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Ferrari SB, Morand GB, Rupp NJ, Krützfeldt J, Vetter D, Hüllner MW, Broglie MA. Clinical predictors of negative/equivocal SPECT imaging outcomes in primary hyperparathyroidism: Factors calling for 18F-choline-PET. Am J Otolaryngol 2024; 45:104315. [PMID: 38701728 DOI: 10.1016/j.amjoto.2024.104315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 04/15/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE For minimally invasive surgery of parathyroid adenomas, exact localization diagnostics are essential. Main imaging modalities used for diagnostics are sonography, SPECT with/without CT (traditional imaging) and 18F-choline-PET. The aim of our study was to identify predictors for inconclusive SPECT imaging and subsequently determine in which cases 18F-choline-PET is needed. METHODS Retrospective analysis of 138 patients with histologically confirmed primary hyperparathyroidism (pHPT). After sonography, patients underwent SPECT or SPECT/CT imaging, with subsequent 18F-choline-PET in cases of disconcordant results. Logistic regression analysis was used to identify clinical and laboratory factors predictive for negative SPECT results. RESULTS Sensitivity rates for sonography, SPECT, SPECT/CT, and choline-PET were 47 %, 49 %, 71.7 %, and 97 %, respectively. Logistic regression revealed lower PTH levels (p < 0.001), presence of structural thyroid disease (p = 0.018), and negative sonography (p < 0.001) as predictive of negative/equivocal SPECT outcome. An additional traditional imaging CT scan to a SPECT enhanced detection odds, as did greater adenoma weight. Urolithiasis, osteoporosis, and calcium values as measurement of activity and duration of disease showed no significant association with the detection rate. Furthermore, our study demonstrated that 18F-choline-PET exhibited remarkable sensitivity in detecting adenomas among patients with negative/equivocal SPECT results. CONCLUSION Our study reveals potential predictive factors for a negative/equivocal SPECT outcome in pHPT. Identifying these factors might allow minimizing futile SPECT examinations and perhaps encourage timely utilization of 18F-choline-PET imaging. Our study reinforces the clinical significance of 18F-choline-PET, especially in complex cases with disconcordant results by conventional parathyroid imaging methods.
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Affiliation(s)
- Sabina B Ferrari
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Switzerland.
| | - Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Switzerland; University of Zurich, Switzerland; Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Niels J Rupp
- University of Zurich, Switzerland; Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Jan Krützfeldt
- Department of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Zurich, Switzerland
| | - Diana Vetter
- Department of Visceral Surgery and Transplantation, University Hospital of Zurich, Switzerland
| | - Martin W Hüllner
- University of Zurich, Switzerland; Department of Nuclear Medicine, University Hospital Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Switzerland
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Dana F, Maurer A, Muehlematter UJ, Husmann L, Schaab J, Mader CE, Beintner-Skawran S, Messerli M, Sah BR, Dana M, Dana M, Duhnsen SH, Mueller SA, Stadler T, Morand GB, Meerwein C, Orita E, Kaufmann PA, Huellner MW. The Monocle Sign on 18F-FDG PET Indicates Contralateral Peripheral Facial Nerve Palsy. Clin Nucl Med 2024:00003072-990000000-01082. [PMID: 38651767 DOI: 10.1097/rlu.0000000000005238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND The aim of our study was to retrospectively analyze FDG PET/CT data in patients with facial nerve palsy (FNP) for the presence of the monocle sign. PATIENTS AND METHODS A total of 85 patients with unilateral FNP were included into our study, thereof 73 with peripheral FNP and 12 with central FNP. FDG uptake (SUVmax, SUVmean, total lesion glycolysis) was measured in both orbicularis oculi muscles (OOMs). FDG uptake of paretic and nonparetic muscles was compared in patients with FNP (Wilcoxon test and Mann-Whitney U test) and was also compared with FDG uptake in 33 patients without FNP (Mann-Whitney U test). SUVmax ratios of OOM were compared. A receiver operating characteristic curve and Youden Index were used to determine the optimal cutoff SUVmax ratio for the prevalence of contralateral peripheral FNP. RESULTS The SUVmax ratio of OOM was significantly higher in patients with peripheral FNP compared with patients with central FNP and those without FNP (1.70 ± 0.94 vs 1.16 ± 0.09 vs 1.18 ± 0.21, respectively; P < 0.001). The SUVmax ratio of OOM yielded an area under the curve (AUC) of 0.719 (95% confidence interval, 0.630-0.809), with an optimal cutoff of 1.41, yielding a specificity of 94.4% and a sensitivity of 44.1% for identifying contralateral peripheral FNP. One hundred percent specificity is achieved using a cutoff of 1.91 (sensitivity, 29.4%). CONCLUSIONS Asymmetrically increased FDG uptake of the OOM (the "monocle sign") indicates contralateral peripheral FNP. A nearly 2-fold higher SUVmax represents a practically useful cutoff.
