002) without a subsequent reduction in 5-year disease-specific survival (52% 2003-2013; 52% 1979-2002) or 5-year overall survival (32% 2003-2013; 33% 1979-2002).
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Affiliation(s)
- Courtenay Henrys
- Department of Otolaryngology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Thomas Slaughter
- Department of Otolaryngology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Anne Bernard
- Department of Otolaryngology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Christopher Perry
- Department of Otolaryngology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Sandro Porceddu
- Department of Otolaryngology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Benedict Panizza
- Department of Otolaryngology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Second primary lung cancer following laryngeal cancer: retrospective study of incidence and multivariate analysis of risk factors in 209 patients. The Journal of Laryngology & Otology 2019; 133:974-979. [PMID: 31668148 DOI: 10.1017/s0022215119002147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To analyse the incidence of second primary lung cancer following treatment for laryngeal cancer and to identify risk factors for its development. METHOD Retrospective case series. RESULTS The five-year actuarial incidence of second primary lung cancer was 8 per cent (1.6 per cent per year). This was associated with a very poor median survival of seven months following diagnosis. Supraglottic tumours were associated with an increased risk of second primary lung cancer compared to glottic tumours in both univariate (hazard ratio = 4.32, p = 0.005) and multivariate analyses (hazard ratio = 4.14, p = 0.03). CONCLUSION Second primary lung cancer occurs at a rate of 1.6 per cent per year following a diagnosis of laryngeal cancer, and this is associated in a statistically significant manner with supraglottic primary tumour. The recent National Lung Cancer Screening Trial suggests a survival advantage of 20 per cent at five years with annual screening using low-dose computed tomography scanning of the chest in a comparable cohort to ours. These findings have the potential to inform post-treatment surveillance protocols in the future.
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Ozdemir Y, Topkan E. Second primary malignancies in laryngeal carcinoma patients treated with definitive radiotherapy. Indian J Cancer 2019; 56:29-34. [PMID: 30950440 DOI: 10.4103/ijc.ijc_273_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Second primary malignancy (SPM) is associated with decreased overall survival (OS) in laryngeal carcinomas (LC). METHODS One hundred eighty three LC patients were analyzed retrospectively. The primary and secondary endpoints were the incidence of SPM and the OS difference between patients with and without SPM. RESULTS SPM developed in 22 (12.0%) patients at median 52 months (range, 4-131 months), with a yearly 2.8% incidence, of which 19 (10.4%) and 3 (1.6%) were metachronous and synchronous, respectively. Lung was the commonest SPM (72.7%). Of 47 deaths, 12 (25.5%) were SPM related. Comparatively SPM patients had significantly shorter median OS (68.0 months vs. median not reached; P = 0.005), with lower 5-year (67.0% vs. 78.9%) and 8-year (32.6 vs. 69.8%) survival rates. CONCLUSION The present findings suggested the SPM as a competing risk factor for death in index LC patients with its annual incidence rate of 2.8% and for accounting one of every four deaths in this patients group. Emergence of lung carcinoma as the most frequent type of SPM and the ability to treat >50% of them with an estimated long-term outcomes emphasizes the importance of early diagnosis and curative treatment of SPMs.
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Affiliation(s)
- Yurday Ozdemir
- Department of Radiation Oncology, Baskent University Adana Treatment and Research Center, Adana, Turkey
| | - Erkan Topkan
- Department of Radiation Oncology, Baskent University Adana Treatment and Research Center, Adana, Turkey
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10
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Sharma D, Sharma N, Goel V. Second primary malignancies in patients with radiotherapy-treated laryngeal carcinoma - A commentary. Indian J Cancer 2019; 56:35-36. [PMID: 30950441 DOI: 10.4103/ijc.ijc_518_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Deepti Sharma
- Department of Radiation Oncology, Max Superspeciality Hospital, Delhi, India
| | - Neha Sharma
- Department of Radiation Oncology, MAMC and Lok Nayak Hospital, New Delhi, India
| | - Vineeta Goel
- Department of Radiation Oncology, Max Superspeciality Hospital, Delhi, India
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Adeel M, Siddiqi MI. Metachronous second primary malignancy in head and neck cancer patients: is five years of follow-up sufficient? J Korean Assoc Oral Maxillofac Surg 2018; 44:220-224. [PMID: 30402413 PMCID: PMC6209691 DOI: 10.5125/jkaoms.2018.44.5.220] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/17/2017] [Accepted: 03/02/2018] [Indexed: 11/07/2022] Open
Abstract
Objectives The aim of this study was to determine the incidence and characteristics of second primary malignancy (SPM) in patients with head and neck squamous cell carcinoma treated at a tertiary care hospital. Materials and Methods We retrospectively reviewed the medical records of 221 patients who underwent surgery with or without adjuvant treatment for head and neck cancer from 2000 to 2002. Data of age, sex, risk factors, sites of primary and SPM, TNM stage of primary tumor, incidence of SPM, and survival were collected from medical charts. Results Eighteen patients developed SPM during a median follow-up of 67 months, with an overall incidence of 8.14%. In addition, 77.7% of SPMs occurred in the oral cavity, followed by 11% in the lungs. The 5-year overall survival after the diagnosis of SPM in the head or neck was 70%, compared to 30% for SPM in other body regions. Conclusion Considering a high incidence of SPM, i.e., 8.14%, in a mean follow-up period of 67 months suggests the need for long-term follow-up. Since treatment of SPM has shown an acceptable survival rate, early detection and curative therapy should be emphasized.
