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Ding W, Cai W, Wang H. P53 and pRB induction improves response to radiation therapy in HPV-positive laryngeal squamous cell carcinoma. Clinics (Sao Paulo) 2024; 79:100415. [PMID: 38897099 DOI: 10.1016/j.clinsp.2024.100415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/19/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION Patients with Human Papillomavirus (HPV+)-associated Laryngeal Squamous Cell Carcinoma (LSCC) exhibit dramatically improved survival relative to those with HPV-Negative (HPV-) tumors. In this study, the authors aimed to investigate the radiosensitivity of all available confirmed HPV+ and HPV-LSCC cells in vitro and in vivo. METHODS Primary LSCC cells were generated from tumor specimens obtained from patients. Real-time PCR was performed to confirm HPV infection and the expression of HPV-related genes (E6 and E7), p53, and pRB. Clonogenic survival assays, western blotting, and flow cytometry were used to assess radiation sensitivity, apoptosis, and the expression of p53 and pRB. p53 and pRB knockout cells were generated using CRISPR/Cas9 technology. RESULTS HPV+ LSCC cells displayed enhanced radiation sensitivity compared to HPV- cells. Radiation-induced apoptosis in HPV+ LSCC cells, accompanied by increased levels of p53 and pRB. Knockout of p53 or pRB led to radiation resistance and attenuated radiation-induced apoptosis in HPV+ LSCC cells. In vivo experiments showed similar results, where knockout of p53 or pRB decreased radiosensitivity in tumor-bearing mice. CONCLUSION The present findings demonstrated that HPV+ LSCC cells displayed obvious inherent radiation sensitivity, corresponding to increased apoptosis following radiation exposure. Mechanism study showed that the expression of p53 and pRB in HPV+ cells are required for radiation sensitivity. These findings highlight a novel mechanism by which p53 and pRB play key roles in the radiation sensitivity of HPV+ LSCC compared to HPV-LSCC.
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Affiliation(s)
- Weiquan Ding
- Department of Otolaryngology Head and Neck Surgery, Panyu Central Hospital, Guangzhou, Guangdong, China.
| | - Weiwei Cai
- Department of Otolaryngology Head and Neck Surgery, Panyu Central Hospital, Guangzhou, Guangdong, China
| | - Haili Wang
- Department of Otolaryngology Head and Neck Surgery, Panyu Central Hospital, Guangzhou, Guangdong, China
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Liu M, Zhao R, Song X, Cheng H, Zhao Y, Xu Y, Liu S. High hsa_circ_0081621 expression indicates a poor prognosis of laryngeal squamous cell carcinoma: A bioinformatics analysis and retrospective clinical study. Oncol Lett 2023; 26:464. [PMID: 37780548 PMCID: PMC10534280 DOI: 10.3892/ol.2023.14051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
Laryngeal squamous cell carcinoma (LSCC) is the second most common malignant tumour of the head and neck with a low 5-year survival rate. There is need to identify novel biomarkers for diagnosis and treatment of LSCC. The present study identified differentially expressed circular RNAs (circRNAs/circs) in LSCC and larynx adjacent non-carcinoma epithelial specimens by analysing the circRNA microarray dataset GSE117001. hsa_circ_0081621 had highest expression among three circRNAs (hsa_circ_0015211, hsa_circ_0023326 and hsa_circ_0081621) in LSCC specimens by reverse transcription-quantitative PCR. The expression levels of hsa_circ_0081621 in 67 LSCC specimens were detected by fluorescence in situ hybridization (FISH). Expression levels of hsa_circ_0081621 were analysed in relation to clinicopathological parameters and prognosis of patients with LSCC. According to FISH results, 59.7% of LSCC specimens exhibited high hsa_circ_0081621 expression. In LSCC specimens, hsa_circ_0081621 high expression was associated with lymph node metastasis and high clinical stage. High expression levels of hsa_circ_0081621 were associated with a poor 5-year overall survival rate in patients with LSCC. In addition, high hsa_circ_0081621 expression was an independent prognostic factor for patients with LSCC. hsa_circ_0081621 may participate in malignant progression of LSCC, and its high expression could be used for prognostic assessment of patients with LSCC.
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Affiliation(s)
- Meng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China
| | - Ruili Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China
| | - Xiaofei Song
- Department of Otorhinolaryngology Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China
| | - Hongkun Cheng
- Department of Otorhinolaryngology Head and Neck Surgery, The Third Hospital of Handan City, Handan, Hebei 056001, P.R. China
| | - Yan Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China
| | - Yuru Xu
- Department of Otorhinolaryngology Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China
| | - Shenghui Liu
- Department of Otorhinolaryngology Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China
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Bang J, Lee OH, Kim GJ, Sun DI, Kim SY. The Role of Open Conservation Surgery in the Era of Minimally Invasive Surgery for Hypopharyngeal Cancer. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1873. [PMID: 37893591 PMCID: PMC10608416 DOI: 10.3390/medicina59101873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Total laryngectomy with partial pharyngectomy is traditionally the principal curative treatment for hypopharyngeal cancer; however, conservative surgical approaches that minimize functional disability are attracting increasing interest. Thus, we evaluated the appropriateness and oncological outcomes of open conservation surgery for such patients. Materials and Methods: We reviewed the medical records of 49 patients who underwent vertical hemipharyngolaryngectomy from 1998 to 2018 at a single institution. Results: Locoregional recurrences developed in 19 patients (38.8%) and distant metastases in 6 (12.2%). Histopathologically, paraglottic space invasion was apparent in 13 patients (26.5%), pre-epiglottic space invasion in 4 (8.2%), thyroid cartilage invasion in 9 (18.4%), thyroid gland invasion in 2, perineural invasion in 11 (22.4%), and lymphovascular invasion in 35 (71.4%). The 5-year overall survival of patients who underwent open conservation surgery was comparable to that of patients who underwent total laryngectomy with partial pharyngectomy (68.7% vs. 48.4%, p = 0.14). Pre-epiglottic space invasion significantly decreased the 5-year disease-free survival rate after open conservation surgery (69.7% vs. 17.9%, p = 0.01). Conclusions: We found that pre-epiglottic space invasion negatively impacted disease control after open conservation surgery, emphasizing the crucial role played by a preoperative evaluation during patient selection.
