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Kumar M, Sekhon P, Singh R. Rare Glottic Pleomorphic Rhabdomyosarcoma: A Case Report with Review of Literature. Indian J Otolaryngol Head Neck Surg 2024; 76:3652-3655. [PMID: 39130312 PMCID: PMC11306833 DOI: 10.1007/s12070-024-04665-0] [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: 12/23/2023] [Accepted: 03/22/2024] [Indexed: 08/13/2024] Open
Abstract
Rhabdomyosarcoma (RMS) is commonly reported in children and very rarely in adults. Laryngeal RMS is a rare but extremely aggressive malignancy with a high mortality rate. Surgery followed by postoperative radiotherapy is the preferred treatment. The use of chemotherapy is debatable. This report highlights a case of rare pleomorphic rhabdomyosarcoma of glottis in a 67-year-old male who presented with hoarseness and a description of its management.
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Affiliation(s)
- Manoj Kumar
- Department of ENT, Command Hospital (SC), Pune, India
| | - Pahaul Sekhon
- Department of ENT, Armed Forces Medical College, Pune, India
| | - Rohit Singh
- Department of ENT, Command Hospital (SC), Pune, India
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2
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Lin M, Ashraf NS, Mahjabeen I. Deregulation of MMP-2 and MMP-9 in laryngeal cancer: A retrospective observational study. Medicine (Baltimore) 2024; 103:e38362. [PMID: 38968481 PMCID: PMC11224865 DOI: 10.1097/md.0000000000038362] [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: 10/12/2023] [Accepted: 05/03/2024] [Indexed: 07/07/2024] Open
Abstract
Laryngeal carcinoma (LC) is reported to have a higher incidence rate among all types of head and neck cancers around the globe. Mechanisms resulting in the pathogenesis of LC are complicated due to involvement of invasion and metastasis and there is a need to understand this complicated multistep process. Numerous molecules including matrix metalloproteinases (MMPs) are involved in regulating metastatic mechanisms. Furthermore, activation and expression of different classes of MMPs have been observed in multiple pathological and physiological events including inflammation, invasion, and metastasis. Among all members of MMPs, matrix metalloproteinases-2 (MMP-2), and matrix metalloproteinases-9 (MMP-9) have been frequently reported to correlate with tumor pathogenesis. The present study is designed to check the involvement of MMP-2 and MMP-9 in LC pathogenesis. 184 laryngeal tumor samples along with adjacent uninvolved healthy sections were collected to check the expression deregulation of the above-mentioned gene in LC using real-time PCR and immunohistochemistry (IHC). Real-time PCR and IHC analyses showed the significant upregulation of MMP-2 (P < .0001) and MMP-9 (P < .0001) genes in laryngeal tumors compared to controls. Spearman correlation showed the positive correlation of expression deregulation of selected MMPs with advanced TNM stage [MMP-2, (P < .0001); MMP-9, P < .0001] and smoking status [MMP-2 (P < .0001); MMP-9 P < .0001] in laryngeal pathogenesis. Receiver operating curve (ROC) analysis showed the good diagnostic/prognostic value of said markers in laryngeal cancer patients. The present study showed that significant upregulation of selected MMPs was found associated with an increased risk of laryngeal cancer and can act as good diagnostic markers for the detection of said disease.
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Affiliation(s)
- Mingxia Lin
- Department of Otolaryngology, Pingyang Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Nida Sarosh Ashraf
- Cancer Genetics and Epigenetics Research Group, Department of Biosciences, COMSATS University Islamabad, Pakistan
| | - Ishrat Mahjabeen
- Cancer Genetics and Epigenetics Research Group, Department of Biosciences, COMSATS University Islamabad, Pakistan
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3
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Alabdullah M, Shaker K, Alomar K, Sardini Z, Hamdan A, Yousef O. Management of pharyngocutaneous fistula following laryngectomy with autologous fat graft: A case report and literature review. Int J Surg Case Rep 2024; 120:109781. [PMID: 38795412 PMCID: PMC11143885 DOI: 10.1016/j.ijscr.2024.109781] [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: 04/06/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 05/28/2024] Open
Abstract
INTRODUCTION AND SIGNIFICANCE Pharyngocutaneous fistula (PCF) is a serious complication following total laryngectomy, significantly impacting patients' quality of life and treatment costs. Management is complex, with potential for recurrence after surgical intervention. CASE PRESENTATION We present a case of PCF that developed following laryngectomy. Initial conservative treatment failed to resolve the fistula. A pectoralis major myofascial flap was then attempted, but the fistula recurred. Finally, autologous fat grafting was performed with excellent results. CLINICAL DISCUSSION Conservative management should be the first-line approach for PCF, as most cases respond favorably. However, if the fistula persists, alternative methods should be explored to achieve optimal outcomes. Our case highlights the importance of not persisting with a failed approach. Autologous fat grafting offers a promising alternative with demonstrably positive outcomes. CONCLUSION Pharyngocutaneous fistula presents a significant challenge in post-laryngectomy care. Surgical repair can be complex with potential complications. Our case demonstrates the effectiveness of autologous fat grafting as a successful treatment modality.
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Affiliation(s)
| | - Kamar Shaker
- Damascus University, University Pediatric Hospital, Syria.
| | - Khaled Alomar
- Damascus University, University Pediatric Hospital, Syria.
| | - Zakaria Sardini
- Otolaryngology Department, Damascus Hospital, Damascus, Syria
| | - Ahmad Hamdan
- Otolaryngology Department, Damascus Hospital, Damascus, Syria
| | - Osama Yousef
- Otolaryngology Department, Damascus Hospital, Damascus, Syria
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Kumar V, Kalwani R, Bindu A, Mathews S, Mantri M, Jaiswal D, Shankhdhar VK. Comparison of Functional Outcomes of Intestinal Flaps Vs Tubed Fasciocutaneous Flaps for Circumferential Pharyngoesophageal Defects-an Indian Perspective. Indian J Surg Oncol 2023; 14:668-676. [PMID: 37900626 PMCID: PMC10611640 DOI: 10.1007/s13193-023-01723-x] [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: 11/01/2022] [Accepted: 02/13/2023] [Indexed: 10/31/2023] Open
Abstract
Pharyngolaryngoesophageal (PLO) reconstruction is a complex and technically demanding procedure. The reconstructive surgeon's concerns include avoiding fistula and stricture formation, as well as restoring normal speech and swallowing. A retrospective observational study with circumferential pharyngo-laryngo-oesophagal defects with aims and objectives of evaluation and comparison of the long-term functional outcomes like speech and swallowing along with the complications of fistula and stricture in two groups of JFF and FC flaps from the data is collected from electronic medical records of Tata Memorial Hospital, Mumbai, from January 2011 to May 2020. A total of 67 patients (52 JFF and 15 fasciocutaneous flaps) were operated on in last 9 years in our institute. The difference in fistula rates and stricture rates between the two groups was not significant (p= 0.98 and 0.947). The difference in 100% oral diet between the two groups was significant (p= 0.019). The difference in speech rehabilitation between the two groups was significant (p= 0.024). The intestinal tubes and fasciocutaneous tubes have comparable outcomes with regard to fistula and stricture formation. Speech outcomes in the form of the ability to have functional speech and voice quality were significantly better with skin-lined tubes. Swallowing outcomes were much better with intestinal tubes, along with early oral alimentation.
