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Lu D, Zhou X, Sun H, Zeng B, Fu J, Gong J, Liao G, Liang Y, Yang L. Risk of second primary cancer in patients with head and neck squamous cell carcinoma: a systemic review and meta-analysis. Clin Oral Investig 2023; 27:4897-4910. [PMID: 37540282 DOI: 10.1007/s00784-023-05066-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 05/07/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Second primary cancer is a common event in patients with head and neck squamous cell carcinoma. However, the incidence and relevant factors vary by studies. We conducted a systematic review and meta-analysis of observational studies to estimate the incidence and relevant risk factors. MATERIALS AND METHODS PubMed and Web of Science were searched for studies published between January 2000 and December 2020 that reported the incidence of SPC in HNSCC patients. Per 1000-person-year incidence and odds ratios were used to estimate the incidence and potential risk factors. Due to the high heterogeneity, random-effects models were used to estimate the incidence and 95% confidence interval. RESULTS Seven thousand seven hundred thirteen articles were identified from the databases, in which 60 studies were included in this meta-analysis. The pooled incidence of the total, synchronous, and metachronous SPC in patients with HNSCC were 29.116 per 1000-person-year, 6.960 per 1000-person-year, and 26.025 per 1000-person-year, respectively. The head and neck region was the most common area where SPC occurred, followed by the lung (7.472 per 1000-person-year) and upper digestive tract (2.696 per 1000-person-year). Smoking, alcohol consumption, betel quid chewing, primary cancer of T1-2, and N0 were risk factors, while HPV infection (OR 0.47, 95% CI 0.30-0.72) was the protective factor. CONCLUSIONS SPC is frequently observed in HNSCC patients and had great impact on the prognosis. The findings could promote a more individualized follow-up strategy for SPC in HNSCC patients. CLINICAL RELEVANCE This systemic review and meta-analysis provide sufficient evidence for the establishment of the follow-up strategy for head and neck squamous cancer patients.
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Affiliation(s)
- Dongheng Lu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Xinyu Zhou
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No 639, Zhizaoju Rd, Shanghai, 200011, China
| | - Huaxiu Sun
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Bin Zeng
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Jiarun Fu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Jianbin Gong
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Guiqing Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Yujie Liang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China.
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China.
| | - Le Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China.
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China.
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Tan A, Eskiizmir G, Kamiloglu U, Sarioglu S. p53 and PTEN expression evaluation with molecular evident recent criteria in laryngeal carcinoma. Medicine (Baltimore) 2023; 102:e33676. [PMID: 37171328 PMCID: PMC10174377 DOI: 10.1097/md.0000000000033676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
The prognosis of laryngeal cancer is affected by clinicopathological factors. Because of that, an effective prognostic marker is very valuable in managing the clinical process. The p53 evaluation method, used in the literature recently, was used for the first time in laryngeal cancer. We evaluated PTEN with 2 methods with the highest significance in the literature on laryngeal cancer. All demographic and histopathological data from 140 laryngeal cancers were compared with p53 and PTEN expressions and survival. p53 staining patterns were classified as wild and mutant. PTEN expression was evaluated according to the staining intensity named PTEN1 and according to the proportion of stained cells named PTEN2. In the series, 93.6% were males, and the mean survival was 38 months. 69.3% of cases were p53 mutants. PTEN loss was found to be 85.7% and 57.9%, respectively. Tumor size and thyroid cartilage invasion for PTEN1 and age for p53 were identified as independent predictive factors (P < .01). Advanced age, total laryngectomy, and extranodal spread were independent poor prognostic factors for overall survival and the presence of subglottic involvement, perineural invasion, and extranodal spread were for disease-free survival (P < .01). This is the first study in which the new p53 classification was used in laryngeal cancer, and will contribute significantly to the literature with differences from the previous evaluation patterns. Evaluation of PTEN based on staining intensity is more appropriate compared to the percentage of stained cells.
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Affiliation(s)
- Ayca Tan
- Department of Pathology, Manisa Celal Bayar University, Manisa, Turkey
- Department of Molecular Pathology, Dokuz Eylul University, Izmir, Turkey
| | - Gorkem Eskiizmir
- Department of Otorhinolaryngology-Head Neck Surgery, Manisa Celal Bayar University, Manisa, Turkey
| | - Ugur Kamiloglu
- Department of Otorhinolaryngology-Head Neck Surgery, Manisa Celal Bayar University, Manisa, Turkey
| | - Sulen Sarioglu
- Department of Molecular Pathology, Dokuz Eylul University, Izmir, Turkey
- Department of Pathology, Dokuz Eylul University, Izmir, Turkey
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Đokanović D, Gajanin R, Gojković Z, Marošević G, Sladojević I, Gajanin V, Jović-Đokanović O, Amidžić L. Clinicopathological Characteristics, Treatment Patterns, and Outcomes in Patients with Laryngeal Cancer. Curr Oncol 2023; 30:4289-4300. [PMID: 37185440 PMCID: PMC10137398 DOI: 10.3390/curroncol30040327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Various factors can affect the survival of patients with laryngeal cancer (LC). In this retrospective study, we assessed clinicopathological features, their prognostic value, and treatment modalities for patients with confirmed squamous cell LC. METHODS We collected patient data on demographics, clinicopathological characteristics, treatment patterns, and outcomes. The primary endpoints were overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and locoregional control (LRC). We assessed survival using the Kaplan-Meier method and Cox regression model analyses of potential prognostic parameters. RESULTS After a median follow-up of 76 months, 28 (33.3%) patients had a recurrence. The median OS was 78 months, with an event recorded in 50% of patients. The DSS median was not reached (NR) with a survival rate of 72.6%, the DFS survival rate was 66.7% with median NR, and the LRC survival rate was 72.6% with median NR. After conducting a multivariate analysis of significant variables, we found that only recurrence and lymphatic invasion had an independent effect on OS and recurrence in DSS, while subsite impacted DFS and LRC. CONCLUSIONS Survival trends were consistent with other studies, except for OS. Recurrence, lymphatic invasion, and subsite location were significant factors that impacted patient survival.
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Affiliation(s)
- Dejan Đokanović
- University Clinical Center of the Republic of Srpska, Oncology Cllinic, 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
- University of Banja Luka, Faculty of medicine 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Radoslav Gajanin
- University of Banja Luka, Faculty of medicine 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Zdenka Gojković
- University Clinical Center of the Republic of Srpska, Oncology Cllinic, 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
- University of Banja Luka, Faculty of medicine 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Goran Marošević
- University of Banja Luka, Faculty of medicine 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
- Affidea-IMC Center for Radiotherapy Banja Luka, 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Igor Sladojević
- University of Banja Luka, Faculty of medicine 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Vesna Gajanin
- University of Banja Luka, Faculty of medicine 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Olja Jović-Đokanović
- University of Banja Luka, Faculty of medicine 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
- University Clinical Center of the Republic of Srpska, Infectology Cllinic, 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Ljiljana Amidžić
- University of Banja Luka, Faculty of medicine 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
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Yan P, Li S, Zhou Z, Liu Q, Wu J, Ren Q, Chen Q, Chen Z, Chen Z, Chen S, Scholp A, Jiang JJ, Kang J, Ge P. Automated detection of glottic laryngeal carcinoma in laryngoscopic images from a multicentre database using a convolutional neural network. Clin Otolaryngol 2023; 48:436-441. [PMID: 36624555 DOI: 10.1111/coa.14029] [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: 09/05/2021] [Revised: 11/22/2022] [Accepted: 12/31/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Little is known about the efficacy of using artificial intelligence (AI) to identify laryngeal carcinoma from images of vocal lesions taken in different hospitals with multiple laryngoscope systems. This multicentre study aimed to establish an AI system and provide a reliable auxiliary tool to screen for laryngeal carcinoma. STUDY DESIGN Multicentre case-control study. SETTING Six tertiary care centres. PARTICIPANTS Laryngoscopy images were collected from 2179 patients with vocal fold lesions. OUTCOME MEASURES An automatic detection system of laryngeal carcinoma was established and used to distinguish malignant and benign vocal lesions in 2179 laryngoscopy images acquired from 6 hospitals with 5 types of laryngoscopy systems. Pathological examination was the gold standard for identifying malignant and benign vocal lesions. RESULTS Out of 89 cases in the malignant group, the classifier was able to correctly identify laryngeal carcinoma in 66 patients (74.16%, sensitivity). Out of 640 cases in the benign group, the classifier was able to accurately assess the laryngeal lesion in 503 cases (78.59%, specificity). Furthermore, the region-based convolutional neural network (R-CNN) classifier achieved an overall accuracy of 78.05%, with a 95.63% negative predictive value and a 32.51% positive predictive value for the testing data set. CONCLUSION This automatic diagnostic system has the potential to assist clinical laryngeal carcinoma diagnosis which may improve and standardise the diagnostic capacity of laryngologists using different laryngoscopes.