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Affiliation(s)
- Jooin Bang
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Oh-Hyeong Lee
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Geun-Jeon Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Dong-Il Sun
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sang-Yeon Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Nakajo M, Nagano H, Jinguji M, Kamimura Y, Masuda K, Takumi K, Tani A, Hirahara D, Kariya K, Yamashita M, Yoshiura T. The usefulness of machine-learning-based evaluation of clinical and pretreatment 18F-FDG-PET/CT radiomic features for predicting prognosis in patients with laryngeal cancer. Br J Radiol 2023; 96:20220772. [PMID: 37393538 PMCID: PMC10461278 DOI: 10.1259/bjr.20220772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 07/03/2023] Open
Abstract
OBJECTIVE To examine whether machine learning (ML) analyses involving clinical and 18F-FDG-PET-based radiomic features are helpful in predicting prognosis in patients with laryngeal cancer. METHODS This retrospective study included 49 patients with laryngeal cancer who underwent18F-FDG-PET/CT before treatment, and these patients were divided into the training (n = 34) and testing (n = 15) cohorts.Seven clinical (age, sex, tumor size, T stage, N stage, Union for International Cancer Control stage, and treatment) and 40 18F-FDG-PET-based radiomic features were used to predict disease progression and survival. Six ML algorithms (random forest, neural network, k-nearest neighbors, naïve Bayes, logistic regression, and support vector machine) were used for predicting disease progression. Two ML algorithms (cox proportional hazard and random survival forest [RSF] model) considering for time-to-event outcomes were used to assess progression-free survival (PFS), and prediction performance was assessed by the concordance index (C-index). RESULTS Tumor size, T stage, N stage, GLZLM_ZLNU, and GLCM_Entropy were the five most important features for predicting disease progression.In both cohorts, the naïve Bayes model constructed by these five features was the best performing classifier (training: AUC = 0.805; testing: AUC = 0.842). The RSF model using the five features (tumor size, GLZLM_ZLNU, GLCM_Entropy, GLRLM_LRHGE and GLRLM_SRHGE) exhibited the highest performance in predicting PFS (training: C-index = 0.840; testing: C-index = 0.808). CONCLUSION ML analyses involving clinical and 18F-FDG-PET-based radiomic features may help predict disease progression and survival in patients with laryngeal cancer. ADVANCES IN KNOWLEDGE ML approach using clinical and 18F-FDG-PET-based radiomic features has the potential to predict prognosis of laryngeal cancer.
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Affiliation(s)
- Masatoyo Nakajo
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiromi Nagano
- Department of Otolaryngology Head and Neck Surgery, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Megumi Jinguji
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yoshiki Kamimura
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Keiko Masuda
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Koji Takumi
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Atsushi Tani
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Daisuke Hirahara
- Department of Management Planning Division, Harada Academy, Kagoshima, Japan
| | - Keisuke Kariya
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masaru Yamashita
- Department of Otolaryngology Head and Neck Surgery, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takashi Yoshiura
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Shelan M, Anschuetz L, Schubert A, Bojaxhiu B, Aebersold DM, Elicin O, Giger R. Superior loco-regional control after primary surgery compared to chemo-radiotherapy for advanced stage laryngeal cancer. Front Oncol 2023; 13:1132486. [PMID: 37593093 PMCID: PMC10431594 DOI: 10.3389/fonc.2023.1132486] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 07/05/2023] [Indexed: 08/19/2023] Open
Abstract
Objective The optimal strategy to treat loco-regionally advanced squamous cell carcinoma of the larynx (LSCC) remains to be defined. The goal of this single institution retrospective study was to report on oncologic outcome of advanced LSCC treated with curative intent. Methods Patients diagnosed and treated for stage T3-T4a LSCC between 2001 and 2014 were retrospectively analyzed. Time-to-event endpoints were calculated beginning from the date of histologic diagnosis, which were analyzed with log-rank test and Cox proportional hazard models. Results The cohort was divided into two subgroups: primary radiotherapy with concomitant cisplatin (CRT) (n=30, 38%) and primary surgery (n=48, 62%). Median follow-up was 56 months. Locoregional control (LRC) for the primary surgery and CRT were 95% and 50% in 5 years, respectively (p<0.01). Progression free survival (PFS) for the primary surgery and CRT were 61% and 38% in 5 years, respectively (p=0.23). The overall survival (OS) after primary surgery and CRT in 5 years were 63% vs. 65%, respectively (p=0.93). The 5-years LRC was significantly superior after surgery compared to RT for cT3 primaries (100% vs 50%, p= 0.0022). No significant differences were observed in the remaining subgroups regarding cT stage and PFS or OS. Conclusion Our series demonstrated superior LRC after primary surgery followed by risk-adapted adjuvant (C)RT compared to primary CRT in cT3 LSCC, but no significant difference in PFS or OS in locally-advanced LSCC. The optimal patient selection criteria for the ideal treatment for loco-regionally advanced LSCC still needs to be defined.
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Affiliation(s)
- Mohamed Shelan
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lukas Anschuetz
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Adrian Schubert
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Beat Bojaxhiu
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel M. Aebersold
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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van den Bovenkamp K, van der Vegt B, Halmos GB, Slagter-Menkema L, Langendijk JA, van Dijk BAC, Schuuring E, van der Laan BFAM. The relation between hypoxia and proliferation biomarkers with radiosensitivity in locally advanced laryngeal cancer. Eur Arch Otorhinolaryngol 2023; 280:3801-3809. [PMID: 37029804 PMCID: PMC10313532 DOI: 10.1007/s00405-023-07951-9] [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] [Accepted: 03/28/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE Treatment decision-making in advanced-stage laryngeal squamous cell carcinoma (LSCC) is difficult due to the high recurrence rates and the desire to preserve laryngeal functions. New predictive markers for radiosensitivity are needed to facilitate treatment choices. In early stage glottic LSCC treated with primary radiotherapy, expression of hypoxia (HIF-1α and CA-IX) and proliferation (Ki-67) tumour markers showed prognostic value for local control. The objective of this study is to examine the prognostic value of tumour markers for hypoxia and proliferation on locoregional recurrent disease and disease-specific mortality in a well-defined cohort of patients with locally advanced LSCC treated with primary, curatively intended radiotherapy. METHODS In pre-treatment biopsy tissues from a homogeneous cohort of 61 patients with advanced stage (T3-T4, M0) LSCC primarily treated with radiotherapy, expression of HIF-1α, CA-IX and Ki-67 was evaluated with immunohistochemistry. Demographic data (age and sex) and clinical data (T- and N-status) were retrospectively collected from the medical records. Cox regression analysis was performed to assess the relation between marker expression, demographic and clinical data, and locoregional recurrence and disease-specific mortality. RESULTS Patients with high expression of HIF-1α developed significantly more often a locoregional recurrence (39%) compared to patients with a low expression (21%) (p = 0.002). The expression of CA-IX and Ki-67 showed no association with locoregional recurrent disease. HIF-1α, CA-IX and Ki-67 were not significantly related to disease-specific mortality. Clinical N-status was an independent predictor of recurrent disease (p < 0.001) and disease-specific mortality (p = 0.003). Age, sex and T-status were not related to locoregional recurrent disease or disease-specific mortality. CONCLUSION HIF-1α overexpression and the presence of regional lymph node metastases at diagnosis were independent predictors of locoregional recurrent disease after primary treatment with curatively intended radiotherapy in patients with locally advanced LSCC.