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Affiliation(s)
- Vineet Kumar
- Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Dr. E Borges Road, Parel, Mumbai, 400 012 India
| | - Rounak Kalwani
- Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Dr. E Borges Road, Parel, Mumbai, 400 012 India
| | - Ameya Bindu
- Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Dr. E Borges Road, Parel, Mumbai, 400 012 India
| | - Saumya Mathews
- Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Dr. E Borges Road, Parel, Mumbai, 400 012 India
| | - Mayur Mantri
- Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Dr. E Borges Road, Parel, Mumbai, 400 012 India
| | - Dushyant Jaiswal
- Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Dr. E Borges Road, Parel, Mumbai, 400 012 India
| | - Vinay Kant Shankhdhar
- Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Dr. E Borges Road, Parel, Mumbai, 400 012 India
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Gheorghe EA, Pleşea IE, Welt LS, Hâlcu G, Foarfă MC, Ioniţă I, Mogoantă CA, Ioniţă E. Influence of tumor topography on clinical-morphological profile of laryngeal malignancies. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:319-332. [PMID: 37867350 PMCID: PMC10720937 DOI: 10.47162/rjme.64.3.04] [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: 08/28/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
AIM Laryngeal cancers are redoubtable because they are still diagnosed in advanced stages which results in poor survival and the decline of life quality. The authors intend to identify if the tumor topography influences clinical behavior, the morphological profile and therapeutic strategy. PATIENTS, MATERIALS AND METHODS The study group included 188 patients with laryngeal malignancies diagnosed and treated in an Ear, Nose and Throat (ENT) Department. The patients have been divided into four groups according to the tumor topography and extension. Three categories of parameters were defined (epidemiological, clinical, and morphological) and analyzed comparatively between the four groups using filter scales and the χ² (chi-squared) correlation test. RESULTS Epidemiological parameters (sex, age, socio-economic status) showed no significant differences between the four groups. Clinical parameters (symptoms, lymphadenopathies, surgical procedures, and hospitalization) instead registered significant differences between the four groups. Morphological parameters (longitudinal diameter, transverse diameter, shape, gross aspect, histopathological aspect, grade, local invasion - pT, lymph node invasion - pN, metastases - pM and tumor stage), excepting shape, registered too significant differences between the four groups. The analysis of the whole set of parameters in each group revealed different, distinct profiles for each of the topographic groups, especially for glottic and large tumors. Our results concerning the entire series of tumors ranged in the limits of variation of each of the parameters observed in the literature. CONCLUSIONS Our study revealed that tumors placed in different regions of the larynx have distinct profiles from epidemiological, clinical, and morphological points of view. However, the profile of our entire group of tumors proved to be comparable with the literature data.
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Affiliation(s)
- Eduard Andrei Gheorghe
- Departments of Pathology, Carol Davila University of Medicine and Pharmacy, and Bagdasar-Arseni Emergency Clinical Hospital, Bucharest, Romania;
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Vats P, Suhag V, Chakravarty N, Vashisth R, Jain M. A Randomized Study to Evaluate Efficacy and Toxicity Profile of Paclitaxel-carboplatin as Neo-adjuvant Chemotherapy in Locally Advanced Supraglottic and Hypopharyngeal Primaries. Indian J Otolaryngol Head Neck Surg 2023; 75:366-373. [PMID: 37275084 PMCID: PMC10235301 DOI: 10.1007/s12070-022-03263-2] [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: 12/13/2021] [Accepted: 10/23/2022] [Indexed: 11/09/2022] Open
Abstract
This study was conducted in locally advanced supraglottic and hypopharyngeal squamous cell carcinoma patients to ascertain the efficacy and toxicity profile of a two drug combination neo adjuvant chemotherapy (NACT) schedule containing Taxane and Platinum; prior to definitive concurrent chemo-radiotherapy (Def CCRT); sixty patients with stage III, IVA and IVB locally advanced squamous cell cancers of larynx and hypopharynx were randomised to two arms. Thirty patients in study group were treated with NACT with Paclitaxel (175 mg/m2) and Carboplatin (AUC 5-7) for 3, 3 weekly cycles; followed by CCRT in the patients who showed at-least a partial response (PR). These patients were compared with the 30 patients of control group who received upfront CCRT. More patients in Study arm developed grade 3 dysphagia (p = 0.001) and mucositis (p = 0.003). Renal, hematogenous and skin toxicities were identical in two arms. At 3 months post treatment complete response (CR) at primary site was 83.3% and 66.6% (p = 0.245) in study and control arms respectively. At 6 months post treatment; 20 patients (66.6%) in the study group and 17 patients (56.6%) in the control group continued to be in clinic-radiological CR (p = 0.20). NACT with Paclitaxel and Carboplatin is tolerated with manageable toxicities in patients with LAHNSCC (Locally advanced head and neck squamous cell carcinoma), with increased Grade 3 dysphagia and mucositis as compared to patients getting upfront CCRT. A longer follow-up period with a larger sample size is required to further evaluate any statistically significant benefit of adding NACT prior to CCRT.
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Affiliation(s)
- Pankaj Vats
- INHS Asvini (DNB Radiation Oncology), R C Church, Colaba, Mumbai, 400005 India
| | - Virender Suhag
- Department of Radiation Oncology, Command Hospital Pune (MD, DNB Radiation Oncology), Pune, India
| | | | - Rekha Vashisth
- Command Hospital Lucknow (DNB Radiation Oncology), Lucknow, India
| | - Mayuri Jain
- Command Hospital (DNB Radiation Oncology), Pune, India
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Rao D, Koteshwara P, Singh R, Jagannatha V. Exploring Radiomics for Classification of Supraglottic Tumors: A Pilot Study in a Tertiary Care Center. Indian J Otolaryngol Head Neck Surg 2023; 75:433-439. [PMID: 37275092 PMCID: PMC10235219 DOI: 10.1007/s12070-022-03239-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/11/2022] [Indexed: 11/27/2022] Open
Abstract
Accurate classification of laryngeal cancer is a critical step for diagnosis and appropriate treatment. Radiomics is a rapidly advancing field in medical image processing that uses various algorithms to extract many quantitative features from radiological images. The high dimensional features extracted tend to cause overfitting and increase the complexity of the classification model. Thereby, feature selection plays an integral part in selecting relevant features for the classification problem. In this study, we explore the predictive capabilities of radiomics on Computed Tomography (CT) images with the incidence of laryngeal cancer to predict the histopathological grade and T stage of the tumour. Working with a pilot dataset of 20 images, an experienced radiologist carefully annotated the supraglottic lesions in the three-dimensional plane. Over 280 radiomic features that quantify the shape, intensity and texture were extracted from each image. Machine learning classifiers were built and tested to predict the stage and grade of the malignant tumour based on the calculated radiomic features. To investigate if radiomic features extracted from CT images can be used for the classification of laryngeal tumours. Out of 280 features extracted from every image in the dataset, it was found that 24 features are potential classifiers of laryngeal tumour stage and 12 radiomic features are good classifiers of histopathological grade of the laryngeal tumor. The novelty of this paper lies in the ability to create these classifiers before the surgical biopsy procedure, giving the clinician valuable, timely information.
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Affiliation(s)
- Divya Rao
- Department of Information and Communication Technology, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, 576104 India
- Department of Otorhinolaryngology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104 India
| | - Prakashini Koteshwara
- Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104 India
| | - Rohit Singh
- Department of Otorhinolaryngology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104 India
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Goel S, Batra A, Singhal G, Goel S. To Study the Role of PTEN, EGFR and HER2 in Early Glottic Squamous Cell Carcinoma. Indian J Otolaryngol Head Neck Surg 2023; 75:707-712. [PMID: 37275058 PMCID: PMC10234964 DOI: 10.1007/s12070-022-03455-w] [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: 10/20/2022] [Accepted: 12/25/2022] [Indexed: 01/09/2023] Open
Abstract
Laryngeal carcinoma is the most common site of malignancy in head and neck region worldwide. Surgical options are limited in cases of laryngeal malignancy and moajority of cases are treated with chemoradiotherapy. Targeted therapy is an evolving novel approach to treat laryngeal carcinoma. The study was conducted to evaluate the role of PTEN, EGF and HER2 in early glottic squamous cell carcinoma cases. 52 samples of early glottis carcoinoma were collected in UCMS and GTB hospital, New Delhi after patients had undergone CO2 laser excision at the centre. Histopathologic and IHC examination was conducted on the specimen for PTEN, EGFR and HER2 molecules. PTEN was negative in 82.69% cases compared to the stroma with three year local control rate of 72.09%. EGFR was positive in 67.31% samples with three year local control rate of 68.57%. HER2 was negative in all the samples. PTEN and EGFR can be used as prognostic markers as well as novel agents for targeted therapy in the future.
