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Bozec A, Culié D, Poissonnet G, Demard F, Dassonville O. Current Therapeutic Strategies in Patients with Oropharyngeal Squamous Cell Carcinoma: Impact of the Tumor HPV Status. Cancers (Basel) 2021; 13:cancers13215456. [PMID: 34771619 PMCID: PMC8582410 DOI: 10.3390/cancers13215456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/28/2021] [Accepted: 10/28/2021] [Indexed: 01/19/2023] Open
Abstract
Simple Summary Contrary to other head and neck subsites, oropharyngeal squamous cell carcinoma (OPSCC) has shown a considerable increase in incidence over the past 20 years. This growing incidence is largely due to the increasing place of human papillomavirus (HPV)-related tumors. HPV-positive and HPV-negative OPSCC are two distinct entities with considerable differences in terms of treatment response and prognosis. However, there are no specific recommendations yet in the therapeutic management of OPSCC patients according to their tumor HPV-status. The aim of this review is therefore to discuss the therapeutic management of patients with OPSCC and the impact of HPV status on treatment selection. Abstract Since there is no published randomized study comparing surgical and non-surgical therapeutic strategies in patients with oropharyngeal squamous cell carcinoma (OPSCC), the therapeutic management of these patients remains highly controversial. While human papillomavirus (HPV)-positive and HPV-negative OPSCC are now recognized as two distinct diseases with different epidemiological, biological, and clinical characteristics, the impact of HPV status on the management of OPSCC patients is still unclear. In this review, we analyze the current therapeutic options in patients with OPSCC, highlighting the most recent advances in surgical and non-surgical therapies, and we discuss the impact of HPV status on the therapeutic strategy.
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Abstract
Based on a review of the medical literature, the authors document the key technical points, variants, technical errors to avoid and main functional results of lateral pharyngotomy for resection of cancers originating from the lateral oro and/or hypopharynx.
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Styloglossus muscle: a critical landmark in head and neck oncology. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:421-425. [PMID: 30341015 DOI: 10.1016/j.anorl.2017.11.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/31/2017] [Accepted: 11/06/2017] [Indexed: 01/07/2023]
Abstract
GOAL To document the role of the styloglossus muscle (SG) in head and neck oncology and at the time of surgical treatment and mandibular preservation surgery for squamous cell carcinoma of the lateral oropharynx (SCCLO). METHOD Based on a search conducted within the Pubmed, Embase, and Cochrane databases, using the key words SG muscle, parapharyngeal space and oropharynx, the authors discuss the embryology, physiology, anatomy and radiology of this muscle as well as its role in the oncologic staging surgery of SCCLO. RESULTS The most specific radiologic exam to evaluate the involvement of SG muscle in SCCLO is magnetic resonance imaging (MRI). According to the eigth international staging classification systems, radiologic invasion of the SG muscle, at the time of MRI, leads to reclassify as T4a many tumors considered as T1-3 at the time of clinical and/or on computerized tomography evaluation. This must lead to extreme care when comparing oncologic results from series published prior and after the MRI era. When transoral resection of the SG muscle is advocated for SCCLO, one must know that this maneuver brings numerous arterial and venous structures within the operative field. If difficulties to achieve safe margins of resection and/or to control bleeding are encountered, a simple trans cervical maneuver described herein is most useful. CONCLUSION The importance of the SG muscle should be emphasized as a touchstone for staging and surgeon's guide to mandibular preservation surgery of SCCLO. The various approaches allowing the control of this muscle and its vascular environment must be taught at the time of initial training.
