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Porras Alonso E, Vilaseca González I, García Teno M, Barberá Durbán R, Viscasillas Pallàs G, Sancho Mestre M, Rebollo Otal J, Menoyo Bueno A, Díaz de Cerio Canduela P. Early glottic tumours with anterior commissure involvement. Literature review and consensus document. Head and Neck and Skull Base Commission, SEORL-CCC. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020; 71 Suppl 1:1-20. [PMID: 32532450 DOI: 10.1016/j.otorri.2020.02.008] [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: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 01/08/2023]
Abstract
The choice of the most appropriate treatment in early-stage glottic cancer with anterior commissure involvement remains controversial. Its therapeutic management is complex because it is a significant prognostic indicator of local control with 37% recurrence, due to the difficulty in establishing tumour extension with understaging of up to 40%, and due to the comparison of results in series on tumours that behave variably as they progress, such as T1a, T1b and T2a with commissure involvement. Furthermore, the complexity of the surgical approach using transoral CO2 laser microsurgery requires surgical skill, appropriate equipment and experience. Aspects to be reviewed in this document are: an updated anatomical definition of the anterior commissure, tumour progression based on histopathological studies, usefulness of videostroboscopy and NBI in diagnostic accuracy, validity of imaging tests, oncological results published in series reviews, systematic reviews and meta-analyses, tumour margin treatment and voice evaluation.Finally, by way of a summary, the document includes a series of recommendations for the treatment of these tumours.
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Early Glottic Tumours With Anterior Commissure Involvement. Literature Review and Consensus Document. Head and Neck and Skull Base Commission, SEORL-CCC. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020. [DOI: 10.1016/j.otoeng.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Samuels TL, Zimmermann MT, Zeighami A, Demos W, Southwood JE, Blumin JH, Bock JM, Johnston N. RNA Sequencing Reveals Cancer-Associated Changes in Laryngeal Cells Exposed to Non-Acid Pepsin. Laryngoscope 2020; 131:121-129. [PMID: 32202667 DOI: 10.1002/lary.28636] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/07/2020] [Accepted: 02/25/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Laryngopharyngeal reflux (LPR) is a common affliction that contributes to laryngeal inflammation, symptoms that impact quality of life, and life-threatening illnesses such as cancer. Effective treatment strategies for LPR are lacking. Pepsin is a proinflammatory and carcinogenic element of refluxate. Investigation of molecular pathways involved in pepsin-mediated damage may lead to identification of novel biomarkers and therapeutic targets for LPR. In this study, RNA sequencing was used to examine changes in human laryngeal epithelial cells following brief pepsin insult. Cells were immortalized to generate a model to aid future study of laryngeal injury and therapeutics. STUDY DESIGN In vitro translational. METHODS Laryngeal epithelial cells were cultured from a patient without signs or symptoms of LPR or laryngeal cancer. Cells were treated with 0.1 mg/ml pepsin for 1 hour or normal growth media (control) prior to RNA sequencing. Cells were immortalized via HPV E6/7 and characterized by microscopy, immunohistochemistry, G-banding, and soft agar assay. RESULTS Three hundred ninety-seven genes exhibited differences in expression with pepsin treatment (P < .05). Pathway analysis revealed association with cancer and related signaling processes including dysregulation of cancer-associated molecules, Metastasis-Associated Lung Adenocarcinoma Transcript 1 and KRT82, and the long-noncoding RNA, lipoprotein receptor-related protein 1 (LRP1)-AS, which regulates the putative pepsin receptor LRP1. CONCLUSIONS A single, brief exposure to pepsin activated cancer-associated signaling pathways in laryngeal cells in vitro, revealing novel mechanisms by which chronic reflux may contribute to carcinogenesis. The cell line developed herein represents a novel tool in which to investigate pepsin-dysregulated pathways identified by RNA sequencing and disparities of tumor proneness of laryngeal subsites. LEVEL OF EVIDENCE N/A Laryngoscope, 131:121-129, 2021.