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Affiliation(s)
- Karlijn van den Bovenkamp
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bert van der Vegt
- Department of Pathology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9723 GZ Groningen, The Netherlands
| | - Gyorgy B. Halmos
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lorian Slagter-Menkema
- Department of Pathology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9723 GZ Groningen, The Netherlands
| | - Johannes A. Langendijk
- Department of Radiotherapy, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Boukje A. C. van Dijk
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Ed Schuuring
- Department of Pathology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9723 GZ Groningen, The Netherlands
| | - Bernard F. A. M. van der Laan
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Present Address: Department of Otorhinolaryngology/Head and Neck Surgery, Haaglanden Medical Center, The Hague, The Netherlands
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Selvaraj JL, Venkatesh L, Varadharajan V, Chandrasekar K, Srinivas S, John C. Development and Evaluation of the Psychometric Properties of the Tamil Version of Eating Assessment Tool - 10 (EAT-10): Preliminary Findings from Persons with Head and Neck Cancer. Indian J Otolaryngol Head Neck Surg 2023; 75:632-640. [PMID: 37275015 PMCID: PMC10234939 DOI: 10.1007/s12070-022-03376-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Aims: This study aimed to develop and evaluate the psychometric properties of the Tamil version of the Eating Assessment Tool (EAT-10). Setting & Study Design: Prospective cross-sectional study on persons with Head and Neck Cancer (HNC) during their follow-up for oncological and swallowing consultation at a tertiary care hospital and healthy individuals recruited from the community. Methods: The study was conducted in two phases: (1) translation and development of the Tamil version of EAT-10 and (2) administration of Tamil EAT-10 to assess internal consistency reliability, test-retest reliability and known-group validity. 92 participants with HNC in the clinical group and 149 healthy adults in the control group completed the Tamil EAT-10. In addition, a subgroup of 20 participants with HNC repeated the questionnaire within a week to assess test-retest reliability. Results: The Cronbach alpha for the 10 items was 0.96 indicating high internal consistency reliability. The test-retest reliability of the individual items and the total scores (r = 0.98) of the Tamil version of EAT-10 were high. The total EAT-10 scores for the HNC group (14.4 ± 11.5) were significantly higher (p < 0.001) than the scores for healthy adults (0.72 ± 2.0). Conclusion: The Tamil version of the EAT-10 developed in this study is a reliable and valid self-administered tool for identifying concerns related to swallowing among persons treated for HNC and healthy adults. This tool can be implemented for clinical practice and research in dysphagia among a Tamil-speaking population. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03376-8.
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Affiliation(s)
- Jasmine Lydia Selvaraj
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Lakshmi Venkatesh
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Vasudharany Varadharajan
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Kavyashree Chandrasekar
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Satish Srinivas
- Department of Radiation Oncology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, India
| | - Christopher John
- Department of Radiation Oncology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, India
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Miśkiewicz-Orczyk K, Ścierski W, Lisowska G, Majewski W, Golusiński P, Misiołek M. Salvage surgery in laryngeal cancer after radiotherapy and partial surgery - comparative results. J Cancer Res Ther 2023; 19:579-584. [PMID: 37470578 DOI: 10.4103/jcrt.jcrt_1548_21] [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] [Indexed: 07/21/2023]
Abstract
Objective The study is a retrospective comparison of the usefulness of salvage surgery between a group of previously radiotherapy-treated patients (RTPs) and a group of patients who previously underwent partial surgery with both local and ± nodal recurrence. Study Design Retrospective study. Setting Multi-center academic hospital. Materials and Methods The former group was comprised 30 previously RTPs, whereas the latter group consisted of 20 patients after partial laryngeal surgery with optional subsequent adjuvant radiotherapy (PSPs). Treatment efficacy was compared in both groups in relation to overall survival (OS) and the locoregional control rate (LCR). Local and ± nodal recurrence was considered primary treatment failure. All patients underwent total laryngectomy. Results The updated 5-year OS in the PSPs was 31%, while the percentage of the updated 5-year LCR was 42%. In the RTPs the updated 5-year OS was 21%, and the percentage of 5-year LCR was 38%. No statistically significant differences were found in terms of the comparison of OS or the comparison of LCR results in both groups (P = 0.427, P = 0.704, respectively). Conclusions Based on the analysis, it was found that irrespective of the initial treatment, salvage surgery was associated with decreased survival and cure rates (by 50%) compared to the group of patients with advanced laryngeal cancer who underwent primary total laryngectomy.
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Affiliation(s)
- Katarzyna Miśkiewicz-Orczyk
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
| | - Wojciech Ścierski
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
| | - Grażyna Lisowska
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
| | - Wojciech Majewski
- Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Góra, Zielona Góra, Poland
| | - Maciej Misiołek
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
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9
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Ebersole BM, McMillan H, Hutcheson K. Evaluation and Management of Speech and Swallowing Issues in RFS. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023. [DOI: 10.1007/s40141-023-00388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
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10
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McDermott JD, Amini A, Molina E, Stokes WA, Karam SD. Treatment outcomes and cost comparisons for older adults with T4 laryngeal squamous cell cancer. Head Neck 2023; 45:664-674. [PMID: 36563300 PMCID: PMC10626713 DOI: 10.1002/hed.27284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To evaluate treatment modalities of T4 larynx cancer in older adults using SEER-Medicare. METHODS The database was queried for patients aged 66 and older with nonmetastatic T4 laryngeal squamous cell cancer from 2006 to 2015. Treatment modalities compared were surgery plus chemoradiation (SCR), surgery plus radiation (SR), chemoradiation (CR), surgery (S), and radiation (R). Multivariate analysis and Kaplan-Meier methods were used to explore the relationship of treatment modality and survival. Total cancer-related costs were calculated. RESULTS A total of 438 patients met inclusion criteria. Patients receiving CR or SR had similar CSS to SCR (HR 1.36 and HR 1.24, respectively). Those receiving S (HR 2.00) or R (HR 2.41) had significantly worse CSS. Similar findings were observed for OS. Cancer care-related costs were not significantly different but highest in SCR ($162215) and lowest in R ($121421). CONCLUSION Older patients with T4 larynx cancer had similar survival rates when treated with CR, SR, and SCR. Average total health care costs were not significantly different between modalities. Patients not eligible for triple-modality could consider these other treatment options.
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Affiliation(s)
- Jessica D McDermott
- Department of Medical Oncology, University of Colorado Anschutz School of Medicine, Aurora, Colorado, USA
| | - Arya Amini
- Department of Radiation Oncology, City of Hope, Duarte, California, USA
| | - Elizabeth Molina
- Department of Health Systems, Management, and Policy, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - William A Stokes
- Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA
| | - Sana D Karam
- Department of Radiation Oncology, University of Colorado Anschutz School of Medicine, Aurora, Colorado, USA
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Effect of transoral laser microsurgery vs open partial laryngectomy on the prognosis of patients with early laryngeal carcinoma: propensity score-based analysis. Eur Arch Otorhinolaryngol 2023; 280:1301-1310. [PMID: 36239784 DOI: 10.1007/s00405-022-07671-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/20/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the effect of surgical procedures (transoral laser microsurgery (TLM) and open partial laryngectomy (OPL)) on the prognosis of patients with early laryngeal cancer. METHODS A total of 760 patients diagnosed with early laryngeal cancer (T1-2N0M0) and treated with TLM (n = 416) or OPL (n = 344) between 2004 and 2015 were abstracted from the SEER database. Propensity score matching (PSM) and stabilized inverse probability of treatment weighting (SIPTW) were performed to obtain comparable cohorts. The survival rates were estimated by the Kaplan-Meier method, and compared using the log-rank test. Univariate and multivariate Cox regression analyses with a false discovery rate (FDR) correction were applied to contrast the association between two surgical approaches and overall survival (OS) and disease-specific survival (DSS). RESULTS The 5-year OS for the TLM group was 79.5% versus 77.7% for the OPL group (P = 0.619). Similar results were revealed for the comparison of 5-year DSS rates (91.1% versus 91.5%, P = 0.891). After PSM and SIPTW balance the confounding factors, no significant difference was observed in the OS and DSS of patients treated with TLM compared to patients treated with OPL. The consistent results were still yielded (all P > 0.05), when stratified by gender, age, year of diagnosis, residence, household income, tumor site, T stage, differentiation, and adjuvant therapy. CONCLUSION This study provides strong evidence that there is no significant difference in the prognosis of early laryngeal carcinoma between the treatment of TLM and OPL, which may be helpful to guide the clinical decision-making of these patients.