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Affiliation(s)
- Fatemeh Dana
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alexander Maurer
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Urs J Muehlematter
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lars Husmann
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Schaab
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Cäcilia E Mader
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stephan Beintner-Skawran
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Messerli
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bert-Ram Sah
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Masih Dana
- Institute of Information Technology Hamfekr Gostar-Mehr-Espadan, Isfahan, Iran
| | - Mohsen Dana
- Department of Application Development and Distribution, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Simon A Mueller
- Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Thomas Stadler
- Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Christian Meerwein
- Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Philipp A Kaufmann
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- From the Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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3
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Morand GB, Tessler I, Noik M, Krasner J, Yamin T, Pusztaszeri MP, Avior G, Payne RJ. Molecular Profiling for Bethesda III to VI Nodules: Results of a Multicenter International Retrospective Study. Endocr Pract 2024; 30:319-326. [PMID: 38184241 DOI: 10.1016/j.eprac.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/26/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Molecular testing is a well-established tool that assists in the management of thyroid nodules. We describe our experience using molecular testing of thyroid nodules with Bethesda III to VI cytology. METHODS This is a retrospective multicenter, multinational study of thyroid nodules that underwent preoperative molecular profiling with ThyGenX/ThyGeNEXT or ThyroSeq V3 between 2015 and 2022. The clinical characteristics and mutational profiles of tumors were compared. Collected data included demographics, cytology results, surgical pathology, and molecular alterations. Molecular alterations were categorized into 3 main phenotypes: BRAF-like, RAS-like, and non-BRAF-non-RAS (NBNR). RESULTS Overall, 784 patients who had surgery were included, of which 603 (76.2%) were females. The most common histologic type was papillary thyroid cancer (PTC) with 727 (91.9%) cases. In total, 205 (28.2%) cases showed an aggressive subtype of PTC (eg, tall cell and hobnail). BRAF-like alterations were most likely to be found in Bethesda V and VI nodules and show extrathyroidal extension (ETE), nodal disease, and/or aggressive subtypes of PTC (P < .001 for all). RAS-like alterations were more commonly found in Bethesda III and IV nodules and were less likely to show ETE, nodal disease, and/or aggressive histology (P < .001 for all). NBNR alterations were more commonly found in Bethesda III and IV nodules and were less likely to show ETE, nodal disease, and/or aggressive subtypes of PTC. However, they were rarely but significantly associated with poorly differentiated thyroid cancer (P < .005). CONCLUSION Molecular testing of thyroid nodules can help determine the likelihood of malignancy and classify nodules into several tumor phenotypes, predicting their behaviors and potentially allowing for a more tailored treatment. NBNR alterations should be managed with caution.
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Affiliation(s)
- Grégoire B Morand
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; Department of Otorhinolaryngology - Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland; Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland.
| | - Idit Tessler
- Department of Otolaryngology - Head and Neck Surgery, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Maxine Noik
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Josh Krasner
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Tzahi Yamin
- Department of Otolaryngology - Head and Neck Surgery, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Marc P Pusztaszeri
- Department of Pathology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Galit Avior
- Department of Otolaryngology - Head and Neck Surgery, Sheba Medical Center, Technion University, Tel-Aviv, Israel
| | - Richard J Payne
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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Morand GB, Eskander A, Fu R, de Almeida J, Goldstein D, Noroozi H, Hosni A, Seikaly H, Tabet P, Pyne JM, Matthews TW, Dort J, Nakoneshny S, Christopoulos A, Bahig H, Johnson-Obaseki S, Hua N, Gaudet M, Jooya A, Nichols A, Laxague F, Cecchini M, Du J, Shapiro J, Karam I, Dziegielewski PT, Hanubal K, Erovic B, Grasl S, Davies J, Monteiro E, Gete M, Witterick I, Sadeghi N, Richardson K, Shenouda G, Maniakas A, Landry V, Gupta M, Zhou K, Mlynarek AM, Pusztaszeri M, Sultanem K, Hier MP. The protective role of postoperative radiation therapy in low and intermediate grade major salivary gland malignancies: A study of the Canadian Head and Neck Collaborative Research Initiative. Cancer 2023; 129:3263-3274. [PMID: 37401841 DOI: 10.1002/cncr.34932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND The objective of this study was to examine the utility of postoperative radiation for low and intermediate grade cancers of the parotid and submandibular glands. METHODS The authors conducted a retrospective, Canadian-led, international, multi-institutional analysis of a patient cohort with low or intermediate grade salivary gland cancer of the parotid or submandibular gland who were treated from 2010 until 2020 with or without postoperative radiation therapy. A multivariable, marginal Cox proportional hazards regression analysis was performed to quantify the association between locoregional recurrence (LRR) and receipt of postoperative radiation therapy while accounting for patient-level factors and the clustering of patients by institution. RESULTS In total, 621 patients across 14 tertiary care centers were included in the study; of these, 309 patients (49.8%) received postoperative radiation therapy. Tumor histologies included 182 (29.3%) acinic cell carcinomas, 312 (50.2%) mucoepidermoid carcinomas, and 137 (20.5%) other low or intermediate grade primary salivary gland carcinomas. Kaplan-Meier LRR-free survival at 10 years was 89.0% (95% confidence interval [CI], 84.9%-93.3%). In multivariable Cox regression analysis, postoperative radiation therapy was independently associated with a lower hazard of LRR (adjusted hazard ratio, 0.53; 95% CI, 0.29-0.97). The multivariable model estimated that the marginal probability of LRR within 10 years was 15.4% without radiation and 8.8% with radiation. The number needed to treat was 16 patients (95% CI, 14-18 patients). Radiation therapy had no benefit in patients who had early stage, low-grade salivary gland cancer without evidence of nodal disease and negative margins. CONCLUSIONS Postoperative radiation therapy may reduce LLR in some low and intermediate grade salivary gland cancers with adverse features, but it had no benefit in patients who had early stage, low-grade salivary gland cancer with negative margins.
