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Shen Z, Ren W, Bai Y, Chen Z, Li J, Li B, Jin T, Cao P, Shao Y. DIRC3 and near NABP1 genetic polymorphisms are associated laryngeal squamous cell carcinoma patient survival. Oncotarget 2016; 7:79596-79604. [PMID: 27793000 PMCID: PMC5346738 DOI: 10.18632/oncotarget.12865] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/14/2016] [Indexed: 11/25/2022] Open
Abstract
Laryngeal squamous cell carcinoma (LSCC) is one of the most common and aggressive malignancies of the upper digestive tract. The present study is a retrospective analysis of data from a prospective longitudinal study. A total of 170 male LSCC patients (average age, 60.75±10.082) at the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine were recruited between January 2002 and April 2013 for this study. We assessed correlations between patient characteristics and survival, and sequenced genomic DNA from patient peripheral blood samples. We found that the single nucleotide polymorphisms (SNPs), rs11903757, with closest proximity to NABP1 and SDPR, and rs966423 in DIRC3, were associated with survival in LSCC patients. Median follow-up was 38 months (range 3-122) and median survival time was 48 months. LSCC patients with total laryngectomy, poor differentiation, T3-T4 stage, N1-N2 stage or III-IV TNM stage had reduced survival. This is the first study to demonstrate that the rs11903757 GT (HR=2.036; 95% CI, 1.071-3.872; p=0.030) and rs966423 TT (HR=11.677; 95% CI, 3.901-34.950; p=0.000) genotypes predict poor patient outcome. These polymorphisms may serve as useful clinical markers to predict patient survival, and to guide individual patient therapeutic decisions.
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Affiliation(s)
- Zhen Shen
- Department of Otolaryngology & head neck, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Wanli Ren
- Department of Otolaryngology & head neck, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yanxia Bai
- Department of Otolaryngology & head neck, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Zhengshuai Chen
- School of Life Sciences, Northwest University, Xi'an, Shaanxi 710069, China
- National Engineering Research Center for Miniaturized Detection Systems, Xi'an 710069, China
| | - Jingjie Li
- School of Life Sciences, Northwest University, Xi'an, Shaanxi 710069, China
- National Engineering Research Center for Miniaturized Detection Systems, Xi'an 710069, China
| | - Bin Li
- School of Life Sciences, Northwest University, Xi'an, Shaanxi 710069, China
- National Engineering Research Center for Miniaturized Detection Systems, Xi'an 710069, China
| | - Tianbo Jin
- School of Life Sciences, Northwest University, Xi'an, Shaanxi 710069, China
- National Engineering Research Center for Miniaturized Detection Systems, Xi'an 710069, China
| | - Peilong Cao
- Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yuan Shao
- Department of Otolaryngology & head neck, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
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Triantafyllou A, Williams MD, Angelos P, Shah JP, Westra WH, Hunt JL, Devaney KO, Rinaldo A, Slootweg PJ, Gnepp DR, Silver C, Ferlito A. Incidental findings of thyroid tissue in cervical lymph nodes: old controversy not yet resolved? Eur Arch Otorhinolaryngol 2016; 273:2867-75. [PMID: 26459007 PMCID: PMC5525538 DOI: 10.1007/s00405-015-3786-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 09/14/2015] [Indexed: 12/21/2022]
Abstract
The clinical significance of papillary or follicular thyroid tissue incidentally discovered in cervical lymph nodes during pathological assessment of neck dissections for non-thyroid cancers of the upper aero-digestive tract is critically reviewed. Special emphasis is given to controversies over normal-looking, nodal, thyroid follicles. Arguments for and against the benign nature of these follicles are considered together with processes that could be involved in their formation. The admittedly limited evidence suggests that benign, thyroid follicular inclusions rarely occur in cervical lymph nodes. Histological criteria that could be helpful in recognizing the inclusions, which include assessing their extent in conjunction with the size of the node, are discussed. Finally, an algorithm based on collaboration between specialists, correlating histological findings with imaging and loco-regional control of the upper aero-digestive tract cancer, is suggested for the management of patients with incidentally discovered, nodal thyroid tissue.
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Affiliation(s)
- Asterios Triantafyllou
- Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool and Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Peter Angelos
- Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA
| | - Jatin P Shah
- Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William H Westra
- Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | - Pieter J Slootweg
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Douglas R Gnepp
- University Pathologists, Providence, RI and Fall River, MA, USA
| | - Carl Silver
- Departments of Surgery and Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy.