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Affiliation(s)
- Peikai Yan
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Shaohua Li
- Department of Otorhinolaryngology Head and Neck Surgery, Zhongshan Hospital of Traditional Chinese Medicine, Affiliated to Guangzhou University of Chinese Medicine, Guangdong, Zhongshan, Guangdong, China
| | - Zhou Zhou
- Department of Otolaryngology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Qian Liu
- Department of Otolaryngology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Jiahui Wu
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Qingyi Ren
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Qiuhuan Chen
- Department of Otolaryngology, Zhaoqing Gaoyao People's Hospital, Zhaoqing, China
| | - Zhipeng Chen
- Department of Otolaryngology, The Second People's Hospital of Longgang District, Shenzhen, China
| | - Ze Chen
- Department of Otolaryngology, Gaozhou People's Hospital, Gaozhou, China
| | - Shaohua Chen
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Austin Scholp
- Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA.,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health (A.S.), University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jack J Jiang
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health (A.S.), University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jing Kang
- Department of Otolaryngology & Head Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Pingjiang Ge
- School of Medicine, South China University of Technology, Guangzhou, China
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Kiong KL, Moreno A, Vu CN, Zheng G, Rosenthal DI, Weber RS, Lewis CM. Enhanced recovery after surgery (ERAS) in head and neck oncologic surgery: Impact on return to intended oncologic therapy (RIOT) and survival. Oral Oncol 2022; 130:105906. [PMID: 35594776 DOI: 10.1016/j.oraloncology.2022.105906] [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: 11/15/2021] [Revised: 04/09/2022] [Accepted: 05/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Enhanced Recovery After Surgery (ERAS) pathways in head and neck cancer (HNC) have shown to improve perioperative outcomes and reduce complications. The longer term implications on adjuvant treatment and survival have not been studied. We hereby report the first study on the impact of an ERAS pathway on return to intended oncologic treatment (RIOT) and overall survival (OS) in HNC. METHODS 200 patients undergoing head and neck oncologic surgery on an ERAS pathway between March 1, 2016 and March 31, 2019 were matched to controls over the same interval. Demographic, tumor and adjuvant therapy-related data were collected, including time to adjuvant therapy(TAT) and treatment package time(TPT). Risk factors for TAT > 42 days and TPT ≥ 85 days were assessed. OS was compared and risk factors for inferior OS determined. RESULTS Baseline characteristics including co-morbidities and tumor stage were similar. Of 179 patients planned for adjuvant treatment, there was no difference in RIOT rate (89.0% vs 87.5%, p = 0.753), proportion of TAT > 42 days of surgery (55.6% vs 59.7%, p = 0.642), or TPT ≥ 85 days (48.1% vs 57.1, p = 0.258), for the ERAS and control groups, respectively. On multivariate analysis, alcohol use (OR 3.58; 95 %CI 1.11-11.52) and recurrent disease status (OR 2.88; 95 %CI 1.40-5.93) were independently associated with prolonged TAT. Three-year OS was similar between the ERAS and control groups (73% vs 76%, p = 0.521). CONCLUSION ERAS has not shown to improve RIOT or OS in the current study. However, its benefit for perioperative outcomes is undeniable and further studies are required on longer term quality and survival outcomes.
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Affiliation(s)
- Kimberley L Kiong
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Amy Moreno
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Catherine N Vu
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Gang Zheng
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Carol M Lewis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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Dyckhoff G, Warta R, Herold-Mende C, Plinkert PK, Ramroth H. [Larynx preservation: recommendations for decision-making in T3 laryngeal cancer patients]. HNO 2022; 70:581-587. [PMID: 35575826 PMCID: PMC9329161 DOI: 10.1007/s00106-022-01177-7] [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] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND By today's standard, the optimal treatment of every individual tumor patient is discussed and determined in an interdisciplinary tumor board. According to the new S3 guidelines, larger volume T3 laryngeal cancers which are no longer safely resectable with larynx-sparing surgery are ideal candidates for a larynx preservation approach using primary chemoradiation (pCRT). So far, no clear criteria have been defined under what circumstances primary radiotherapy alone (pRT) might be acceptable in case chemotherapy (CT) is prohibited or in what cases, even in T3, upfront total laryngectomy with risk-adapted adjuvant treatment (TL±a[C]RT) should be recommended. METHOD The literature was searched for parameters chosen as criteria for an inclusion in the surgical rather than the conservative arm in non-randomized LP studies or which proved to be significant prognostic markers after conservative treatment. Development of a counselling tool for therapeutic decision making. RESULTS Significant prognostic markers were tumor volume (< 3.5 ccm/< 6 ccm vs. 6-12 ccm vs. > 12 ccm), presence and kind of vocal cord fixation (none vs. Succo I/II vs. Succo III/IV), extent of cartilage infiltration (none vs. minimal vs. multiple/gross), nodal status (N0‑1 vs. N2-3), and laryngeal dysfunction (pretreatment necessity of feeding tube or tracheostomy). CONCLUSION For T3 laryngeal cancers, pRT could be acceptable when the tumor volume is < 3.5 ccm for glottic and < 6 ccm for supraglottic tumors and there are no further risk factors. pCRT can be regarded as the standard for LP for tumors between 6 ccm and 12 ccm, vocal cord fixation Succo pattern I/II, only minimal cartilage infiltration and a high nodal burden. For tumor > 12 ccm, vocal cord fixation Succo pattern III/IV, gross or multiple cartilage infiltration or clinically relevant laryngeal dysfunction, upfront TL±a[C]RT should be considered.
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Affiliation(s)
- Gerhard Dyckhoff
- Universitäts-Hals-Nasen-Ohrenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - Rolf Warta
- Universitäts-Hals-Nasen-Ohrenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.,Neurochirurgische Universitätsklinik Heidelberg, Heidelberg, Deutschland
| | - Christel Herold-Mende
- Universitäts-Hals-Nasen-Ohrenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.,Neurochirurgische Universitätsklinik Heidelberg, Heidelberg, Deutschland
| | - Peter K Plinkert
- Universitäts-Hals-Nasen-Ohrenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Heribert Ramroth
- Heidelberger Institut für Global Health, Universität Heidelberg, Heidelberg, Deutschland
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The combination of brush cytology with the results of histopathological examination in laryngeal cancer diagnosis. POSTEP HIG MED DOSW 2021. [DOI: 10.2478/ahem-2021-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Recently, the incidence rate of head and neck cancer (HNC) has been increasing significantly. It is estimated that there are over 550,000 new cases per year, of which over 130,000 are laryngeal cancers. It is assumed that in more than 60% of patients the disease is diagnosed late, at stages III–IV, which is associated with unfavorable prognoses: the average survival ranges from 15% to 45%. The mainstay of successful tumor therapy is the early detection of neoplastic tissue. The laryngological examination with the use of traditional instruments should be expanded with an endoscopic examination of the larynx using optics in the outpatient clinics. This procedure is sufficient to select patients who need a direct laryngoscopy with a surgical biopsy, usually under general anesthesia in operating room conditions. However, it may bear potential complications. In 1941, Papanicolaou and Traut showed that brush cytology could be useful in detecting precancerous conditions and cervical cancers. For decades, research on the usefulness of brush cytology in diagnosing precancerous conditions and laryngeal cancers has been conducted. This paper aims to enable the reader to understand the issues related to laryngeal cancer and present the results of the previous use of brush cytology in the diagnostic process.
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Chemoradiotherapy but Not Radiotherapy Alone for Larynx Preservation in T3. Considerations from a German Observational Cohort Study. Cancers (Basel) 2021; 13:cancers13143435. [PMID: 34298650 PMCID: PMC8306673 DOI: 10.3390/cancers13143435] [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: 05/14/2021] [Revised: 06/13/2021] [Accepted: 07/02/2021] [Indexed: 01/02/2023] Open
Abstract
Simple Summary For advanced laryngeal carcinoma, primary radiotherapy with or without chemotherapy (pCRT or pRT) is used as an alternative to total laryngectomy (TL) to preserve a functional larynx. For advanced laryngeal cancer (T4), poorer survival has been reported after nonsurgical treatment. Is there a need to fear worse survival in moderately advanced tumors (T3)? The outcomes after pRT, pCRT, or surgery were evaluated in 121 patients with T3 laryngeal cancers. pCRT and TL with risk-adopted adjuvant (chemo)radiotherapy (TL ± a(C)RT) yielded results without a significant survival difference. However, after pRT alone, survival was significantly poorer than after TL ± a(C)RT. Thus, according to our data and supported by the literature, pCRT instead of pRT alone is recommended for T3 laryngeal cancers. According to the literature, this recommendation also applies to bulky tumors (6–12 mm), vocal cord fixation, at least minimal cartilage infiltration, and advanced N stage. TL ± a(C)RT instead of larynx preservation should be considered if any of these factors is present and chemotherapy is prohibited; in cases with a tumor volume > 12 mm, severe forms of vocal cord fixation or cartilage infiltration; or when the patient needs a feeding tube or a tracheotomy before the onset of therapy. Abstract For advanced laryngeal cancers, after randomized prospective larynx preservation studies, nonsurgical therapy has been applied on a large scale as an alternative to laryngectomy. For T4 laryngeal cancer, poorer survival has been reported after nonsurgical treatment. Is there a need to fear worse survival also in T3 tumors? The outcomes of 121 T3 cancers treated with pCRT, pRT alone, or surgery were evaluated in an observational cohort study in Germany. In a multivariate Cox regression of the T3 subgroup, no survival difference was noted between pCRT and total laryngectomy with risk-adopted adjuvant (chemo)radiotherapy (TL ± a(C)RT) (HR 1.20; 95%-CI: 0.57–2.53; p = 0.63). However, survival was significantly worse after pRT alone than after TL ± a(C)RT (HR 4.40; 95%-CI: 1.72–11.28, p = 0.002). A literature search shows that in cases of unfavorable prognostic markers (bulky tumors of 6–12 ccm, vocal cord fixation, minimal cartilage infiltration, or N2–3), pCRT instead of pRT is indicated. In cases of pretreatment dysphagia or aspiration requiring a feeding tube or tracheostomy, gross or multiple cartilage infiltration, or tumor volume > 12 ccm, outcomes after pCRT were significantly worse than those after TL. In these cases, and in cases where pCRT is indicated but the patient is not suitable for the addition of chemotherapy, upfront total laryngectomy with stage-appropriate aRT is recommended even in T3 laryngeal cancers.
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Keek SA, Wesseling FWR, Woodruff HC, van Timmeren JE, Nauta IH, Hoffmann TK, Cavalieri S, Calareso G, Primakov S, Leijenaar RTH, Licitra L, Ravanelli M, Scheckenbach K, Poli T, Lanfranco D, Vergeer MR, Leemans CR, Brakenhoff RH, Hoebers FJP, Lambin P. A Prospectively Validated Prognostic Model for Patients with Locally Advanced Squamous Cell Carcinoma of the Head and Neck Based on Radiomics of Computed Tomography Images. Cancers (Basel) 2021; 13:3271. [PMID: 34210048 PMCID: PMC8269129 DOI: 10.3390/cancers13133271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Locoregionally advanced head and neck squamous cell carcinoma (HNSCC) patients have high relapse and mortality rates. Imaging-based decision support may improve outcomes by optimising personalised treatment, and support patient risk stratification. We propose a multifactorial prognostic model including radiomics features to improve risk stratification for advanced HNSCC, compared to TNM eighth edition, the gold standard. PATIENT AND METHODS Data of 666 retrospective- and 143 prospective-stage III-IVA/B HNSCC patients were collected. A multivariable Cox proportional-hazards model was trained to predict overall survival (OS) using diagnostic CT-based radiomics features extracted from the primary tumour. Separate analyses were performed using TNM8, tumour volume, clinical and biological variables, and combinations thereof with radiomics features. Patient risk stratification in three groups was assessed through Kaplan-Meier (KM) curves. A log-rank test was performed for significance (p-value < 0.05). The prognostic accuracy was reported through the concordance index (CI). RESULTS A model combining an 11-feature radiomics signature, clinical and biological variables, TNM8, and volume could significantly stratify the validation cohort into three risk groups (p < 0∙01, CI of 0.79 as validation). CONCLUSION A combination of radiomics features with other predictors can predict OS very accurately for advanced HNSCC patients and improves on the current gold standard of TNM8.
