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Lechien JR, Vaira LA, Chiesa-Estomba CM. Laryngeal verrucous cell carcinoma. Curr Opin Otolaryngol Head Neck Surg 2024; 32:118-124. [PMID: 37820109 DOI: 10.1097/moo.0000000000000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
PURPOSE OF REVIEW To summarize the recent literature on epidemiology, clinical findings, treatment, and survival of laryngeal verrucous cell carcinoma (LVC). RECENT FINDINGS Epidemiological studies report that LVC accounts for 1-3% of all laryngeal cancers. The incidence is decreasing, while most patients are male individuals and smokers. LVC are commonly detected in early stages because they are more frequently located in the glottic region. Tobacco, alcohol overuse, and, possibly, human papilloma virus are the main contributing factors. Recent studies confirm that surgery is the primary therapeutic approach with better prognosis when compared with other treatment modalities. Surgery alone is associated with 86.8% disease-free and 80.3% overall survival rates, while metastases are anecdotal. SUMMARY LVC presents different clinical, pathological, and survival outcomes when compared with the classic laryngeal squamous cell carcinoma. Biopsies need often to be repeated before getting the most appropriate diagnosis; this supports the need of large-sample biopsy during the tumor diagnosis and staging. The glottic location of most LVC leads to detection of this lesion in its early stages, with ensuing better survival and outcomes after surgery compared with the classic form of squamous cell carcinoma. Future studies are needed to understand the biology of LVC and its related better prognostic outcomes when compared to other laryngeal malignancies.
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Affiliation(s)
- Jerome R Lechien
- Laryngology Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
| | - Luigi A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy
- School of Biomedical Sciences, Biomedical Sciences Department, University of Sassari, Sassari, Italy
| | - Carlos M Chiesa-Estomba
- Laryngology Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otolaryngology-Head and Neck Surgery, San Sebastian University Hospital, San Sebastian, Spain
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Lechien JR, Hans S. Epidemiological, clinical and oncological outcomes of laryngeal verrucous carcinomas: a systematic review. J Otolaryngol Head Neck Surg 2023; 52:81. [PMID: 38093339 PMCID: PMC10716941 DOI: 10.1186/s40463-023-00666-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/28/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE To investigate epidemiological, clinical and oncological outcomes of patients with laryngeal verrucous carcinomas (LVC). METHODS Two independent authors investigated PubMed, Scopus and Cochrane Library for studies dedicated to epidemiological, clinical and oncological outcomes of patients with LVC. The following outcomes were investigated with PRISMA criteria: age; gender; tobacco/alcohol consumption; HPV infection; anatomical, pathological, therapeutic and survival outcomes. Studies were analyzed for bias through a validated clinical tool. RESULTS Of the 212 identified articles, 15 retrospective studies and one prospective uncontrolled study met our inclusion criteria. Three studies reported findings from national databases. The males/females ratio is 9/1. Mean age was 60.3 years, which was younger compared to other laryngeal malignancies. The alcohol, cigarette overuse and the HPV status of patients were lacking in most studies. Glottis and supraglottis were the most common anatomical locations, corresponding to 78.7% and 12.4% of cases, respectively. The main therapeutic approaches consisted of surgery, radiotherapy, surgery followed by radiotherapy. Treatments reported 5-year overall survival and disease-specific survival of 86.3 and 90.8, respectively. The 5- and 10-year local control rate were 83.6 and 72.6, respectively. The 10-year disease-specific survival was 80.2. Heterogeneity between studies was found for inclusion criteria, comorbidity data, and treatments. CONCLUSION LVC is a rare laryngeal cancer associated with better survival and recurrence outcomes than laryngeal squamous cell carcinoma. The role of radiotherapy in the treatment regimen needs to be investigated in future prospective controlled studies.
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Affiliation(s)
- Jérôme R Lechien
- Laryngeal and Head and Neck Surgery Study Groups of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.
- Department of Otolaryngology, Elsan Hospital, Paris, France.
