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Fornieles G, Núñez MI, Expósito J. Matrix Metalloproteinases and Their Inhibitors as Potential Prognostic Biomarkers in Head and Neck Cancer after Radiotherapy. Int J Mol Sci 2023; 25:527. [PMID: 38203696 PMCID: PMC10778974 DOI: 10.3390/ijms25010527] [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: 11/17/2023] [Revised: 12/18/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Head and neck cancer (HNC) is among the ten most frequent tumours, with 5-year survival rates varying from 30% to 70% depending on the stage and location of the tumour. HNC is traditionally known as head and neck squamous cell carcinoma (HNSCC), since 90% arises from epithelial cells. Metastasis remains a major cause of mortality in patients with HNSCC. HNSCC patients with metastatic disease have an extremely poor prognosis with a survival rate of less than a year. Matrix metalloproteinases (MMPs) have been described as biomarkers that promote cell migration and invasion. Radiotherapy is widely used to treat HNSCC, being a determining factor in the alteration of the tumour's biology and microenvironment. This review focuses on analysing the current state of the scientific literature on this topic. Although few studies have focused on the role of these proteinases in HNC, some authors have concluded that radiotherapy alters the behaviour of MMPs and tissue inhibitors of metalloproteinases (TIMPs). Therefore, more research is needed to understand the roles played by MMPs and their inhibitors (TIMPs) as prognostic biomarkers in patients with HNC and their involvement in the response to radiotherapy.
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Affiliation(s)
- Gabriel Fornieles
- Doctoral Programme in Clinical Medicine and Public Health, University of Granada, 18012 Granada, Spain;
| | - María Isabel Núñez
- Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain;
- Biopathology and Regenerative Medicine Institute (IBIMER), Centre for Biomedical Research, University of Granada, 18016 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18012 Granada, Spain
| | - José Expósito
- Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain;
- Biosanitary Institute of Granada (ibs.GRANADA), 18012 Granada, Spain
- Radiation Oncology Department, Virgen de las Nieves University Hospital, 18014 Granada, Spain
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2
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De Virgilio A, Costantino A, Festa BM, Russo E, Malvezzi L, Pellini R, Colombo G, Spriano G, Mercante G, Ferreli F. Surgical prevention of pharyngocutaneous fistula in salvage total laryngectomy: a systematic review and network meta-analysis. Eur Arch Otorhinolaryngol 2022; 279:5839-5849. [PMID: 35731297 DOI: 10.1007/s00405-022-07490-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/05/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE To compare the efficacy of different reconstructive techniques in preventing pharyngocutaneous fistula (PCF) after salvage total laryngectomy (STL). METHODS An arm-based network analysis was conducted using a Bayesian hierarchical model according to the PRISMA-NMA guidelines. RESULTS A total of 1694 patients with a median age of 64 years (n = 1569, 95% CI: 62-66 years) were included. If compared to primary pharyngeal closure alone, only a pedicled flap onlay (PFO) showed a statistically significant reduction in PCF rate (OR: 0.35, CI: 0.20-0.61). PFO seemed to perform better than other treatments according to the rank probabilities test (39.9% chance of ranking first). CONCLUSIONS A pedicled flap placed with an overlay technique might be preferred over a patch reconstruction to prevent PCF after STL.
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Affiliation(s)
- Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Bianca Maria Festa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy. .,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Elena Russo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Luca Malvezzi
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Raul Pellini
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Giovanni Colombo
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
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Javaux C, Daveau C, Bettinger C, Daurade M, Dupieux-Chabert C, Craighero F, Fuchsmann C, Céruse P, Gleizal A, Sigaux N, Ferry T, Valour F. Osteocutaneous-flap-related osteomyelitis following mandibular reconstruction: a cohort study of an emerging and complex bone infection. J Bone Jt Infect 2022; 7:127-136. [PMID: 35855050 PMCID: PMC9285487 DOI: 10.5194/jbji-7-127-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/23/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract. Osteocutaneous flap (OCF) mandible reconstruction is at
high risk for surgical site infection. This study aimed to describe
diagnosis, management, and outcome of OCF-related osteomyelitis. All
patients managed at our institution for an OCF-related osteomyelitis
following mandible reconstruction were included in a retrospective cohort
study (2012–2019). Microbiology was described according to gold-standard
surgical samples, considering all virulent pathogens, and potential
contaminants if present on at least two samples. Determinants of treatment
failure were assessed by logistic regression and Kaplan–Meier curve
analysis. The 48 included patients (median age 60.5 (IQR, 52.4–66.6) years)
benefited from OCF mandible reconstruction mostly for carcinoma (n=27/48;
56.3 %) or osteoradionecrosis (n=12/48; 25.0 %). OCF-related
osteomyelitis was mostly early (≤3 months post-surgery; n=43/48;
89.6 %), presenting with local inflammation (n=28/47; 59.6 %), nonunion (wound dehiscence)
or sinus tract (n=28/47; 59.6 %), and/or bone or device exposure
(n=21/47; 44.7 %). Main implicated pathogens were Enterobacteriaceae (n=25/41; 61.0 %),