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Affiliation(s)
- Simon A. Keek
- The D-Lab, Department of Precision Medicine, GROW-School for Oncology, Maastricht University, Maastricht, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (S.A.K.); (H.C.W.); (S.P.)
| | - Frederik W. R. Wesseling
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Postbus 3035, 6202 NA Maastricht, The Netherlands; (F.W.R.W.); (F.J.P.H.)
| | - Henry C. Woodruff
- The D-Lab, Department of Precision Medicine, GROW-School for Oncology, Maastricht University, Maastricht, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (S.A.K.); (H.C.W.); (S.P.)
- Department of Radiology and Nuclear Medicine, GROW-School for Oncology, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Janita E. van Timmeren
- Department of Radiation Oncology, University Hospital Zürich, University of Zürich, Rämistrasse 100, 8091 Zürich, Switzerland;
| | - Irene H. Nauta
- Amsterdam UMC, Otolaryngology/Head and Neck Surgery, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Postbus 7057, 1007 MB Amsterdam, The Netherlands; (I.H.N.); (C.R.L.); (R.H.B.)
| | - Thomas K. Hoffmann
- Department of Otorhinolaryngology, Head Neck Surgery, i2SOUL Consortium, University of Ulm, Frauensteige 14a (Haus 18), 89075 Ulm, Germany;
| | - Stefano Cavalieri
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian, University of Milan, 1 20133 Milano, Italy; (S.C.); (L.L.)
| | - Giuseppina Calareso
- Radiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori via Giacomo Venezian, 1 20133 Milano, Italy;
| | - Sergey Primakov
- The D-Lab, Department of Precision Medicine, GROW-School for Oncology, Maastricht University, Maastricht, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (S.A.K.); (H.C.W.); (S.P.)
| | | | - Lisa Licitra
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian, University of Milan, 1 20133 Milano, Italy; (S.C.); (L.L.)
- Department of Oncology and Hemato-Oncology, University of Milan, via S. Sofia 9/1, 20122 Milano, Italy
| | - Marco Ravanelli
- Department of Medicine and Surgery, University of Brescia, Viale Europa, 11-25123 Brescia, Italy;
| | - Kathrin Scheckenbach
- Department. of Otorhinolaryngology-Head and Neck Surgery, University Hospital Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany;
| | - Tito Poli
- Maxillofacial Surgery Unit, Department of Medicine and Surgery, University of Parma-University Hospital of Parma, via Università, 12-I, 43121 Parma, Italy; (T.P.); (D.L.)
| | - Davide Lanfranco
- Maxillofacial Surgery Unit, Department of Medicine and Surgery, University of Parma-University Hospital of Parma, via Università, 12-I, 43121 Parma, Italy; (T.P.); (D.L.)
| | - Marije R. Vergeer
- Amsterdam UMC, Cancer Center Amsterdam, Department of Radiation Oncology, Vrije Universiteit Amsterdam, Postbus 7057, 1007 MB Amsterdam, The Netherlands;
| | - C. René Leemans
- Amsterdam UMC, Otolaryngology/Head and Neck Surgery, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Postbus 7057, 1007 MB Amsterdam, The Netherlands; (I.H.N.); (C.R.L.); (R.H.B.)
| | - Ruud H. Brakenhoff
- Amsterdam UMC, Otolaryngology/Head and Neck Surgery, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Postbus 7057, 1007 MB Amsterdam, The Netherlands; (I.H.N.); (C.R.L.); (R.H.B.)
| | - Frank J. P. Hoebers
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Postbus 3035, 6202 NA Maastricht, The Netherlands; (F.W.R.W.); (F.J.P.H.)
| | - Philippe Lambin
- The D-Lab, Department of Precision Medicine, GROW-School for Oncology, Maastricht University, Maastricht, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (S.A.K.); (H.C.W.); (S.P.)
- Department of Radiology and Nuclear Medicine, GROW-School for Oncology, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
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Development and validation of nomogram to predict risk of survival in patients with laryngeal squamous cell carcinoma. Biosci Rep 2021; 40:225966. [PMID: 32744320 PMCID: PMC7432998 DOI: 10.1042/bsr20200228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 12/14/2022] Open
Abstract
To the best of our knowledge, this is the first study established a nomogram to predict survival probability in Asian patients with LSCC. A risk prediction nomogram for patients with LSCC, incorporating easily assessable clinicopathologic factors, generates more precise estimations of the survival probability when compared TNM stage alone, but still need additional data before being used in clinical application. Background: Due to a wide variation of tumor behavior, prediction of survival in laryngeal squamous cell carcinoma (LSCC) patients received curative-intent surgery is an important but formidable challenge. We attempted to establish a nomogram to precisely predict survival probability in LSCC patients. Methods: A total of 369 consecutive LSCC patients underwent curative resection between 2008 and 2012 at Hunan Province Cancer Hospital were included in the present study. Subsequently, 369 LSCC patients were assigned to a training set (N=261) and a validation set (N=108) at random. On the basis of multivariable Cox regression analysis results, we developed a nomogram. The predictive accuracy and discriminative ability of the nomogram were confirmed by calibration curve and a concordance index (C-index), and compared with TNM stage system by C-index, receiver operating characteristic (ROC) analysis. Results: Six independent parameters to predict prognosis were age, pack years, N-stage, lymph node ratio (LNR), anemia and albumin, which were all assembled into the nomogram. The calibration curve verified excellent models’ concordance. The C-index of the nomogram was 0.73 (0.68–0.78), and the area under curve (AUC) of nomogram in predicting overall survival (OS) was 0.766, which were significantly higher than traditional TNM stage. Decision curve analysis further demonstrated that our nomogram had a larger net benefit than the TNM stage. Conclusion: A risk prediction nomogram for patients with LSCC, incorporating easily assessable clinicopathologic factors, generates more precise estimations of the survival probability when compared TNM stage alone, but still need additional data before being used in clinical application.
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11
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Seeking Medical Assistance for Dysphonia Is Associated with an Improved Survival Rate in Laryngeal Cancer: Real-World Evidence. Diagnostics (Basel) 2021; 11:diagnostics11020255. [PMID: 33562222 PMCID: PMC7915002 DOI: 10.3390/diagnostics11020255] [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: 01/05/2021] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Patients with laryngeal cancer usually present with dysphonia. However, some studies reported that the duration from dysphonia to cancer diagnosis has been prolonged significantly in recent years. This study aimed to evaluate that in the initial dysphonia-related diagnosis and the interval between the diagnosis of laryngeal cancer may affect the overall survival (OS). (2) Methods: The 1997–2013 Longitudinal Health Insurance Database was used in this study. A propensity score with 1-to-1 matching was applied to balance the baseline characteristics. The OS was examined by the Kaplan-Meier method and log-rank test. (3) Results: A total of 2753 patients with a first primary laryngeal cancer diagnosis were identified. The patients without prior dysphonia-related diagnosis (PD−) group did have a significantly worse five-year survival (p = 0.015) comparing with those with a prior dysphonia-related diagnosis (PD+) group among glottic cancer patients. The group with a shorter dysphonia-to-diagnosis interval had a better five-year OS than the prolonged group (p = 0.007) in laryngeal cancer. (4) Conclusions: Looking for medical assistance before a diagnosis of glottic cancer is associated with a better overall survival, while a diagnostic delay of more than 30 days from the first medical examination for dysphonia is associated with a worse outcome among in patients with laryngeal cancer.
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12
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Zarei M, Mirzaee M, Alizadeh H, Jahani Y. Investigation of the affective factors on the survival rate of patients with laryngeal cancer using Cox proportional hazards and Lin -Ying's additive hazards models. Med J Islam Repub Iran 2021; 35:16. [PMID: 33996667 PMCID: PMC8111620 DOI: 10.47176/mjiri.35.16] [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: 05/10/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Determining the factors affecting survival and appropriate treatment methods leads to improving the survival rate and quality of life in cancer patients; therefore this study was aimed to determine the effective factors on the survival rate of patients with Laryngeal cancer in Kerman city, Iran.
Methods: This retrospective cohort study included 370 patients with Laryngeal cancer who referred to the hospitals of Kerman city, Iran during 2008 to 2018. Data were analyzed using Cox Proportional Hazards and Lin-Ying’s Additive Hazards models. Data analysis was done using SAS software version 9.4. The P-value of less than 0.05 was considered as statistically significant.
Results: The mean age at the time of diagnosis was 58.16±10.60 years. About 92% of the patients were men. The patient’s 1, 3, 5, 7 and 10-years of overall survival rates were equal to 82.38%, 60.68%, 55.98%, 49.83%, and 30.91%, respectively. Age at the diagnosis (p=0.001), radiotherapy (p=0.001), chemotherapy (p=0.015), surgery (p=0.031), and smoking (p=0.001) were found to have significant effect on the patient’s survival rate in the Cox model. These variables were significant in the Lin-Ying model too.
Conclusion: Treatment is an important factor in controlling the disease and survival of cancer patients, and choosing the best treatment depends on the condition of the patient and the disease level.