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
| | - Stéphane Hans
- Laryngeal and Head and Neck Surgery Study Groups of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
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Patel AM, Vedula S, Haleem A, Choudhry HS, Tseng CC, Park RCW. Elective Neck Dissection for cT1-4 N0M0 Head and Neck Verrucous Carcinoma. Otolaryngol Head Neck Surg 2023; 169:1187-1199. [PMID: 37278222 DOI: 10.1002/ohn.374] [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: 12/20/2022] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the survival benefit of elective neck dissection (END) over neck observation in cT1-4 N0M0 head and neck verrucous carcinoma (HNVC). STUDY DESIGN Retrospective cohort study. SETTING The 2006 to 2017 National Cancer Database. METHODS Patients with surgically resected cT1-4 N0M0 HNVC were selected. Linear, binary logistic, Kaplan-Meier, and Cox proportional hazards regression models were utilized. RESULTS Of 1015 patients satisfying inclusion criteria, 223 (22.0%) underwent END. The majority of patients were male (55.4%) and white (91.0%) with disease of the oral cavity (67.6%) classified as low grade (90.0%) and cT1-2 (81.8%). The minority of ENDs (4.0%) detected occult nodal metastases. The rate of END increased from 2006 to 2017 for both cT1-2 (16.3% vs 22.0%, p = .126, R2 = 0.405) and cT3-4 (41.7% vs 70.0%, p = .424, R2 = 0.232) disease but these trends were not statistically significant. Independent predictors of undergoing END included treatment at an academic facility (adjusted odds ratio [aOR]: 1.75, 95% confidence interval [CI]: 1.19-2.55), cT3-4 disease (aOR: 3.31, 95% CI: 2.16-5.07), and tumor diameter (aOR: 1.09, 95% CI: 1.01-1.19) (p < 0.05). The 5-year overall survival (OS) of patients treated with and without END was 71.3% and 70.6%, respectively (p = .661). END did not significantly reduce the 5-year hazard of death (adjusted hazard ratio: 1.25, 95% CI: 0.91-1.71, p = .172). END did not significantly improve 5-year OS in univariate and multivariate analyses stratified by several patient, facility, tumor, and treatment characteristics. CONCLUSION END does not confer an appreciable survival benefit in HNVC, even after stratifying univariate and multivariate analyses by several patient, facility, tumor, and treatment characteristics. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Aman M Patel
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Sudeepti Vedula
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Afash Haleem
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Hassaam S Choudhry
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Christopher C Tseng
- Department of Otolaryngology-Head and Neck Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Richard Chan Woo Park
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Amanian A, Anderson DW, Durham JS, Prisman E, Ng T, Hu A. Treatment of Laryngeal Verrucous Carcinoma: 28-Year Retrospective Cohort Study and Literature Review. OTO Open 2023; 7:e50. [PMID: 37275458 PMCID: PMC10234623 DOI: 10.1002/oto2.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/25/2023] [Indexed: 06/07/2023] Open
Abstract
Objective Laryngeal verrucous carcinoma (LVC) comprises 1% to 4% of all laryngeal tumors. Although controversial, surgery has been the mainstay of treatment, due to concern about anaplastic transformation with radiotherapy. We aimed to study LVC patients to identify treatment patterns for primary and recurrent diseases. Study Design Retrospective cohort study. Setting Tertiary referral center. Methods Patients with a pathological diagnosis of LVC treated over a 28-year period were included. Baseline demographics, and treatment outcome measures including 5-year laryngeal preservation rates (LPR), overall survival (OS), and recurrence-free survival (RFS) were included. A literature review of published studies within the same study period was also completed. Results Thirty-two patients were included in the analysis (median age 61.5 years, 93.8% [30/32] male). Twenty-three patients had T1 disease, and 9 had T2 disease with no evidence of regional or metastatic disease. The most common presenting symptom was hoarseness (93.8%) and the majority within the glottis 81.3% (26/32). Twenty-nine patients underwent primary surgery only (28 local excisions, 1 vertical partial laryngectomy) meanwhile 3 underwent local excision with postoperative radiotherapy. LPR, OS, and RFS at 5 years were 95.8%, 90.1%, and 80.6%, respectively. Our literature review identified 23 previous studies, mostly single-institution retrospective case series. Our study was the largest Canadian study in the literature to date. Conclusion All LVC patients were treated with primary surgery, consistent with the current literature with excellent 5-year OS and LPR. There was no consensus on the treatment of recurrent disease. Future prospective multicenter studies are warranted to further study this rare disease population.