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Roux M, Dassonville O, Ettaiche M, Poissonnet G, Sudaka A, Bozec A. Transoral-transcervical oropharyngectomy without mandibulotomy, associated to fasciocutaneous radial forearm free-flap reconstruction, for oropharyngeal cancer: Postoperative course, oncologic and functional results, and prognostic factors. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:71-76. [DOI: 10.1016/j.anorl.2016.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sinha P, Pipkorn P, Zenga J, Haughey BH. The Hybrid Transoral-Pharyngotomy Approach to Oropharyngeal Carcinoma: Technique and Outcome. Ann Otol Rhinol Laryngol 2017; 126:357-364. [DOI: 10.1177/0003489417691297] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The indications, techniques, and outcomes for a minimally invasive surgical approach in oropharyngeal squamous cell carcinoma (OPSCC) unsuitable for transoral resection are not well-described. Methods: A retrospective case series was performed using a prospectively assembled database of transoral surgery–treated OPSCC patients who also underwent a “hybrid” approach of combined transoral and limited pharyngotomy for tumor resection. Disease and functional outcomes were evaluated. Results: Twenty patients underwent complete tumor resection using the hybrid approach. Median follow-up was 48 months. No postoperative pharyngocutaneous fistula occurred. One patient (5%) had a local recurrence. Kaplan-Meier estimates for disease-specific survival at 2 and 5 years were 94.4% (95% CI, 84%-100%) and 87% (95% CI, 70%-100%). All but 1 patient (due to chemoradiotherapy-related chondroradionecrosis) were decannulated, and 2 required long-term gastrostomy. Conclusion: In the absence of a favorable transoral access, the “hybrid” approach of combined transoral and limited pharyngotomy can accomplish margin-negative primary tumor resection, with a high degree of disease control and functional recovery in selected OPSCC patients.
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Affiliation(s)
- Parul Sinha
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Patrik Pipkorn
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joseph Zenga
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bruce H. Haughey
- Department of Head and Neck Surgery, Florida Hospital Celebration Health, Celebration, Florida, USA
- Department of Surgery, University of Auckland Faculty of Medicine and Health Sciences, Auckland, New Zealand
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Peisker A, Raschke GF, Guentsch A, Roshanghias K, Eichmann F, Schultze-Mosgau S. Longterm quality of life after oncologic surgery and microvascular free flap reconstruction in patients with oral squamous cell carcinoma. Med Oral Patol Oral Cir Bucal 2016; 21:e420-4. [PMID: 27031070 PMCID: PMC4920454 DOI: 10.4317/medoral.21111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/21/2016] [Indexed: 01/19/2023] Open
Abstract
Background Quality of life (QoL) has become increasingly important in cancer treatment. It refers to the patient’s perception of the effects of the disease and therapy, and their impact on daily functioning and general feeling of well being. Material and Methods n this prospective study, a total of 100 patients treated at our institution, completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire and the specific EORTC QLQ-H&N35 module. The questionnaires were distributed to the patients between 12 and 60 months postoperatively. Results Global QoL score was 58.3 and mean score for functioning scale was 76.7. Fatigue (28.7 ± 26.1), followed by financial problems (27.7 ± 33.5), insomnia (26.7 ± 34.5) and pain (26.3 ± 29.9) had highest symptom score on QLQ-C30. Fatigue (r=-0.488), insomnia (r=-0.416) and pain (r =-0.448) showed highest value for significantly negative correlation to global QoL. In the H&N35 module, restriction of mouth opening (43.3 ± 38.6), dry mouth (40.7 ± 36.9), sticky saliva (37.3 ± 37.1) and eating in public (33.8 ± 31.9) were the four worst symptoms. Swallowing problem (r=-0.438), eating in public (r=-0.420) and persistent severe speech (r=-0.398) ranked as the three worst symptoms with highest value for significantly negative correlation to global QoL. Conclusions Longterm QoL after oncologic surgery and microvascular free flap reconstruction in patients with oral cancer is satisfactory. Measuring QoL should be considered as part of the evaluation of cancer treatment. Key words:Longterm quality of life, oral cancer, oncologic surgery, microvascular free flap reconstruction.