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Lee DS, Lee JJ, Sinha P, Puram SV, Jackson RS, Adkins DR, Oppelt P, Brenneman R, Thorstad WL, Pipkorn P. Risk Factors for Functional Outcomes in Advanced Laryngeal Squamous Cell Carcinoma. Laryngoscope 2023; 133:594-600. [PMID: 35611799 PMCID: PMC9691786 DOI: 10.1002/lary.30166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/23/2022] [Accepted: 04/13/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Chemoradiation for patients with laryngeal squamous cell carcinoma (SCC) may achieve organ preservation, but appropriate patient selection remains unknown. This study investigates pre-treatment risk factors associated with functional and survival outcomes after radiation-based therapy in patients with advanced laryngeal SCC. METHODS A retrospective cohort study was performed on 75 adult patients with stage III or IV laryngeal SCC receiving definitive radiation-based therapy from 1997 to 2016 at a tertiary care center. Tracheostomy and gastrostomy dependence were the primary functional outcomes. Multivariable logistic regressions were performed to evaluate relationships between pre-treatment factors and tracheostomy and gastrostomy dependence. Time-to-event analyses were performed to determine risk factors associated with overall survival. RESULTS Among 75 patients included in the analysis, 30 (40%) patients were tracheostomy dependent and 31 (41%) were gastrostomy tube dependent. The median length of follow-up was 31 months (range = 1 to 142 months). Pre-treatment tracheostomy was a significant predictor of post-treatment tracheostomy (aOR = 13.9, 95% CI = 3.35 to 57.5) and moderate-severe comorbidity was a significant predictor of post-treatment gastrostomy dependence (aOR = 2.96, 95% CI = 1.04 to 8.43). The five-year overall survival was 51% (95% CI = 38 to 64%). Pre-treatment gastrostomy tube dependence was associated with an increased risk of death (aHR = 2.45, 95% CI = 1.09 to 5.53). CONCLUSIONS Baseline laryngeal functional status and overall health in advanced laryngeal SCC are associated with poor functional outcomes after radiation-based therapy, highlighting the importance of patient selection when deciding between surgical and non-surgical treatment plans. Laryngoscope, 133:594-600, 2023.
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Affiliation(s)
- David S. Lee
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jake J. Lee
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Parul Sinha
- Department of Otolaryngology – Head and Neck Surgery, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Sidharth V. Puram
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ryan S Jackson
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Douglas R. Adkins
- Department of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Peter Oppelt
- Department of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Randall Brenneman
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Wade L. Thorstad
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Patrik Pipkorn
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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13
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Yang D, Liu J, Liu N, Yin C, Zhang H, Xu J. The prognostic value of tumor mutational burden related 6-gene-based Risk Score in laryngeal cancer patients. BMC Oral Health 2022; 22:510. [DOI: 10.1186/s12903-022-02534-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
Laryngeal cancer (LC) is the second frequent malignant head and neck cancer around world, while LC patients’ prognosis is unsatisfactory. This study aims to investigate the prognostic value of tumor mutation burden (TMB)-related genes in LC.
Methods
LC data was downloaded from The Cancer Genome Atlas and Gene Expression Omnibus databases. TMB values of all samples were calculated basing on mutation data. The differentially expressed genes (DEGs) between LC samples with distinct TMB were subjected to univariate and LASSO Cox regression analysis to build Risk Score. Immune cell infiltration analysis was conducted in CIBERSORT.
Results
Between high and low TMB LC samples, we identified 210 DEGs. Of which, six optimal genes were included to construct Risk Score, comprising FOXJ1, EPO, FGF5, SPOCK1, KCNF1 and PSG5. High risk LC patients had significantly poorer overall survival than low risk patients. The nomogram model constructed basing on Risk Score and gender showed good performance in predicting LC patients’ survival probability.
Conclusions
The prognostic Risk Score model, basing on six TMB-related genes (FOXJ1, EPO, FGF5, SPOCK1, KCNF1 and PSG5), was a reliable prognostic model to separate LC patients with different prognoses.
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Batchelor CJJ, Flukes SP. Tracheostomy dependence following "organ preservation" (chemo)radiation protocol for laryngeal and hypopharyngeal cancers. Head Neck 2022; 44:2779-2785. [PMID: 36121012 DOI: 10.1002/hed.27195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/15/2022] [Accepted: 08/31/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Patients receiving primary (chemo)radiotherapy for laryngeal or hypopharyngeal cancer risk developing severe laryngeal dysfunction and becoming tracheostomy dependent, detracting from the benefits of organ preservation. We aim to describe the airway outcomes for this cohort and identify risk factors for developing tracheostomy dependence. METHODS Patients with laryngeal or hypopharyngeal cancer who were recommended for and underwent primary (chemo)radiotherapy over a 6-year period were identified from a tertiary hospital Head and Neck cancer database. Patient, tumor, and treatment details were collected and analyzed. RESULTS Of 166 patients, 18.7% (N = 31) required tracheostomy insertion. Advanced tumor classification was the only significant predictor (p < 0.00001). Successful decannulation was observed in 12.9% (N = 4). Decannulation was observably less successful with advanced tumors, bilateral vocal cord immobility, tracheostomies inserted under emergency conditions. CONCLUSION We quantified tracheostomy insertion rates and dependence in patients undergoing "organ-preserving" (chemo)radiotherapy, to assist in the pre-treatment counseling of patients opting for this approach.