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Affiliation(s)
- Grégoire B Morand
- Department of Otolaryngology Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - Rui Fu
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - John de Almeida
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - David Goldstein
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Hesameddin Noroozi
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ali Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Center-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Hadi Seikaly
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Paul Tabet
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Justin M Pyne
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - T Wayne Matthews
- Department Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Joseph Dort
- Department Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Steve Nakoneshny
- Department Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Apostolos Christopoulos
- Department of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l'Université de Montreal (CHUM), Université de Montreal, Montreal, Quebec, Canada
| | - Houda Bahig
- Department of Radiation Oncology, CHUM, Université de Montreal, Montreal, Quebec, Canada
| | - Stephanie Johnson-Obaseki
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Nadia Hua
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Marc Gaudet
- Department of Radiation Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Alborz Jooya
- Department of Radiation Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Anthony Nichols
- Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada
| | - Francisco Laxague
- Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada
| | - Matthew Cecchini
- Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada
| | - Jenny Du
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - Justin Shapiro
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - Irene Karam
- Department of Radiation Oncology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - Peter T Dziegielewski
- Department of Otolaryngology-Head and Neck Surgery, University of Florida Health Shands Hospital, University of Florida, Gainesville, Florida, USA
| | - Krishna Hanubal
- Department of Otolaryngology-Head and Neck Surgery, University of Florida Health Shands Hospital, University of Florida, Gainesville, Florida, USA
| | - Boban Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, Vienna, Austria
| | - Stefan Grasl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Joel Davies
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Eric Monteiro
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Maru Gete
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Ian Witterick
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nader Sadeghi
- Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada
| | - Keith Richardson
- Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada
| | - George Shenouda
- Department of Radiation Oncology, McGill University Heath Center, Montreal, Quebec, Canada
| | - Anastasios Maniakas
- Department Otolaryngology-Head and Neck Surgery, Hôpital Maisonneuve-Rosemont, Université de Montreal, Montreal, Quebec, Canada
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Vivianne Landry
- Department Otolaryngology-Head and Neck Surgery, Hôpital Maisonneuve-Rosemont, Université de Montreal, Montreal, Quebec, Canada
| | - Michael Gupta
- Department of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Kelvin Zhou
- Department of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Alex M Mlynarek
- Department of Otolaryngology Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Marc Pusztaszeri
- Department of Pathology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Khalil Sultanem
- Department of Radiation Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Michael P Hier
- Department of Otolaryngology Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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Morand GB, Golliez A, Rupp NJ. Histopathological Analysis of Nodal Disease After Chemoradiation Reveals Viable Tumor Cells as the most Important Prognostic Factor in Head and Neck Squamous Cell Carcinoma, DOI 10.1007/s12105-023-01557-7. Head Neck Pathol 2023; 17:881-882. [PMID: 37612574 PMCID: PMC10513993 DOI: 10.1007/s12105-023-01573-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 08/25/2023]
Affiliation(s)
- Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis - Jewish General Hospital, McGill University, Montreal, QC, Canada
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Aline Golliez
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Morand GB, Tessler I, Krasner J, Pusztaszeri MP, Yamin T, Gecel NA, Avior G, Payne RJ. Investigation of genetic sex-specific molecular profile in well-differentiated thyroid cancer: Is there a difference between females and males? Clin Otolaryngol 2023; 48:748-755. [PMID: 37212457 DOI: 10.1111/coa.14075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/28/2023] [Accepted: 05/01/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Although more common in females, thyroid cancer is deemed to be more aggressive in males. The reasons for sex disparities in thyroid cancer are not well understood. We hypothesised that differences in molecular mutations between females and males contribute to this phenomenon. METHODS Retrospective multicentre multinational study of thyroid nodules that underwent preoperative molecular profiling between 2015 and 2022. The clinical characteristics and mutational profiles of tumours in female and male patients were compared. Collected data included demographics, cytology results, surgical pathology, and molecular alterations. RESULTS A total of 738 patients were included of which 571 (77.4%) were females. The extrathyroidal extension was more common in malignancies in males (chi-squared, p = 0.028). The rate of point mutations and gene fusions were similar in both sex groups (p > 0.05 for all mutations). Patients with nodules with BRAFV600E mutations were significantly younger than BRAF wild-type nodule patients (t-test, p = 0.0001). Conversely, patients with TERT promoter mutations were significantly older than patients with wild-type TERT (t-test, p < 0.0001). For patients harbouring both BRAFV600E and TERT mutations, the difference in age at presentation was significantly different in females (t-test, p = 0.009) but not in males (t-test, p = 0.433). Among females, patients with BRAFV600E and TERT mutations were significantly older than their wild-type or single-mutation counterpart (t-test, p = 0.003). CONCLUSION The absolute rate of molecular mutations was similar in females and males. We found that extrathyroidal extension was more common in males. Moreover, BRAFV600E and TERT mutations occur at a younger age in males than in females. These two findings are factors that may explain the tendency of more aggressive disease in males.
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Affiliation(s)
- Grégoire B Morand
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
- Department of Otorhinolaryngology-Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Idit Tessler
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Josh Krasner
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Marc P Pusztaszeri
- Department of Pathology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Tzahi Yamin
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Nir A Gecel
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Galit Avior
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Technion University, Tel-Aviv, Israel
| | - Richard J Payne
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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7
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Golliez A, Morand GB, Broglie MA, Balermpas P, Rupp NJ. Histopathological Analysis of Nodal Disease After Chemoradiation Reveals Viable Tumor Cells as the most Important Prognostic Factor in Head and Neck Squamous Cell Carcinoma. Head Neck Pathol 2023; 17:599-606. [PMID: 37195519 PMCID: PMC10514022 DOI: 10.1007/s12105-023-01557-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 04/16/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND In head and neck squamous cell carcinoma (HNSCC), salvage neck dissection (ND) is required after primary chemoradiation in case of residual nodal disease. Upon histopathological examination, viability of tumor cells is assessed but little is known about other prognostic histopathological features. In particular, the presence of swirled keratin debris and its prognostic value is controversial. The aim of this study is to examine histopathological parameters in ND specimens and correlate them with patient outcome to determine the relevant parameters for histopathological reporting. MATERIALS AND METHODS Salvage ND specimen from a cohort of n = 75 HNSCC (oropharynx, larynx, hypopharynx) patients with prior (chemo) radiation were evaluated on H&E stains for the following parameters: viable tumor cells, necrosis, swirled keratin debris, foamy histiocytes, bleeding residues, fibrosis, elastosis, pyknotic cells, calcification, cholesterol crystals, multinucleated giant cells, perineural, and vascular invasion. Histological features were correlated with survival outcomes. RESULTS Only the presence / amount (area) of viable tumor cells correlated with a worse clinical outcome (local and regional recurrence-free survival, (LRRFS), distant metastasis-free survival, disease-specific survival, and overall survival, p < 0.05) in both the univariable and multivariable analyses. CONCLUSION We could confirm the presence of viable tumor cells as a relevant negative prognostic factor after (chemo) radiation. The amount (area) of viable tumor cells further substratified patients with worse LRRFS. None of the other parameters correlated with a distinctive worse outcome. Importantly, the presence of (swirled) keratin debris alone should not be considered viable tumor cells (ypN0).