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Affiliation(s)
- Tina L Samuels
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Michael T Zimmermann
- Bioinformatics Research and Development Laboratory, Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
- Clinical and Translational Science Institute, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Atefeh Zeighami
- Bioinformatics Research and Development Laboratory, Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Wendy Demos
- Bioinformatics Research and Development Laboratory, Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Jessica E Southwood
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Joel H Blumin
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Jonathan M Bock
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Nikki Johnston
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
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Kontić M, Čolović Z, Paladin I, Gabelica M, Barić A, Pešutić-Pisac V. Association between EGFR expression and clinical outcome of laryngeal HPV squamous cell carcinoma. Acta Otolaryngol 2019; 139:913-917. [PMID: 31430224 DOI: 10.1080/00016489.2019.1651938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Expression of the epidermal growth factor receptor (EGFR) and human papillomavirus (HPV) DNA can serve as independent prognostic factors in squamous cell carcinoma (SCC) of the larynx. EGFR correlation with the course of disease and its effect on survival makes EGFR expression a negative prognostic factor, whereas HPV DNA is a positive prognostic factor. Aim: To assess the association of EGFR expression with clinical outcome of laryngeal HPV SCC. Materials and methods: This retrospective study included 196 SCC patients operated on at the Department of ENT, Head and Neck Surgery, Split University Hospital Center in Split, Croatia, between 1 January 2000 and 31 December 2009. Results: The association of HPV infection and EGFR expression was found to be statistically significant, and so was the difference in survival between patient groups with different HPV to EGFR expression ratio. Conclusions: The group of laryngeal HPV SCC patients with increased EGFR expression had shorter survival, confirming EGFR as a major component in predicting patient prognosis and survival. Significance: This article confirms the importance of EGFR expression as a biomarker in laryngeal SCC.
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Affiliation(s)
- Mirko Kontić
- School of Medicine, University of Split, Split, Croatia
- Clinic for ENT and Head and Neck Surgery, Split University Hospital Center, Split, Croatia
| | - Zaviša Čolović
- School of Medicine, University of Split, Split, Croatia
- Clinic for ENT and Head and Neck Surgery, Split University Hospital Center, Split, Croatia
| | - Ivan Paladin
- Clinic for ENT and Head and Neck Surgery, Split University Hospital Center, Split, Croatia
| | - Mirko Gabelica
- Clinic for ENT and Head and Neck Surgery, Split University Hospital Center, Split, Croatia
| | - Ana Barić
- Clinical Department of Nuclear Medicine, Split University Hospital Center, Split, Croatia
| | - Valdi Pešutić-Pisac
- School of Medicine, University of Split, Split, Croatia
- Clinical Department of Pathology, Split University Hospital Center, Split, Croatia
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Mo TT, Tan JJ, Wang MG, Dai YF, Liu X, Li XP. Optimized Generation of Primary Human Epithelial Cells from Larynx and Hypopharynx: A Site-Specific Epithelial Model for Reflux Research. Cell Transplant 2019; 28:630-637. [PMID: 30917697 PMCID: PMC7103601 DOI: 10.1177/0963689719838478] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Laryngopharyngeal reflux (LPR) induces a differential damage effect on several anatomic
sites within the larynx and hypopharynx; therefore, an in vitro model is needed for each
anatomic site. This study aimed to establish a primary culture method for human laryngeal
and hypopharyngeal epithelial cells derived from multiple anatomic sites. Surgical mucosa
specimens were treated with a two-step enzymatic strategy to establish a primary culture.
Of the 46 samples, primary cultivation was achieved successfully with 36 samples, and the
positive ratio was 78.3%. In addition, flow cytometry revealed that these primary cells
were epithelial cells with a purity of 94.9%. The proliferative ability was confirmed by
positive staining for Ki-67. Laryngeal and hypopharyngeal epithelial cells from multiple
sites exhibited similar epithelial morphology and positive cytokeratin expression. These
cells can be cultured to passage 4. In summary, we successfully established the in vitro
epithelial model of larynx and hypopharynx subsites, which may potentially be used as a
platform for reflux research, especially for site-specific damage effect.