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Affiliation(s)
- A Peisker
- Department of Cranio-Maxillofacial & Plastic Surgery, Jena University Hospital, 07747 Jena, Germany,
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Culié D, Benezery K, Chamorey E, Ettaiche M, Fernandez J, Poissonnet G, Riss JC, Hannoun-Lévi JM, Chand ME, Leysalle A, Saada E, Sudaka A, Haudebourg J, Demard F, Santini J, Peyrade F, Dassonville O, Bozec A. Salvage surgery for recurrent oropharyngeal cancer: post-operative oncologic and functional outcomes. Acta Otolaryngol 2015. [PMID: 26223741 DOI: 10.3109/00016489.2015.1066935] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Post-operative outcomes of salvage surgery for recurrent oropharyngeal squamous-cell carcinoma (OPSCC) were acceptable. Pathologic overall, T- or N-stage and patient comorbidities were the main predictors of patient clinical outcomes. OBJECTIVES To evaluate post-operative outcomes of salvage surgery in patients with recurrent OPSCC and to determine their predictive factors. MATERIALS AND METHODS This study retrospectively reviewed the electronic medical records of all patients who underwent salvage surgery for recurrent OPSCC, between 2000-2013, in our institution. Overall survival (OS) and cause-specific survival (SS) were determined by Kaplan-Meier analysis. Predictive factors of post-operative outcomes were investigated by using univariate and multivariate analyses. RESULTS A total of 34 patients were included in this study. Local and general post-operative complication rates were 26% and 27%, respectively. A high level of comorbidity (Kaplan Feinstein Index: KFI ≥ 2) was the only factor associated with a higher risk of local (p = 0.03) and general (p = 0.04) complications. OS and SS rates at 3 years were 48% and 61%, respectively. In multivariate analysis, pathologic overall stage ≥ III was a significant predictor of OS (p = 0.02) and pathologic T-stage ≥ 3 was a significant predictor of SS (p = 0.01). Mean pre-operative and post-operative DOSS (dysphagia outcome and severity scale) scores were 4.4 and 3.9, respectively.
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Affiliation(s)
- Dorian Culié
- a 1 Institut Universitaire de la Face et du Cou , Nice, France
| | - Karen Benezery
- b 2 Department of Radiotherapy, Centre Antoine Lacassagne , Nice, France
| | - Emmanuel Chamorey
- c 3 Department of Statistics, Centre Antoine Lacassagne , Nice, France
| | - Marc Ettaiche
- c 3 Department of Statistics, Centre Antoine Lacassagne , Nice, France
| | | | | | | | | | - Marie-Eve Chand
- b 2 Department of Radiotherapy, Centre Antoine Lacassagne , Nice, France
| | - Axel Leysalle
- b 2 Department of Radiotherapy, Centre Antoine Lacassagne , Nice, France
| | - Esma Saada
- d 4 Department of Medical Oncology, Centre Antoine Lacassagne , Nice, France
| | - Anne Sudaka
- e 5 Department of Pathology, Centre Antoine Lacassagne , Nice, France
| | | | - François Demard
- a 1 Institut Universitaire de la Face et du Cou , Nice, France
| | - José Santini
- a 1 Institut Universitaire de la Face et du Cou , Nice, France
| | - Frédéric Peyrade
- d 4 Department of Medical Oncology, Centre Antoine Lacassagne , Nice, France
| | | | - Alexandre Bozec
- a 1 Institut Universitaire de la Face et du Cou , Nice, France
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Laccourreye O, Benito J, Menard M, Garcia D, Malinvaud D, Holsinger C. Lateral pharyngotomy for selected invasive squamous cell carcinoma of the lateral oropharynx-part I: How. Laryngoscope 2013; 123:2712-7. [DOI: 10.1002/lary.24161] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ollivier Laccourreye
- Department of Otorhinolaryngology Head & Neck Surgery , HEGP; University Paris Descartes Sorbonne Paris Cité; Paris France
| | - José Benito
- Department of Oto-Rhino-Laryngology; Sant Joan University teaching Hospital; Reus Spain
| | - Madeleine Menard
- Department of Otorhinolaryngology Head & Neck Surgery , HEGP; University Paris Descartes Sorbonne Paris Cité; Paris France
| | | | - David Malinvaud
- Department of Otorhinolaryngology Head & Neck Surgery , HEGP; University Paris Descartes Sorbonne Paris Cité; Paris France
| | - Christopher Holsinger