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Affiliation(s)
- Masoud Zarei
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Moghaddameh Mirzaee
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hosniyeh Alizadeh
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
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13
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Chen S, Dee EC, Muralidhar V, Nguyen PL, Amin MR, Givi B. Disparities in Mortality from Larynx Cancer: Implications for Reducing Racial Differences. Laryngoscope 2020; 131:E1147-E1155. [PMID: 32869893 DOI: 10.1002/lary.29046] [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: 06/12/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Race predicts overall mortality (OM) of laryngeal squamous cell carcinoma (LSCC) in the United States (US). We assessed whether racial disparities affect cancer-specific mortality (CSM) using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS Adults with LSCC from 2004 to 2015 were selected. Univariable and multivariable Cox proportional hazards and Fine-Gray competing-risks regression analysis adjusted for clinicodemographic factors defined hazard ratios (aHR). RESULTS We identified 14,506 patients. The median age was 63 years. Most were male (11,725, 80.8%) and white (11,653, 80.3%), followed by Black (2294, 15.8%). Most had early-stage disease (7544, 52.0%) and received radiotherapy only (4107, 28.3%), followed by chemoradiation (3748, 25.8%). With median follow-up of 60 months, overall 3- and 5-year OM were 34.0% and 43.2%; CSM were 16.0% and 18.9%, respectively. Black patients had higher OM than white patients on univariable (HR 1.35, 95% CI, 1.26-1.44, P < .001) and multivariable (aHR 1.10, 95% CI, 1.02-1.18, P = .011) analyses. Black patients had higher CSM on univariable analysis (HR 1.22, 95% CI, 1.09-1.35, P < .001) but not on multivariable CSM analysis (aHR 1.01, 95% CI, 0.90-1.13, P = .864). On multivariable analysis, year of diagnosis, age, disease site, stage, treatment, nodal metastasis, marital status, education, and geography significantly predicted CSM. CONCLUSION On multivariable analyses controlling for sociodemographic, clinical, and treatment characteristics, Black and white patients differed in OM but not in CSM. However, Black patients presented with greater proportions of higher stage cancers and sociodemographic factors such as income and marital status that were associated with worse outcomes. Efforts to target sociodemographic disparities may contribute to the mitigation of racial disparities in LSCC. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1147-E1155, 2021.
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Affiliation(s)
- Sophia Chen
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A
| | - Edward Christopher Dee
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.,Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Vinayak Muralidhar
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Milan R Amin
- Department of Otolaryngology-Head & Neck Surgery, New York University Langone Health, New York, New York, U.S.A
| | - Babak Givi
- Department of Otolaryngology-Head & Neck Surgery, New York University Langone Health, New York, New York, U.S.A
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Tangsriwong K, Jitreetat T. Clinical Predictors of Laryngeal Preservation Rate in Stage III-IV Laryngeal Cancer and Hypopharyngeal Cancer Patients Treated with Organ Preservation. Asian Pac J Cancer Prev 2019; 20:2051-2057. [PMID: 31350965 PMCID: PMC6745228 DOI: 10.31557/apjcp.2019.20.7.2051] [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: 09/29/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose: To determine factors affecting laryngeal preservation rate in laryngeal and hypopharyngeal cancer patients
treated with organ preservation. Material and Methods: Retrospective study examining stage III to IV laryngeal and
hypopharyngeal cancer patients who have been treated with organ preservation. Conventional radiation must be applied
in all patients with minimum dose of 45 Gray. Weekly or triweekly chemotherapy can be adding during radiation. Salvage
surgery should be considered in residual disease or local recurrence. Kaplan-Meier was used for survival analysis and,
Log rank test and Cox proportional hazard test were used for uni and multivariate analysis. Results: From January
2010 to October 2014, there were 69 patients treated with laryngeal preservation and 53 patients received radiation
dose 61-70 Gray. After completing radiation, we found that 44 patients have no residual tumor within 6 months and
33 patients can preserve their functional larynx later with complete response (median follow up 6 mo, range 0-46.3
mo). The 1-year, 2-year and 3-year laryngeal preservation rate was 49%, 36 % and 32 % respectively. On univariate
analysis, lower nodal stage (p = 0.008), stage III disease (p = 0.046), tumor volume <10 ml (p = 0.005), no true vocal
cord involvement (p = 0.016), dose 61-70 Gray (p < 0.001) and no interruption of treatment (p = 0.017) have better
laryngeal preservation rates. ECOG performance status 2, higher nodal stage, stage IV, presence of true vocal cord
involvement, upper airway obstruction before/during radiation and radiation dose below 61-70 Gray had an effect on
worse overall survival when evaluated with univariate analysis statistical significance. Conclusion: For factors that
affected laryngeal preservation in our study were nodal stage, group stage, tumor volume, true vocal cord involvement,
radiation dose and treatment break time more than one week with statistical significance.
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Affiliation(s)
- Kanograt Tangsriwong
- Department of Radiation Oncology, Rajavithi Hospital, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
| | - Tastsanachart Jitreetat
- Department of Otolaryngology, Head and Neck Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
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15
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Zhang M, Deng W, Gong H, Li C, Wang Y, Liu X, Tao L, Zhou L. Clinical effect of postoperative chemoradiotherapy in resected advanced laryngeal squamous cell carcinoma. Oncol Lett 2019; 17:4717-4725. [PMID: 30988826 DOI: 10.3892/ol.2019.10104] [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: 01/27/2018] [Accepted: 01/25/2019] [Indexed: 11/06/2022] Open
Abstract
Laryngeal squamous cell carcinoma (LSCC) is one of the most prevalent types of head and neck malignancies. Advanced LSCC has failed to demonstrate a satisfactory prognosis, despite the progresses in the diagnosis and treatment, and the optimal treatment modality continues to be debated. To evaluate the clinical utility and survival outcomes of adjuvant chemoradiotherapy (CRT) for patients with resected advanced LSCC, a retrospective analysis of 232 patients with LSCC who had undergone total laryngectomy and neck dissection between 2005 and 2010 was conducted. Of the 232 eligible patients, 167 patients (72%) received surgery alone, whereas 65 patients (28%) received surgery + adjuvant CRT. In the overall cohort, the 5- and 10-year overall survival (OS) rates were 55.2 and 48.3%, respectively. Multivariate analysis revealed that the clinical stage was significantly associated with OS. However, the N classification was an independent indicator in disease-free survival and laryngeal cancer-specific survival. In those patients with stage IV disease, patients receiving adjuvant CRT exhibited a markedly improved survival benefit compared with patients receiving surgical treatment only, following propensity score matching of the data (P<0.05). The application of adjuvant CRT confers additional survival benefits in comparison with surgery-only treatment regimens for advanced LSCC. However, additional prospective studies are required.
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Affiliation(s)
- Ming Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Weiye Deng
- Departments of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Hongli Gong
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Cai Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Yifan Wang
- Departments of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Xiangyu Liu
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Lei Tao
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Liang Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
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16
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Ingarfield K, McMahon AD, Douglas CM, Savage SA, Conway DI, MacKenzie K. Determinants of long-term survival in a population-based cohort study of patients with head and neck cancer from Scotland. Head Neck 2019; 41:1908-1917. [PMID: 30620423 DOI: 10.1002/hed.25630] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 11/15/2018] [Accepted: 12/19/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND We investigated long-term survival from head and neck cancer (HNC) using different survival approaches. METHODS Patients were followed-up from the Scottish Audit of Head and Neck Cancer. Overall survival and disease-specific survival were calculated using the Kaplan-Meier method. Net survival was calculated by the Pohar-Perme method. Mutually adjusted Cox proportional hazards models were used to determine the predictors of survival. RESULTS A total of 1820 patients were included in the analyses. Overall survival at 12 years was 26.3% (24.3%, 28.3%). Disease-specific survival at 12 years was 56.9% (54.3%, 59.4%). Net survival at 12 years was 41.4% (37.6%, 45.1%). CONCLUSION Determinants associated with long-term survival included age, stage, treatment modality, WHO performance status, alcohol consumption, smoking behavior, and anatomical site. We recommend that net survival is used for long-term outcomes for HNC patients-it disentangles other causes of death, which are overestimated in overall survival and underestimated in disease-specific survival.
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Affiliation(s)
- Kate Ingarfield
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Alex D McMahon
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Catriona M Douglas
- Department of Otolaryngology - Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | | | - David I Conway
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Kenneth MacKenzie
- Department of Otolaryngology - Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, United Kingdom
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17
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Zhao X, Zhang W, Ji W. miR-196b is a prognostic factor of human laryngeal squamous cell carcinoma and promotes tumor progression by targeting SOCS2. Biochem Biophys Res Commun 2018; 501:584-592. [PMID: 29753737 DOI: 10.1016/j.bbrc.2018.05.052] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/09/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Laryngeal squamous cell carcinoma (LSCC) has the second highest incidence among the head and neck malignancies. Additionally, the incidence of LSCCs has been recently increasing. Therefore, understanding the mechanisms of LSCC tumorigenesis and identifying novel biomarkers to accurately predict and improve the prognosis of patients with LSCC is extremely important. METHODS miR-196b and SOCS2 expression was measured by qRT-PCR and western blot. Their correlation was analyzed with the Pearson test. TU212 and TU177 cells were cultured and transfected for MTT, Transwell, and apoptosis assays upon miR-196b knockdown, SOSC2 overexpression or SOCS2 silencing. Dual-luciferase reporter assay were conducted to identify the relationship between miR-196b and SOCS2. Moreover, the correlation between clinicopathological parameters and miR-196b/SOCS2 expression in patients was analyzed. Univariate and multivariate analysis and log-rank tests were used to determine if miR-196 was an independent LSCC prognostic factors. RESULTS We reported the aberrant expression and inverse correlation of miR-196b and SOCS2 in LSCC samples. miR-196b promoted LSCC cells proliferation and invasion, and suppressed apoptosis by directly inhibiting SOCS2 expression in vitro. Moreover, we also revealed that miR-196b/SOCS2 expression correlated with T stage and cervical metastasis. miR-196b was demonstrated to be an independent prognostic factor for overall survival of patients with LSCC. CONCLUSIONS Overexpression of miR-196b suppresses SOCS2 in human LSCC resulting in tumor progression and poor prognosis. miR-196b is a potential marker for prognosis assessment and targeting miR-196b may be a novel valuable strategy for the treatment of LSCC.
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Affiliation(s)
- Xudong Zhao
- Department of Otorhinolaryngology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Wei Zhang
- Department of Endocrinology Shengjing Hospital, China Medical University, Shenyang, China
| | - Wenyue Ji
- Department of Otorhinolaryngology, Shengjing Hospital, China Medical University, Shenyang, China.