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Affiliation(s)
- Ting-Ting Mo
- 1 Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jia-Jie Tan
- 1 Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mei-Gui Wang
- 1 Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuan-Feng Dai
- 1 Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiong Liu
- 1 Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiang-Ping Li
- 1 Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
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CO2 laser cordectomy for glottic squamous cell carcinoma involving the anterior commissure: voice and oncologic outcomes. Eur Arch Otorhinolaryngol 2014; 272:413-8. [DOI: 10.1007/s00405-014-3368-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
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Kontić M, Milovanović J, Čolović Z, Poljak NK, Šundov Ž, Sučić A, Pešutić-Pisac V. Epidermal growth factor receptor (EGFR) expression in patients with laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2014; 272:401-5. [PMID: 25294054 DOI: 10.1007/s00405-014-3323-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 09/30/2014] [Indexed: 11/30/2022]
Abstract
To assess the epidermal growth factor receptor (EGFR) correlation with histopathologic and clinical characteristics of laryngeal squamous cell carcinoma (SCC) and the impact of EGFR overexpression on patient survival. This retrospective study included 185 SCC patients treated at Clinical Department of ENT, Head and Neck Surgery, Split University Hospital Center between January 1, 2000 and December 31, 2009. A statistically significant correlation (p < 0.001) was recorded between the level of EGFR expression and SCC histopathologic grade, stage, metastasizing potential, relapsing potential, and patient survival. Kaplan-Meier survival curve yielded a statistically significant difference (χ(2) = 75.05; p < 0.001) among the four patient groups with different levels of EGFR expression. The higher the level of EGFR expression, the poorer is the patient prognosis and survival. In our study, expression of EGFR as a biomarker showed a potential predictive value in laryngeal SCC.
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Affiliation(s)
- Mirko Kontić
- ENT Department, University of Split School of Medicine, University Hospital Centre Split, Split, Croatia,
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Lee SH, Samuels T, Bock JM, Blumin JH, Johnston N. Establishment of an immortalized laryngeal posterior commissure cell line as a tool for reflux research. Laryngoscope 2014; 125:E73-7. [PMID: 25272366 DOI: 10.1002/lary.24952] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 08/07/2014] [Accepted: 09/08/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Laryngopharyngeal reflux (LPR) has been implicated as a promoter of laryngeal cancer. Within the larynx, the posterior commissure (PC) is the region that usually comes into direct contact with refluxed materials. Specific laryngeal cell lines useful for in vitro studies are not widely available, and noncancer-derived PC laryngeal cell line has not yet been described. STUDY DESIGN Experimental study. METHODS Specimens of squamous epithelium from the PC of the larynx were collected from patients without a history or evidence of laryngeal inflammatory or neoplastic diseases. Harvested tissue was cultured and then immortalized by transduction with human papillomavirus E6/E7-encoding lentivirus. PC primary and transformed cells were characterized by light microscopy and immunohistochemistry. RESULTS Primary cultures established from PC contained < 5% fibroblasts and displayed normal epithelial cell morphology and cytokeratin expression. These cells survived nine passages in culture. Following lentiviral-mediated immortalization, cells retained normal squamous epithelial morphology and survived > 20 passages in culture. Methods were optimized for culture of PC laryngeal epithelial cells, resulting in 90% success rate of culture. CONCLUSION A novel immortalized PC laryngeal epithelial cell line has been established. This cell line provides a unique tool for investigating the mechanism of LPR in the development and progression of laryngeal cancer. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Sang-Hyuk Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Shoffel-Havakuk H, Halperin D, Yosef L, Feldberg E, Lahav Y. Lesions of the Posterior Glottis: Clinical and Pathologic Considerations and Treatment Outcome. J Voice 2014; 28:263.e1-263.e8. [DOI: 10.1016/j.jvoice.2013.08.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 08/22/2013] [Indexed: 12/01/2022]
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Rucci L, Romagnoli P, Scala J. CO(2) laser therapy in Tis and T1 glottic cancer: indications and results. Head Neck 2010; 32:392-8. [PMID: 19691026 DOI: 10.1002/hed.21200] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Laser cordectomy for glottic cancer is still hampered by recurrence, which is more frequent upon anterior commissure (AC) involvement. Analysis of results may be a step to improve the efficacy of this therapy for early glottic cancer. METHODS In all, 81 patients who underwent surgery with CO(2) laser for Tis and T1, AC0 to AC2 glottic carcinoma were followed up to 55 months. RESULTS The incidence of recurrence increased significantly with T and AC classifications. The disease-free interval decreased with increasing T and AC classifications and with increasing severity of histology, but only the AC classification appeared significant. Recurrences occurred in 5 of 35 patients upon type I and type II cordectomy, in 16 of 24 patients upon type V cordectomy, and never upon type III and IV cordectomy. CONCLUSIONS Type I to type IV cordectomy, when indicated, can achieve radical treatment of most T1 glottic cancer. Type V cordectomy requires that any suspicion of cartilage invasion, even microscopic, be excluded.