streptococci (n=22/41; 53.7 %), Staphylococcus aureus (n=10/41; 24.4 %), enterococci
(n=9/41; 22.0 %), non-fermenting Gram-negative bacilli (n=8/41;
19.5 %), and anaerobes (n=8/41; 19.5 %). Thirty-nine patients (81.3 %)
benefited from surgery, consisting of debridement with implant retention
(DAIR) in 25/39 (64.1 %) cases, associated with 93 (IQR, 64–128) days of
antimicrobial therapy. After a follow-up of 18 (IQR, 11–31) months, 24/48
(50.0 %) treatment failures were observed. Determinants of treatment
outcomes were DAIR (OR, 3.333; 95 % CI, 1.020–10.898) and an early
infectious disease specialist referral (OR, 0.236 if ≤2 weeks;
95 % CI, 0.062–0.933). OCF-related osteomyelitis following mandibular reconstruction represents
difficult-to-treat infections. Our results advocate for a multidisciplinary
management, including an early infectious-disease-specialist referral to
manage the antimicrobial therapy driven by complex microbiological
documentation.
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Mijiti A, Kuerbantayi N, Zhang ZQ, Su MY, Zhang XH, Huojia M. Influence of preoperative radiotherapy on head and neck free-flap reconstruction: Systematic review and meta-analysis. Head Neck 2020; 42:2165-2180. [PMID: 32129547 DOI: 10.1002/hed.26136] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 02/08/2020] [Accepted: 02/20/2020] [Indexed: 01/04/2023] Open
Abstract
The effect of preoperative external radiotherapy (XRT) on head and neck free-flap reconstruction is still controversial. In this study, we aimed to determine the impact of preoperative XRT on the outcomes of head and neck microvascular free-flap reconstruction. A systematic review and meta-analysis was conducted in concordance with the Systematic reviews and Meta-Analyses protocol. We searched several databases (PubMed, EMBASE, Web of Science, and Cochrane Library) to find published papers on the topic. The R program was used for data synthesis and statistical heterogeneity evaluation; then, fixed effect or random effect models were used. A total of 37 studies, involving 12 408 patients with 12 668 flaps, were included in this meta-analysis. The overall flap success rate for all studies was 94.4%. Pooled analysis showed that patients with preoperative XRT were significantly associated with an increased risk of total flap failure (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 1.45-2.23, P < .001), partial flap failure (OR = 1.90, 95% CI = 1.07-3.38, P = .029), and postoperative complication rates (OR = 2.22, 95% CI = 1.64-2.72, P < .001). Our study suggests that preoperative XRT is associated with an increased risk of developing free-flap failure and an increased postoperative complication rate.
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Affiliation(s)
- Ainiwaer Mijiti
- Department of Oral and Maxillofacial Surgery, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen, China
| | - Nazuke Kuerbantayi
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Zhi Q Zhang
- Department of Stomatology, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen, China
| | - Ming Y Su
- Department of Oral and Maxillofacial Surgery, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen, China
| | - Xiao H Zhang
- Department of Oral and Maxillofacial Surgery, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen, China
| | - Muhetaer Huojia
- Department of Oral and Maxillofacial Surgery, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen, China
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Lei ZY, Chen JJ, Cao ZJ, Ao MZ, Yu LJ. Efficacy of Aeschynomene indica L. leaves for wound healing and isolation of active constituent. JOURNAL OF ETHNOPHARMACOLOGY 2019; 228:156-163. [PMID: 30107245 DOI: 10.1016/j.jep.2018.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 08/05/2018] [Accepted: 08/09/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE In traditional Chinese medicine, the aerial parts of Aeschynomene indica L. (AIL) have been used for wound healing, and to treat urinary tract infection, hepatitis, enteritis, dysentery, nyctalopia, conjunctivitis, urticaria, and furuncle. However, no scientific investigation has been conducted on its wound healing potential. AIM OF THE STUDY To investigate the effects of AIL extract on wound healing, isolate the active constituent and reveal the possible mechanism of enhancing wound healing. MATERIALS AND METHODS The circular excision wound healing model was used to evaluate in vivo wound-healing activity. Hematoxylin and eosin staining was applied to assess inflammatory cells infiltration, angiogenesis, fibroblast proliferation, collagen synthesis, collagen remodeling, and skin appendages generation. Sirius red-picric acid staining was employed for quantitative analysis of the ratio of collagen I/III. Immunohistochemical staining for CD68, CCR7 (CD197), CD163, TGF-β1 and α-SMA was performed to determine macrophages phenotypes transition (M1-to-M2) and prove the scar-improving effect of AIL on wound healing. RESULTS We successfully isolated the active constituent (Sub-Fr0.2) for wound healing from AIL extract, circular excision wound healing experiment and hematoxylin & eosin staining showed Sub-Fr0.2 has a significant promoting effect on wound healing. Results of sirius red-picric acid staining demonstrated a reduced ratio of collagen I/III in the Sub-Fr0.2 group as compared with the vehicle group. Immunohistochemical staining for CD68, CCR7 (CD197), and CD163 in the Sub-Fr0.2 group exhibited an elevated speed of macrophages transiting from M1 phenotype to M2 phenotype, when compared with the vehicle group. Besides, the expression of TGF-β1 and α-SMA were inhibited on wounds treated with the ointment containing Sub-Fr0.2. CONCLUSION Leaves of AIL and its active constituent (Sub-Fr0.2) effectively promoted wound healing and reduced scar formation, this efficacy might be exerted by accelerating macrophages phenotypes transition and inhibiting TGF-β1 and α-SMA expression.