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Affiliation(s)
- Ameen Amanian
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of British ColumbiaVancouverCanada
| | - Donald W. Anderson
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of British ColumbiaVancouverCanada
| | - James Scott Durham
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of British ColumbiaVancouverCanada
| | - Eitan Prisman
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of British ColumbiaVancouverCanada
| | - Tony Ng
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverCanada
| | - Amanda Hu
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of British ColumbiaVancouverCanada
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Naik AN, Silverman DA, Rygalski CJ, Zhao S, Brock G, Lin C, Puram SV, Rocco JW, Baliga S, VanKoevering KK, Old MO, Seim NB, Kang SY. Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma. Laryngoscope 2022; 132:1953-1961. [PMID: 34989407 DOI: 10.1002/lary.30009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/16/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS We investigate the clinicopathologic and treatment factors associated with the use of postoperative radiation therapy (PORT) and its effect on overall survival (OS) for patients with oral cavity verrucous carcinoma (VC). STUDY DESIGN Retrospective cohort study. METHODS A retrospective cohort study of the National Cancer Database (NCDB) from 2006 to 2015 was performed. Multivariable logistic regression was used to identify independent predictive factors associated with the use of PORT. Cox Regression survival and propensity score analyses were used to evaluate the effect of PORT on mortality. RESULTS A total of 356 adult patients with primary oral cavity VC who underwent definitive surgical resection were identified. A total of 10.7% of patients underwent definitive surgical resection followed by PORT. Variables associated with PORT included distance to the hospital per 10 miles (adjusted odds ratio [aOR], 0.81 [95% confidence interval (CI), 0.70-0.95]) and stage III-IV disease (aOR, 12.13 and 23.92, respectively). Multivariable Cox regression survival analysis indicated no evidence of survival benefit in patients undergoing PORT compared to surgery alone (adjusted hazard ratio 1.50 [0.74-3.05], P = .23). Propensity score analysis also showed no OS benefit with the use of PORT (P = .41). CONCLUSIONS Variables associated with the use of PORT on multivariable analysis included closer distance to hospital and stage III-IV disease. No clear survival benefit with PORT was identified on either multivariable survival analysis or propensity score analysis. These results suggest that surgery alone with negative margins may be the optimal treatment for patients with oral cavity VC. LEVEL OF EVIDENCE 4 Laryngoscope, 2022.
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Affiliation(s)
- Akash N Naik
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Dustin A Silverman
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis Health System, Sacramento, California, U.S.A
| | | | - Songzhu Zhao
- Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University, Columbus, Ohio, U.S.A
| | - Guy Brock
- Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University, Columbus, Ohio, U.S.A
| | - Chen Lin
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, U.S.A
| | - Sidharth V Puram
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - James W Rocco
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Sujith Baliga
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Kyle K VanKoevering
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Matthew O Old
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Nolan B Seim
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Stephen Y Kang
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
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6
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Gurău P, Tîrbu V, Sencu E, Vetricean S. Flexible endoscopic approach to verrucous carcinoma of the larynx. Clin Otolaryngol 2021; 46:1379-1382. [PMID: 34473404 DOI: 10.1111/coa.13855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/02/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Petru Gurău
- Department of Thoracic Surgery, "Timofei Moșneaga" Republican Clinical Hospital, Chișinău, Moldova
| | | | - Eusebiu Sencu
- Department of Otorhinolaryngology, Faculty of Medicine, Nicolae Testemițanu" University of Medicine and Pharmacy, Chișinău, Moldova
| | - Sergiu Vetricean
- Department of Otorhinolaryngology, Faculty of Medicine, Nicolae Testemițanu" University of Medicine and Pharmacy, Chișinău, Moldova