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18
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Chen J, Shen Z, Deng H, Zhou W, Liao Q, Mu Y. Long non-coding RNA biomarker for human laryngeal squamous cell carcinoma prognosis. Gene 2018; 671:96-102. [DOI: 10.1016/j.gene.2018.05.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/13/2018] [Indexed: 12/30/2022]
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19
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Chen L, Zeng H, Yang J, Lu Y, Zhang D, Wang J, Kuang C, Zhu S, Wang M, Ma X. Survival and prognostic analysis of preoperative inflammatory markers in patients undergoing surgical resection for laryngeal squamous cell carcinoma. BMC Cancer 2018; 18:816. [PMID: 30103707 PMCID: PMC6090788 DOI: 10.1186/s12885-018-4730-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 08/07/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To estimate the prognostic value of inflammatory markers in patients with laryngeal squamous cell carcinoma (LSCC). METHODS A total of 361 resected LSCC patients were included. The preoperative and postoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), alkaline phosphatase (ALP) and l actate dehydrogenase (LDH) were assessed. The Kaplan-Meier survival analysis and Cox regression analysis were conducted on overall survival (OS) and progression-free survival (PFS). RESULTS Both Kaplan-Meier analysis and univariate analysis demonstrated significant prognostic value of preoperative and postoperative NLR, PLR and MLR. However, only preoperative ALP was predictive of OS and PFS, and LDH failed to be predictor of OS and PFS. The multivariate analysis showed that preoperative NLR (OS: HR = 1.64, 95%CI: 1.06-2.54, p = 0.026; PFS: HR = 1.52, 95%CI: 1.04-2.23, p = 0.029) and postoperative MLR (OS: HR = 2.02, 95%CI: 1.29-3.14, p = 0.002; PFS: HR = 1.57, 95%CI: 1.05-2.34, p = 0.026) were independently related with survival. CONCLUSIONS The elevated preoperative NLR, PLR, MLR and ALP were significantly associated with worse survival and cancer progression. The preoperative NLR and postoperative MLR might be independent prognostic markers of OS and PFS in LSCC patients undergoing surgical resection.
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Affiliation(s)
- Linyan Chen
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, No.37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Hao Zeng
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, No.37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Jiapeng Yang
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, No.37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Yuqing Lu
- The People's Hospital of Hechi, Hechi, Guangxi, People's Republic of China
| | - Dan Zhang
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, No.37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Jinggan Wang
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, No.37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Chienyun Kuang
- West China School of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Sha Zhu
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, No.37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Manni Wang
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, No.37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Xuelei Ma
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, No.37, Guoxue Alley, Chengdu, 610041, People's Republic of China.
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Effects of Different Treatment Strategies and Tumor Stage on Survival of Patients with Advanced Laryngeal Carcinoma: A 15-Year Cohort Study. J Cancer Epidemiol 2018; 2018:9678097. [PMID: 29973955 PMCID: PMC6008834 DOI: 10.1155/2018/9678097] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/22/2018] [Accepted: 04/15/2018] [Indexed: 12/15/2022] Open
Abstract
Background Laryngeal cancer is the second most common cancer in the head and neck. Since laryngeal cancer management is a complex process, there is still no standard strategy to treat this disease in order to increase the survival rate of the patients especially among those with advanced form of the disease. Methods A cohort study was undertaken to analyze factors predicting survival of the patients in advanced stage laryngeal cancer in the Southern Iran among all patients newly diagnosed with laryngeal cancer between 2000 and 2015. Results Data of a total number of 415 patients who have had been diagnosed with advanced laryngeal cancer during this period was used for analysis. The patients' 1-, 3-, 5-, and 10-year survival rates were 81%, 62%, 53%, and 38%, respectively. Multivariable Cox regression analyses indicated a significant relationship between patients' survival and age at diagnosis (P < 0.001), disease stage (P = 0.002), tumor grade (P = 0.008), positive L. node (P = 0.008), and type of treatment (P < 0.001). As expected, treatment strategy was identified as the most effective factor in survival of the patients. According to the results, patients who undergone surgical treatment experienced a longer survival than those who received other treatments. Conclusion This study showed that the survival of patients depends on several factors, among which, treatment strategy is the most important. Combination of total laryngectomy plus chemoradiation provides superior local control and better survival compared to either radiotherapy or chemoradiation in patients with advanced laryngeal cancer.
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Zhang SY, Lu ZM, Lin YF, Chen LS, Luo XN, Song XH, Chen SH, Wu YL. miR-144-3p, a tumor suppressive microRNA targeting ETS-1 in laryngeal squamous cell carcinoma. Oncotarget 2017; 7:11637-50. [PMID: 26826553 PMCID: PMC4905499 DOI: 10.18632/oncotarget.7025] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 11/28/2015] [Indexed: 02/01/2023] Open
Abstract
Regional lymph node metastasis and distant metastasis are critical in the prognosis of laryngeal squamous cell carcinoma (LSCC). This study investigated the roles of miR-144-3p and E26 transformation specific-1 (ETS-1) in the invasion and migration of LSCC cells. The effects of miR-144-3p and ETS-1 on FaDu and Hep2 cell growth, migration and invasion were determined. Suppression of ETS-1 by miR-144-3p was confirmed using luciferase assays; the effects of ETS-1 silencing were determined using a xenograft tumor model. The expression of ETS-1 was analyzed in 71 paraffin-embedded tissue biopsies and eight fresh frozen biopsies obtained from LSCC patients. miR-144-3p inhibited the growth, invasion and migration of FaDu and Hep2 cells in part through suppression of epithelial-mesenchymal transition as determined by increased E-cadherin and α-catenin and reduced fibronectin and vimentin expression. Additionally, ETS-1 is a molecular target of miR-144-3p, and silencing ETS-1 expression inhibited FaDu and Hep2 cell invasion and migration as well as reduced Hep2 xenograft tumor volume. In LSCC, the expression of ETS-1 is upregulated with disease progression, and higher ETS-1 expression, which was negatively associated with miR-144-3p levels, adversely corresponded with prognoses. Thus, upregulated ETS-1 levels may promote LSCC metastasis, resulting in poor patient prognosis.
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Affiliation(s)
- Si-Yi Zhang
- Department of Otorhinolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Zhong-Ming Lu
- Department of Otorhinolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Ye-Feng Lin
- Department of Otorhinolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Liang-Si Chen
- Department of Otorhinolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Xiao-Ning Luo
- Department of Otorhinolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Xin-Han Song
- Department of Otorhinolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Shao-Hua Chen
- Department of Otorhinolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
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Liu Y, Liu J, Wang L, Yang X, Liu X. MicroRNA‑195 inhibits cell proliferation, migration and invasion in laryngeal squamous cell carcinoma by targeting ROCK1. Mol Med Rep 2017; 16:7154-7162. [PMID: 28901478 DOI: 10.3892/mmr.2017.7460] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 07/20/2017] [Indexed: 11/05/2022] Open
Abstract
Laryngeal carcinoma is the second most common malignancy of the head and neck cancers. The most common type of laryngeal carcinoma comprises laryngeal squamous cell carcinoma (LSCC), which accounts for ~95% of laryngeal carcinoma cases. Despite great progress in diagnostic and therapeutic techniques over the last few decades, the prognosis for patients with LSCC remains poor. A number of studies reported that various miRNAs are dysregulated in LSCC and serve critical roles in LSCC tumorigenesis and tumor development. The present study aimed to evaluate the expression level of microRNA (miR)‑195 and its possible roles in LSCC. Briefly, miR‑195 was downregulated in LSCC tissues and cell lines. In addition, low miR‑195 expression was significantly correlated with lymph node metastasis and TNM stage of LSCC patients. Further study has demonstrated that miR‑195 overexpression suppressed cell proliferation, migration and invasion of LSCC. Moreover, rho‑associated kinase 1 (ROCK1) was identified as a direct target gene of miR‑195. Downregulation of ROCK1 exerted similar roles to that of miR‑195 overexpression in LSCC, suggesting ROCK1 was a direct downstream target of miR‑195. These findings elucidated a novel molecular mechanism for the pathogenic mechanism in LSCC carcinogenesis and progression, and may have a potential role in the treatment of patients with LSCC.
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Affiliation(s)
- Yang Liu
- Department of Otolaryngology, Head and Neck Surgery, Tianjin Union Medical Center, Tianjin 300121, P.R. China
| | - Jixiang Liu
- Department of Otolaryngology, Head and Neck Surgery, Tianjin Union Medical Center, Tianjin 300121, P.R. China
| | - Lin Wang
- Department of Otolaryngology, Head and Neck Surgery, Tianjin Union Medical Center, Tianjin 300121, P.R. China
| | - Xiangli Yang
- Department of Otolaryngology, Head and Neck Surgery, Tianjin Union Medical Center, Tianjin 300121, P.R. China
| | - Xiang Liu
- Department of Otolaryngology, Head and Neck Surgery, Tianjin Union Medical Center, Tianjin 300121, P.R. China
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Larbcharoensub N, Wattanatranon D, Leopairut J, Suntisuktana S, Roongpupaht B, Chintrakarn C, Tungkeeratichai J, Praneetvatakul P, Bhongmakapat T, Cheewaruangroj W, Prakunhungsit S. Clinicopathologic Findings and Treatment Outcome of Laryngectomized Patients with Laryngeal Cancer and Hypopharyngeal Cancer: An Experience in Thailand. Asian Pac J Cancer Prev 2017; 18:2035-2042. [PMID: 28843218 PMCID: PMC5697456 DOI: 10.22034/apjcp.2017.18.8.2035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: To evaluate the clinicopathologic findings and treatment outcome in laryngectomized patients with laryngeal cancer and hypopharyngeal cancer. Materials and Methods: The authors retrospectively reviewed the medical records of 212 patients who had been newly diagnosed and treated with laryngectomy between January 2000 and December 2010. The age, gender, clinical manifestations, associated predisposing condition, tumor WHO grade, AJCC tumor stage, maximum tumor size, anatomical involvement, type of surgery, postoperative sequelae, treatment and therapeutic outcome were analyzed. Results: The present study included laryngeal cancer (n = 155) and hypopharyngeal cancer (n = 57). The patients’ age ranged from 38 to 84 years, with the mean age of 62.08±9.67 years. The common clinical presentations were hoarseness (73.6%), cervical lymphadenopathy (35.8%), sorethroat (22.2%), and odynophagia (14.6%). The laryngeal cancer commonly involves true vocal cord (86.5%), anterior commissure (65.8%), false vocal cord (56.8%), laryngeal ventricle (53.5%), subglottis (47.1%), and paraglotic space (35.5%), respectively. Fifty-three percent of cases had stage IV cancer. The most common postoperative surgical sequela was hypothyroidism (77.8%). The overall 5-year survivals for laryngeal cancer and hypopharyngeal cancer were 55% and 9%, respectively. The 5-year survival for node-negative cases was 61.8% versus 17% for node-positive cases (p< 0.001). AJCC stage of laryngeal cancer and hypopharyngeal cancer was a significant predictor of 5-year survival (p< 0.001 and p = 0.004, respectively). Conclusions: The advanced AJCC stage, advanced T stage, advanced N stage, extracapsular tumor spread, and tumor invasion of false vocal cord, epiglottis, preepiglottic space, paraglottic space, thyroid cartilage, cricothyroid membrane were found to significantly augment the decrease of 5-year survival in laryngeal cancer. Only advanced AJCC stage was significantly associated with 5-year survival rate in hypopharyngeal cancer.