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Affiliation(s)
- Zhi-Yong Lei
- Institute of Resource Biology and Biotechnology, Department of Biotechnology, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Jing-Jing Chen
- Institute of Resource Biology and Biotechnology, Department of Biotechnology, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Zhi-Jian Cao
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Ming-Zhang Ao
- Institute of Resource Biology and Biotechnology, Department of Biotechnology, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Long-Jiang Yu
- Institute of Resource Biology and Biotechnology, Department of Biotechnology, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China.
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6
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Michel G, Blery P, Henoux M, Guicheux J, Weiss P, Brouard S, Malard O, Espitalier F. Bone marrow cell extract promotes the regeneration of irradiated bone. PLoS One 2017; 12:e0178060. [PMID: 28542343 PMCID: PMC5436862 DOI: 10.1371/journal.pone.0178060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 05/08/2017] [Indexed: 11/21/2022] Open
Abstract
Mandibular osteoradionecrosis is a severe side effect of radiotherapy after the treatment of squamous cell carcinomas of the upper aerodigestive tract. As an alternative to its treatment by micro-anastomosed free-flaps, preclinical tissular engineering studies have been developed. Total bone marrow (TBM) associated with biphasic calcium phosphate (BCP) significantly enhanced bone formation in irradiated bone. One mechanism, explaining how bone marrow cells can help regenerate tissues like this, is the paracrine effect. The bone marrow cell extract (BMCE) makes use of this paracrine mechanism by keeping only the soluble factors such as growth factors and cytokines. It has provided significant results in repairing various tissues, but has not yet been studied in irradiated bone reconstruction. The purpose of this study was to evaluate the effect of BMCE via an intraosseous or intravenous delivery, with a calcium phosphate scaffold, in irradiated bone reconstruction. Twenty rats were irradiated on their hind limbs with a single 80-Gy dose. Three weeks later, surgery was performed to create osseous defects. The intraosseous group (n = 12) studied the effect of BMCE in situ, with six combinations (empty defect, BCP, TBM, BCP-TBM, lysate only, BCP-lysate). After four different combinations of implantation (empty defect, BCP, TBM, BCP-TBM), the intravenous group (n = 8) received four intravenous injections of BMCE for 2 weeks. Five weeks after implantation, samples were explanted for histological and scanning electron microscopy analysis. Lysate immunogenicity was studied with various mixed lymphocyte reactions. Intravenous injections of BMCE led to a significant new bone formation compared to the intraosseous group. The BCP-TBM mixture remained the most effective in the intraosseous group. However, intravenous injections were more effective, with TBM placed in the defect, with or without biomaterials. Histologically, highly cellularized bone marrow was observed in the defects after intravenous injections, and not after an in situ use of the lysate. The mixed lymphocyte reactions did not show any proliferation after 3, 5, or 7 days of lysate incubation with lymphocytes from another species. This study evaluated the role of BMCE in irradiated bone reconstruction. There were significant results arguing in favor of BMCE intravenous injections. This could open new perspectives to irradiated bone reconstruction.