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Affiliation(s)
- Sachin Goel
- Department of ENT, ABVIMS & Dr RML Hospital, New Delhi, India
| | - Ankur Batra
- Department of ENT, Royal Hmapshire County Hospital, Winchester, UK
| | - Gaurang Singhal
- Department of pathology, Action Care hospital, New Delhi, India
| | - Snigdha Goel
- Department of ENT, ABVIMS and Dr. Ram Manohar Lohia hospital, New Delhi, India
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Jaiswal AS, Bollu S, Budhiraja S, Kaushal S, Sikka K, Thakar A, Verma H. Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review. Turk Arch Otorhinolaryngol 2023; 61:20-24. [PMID: 37583977 PMCID: PMC10424581 DOI: 10.4274/tao.2023.2023-2-12] [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: 02/28/2023] [Accepted: 05/10/2023] [Indexed: 08/17/2023] Open
Abstract
Objective To evaluate bilateral superior and recurrent laryngeal nerves for tumor spread in patients of advanced-stage laryngeal carcinoma undergoing surgical resection. Methods A prospective study was conducted including biopsy-proven cases of laryngeal squamous cell carcinoma (SCC) that were planned for total laryngectomy. Patients with metachronous or synchronous SCC were excluded from the study. All patients underwent total laryngectomy, where both superior and recurrent laryngeal nerves were harvested along with the specimen, and the proximal ends of the nerves were marked for reference. Perineural invasion (PNI) was assessed in nerves within the tumor and in bilateral extra-laryngeal nerves. Results The study included 22 patients with a mean age of 58 years. Intra-tumoral PNI was found in 7 of the 22 cases (32%). The free nerve margins of superior and recurrent laryngeal nerves, which were examined from proximal to distal orientation, showed no tumor infiltration in any of the cases. Conclusion Perineural invasion of minor nerves constitutes a major pathway of spread. On the contrary, invasion of superior or recurrent laryngeal nerves does not constitute a route for tumor spread. Hence, there is no need to extend the surgical boundary for total laryngectomy to include these major nerves separately.
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Affiliation(s)
- Avinash Shekhar Jaiswal
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sumanth Bollu
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shilpi Budhiraja
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Sikka
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Alok Thakar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Hitesh Verma
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
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Jayarajah U, Jayasinghe R, Fernando A, Seneviratne S. The incidence and trends of laryngeal malignancies in Sri Lanka from 2001 to 2019: a Joinpoint analysis of the national cancer database. J Egypt Natl Canc Inst 2023; 35:3. [PMID: 36809602 DOI: 10.1186/s43046-023-00163-6] [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: 03/07/2022] [Accepted: 02/13/2023] [Indexed: 02/23/2023] Open
Abstract
INTRODUCTION Laryngeal cancer is the ninth commonest cancer among Asian males. Global and regional epidemiological analyses have shown varying patterns in the incidence and risk factors for laryngeal cancer. Therefore, we aimed to analyse the trends in the incidence and histological patterns of laryngeal cancers for the first time in Sri Lanka. METHODS We used the population-based Sri Lanka cancer registry data and pooled all newly diagnosed patients with laryngeal malignancies from 2001 to 2019 (a 19-year study period). The WHO age-standardised incidence rates (ASR) were calculated using the WHO standard pollution. We used the Joinpoint regression software to calculate the estimated annual percentage change (EAPC) and analysed the trends in the incidence by different age categories and sex. RESULTS From 2001 to 2019, 9808 new cases of laryngeal cancers (males = 8927, 91%, mean age = 62 years) were registered. The incidence of laryngeal cancers was greatest in the 70-74-year followed by 65-69-year age groups. Around 7.9% were reported as carcinoma not otherwise specified (NOS). Squamous cell carcinoma (90.1%) was the commonest documented histology type. A rise in the WHO-ASR was noted from 1.91 per 100,000 in 2001 [95% confidence interval (95% CI): 1.69-2.12] to 3.59 per 100,000 in 2017 [(95% CI: 3.34-3.84); EAPC: 4.4 (95% CI: 3.7-5.2), p < 0.05 for trend] followed by a decrease in the incidence [2.97 per 100,000 in 2019 (95% CI: 2.74-3.2), EAPC: - 7.2 (95% CI: - 21.1-9.1, p > 0.05)]. From 2001 to 2017, the proportional increase in incidence was greater in males than females [EAPC: 4.9 (95% CI: 4.1-5.7 vs. 3.7 (95% CI: 1.7-5.6)]. CONCLUSIONS We identified an increasing incidence of laryngeal cancer in Sri Lanka from 2001 to 2017 followed by a slight decrease. Further studies are essential to identify the aetiological factors. Development of laryngeal cancer prevention and screening programmes for high-risk populations may be considered.
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Affiliation(s)
- Umesh Jayarajah
- Department of Surgery, Faculty of Medicine, University of Colombo, Kynsey Road, , P.O. Box 271, Colombo 8, Western Province, Sri Lanka.
| | - Ravindri Jayasinghe
- Department of Surgery, Faculty of Medicine, University of Colombo, Kynsey Road, , P.O. Box 271, Colombo 8, Western Province, Sri Lanka
| | - Ashan Fernando
- Department of Surgery, Faculty of Medicine, University of Colombo, Kynsey Road, , P.O. Box 271, Colombo 8, Western Province, Sri Lanka
| | - Sanjeewa Seneviratne
- Department of Surgery, Faculty of Medicine, University of Colombo, Kynsey Road, , P.O. Box 271, Colombo 8, Western Province, Sri Lanka
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Sahu A, Mahajan A, Palsetia D, Vaish R, Laskar SG, Kumar J, Kamath N, Bhalla AS, Shah D, Sahu A, Agarwal U, Venkatesh A, Ankathi SK, Janu A, Patil V, Kapadia TH, Bal M, Sinha S, Prabhash K, Dcruz AK. Imaging Recommendations for Diagnosis, Staging and Management of Larynx and Hypopharynx Cancer. Indian J Med Paediatr Oncol 2023. [DOI: 10.1055/s-0042-1759504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
AbstractWe discussed the imaging recommendations for diagnosis, staging, and management of larynx and hypopharynx cancer. Carcinoma of the larynx is a common cancer, with males being affected more. Hypopharyngeal carcinoma is less common than laryngeal malignancies. Squamous cell carcinoma is the most common histological type. Nonsquamous cell malignant lesions are rare and mostly submucosal lesions. Clinical examination and endoscopy play an integral role in its detection and staging. Imaging also plays a major role in its staging, including local disease extent, nodal and distant metastatic status, as well as to assess response to therapy. Follow-up of treated cases and differentiation of recurrence from post treatment changes can be done on imaging. Early stage disease is treated with single modalities such as radiotherapy or surgery. Advanced disease is treated with multimodality of either chemoradiotherapy or surgery followed by adjuvant radiotherapy with or without concurrent chemotherapy.
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Affiliation(s)
- Arpita Sahu
- Department of Radiodiagnosis and Imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Abhishek Mahajan
- Department of Radiodiagnosis, The Clatterbridge Cancer Centre, Liverpool, United Kingdom
| | - Delnaz Palsetia
- Department of Radiodiagnosis, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Richa Vaish
- Department of Head and Neck Oncology, Mumbai, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sarbani Ghosh Laskar
- Department of Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Jyoti Kumar
- Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India
| | - Namita Kamath
- Department of Radiodiagnosis, Southend University Hospital, Southend, United Kingdom
| | - Ashu Seith Bhalla
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Diva Shah
- Departmentof Radiodiagnosis, HCG Cancer Centre, Gujarat, India
| | - Amit Sahu
- Department of Neuro and Peripheral Interventional Radiology, Neuro and Peripheral Interventional Radiology, Lilavati Hospital, Mumbai, Maharashtra, India
| | - Ujjwal Agarwal
- Department of Radiodiagnosis, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Aditi Venkatesh
- Department of Radiodiagnosis, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Suman Kumar Ankathi
- Department of Radiodiagnosis and Imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Amit Janu
- Department of Radiodiagnosis and Imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vasundhara Patil
- Department of Radiodiagnosis and Imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Tejas H. Kapadia
- Children's X-ray Department/Academic Unit of Paediatric Radiology, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Munita Bal
- Department of Pathology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shwetabh Sinha
- Department of Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - A. K. Dcruz
- Department of Oncology, Apollo Hospitals, Tata Memorial Hospital Mumbai, Mumbai, Maharashtra, India
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Resurgence of Emergency Total Laryngectomy: An Impact of COVID-19 Pandemic. Indian J Otolaryngol Head Neck Surg 2023; 75:45-48. [PMID: 36684824 PMCID: PMC9838322 DOI: 10.1007/s12070-022-03422-5] [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: 04/11/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
Laryngeal cancer is one of the most common head and neck cancers in India. Surgery is the preferred modality of treatment in majority of cT4a cases and selective cT3 cases of Carcinoma Larynx. COVID-19 outbreak became a global pandemic and caused significant delays and disruptions in every aspect of cancer care. Similarly, patients of laryngeal cancer presented with advanced disease and significant stridor. In such cases, Emergency total laryngectomy (ETL) proved to be a valid treatment modality in the place of conventional workup and treatment. We present our experience with Emergency laryngectomy during the COVID-19 pandemic and how we overcame its challenges. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03422-5.