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Affiliation(s)
- Noppadol Larbcharoensub
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. E-mail:
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Ma H, Du X, Zhang S, Wang Q, Yin Y, Qiu X, Da P, Yue H, Wu H, Xu F. Achaete-scute complex homologue-1 promotes development of laryngocarcinoma via facilitating the epithelial-mesenchymal transformation. Tumour Biol 2017; 39:1010428317705752. [PMID: 28618959 DOI: 10.1177/1010428317705752] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Laryngeal cancer is one of the most common fatal cancers among head and neck carcinomas, whose mechanism, however, remains unclear. The proneural basic-helix-loop-helix protein achaete-scute complex homologue-1, a member of the basic helix-loop-helix family, plays a very important role in many cancers. This study aims to explore the clinical value and mechanism of achaete-scute complex homologue-1 in laryngeal cancer. Methods including Cell Counting Kit-8, flow cytometry, Transwell invasion assays, and scratch assay were adopted to further explore the bio-function of achaete-scute complex homologue-1, whose expression was examined in fresh and paraffin chip of laryngeal carcinoma tissues by means of western blot and immunohistochemistry, after the interference of achaete-scute complex homologue-1; achaete-scute complex homologue-1, an overexpression in laryngeal carcinoma whose carcinogenicity potential was confirmed via western blot, was correlative with T classification (p = 0.002), histological differentiation (p = 0.000), lymph node metastasis (p = 0.000), and poor survival (p = 0.000). Multivariate analysis shows that achaete-scute complex homologue-1 overexpression is an independent prognostic factor unfavorable to laryngeal carcinoma patients (p = 0.000). Moreover, knocking down achaete-scute complex homologue-1 expression could significantly suppress the proliferation, migration, and invasion of laryngeal carcinoma cell in vitro and disorder epithelial-mesenchymal transformation-associated protein expression. Achaete-scute complex homologue-1 plays an important role in the genesis and progression of laryngeal carcinoma and may act as a potential biomarker for therapeutic target and prognostic prediction.
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Affiliation(s)
- Huaci Ma
- 1 Department of Otorhinolaryngology, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiaodong Du
- 2 Department of Otolaryngology/Head and Neck Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Shu Zhang
- 1 Department of Otorhinolaryngology, Affiliated Hospital of Nantong University, Nantong, China
| | - Qiang Wang
- 1 Department of Otorhinolaryngology, Affiliated Hospital of Nantong University, Nantong, China
| | - Yong Yin
- 1 Department of Otorhinolaryngology, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiaoxia Qiu
- 1 Department of Otorhinolaryngology, Affiliated Hospital of Nantong University, Nantong, China
| | - Peng Da
- 1 Department of Otorhinolaryngology, Affiliated Hospital of Nantong University, Nantong, China
| | - Huijun Yue
- 1 Department of Otorhinolaryngology, Affiliated Hospital of Nantong University, Nantong, China
| | - Hao Wu
- 1 Department of Otorhinolaryngology, Affiliated Hospital of Nantong University, Nantong, China
| | - Fenglei Xu
- 3 Department of Otolaryngology/Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
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Ibrahim BB, Salem MM, Khairy RA, Al Gunaid RAR. Expression of Podoplanin in Laryngeal Squamous Cell Carcinoma and Dysplasia. J Clin Diagn Res 2017; 11:EC31-EC35. [PMID: 28658769 DOI: 10.7860/jcdr/2017/25939.9882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 02/14/2017] [Indexed: 12/16/2022]
Abstract
INTRODUCTION In human cancers, podoplanin expression and its correlation with tumour invasive potential raise its possible role as a diagnostic and prognostic marker for cancer. AIM To investigate the immunohistochemical expression of podoplanin in laryngeal Squamous Cell Carcinoma (SCC) and dysplasia. MATERIALS AND METHODS This study included a total of 60 archived, formalin fixed, paraffin embedded tissue blocks of 40 cases of laryngeal SCC and 20 cases of dysplastic lesions. The samples were immunohistochemically analysed for podoplanin expression. RESULTS Podoplanin expression was significantly higher in laryngeal SCC (90%) than laryngeal dysplastic lesions (55%) (p-value=0.002). The expression of podoplanin was significantly increased with the higher grades of dysplasia (p-value=0.016). A significant positive correlation was detected between podoplanin expression in laryngeal SCC and depth of tumour invasion (p-value=0.035), and stage (p-value=0.026). CONCLUSION The high expression of podoplanin in laryngeal SCC and its significant correlation with poor prognostic parameters recommends podoplanin as a prognostic marker in laryngeal SCC. In addition, increased podoplanin expression with higher grades of dysplasia, supports its role in malignant transformation and allows us to recommend its evaluation in premalignant lesions.
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Affiliation(s)
| | - Mostafa Mohamed Salem
- Assistant Professor, Department of Pathology, Faculty of Medicine, Cairo University, Egypt
| | - Rasha Ahmed Khairy
- Lecturer, Department of Pathology, Faculty of Medicine, Cairo University, Egypt
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Cybula M, Wieteska Ƚ, Józefowicz-Korczyńska M, Karbownik MS, Grzelczyk WL, Szemraj J. New miRNA expression abnormalities in laryngeal squamous cell carcinoma. Cancer Biomark 2017; 16:559-68. [PMID: 27002759 DOI: 10.3233/cbm-160598] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although the development of novel diagnostic and treatment strategies concerning laryngeal cancer is highly intensive, the survival rate remains virtually unchanged. Small non-coding RNAs appear to be very promising biomarkers - and so remain the focus of extensive investigation in laryngeal cancer. OBJECTIVE We examined the expression of five miRNA and five genes related to cancer whether they could be potential laryngeal cancer biomarkers. METHODS We performed an analysis in 47 patients diagnosed with laryngeal cancer. The qPCR technique was used to investigate the expression profile. RESULTS While miR-21-3p and miR-525-5p were found to be significantly up-regulated, miR-139-3p and miR-885-5p expression is lower in laryngeal cancer. Moreover, PIK3R1 and HACE1 were found to be also down-regulated. CONCLUSIONS The change in miRNA expression is frequent than the expression of other tested genes. The expression of passenger strands such as miR-21-3p and miR-139-3p, which are rarely investigated, is also significantly affected in laryngeal cancer. While PIK3R1, HACE1, miR-139-3p, and miR-885-5p may act as tumor suppressor genes in the studied tumour type, miR-21-3p and miR-525-5p seem to have oncogenic properties. Our findings suggest that miR-885-5p and PIK3R1 are the best indicators for the classification of laryngeal cancer tissue and normal mucosa.
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Affiliation(s)
- Magdalena Cybula
- Department of Medical Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Ƚukasz Wieteska
- Department of Medical Biochemistry, Medical University of Lodz, Lodz, Poland
| | | | | | - Weronika Lucas Grzelczyk
- Department of Otolaryngology and Oncological Laryngology, Medical University of Lodz, Lodz, Poland
| | - Janusz Szemraj
- Department of Medical Biochemistry, Medical University of Lodz, Lodz, Poland
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Hypoxia-Inducible Factor-1 α Expression in Indonesian Laryngeal Squamous Cell Carcinoma Patients. JOURNAL OF ONCOLOGY 2016; 2016:3215463. [PMID: 27882053 PMCID: PMC5108852 DOI: 10.1155/2016/3215463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/06/2016] [Accepted: 10/16/2016] [Indexed: 11/18/2022]
Abstract
Objectives. This research aimed to determine the association between hypoxia-inducible factor-1α (HIF-1α) expression and laryngeal squamous cell carcinoma clinical stage. Methods. We retrospectively analyzed paraffin-embedded tissue from 47 laryngeal squamous cell carcinoma (LSCC) patients from 2011 to 2014. HIF-1α expression was analyzed by immunohistochemistry using an anti-HIF-1α mouse monoclonal antibody. The association between HIF-1α expression and clinical stage was analyzed using the chi square test. Results. The glottis was the predominant site of laryngeal squamous cell carcinoma occurrence, and 43/47 (91.5%) patients presented at an advanced stage. Of the advanced stage patients, 27/43 stained positive for HIF-1α expression and 16/43 stained negative. Of the early stage patients, 2/4 stained positive for HIF-1α expression and 2/4 stained negative. Statistical analysis did not demonstrate significant association of HIF-1α expression. Conclusion. There was no statistically significant association between HIF-1α expression and the clinical stage or histological differentiation of LSCC.
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Clinical and histopathological prognostic factors in locoregional advanced laryngeal cancer. The Journal of Laryngology & Otology 2016; 130:948-953. [DOI: 10.1017/s002221511600880x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To evaluate the clinical and histopathological factors affecting the prognosis of patients with squamous cell locoregional advanced laryngeal cancer.Methods:A retrospective chart review was conducted of 121 patients with locoregional advanced laryngeal cancer, primarily treated with surgery from 2007 to 2011. Disease-free survival and overall survival rates were analysed as oncological outcomes. Prognostic variables, namely gender, pharyngeal invasion, pathological assessment of tumour and nodal stage, adjuvant therapy, margin status, nodal extracapsular extension, tumour differentiation, lymphovascular and perineural invasion, and predominant growth pattern, were also analysed.Results:One-year and three-year disease-free survival rates were 81.3 per cent and 63.5 per cent, respectively. One-year and three-year overall survival rates were 88.3 per cent and 61.4 per cent, respectively. Multivariate analysis showed that nodal extracapsular extension (p < 0.05) and an infiltrative growth pattern (p < 0.05) were associated with disease progression. Nodal extracapsular extension (p < 0.05) was associated with higher mortality.Conclusion:Nodal extracapsular extension and an infiltrative growth pattern were the main prognostic factors in locoregional advanced laryngeal cancer. The presence of pharyngeal invasion, pathologically confirmed node-positive stage 2–3 disease, close or microscopic positive margins, and lymphovascular and perineural invasion have a negative impact on prognosis.