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Jayakrishnan TT, Abel S, Interval E, Colonias A, Wegner RE. Patterns of Care and Outcomes in Verrucous Carcinoma of the Larynx Treated in the Modern Era. Front Oncol 2020; 10:1241. [PMID: 32850375 PMCID: PMC7426485 DOI: 10.3389/fonc.2020.01241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 06/16/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Verrucous carcinoma of the larynx (VCL) is a rare form of laryngeal squamous cell carcinoma. We analyzed the National Cancer Database (NCDB) to examine national treatment pattern, identify factors associated with primary radiation therapy (RT), and compare outcomes in patients with Tis-T2 N0 VCL treated primary surgery and primary RT. Methods: We accessed the NCDB from 2004 to 2015 for patients with Tis-T2 N0 VCL and recorded the treatment modality employed. Multivariable logistic regression was used to identify predictors for radiation therapy. Cox regression was used to calculate hazard ratios for survival. A propensity score matched Kaplan-Meier analysis compared primary surgical treatment to definitive radiation. Results: We identified 732 patients with laryngeal verrucous carcinoma from the NCDB. The majority were cTis-T2 (87%) N0 (96%). We identified 286 vs. 110 Tis-T2N0 patients treated primary surgery and with definitive radiation, respectively, for the purpose of this study. Predictors of radiation were treatment at a community center, no insurance, and higher T stage. Cox regression identified increased age, higher comorbidity score, and government insurance as predictive of worse survival. Propensity matching revealed a trend toward worse survival with definitive radiation, with a median survival of 98 months compared to 143 months (p = 0.02). When including only T1-2 lesions, that is, invasive disease, the trend toward increased survival with surgery [98 months vs. 135 months (p = 0.08)] persisted. Conclusion: The results of the present study support the use of surgery in the management of Tis-T2 N0 VCL when organ preservation is possible.
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Affiliation(s)
- Thejus T Jayakrishnan
- Allegheny Health Network, Department of Internal Medicine, Pittsburgh, PA, United States
| | - Stephen Abel
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, United States
| | - Erik Interval
- Division of Otolaryngology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, United States
| | - Athanasios Colonias
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, United States
| | - Rodney E Wegner
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, United States
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Alonso JE, Kuan EC, Arshi A, St. John MA. A population-based analysis of verrucous carcinoma of the oral cavity. Laryngoscope 2017; 128:393-397. [DOI: 10.1002/lary.26745] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/25/2017] [Accepted: 05/22/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Jose E. Alonso
- Department of Head and Neck Surgery; David Geffen School of Medicine at UCLA; the UCLA Head and Neck Cancer Program; Los Angeles California U.S.A
| | - Edward C. Kuan
- Department of Head and Neck Surgery; David Geffen School of Medicine at UCLA; the UCLA Head and Neck Cancer Program; Los Angeles California U.S.A
| | - Armin Arshi
- Department of Orthopaedic Surgery; David Geffen School of Medicine at UCLA; the UCLA Head and Neck Cancer Program; Los Angeles California U.S.A
| | - Maie A. St. John
- Department of Head and Neck Surgery; David Geffen School of Medicine at UCLA; the UCLA Head and Neck Cancer Program; Los Angeles California U.S.A
- Department of Orthopaedic Surgery; David Geffen School of Medicine at UCLA; the UCLA Head and Neck Cancer Program; Los Angeles California U.S.A
- UCLA Jonsson Comprehensive Cancer Center; Los Angeles California U.S.A
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Abstract
Squamous cell carcinoma (SCC) is a malignant epithelial tumor showing evidence of squamous differentiation. It is the most common malignancy of the larynx, with several variants (verrucous, exophytic or papillary, spindle-cell, basaloid, acantholytic, adenosquamous) recognized, with well-established precursor lesions. Dysplasia is now separated into only low-grade and high-grade categories. Each SCC variant has unique cytomorphologic features and histologic differential diagnoses that are important to consider, as management and outcomes are different.
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Affiliation(s)
- Lester D R Thompson
- Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91367, USA.