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Affiliation(s)
- Aline Golliez
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
| | - Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis - Jewish General Hospital, McGill University, Montreal, QC, Canada
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Panagiotis Balermpas
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
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8
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Freiberger SN, Holzmann D, Morand GB, Hüllner M, Levesque MP, Dummer R, Koelzer VH, Rupp NJ. Combinational expression of tumor testis antigens NY-ESO-1, MAGE-A3, and MAGE-A4 predicts response to immunotherapy in mucosal melanoma patients. J Cancer Res Clin Oncol 2023; 149:5645-5653. [PMID: 36527482 PMCID: PMC10356647 DOI: 10.1007/s00432-022-04514-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Immunotherapy using immune checkpoint inhibitors (ICI) has revolutionized cancer treatment in recent years, particularly in melanoma. While response to immunotherapy is associated with high tumor mutational burden (TMB), PD-L1 expression, and microsatellite instability in several cancers, tumors lacking these biomarkers can still respond to this treatment. Especially, mucosal melanoma, commonly exhibiting low TMB compared to cutaneous melanoma, may respond to immunotherapy with immune checkpoint inhibitors. Therefore, the aim of our study was to investigate novel biomarkers in mucosal melanoma that predict response to combined ipilimumab and nivolumab. METHODS We investigated 10 tumor samples from 10 patients (three responders, seven non-responders) before treatment and six tumor samples from five patients after progression using a targeted Next Generation Sequencing (NGS) gene expression panel. The findings were corroborated with an independent method (i.e., immunohistochemical staining) on the same 10 tumor samples before treatment and, to increase the cohort, in addition on three tumor samples before treatment of more recent patients (one responder, two non-responders). RESULTS With the targeted gene expression panel, we found the three tumor testis antigens CTAG1B (NY-ESO-1), MAGE-A3, and MAGE-A4 to be predominantly expressed in responding tumors. This marker panel was either not or not completely expressed in non-responders (p < 0.01). Using immunohistochemistry for all three markers, we could confirm the elevated expression in tumors responding to the ipilimumab/nivolumab combination therapy. CONCLUSION In conclusion, these three biomarkers await validation in a larger patient cohort and could be easily used in future routine diagnostics to predict the outcome of ipilimumab/nivolumab combination therapy in mucosal melanoma patients.
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Affiliation(s)
- Sandra N Freiberger
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstrasse 12, 8091, Zurich, Switzerland.
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
| | - David Holzmann
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis - Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Martin Hüllner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Mitchell P Levesque
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Reinhard Dummer
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Viktor H Koelzer
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstrasse 12, 8091, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstrasse 12, 8091, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
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9
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Morand GB, Huellner MW. Improved diagnostic accuracy of hybrid positron emission tomography (PET) with tumor-specific radiotracer for head and neck squamous cell carcinoma staging. Transl Cancer Res 2023; 12:676-679. [PMID: 37033356 PMCID: PMC10080303 DOI: 10.21037/tcr-22-2892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023]
Affiliation(s)
- Grégoire B. Morand
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
- University of Zurich, Zurich, Switzerland
- Department of Otolaryngology-Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Martin W. Huellner
- University of Zurich, Zurich, Switzerland
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
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10
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Morand GB. [Metabolic Tumor Imaging in Head and Neck Oncology]. Praxis (Bern 1994) 2022; 111:878-883. [PMID: 36415988 DOI: 10.1024/1661-8157/a003926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Metabolic Tumor Imaging in Head and Neck Oncology Abstract. Fluorodeoxyglucose with position emission tomography combined with CT or MRI (FDG-PET) has become an important diagnostic and staging method in head and neck squamous cell carcinoma. Some regard FDG-PET merely as a tool able of displaying cancer cells as bright spots on imaging. However, quantification of FDG uptake can be used as a surrogate marker for tumor aggressiveness and predict tumor response before (chemo)-radiation. The FDG uptake of the primary tumor can also predict surgical outcome measures such as depth of invasion, occult nodal metastasis, or bone invasion for oral cancer and/or organ preservation in hypopharyngeal cancer.
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11
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Morand GB, Alsayegh R, Mlynarek AM, Plourde M, Mach T, Mascarella MA, Hier MP, Florianova L, Pusztaszeri MP. Application of the Milan system for reporting salivary gland cytopathology using cell blocks. Virchows Arch 2022; 481:575-583. [PMID: 35750873 DOI: 10.1007/s00428-022-03364-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/24/2022]
Abstract
The Milan system for reporting salivary gland cytopathology (MSRSGC) is a novel standardized classification tool for salivary gland cytology specimens based on the use of direct smears. Formalin-fixed paraffin-embedded (FFPE) cell blocks facilitate the use of ancillary studies, leading to improved diagnostic accuracy. However, the application of the MSRSGC with only cell blocks has not been well established. Consecutive cohort of all parotid gland cytology specimens between 01/01/2018 and 30/06/2021 was performed. All cytology specimens were processed into cell blocks only. Cytologic diagnoses were classified prospectively according to the MSRSGC categories. The risk of malignancy (ROM) for each diagnostic category and the diagnostic performance were calculated. A total of 230 FNA samples from 221 patients were identified, including 47% and 78.4% with surgical or clinical follow-up, respectively. The ROMs based on surgical follow-up for the non-diagnostic, non-neoplastic, AUS, neoplasm: benign, SUMP, SFM and malignant categories were 21.4%,0%,50%,0%,30%,100% and 100%, respectively. The ROMs based on the clinical follow-up for these categories were 7.3%,0%,37.3%,0%,27.3%,100% and 100%, respectively. Following surgical excision, all Milan IVa category samples were confirmed as benign, and all Milan V and VI category samples were confirmed as malignant. This study validates the application of the MSRSGC with the sole use of FFPE cell blocks. The diagnostic accuracy of MSRSGC is high and compares favorably to other institutions using traditional cytology assessment methods. Furthermore, FNA results using this technique enabled to provide optimal patient management based on the ROM of the different Milan system categories.