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Affiliation(s)
- Guillaume Michel
- Service d'O.R.L. et de chirurgie cervico-faciale, Centre Hospitalier Universitaire, Nantes, France
- INSERM, UMRS 791, LIOAD, Université de Nantes, Nantes, France
- * E-mail:
| | - Pauline Blery
- INSERM, UMRS 791, LIOAD, Université de Nantes, Nantes, France
- Service d’Odontologie Restauratrice et Chirurgicale, Centre Hospitalier Universitaire, Nantes, France
| | - Michaël Henoux
- Service d'O.R.L. et de chirurgie cervico-faciale, Centre Hospitalier Universitaire, Nantes, France
- INSERM, UMRS 791, LIOAD, Université de Nantes, Nantes, France
| | - Jérôme Guicheux
- INSERM, UMRS 791, LIOAD, Université de Nantes, Nantes, France
| | - Pierre Weiss
- INSERM, UMRS 791, LIOAD, Université de Nantes, Nantes, France
- Service d’Odontologie Restauratrice et Chirurgicale, Centre Hospitalier Universitaire, Nantes, France
| | - Sophie Brouard
- INSERM UMR 1064, ITUN, Université de Nantes, Nantes, France
| | - Olivier Malard
- Service d'O.R.L. et de chirurgie cervico-faciale, Centre Hospitalier Universitaire, Nantes, France
- INSERM, UMRS 791, LIOAD, Université de Nantes, Nantes, France
| | - Florent Espitalier
- Service d'O.R.L. et de chirurgie cervico-faciale, Centre Hospitalier Universitaire, Nantes, France
- INSERM, UMRS 791, LIOAD, Université de Nantes, Nantes, France
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7
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Baek CH, Park W, Choi N, Gu S, Sohn I, Chung MK. Free flap outcome of salvage surgery compared to primary surgery for head and neck defects: A propensity score analysis. Oral Oncol 2016; 62:85-89. [PMID: 27865376 DOI: 10.1016/j.oraloncology.2016.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/04/2016] [Accepted: 10/15/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To compare free flap outcomes for head and neck defects between primary surgery and salvage surgery and identify factors affecting the outcomes in the two settings. METHODS A total of 225 patients (primary group, n=56; salvage group, n=169) were retrospectively identified. The salvage group was previously treated with radiotherapy, chemoradiation, surgery, or any combination of these treatments. Clinical data were retrieved and analyzed between the two groups to compare the incidence and contributing factors of flap-related complications and flap failure. A propensity score analysis with matching T stage, defect, and flap types was also performed for unbiased comparisons. RESULTS Flap-related complication rate was 22.2% in all patients. The salvage group showed higher rates of wound dehiscence than the primary group (3.6% in primary vs. 13.0% in salvage; p=0.04). Flap failures occurred in 10 patients (4.4%), including 3 (5.4%) in the primary group and 7 (4.1%) in the salvage group (p=0.71). Multivariate analysis showed no critical factor that influenced the occurrence of flap-related complications or flap failure, including surgery type (primary or salvage). In propensity score analysis, incidences and types of flap-related complications and flap failure were not statistically different between the two groups (primary and salvage). CONCLUSIONS Free flap reconstruction is a safe and reliable method to restore the ablative defects in previously irradiated or operated head and neck defects.
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Affiliation(s)
- Chung-Hwan Baek
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Woori Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Nayeon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Seonhye Gu
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Insuk Sohn
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
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Han DH, Joo DJ, Kim MS, Choi GH, Choi JS, Park YN, Seong J, Han KH, Kim SI. Living Donor Liver Transplantation for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis after Concurrent Chemoradiation Therapy. Yonsei Med J 2016; 57:1276-81. [PMID: 27401662 PMCID: PMC4960397 DOI: 10.3349/ymj.2016.57.5.1276] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 01/02/2016] [Accepted: 01/04/2016] [Indexed: 02/06/2023] Open
Abstract
Locally advanced hepatocellular carcinoma (HCC) with portal vein thrombosis carries a 1-year survival rate <10%. Localized concurrent chemoradiotherapy (CCRT), followed by hepatic arterial infusion chemotherapy (HAIC), was recently introduced in this setting. Here, we report our early experience with living donor liver transplantation (LDLT) in such patients after successful down-staging of HCC through CCRT and HAIC. Between December 2011 and September 2012, eight patients with locally advanced HCC at initial diagnosis were given CCRT, followed by HAIC, and underwent LDLT at the Severance Hospital, Seoul, Korea. CCRT [45 Gy over 5 weeks with 5-fluorouracil (5-FU) as HAIC] was followed by HAIC (5-FU/cisplatin combination every 4 weeks for 3-12 months), adjusted for tumor response. Down-staging succeeded in all eight patients, leaving no viable tumor thrombi in major vessels, although three patients first underwent hepatic resections. Due to deteriorating liver function, transplantation was the sole therapeutic option and offered a chance for cure. The 1-year disease-free survival rate was 87.5%. There were three instances of post-transplantation tumor recurrence during follow-up monitoring (median, 17 months; range, 10-22 months), but no deaths occurred. Median survival time from initial diagnosis was 33 months. Four postoperative complications recorded in three patients (anastomotic strictures: portal vein, 2; bile duct, 2) were resolved through radiologic interventions. Using an intensive tumor down-staging protocol of CCRT followed by HAIC, LDLT may be a therapeutic option for selected patients with locally advanced HCC and portal vein tumor thrombosis.