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10
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Vazquez A, Khan MN, Blake DM, Patel TD, Baredes S, Eloy JA. Sinonasal squamous cell carcinoma and the prognostic implications of its histologic variants: a population-based study. Int Forum Allergy Rhinol 2014; 5:85-91. [DOI: 10.1002/alr.21418] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 07/29/2014] [Accepted: 08/20/2014] [Indexed: 02/03/2023]
Affiliation(s)
- Alejandro Vazquez
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - Mohemmed N. Khan
- Department of Otolaryngology-Head and Neck Surgery; Mount Sinai School of Medicine; New York NY
| | - Danielle M. Blake
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - Tapan D. Patel
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey; Rutgers New Jersey Medical School; Newark NJ
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark NJ
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey; Rutgers New Jersey Medical School; Newark NJ
- Department of Neurological Surgery; Rutgers New Jersey Medical School; Newark NJ
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11
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The Kaiser's cancer revisited: was Virchow totally wrong? Virchows Arch 2011; 458:649-57. [DOI: 10.1007/s00428-011-1075-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 03/30/2011] [Indexed: 01/06/2023]
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12
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Rekha KP, Angadi PV. Verrucous carcinoma of the oral cavity: a clinico-pathologic appraisal of 133 cases in Indians. Oral Maxillofac Surg 2010; 14:211-218. [PMID: 20396919 DOI: 10.1007/s10006-010-0222-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Verrucous carcinoma (VC), a rare variant of squamous cell carcinoma is an established entity with distinctive morphology and specific clinical behavior. To date, only a small series of head and neck verrucous carcinomas have been reported in the literature. MATERIALS AND METHODS The present study evaluated 133 cases of verrucous carcinoma for the age, sex, site of involvement, duration of disease at the time of diagnosis, associated habits and common presenting symptoms, presence of other mucosal lesions, recurrence, and the histopathology. RESULTS AND DISCUSSION Verrucous carcinoma accounted for 16.08% among oral squamous cell carcinoma compared to 2-12% reported in the literature. VC was more common in males with greater predilection to buccal mucosa due to widespread use of tobacco chewing in Indian scenario. Age distribution was lower as compared to other studies with prominence in the fifth decade. Mandibular involvement was more frequent as compared to those in literature. CONCLUSION Development of recurrence following radiotherapy in few cases supports anaplastic changes by radiotherapy.
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Affiliation(s)
- K P Rekha
- Department of Oral and Maxillofacial Pathology and Microbiology, SDM College of Dental Sciences, Dharwad 580009 Karnataka, India
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13
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Miller ME, Martin N, Juillard GF, Bhuta S, Ishiyama A. Temporal bone verrucous carcinoma: outcomes and treatment controversy. Eur Arch Otorhinolaryngol 2010; 267:1927-31. [PMID: 20502907 PMCID: PMC2966949 DOI: 10.1007/s00405-010-1281-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Accepted: 05/06/2010] [Indexed: 11/28/2022]
Abstract
Verrucous carcinoma is a rare tumor that presents in the head and neck with the most common sites being the oral cavity and larynx. Fourteen cases of verrucous carcinoma of the temporal bone have been described in literature; this study aims to examine treatment outcomes and discuss the controversy surrounding postoperative radiation. The study design included a literature review along with individual case report in the setting of a tertiary care medical center. Outcome analysis of all cases of verrucous carcinoma of the temporal bone, which are documented in the English literature, and presentation of a single patient report including gross, histologic and radiologic analyses were performed. The longest recorded survival for verrucous carcinoma of the temporal bone occurs in patients treated with surgery alone. Poorer outcomes for patients treated with adjuvant (chemo)radiation may be due to more advanced stage of disease at the time of treatment. Early reports of radiation leading to tumor dedifferentiation or early recurrence are not supported by more recent studies. Whether adjuvant radiation therapy is indicated in verrucous carcinoma of the temporal bone remains controversial.