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Affiliation(s)
- Grégoire B Morand
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Raihanah Alsayegh
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Alex M Mlynarek
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Marianne Plourde
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Tiffany Mach
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Marco A Mascarella
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Michael P Hier
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Livia Florianova
- Department of Pathology, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine Road, Montreal, QC, Canada
| | - Marc P Pusztaszeri
- Department of Pathology, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine Road, Montreal, QC, Canada.
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12
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Morand GB, Sultanem K, Mascarella MA, Hier MP, Mlynarek AM. Historical Perspective: How the Discovery of HPV Virus Led to the Utilization of a Robot. Front Oral Health 2022; 3:912861. [PMID: 35601819 PMCID: PMC9120614 DOI: 10.3389/froh.2022.912861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/20/2022] [Indexed: 12/14/2022] Open
Abstract
The treatment of oropharyngeal cancer has undergone many paradigms shifts in recent decades. First considered a surgical disease, improvements in radiotherapy led to its popularization in the 1990s. Subsequently, the discovery of the human papillomavirus (HPV) in the pathogenesis of oropharyngeal cancer, as well as the increase in HPV-associated oropharynx cancer incidence, have prompted a reevaluation of its management. Its sensitivity to standard treatment with a favorable prognosis compared to non HPV-associated oropharyngeal cancer led to a focus on minimizing treatment toxicity. Advances in radiation and surgical techniques, including the use of transoral robotic surgery, gave the rationale to ongoing de-escalation clinical trials in HPV-associated oropharynx cancer.
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Affiliation(s)
- Grégoire B. Morand
- Department of Otolaryngology Head and Neck Surgery, Centre Intégré Universitaire de Santé et de Services Sociaux West-Central Montreal-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Khalil Sultanem
- Department of Radiation Oncology, Centre Intégré Universitaire de Santé et de Services Sociaux West-Central Montreal-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Marco A. Mascarella
- Department of Otolaryngology Head and Neck Surgery, Centre Intégré Universitaire de Santé et de Services Sociaux West-Central Montreal-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Michael P. Hier
- Department of Otolaryngology Head and Neck Surgery, Centre Intégré Universitaire de Santé et de Services Sociaux West-Central Montreal-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Alex M. Mlynarek
- Department of Otolaryngology Head and Neck Surgery, Centre Intégré Universitaire de Santé et de Services Sociaux West-Central Montreal-Jewish General Hospital, McGill University, Montreal, QC, Canada
- *Correspondence: Alex M. Mlynarek
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13
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Semsar-Kazerooni K, Morand GB, Payne AE, da Silva SD, Forest VI, Hier MP, Pusztaszeri MP, Tamilia M, Payne RJ. Mutational status may supersede tumor size in predicting the presence of aggressive pathologic features in well differentiated thyroid cancer. J Otolaryngol Head Neck Surg 2022; 51:9. [PMID: 35246262 PMCID: PMC8895819 DOI: 10.1186/s40463-022-00559-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 01/17/2022] [Indexed: 12/14/2022] Open
Abstract
Background In clinical practice, thyroid tumor size plays a critical role in the staging of thyroid malignancies and in the selection of nodules that should undergo ultrasound-guided fine-needle aspiration. Thyroid tumor size is influenced by the elapsed time since the beginning of oncogenesis and by the presence of somatic mutations driving growth, such as BRAFV600E mutations, associated with aggressive phenotypes, and RAS-like mutations, associated with more indolent behavior. Although large nodules are often considered to be more alarming, the true impact of tumor size on prognosis remains controversial. The aim of this study was to assess the relationship between mutational status, tumor size and aggressiveness, with emphasis on BRAFV600E and RAS-like mutations. Method We conducted a multicentric retrospective chart review in Montréal, Canada, of all patients who underwent thyroid surgery between January 2016 and December 2020, with well-differentiated thyroid cancer on final pathology, and who had undergone molecular testing revealing the presence of BRAFV600E mutations or RAS-like mutations (NRAS, HRAS or KRAS). Results We included 214 cases. There were 117 (54.7%) cases of BRAFV600E and 97 (45.3%) cases of RAS-like mutations. The BRAFV600E group was statistically associated with a smaller mean tumor size when compared with the RAS group of 1.55 cm and 2.04 cm, respectively. In a multivariate model, tumors with BRAFV600E mutations were also more likely to display aggressive pathological features, including extra-thyroidal extension, lymph node metastasis, columnar cell features, tall cell histology, or hobnail histology (OR 26.69; 95% CI 11.15–70.81). In contrast, tumor size was not associated with pathologic aggressive features on multivariate analysis (OR 0.81; 95% CI 0.54–1.22). Conclusion This study demonstrates that thyroid tumors expressing BRAFV600E mutations correlate with aggressive pathologic features more than tumors expressing RAS-like mutations. When comparing tumors with BRAFV600E and RAS-like mutations, the former were found to be smaller. As a result of this finding, this study suggests that molecular alterations may better predict aggressive pathologic features than the size of the tumor. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40463-022-00559-9.
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Affiliation(s)
| | - Grégoire B Morand
- Faculty of Medicine, McGill University, Montréal, QC, Canada.,Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montréal, QC, H3T 1E2, Canada
| | | | - Sabrina D da Silva
- Faculty of Medicine, McGill University, Montréal, QC, Canada.,Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montréal, QC, H3T 1E2, Canada
| | - Véronique-Isabelle Forest
- Faculty of Medicine, McGill University, Montréal, QC, Canada.,Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montréal, QC, H3T 1E2, Canada
| | - Michael P Hier
- Faculty of Medicine, McGill University, Montréal, QC, Canada.,Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montréal, QC, H3T 1E2, Canada
| | - Marc P Pusztaszeri
- Faculty of Medicine, McGill University, Montréal, QC, Canada.,Department of Pathology, Jewish General Hospital, McGill University, Montréal, QC, Canada
| | - Michael Tamilia
- Faculty of Medicine, McGill University, Montréal, QC, Canada.,Division of Endocrinology and Metabolism, Jewish General Hospital, McGill University, Montréal, QC, Canada
| | - Richard J Payne
- Faculty of Medicine, McGill University, Montréal, QC, Canada. .,Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montréal, QC, H3T 1E2, Canada.