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Affiliation(s)
- Dai Hoon Han
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Jin Joo
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
- Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - Myoung Soo Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - Gi Hong Choi
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
- Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Sub Choi
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
- Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - Young Nyun Park
- Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Jinsil Seong
- Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
- Department of Radiological Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Hyub Han
- Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | - Soon Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea.
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Espitalier F, Durand N, Rémy S, Corre P, Sourice S, Pilet P, Weiss P, Guicheux J, Malard O. Development of a cyclosporin-A-induced immune tolerant rat model to test marrow allograft cell type effects on bone repair. Calcif Tissue Int 2015; 96:430-7. [PMID: 25694361 DOI: 10.1007/s00223-015-9970-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 02/11/2015] [Indexed: 01/16/2023]
Abstract
Bone repair is an important concept in tissue engineering, and the ability to repair bone in hypotrophic conditions such as that of irradiated bone, represents a challenge for this field. Previous studies have shown that a combination of bone marrow and (BCP) was effective to repair irradiated bone. However, the origin and role played by each cell type in bone healing still remains unclear. In order to track the grafted cells, the development of an animal model that is immunotolerant to an allograft of bone marrow would be useful. Furthermore, because the immune system interacts with bone turnover, it is of critical importance to demonstrate that immunosuppressive drugs do not interfere with bone repair. After a preliminary study of immunotolerance, cyclosporin-A was chosen to be used in immunosuppressive therapy. Ten rats were included to observe qualitative and quantitative bone repair 8 days and 6 weeks after the creation of bone defects. The defects were filled with an allograft of bone marrow alone or in association with BCP under immunosuppressive treatment (cyclosporin-A). The results showed that there was no significant interaction of cyclosporin-A with osseous regeneration. The use of this new immunotolerant rat model of bone marrow allograft in future studies will provide insight on how the cells within the bone marrow graft contribute to bone healing, especially in irradiated conditions.
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Affiliation(s)
- Florent Espitalier
- INSERM, UMRS 791, Laboratoire d'ingénierie ostéo-articulaire et dentaire, LIOAD, 1 place Alexis Ricordeau, 44042, Nantes Cedex 1, France,
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10
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Azad GK, Corner C. Radiation therapy and soft tissue response. Plast Reconstr Surg 2015. [DOI: 10.1002/9781118655412.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Herle P, Shukla L, Morrison WA, Shayan R. Preoperative radiation and free flap outcomes for head and neck reconstruction: a systematic review and meta-analysis. ANZ J Surg 2014; 85:121-7. [DOI: 10.1111/ans.12888] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Pradyumna Herle
- Regenerative Surgery Group; Australian Catholic University and O'Brien Institute Regenerative Tissue Engineering Centre (AORTEC); Melbourne Victoria Australia
| | - Lipi Shukla
- Regenerative Surgery Group; Australian Catholic University and O'Brien Institute Regenerative Tissue Engineering Centre (AORTEC); Melbourne Victoria Australia
| | - Wayne A. Morrison
- Regenerative Surgery Group; Australian Catholic University and O'Brien Institute Regenerative Tissue Engineering Centre (AORTEC); Melbourne Victoria Australia
| | - Ramin Shayan
- Regenerative Surgery Group; Australian Catholic University and O'Brien Institute Regenerative Tissue Engineering Centre (AORTEC); Melbourne Victoria Australia
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Benatar MJ, Dassonville O, Chamorey E, Poissonnet G, Ettaiche M, Pierre CS, Benezery K, Hechema R, Demard F, Santini J, Bozec A. Impact of preoperative radiotherapy on head and neck free flap reconstruction: a report on 429 cases. J Plast Reconstr Aesthet Surg 2013; 66:478-82. [PMID: 23352884 DOI: 10.1016/j.bjps.2012.12.019] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 12/04/2012] [Accepted: 12/18/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND The primary objective of this study was to evaluate the impact of preoperative radiotherapy on the outcomes of head and neck microvascular reconstruction. The secondary objective was to assess the specific effects of irradiation doses (IDs) ≥60 Gy on the outcomes of head and neck microvascular reconstruction. METHODS All patients who underwent head and neck free-flap reconstruction in our institution between 2000 and 2010 were included in this retrospective study. A total of 429 patients were enrolled including 136 patients previously irradiated on the head and neck. The impact of preoperative radiotherapy on free-flap success, local and general complications, postoperative mortality, time of decannulation, duration of enteral nutrition and length of stay was assessed in univariate and multivariate analyses. RESULTS In multivariate analysis, preoperative radiotherapy (irrespective of ID) was a significant risk factor for fistula formation (p = 0.003) and wound infection (p = 0.005). Previous neck irradiation at doses ≥60 Gy was associated with an increased risk of free-flap failure (p = 0.04), overall local complications (p = 0.05), haematoma (p = 0.04) and longer duration of enteral nutrition (p = 0.006) and hospital stay (p = 0.004). CONCLUSIONS Preoperative radiotherapy, particularly for ID ≥ 60 Gy, is one of the main determinants of the outcomes of head and neck microvascular reconstruction.