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Affiliation(s)
| | - Stephanie Patricia Flukes
- Otolaryngology Head and Neck Surgery, Fiona Stanley Hospital, Perth, Australia.,Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
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15
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Bao Y, Zhong J, Shen L, Dai L, Zhou S, Fan J, Yao H, Lu Z. Effect of Glut-1 and HIF-1α double knockout by CRISPR/CAS9 on radiosensitivity in laryngeal carcinoma via the PI3K/Akt/mTOR pathway. J Cell Mol Med 2022; 26:2881-2894. [PMID: 35415942 PMCID: PMC9907005 DOI: 10.1111/jcmm.17303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 12/16/2022] Open
Abstract
Hypoxic resistance is the main obstacle to radiotherapy for laryngeal carcinoma. Our previous study indicated that hypoxia-inducible factor 1α (HIF-1α) and glucose transporter 1 (Glut-1) double knockout reduced tumour biological behaviour in laryngeal carcinoma cells. However, their radioresistance mechanism remains unclear. In this study, cell viability was determined by CCK8 assay. Glucose uptake capability was evaluated by measurement of 18 F-fluorodeoxyglucose radioactivity. A tumour xenograft model was established by subcutaneous injection of Tu212 cells. Tumour histopathology was determined by haematoxylin and eosin staining, immunohistochemical staining, and TUNEL assays. Signalling transduction was evaluated by Western blotting. We found that hypoxia induced radioresistance in Tu212 cells accompanied by increased glucose uptake capability and activation of the PI3K/Akt/mTOR pathway. Inhibition of PI3K/Akt/mTOR activity abolished hypoxia-induced radioresistance and glucose absorption. Mechanistic analysis revealed that hypoxia promoted higher expressions of HIF-1α and Glut-1. Moreover, the PI3K/Akt/mTOR pathway was a positive mediator of HIF-1α and/or Glut-1 in the presence of irradiation. HIF-1α and/or Glut-1 knockout significantly reduced cell viability, glucose uptake and PI3K/Akt/mTOR activity, all of which were induced by hypoxia in the presence of irradiation. In vivo analysis showed that knockout of HIF-1α and/or Glut-1 also inhibited tumour growth by promoting cell apoptosis, more robustly compared with the PI3K inhibitor wortmannin, particularly in tumours with knockout of both HIF-1α and Glut-1. HIF-1α and/or Glut-1 knockout also abrogated PI3K/Akt/mTOR signalling transduction in tumour tissues, in a manner similar to wortmannin. HIF-1α and/or Glut-1 knockout facilitated radiosensitivity in laryngeal carcinoma Tu212 cells by regulation of the PI3K/Akt/mTOR pathway.
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Affiliation(s)
- Yang‐Yang Bao
- Department of OtolaryngologyThe First Affiliated HospitalZhejiang University School of MedicineHangzhou CityChina
| | - Jiang‐Tao Zhong
- Department of OtolaryngologyThe First Affiliated HospitalZhejiang University School of MedicineHangzhou CityChina
| | - Li‐Fang Shen
- Department of OtolaryngologyThe First Affiliated HospitalZhejiang University School of MedicineHangzhou CityChina
| | - Li‐Bo Dai
- Department of OtolaryngologyThe First Affiliated HospitalZhejiang University School of MedicineHangzhou CityChina
| | - Shui‐Hong Zhou
- Department of OtolaryngologyThe First Affiliated HospitalZhejiang University School of MedicineHangzhou CityChina
| | - Jun Fan
- State Key Laboratory for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalZhejiang University School of MedicineHangzhou CityChina
| | - Hong‐Tian Yao
- Department of PathologyThe First Affiliated HospitalZhejiang University School of MedicineHangzhou CityChina
| | - Zhong‐Jie Lu
- Department of RadiotherapyThe First Affiliated HospitalZhejiang University School of MedicineHangzhou CityChina
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Layton T, Thomas R, Harris C, Holmes S, Fraser L, Silva P, Winter SC. Functional Outcomes Following Total Laryngectomy and Pharyngolaryngectomy: A 20-Year Single Center Study. Ann Otol Rhinol Laryngol 2022; 131:1301-1309. [PMID: 35081778 DOI: 10.1177/00034894211072987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Laryngeal cancer accounts for 1% of all cancers in men and 0.3% of all cancers in women. Pharyngolaryngectomy (TPL) and total laryngectomy (TL) are central surgical techniques in the management of advanced laryngeal malignancies but are associated with significant morbidity. In addition, optimal reconstruction following TPL remains an area of active research. METHODS Here, we compared speech and swallowing outcomes following circumferential and partial pharyngeal resection alongside total laryngectomy in patients with laryngeal and hypolaryngeal tumors. We performed a systemic analysis of patient demographics, tumor characteristics, treatment modality, and pharyngeal reconstruction technique following TPL and TL, leveraging data collected over a 20-year period at a large tertiary referral center. RESULTS Analyzing 155 patients the results show circumferential pharyngeal defects and prior radiotherapy have a significant impact on surgical complications. CONCLUSION Pharyngeal resection carries a substantial risk of incurring impaired speech and swallowing in patients. Moreover, our results support poorer functional outcomes with more radical pharyngeal resections and show a clear trend toward worse swallowing outcomes in salvage surgery.
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Affiliation(s)
- Thomas Layton
- The Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Rachel Thomas
- Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Carol Harris
- Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sam Holmes
- Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Lisa Fraser
- Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Priy Silva
- Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Stuart C Winter
- Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Kennedy MM, Abdel-Aty Y, Lott DG. Comparing tracheostomy techniques: Bjork flap vs. tracheal window. Am J Otolaryngol 2021; 42:103030. [PMID: 33894562 DOI: 10.1016/j.amjoto.2021.103030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/04/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Various operative techniques are used to perform tracheostomies. The objective of this study was to evaluate patient factors that influence the decision to perform a Bjork flap or a window. METHODS A retrospective review was conducted of all patients who underwent tracheostomies from January 2015 to December 2019 at a tertiary care medical center. All patients underwent tracheostomy with either a Bjork flap or a window. Charts were reviewed for demographics, comorbidities, indication for tracheostomy, operative details, and complications. RESULTS A total of 217 tracheostomies were evaluated, of which 104 (47.9%) had a Bjork flap and 113 (52.1%) had a window. Bjork flap was significantly more likely to be performed in patients with a higher average body mass index (p = 0.05), requiring ventilatory support (p = 0.0001), or had a stroke (p = 0.0140). A window was used significantly more in patients with prior neck dissection (p = 0.0110) or neck radiation (p < 0.0001). No significant difference was observed for post-op bleeding, returning to the operating room, or days to decannulation. In all tracheostomies, thrombocytopenia was found to significantly correlate with post-op bleeding (p = 0.0006), while blood thinner use did not. CONCLUSION Bjork flaps were more likely to be performed in those with a history of prolonged mechanical ventilation and elevated body mass index. Windows were performed more frequently in patients with a head and neck cancer history. Future prospective studies are needed to compare the outcomes of these techniques and their impacts on the trachea long term.
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18
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Han L, Zheng C, Wu S. Long non-coding RNA NEAT1 promotes the malignancy of laryngeal squamous cell carcinoma by regulating the microRNA-204-5p/SEMA4B axis. Oncol Lett 2021; 22:802. [PMID: 34630709 PMCID: PMC8477075 DOI: 10.3892/ol.2021.13063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 06/11/2021] [Indexed: 12/18/2022] Open
Abstract
Laryngeal squamous cell carcinoma (LSCC) is a highly invasive malignant tumor in the head and neck area. As an oncogene, long non-coding RNA (lncRNA) nuclear enriched abundant transcript 1 (NEAT1) promotes cell proliferation, migration and invasion several types of cancer. The present study aimed to reveal the effects of NEAT1 on the progression of LSCC. Reverse transcription-quantitative PCR (RT-qPCR) was used to detect relative mRNA expression levels of NEAT1, microRNA (miR)-204-5p and semaphorin (SEMA) 4B. Kaplan-Meier analysis was used to analyze overall survival times. RNA in-situ hybridization (ISH) exhibited the distribution of NEAT1 and miR-204-5p in tissues. RNA fluorescence ISH was used to analyze the distribution of NEAT1 and miR-204-5p in the cells. Western blot analysis was used to detect the expression level of target proteins. Cell viability was analyzed using a MTT assay, while flow cytometry was used to determine cell apoptosis. Wound healing and Transwell invasion assays were used to value cell migration and invasion, respectively. RNA immunoprecipitation assay, bioinformatics prediction and a dual luciferase reporter assay were used to analyze the target relationship. The RT-qPCR results showed that NEAT1 was highly expressed and miR-204-5p had decreased expression in LSCC tissues and cells compared with that in the normal tissue and the 16HBE-14o cell line, respectively. Knockdown of NEAT1 using small interfering (si) RNA and overexpressed miR-204-5p both effectively inhibited the proliferation, migration and invasion of LSCC cells. Besides, further experiments revealed that miR-204-5p was a target of NEAT1. At the same time, silenced miR-204-5p reversed the anti-tumor effects of si-NEAT1. In addition, SEMA4B was targeted by miR-204-5p in LSCC cells and upregulated SEMA4B weakened the antitumor effects of miR-204-5p in LSCC cells. NEAT1 regulated the expression of SEMA4B by targeting miR-204-5p in LSCC cells. Overall, NEAT1 promoted the proliferation and invasion of LSCC cells by regulating the miR-204-5p/SEMA4B axis.