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Primary papillary carcinoma arising from ectopic thyroid tissue in the cervical lymph node: A case report. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2015. [DOI: 10.1016/j.ajoms.2014.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gilbert MR, Kim S. Incidental thyroid cancer found during surgery for head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg 2012; 147:647-53. [PMID: 22714422 DOI: 10.1177/0194599812451559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To quantify the incidence of occult thyroid cancer encountered during neck dissection in patients with head and neck squamous cell carcinoma (HNSCC), to discuss the management of these patients, and to assess the need for further treatment of the incidentally discovered thyroid cancer. STUDY DESIGN Case series with chart review. SETTING University-based tertiary care hospital. METHODS The authors retrospectively reviewed 2538 neck dissections performed at their institution over a 15-year period. Twenty-nine patients had an incidental pathologic finding of thyroid cancer at surgery. The authors reviewed demographics, diagnoses, histopathology, initial and subsequent management, and outcome. RESULTS Well-differentiated thyroid cancer (WDC) was found in every case in this cohort. Fifteen patients died during the period of the study (2.4-year follow-up), with 14 patients still alive (4.3-year follow-up). Seven patients, all of whom are still alive, received further treatment for their thyroid cancer: 2 with completion thyroidectomy, 2 with I-131 ablation, and 3 with both. There was no clinical evidence of recurrence of thyroid cancer in any of the patients who died, and none died as a result of thyroid cancer. In addition, none of the patients still alive have biopsy-proven evidence of thyroid cancer recurrence. CONCLUSION None of the patients in this cohort died as a result of their thyroid disease, and none of the patients had evidence of recurrence of their WDC during the follow-up period. The results suggest that further management of occult WDC discovered in patients receiving neck dissections for HNSCC is not necessary.
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Affiliation(s)
- Mark R Gilbert
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA
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Thyroid cancer incidentally found in radical surgery for laryngeal/hypopharyngeal cancer. Otolaryngol Head Neck Surg 2009; 141:343-6. [PMID: 19716011 DOI: 10.1016/j.otohns.2009.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Revised: 03/16/2009] [Accepted: 05/08/2009] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To report on four patients with thyroid cancer found in their specimen of laryngectomy for laryngeal/hypopharyngeal cancer. STUDY DESIGN Retrospective case series. SETTING Patients with laryngeal cancer and hypopharyngeal cancers treated at our institution between 1991 and 2005 were enrolled. SUBJECTS AND METHODS There were 463 patients with laryngeal cancer and 219 patients with hypopharyngeal cancers under retrospective review. RESULTS There were 254 patients with laryngeal caner and 130 patients with hypopharyngeal cancer receiving surgery. Thyroid cancer was observed in the resected thyroid gland in two cases of laryngeal cancer and in two cases of hypopharyngeal cancer. They received treatment only for their laryngeal/hypopharyngeal cancers. Two patients died of distant metastases from larynx/hypopharynx cancer within one year. The other two patients are currently alive without disease from either of the two types of cancer. CONCLUSIONS It is rare to discover an unexpected simultaneous thyroid cancer confirmed postoperatively from thyroid tissue partially removed in laryngectomy. A conservative approach is suggested for such patients.
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Yamamoto T, Tatemoto Y, Hibi Y, Ohno A, Osaki T. Thyroid Carcinomas Found Incidentally in the Cervical Lymph Nodes: Do They Arise From Heterotopic Thyroid Tissues? J Oral Maxillofac Surg 2008; 66:2566-76. [DOI: 10.1016/j.joms.2008.06.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2007] [Revised: 01/05/2008] [Accepted: 06/16/2008] [Indexed: 10/21/2022]
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Collision metastasis of squamous carcinoma of the oral tongue and incidental thyroid papillary carcinoma to a single cervical lymph node. Int J Oral Maxillofac Surg 2008; 37:494-6. [DOI: 10.1016/j.ijom.2007.11.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Revised: 08/03/2007] [Accepted: 11/22/2007] [Indexed: 11/21/2022]
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Guzzo M, Quattrone P, Seregni E, Bianchi R, Mattavelli F. Thyroid carcinoma associated with squamous cell carcinoma of the head and neck: which policy? Head Neck 2007; 29:33-7. [PMID: 16983696 DOI: 10.1002/hed.20474] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thyroid carcinoma occurring as a second primary associated with head and neck squamous cell carcinoma (HNSCC) is unusual. The clinical management of thyroid cancer in such cases has been debated. METHODS Between 1975 and 2004, we collected 33 cases. The associated thyroid carcinoma was diagnosed either during or as a consequence of surgery planned as head and neck cancer treatment. RESULTS The associated thyroid carcinoma was never seen to recur. Five-year overall survival was 41%. Disease-free survival after 40 and 66 months was 11.1% and 5.6%, respectively. CONCLUSIONS We consider the treatment of thyroid cancer to be complete when the thyroid gland, either with or without lymph nodes, has been included in the specimen obtained during surgery for HNSCC. In the group of cases in which associated thyroid carcinoma was only found within the neck lymph nodes and the thyroid gland has not been treated, we discourage further surgical treatment or radioactive iodine therapy.