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14
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Rupp NJ, Höller S, Brada M, Vital D, Morand GB, Broglie MA, Huellner MW, Freiberger SN. Expanding the clinicopathological spectrum of TGFBR3-PLAG1 rearranged salivary gland neoplasms with myoepithelial differentiation including evidence of high-grade transformation. Genes Chromosomes Cancer 2021; 61:94-104. [PMID: 34755406 PMCID: PMC9299195 DOI: 10.1002/gcc.23009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/03/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022] Open
Abstract
PLAG1 rearrangements have been described as a molecular hallmark of salivary gland pleomorphic adenoma (PA), carcinoma ex pleomorphic adenoma (CEPA), and myoepithelial carcinoma (MECA). Several fusion partners have been described, however, commonly no further assignment to the aforementioned entities or a morphological prediction can be made based on the knowledge of the fusion partner alone. In contrast, TGFBR3‐PLAG1 fusion has been specifically described and characterized as an oncogenic driver in MECA, and less common in MECA ex PA. Here, we describe the clinicopathological features of three TGFBR3‐PLAG1 fusion‐positive salivary gland neoplasms, all of which arose in the deep lobe of the parotid gland. Histopathology showed high morphological similarities, encompassing encapsulation, a polylobular growth pattern, bland basaloid and oncocytoid cells with myoepithelial differentiation, and a distinct sclerotic background. All cases showed at least limited, unusual foci of minimal invasion into adjacent salivary gland tissue, including one case with ERBB2 (Her2/neu) amplified, TP53 mutated high‐grade transformation, and lymph node metastases. Of note, all cases illustrated focal ductal differentiation. Classification remains difficult, as morphological overlaps between myoepithelial‐rich cellular PA, myoepithelioma, and MECA were observed. However, evidence of minimal invasion advocates classification as low‐grade MECA. This case series further characterizes the spectrum of uncommon cellular myoepithelial neoplasms harboring TGFBR3‐PLAG1 fusion, which show recurrent minimal invasion of the adjacent salivary gland tissue, a predilection to the deep lobe of the parotid gland, and potential high‐grade transformation.
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Affiliation(s)
- Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Sylvia Höller
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Muriel Brada
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Domenic Vital
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis - Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Martina A Broglie
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Martin W Huellner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Sandra N Freiberger
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
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15
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Lubov J, Labbé M, Sioufi K, Morand GB, Hier MP, Khanna M, Sultanem K, Mlynarek AM. Prognostic factors of head and neck cutaneous squamous cell carcinoma: a systematic review. J Otolaryngol Head Neck Surg 2021; 50:54. [PMID: 34493343 PMCID: PMC8425113 DOI: 10.1186/s40463-021-00529-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 06/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Head and neck cutaneous squamous cell carcinoma (HNCSCC) is a non-melanoma skin cancer that is mostly caused by solar ultraviolet radiation exposure. While it usually has an excellent prognosis, a subset of patients (5%) develops nodal metastasis and has poor outcomes. The aim of this study was to systematically review the literature and evaluate the prognostic factors of HNCSCC in order to better understand which patients are the most likely to develop metastatic disease. METHODS A comprehensive literature search was performed on PubMed and EMBASE to identify the studies that evaluated the prognostic factors of HNCSCC. Prognostic factors were deemed significant if they had a reported p-value of < 0.05. Proportions of studies that reported a given factor to be statistically significant were calculated for each prognostic factor. RESULTS The search yielded a total of 958 citations. Forty studies, involving a total of 8535 patients, were included in the final analysis. The pre-operative/clinical prognostic factors with the highest proportion of significance were state of immunosuppression (73.3%) and age (53.3%); while post-operative/pathological prognostic factors of importance were number of lymph nodes involved with carcinoma (70.0%), margins involved with carcinoma (66.7%), and tumor depth (50.0%). CONCLUSION This systematic review is aimed to aid physicians in assessing the prognosis of HNCSCC and identifying the subsets of patients that are most susceptible to metastasis. It also suggests that immunosuppressed patients with a high-risk feature on biopsy, such as invasion beyond subcutaneous fat, could possibly benefit from a sentinel lymph node biopsy.
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Affiliation(s)
- Joshua Lubov
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General HospitalMcGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Mathilde Labbé
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General HospitalMcGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Krystelle Sioufi
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General HospitalMcGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Grégoire B Morand
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General HospitalMcGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Michael P Hier
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General HospitalMcGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Manish Khanna
- Department of Dermatology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Khalil Sultanem
- Department of Radiation Oncology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Alex M Mlynarek
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General HospitalMcGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada.