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Affiliation(s)
- Mohammad Adeel
- Department of Surgical Oncology, Section of Head and Neck Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan
| | - Moghira Iqbal Siddiqi
- Department of Otolaryngology & Head and Neck Surgery, The Aga Khan University Hospital, Karachi, Pakistan
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Esophageal squamous cell neoplasia is an independent negative prognostic factor for head and neck cancer patients. Int J Clin Oncol 2017; 23:243-248. [PMID: 29063984 DOI: 10.1007/s10147-017-1201-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 10/07/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Patients with head and neck cancer (HNC) have a high incidence of esophageal squamous cell neoplasms (ESCN). ESCN also has a negative impact on the survival of HNC patients. However, recent endoscopic advances enable the early detection of ESCN, and novel treatments may lead to improving survival rates for HNC patients with ESCN. METHODS HNC patients who underwent magnifying esophagogastroduodenoscopy (EGDS) from 2005 to 2012 were included in this study (n = 226). We analyzed the prevalence and prognostic value of ESCN in HNC patients and the difference in overall survival between HNC patients with and without ESCN. RESULTS Thirty-four patients (15%) developed an ESCN during their clinical course. Of the 34 patients, 10 patients underwent endoscopic resection for ESCN and 10 patients underwent simultaneous chemoradiation therapy for HNC and ESCN. The 3-year survival rates in HNC patients with and without ESCN were 53% and 70%, respectively. Multivariate analysis identified the advanced clinical stage of the HNC [hazard ratio (HR) = 2.15; 95% confidence interval (CI) = 1.18-3.93; p = 0.012] and the presence of ESCN (HR = 1.73; 95% CI = 1.00-2.97; p = 0.049) as significant and independent determinants of overall survival. CONCLUSIONS Our study suggests that although the survival of HNC patients with ESCN may be improved by routine EGDS during tumor surveys and by advances in endoscopy, the presence of ESCN still remains an independent negative prognostic factor for HNC patients.
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Wang YK, Chuang YS, Wu TS, Lee KW, Wu CW, Wang HC, Kuo CT, Lee CH, Kuo WR, Chen CH, Wu DC, Wu IC. Endoscopic screening for synchronous esophageal neoplasia among patients with incident head and neck cancer: Prevalence, risk factors, and outcomes. Int J Cancer 2017; 141:1987-1996. [PMID: 28758200 DOI: 10.1002/ijc.30911] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/04/2017] [Accepted: 07/20/2017] [Indexed: 12/14/2022]
Abstract
Esophageal squamous-cell neoplasia (ESCN) is a common second primary neoplasia found in patients with head-and-neck squamous-cell carcinoma (HNSCC). This study sought to identify the risk factors for synchronous ESCN and how they influence survival in HNSCC patient. Eight hundred and fifteen incident HNSCC patients were prospectively recruited for endoscopy screening for ESCN using white-light imaging, narrow-band imaging, Lugol chromoendoscopy, and pathological confirmation. Associated lifestyle and clinicopathological data were collected. The interquartile follow-up period cutoffs were 11.3, 20.5 and 34.9 months. 124 patients (15.2%) were diagnosed as having synchronous ESCN (66 low-grade dysplasia, 29 high-grade dysplasia, and 29 esophageal squamous-cell carcinoma). Consumption of alcohol, but not betel nut or cigarette, was significantly associated with the presence of synchronous ESCN (adjusted odds ratio [aOR] = 7.1 and 10.9 for former and current drinkers, respectively). There was an interaction between cumulative dose of alcohol consumption and alcohol flushing response on the development of ESCN. High-dose drinkers with flush response were 16.9 times more likely to have esophageal high-grade dysplasia/SCC than non-drinkers. Compared with oral cavity cancer patients, those with hypopharyngeal, laryngeal and oropharyngeal cancer were 6.8, 4.6 and 2.8 times more likely to have esophageal high-grade dysplasia/SCC. HNSCC patients with synchronous ESCN had lower overall survival than those without (p < 0.0001). In conclusion, surveillance of ESCN is strongly recommended for the high-risk subpopulation of HNSCC patients, especially drinkers who have a flush response to alcohol, and those with distant metastasis of index cancer and cancers in hypopharynx, oropharynx and larynx.