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Affiliation(s)
- Mia E Miller
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, CHS 62-237, 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
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14
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Chute DJ, Stelow EB. Cytology of head and neck squamous cell carcinoma variants. Diagn Cytopathol 2010; 38:65-80. [PMID: 19582815 DOI: 10.1002/dc.21134] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The most common diagnosis rendered with head and neck fine needle aspiration (FNA) biopsy is metastatic squamous cell carcinoma (SCC). While most cases of metastatic SCC pose little diagnostic difficulty, the diagnosis of metastatic histologic variants of SCC, often coupled with less common etiologies, can be more problematic. This manuscript reviews the clinicopathologic features of the histologic variants of upper aerodigestive tract SCC (verrucous, papillary, spindle cell, undifferentiated, acantholytic, and basaloid) and uncommon etiologies of head and neck SCC (human papillomavirus, Epstein-Barr Virus, and NUT midline carcinomas). Particular attention is paid to the cytologic features of these lesions. Differential diagnoses and the use of ancillary testing are discussed.
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Affiliation(s)
- Deborah J Chute
- Department of Pathology, University of Virginia, Charlottesville, Virginia 22908, USA
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15
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Carbon dioxide laser cordectomy for verrucous carcinoma of vocal folds. The Journal of Laryngology & Otology 2009; 124:55-8. [DOI: 10.1017/s002221510999140x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Verrucous carcinoma occurs infrequently in the vocal folds. This tumour has an excellent prognosis with proper treatment. Management strategies include surgery, radiotherapy or both.Aim:To evaluate the long-term results of type I and II laser cordectomy for the treatment of verrucous carcinoma of the vocal folds.Materials and methods:We reviewed the files of 18 patients with verrucous carcinoma of the vocal folds treated by type I or II laser cordectomy in our department from 1989 to 2006, and recorded clinical and outcome data.Results:None of the patients had any major post-operative complications. All had a subjectively satisfactory quality of voice, with no morbidity. Patient follow up ranged from three to 228 months (mean, 48 months). Five patients were treated with post-operative radiotherapy for persistent disease, of whom four underwent repeated surgery due to recurrence.Conclusion:Type I or II laser cordectomy is a safe, feasible, secure method of treating verrucous carcinoma of the vocal folds. There were no major complications in our patient series. Most recurrent disease was manageable locally with repeated surgery.
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Huang SH, Lockwood G, Irish J, Ringash J, Cummings B, Waldron J, Kim J, Dawson LA, Bayley A, Hope A, O'Sullivan B. Truths and Myths About Radiotherapy for Verrucous Carcinoma of Larynx. Int J Radiat Oncol Biol Phys 2009; 73:1110-5. [DOI: 10.1016/j.ijrobp.2008.05.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2008] [Accepted: 05/09/2008] [Indexed: 10/21/2022]
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Strojan P, Soba E, Budihna M, Auersperg M. Radiochemotherapy with Vinblastine, Methotrexate, and Bleomycin in the treatment of verrucous carcinoma of the head and neck. J Surg Oncol 2005; 92:278-83. [PMID: 16299796 DOI: 10.1002/jso.20422] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To explore whether the combined radiochemotherapy with Vinblastine, Methotrexate, and Bleomycin could be an effective alternative treatment to surgery in verrucous carcinoma (VC) of the head and neck. METHODS Combined radiochemotherapy was used in 12 patients with previously untreated VC. They were irradiated to equivalent tumor dose of 44-70 Gy (median, 56 Gy) and had > or = 2 courses of concomitant chemotherapy. Chemotherapy regimen consisted of prolonged intravenous infusions of Vinblastine 2 mg (day 1); Methotrexate 50 mg (day 2); Bleomycin 15 mg (days 2 and 3), and repetition at 2-3 week intervals. RESULTS Eleven of 12 patients were cured of VC, and one died of purulent meningitis associated with intracranial extension of VC from the oral cavity. Of 11 patients cured of VC, eight had advanced tumors. The median follow-up of cured patients was 3.6 years (range, 1.4-13.6 years). All the patients developed mucositis of grade > or = 3, whereas no serious late side-effects were recorded. CONCLUSIONS Combined radiochemotherapy with Vinblastine, Methotrexate, and Bleomycine is highly effective in the treatment of VC of the head and neck. It could be successfully used in the patients with inoperable VC or as an alternative to surgery.