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Affiliation(s)
- Lucio Rucci
- Department of Oto-Neuro-Ophthalmological Surgical Sciences, Division of Otorhinolaryngology-Head and Neck Surgery, University of Florence, Florence, Italy.
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Chawla S, Carney AS. Organ preservation surgery for laryngeal cancer. HEAD & NECK ONCOLOGY 2009; 1:12. [PMID: 19442314 PMCID: PMC2686690 DOI: 10.1186/1758-3284-1-12] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Accepted: 05/15/2009] [Indexed: 11/04/2022]
Abstract
The principles of management of the laryngeal cancer have evolved over the recent past with emphasis on organ preservation. These developments have paralleled technological advancements as well as refinement in the surgical technique. The surgeons are able to maintain physiological functions of larynx namely speech, respiration and swallowing without compromising the loco-regional control of cancer in comparison to the more radical treatment modalities. A large number of organ preservation surgeries are available to the surgeon; however, careful assessment of the stage of the cancer and selection of the patient is paramount to a successful outcome. A comprehensive review of various organ preservation techniques in vogue for the management of laryngeal cancer is presented.
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Affiliation(s)
- Sharad Chawla
- Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, South Australia, Australia
| | - Andrew Simon Carney
- Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, South Australia, Australia
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Shvero J, Shvili I, Mizrachi A, Shpitzer T, Nageris B, Koren R, Hadar T. T1 glottic carcinoma involving the posterior commissure. Laryngoscope 2009; 119:1116-9. [DOI: 10.1002/lary.20138] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Jiang H, Yang BB. p53, epidermal growth factor receptor and proliferating cell nuclear antigen in laryngeal squamous cell carcinoma are not predictive markers for the effect of adjuvant radiotherapy. Acta Otolaryngol 2009; 129:101-7. [PMID: 18607952 DOI: 10.1080/00016480802054185] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
CONCLUSION These data indicate that the expression of p53, epidermal growth factor receptor (EGFR) or proliferating cell nuclear antigen (PCNA) is not a reliable predictor of the prognosis or the effect of adjuvant radiotherapy in patients with laryngeal squamous cell carcinoma (LSCC). OBJECTIVE The aim of this study was to investigate the prognostic significance of p53, EGFR, and PCNA in LSCC and to assess the relationships between the expression of these molecular markers and the effect of adjuvant radiotherapy. PATIENTS AND METHODS We retrospectively reviewed the expression of these molecular markers in 75 patients with LSCC. RESULTS None of the expressions of these molecular markers was associated with disease-free survival or overall survival and no significant correlations were found between them and the effect of adjuvant radiotherapy. Also, they were not associated with each other.
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Wei Q, Sheng L, Shui Y, Hu Q, Nordgren H, Carlsson J. EGFR, HER2, and HER3 expression in laryngeal primary tumors and corresponding metastases. Ann Surg Oncol 2008; 15:1193-201. [PMID: 18172732 DOI: 10.1245/s10434-007-9771-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Revised: 11/22/2007] [Accepted: 11/26/2007] [Indexed: 12/21/2022]
Abstract
BACKGROUND There are several substances available to target members of the epidermal growth factor receptor (EGFR) family, both for imaging in nuclear medicine and for various forms of therapy. The level and stability of expression in both primary tumors and corresponding metastases is crucial in the assessment of a receptor as a target in systemic tumor therapy. To date, the expression of EGFR family members has only been determined in primary laryngeal carcinomas, and we have not found published data regarding the receptor status in corresponding metastatic lesions. METHODS Expression of EGFR, HER2, and HER3 was investigated immunohistochemically in both lymph node metastases and corresponding primary laryngeal squamous carcinomas (n = 40). RESULTS EGFR overexpression (2+ or 3+) was found in 87.5% (35/40) of the laryngeal primary tumors and 82.5% (33/40) of the corresponding lymph node metastases. There was a good agreement between the primary tumors and the paired metastases regarding EGFR expression. HER2 overexpression was found in only four cases (10.5%) of the studied primary tumors and in all cases the HER2 expression was retained in the paired metastases. Another two metastases gained HER2 status when compared to the corresponding primary tumors. Strong HER3 staining was found in 26.7% of both the primary tumors and the corresponding metastases. CONCLUSIONS The high frequency and stability in EGFR expression is encouraging for efforts to use EGFR targeting agents (e.g. Iressa, Tarceva, Erbitux or radiolabeled antibodies) for therapy of laryngeal carcinoma. For a few laryngeal carcinoma patients with HER2 overexpression, anti-HER2 agents could possibly be used.