- Department of Head and Neck Surgery; The University of Texas M. D. Anderson Cancer Center; Houston Texas U.S.A
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Laccourreye O, Benito J, Garcia D, Menard M, Bonfils P, Holsinger C. Lateral pharyngotomy for selected invasive squamous cell carcinoma of the lateral oropharynx. Part II: When and why. Laryngoscope 2013; 123:2718-22. [DOI: 10.1002/lary.24246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 04/14/2013] [Accepted: 05/20/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Ollivier Laccourreye
- Université Paris Descartes Sorbonne Paris Cité, HEGP, APHP, Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale; Paris
| | - José Benito
- Department of Otorhinolaryngology; Hospital Universitario Sant Joan, calle Sant Joan s/n; Reus Spain
| | | | - Madeleine Menard
- Université Paris Descartes Sorbonne Paris Cité, HEGP, APHP, Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale; Paris
| | - Pierre Bonfils
- Université Paris Descartes Sorbonne Paris Cité, HEGP, APHP, Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale; Paris
| | - Christopher Holsinger
- Department of Head & Neck Surgery; The University of Texas M.D., Anderson Cancer Center; Houston Texas U.S.A
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Pierre CS, Dassonville O, Chamorey E, Poissonnet G, Ettaiche M, Santini J, Peyrade F, Benezery K, Sudaka A, Bozec A. Long-term quality of life and its predictive factors after oncologic surgery and microvascular reconstruction in patients with oral or oropharyngeal cancer. Eur Arch Otorhinolaryngol 2013; 271:801-7. [DOI: 10.1007/s00405-013-2592-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 06/05/2013] [Indexed: 10/26/2022]
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Vincent N, Dassonville O, Chamorey E, Poissonnet G, Pierre CS, Nao EEM, Peyrade F, Benezery K, Viel D, Sudaka A, Marcy PY, Vallicioni J, Demard F, Santini J, Bozec A. Clinical and histological prognostic factors in locally advanced oral cavity cancers treated with primary surgery. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:291-6. [PMID: 23149218 DOI: 10.1016/j.anorl.2012.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 01/05/2012] [Accepted: 01/17/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The primary objective of this study was to determine the clinical and pathological prognostic factors in locally advanced oral cavity cancers treated by primary surgery. METHODS All patients treated by primary surgery with free-flap reconstruction for locally advanced oral cavity squamous cell carcinoma in our institution between 2000 and 2010 were included in this retrospective study. Overall, cause-specific and locoregional disease-free survivals were determined by Kaplan-Meier analyses. Clinical and histological prognostic factors were assessed by univariate (Log Rank tests) and multivariate (Cox models) analyses. RESULTS A total of 149 patients (102 men and 47 women; mean age=61.3±12.1 years) were included in the study. Five-year overall, cause-specific and locoregional disease-free survivals were 55%, 68% and 71%, respectively. Age, comorbidity and tumour size (histological evaluation) were significantly correlated with overall survival (P<0.05). Age, tumour size, bone invasion and surgical margins were significantly correlated with locoregional disease-free survival (P<0.05). CONCLUSION The main prognostic factors identified in this study were clinical (age and comorbidity) and histological (pathological tumour size, bone invasion and surgical margins).
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Affiliation(s)
- N Vincent
- Département de chirurgie, institut universitaire de la face et du cou, centre Antoine-Lacassagne, 31, avenue de Valombrose, 06107 Nice, France
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Vandersteen C, Dassonville O, Chamorey E, Poissonnet G, Nao EEM, Pierre CS, Leyssale A, Peyrade F, Falewee MN, Sudaka A, Haudebourg J, Demard F, Santini J, Bozec A. Impact of patient comorbidities on head and neck microvascular reconstruction. A report on 423 cases. Eur Arch Otorhinolaryngol 2012; 270:1741-6. [DOI: 10.1007/s00405-012-2224-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 10/07/2012] [Indexed: 10/27/2022]
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