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Affiliation(s)
- Yao-Kuang Wang
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Yun-Shiuan Chuang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tzung-Shiun Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ka-Wo Lee
- Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Che-Wei Wu
- Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiang-Chen Wang
- Graduate Institute of Opto-Mechatronics, National Chung Cheng University, Chia-Yi, Taiwan
| | - Chie-Tong Kuo
- Department of Physics, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.,Environmental Medicine Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wen-Rei Kuo
- Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Ho Chen
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Deng-Chyang Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - I-Chen Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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14
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Liu CJ, Chang WJ, Chen CY, Sun FJ, Cheng HW, Chen TY, Lin SC, Li WC. Dynamic cellular and molecular modulations of diabetes mediated head and neck carcinogenesis. Oncotarget 2015; 6:29268-84. [PMID: 26337468 PMCID: PMC4745725 DOI: 10.18632/oncotarget.4922] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 08/11/2015] [Indexed: 01/01/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most prevalent neoplasms worldwide. While numerous potent dietary insults were considered as oncogenic players for HNSCC development, the impact of metabolic imbalance was less emphasized during HNSCC carcinogenesis. Previous preclinical and epidemiological investigations showed that DM could possibly be correlated with greater incidence and poorer prognosis in HNSCC patients; however, the outcomes from different groups are contradictive and underlying mechanisms remains elusive. In the present study, the changes of cellular malignancy in response to prolonged glucose incubation in HNSCC cells were examined. The results demonstrated that hyperglycemia enhanced HNSCC cell malignancy over time through suppression of cell differentiation, promotion of cell motility, increased resistance to cisplatin, and up-regulation of the nutrient-sensing Akt/AMPK-mTORC1 pathway. Further analysis showed that a more aggressive tongue neoplastic progression was found under DM conditions compared to non-DM state whereas DM pathology led to a higher percentage of cervical lymph node metastasis and poorer prognosis in HNSCC patients. Taken together, the present study confirms that hyperglycemia and DM could enhance HNSCC malignancy and the outcomes are of great benefit in providing better anti-cancer treatment strategy for DM patients with HNSCC.
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MESH Headings
- AMP-Activated Protein Kinases/metabolism
- Adult
- Aged
- Animals
- Antineoplastic Agents/pharmacology
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/pathology
- Cell Differentiation
- Cell Line, Tumor
- Cell Movement
- Cell Proliferation
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- Cell Transformation, Neoplastic/pathology
- Cisplatin/pharmacology
- Cytoskeleton/metabolism
- Diabetes Complications/etiology
- Diabetes Complications/genetics
- Diabetes Complications/metabolism
- Diabetes Complications/pathology
- Drug Resistance, Neoplasm
- Epithelial-Mesenchymal Transition
- Female
- Glucose/metabolism
- Head and Neck Neoplasms/drug therapy
- Head and Neck Neoplasms/etiology
- Head and Neck Neoplasms/genetics
- Head and Neck Neoplasms/metabolism
- Head and Neck Neoplasms/pathology
- Humans
- Kaplan-Meier Estimate
- Lymphatic Metastasis
- Male
- Mechanistic Target of Rapamycin Complex 1
- Mice, Inbred C57BL
- Middle Aged
- Multiprotein Complexes/metabolism
- Proportional Hazards Models
- Proto-Oncogene Proteins c-akt/genetics
- Proto-Oncogene Proteins c-akt/metabolism
- RNA Interference
- Retrospective Studies
- Risk Factors
- Signal Transduction
- Squamous Cell Carcinoma of Head and Neck
- TOR Serine-Threonine Kinases/metabolism
- Time Factors
- Transfection
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Chung-Ji Liu
- Department of Oral and Maxillofacial Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
- Institute of Oral Biology and Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Wan-Jung Chang
- Institute of Oral Biology and Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Chang-Yi Chen
- Institute of Oral Biology and Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
- Mackay College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Hui-Wen Cheng
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tsai-Ying Chen