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Affiliation(s)
- Ling Han
- Department of Otorhinolaryngology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518020, P.R. China
| | - Chaopan Zheng
- Department of Otorhinolaryngology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518020, P.R. China
| | - Shihai Wu
- Department of Radiation Oncology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518020, P.R. China
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Wu Y, Dai F, Zhang Y, Zheng X, Li L, Zhang Y, Cao J, Gao W. miR-1207-5p suppresses laryngeal squamous cell carcinoma progression by downregulating SKA3 and inhibiting epithelial-mesenchymal transition. MOLECULAR THERAPY-ONCOLYTICS 2021; 22:152-165. [PMID: 34514096 PMCID: PMC8416975 DOI: 10.1016/j.omto.2021.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/12/2021] [Indexed: 12/12/2022]
Abstract
Laryngeal squamous cell carcinoma (LSCC) is the second most common head and neck cancer. Previously, we discovered that miR-1207-5p was downregulated in LSCC. In this study, the clinical significance, function, and mechanism of miR-1207-5p in LSCC were investigated. Downregulation of miR-1207-5p was found to be strongly linked to the malignant progression of LSCC. Functional studies revealed that miR-1207-5p upregulation suppressed LSCC cell proliferation, invasion, migration, and xenograft tumor growth. Bioinformatics analysis revealed that miR-1207-5p target genes were involved in cell cycle regulation, proliferation, adhesion, and the phosphatidylinositol 3-kinase (PI3K)/Akt pathway. Mechanistic studies revealed that miR-1207-5p interacts directly with the 3′ untranslated region of spindle and kinetochore associated complex subunit 3 (SKA3) and downregulates SKA3 expression. Furthermore, SKA3 was found to be overexpressed in LSCC, and its high expression was associated with tumor progression and a poor prognosis. Rescue experiments demonstrated that miR-1207-5p inhibited the malignant phenotypes of LSCC via SKA3. Furthermore, miR-1207-5p upregulation or knockdown of SKA3 inhibited the epithelial-mesenchymal transition (EMT). Collectively, miR-1207-5p inhibited LSCC malignant progression by downregulating SKA3 and preventing EMT. These findings provide new insights into the mechanism of LSCC progression, as well as new potential biomarkers and therapeutic targets for LSCC diagnosis and treatment.
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Affiliation(s)
- Yongyan Wu
- General Hospital, Clinical Medical Academy, Shenzhen University, Shenzhen 518055, Guangdong, China.,Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Shanxi Province Clinical Medical Research Center for Precision Medicine of Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.,Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan 030001, Shanxi, China.,Department of Biochemistry & Molecular Biology, Shanxi Medical University, Taiyuan 030001, Shanxi, China
| | - Fengsheng Dai
- Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Shanxi Province Clinical Medical Research Center for Precision Medicine of Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
| | - Yuliang Zhang
- Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Shanxi Province Clinical Medical Research Center for Precision Medicine of Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
| | - Xiwang Zheng
- General Hospital, Clinical Medical Academy, Shenzhen University, Shenzhen 518055, Guangdong, China.,Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Shanxi Province Clinical Medical Research Center for Precision Medicine of Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
| | - Li Li
- Department of Cell biology and Genetics, Basic Medical School of Shanxi Medical University, Taiyuan 030001, Shanxi, China
| | - Yu Zhang
- Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan 030001, Shanxi, China
| | - Jimin Cao
- Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan 030001, Shanxi, China
| | - Wei Gao
- General Hospital, Clinical Medical Academy, Shenzhen University, Shenzhen 518055, Guangdong, China.,Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Shanxi Province Clinical Medical Research Center for Precision Medicine of Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.,Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan 030001, Shanxi, China.,Department of Cell biology and Genetics, Basic Medical School of Shanxi Medical University, Taiyuan 030001, Shanxi, China
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20
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Voora RS, Panuganti B, Flagg M, Kumar A, Qian AS, Kotha NV, Qiao EM, Weissbrod PA, Rose B, Orosco RK. Salvage Following Transoral Laser Microsurgery for Early Glottic Cancer in National Veteran Database. Laryngoscope 2021; 131:2766-2772. [PMID: 34296772 DOI: 10.1002/lary.29740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/07/2021] [Accepted: 06/28/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Transoral laser microsurgery (TLM) is commonly utilized for early glottic cancer and offers favorable oncologic and functional outcomes. However, the survival implications of salvage therapy for recurrent or persistent disease have not been definitively characterized. STUDY DESIGN Retrospective, national database cohort study. METHODS Data were extracted from Veterans Health Affairs (VHA) Informatics and Computing Infrastructure (VINCI) concerning the TLM-based management of T1-T2 glottic squamous cell carcinoma patients between 2000 and 2017. Patients were characterized as either requiring TLM-only, or in cases of persistent or recurrent local disease, TLM plus change in treatment modality (radiotherapy, chemoradiotherapy, or open surgery). Predictors of overall survival (OS), cancer-specific survival (CSS), and salvage-free survival were evaluated via Cox and Fine-Gray models. RESULTS About 553 patients (70.9% T1a, 13.4% T1b, 15.7% T2) were included, with a median follow-up time of 74.5 months. The need for non-TLM salvage increased along with more advanced disease (11.7% T1a, 29.7% T1b, 32.2% T2). Compared to patients with T1a disease, those with T1b and T2 tumors initially treated with TLM had a significantly higher probability of receiving non-TLM salvage (T1b: HR 2.70, 95% CI: 1.61-4.54; T2: HR 3.02, 95% CI: 1.88-4.84). In a multivariable model, receipt of non-TLM salvage was not a significant predictor of either OS (HR = 0.91, 95% CI: 0.62-1.33, P = .624) or CSS (HR 1.21 95% CI 0.51-2.86, P = .667). CONCLUSION The majority of patients with early glottic cancer that are managed with TLM do not require additional salvage therapy. When non-TLM salvage was required, there was no decrement in OS or CSS. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