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Affiliation(s)
- Qichun Wei
- Department of Radiation Oncology, The Second Affiliated Hospital, and Cancer Institute, Zhejiang University School of Medicine, Jiefang Road 88, Hangzhou, 310009, PR China.
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Dagan R, Morris CG, Bennett JA, Mancuso AA, Amdur RJ, Hinerman RW, Mendenhall WM. Prognostic Significance of Paraglottic Space Invasion in T2N0 Glottic Carcinoma. Am J Clin Oncol 2007; 30:186-90. [PMID: 17414469 DOI: 10.1097/01.coc.0000251403.54180.df] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the prognostic significance of paraglottic space invasion determined with pretreatment computed tomography (CT) for patients with T2N0 glottic carcinoma treated with radiotherapy (RT). METHODS Eighty patients with T2N0 glottic squamous cell carcinomas treated with definitive RT between 1983 and 2002 who had pretreatment CT information available regarding paraglottic space invasion were analyzed. Follow up ranged from 0.14 to 18 years (median, 7.1 years). No patient was lost to follow up. RESULTS Five-year outcomes were: local control, 78%; local control with larynx preservation, 80%; relapse-free survival, 71%; and cause-specific survival, 91%. Multivariate analyses of various parameters (including vocal cord mobility, paraglottic space invasion, supraglottic invasion, and subglottic extension) showed that only subglottic extension significantly influenced the probability of cure. CONCLUSION Paraglottic space invasion is likely associated with increased tumor volume and, by itself, is not necessarily associated with poorer outcome after definitive RT.
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Affiliation(s)
- Roi Dagan
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA
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Bradley PJ, Rinaldo A, Suárez C, Shaha AR, Leemans CR, Langendijk JA, Patel SG, Ferlito A. Primary treatment of the anterior vocal commissure squamous carcinoma. Eur Arch Otorhinolaryngol 2006; 263:879-88. [PMID: 16909217 DOI: 10.1007/s00405-006-0138-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Accepted: 06/19/2006] [Indexed: 11/24/2022]
Abstract
Squamous cell carcinoma may involve the anterior commissure (AC) area of the laryngeal glottis, and can be grouped morphologically into four groups; (1) tumor confined to the AC, (2) tumor involving one cord and the AC, (3) tumor involving the AC and a portion of both vocal cords, and (4) tumor involving a greater part of one cord and crossing over to involve a variable length of the other cord. Some of these patients when evaluated by imaging, either CT and/or MRI, may demonstrate thyroid cartilage erosion or involvement, thereby upstaging a T1a, T1b into a T3 or a T4 glottic cancer. The majority of patients treated by radiotherapy have only been staged clinically, and hence a failure or recurrence rate of 15%. In patients treated surgically by endoscopic or external surgery, the local recurrence rates are similar at 15%. Therefore, future reporting of patients treated with AC involvement should be staged radiologically, to include CT or MRI, and documentation of the treatment results be reported in subgroups, according to whether there is no cartilage involvement, inner-table cartilage erosion, or through-and-through cartilage invasion. Should endoscopic cordectomy be used, then the type of surgery performed should be based on the classification as suggested by the European Laryngological Society. The use of the above recommendations would allow for more meaningful results to be reported and for cause specific analysis of failure of treatment techniques applied.
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Affiliation(s)
- Patrick J Bradley
- Department of Otorhinolaryngology-Head and Neck Surgery, Queens Medical Centre, Nottingham, UK
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