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Affiliation(s)
- M J Benatar
- Department of Surgery, Institut Universitaire de la Face et du Cou, 31 avenue de Valombrose, 06103 Nice, France
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Atkinson MJ. Radiation treatment effects on the proteome of the tumour microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 990:49-60. [PMID: 23378002 DOI: 10.1007/978-94-007-5896-4_3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exposure of tumourous tissue to ionizing radiation initiates a wound-healing response involving remodelling of the extracellular microenvironment. The initial reaction involves direct damage to the matrix proteins and the secretion and activation of proteolytic enzymes that lead to local destruction of the extracellular matrix. Subsequently the wounded area may undergo complete repair, may enter a prolonged period of heightened proteolysis, or may overproduce matrix proteins leading to fibrosis. The source of matrix degrading enzymatic activity may be the tumour cells and the tumour stroma. Additional complexity is provided by proteolytic activity released from tissue macrophages, mast cells and by invading inflammatory cells. The local production of growth factors, including VEGF and TGF-β play a key role in coordinating the response. It is anticipated that the application of modern proteomic technologies will reveal hitherto unrecognised levels of complexity in these processes. Hopefully this will lead to the development of new therapeutic strategies to prevent long-term health implications of radiation exposure.
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Affiliation(s)
- Michael J Atkinson
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Radiation Biology, Ingolstaedter Landstrasse 1, Neuherberg, 85764, Germany.
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Pérez-Sayáns M, Suárez-Peñaranda JM, Gayoso-Diz P, Barros-Angueira F, Gándara-Rey JM, García-García A. Tissue inhibitor of metalloproteinases in oral squamous cell carcinomas - a therapeutic target? Cancer Lett 2012; 323:11-19. [PMID: 22484495 DOI: 10.1016/j.canlet.2012.03.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 03/30/2012] [Indexed: 11/30/2022]
Abstract
Matrix metalloproteinases (MMPs) are proteases responsible for remodeling the extracellular matrix (ECM) and enabling spreading and metastasis of tumor cells, a common phenomenon in oral squamous cell carcinomas (OSCC). They are strongly blocked by several inhibitors, among which we must highlight, for their specificity and potency, the endogenous tissue inhibitors of metalloproteinases (TIMP-1, -2, -3 and -4). The goal of this paper is to describe the expression of TIMPs in OSCC, determining their relation with clinical, histological and prognostic factors, delving into OSCC regulation mechanisms and discussing the use of exogenous TIMPs to treat this type of tumors. Expression of TIMPs in OSCC is higher in tumors than in normal tissue, which correlates with an increase of metastatic risk and regional lymph node affectation. Although some metalloproteinases inhibitors (MMIs) have shown promising results in the treatment of these tumors, their use in OSCC has not been widely tested; and although some indirect MMIs, like COX-2 inhibitors, flavonoids and endostatin seem to have beneficial effects on the invasive capacity of OSCC through regulation of MMPs and TIMP levels, routine clinical use has not been accepted yet.
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Affiliation(s)
- Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Entrerríos s/n, Santiago de Compostela C.P. 15782, Spain.
| | - José Manuel Suárez-Peñaranda
- Servicio de Anatomia Patológica, Hospital Clinico Universitario de Santiago, Choupana s/n, Santiago de Compostela C.P. 15706, Spain.
| | - Pilar Gayoso-Diz
- Clinical Epidemiology and Biostatistics Unit, Hospital Clínico Universitario de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), A Choupana s/n, Santiago de Compostela 15706, Spain.
| | - Francisco Barros-Angueira
- Unidad de Medicina Molecular, Fundación Pública Galega de Medicina Xenómica, Edificio de Consultas planta-2, Hospital Clinico Universitario, Santiago de Compostela C.P. 15706, Spain.
| | | | - Abel García-García
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Entrerríos s/n, Santiago de Compostela C.P. 15782, Spain.