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Gupta S, Sreeram S, Pinto AC, Suresh PK, Basavaiah SH. Tumor Budding Assessment with Cytokeratin and Its Significance in Laryngeal Squamous Cell Carcinomas. Indian J Otolaryngol Head Neck Surg 2022; 74:494-500. [PMID: 36514426 PMCID: PMC9741683 DOI: 10.1007/s12070-021-02981-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/08/2021] [Indexed: 12/15/2022] Open
Abstract
There is a need for novel prognostic parameters in assessing laryngeal squamous cell carcinoma (LSCC). Tumor budding is an instrumental parameter, which has hardly been studied before in this organ. This study aimed to assess tumor budding in LSCCs with routine hematoxylin and eosin (H&E) stain as well as cytokeratin (CK) immunohistochemistry (IHC). Objectives were to compare the effectiveness of both these methods to assess tumor budding, to investigate the association of tumor budding and clinicopathologic features, and to determine the prognostic significance of tumor budding in LSCCs. Fifty laryngectomy specimens were included. Tumor budding was counted (20x) on slides stained with IHC-CK, and highest count per slide was noted. The cases were classified as positive (> 1 buds) or negative (no buds present). The budding index was categorized as low (< 5 buds) or high (> 5 buds). Tumor budding on H&E was absent, low and high grade in 28%, 30% and 42% cases respectively, when compared to CK-IHC in 17%, 24% and 59% of cases, respectively. Presence of lymphoplasmacytic infiltration significantly correlated with tumor budding and higher grade. Transglottic location of tumor and pT stage was associated with high budding. Presence of lymphoplasmacytic infiltrate significantly correlated with worse prognosis. Tumor budding, an easily assessable, inexpensive histopathologic parameter has seldom been studied in LSCCs. Presence of lymphoplasmacytic infiltrate in routine preoperative biopsy reporting could be useful in prognostication. CK-IHC is helpful to detect especially cases with low-grade tumor budding.
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Affiliation(s)
- Shreyanshi Gupta
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Saraswathy Sreeram
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Amanda Christina Pinto
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Pooja Kundapur Suresh
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Rao KN, Arora RD, Singh A, Nagarkar NM, Aggarwal A. Pharyngocutaneous Fistula Following Primary Total Laryngectomy: a Meta-analysis. Indian J Surg Oncol 2022; 13:797-808. [PMID: 36687232 PMCID: PMC9845480 DOI: 10.1007/s13193-022-01581-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023] Open
Abstract
Pharyngocutaneous fistula (PCF) is the most common complication which significantly increases morbidity. High-level evidence is lacking that determines the PCF rates in the primary laryngectomy. The main objective of this study was to systematically identify the factors leading to the PCF formation in primary laryngectomy. Human studies reporting at least one risk factor for developing PCF in patients undergoing primary total laryngectomy for laryngeal cancer were included. PubMed, EMBASE, and Cochrane databases were searched for the data extraction. Risk of bias assessment tool for non-randomized trial tool was used. Cochrane's Q test and Higgin's I 2-heterogeneity was applied. The Mantel-Haenszel and DerSimonian Laird method was employed. Odds ratio was calculated for each risk factor, a P-value < 0.05 was considered as statistically significant. PROSPERO registration CRD42021248382. The meta-analysis comprised a total of 2446 patients in 14 included non-randomized studies. The among the analyzed risk factors-comorbidities (OR 2.781, R: 1.892-4.088, P < 0.001), site of tumor (OR 4.485, R: 3.003-6.699, P < 0.001), low pre-operative hemoglobin (OR 3.590, R: 2.130-6.050, P < 0.001), low pre-operative albumin (OR 2.833, R: 1.596-5.031, P < 0.001), utilization of surgical staplers (OR 0.172, R: 0.064-0.460, P < 0.001) (protective effect), positive mucosal margin (OR 4.92 R: 1.90-12.75, P = 0.001). The risk factors for PCF in patients undergoing primary TL included comorbidities, hypopharyngeal involvement, pre-operative hemoglobin and albumin, stapler usage, and positive mucosal margin. Level of Evidence - III. Supplementary Information The online version contains supplementary material available at 10.1007/s13193-022-01581-z.
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Affiliation(s)
- Karthik Nagaraja Rao
- Department of Head and Neck Oncology, All India Institute of Medical Sciences, Raipur, India
| | - Ripu Daman Arora
- Department of Otolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India
| | - Ambesh Singh
- Department of Head and Neck Oncology, All India Institute of Medical Sciences, Raipur, India
| | | | - Aakash Aggarwal
- Department of Otolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India
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Fasaludeen A, Kumar RR, Rafi M, Nazeer F, Prakasan AM, Kumar N, George P, Ramadas K, Thommachan KC. Outcomes of organ preservation treatment in advanced laryngeal carcinoma: A retrospective analysis from a single institution. Mol Clin Oncol 2022; 18:1. [PMID: 36545209 PMCID: PMC9756020 DOI: 10.3892/mco.2022.2597] [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: 05/23/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Chemoradiation is the standard treatment for patients with locally advanced laryngeal carcinoma with intact cartilage and functional larynx. The aim of this retrospective study was to assess overall survival (OS) and disease-free survival (DFS) of patients with locally advanced (stage III and stage IV) squamous cell carcinoma of the larynx who have been treated with definitive radical radiotherapy (RT) with or without chemotherapy in a tertiary cancer center in India between January 1, 2006 and December 31, 2015. Data were collected using structured proforma. The patients were treated with RT alone, induction chemotherapy (IC) followed by RT, concurrent chemoradiation therapy (CCRT) or IC followed by CCRT. Response assessment was conducted at 3-4 months post-treatment. Patient-, tumor- and treatment-related factors were documented and were associated with DFS and OS. Survival curves were generated using the Kaplan-Meier method and the statistical significance of survival curves was assessed using the log-rank test. Prognostic factors were assessed using the Cox proportional hazards regression model. A total of 630 patients were included in the present study. The most common age group at presentation was 50-70 years (n=477; 75.7%) and 95.4% (n=601) patients were male. The most common stage at presentation was stage III (n=367, 58.1%). The median follow-up period for the entire group of was 59 months (range, 2-175 months). A complete response after treatment was seen in 549 patients (87.1%). Salvage surgery was performed for 11 patients with residual disease. A total of 134 patients (21.3%) had developed locoregional and distant relapses, and salvage surgery was performed for 31 out of 102 patients with locoregional relapse. The 5-year OS was 48.7% and the 5-year DFS was 45.7%. The stage-wise OS rates were 58.9, 34.9 and 30.4% (P=0.001) and the stage-wise DFS rates were 56.3, 32.0 and 21.7 (P=0.001) for stage III, IVa and IVb, respectively. Results from the present study demonstrated the feasibility of delivery of chemoradiation protocols with good results in a developing country.