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Affiliation(s)
- Rohith S Voora
- University of California, San Diego School of Medicine, La Jolla, California, U.S.A.,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A.,Veterans Affairs San Diego Healthcare System, San Diego, California, U.S.A
| | - Bharat Panuganti
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A.,Moores Cancer Center, La Jolla, California, U.S.A
| | - Mitchell Flagg
- University of California, San Diego School of Medicine, La Jolla, California, U.S.A.,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Abhishek Kumar
- Veterans Affairs San Diego Healthcare System, San Diego, California, U.S.A.,Department of Radiation Medicine and Applied Sciences, University of California San Diego School of Medicine, La Jolla, California, U.S.A
| | - Alexander S Qian
- University of California, San Diego School of Medicine, La Jolla, California, U.S.A.,Department of Radiation Medicine and Applied Sciences, University of California San Diego School of Medicine, La Jolla, California, U.S.A
| | - Nikhil V Kotha
- University of California, San Diego School of Medicine, La Jolla, California, U.S.A.,Veterans Affairs San Diego Healthcare System, San Diego, California, U.S.A.,Department of Radiation Medicine and Applied Sciences, University of California San Diego School of Medicine, La Jolla, California, U.S.A
| | - Edmund M Qiao
- University of California, San Diego School of Medicine, La Jolla, California, U.S.A.,Veterans Affairs San Diego Healthcare System, San Diego, California, U.S.A.,Department of Radiation Medicine and Applied Sciences, University of California San Diego School of Medicine, La Jolla, California, U.S.A
| | - Philip A Weissbrod
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A.,Moores Cancer Center, La Jolla, California, U.S.A
| | - Brent Rose
- Veterans Affairs San Diego Healthcare System, San Diego, California, U.S.A.,Moores Cancer Center, La Jolla, California, U.S.A.,Department of Radiation Medicine and Applied Sciences, University of California San Diego School of Medicine, La Jolla, California, U.S.A
| | - Ryan K Orosco
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A.,Veterans Affairs San Diego Healthcare System, San Diego, California, U.S.A.,Moores Cancer Center, La Jolla, California, U.S.A
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Shanmuganathan J, Palanisamy V, Wei NS, Prahaspathiji UJ, Bin Hj Ahmad HAR, Mahat M. A Case Report on Challenging Management of Multiple Neoplasms in Elderly. JOURNAL OF AGING RESEARCH AND HEALTHCARE 2020; 3:15-21. [DOI: 10.14302/issn.2474-7785.jarh-20-3628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Multiple primary malignancies especially in the head and neck region is no longer a rare occurrence and the prevalence is increasing. They were described as synchronous when the malignancies present within 6 months of another or metachronous tumors if the subsequent malignancy presents 6 months later. Many etiologies had been hypothesised including similar carcinogens exposure, genetic susceptibility and mutation, immunodeficiency or treatment of the index tumor. Among the hypotheses, the most accepted theory was field cancerisation in which the occurrence of multiple primaries in the aerodigestive tract was due to persistent exposure of similar carcinogens through inhalation or oral intake . However the co-incidence of thyroid and aerodigestive malignancies is relatively low. Hereby we would like to report a case of a 74 years old lady with known esophageal squamous cell carcinoma presented with metachronous laryngeal squamous cell carcinoma and papillary micro carcinoma of thyroid.
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Affiliation(s)
- Jothi Shanmuganathan
- Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, Malaysia
| | - Vanitha Palanisamy
- Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, Malaysia
| | - Ng Syiao Wei
- Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, Malaysia
| | | | | | - Mahfida Mahat
- Hospital Melaka, Jalan Mufti Haji Khalil 75400 Melaka, Malaysia
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22
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Zhao Z, Xing Y, Liu Y, Jing S. Lung cancer‑associated transcript 1 facilitates tumorigenesis in laryngeal squamous cell carcinoma through the targeted inhibition of miR‑493. Mol Med Rep 2020; 23:59. [PMID: 33215214 PMCID: PMC7705996 DOI: 10.3892/mmr.2020.11697] [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: 04/15/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) serve important roles in the tumorigenesis of a diverse range of cancer types. The lung cancer-associated transcript 1 (LUCAT1), has been reported to promote the proliferation, migration and invasion of oral squamous cell carcinoma cells. However, the exact role of LUCAT1 in laryngeal squamous cell carcinoma (LSCC) remains to fully understood. The present study aimed to interrogate the role and modulatory mechanism of LUCAT1 in LSCC. Reverse transcription-quantitative PCR and western blotting were used to investigate the expression of LUCAT1 and miR-493, as well as the protein expression of cyclin-dependent kinase 2, cyclin E1, p21, matrix metalloproteinase (MMP)2, MMP9, vascular endothelial growth factor-C, Bcl-2, Bax, cleaved caspase-3 and procaspase-3. Cell Counting Kit-8, flow cytometry, wound healing and Transwell assays were performed to analyze the proliferation, cell cycle, apoptosis levels, and the migratory and invasive abilities, respectively, of the LSCC AMC-HN-8 cell line. In addition, dual-luciferase reporter and ribonucleoprotein immunoprecipitation assays were used to investigate the binding between LUCAT1 and microRNA (miR)-493. The results of the present study revealed that the expression levels of LUCAT1 were upregulated in AMC-HN-8 cells. The genetic knockdown of LUCAT1 expression levels significantly suppressed the cell proliferation, alongside downregulating the expression levels of CDK2 and cyclin E1 and upregulating p21 expression levels. In addition, the knockdown of LUCAT1 inhibited cell migration and invasion, as demonstrated using the wound healing and Transwell assays, respectively. Moreover, LUCAT1 knockdown promoted cell apoptosis and upregulated the expression levels of Bax and cleaved caspase-3, whilst downregulating the expression levels of Bcl-2. Furthermore, LUCAT1 was discovered to directly bind to and inhibit the well-known tumor suppressor, miR-493. Notably, the specific inhibition of miR-493 partly blocked the anticancer effects of LUCAT1 knockdown in AMC-HN-8 cells. In conclusion, these results suggested that LUCAT1 may facilitate tumorigenesis in LSCC through the targeted inhibition of miR-493, which provides evidence for a novel target for the treatment of LSCC.