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A Novel Inflammation- and Nutrition-Based Prognostic System for Patients with Laryngeal Squamous Cell Carcinoma: Combination of Red Blood Cell Distribution Width and Body Mass Index (COR-BMI). PLoS One 2016; 11:e0163282. [PMID: 27658208 PMCID: PMC5033418 DOI: 10.1371/journal.pone.0163282] [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: 03/30/2016] [Accepted: 09/05/2016] [Indexed: 12/13/2022] Open
Abstract
Background Laryngeal squamous cell carcinoma (LSCC) is a head and neck cancer type. In this study, we introduced a novel inflammation- and nutrition-based prognostic system, referred to as COR-BMI (Combination of red blood cell distribution width and body mass index), for LSCC patients. Methods A total of 807 LSCC patients (784 male and 23 female, 22–87 y of age) who underwent surgery were enrolled in this retrospective cohort study. The patients were stratified by COR-BMI into three groups: COR-BMI (0) (RDW ≤ 13.1 and BMI ≥ 25); COR-BMI (1) (RDW ≤ 13.1 and BMI < 18.5 or 18.5 ≤ BMI < 25; RDW > 13.1 and 18.5 ≤ BMI < 25 or BMI ≥ 25); or COR-BMI (2) (RDW > 13.1 and BMI < 18.5). Cox regression models were used to investigate the association between COR-BMI and cancer-specific survival (CSS) rate among LSCC patients. Results The 5-y, 10-y, and 15-y CSS rates were 71.6%, 60.1%, and 55.4%, respectively. There were significant differences among the COR-BMI groups in age (< 60 versus ≥ 60 y; P = 0.005) and T stage (T1, T2, T3, or T4; P = 0.013). Based on the results, COR-BMI (1 versus 0: HR = 1.76; 95% CI = 0.98–3.15; 2 versus 0: HR = 2.91; 95% CI = 1.53–5.54, P = 0.001) was a significant independent predictor of CSS. Conclusion COR-BMI is a novel inflammation- and nutrition-based prognostic system, which could predict long-term survival in LSCC patients who underwent surgery.
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Lotfi A, Mohammadi G, Saniee L, Mousaviagdas M, Chavoshi H, Tavassoli A. Serum Level of Matrix Metalloproteinase-2 and -9 in Patients with Laryngeal Squamous Cell Carcinoma and Clinical Significance. Asian Pac J Cancer Prev 2016; 16:6749-51. [PMID: 26434905 DOI: 10.7314/apjcp.2015.16.15.6749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Laryngeal cancer is an important malignancy in head and neck area and squamous cell carcinoma (SCC) is the most common type accounting for 95% of cases. Increase in matrix metalloproteinases (MMPs) in different tumors and their correlation with tumor invasiveness has been documented. However, most studies have evaluated MMP-2 and MMP-9 expression and few have evaluated serum levels. The aim of current study was to evaluate serum levels in patients with laryngeal SCC compared to normal subjects and assess any relation with tumor clinicopathological findings. MATERIALS AND METHODS In this case control study, 20 patients with oral SCC and 20 healthy subjects were included. Serum levels of MMP-2 and MMP-9 were compared between groups and correlations with findings including grade (T) and node involvement (N) were evaluated. RESULTS Patients with laryngeal SCC had significantly higher serum levels of MMP-2 (p=0.01) and MMP-9 (p=0.03) compared to healthy subjects. Patients with higher T stage (T3,4) had significantly higher MMP-2 (p=0.04) and MMP-9 (p=0.01). There was significant positive correlation between serum levels of MMP-2 with T stage (r=0.45, p=0.04) and lymph node involvement (r=0.563, p=0.01) and between levels of MMP-9 with T stage (r=0.527, p=0.01). CONCLUSIONS Our results showed that compared to healthy subjects, both MMP-2 and MMP-9 are significantly increased in serum of laryngeal SCC cases. MMP-2 was correlated with lymph node involvement while MMP-9 has stronger correlation with T stage compared to MMP-2.
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Affiliation(s)
- Alireza Lotfi
- Department of Otorhinolaryngology, Tabriz University of Medical Sciences, Tabriz, Iran E-mail :
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Organ preservation with chemoradiation in advanced laryngeal cancer: The problem of generalizing results from randomized controlled trials. Auris Nasus Larynx 2016; 44:18-25. [PMID: 27397024 DOI: 10.1016/j.anl.2016.06.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 05/23/2016] [Accepted: 06/06/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND The primary goal of treatment in advanced laryngeal cancer is to achieve optimal oncologic outcomes while preserving function and quality of life. Combination of chemotherapy and radiation has been popularized as an alternative to surgery for patients facing total laryngectomy. However, survival analyses from large, population-based databases have not duplicated results reported from randomized trials. METHODS A comprehensive literature review was undertaken to try to better understand the reasons why results differ among randomized trials and population cohort studies. RESULTS A variety of reasons are discussed, including differences in patient staging, selection bias, complexity bias, inconsistent terminology, patient compliance and treatment expertise. CONCLUSIONS Personalized treatment considering all factors is critical for optimal outcomes. In general, evidence supports total laryngectomy for patients with T4 cancers. Definitive chemoradiotherapy strategies are acceptable alternatives for T3 cancers, provided that all resources for the administration of the treatment, follow-up and surgical salvage are available.
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Gao X, Wang J, Bai W, Ji W, Wang L. NOB1 silencing inhibits the growth and metastasis of laryngeal cancer cells through the regulation of JNK signaling pathway. Oncol Rep 2016; 35:3313-20. [PMID: 27035645 DOI: 10.3892/or.2016.4707] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/05/2016] [Indexed: 11/06/2022] Open
Abstract
Nin one binding protein (NOB1) plays important roles in the synthesis and degradation of proteins, thus having effects on the cellular process. In the present study, the expression level of NOB1 in laryngeal cancer patients was detected by quantitative PCR and western blotting, and the effect of NOB1 on growth and metastasis of laryngeal cancer cells was explored. Silence of NOB1 was found to inhibit the proliferation of laryngeal cancer cells, arrest cell cycle and induce cell apoptosis. NOB1 silence was also found to inhibit the migration and invasion of laryngeal cancer cells and to downregulate the protein levels of matrix metalloproteinases (MMPs)-2 and MMP-9. Further mechanism study revealed that the JNK signaling pathway was involved in the function of NOB1. Our present results suggest that NOB1 plays an oncogenic role in laryngeal cancer cells through the regulation of JNK signaling pathway, and lays a theoretical foundation for further exploration of NOB1.
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Affiliation(s)
- Xin Gao
- Department of Otorhinolaryngology-Head and Neck Surgery, Shengjing Hospital of China Medical University, Heping, Shenyang, Liaoning 110004, P.R. China
| | - Jin Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Shengjing Hospital of China Medical University, Heping, Shenyang, Liaoning 110004, P.R. China
| | - Weiliang Bai
- Department of Otorhinolaryngology-Head and Neck Surgery, Shengjing Hospital of China Medical University, Heping, Shenyang, Liaoning 110004, P.R. China
| | - Wenyue Ji
- Department of Otorhinolaryngology-Head and Neck Surgery, Shengjing Hospital of China Medical University, Heping, Shenyang, Liaoning 110004, P.R. China
| | - Liping Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Shengjing Hospital of China Medical University, Heping, Shenyang, Liaoning 110004, P.R. China
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Microbiota in the Throat and Risk Factors for Laryngeal Carcinoma. Appl Environ Microbiol 2014; 80:7356-63. [PMID: 25239901 DOI: 10.1128/aem.02329-14] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 09/15/2014] [Indexed: 01/05/2023] Open
Abstract
The compositions and abundances of the microbiota in the ecological niche of the human throat and the possible relationship between the microbiota and laryngeal cancer are poorly understood. To obtain insight into this, we enrolled 27 laryngeal carcinoma patients and 28 subjects with vocal cord polyps as controls. For each subject, we simultaneously collected swab samples from the upper throat near the epiglottis (site I) and tissue samples from the vestibulum laryngis to the subglottic region (site II). The microbiota of the throat were fully characterized by pyrosequencing of barcoded 16S rRNA genes. We found 14 phyla, 20 classes, 38 orders, 85 families, and 218 genera in the throats of enrolled subjects. The main phyla were Firmicutes (54.7%), Fusobacteria (14.8%), Bacteroidetes (12.7%), and Proteobacteria (10.6%). Streptococcus (37.3%), Fusobacterium (11.3%), and Prevotella (10.6%) were identified as the three most predominant genera in the throat. The relative abundances of 23 bacterial genera in site I were significantly different from those in site II (P < 0.05). The relative proportions of 12 genera largely varied between laryngeal cancer patients and control subjects (P < 0.05). Collectively, this study outlined the spatial structure of microbial communities in the human throat. The spatial structure of bacterial communities significantly varied in two anatomical sites of the throat. The bacterial profiles of the throat of laryngeal cancer patients were strongly different from those of control subjects, and several of these microorganisms may be related to laryngeal carcinoma.