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16
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Baettig SJ, Parini A, Cardona I, Morand GB. Case series of coronavirus (SARS-CoV-2) in a military recruit school: clinical, sanitary and logistical implications. BMJ Mil Health 2021; 167:251-254. [PMID: 32303575 PMCID: PMC7306277 DOI: 10.1136/bmjmilitary-2020-001482] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 01/23/2023]
Abstract
INTRODUCTION A new coronavirus, called Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2), has emerged from China in late 2019 and has now caused a worldwide pandemic. The impact of COVID-19 has not been described so far in a military setting. We therefore report a case series of infected patients in a recruit school in Switzerland and the herein associated challenges. METHODS Retrospective review of COVID-19 cases among Swiss Armed Forces recruits in the early weeks of SARS-CoV-2 pandemic in the canton of Ticino, the southernmost canton of Switzerland. Positive cases were defined with two positive PCR testing for SARS-CoV-2 from nasopharyngeal swabs. Serological testing was performed with a commercially available kit according to manufacturers' instructions. RESULTS The first case was likely contaminated while skiing during weekend permission. He became symptomatic 4 days later, tested positive for SARS-CoV-2 and was put into isolation. He showed complete symptom resolution after 48 hours. Quarantine was ordered for all recruits with close contact in the past 2 days, a total of 55 persons out of 140 in the company. Seven out of nine recruits in one particular quarantine room became mildly symptomatic. SARS-CoV-2 PCR was positive in one of them. Seven days after initial diagnosis, the index patient and the other one from the quarantine retested positive for SARS-CoV-2, although they had been completely asymptomatic for over 96 hours. Serological testing revealed positive for both patients. All others showed negative IgM and IgG. CONCLUSIONS Young healthy recruits often showed a mild course of COVID-19 with rapid symptom decline but were persistent SARS-CoV-2 carriers. This illustrates how asymptomatic patients may be responsible for covert viral transmission. An early and prolonged establishment of isolation and quarantine for patients and close contacts is essential to slow down the spread of SARS-CoV-2, especially in the confined space of a military environment.
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Affiliation(s)
- Sascha J Baettig
- Department of Anaesthesiology, Kantonsspital Winterthur, Winterthur, Switzerland
- Military Medical Services, Swiss Armed Forces, Bern, Switzerland
| | - A Parini
- Military Medical Services, Swiss Armed Forces, Bern, Switzerland
| | - I Cardona
- Department of Gynaecology and Obstetrics, Spitalzentrum Biel, Biel, Switzerland
| | - G B Morand
- Military Medical Services, Swiss Armed Forces, Bern, Switzerland
- Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
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17
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Freiberger SN, Turko P, Hüllner M, Dummer R, Morand GB, Levesque MP, Holzmann D, Rupp NJ. Who's Driving? Switch of Drivers in Immunotherapy-Treated Progressing Sinonasal Melanoma. Cancers (Basel) 2021; 13:cancers13112725. [PMID: 34072863 PMCID: PMC8198298 DOI: 10.3390/cancers13112725] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/12/2021] [Accepted: 05/28/2021] [Indexed: 01/19/2023] Open
Abstract
Simple Summary Here, we monitored the course of the disease and treatment of sinonasal melanoma patients. Since treatment options are rare, immunotherapy is often the treatment of choice. However, intrinsic or acquired resistance to treatment may occur. We assessed the mutational status of the tumors and metastases during the course of therapy and recognized a switch of the oncogenic drivers to mutant NRAS in progressing disease. As a switch of drivers (other than the addition of a second driver) has not been reported yet, longitudinal molecular testing and the awareness of molecular heterogeneity of sinonasal melanoma is crucial. Abstract Mucosal melanoma can be driven by various driver mutations in genes such as NRAS, KIT, or KRAS. However, some cases present with only weak drivers, or lacking known oncogenic drivers, suggesting immunotherapy over targeted therapy. While resistance mechanisms to immunotherapy in cutaneous melanoma have been uncovered, including alterations in JAK1/2, B2M, or STK11, a switch of oncogenic drivers under immunotherapy has not yet been observed. We report three cases of metastatic sinonasal melanoma that switched oncogenic drivers from KRAS, KIT, or no driver to NRAS during or after immunotherapy, thereby showing progressive disease. One of the cases presented with three spatially separate driver mutations in the primary tumor, whereas the NRAS clone persisted under immunotherapy. In comparison, three different control cases receiving radiotherapy only did not show a change of the detectable molecular drivers in their respective recurrences or metastases. In summary, these data provide an important rationale for longitudinal molecular testing, based on evidence for an unforeseen recurrent event of molecular driver switch to NRAS in progressing sinonasal melanoma. These findings provide the basis for further studies on a potential causal relation of emerging NRAS mutant clones and immunotherapy.
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Affiliation(s)
- Sandra N. Freiberger
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland;
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland; (M.H.); (R.D.); (G.B.M.); (M.P.L.); (D.H.)
- Correspondence: ; Tel.: +41-44-255-3929
| | - Patrick Turko
- Department of Dermatology, University Hospital Zurich, 8058 Zurich, Switzerland;
| | - Martin Hüllner
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland; (M.H.); (R.D.); (G.B.M.); (M.P.L.); (D.H.)
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Reinhard Dummer
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland; (M.H.); (R.D.); (G.B.M.); (M.P.L.); (D.H.)
- Department of Dermatology, University Hospital Zurich, 8058 Zurich, Switzerland;
| | - Grégoire B. Morand
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland; (M.H.); (R.D.); (G.B.M.); (M.P.L.); (D.H.)
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland
- Department of Otolaryngology, Head and Neck Surgery, Sir Mortimer B. Davis—Jewish General Hospital, McGill University, Montreal, QC H3T1E2, Canada
| | - Mitchell P. Levesque
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland; (M.H.); (R.D.); (G.B.M.); (M.P.L.); (D.H.)
- Department of Dermatology, University Hospital Zurich, 8058 Zurich, Switzerland;
| | - David Holzmann
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland; (M.H.); (R.D.); (G.B.M.); (M.P.L.); (D.H.)
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Niels J. Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland;
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland; (M.H.); (R.D.); (G.B.M.); (M.P.L.); (D.H.)
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18
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Stadler TM, Morand GB, Rupp NJ, Hüllner MW, Broglie MA. FDG-PET-CT/MRI in head and neck squamous cell carcinoma: Impact on pretherapeutic N classification, detection of distant metastases, and second primary tumors. Head Neck 2021; 43:2058-2068. [PMID: 33729625 DOI: 10.1002/hed.26668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/09/2021] [Accepted: 02/26/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To assess the effect of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in the pretherapeutic staging of N classification, detection rate of distant metastases, and second primaries. METHODS Retrospective study on patients with head and neck carcinoma. We compared pretherapeutic N classification by ultrasound, computed tomography (CT)/magnetic resonance imaging (MRI), and FDG-PET-CT/MRI. RESULTS A change in the N classification due to FDG-PET-CT/MRI was observed in 116 patients (39.5%) compared to N classification by ultrasound and fine-needle aspiration cytology. Patients with advanced nodal classification (>N2a) were more likely to be reclassified. Distant metastases were detected in 19 patients and a total of 36 second primaries were diagnosed by FDG-PET-CT/MRI. Detection of distant metastases was more likely in regional advanced disease (>N2a). Smokers (>10 py) had a significantly higher risk of second primary. CONCLUSION FDG-PET-CT/MRI leads to a significant change in pretherapeutic N classification. The cumulative incidence of distant metastases and second primaries was 18.7%.