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15
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Mueller CK, Thorwarth M, Schmidt M, Schlegel KA, Schultze-Mosgau S. Comparative analysis of osseointegration of titanium implants with acid-etched surfaces and different biomolecular coatings. ACTA ACUST UNITED AC 2011; 112:726-36. [DOI: 10.1016/j.tripleo.2011.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Revised: 12/07/2010] [Accepted: 01/01/2011] [Indexed: 10/18/2022]
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Vande Walle C, Ceelen WP, Boterberg T, Vande Putte D, Van Nieuwenhove Y, Varin O, Pattyn P. Anastomotic complications after Ivor Lewis esophagectomy in patients treated with neoadjuvant chemoradiation are related to radiation dose to the gastric fundus. Int J Radiat Oncol Biol Phys 2011; 82:e513-9. [PMID: 22014951 DOI: 10.1016/j.ijrobp.2011.05.071] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 05/21/2011] [Accepted: 05/26/2011] [Indexed: 01/29/2023]
Abstract
PURPOSE Neoadjuvant chemoradiation (CRT) is increasingly used in locally advanced esophageal cancer. Some studies have suggested that CRT results in increased surgical morbidity. We assessed the influence of CRT on anastomotic complications in a cohort of patients who underwent CRT followed by Ivor Lewis esophagectomy. PATIENTS AND METHODS Clinical and pathologic data were collected from all patients treated with neoadjuvant CRT (36 Gy combined with 5-fluorouracil and cisplatin) followed by Ivor Lewis esophagectomy. On the radiotherapy (RT) planning computed tomography scans, normal tissue volumes were drawn encompassing the proximal esophageal region and the gastric fundus. Within these volumes, dose-volume histograms were analyzed to generate the total dose to 50% of the volume (D(50)). We studied the ability of the D(50) to predict anastomotic complications (leakage, ischemia, or stenosis). Dose limits were derived using receiver operating characteristics analysis. RESULTS Fifty-four patients were available for analysis. RT resulted in either T or N downstaging in 51% of patients; complete pathologic response was achieved in 11%. In-hospital mortality was 5.4%, and major morbidity occurred in 36% of patients. Anastomotic complications (AC) developed in 7 patients (13%). No significant influence of the D(50) on the proximal esophagus was noted on the anastomotic complication rate. The median D(50) on the gastric fundus, however, was 33 Gy in patients with AC and 18 Gy in patients without AC (p = 0.024). Using receiver operating characteristics analysis, the D(50) limit on the gastric fundus was defined as 29 Gy. CONCLUSIONS In patients undergoing neoadjuvant CRT followed by Ivor Lewis esophagectomy, the incidence of AC is related to the RT dose on the gastric fundus but not to the dose received by the proximal esophagus. When planning preoperative RT, efforts should be made to limit the median dose on the gastric fundus to 29 Gy with a V(30) below 40%.
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Rodemann HP, Wouters BG. Frontiers in molecular radiation biology/oncology. Radiother Oncol 2011; 101:1-6. [DOI: 10.1016/j.radonc.2011.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 09/30/2011] [Indexed: 12/15/2022]
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Thariat J, Julieron M, Brouchet A, Italiano A, Schouman T, Marcy PY, Odin G, Lacout A, Dassonville O, Peyrottes-Birstwisles I, Miller R, Thyss A, Isambert N. Osteosarcomas of the mandible: are they different from other tumor sites? Crit Rev Oncol Hematol 2011; 82:280-95. [PMID: 21868246 DOI: 10.1016/j.critrevonc.2011.07.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 07/03/2011] [Accepted: 07/29/2011] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND Osteosarcomas of the mandible (MOS) affect 1/10 million persons/year, mostly the young adult. Due to lack of specific data, the treatment of MOS is extrapolated from that of extragnathic OS but varies widely between institutions. MATERIALS AND METHODS We aimed at providing a focused description of MOS histologies and grades through the English literature, at determining the evidence-based role of chemotherapy, of adjuvant radiation therapy and the potential of reconstructive surgery tailored through modern pre-operative multi-modal imaging. RESULTS The estimated proportion of high grade MOS was 58%. However, low-grade MOS may be underestimated as they are mostly reported as case reports. The intermediate grade was hardly found in the literature. Estimated weighted-mean proportions of chondroblastic and osteoblastic MOS were 37% and 46%, respectively. Multimodal imaging modalities including MRI has a great potential for accurate pre-operative assessment of tumor extensions into bone and soft tissues. Surgery is the mainstay of treatment and margins the most important factor. The role of neoadjuvant chemotherapy in treating occult systemic metastases and in increasing the probability of clear margins is controversial, as well as the histology-dependent response to chemotherapy. The role of adjuvant radiotherapy (mostly proposed for positive margins) and/or adjuvant chemotherapy is still controversial. Crude survival is around 77% and local control around 67%. Local failure is the main cause of death in MOS compared to extragnathic sites.
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Affiliation(s)
- Juliette Thariat
- Department of Radiation Oncology/IBDC CNRS UMR 6543, Cancer Center Antoine-Lacassagne - Institut Universitaire de la Face et du Cou, University Nice Sophia-Antipolis, 33 Av. Valombrose, 06189 NICE Cedex 2 France.