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Afrogheh A, Pelser A, Hille J, Attwood R, Loock J, Schubert PT. Application of liquid-based transepithelial flexible brush cytology in the detection of high-grade laryngeal mucosal lesions. Diagn Cytopathol 2014; 43:21-7. [DOI: 10.1002/dc.23180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 05/09/2014] [Indexed: 11/12/2022]
Affiliation(s)
- Amir Afrogheh
- Division of Anatomical Pathology; Faculty of Medicine, University of Stellenbosch and NHLS, Tygerberg Hospital; Cape Town South Africa
| | - Andrew Pelser
- Division of Otorhinolaryngology, Faculty of Medicine; University of Stellenbosch, Tygerberg Hospital; Cape Town South Africa
| | - Jos Hille
- Department of Oral Pathology; Faculty of Dentistry; University of the Western Cape and NHLS, Tygerberg Hospital; Cape Town South Africa
| | - Rory Attwood
- Division of Otorhinolaryngology, Faculty of Medicine; University of Stellenbosch, Tygerberg Hospital; Cape Town South Africa
| | - James Loock
- Division of Otorhinolaryngology, Faculty of Medicine; University of Stellenbosch, Tygerberg Hospital; Cape Town South Africa
| | - Pawel Tomasz Schubert
- Division of Anatomical Pathology; Faculty of Medicine, University of Stellenbosch and NHLS, Tygerberg Hospital; Cape Town South Africa
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Habbous S, Harland LTG, La Delfa A, Fadhel E, Xu W, Liu FF, Goldstein D, Waldron J, Huang SH, O'Sullivan B, Liu G. Comorbidity and prognosis in head and neck cancers: Differences by subsite, stage, and human papillomavirus status. Head Neck 2013; 36:802-10. [DOI: 10.1002/hed.23360] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 02/01/2013] [Accepted: 04/11/2013] [Indexed: 01/16/2023] Open
Affiliation(s)
- Steven Habbous
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Biostatistics; Princess Margaret Hospital; Toronto Ontario Canada
| | - Luke T. G. Harland
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
| | - Anthony La Delfa
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
| | - Ehab Fadhel
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
| | - Wei Xu
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Biostatistics; Princess Margaret Hospital; Toronto Ontario Canada
| | - Fei-Fei Liu
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - David Goldstein
- Department of Otolaryngology - Head and Neck Surgery; Princess Margaret Cancer Centre; University Health Network, University of Toronto; Toronto Ontario Canada
| | - John Waldron
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - Shao-Hui Huang
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - Brian O'Sullivan
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - Geoffrey Liu
- Department of Medicine, Medical Biophysics, and Epidemiology; Ontario Cancer Institute, Princess Margaret Hospital/University Health Network; Toronto Ontario Canada
- Department of Medical Biophysics and Epidemiology; Division of Epidemiology; Dalla Lana School of Public Health; University of Toronto; Toronto Ontario Canada
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Zhang SY, Lu ZM, Luo XN, Chen LS, Ge PJ, Song XH, Chen SH, Wu YL. Retrospective analysis of prognostic factors in 205 patients with laryngeal squamous cell carcinoma who underwent surgical treatment. PLoS One 2013; 8:e60157. [PMID: 23593169 PMCID: PMC3617169 DOI: 10.1371/journal.pone.0060157] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 02/22/2013] [Indexed: 11/19/2022] Open
Abstract
Objectives To investigate the most important factors affecting the prognosis of the patients with squamous cell carcinoma (SCC) of the larynx. Methods Based on the clinical and follow-up data, 205 patients with SCC of the larynx receiving total laryngectomy, partial laryngectomy, or CO2 laser surgery in GuangDong General Hospital were retrospectively analyzed. A survival analysis was performed by the Kaplan-Meier method and a multivariable analysis of prognostic factors was carried out using the Cox proportional hazard model. Results Subtypes of carcinoma included 69.8% glottic and 30.2% supraglottic. Most patients were in N0 stage (77.6%), and 22.4% patients were in N1∼N3 stage. Over half of the patients were in T1∼T2 stage (55.1%), 20.0% in T3, and 24.9% in T4. Mean follow-up duration was 49.2 months. The survival rates 1, 2, and 3 years after the surgery were 99.0%, 91.7%, and 81.5%, respectively. The survival rate for those patients with clinical stage IV was significantly lower than for those with clinical stage I and II (p<0.001 and p = 0.013, respectively). The disease-free progression rates 1, 2, and 3 years after the surgery were 83.9%, 74.6%, and 71.2%, respectively. Futhermore, those patients with a Charlson score of 1 to 2 and ≥3 had higher risk of mortality than those with a Charlson score of 0 (hazard ratios of 1.8 and 2.41 p = 0.042 and p = 0.008). Multivariable analysis revealed that clinical stage, surgical margin, and comorbidity were significantly associated with both mortality and disease-free progression. Conclusion The surgical resection margin, clinical stage, and comorbidity were independent factors affecting the laryngeal cancer prognosis. The survival rates were lower for patients with advanced laryngeal cancer, positive surgical margins, or severe comorbidity, suggesting the importance of early diagnosis, early treatment, negative surgical margins, and conditions of comorbidity.
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Affiliation(s)
- Si-Yi Zhang
- Department of Otorhinolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
- Southern Medical University, Guangzhou, Guangdong Province, China
| | - Zhong-Ming Lu
- Department of Otorhinolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
- Southern Medical University, Guangzhou, Guangdong Province, China
| | - Xiao-Ning Luo
- Department of Otorhinolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Liang-Si Chen
- Department of Otorhinolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Ping-Jiang Ge
- Department of Otorhinolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Xin-Han Song
- Department of Otorhinolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Shao-hua Chen
- Department of Otorhinolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
- * E-mail: (Y-LW); (S-hC)
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
- * E-mail: (Y-LW); (S-hC)
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Habbous S, Chu KP, Harland LTG, La Delfa A, Fadhel E, Sun B, Xu W, Wong A, Howell D, Ringash J, Waldron J, O'Sullivan B, Goldstein D, Huang SH, Liu G. Validation of a one-page patient-reported Charlson comorbidity index questionnaire for upper aerodigestive tract cancer patients. Oral Oncol 2013; 49:407-12. [PMID: 23291295 DOI: 10.1016/j.oraloncology.2012.11.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 11/22/2012] [Accepted: 11/30/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Cancer patients have a wide range of comorbidities that are important confounders for biomarker and clinical studies of prognosis and outcome. Comorbidities can be captured using the Charlson Comorbidity Index (CCI) through abstraction of medical records, but patient-reported outcome (PRO) questionnaires have also been used. The objective was to validate the PRO-CCI in a head and neck cancer (HNC) population, and to assess its level of agreement with the standard (std-CCI) method of chart review. METHODS A one-page PRO-CCI was compared with the std-CCI obtained through independent abstraction in 882 HNC patients (2007-2010). Kappa statistics and associated measures (p(pos) and p(neg)) were used to assess agreement. Discrepancy for each comorbid illness was evaluated. Proportional hazard models compared the association of std-CCI and PRO-CCI with overall survival (OS). Adjustments were made and a modified PRO-CCI was re-evaluated in a new cohort of upper aerodigestive tract cancers patient. RESULTS PRO-CCI was higher than the std-CCI (p < 0.0001). After adjustment, having at least two comorbidities according to either the std-CCI [HR 1.97 (1.38-2.80)] or the PRO-CCI [HR 1.62 (1.18-2.24)] was prognostic. Of the most prevalent comorbidities, agreement was high for most of the CCI elements (kappa 0.76-0.93), but poorest agreement for connective tissue disease (kappa = 0.29, p(pos) = 43%, p(neg) = 84%) and COPD (kappa = 0.48, p(pos) = 53%, p(neg) = 95%). When the connective tissue disease question was modified, agreement of this item improved (kappa = 0.47, p(pos) = 50%). CONCLUSION PRO-CCI can be an easy and effective tool in prognostic and outcomes research in HNC patients.
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Affiliation(s)
- Steven Habbous
- Medical Biophysics, Ontario Cancer Institute, 610 University Ave., Toronto, ON, Canada M5G 2M9.
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Hao W, Zhu Y, Zhou H. Prognostic value of interleukin-6 and interleukin-8 in laryngeal squamous cell cancer. Med Oncol 2012; 30:333. [PMID: 23269580 DOI: 10.1007/s12032-012-0333-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 09/26/2012] [Indexed: 01/28/2023]
Abstract
The aim of this study was to evaluate serum levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) as prognostic variables in patients with laryngeal squamous cell cancer. A total of 92 patients with primary diagnosis of laryngeal squamous cell cancer (LSCC), treated between 2003 and 2005, were included in this evaluation. Preoperative serum levels of IL-6 and IL-8 were measured by enzyme-linked immunosorbent assay methods. Results were compared according to clinical and pathological date criteria. Serum IL-6 and IL-8 levels were significantly higher in patients with LSCC compared to healthy controls (P < 0.0001). Serum IL-6 level was associated with lymph node metastasis (P < 0.001), T classification (P < 0.001) and clinical stage (P = 0.001). Multivariate analysis indicated that serum IL-6 was an independent predictor of LSCC-specific progression-free survival (P = 0.049) and overall survival (P = 0.040). Higher serum IL-6 level (IL-6 > 9.7 pg/ml) was associated with a shortened overall survival and progression-free survival (P < 0.05). Our data indicate that serum IL-6 is associated with the development and progression of LSCC. Serum IL-6 may serve as an independent prognostic marker for LSCC patients.
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Affiliation(s)
- Wenwei Hao
- Department of Otolaryngological, Tianjin Medical University General Hospital, Tianjin 300052, People's Republic of China
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Smee RI, De-loyde KJ, Broadley K, Williams JR. Prognostic factors for supraglottic laryngeal carcinoma: Importance of the unfit patient. Head Neck 2012; 35:949-58. [PMID: 22730206 DOI: 10.1002/hed.23061] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2012] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The purpose of this study was to define prognostic factors for supraglottic laryngeal cancer that may influence management. METHODS This ethics-approved study captured information on patients who presented with supraglottic laryngeal cancer between 1967 and 2008. Endpoints were local/ultimate failure and cancer-specific survival (CSS). Analysis was performed using chi-square, Fisher exact test, and logistic regression. Kaplan-Meier and Cox regression analysis were used to describe time-to-event data. RESULTS Three hundred sixty-nine patients were analyzed. Two hundred seventeen patients received radiotherapy, 30 were treated with surgery, and 122 were treated with radiotherapy and surgery. The 5-year ultimate local control and CSS rates were 79.5% and 62.8%. Treatment type was a univariate predictor for outcome; however, it was not an independent predictor for ultimate local control or CSS. CONCLUSIONS This study highlights the fact that by documenting information it is possible to define prognostic factors. It also shows the importance of adjusting for clinical predictors such as patients being unfit for surgery.
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Affiliation(s)
- Robert I Smee
- Department of Radiation Oncology, The Prince of Wales Cancer Centre, Level 2, High St, Randwick, New South Wales, Australia
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