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Affiliation(s)
- Afsar Fasaludeen
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India
| | - Rejnish Ravi Kumar
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India
| | - Malu Rafi
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India
| | - Farida Nazeer
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India
| | | | - Naveen Kumar
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India
| | - Preethi George
- Department of Cancer Epidemiology and Biostatistics, Regional Cancer Centre, Thiruvananthapuram 695011, India
| | - Kunnambath Ramadas
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India
| | - Kainickal Cessal Thommachan
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India,Correspondence to: Dr Kainickal Cessal Thommachan, Department of Radiation Oncology, Regional Cancer Centre, Medical College Campus, Thiruvananthapuram 695011, India
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Mishra AK, Sinha VR, Suhag V, Nilakantan A. Evaluation of Voice After Definitive Radiotherapy in Patients of Early Stage Squamous Cell Carcinoma of Larynx (Glottis): A Prospective Observational Study. Indian J Otolaryngol Head Neck Surg 2022; 74:2386-2394. [PMID: 36452620 PMCID: PMC9701973 DOI: 10.1007/s12070-020-02193-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022] Open
Abstract
Post treatment voice quality is an important consideration in choosing the management option for laryngeal cancer. We assessed voice quality after radiotherapy in patients of early squamous cell carcinoma of glottis comprehensively using Videolaryngostroboscopy (VLS), Grade, Roughness, Breathiness, Asthenia and Strain (GRBAS) scores and Voice Handicap Index (VHI)-10. Fifty four consenting patients of early squamous cell carcinoma of glottis (Tis, T1 and T2) awaiting definitive radiotherapy were recruited consecutively. Voice was evaluated by VLS, GRBAS scores and VHI-10 before radiotherapy as well as 3 months and 12 months after radiotherapy. There were 52 males and 2 females in the study. Hoarseness of voice was the commonest presenting symptom. Mean duration of symptoms was 2.45 months (± 0.80), ranging from 1 to 4 months. 35 (64.82%) were T1 while 19 (35.18%) were T2 lesions. They received 60-70 Gy of radiotherapy in 28-35 fractions. There was only one recurrence on follow up for 12 months. On VLS at 12 months post-RT the periodicity, phase symmetry, mucosal waves and amplitude were normal in 74.07%, 70.37%, 56.67% and 78.7% cases respectively. Complete glottic closure was obtained in 72.22%. The voice was 'acceptable' (Grade 1 or 2 on VLS parameters) in more than 90% cases. Mean total GRBAS score was 3.39 (± 2.67). Mean total VHI-10 was 6.7 (± 1.75). All indices were significantly better than pre RT levels. Good quality of voice can be expected after radiotherapy for early glottic cancer in majority of patients.
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Michael RC, Das S, Mani S, Arunagiri S, Thomas R, Vediappan RS, Philip DM. Pharyngocutaneous Fistula Following Primary and Salvage Laryngectomy: Aetiology and Predictive Factors. Indian J Otolaryngol Head Neck Surg 2022; 74:2139-2148. [PMID: 36452720 PMCID: PMC9701951 DOI: 10.1007/s12070-020-02046-x] [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: 05/21/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022] Open
Abstract
Laryngeal cancer treatment is often wrought with challenges, pharyngocutaneous fistula formation (PCF) in patients undergoing either primary or salvage laryngectomy for laryngeal and hypopharyngeal for squamous cell carcinoma is an important one. We aimed to study the factors before and at the surgery that are associated with PCF formation in a South Indian tertiary care hospital. A retrospective chart review of 127 patients who underwent total laryngectomy (TL) between May 2014 and April 2019 at our centre were done. Data was collected, including patient age and gender, comorbidities (Diabetes mellitus, COPD and hypothyroidism), smoking, tumor stage and site, prior tracheostomy, prior radiation, concurrent neck dissection and type of pharyngoplasty, Preoperative hemoglobin and albumin levels, surgical margin status and development of a PCF was also done. Further details specific to the development of a PCF were recorded for that subset of patients including the length of time to fistula, mode of closure, time of closure and modality of management. The overall incidence of PCF was 16.5% (21 of 127 patients), and the median time from TL to the diagnosis of PCF was 6 days (range, 3-20 days). The analysis was done separately for laryngectomies without any pharyngeal reconstruction (112/127 patients). In patients treated with a primary TL, the incidence of PCF was 12.20% (10 of 82) and 26.66% (8 of 30) after salvage TL. Subset analysis for type of pharyngoplasty repair showed 12% (15/127) underwent different types of vascularised/muscular flap for smaller residual pharyngeal mucosa, of which 20% (3/15) developed PCF and one patient developed haematoma needing exploration and re-suturing. The predictive factors for PCF were hypopharynx cancer (P < 0.05), surgical margin positivity (P < 0.0001), female gender (P < 0.05), absence of prior tracheostomy (P < 0.05) and tumor extension into pyriform sinus mucosa (P < 0.05). Preoperative patient factors of gender and site of primary along with histological margin positivity and extension of tumor to the pyriform sinus mucosa were significant risk factors for PCF formation. Pre-Op radiotherapy remains a strong clinical suspicion but not statistically significant.
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Affiliation(s)
- Rajiv C. Michael
- Department of Head and Neck Surgery, Christian Medical College, Vellore, 6320004 India
| | - Sukamal Das
- Department of Head and Neck Surgery, Christian Medical College, Vellore, 6320004 India
| | - Suresh Mani
- Department of Head and Neck Surgery, Christian Medical College, Vellore, 6320004 India
| | | | - Regi Thomas
- Department of ENT, Christian Medical College, Vellore, India
| | | | - Dona Maria Philip
- Department of Biostatistics, Christian Medical College, Vellore, India
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Szklanny K, Lachowicz J. Implementing a Statistical Parametric Speech Synthesis System for a Patient with Laryngeal Cancer. SENSORS (BASEL, SWITZERLAND) 2022; 22:3188. [PMID: 35590877 PMCID: PMC9099606 DOI: 10.3390/s22093188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
Total laryngectomy, i.e., the surgical removal of the larynx, has a profound influence on a patient's quality of life. The procedure results in a loss of natural voice, which in effect constitutes a significant socio-psychological problem for the patient. The main aim of the study was to develop a statistical parametric speech synthesis system for a patient with laryngeal cancer, on the basis of the patient's speech samples recorded shortly before the surgery and to check if it was possible to generate speech quality close to that of the original recordings. The recording made use of a representative corpus of the Polish language, consisting of 2150 sentences. The recorded voice proved to indicate dysphonia, which was confirmed by the auditory-perceptual RBH scale (roughness, breathiness, hoarseness) and by acoustical analysis using AVQI (The Acoustic Voice Quality Index). The speech synthesis model was trained using the Merlin repository. Twenty-five experts participated in the MUSHRA listening tests, rating the synthetic voice at 69.4 in terms of the professional voice-over talent recording, on a 0-100 scale, which is a very good result. The authors compared the quality of the synthetic voice to another model of synthetic speech trained with the same corpus, but where a voice-over talent provided the recorded speech samples. The same experts rated the voice at 63.63, which means the patient's synthetic voice with laryngeal cancer obtained a higher score than that of the talent-voice recordings. As such, the method enabled for the creation of a statistical parametric speech synthesizer for patients awaiting total laryngectomy. As a result, the solution would improve the quality of life as well as better mental wellbeing of the patient.
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19
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Mathew LR, Gopakumar K. Improving the Quality and Intelligibility of Electrolaryngeal Speech during Mobile Communication with Landline Analogous Bandpass Filtering. J Voice 2022:S0892-1997(22)00065-0. [PMID: 35430122 DOI: 10.1016/j.jvoice.2022.02.026] [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: 11/08/2021] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022]
Abstract
The normal functioning of the larynx or voicebox gives humans the ability to converse with others effortlessly. However, if the larynx is permanently removed due to injury or illness, speech cannot be produced. The electrolarynx, a noninvasive device used to produce speech for such persons, has a motor-induced hum which hinders telephone-based communication among electrolaryngeal speakers. This adversely affects the morale of electrolarynx users, leading to abandonment of technology, psychological issues and decreased quality of life. This paper examines a technique based on bandpass filtering of electrolaryngeal speech which has the potential of increasing the quality and intelligibility of speech produced by means of an electrolarynx. Finite impulse response and infinite impulse response filtering with bandpass frequencies analogous to telephone landline and wideband filtering were investigated. Objective testing and subjective testing of quality and intelligibility of electrolaryngeal speech have been performed in each phase of the work. Statistical analysis based on one-way analysis of variance (ANOVA) has been conducted after each round of subjective testing. Results indicate that the quality as well as intelligibility of electrolaryngeal speech can be improved with the help of bandpass filtering.