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Affiliation(s)
- Marco Guzzo
- Otorhinolaryngology Unit, Istituto Nazionale Tumori, Milan, Italy
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Sheahan P, Hafidh M, Toner M, Timon C. Unexpected findings in neck dissection for squamous cell carcinoma: Incidence and implications. Head Neck 2004; 27:28-35. [PMID: 15459919 DOI: 10.1002/hed.20110] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND During the pathologic examination of neck dissections, unexpected pathologic findings may occasionally be encountered. These pathologic findings may simulate malignant disease and/or have implications on the already complicated management of patients with head and neck cancer. METHODS We retrospectively reviewed 202 consecutive patients with a preoperative diagnosis of squamous cell carcinoma (SCC), who underwent 307 neck dissections performed by a single surgeon and examined by a single pathologist. RESULTS Ten patients had an unexpected finding. These included metastatic papillary thyroid carcinoma, leukemia, lymphoma, Warthin's tumor, and tuberculosis. Two of three patients with benign-appearing thyroid tissue within lymph nodes received no further treatment, and both remained well beyond 6 years. Four patients succumbed to SCC; none died from the incidentally discovered pathologic findings. CONCLUSIONS Unexpected pathologic findings may be present in more than 3% of neck dissections. Although this is usually indolent, with the underlying SCC remaining the main prognostic determinate, it may significantly complicate postoperative management.
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MESH Headings
- Adenolymphoma/pathology
- Adenolymphoma/therapy
- Aged
- Aged, 80 and over
- Carcinoma, Papillary/pathology
- Carcinoma, Papillary/secondary
- Carcinoma, Papillary/surgery
- Carcinoma, Squamous Cell/surgery
- Cricoid Cartilage/pathology
- Female
- Head and Neck Neoplasms/surgery
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Lymphatic Metastasis
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Male
- Middle Aged
- Neck Dissection
- Retrospective Studies
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/secondary
- Thyroid Neoplasms/surgery
- Thyroidectomy
- Tuberculosis, Lymph Node/drug therapy
- Tuberculosis, Lymph Node/pathology
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Affiliation(s)
- Patrick Sheahan
- Department of Otolaryngology, St. James Hospital, 17 Hampton Square, Navan Road, Dublin 7, Ireland.
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Resta L, Piscitelli D, Fiore MG, Di Nicola V, Fiorella ML, Fiorella AM, Altavilla A, Marzullo A. Incidental metastases of well-differentiated thyroid carcinoma in lymph nodes of patients with squamous cell head and neck cancer: eight cases with a review of the literature. Eur Arch Otorhinolaryngol 2003; 261:473-8. [PMID: 15546174 DOI: 10.1007/s00405-003-0722-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The examination of a large series of cervical lymph nodes in patients with head and neck cancer revealed the presence of incidental metastases of occult thyroid carcinoma in eight patients, of which six cases were squamous cell carcinoma of glottic and supraglottic sites of the larynx and two cases were pyriform sinus and tongue carcinomas. Three patients had two lymph nodes and the remaining patients had one lymph node each involved. The nodal chains affected were the jugular (n=5; level IV), Kuttner (level II), supraomohyoid (level III) and supraclavicular (level VI). In four cases, a subtotal thyroidectomy or unilateral lobectomy was performed during laryngectomy (for surgical reasons) or after histologic nodal examination; a minimal focus of thyroid papillary carcinoma was detected in one patient. Three of eight patients died from recurrence of the squamous cell carcinoma; no case presented clinical evidence of thyroid malignancy. The differential diagnosis from benign thyroid heterotopia was based on the presence of minimal nuclear atypia. The choice of treatment of patients with a coexisting neoplasm characterized by poor prognosis is difficult, and contrasting opinions exist regarding the use of radical thyroidectomy and the subsequent management. As reported in the literature (66 cases), the more aggressive squamous cell carcinoma will determine the prognosis of these patients; in fact, only one of the referred cases died of cerebellar metastases of the thyroid cancer. Our results emphasize the importance of an accurate re-evaluation and follow-up of patients with incidental occult metastases for detection of a primary thyroid tumor. In the general population, this incidental nodal involvement may be related to a minimal occult thyroid carcinoma.
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Affiliation(s)
- Leonardo Resta
- Department of Pathological Anatomy and Genetics, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
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