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Affiliation(s)
- Primoz Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
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Ferlito A, Buckley JG, Shaha AR, Rinaldo A. Contemporary important considerations in diagnosis and treatment of head and neck cancer. Acta Otolaryngol 2002; 122:115-20. [PMID: 11876590 DOI: 10.1080/00016480252775841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Alfio Ferlito
- Department of Otolaryngology-Head and Neck Surgery, University of Udine, Policlinico Universitario, Italy.
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Koch BB, Trask DK, Hoffman HT, Karnell LH, Robinson RA, Zhen W, Menck HR. National survey of head and neck verrucous carcinoma: patterns of presentation, care, and outcome. Cancer 2001; 92:110-20. [PMID: 11443616 DOI: 10.1002/1097-0142(20010701)92:1<110::aid-cncr1298>3.0.co;2-k] [Citation(s) in RCA: 131] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Verrucous carcinoma is distinguished by controversy regarding appropriate diagnosis and treatment. This study provides a contemporary survey of demographics, patterns of care, and outcome for this disease in the United States. METHODS The National Cancer Data Base had 2350 cases of verrucous carcinoma of the head and neck diagnosed between 1985 and 1996. Statistical procedures included chi-square analyses, Student t tests, and relative survival. RESULTS Tumors originated most frequently in the oral cavity (55.9%) and larynx (35.2%). Although most patients were male (60.0%), oral cavity tumors were more common among older females. The most prevalent treatment was surgery alone (69.7%), followed by surgery combined with irradiation (11.0%) and irradiation alone (10.3%). For oral cavity tumors, surgery alone was more common among early (85.8%) than advanced cases (56.9%); a larger proportion of advanced disease received radiation alone or surgery and irradiation combined. Most laryngeal tumors were treated with surgery (60.3% for early and 55.6% for advanced disease), but a higher proportion received radiation alone or surgery combined with radiation compared with oral cavity cases. Five-year relative survival was 77.9%. For localized disease, survival after surgery was 88.9% compared with 57.6% after irradiation. CONCLUSIONS Demographic differences implicate different mechanisms of carcinogenesis for verrucous carcinoma arising in the oral cavity and the larynx. Although selection bias may account for the differences observed, patients receiving initial treatment with surgery had better survival than those treated with irradiation, especially for cases originating in the oral cavity.
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Affiliation(s)
- B B Koch
- Department of Otolaryngology--Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Ferlito A, Rinaldo A, Devaney KO, Carbone A. Management of the clinically negative cervical lymph nodes in patients with non-conventional squamous carcinoma of the larynx. J Laryngol Otol 1999; 113:619-23. [PMID: 10605556 DOI: 10.1017/s0022215100144688] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This paper discusses the indications for neck dissection in those patients with laryngeal tumours which prove to be, on pathologic examination, not conventional squamous carcinomas but rather fall into the category either of one of the uncommon histological subtypes of carcinoma, or another type of unusual histological variant of laryngeal malignancy, a mesenchymal tumour. It appears as though these unusual laryngeal malignancies may manifest both biological behaviours and propensities to metastasize to regional lymph nodes that differ from those of the more commonly encountered conventional squamous carcinomas of the larynx. This heterogeneous group of tumours accounts for about 10 per cent of all malignant tumours of the larynx.
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Affiliation(s)
- A Ferlito
- Department of Otolaryngology, Head and Neck Surgery, University of Udine, Italy.
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Ferlito A, Devaney KO, Rinaldo A, Putzi MJ. Papillary squamous cell carcinoma versus verrucous squamous cell carcinoma of the head and neck. Ann Otol Rhinol Laryngol 1999; 108:318-22. [PMID: 10086629 DOI: 10.1177/000348949910800318] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Papillary squamous cell carcinoma and verrucous squamous cell carcinoma of the head and neck may be confused. The clinicopathological profile of the two neoplasms is presented and the differential diagnosis is discussed. A correct diagnosis is imperative in order to institute the most appropriate treatment.
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Affiliation(s)
- A Ferlito
- Department of Otolaryngology-Head and Neck Surgery, University of Udine, Italy
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