- Institute of Oral Biology and Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Shu-Chun Lin
- Institute of Oral Biology and Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wan-Chun Li
- Institute of Oral Biology and Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
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Kim DH, Gong EJ, Jung HY, Lim H, Ahn JY, Choi KS, Lee JH, Choi KD, Song HJ, Lee GH, Kim JH, Roh JL, Choi SH, Nam SY, Kim SY, Baek S. Clinical significance of intensive endoscopic screening for synchronous esophageal neoplasm in patients with head and neck squamous cell carcinoma. Scand J Gastroenterol 2014; 49:1486-92. [PMID: 25372595 DOI: 10.3109/00365521.2013.832369] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Patients with head and neck squamous cell carcinoma (HNSCC) often develop second primary tumors in the upper aerodigestive tract. Early detection of synchronous esophageal squamous cell neoplasm (ESCN) is important because the prognosis of HNSCC can be affected by the statuses of second primary tumors. METHODS In a prospective study, 308 patients with HNSCC were screened for synchronous ESCN between May 2010 and April 2012. All patients underwent conventional white-light endoscopic examination with Lugol chromoendoscopy and narrow band image. RESULTS The median age was 61 years (range, 26-87 years), and the male-to-female ratio was 4.2:1. Two hundred and thirty-four patients (76.0%) were current or ex-smokers, 207 patients (67.2%) had a history of alcohol consumption and 56 patients (18.2%) had previous history of cancer. Synchronous ESCN was detected in 22 patients (7.1%), and most patients were at an early stage. The locations of index HNSCC in these patients were as follows: hypopharynx (n = 12), larynx (n = 6), oropharynx (n = 2) and oral cavity (n = 2). Synchronous ESCN was detected in 25.5% (12/47) of hypopharyngeal cancer and in 27.8% (15/54) of HNSCC involving the pyriform sinus. Multivariate analysis showed that smoking (current smoker vs. never smoker, Odds Ratio [OR] 8.3, p = 0.028), a history of cancer (OR 5.0, p = 0.002) and pyriform sinus involvement (OR 9.2, p < 0.0001) increased the risk of developing synchronous ESCN. CONCLUSIONS Patients with HNSCC, especially those who are current smokers, have a history of cancer and have pyriform sinus involvement, should undergo intensive endoscopic screening to detect synchronous ESCN.
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Affiliation(s)
- Do Hoon Kim
- Departments of Gastroenterology, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, Asan Medical Center , Seoul , Korea
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Abstract
BACKGROUND Coincident thyroid and head and neck squamous cell carcinomas are rare. This paper presents a case of synchronous laryngeal squamous cell carcinoma, follicular thyroid carcinoma and micropapillary thyroid carcinoma. METHODS A PubMed search was performed for articles describing synchronous thyroid and head and neck squamous cell carcinomas, using the search terms 'thyroid cancer', 'cancer of the head and neck', 'synchronous' and 'synchronous neoplasm'. RESULTS The literature suggests that the head and neck squamous cell carcinoma stage is a better predictor of outcome than the extent of surgical treatment of the thyroid gland in synchronous malignancies. CONCLUSION The decision regarding surgical treatment of the thyroid in synchronous thyroid and head and neck squamous cell carcinomas should take several factors into account. The head and neck squamous cell carcinoma stage is the strongest predictor of outcome, although patient-related factors and the location of malignant thyroid tissue may also affect management.
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17
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Causes of death of patients with laryngeal cancer. Eur Arch Otorhinolaryngol 2013; 271:425-34. [PMID: 23591796 DOI: 10.1007/s00405-013-2478-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 03/27/2013] [Indexed: 12/19/2022]
Abstract
Despite remarkable advances in the care of patients with laryngeal cancer over the past several decades, including a growing awareness of therapeutic complications and attention to quality of life, little is known about the causes of mortality in this population. In addition to the laryngeal malignancy itself, acute and late or chronic treatment-associated causes, second primary cancers, intercurrent disease and psychosocial factors are all responsible for patient morbidity and mortality. We examine the current literature related to the causes of death in patients with laryngeal cancer, in the hope of guiding future interventions to improve the longevity and quality of life of individuals with this cancer.