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Affiliation(s)
- Lani Rachel Mathew
- Dept. of Electronics & Communication, Mar Baselios College of Engineering & Technology, LBS Center for Science and Technology, University of Kerala, Kerala,India.
| | - K Gopakumar
- APJ Abdul Kalam Technological University, Kerala, India
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20
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Hoarseness: its spectrum, associations and management in a tertiary care centre in India. The Journal of Laryngology & Otology 2022; 136:1211-1216. [DOI: 10.1017/s0022215121004345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Objective
To determine the demographic, aetiopathological and diagnostic profiles of patients presenting with hoarseness to a laryngology unit of a tertiary care centre in India.
Methods
A retrospective observational study was conducted.
Results
The 1033 patients who presented with dysphonia showed a male predominance (70 per cent), high rates of malignancy (18 per cent), late presentation (mean, 24 months) and poor follow-up trends (53 per cent with 3 months’ follow up), which contrasts with data from developed countries. The patient population hailed from different states in India and neighbouring countries around India, serving as a good sample for the subcontinent. The majority (67 per cent) were managed conservatively; however, surgical management was the preferred choice for those who presented with airway stenosis (91 per cent) and laryngeal trauma (75 per cent). Significant associations between vocal professionalism level and co-morbidities and dysphonia aetiopathologies are discussed.
Conclusion
These findings give insight into the trends of hoarseness in the developing Indian subcontinent, which can aid understanding and management.
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Pruthi DS, Nagpal P, Yadav A, Bansal B, Pandey M, Agarwal N. Shifting Paradigm of Adult Cancers at Young Age –A Case Series. CLINICAL CANCER INVESTIGATION JOURNAL 2022. [DOI: 10.51847/wxhwcy0kxx] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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22
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Kumbar VM, Muddapur UM, Bhat KG, Shwetha HR, Kugaji MS, Peram MR, Dindawar S. Cancer Stem Cell Traits in Tumor Spheres Derived from Primary Laryngeal Carcinoma Cell Lines. Contemp Clin Dent 2021; 12:247-254. [PMID: 34759681 PMCID: PMC8525812 DOI: 10.4103/ccd.ccd_252_20] [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: 04/20/2020] [Revised: 05/21/2020] [Accepted: 07/19/2020] [Indexed: 12/13/2022] Open
Abstract
Objective Cancer stem cells (CSCs) belong to a subpopulation of undifferentiated cells present within tumors that have the potential to regenerate, differentiate, maintenance of pluripotency, drug resistance, and tumorigenicity when transplanted into an innate host. These can influence the growth and behavior of these tumors and are used to investigate the initiation, progression, and treatment strategies of laryngeal cancer. Research on CSC science and targeted therapies were hinge on their isolation and/or enrichment procedures. The object of the study is to isolate cancer stem cells from primary laryngeal carcinoma (CSCPLC) by tumor spheres enrichment. We checked the properties of self-renewal, stemness, clonogenicity, and chemotherapeutic resistance. Materials and Methods We performed tumor sphere formation assay (primary, secondary, and tertiary) chemotherapy resistance by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay were performed to evaluate the CSC cells. Immunofluorescence for stem cell markers (CD133+, CD44+) and gene expression of stem cell markers for CD133+, CD44+, OCT4, SOX2, and NANOG was done using the real-time polymerase chain reaction technique. Results We were able to isolated CSC subpopulations from PLC cell lines by the tumor sphere method. These cells exhibited good primary, secondary, and tertiary tumor sphere formation efficiency and also disclosed a resistant index of more than 2. Immunofluorescence for stem cell markers (CD133+ and CD44+) confirms the presence of CSC. There was significantly higher mRNA expression of stem cell markers in CSC enriched subpopulations compared to the parental cell lines. Conclusion We conclude that tumor spheres enrichment is an efficient, economical, and reliable approach for the isolation and characterization of CSC from PLC cell lines. These cells demonstrated the properties of self-renewal, stemness, clonogenicity, and chemotherapeutic resistance.
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Affiliation(s)
- Vijay Mahadev Kumbar
- Central Research Laboratory, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences and Research Centre, Hubballi, India.,Department of Biotechnology, KLE Technological University, BVB Campus, Hubballi, India
| | - Uday M Muddapur
- Department of Biotechnology, KLE Technological University, BVB Campus, Hubballi, India
| | - Kishore G Bhat
- Central Research Laboratory, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences and Research Centre, Hubballi, India
| | - H R Shwetha
- Department of Oral Pathology, Maratha Mandal's N. G. Halgekar Institute of Dental Sciences and Research Centre, Belagavi, Karnataka, India
| | - Manohar S Kugaji
- Central Research Laboratory, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences and Research Centre, Hubballi, India.,Department of Biotechnology, KLE Technological University, BVB Campus, Hubballi, India
| | - Malleswara Rao Peram
- Central Research Laboratory, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences and Research Centre, Hubballi, India.,Department of Pharmaceutics, Maratha Mandal's College of Pharmacy, Belagavi, Karnataka, India
| | - Santosh Dindawar
- Department of Oral and Maxillofacial Surgery, Maratha Mandal's N. G. Halgekar Institute of Dental Sciences and Research Centre, Belagavi, Karnataka, India
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23
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Arora M, Thakker VD, Sindhwani G, Bhatt J, Gupta M, Shah J. Pretherapeutic Assessment by Multidetector Computed Tomography for Thyroid Cartilage Invasion in Laryngeal Cancer: A Double‑edged Sword. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_101_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Abstract
Introduction:Almost one-fourth of head and neck cancers in India are laryngeal cancers. Both conservative and surgical therapeutic approaches are available. According to present tumor-node-metastasis staging protocol, thyroid cartilage invasion is a crucial criterion for diagnosing advanced stages of the disease. A major cartilage invasion depicts T4A stage of disease for which surgical treatment is required. Aims: The present study aims to evaluate the accuracy of multidetector computed tomography (MDCT) in evaluation thyroid cartilage invasion in T3 and T4 stage of laryngeal cancers. Materials and Methods: It is a retrospective analysis done in the Department of Radiology, Pramukhswami Medical College, Anand, Gujarat, on 22 patients of T3 and T4 stage of laryngeal cancer who presented for pretherapeutic MDCT neck evaluation. The MDCT results were retrospectively reviewed and compared with postoperative histopathological results. Statistical analysis was done for each parameter as positive predictive value (PPV) (main statistical parameter), negative predictive value, sensitivity, and specificity. Results: MDCT showed a PPV of 60.00% in detecting any type of thyroid cartilage invasion, 66.66% for major and 33.33% for minor cartilage invasion. Extralaryngeal spread of disease was the most specific marker for cartilage involvement. In total, 31.8% of cases were downgraded in staging by pathology. Conclusion: Overestimation of thyroid cartilage invasion by MDCT is a reality which should be in mind before making final therapeutic decisions. Although crucial, it should not be the sole criteria preventing while making a surgical versus conservative therapeutic call.