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Molecular and translational radiation biology/oncology: What’s up? Radiother Oncol 2011; 99:257-61. [DOI: 10.1016/j.radonc.2011.06.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 06/14/2011] [Indexed: 01/02/2023]
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Mueller CK, Bader RD, Schultze-Mosgau S. Microvascular Free Flaps for Mandibular Reconstruction in Goldenhar Syndrome. J Craniofac Surg 2011; 22:1161-3. [DOI: 10.1097/scs.0b013e318210bbec] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mueller C, Schultze-Mosgau S. Histomorphometric analysis of the phenotypical differentiation of recruited macrophages following subcutaneous implantation of an allogenous acellular dermal matrix. Int J Oral Maxillofac Surg 2011; 40:401-7. [DOI: 10.1016/j.ijom.2010.10.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2009] [Revised: 08/16/2010] [Accepted: 10/27/2010] [Indexed: 12/12/2022]
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Analysis of inflammatory periimplant lesions during a 12-week period of undisturbed plaque accumulation—a comparison between flapless and flap surgery in the mini-pig. Clin Oral Investig 2011; 16:379-85. [DOI: 10.1007/s00784-011-0546-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 03/09/2011] [Indexed: 10/18/2022]
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Mueller CK, Nicolaus K, Thorwarth M, Schultze-Mosgau S. Multivariate analysis of the influence of patient-, tumor-, and management-related factors on the outcome of surgical therapy for facial basal-cell carcinoma. Oral Maxillofac Surg 2010; 14:163-8. [PMID: 20349095 DOI: 10.1007/s10006-010-0215-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE This retrospective, case-control study aimed at evaluating the influence of patient-, tumor-, and management-related factors on the outcome of surgical therapy for facial basal-cell carcinoma (BCC) employing a multivariate analysis. METHODS One hundred one patients who underwent ablative surgery for BCC of the face at the Department of Oral and Maxillofacial Surgery/ Plastic Surgery, University Hospital Jena, between April 2005 and January 2009, were analyzed. Patients' charts were screened for anamnestic features as well as management- and follow-up-related details. Standardized photographs were subjected to an esthetic evaluation. Logistic regression was used to identify factors associated with postsurgical wound healing disorders, recurrence, and esthetic impairment. RESULTS Following surgical BCC treatment, age and tumor location in the area of the eyes, nose, lips, and ears were independent predictors of wound healing disorders. Tumor location in the area of the eyes, nose, lips, and ears, subtype and class were independent predictors of recurrence. Female gender and location in the area of the eyes, nose, lips, and ears were independent predictors of esthetic impairment. Micrographic surgery and distant reconstruction technique were management-related predictors of wound healing disorders and esthetic outcome, respectively. CONCLUSIONS The identified negative predictors of treatment outcome should be included in the informed consent to objectify the patient's preoperative expectations.
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Affiliation(s)
- Cornelia Katharina Mueller
- Department of Oral and Maxillofacial Surgery/ Plastic Surgery, University of Jena, Erlanger Allee 101, 07747, Jena, Germany.
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Mueller CK, Thorwarth M, Schultze-Mosgau S. Late changes in cutaneous gene expression patterns after adjuvant treatment of oral squamous cell carcinoma (OSCC) by radiation therapy. ACTA ACUST UNITED AC 2010; 109:694-9. [PMID: 20185344 DOI: 10.1016/j.tripleo.2009.10.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2009] [Revised: 10/09/2009] [Accepted: 10/21/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of this study was to investigate radiation-induced late changes in cutaneous gene expression using a microarray platform and quantitative, real-time, reverse-transcriptase polymerase chain reaction (RT-PCR) validation. STUDY DESIGN Paired irradiated and nonirradiated skin biopsies were obtained from 19 patients with a history of oral squamous cell carcinoma (OSCC) treated by surgery and adjuvant radiotherapy at the time of secondary corrective surgery. Topic-defined PIQOR (Parallel Identification and Quantification of RNAs) skin microarrays were used to compare gene expression profiles between control and irradiated skin sample in 8 patients. The data were validated for matrixmetalloproteinase (MMP)-1 and tissue-inhibitor of matrixmetalloproteinase (TIMP)-1 by RT-PCR for all patients. RESULTS Irradiation markedly enhanced the expression of molecules associated with the transforming growth factor (TGF)-beta(1) signaling pathway, blood vessel development, as well as extracellular matrix constitution and turn-over. CONCLUSIONS Our data suggest that radiation-induced late changes in cutaneous gene expression mainly affect molecules related to extracellular matrix (ECM)-constitution and-remodeling.
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Affiliation(s)
- Cornelia K Mueller
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University of Jena, Germany.
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