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Affiliation(s)
- Zhen Zhao
- Department of Otorhinolaryngology‑Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Yan Xing
- The Third Department of Rehabilitation, Shijiazhuang No. 1 Hospital, Shijiazhuang, Hebei 050000, P.R. China
| | - Yan Liu
- Department of Otorhinolaryngology‑Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Shanghua Jing
- Department of Otorhinolaryngology‑Head and Neck Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
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23
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Visini M, Giger R, Shelan M, Elicin O, Anschuetz L. Predicting Factors for Oncological and Functional Outcome in Hypopharyngeal Cancer. Laryngoscope 2020; 131:E1543-E1549. [PMID: 33098325 DOI: 10.1002/lary.29186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/31/2020] [Accepted: 10/05/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Hypopharyngeal squamous cell carcinoma (SCC) is a rare but aggressive malignancy, with low survival rates and high incidence of tumor and treatment-related morbidity. This study aims to analyze the long-term oncologic and functional outcomes of a large cohort of patients and to determine prognostic factors. STUDY DESIGN Retrospective cohort study. METHODS The records of all patients diagnosed with hypopharyngeal SCC and treated with curative intent at our tertiary referral center were reviewed. Patient and initial disease characteristics, features, and complications of primary treatment, recurrence patterns, and corresponding treatments and the oncologic and functional long-term outcome were determined. RESULTS For a total of 179 patients, primary radiotherapy (RT) was the predominant treatment modality (78%), whereas 22% underwent primary surgery. The median, 2-year, and 5-year overall survival (OS) for the study cohort were 47 months, 64% and 43%. The median survival after first and second relapse was 7 and 6 months, respectively. The 2 and 5-year relapse-free survival (RFS) was 52% and 36%. The median RFS after first relapse and salvage treatment was 9 months. A nodal status of ≥cN2 (HR = 1.89, CI:1.21-3.05, P < .005) and any other primary tumor localization than pyriform sinus (HR = 1.60, CI: 1.04-2.42, P < .05) were identified as independent risk factors for shorter OS and RFS. Regarding functional outcome, the 2- and 5-year laryngectomy-free-survival was 55% and 37%, respectively. CONCLUSIONS In this large cohort with long-term follow-up, any other primary tumor localization than pyriform sinus and a nodal status of ≥cN2 were identified as risk factors for reduced OS and RFS. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1543-E1549, 2021.
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Affiliation(s)
- Miranda Visini
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Mohamed Shelan
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Lukas Anschuetz
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
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24
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Suzuki G, Yamazaki H, Aibe N, Masui K, Shimizu D, Kimoto T, Nishimura T, Kawabata K, Nagasawa S, Machida K, Yoshino Y, Watanabe S, Sugiyama Y, Arai A, Hirano S, Yamada K. Comparison of Three Fractionation Schedules in Radiotherapy for Early Glottic Squamous Cell Carcinoma. In Vivo 2020; 34:2769-2774. [PMID: 32871813 PMCID: PMC7652429 DOI: 10.21873/invivo.12101] [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: 05/29/2020] [Revised: 06/20/2020] [Accepted: 06/24/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Radiotherapy is widely accepted as the treatment of choice for early glottic squamous cell carcinoma (EGSCC), although it varies greatly with respect to dose, dose per fraction, and treatment techniques. The study aim was to evaluate the use of accelerated fractionation strategy (AFS) for EGSCC in standard clinical practice. PATIENTS AND METHODS Patients treated with definitive radiotherapy for EGSCC between 2008 and 2019 were retrospectively identified and received either conventional fractionation, hypofractionation, or hyperfractionation. RESULTS One hundred six patients were analyzed, and 19, 71, and 16 patients underwent conventional fractionation, hypofractionation, and hyperfractionation, respectively. The median follow-up was 56 months. The 5-year local control and overall survival rates were 79% and 83%; 78% and 79%; and 87% and 77%, respectively, and no significant difference was observed between the fractionation schedules. CONCLUSION Our findings confirmed the utility of AFS in standard clinical practice and support its use for patients with EGSCC.
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Affiliation(s)
- Gen Suzuki
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Hideya Yamazaki
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Norihiro Aibe
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Koji Masui
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Daisuke Shimizu
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Takuya Kimoto
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Takeshi Nishimura
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Kanako Kawabata
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Shinsuke Nagasawa
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Kazutaka Machida
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Yuki Yoshino
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Sho Watanabe
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Yoichiro Sugiyama
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Akihito Arai
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Shigeru Hirano
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan
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25
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Silverman DA, Zhan KY, Puram SV, Eskander A, Teknos TN, Rocco JW, Old MO, Kang SY. Predictors of Postoperative Radiation Following Laser Resection in Early-Stage Glottic Cancer. Otolaryngol Head Neck Surg 2020; 163:1218-1225. [PMID: 32631147 DOI: 10.1177/0194599820933183] [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] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Guideline recommendations for the treatment of early-stage glottic cancer are limited to single-modality therapy with surgery or radiation alone. We sought to investigate the clinicopathologic and treatment factors associated with the use of postoperative radiation therapy (PORT) following laser excision for patients with T1-T2N0 glottic squamous cell carcinoma (SCC). STUDY DESIGN Retrospective observational study of the National Cancer Database. SETTING National Cancer Database review from 2004 to 2014. PATIENTS AND METHODS A total of 1338 patients with primary cT1-T2N0M0 glottic SCC undergoing primary laser excision were included. Hospitals were divided into quartiles based on yearly volume of laryngeal laser cases performed. Multivariate logistic regression was performed to identify independent predictors of PORT. RESULTS The overall rate of PORT was 30.0%. Predictors of PORT included treatment at lower-volume hospitals (adjusted odds ratio [aOR] for quartiles 2-4, 1.32-4.84), positive margins (aOR, 3.83 [95% CI, 2.54-5.78]), and T2 tumors (aOR, 3.58 [95% CI, 2.24-5.74]). PORT utilization demonstrated a strong inverse correlation with hospital volume. Among top-quartile hospitals, the rate of PORT was 11.2%, while rates of PORT at second-, third-, and fourth-quartile institutions were 19.2%, 32.2%, and 37.4%, respectively. CONCLUSIONS Predictors of PORT in multivariable analysis included treatment at lower-volume facilities, positive margins, and T2 disease. This study highlights the importance of treating early-stage glottic carcinoma at high-volume institutions. In addition, there is a need to reevaluate the use of PORT and reduce the rate of dual-modality therapy for patients with early-stage glottic SCC.
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Affiliation(s)
- Dustin A Silverman
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Kevin Y Zhan
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Sidharth V Puram
- Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, Siteman Cancer Center, Saint Louis, Missouri, USA
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Theodoros N Teknos
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - James W Rocco
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Matthew O Old
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Stephen Y Kang
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
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26
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Bozec A, Culié D, Poissonnet G, Dassonville O. Current Role of Total Laryngectomy in the Era of Organ Preservation. Cancers (Basel) 2020; 12:cancers12030584. [PMID: 32138168 PMCID: PMC7139381 DOI: 10.3390/cancers12030584] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 01/02/2023] Open
Abstract
In this article, we aimed to discuss the role of total laryngectomy (TL) in the management of patients with larynx cancer (LC) in the era of organ preservation. Before the 1990s, TL followed by radiotherapy (RT) was the standard treatment for patients with locally advanced LC. Over the last 30 years, various types of larynx preservation (LP) programs associating induction or concurrent chemotherapy (CT) with RT have been developed, with the aim of treating locally advanced LC patients while preserving the larynx and its functions. Overall, more than two-thirds of patients included in a LP program will not require total laryngectomy (TL) and will preserve a functional larynx. However, despite these advances, the larynx is the only tumor site in the upper aero-digestive tract for which prognosis has not improved during recent decades. Indeed, none of these LP protocols have shown any survival advantage compared to primary radical surgery, and it appears that certain LC patients do not benefit from an LP program. This is the case for patients with T4a LC (extra-laryngeal tumor extension through the thyroid cartilage) or with poor pretreatment laryngeal function and for whom primary TL is still the preferred therapeutic option. Moreover, TL is the standard salvage therapy for patients with recurrent tumor after an LP protocol.
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Affiliation(s)
- Alexandre Bozec
- Correspondence: ; Tel.: +0033-4-92-03-17-66; Fax: +0033-4-92-03-17-64
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