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Affiliation(s)
- Manali Arora
- Department of Radio-Diagnosis, Pramukhswami Medical College, Anand, Gujarat, India
| | - Vishal D Thakker
- Department of Radio-Diagnosis, Pramukhswami Medical College, Anand, Gujarat, India
| | - Geetika Sindhwani
- Department of Radio-Diagnosis, Pramukhswami Medical College, Anand, Gujarat, India
| | - Jayesh Bhatt
- Department of Radio-Diagnosis, Pramukhswami Medical College, Anand, Gujarat, India
| | - Monica Gupta
- Department of Pathology, Pramukhswami Medical College, Anand, Gujarat, India
| | - Jay Shah
- Department of Radio-Diagnosis, Pramukhswami Medical College, Anand, Gujarat, India
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24
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Rao VUS, Majumdar KS, Subash A, Banerjee N, Sinha P, Prasad R, Kudpaje A, Nayar RC. Prognostic Significance of Vocal Cord Mobility after Laryngeal Preservation Protocols in Locally Advanced Laryngopharyngeal Cancers: A Retrospective Analysis. Indian J Otolaryngol Head Neck Surg 2021; 73:207-211. [PMID: 34150595 DOI: 10.1007/s12070-020-02306-w] [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: 11/21/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022] Open
Abstract
In the present study, we look at the prognostic implications of the recovery of vocal cord mobility after treatment in T3 laryngeal and hypopharyngeal cancers with fixed vocal cords. Patients with T3 laryngeal and hypopharyngeal carcinoma were considered for the study. All patients were treated with standard laryngeal preservation protocols as per treatment guidelines. Recovery of vocal cord functions was assessed with serial flexible laryngoscopic evaluation. Recovery of vocal cord mobility was compared with oncological outcomes. Twenty seven patients were available for final analysis. Cases, where vocal cords remained fixed or continued to have restricted mobility on follow up, were categorised as "unfavourable" and those with complete recovery of function as compared to pre treatment FOL as "Favourable". Thirteen (48%) patients did not regain complete mobility of vocal cords. Six patients from the 'unfavourable' group (46%) developed recurrence, whereas only one patient from the 'favourable' group (7%) had a recurrence (p = 0.03). The findings of the present study suggest that failure to regain complete vocal cord mobility after CTRT is a poor prognostic factor in T3 laryngeal and hypopharyngeal cancers.
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Affiliation(s)
- Vishal U S Rao
- Department of Head and Neck Oncology, HCG Cancer Centre, Sampangi Ram Nagar, P. Kalinga Rao Road, Bangalore, Karnataka 560020 India
| | - Kinjal Shankar Majumdar
- Department of Head and Neck Oncology, HCG Cancer Centre, Sampangi Ram Nagar, P. Kalinga Rao Road, Bangalore, Karnataka 560020 India.,Department of Surgical Oncology, AIIMS, Rishikesh, India
| | - Anand Subash
- Department of Head and Neck Oncology, HCG Cancer Centre, Sampangi Ram Nagar, P. Kalinga Rao Road, Bangalore, Karnataka 560020 India
| | - Nabanita Banerjee
- Dept of Community Medicine and Biostatistics, North Bengal Medical College, Darjeeling, India
| | - Piyush Sinha
- Department of Head and Neck Oncology, HCG Cancer Centre, Sampangi Ram Nagar, P. Kalinga Rao Road, Bangalore, Karnataka 560020 India.,Department of Head and Neck Oncology, Medanta Hospital, Lucknow, India
| | - Rachana Prasad
- Department of Head and Neck Oncology, HCG Cancer Centre, Sampangi Ram Nagar, P. Kalinga Rao Road, Bangalore, Karnataka 560020 India.,Department of Otolaryngology Head and Neck Surgery, RIMS, Ranchi, India
| | - Akshay Kudpaje
- Department of Head and Neck Oncology, HCG Cancer Centre, Sampangi Ram Nagar, P. Kalinga Rao Road, Bangalore, Karnataka 560020 India
| | - Ravi C Nayar
- Department of Head and Neck Oncology, HCG Cancer Centre, Sampangi Ram Nagar, P. Kalinga Rao Road, Bangalore, Karnataka 560020 India
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Baskaran D, Arunachalam K. Design of Site-Specific Microwave Phased Array Hyperthermia Applicators Using 434 MHz Reduced Cavity-Backed Patch Antenna. Bioelectromagnetics 2020; 41:630-648. [PMID: 32956531 DOI: 10.1002/bem.22298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/15/2020] [Accepted: 09/05/2020] [Indexed: 11/10/2022]
Abstract
Cancers of the neck, breast, and lower extremities are common malignancies diagnosed in India with a higher incidence of advanced-stage disease. Phased array (PA) applicators reported for hyperthermia treatment (HT) of the breast have small focal region and high cross-coupling, and those reported for lower extremities provide regional heating and limited steering. In this study, we present the numerical design of site-specific PA applicators for HT of large solid tumors in the neck, breast, and lower extremities using a miniaturized 434 MHz cavity-backed water-loaded patch antenna. The fabricated antenna has 38 × 36 mm2 aperture, more than 90% power coupling, 25 MHz bandwidth, and good agreement between simulated and measured specific absorption rate (SAR) in phantom. The site-specific applicators demonstrated less power reflection (<-17.9 dB) and cross-coupling (<-26.8 dB) for 5 mm inter-ring spacing. SAR indicators for 64 cc tumor at varying locations in simplified layered three-dimensional (3D) tissue models of the neck, breast, and leg showed average power absorption ratio (aPAratio ) ≥ 3.16, target to hotspot quotient (THQ) ≥ 0.57, 25% iso-SAR coverage (TC25 ) ≥ 81%, and 50% iso-SAR coverage (TC50 ) ≥51.8%. Simulation results of site-specific applicators for 3D inhomogeneous patient models showed aPAratio ≥ 5.98, THQ ≥ 0.9, TC50 ≥ 86%, and 100% TC25 for all sites. It is concluded that the 434 MHz miniaturized cavity-backed patch antenna can be used to develop high-density PA applicators with 12-24 antennas for HT of large solid tumors (≥4 cm) in the neck, breast, and lower extremities with 3D steering ability and less cross-coupling (≤-26.8 dB). © 2020 Bioelectromagnetics Society.
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Affiliation(s)
- Divya Baskaran
- Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India
| | - Kavitha Arunachalam
- Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India
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Bakshi J, Goyal AK, Singh V, Sannigrahi M, Khullar M. Stage-specific expression analysis ofMMP-2 & MMP-9 in laryngeal carcinoma. J Cancer Res Ther 2020; 16:517-520. [PMID: 32719260 DOI: 10.4103/jcrt.jcrt_360_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aim of the Study Both matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) is involved in degradation of extracellular matrix and found to stimulate invasion and metastasis in cancer patients. However, studies on the stage-specific expression of MMPs at different stages of larynx carcinoma are still lacking. In the present study, we compare the expression level of MMP-2 and MMP-9 at different stages of laryngeal carcinoma. Material and Methods Tumor tissues samples were taken from larynx cancer patients by deep biopsy during direct laryngoscopy. Gene expression for MMP-2 and MMP-9 was analyzed using RT-PCR. Results Significantly high expression of MMP-2 was observed compared to the MMP-9 at stage IV compared to the less advanced stages of the disease. Conclusion Present study concluded that the MMP-2 expressed with a greater magnitude as compared to the MMP-9 in advance stages of laryngeal carcinoma.
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Affiliation(s)
- Jaimanti Bakshi
- Department of Otolaryngology and Head Neck Surgery (ENT), PGIMER, Chandigarh, India
| | - Atul Kumar Goyal
- Department of Otolaryngology and Head Neck Surgery (ENT), PGIMER, Chandigarh, India
| | - Virender Singh
- Department of Otolaryngology and Head Neck Surgery (ENT), PGIMER, Chandigarh, India
| | | | - Madhu Khullar
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh, India
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Oncological and Functional Outcomes of Conservation Surgery for Carcinoma Glottis. Indian J Surg Oncol 2020; 11:438-445. [PMID: 33013124 DOI: 10.1007/s13193-020-01157-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/30/2020] [Indexed: 12/24/2022] Open
Abstract
Conservation laryngectomy has gained considerable acceptance as a means of enhancing overall long-term function preservation in the management of glottic cancers. This study aims to evaluate the oncological and functional outcomes of conservation surgery for carcinoma of the glottis. Fifty consecutive conservation laryngectomies from January 2010 to December 2018 were studied. Glottic cancers of stages I to IVa were carefully selected both in the primary and salvage settings after a consensus from the multidisciplinary tumour board (MDT). Oncological outcomes in terms of overall survival and disease-free survival were measured, and the long-term functional outcomes of voice and swallowing were evaluated using the GRBAS vocal scale and SWAL-QOL questionnaire. The median follow-up period was 63.4 months. The overall 5-year survival probability was 98% (standard error 2.2%), while median disease-free survival was 23 months. The median GRBAS scores in the open and transoral laser microsurgery (TOLMS) group were 1.828 and 1.428, respectively. The median SWAL-QOL scores in majority of quality of life domains were in the mild or no disease impact zone (71-100). Conservative laryngeal surgery plays a crucial role in the treatment of glottic cancers in all stages. It is oncologically safe, and the functional outcomes are favourable.