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18
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Atienza JAS, Dasanu CA. Incidence of second primary malignancies in patients with treated head and neck cancer: a comprehensive review of literature. Curr Med Res Opin 2012; 28:1899-909. [PMID: 23121148 DOI: 10.1185/03007995.2012.746218] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Increased incidence of a second primary aero-digestive malignancy after an index head and neck cancer (HNC) is well-documented. Furthermore, a clear set of surveillance strategies for second primary aero-digestive cancers in these patients exists. METHODS The goal of this article is to review the published literature on risk of second primary malignancies (SPMs) (including aero-digestive malignancies) after a treated index HNC as well as its associated predictors, prognosis and surveillance. Most relevant publications were identified through searching the PubMed database for articles published up to July 2012; epidemiologic evidence was synthesized and thoroughly analyzed. FINDINGS Data from randomized controlled trials, meta-analyses, population-based and cohort group studies, prior reviews, and case reports indicate an increased incidence of various SPMs after occurrence of a HNC. These cancers are not limited to upper aero-digestive sites. Common risk factors including environmental, genetic and immune factors may explain the increased incidence of second cancers in this patient population. In addition, site of the index HNC may predict the site of a future SPM. CONCLUSIONS As a general rule, oral cavity and oropharyngeal squamous cell cancers are associated more with head and neck region SPM, while laryngeal and hypopharyngeal cancers - with that of the lung. As these cancers confer dismal prognosis and shorter survival in patients with HNCs, several literature sources recommend close surveillance for and an aggressive therapy of SPM. Notwithstanding, their optimal management and follow-up schedule remains to be established.
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Affiliation(s)
- Jonessa Ann S Atienza
- University of Connecticut, Department of Internal Medicine, Farmington, CT 06030, USA.
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19
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Wierzbicka M, Waśniewska E, Jackowska J, Leszczyńska M, Szyfter W. Problematyka monitorowania chorych leczonych z powodu nowotworów głowy i szyi. Otolaryngol Pol 2012; 66:138-47. [DOI: 10.1016/s0030-6657(12)70762-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 11/30/2011] [Indexed: 11/17/2022]
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20
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Schultz P. Vocal fold cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128:301-8. [PMID: 21959270 DOI: 10.1016/j.anorl.2011.04.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 04/03/2011] [Accepted: 04/16/2011] [Indexed: 11/17/2022]
Abstract
Ninety percent of vocal fold cancers take the form of squamous cell carcinoma. Since the 1980s, incidence in France has been constantly falling in males while increasing in females. The main risk factor is smoking, alcohol being less implicated than in other laryngeal or extralaryngeal locations. Vocal fold squamous cell carcinoma generally develops on healthy mucosa, although primary precancerous lesions such as leukoplakia or papillomatous keratosis are also frequent. The tumor usually originates in the non-lymphophilic mucosal free edge of the vocal fold then invades the various anatomic subunits of the larynx, acquiring lymph-node metastatic potential. Dysphonia is the first presenting symptom, initially caused by defective mucosal vibration and then by impaired mobility and finally fixation of the vocal fold. Extension, risk factor and pretreatment assessments are as in other upper-aerodigestive-tract cancer locations. The possibilities of laryngoscopic exposure and the tumor limits, however, need to be precisely determined if transoral resection is to be considered. For small tumors, surgery or exclusive radiation therapy can be suggested to the patient as part of an individual treatment plan, each having its advantages and drawbacks. Cutting-edge teams report 5-year local control rates of 85-95% in T1-class tumor and 60-90% in T2. Whatever the treatment option, smoking cessation, close surveillance and cardiovascular prevention enable screening of other oncologic locations and limit onset of the other pathologies implicated in most deaths.
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Affiliation(s)
- P Schultz
- Service d'ORL et de chirurgie cervicofaciale, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, avenue Molière, 67098 Strasbourg cedex, France.
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21
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Liu Y, Li Y, Liu Z, Zhang L, Anniko M, Duan M. Prognostic significance of matrix metalloproteinase-20 overexpression in laryngeal squamous cell carcinoma. Acta Otolaryngol 2011; 131:769-73. [PMID: 21466263 DOI: 10.3109/00016489.2011.560186] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
CONCLUSION Matrix metalloproteinase (MMP)-20 is overexpressed in laryngeal squamous cell carcinoma (LSCC) compared with the adjacent normal laryngeal epithelium and MMP-20 plays a role in lymph node metastasis. Overexpression of MMP-20 may be used as a significant prognostic factor for lymph node metastasis. All the findings indicate that MMP-20 may play a role in the initiation and progression of LSCC. OBJECTIVE The MMPs are a gene family of zinc-dependent endopeptidases that have been implicated in tumor invasion and metastasis, and MMP-20 is a new member of the MMP family. The purpose of this study was to investigate whether MMP-20 is overexpressed in human LSCC and, if so, the significance of its overexpression in relation to clinical parameters. METHODS We analyzed 33 cases of LSCC with RT-PCR and 73 cases of LSCC with immunohistochemistry compared with normal laryngeal epithelium. RESULTS We found that MMP-20 is overexpresssed in LSCC compared with the adjacent normal laryngeal epithelium.
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Affiliation(s)
- Yehai Liu
- Department of Otolaryngology, Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
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