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28
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Li K, Zhang C, Chen L, Wang P, Fang Y, Zhu J, Chen S, Du J, Shen B, Wu K, Liu Y. The role of acetyl-coA carboxylase2 in head and neck squamous cell carcinoma. PeerJ 2019; 7:e7037. [PMID: 31218122 PMCID: PMC6568254 DOI: 10.7717/peerj.7037] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 04/27/2019] [Indexed: 12/19/2022] Open
Abstract
Background Acetyl-CoA carboxylase (ACC) plays an important role in the metabolism of various cancer cells, but its role in head and neck squamous cell carcinoma (HNSCC) is uncertain. Therefore, in the present study, we explored the role of ACC2 in HNSCC. Methods Western blot and immunohistochemistry assays were used to determine ACC2 protein expression levels in laryngocarcinoma and adjacent normal tissues derived from patients with laryngocarcinoma. ACC2 expression was knocked down in the hypopharyngeal cancer cell line FaDu to determine its effect on apoptosis. Lipid oil red staining was used to test the change of intracellular lipid. Results The results showed that the ACC2 protein was highly expressed in laryngocarcinoma and that the ACC2 expression level was positively associated with the clinical cancer stage and negatively associated with the degree of laryngocarcinoma cell differentiation. Kaplan-Meier analyses indicated that compared with patients having low levels of ACC2, those with high ACC2 levels had a decreased 5-year survival rate. The results of western blot and terminal deoxynucleotidyl transferase dUTP nick-end labeling assays showed that knockdown of ACC2 accelerated apoptosis in FaDu cells. Furthermore, knockdown of ACC2 significantly reduced the intracellular lipid levels in FaDu cells. Conclusion These findings suggest that ACC2 may be an important prognostic marker for patients with HNSCC and that ACC2 may be a potential target in the treatment of HNSCC.
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Affiliation(s)
- Kun Li
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chengcheng Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Lei Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Pingping Wang
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Yang Fang
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Junwei Zhu
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Shuo Chen
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Juan Du
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Bing Shen
- Department of Physiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Kaile Wu
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yehai Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Nerurkar NK, Shah R. Factors responsible for the development of carbon granuloma post transoral laser cordectomy. Lasers Med Sci 2019; 34:1383-1389. [PMID: 30761442 DOI: 10.1007/s10103-019-02726-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/17/2019] [Indexed: 01/08/2023]
Abstract
Our study was performed with an aim to analyse the factors responsible for the formation of a carbon granuloma (CG) following transoral laser microlaryngeal cordectomy (TLMC) for early glottic carcinoma. Our study comprises of retrospective data analysis of 78 patients who underwent TLMC for early glottic carcinoma between 2012 and 2017 with the laser settings of an acublade with scanning system, size 1-2 mm, depth 1-3 (250-750 μm), power 10 watts in a repeat mode with time off 0.25 s. A total of 19 patients had undergone type 1 cordectomy, 38 patients a type 2 cordectomy, 20 patients a type 3 cordectomy and 1 type 4 cordectomy. In the follow-up period, patients were divided into two groups-group A, who healed well and group B, who developed a CG. Both groups were analysed based on surgical factors (type of cordectomy, postoperative surface of vocal fold and cautery use) and healing factors (presence of diabetes mellitus and laryngopharyngeal reflux). Of 81 cordectomies, 15 (18.5%) developed a CG at an average period of 4 weeks postoperatively. All 15 patients were managed medically and by 4-8 weeks, 13 carbon granulomas resolved. Surgical excision in 2 patients who did not improve revealed granulation tissue. Of 40 type 2 cordectomies, 9 developed a CG (22.5%); of 20 type 3 cordectomies, 5 developed a CG (25%) and the 1 patient of type 4 cordectomy developed a CG (100%). Patients with cautery use, diabetes mellitus (DM) and laryngopharyngeal reflux (LPR) had a higher rate of CG formation. To summarise, in our study, a CG developed in 18.5% of our TLMC patients at an average postoperative duration of 4 weeks. An algorithm for treating and preventing this type of lesion is recommended.
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Affiliation(s)
- Nupur Kapoor Nerurkar
- Bombay Hospital Voice and Swallowing Centre, 2nd floor, MRC, Bombay Hospital & Medical Research Centre, 12 New Marine Lines, Mumbai, Maharashtra, 400020, India.
| | - Ruchi Shah
- Bombay Hospital Voice and Swallowing Centre, 2nd floor, MRC, Bombay Hospital & Medical Research Centre, 12 New Marine Lines, Mumbai, Maharashtra, 400020, India
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Thavarool S, Vijay S, Manu S, George N, Nair R. Low survival of advanced laryngeal cancers: Time to change the treatment regime? JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2019. [DOI: 10.4103/jhnps.jhnps_30_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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31
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Bui AT, Yong Ji KS, Pham CT, Le KM, Tong TX, Lee WT. Longitudinal evaluation of quality of life in Laryngeal Cancer patients treated with surgery. Int J Surg 2018; 58:65-70. [PMID: 30261330 DOI: 10.1016/j.ijsu.2018.09.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/12/2018] [Accepted: 09/19/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is insufficient prospective data on quality of life outcomes for laryngeal cancer patients undergoing surgery, especially in low- and middle-income countries. This limits clinical and patient decision-making, and survivorship expectations. This research aimed to define longitudinal changes in quality of life in patients with laryngeal cancer from the pre-operative to post-operative period. MATERIALS AND METHODS A prospective cohort with primary laryngeal cancer treated with standard-of-care surgery who have completed a minimum follow-up of 1 year were evaluated. Patients underwent one of three standard-of-care surgical treatments: transoral laser microsurgery, open partial laryngectomy and total laryngectomy. Patients completed the EORTC-C30 quality of life questionnaire and associated Head and Neck module (EORTC-H&N35) pre- and post-operatively at 1, 3, 6, and 12 months. Global, functional- and symptom-related domains were assessed. RESULTS 140 patients participated in the study (135 males and 5 females, mean [SD] age 57.0 [7.8] years). Patients were grouped based on primary surgical treatment: (Group 1-transoral laser microsurgery; Group 2-open partial laryngectomy; Group 3-total laryngectomy). In Group 1, a significant decline at 3 months was reported in all five functional scales and five symptom scales: speech, social eating, cough, appetite, and fatigue. In Group 2, significant decline at 1 month post-operative period was seen in the global health scale, all five functional scales and six symptom scales: speech, social eating, cough, appetite, sexuality, and feeling ill. In Group 3, significant decline without return to baseline was seen in the global health scale, all five functional scales and six symptom scales: speech, sense, cough, sticky saliva, sexuality, and social contact. These scores were lowest at 1 month post-op. CONCLUSIONS Significant changes in quality of life domains after laryngeal cancer surgery were identified. This research provides critical information for improving clinical and patient decision-making and for informing survivorship expectations for those undergoing surgery for laryngeal cancer.
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Affiliation(s)
- Anh The Bui
- Department of Head and Neck Surgery, National ENT Hospital of Vietnam, Hanoi, Viet Nam
| | | | - Canh Tuan Pham
- Department of Head and Neck Surgery, National ENT Hospital of Vietnam, Hanoi, Viet Nam
| | - Ky Minh Le
- Department of Head and Neck Surgery, National ENT Hospital of Vietnam, Hanoi, Viet Nam
| | - Thang Xuan Tong
- Department of Head and Neck Surgery, National ENT Hospital of Vietnam, Hanoi, Viet Nam
| | - Walter Tsong Lee
- Duke University School of Medicine, Durham, NC, USA; Section of Otolaryngology, Durham VA Medical Center, Durham, NC, USA; Division of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA.
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