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Affiliation(s)
- Thomas M Stadler
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Martin W Hüllner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
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19
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Morand GB, Anderegg N, Kleinjung T, Bohlender JE, Veraguth D, Broglie MA, Holzmann D, Huber AM, Röösli C, Soyka MB. Assessment of Surgical Complications With Respect to the Surgical Indication: Proposal for a Novel Index. Front Surg 2021; 8:638057. [PMID: 33681285 PMCID: PMC7930554 DOI: 10.3389/fsurg.2021.638057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/11/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: The Clavien–Dindo classification is a broadly accepted surgical complications classification system, grading complications by the extent of therapy necessary to resolve them. A drawback of the method is that it does not consider why the patient was operated on primarily. Methods: We designed a novel index based on Clavien–Dindo but with respect to the surgical indication. We surveyed an international panel of otolaryngologists who filled out a questionnaire with 32 real case-inspired scenarios. Each case was graded for the surgical complication, surgical indication, and a subjective rating whether the complication was acceptable or not. Results: Seventy-seven otolaryngologists responded to the survey. Mean subjective rating and surgical complication grading for each scenario showed an inverse correlation (r2 = 0.147, p = 0.044). When grading the surgical complication with respect to the surgical indication, the correlation with the subjective rating increased dramatically (r2 = 0.307, p = 0.0022). Conclusion: We describe a novel index grading surgical complications with respect to the surgical indication. In our survey, most respondents judged a complication as acceptable or not according to its grade but kept in mind the surgical indication. This subjective judgment could be quantified with our novel index.
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Affiliation(s)
- Grégoire B Morand
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Nanina Anderegg
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Jörg E Bohlender
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Dorothe Veraguth
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Alexander M Huber
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Christof Röösli
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Michael B Soyka
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
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20
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Morand GB. Neutralising antibodies and virus isolation: The keys to control covert COVID-19 spread? Lancet Reg Health Eur 2021; 2:100027. [PMID: 34173626 PMCID: PMC7832109 DOI: 10.1016/j.lanepe.2021.100027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Grégoire B Morand
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis - Jewish General Hospital, McGill University, Montreal, Canada.,Department of Otorhinolaryngology - University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Military Medical Services, Swiss Armed Forces, Bern, Switzerland
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21
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Waech T, Pazahr S, Guarda V, Rupp NJ, Broglie MA, Morand GB. Measurement variations of MRI and CT in the assessment of tumor depth of invasion in oral cancer: A retrospective study. Eur J Radiol 2020; 135:109480. [PMID: 33370639 DOI: 10.1016/j.ejrad.2020.109480] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/24/2020] [Accepted: 12/11/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE In oral squamous cell carcinoma (OSCC), depth of invasion (DOI) is an important predictive, prognostic, and staging parameter. While it is known that DOI can be estimated from preoperative imaging, an analysis of measurements variations according to imaging modality and to depth of tumor itself is lacking. The aim of the study was to assess the accuracy of imaging-based estimation of DOI in relation with the tumor histological DOI. METHODS We retrospectively reviewed 121 patients with OSCC treated at University Hospital Zurich. The radiologic DOI of CT, T1-weighted, and T2-weighted MRI were compared with histological DOI. Frequency of relevant imaging artifacts was assessed as well. RESULTS A total of 110 CT (90.9 %) and 90 MRI (74 %) were analyzed. Both modalities were available for 79 patients (65.3 %). The median histological depth of invasion was 9 mm (IQR 4.5-14). The median depth of invasion was 14 mm (IQR 10-20) on CT, 13 mm (IQR 8.25-18) on T1-weighted MRI, and 13 mm (IQR 9-18.75) on T2-weighted MRI. All diagnostic modalities tended towards an overestimation of the histopathologic DOI from about 5-15 %. This trend was most pronounced for thin tumors, for which both CT and MRI lead to upstaging in over 50 % of the cases. For 25 (22.7 %) patients, dental scattering on CT rendered DOI not estimable. For MRI, 18 patients (20 %) had artifacts (blooming, motion artifacts) rendering DOI not estimable. CONCLUSION CT and MRI measurements of DOI in OSCC lead to an overestimation of histological DOI, especially in tumors with DOI<5 mm, with upstaging by imaging in over 50 % of the cases. Artifacts were present in more than 20 % of performed images.
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Affiliation(s)
- Tobias Waech
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| | - Shila Pazahr
- University of Zurich, Zurich, Switzerland; Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Vittoria Guarda
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- University of Zurich, Zurich, Switzerland; Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland.
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22
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de Lima JM, Morand GB, Macedo CCS, Diesel L, Hier MP, Mlynarek A, Kowalski LP, Maschietto M, Alaoui-Jamali MA, da Silva SD. NDRG1 deficiency is associated with regional metastasis in oral cancer by inducing epithelial-mesenchymal transition. Carcinogenesis 2020; 41:769-777. [PMID: 32112078 DOI: 10.1093/carcin/bgaa017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/13/2020] [Accepted: 02/24/2020] [Indexed: 12/17/2022] Open
Abstract
Regional metastasis is the single most important prognostic factor in oral squamous cell carcinoma (OSCC). Abnormal expression of N-myc downstream-regulated genes (NDRGs) has been identified to occur in several tumor types and to predict poor prognosis. In OSCC, the clinical significance of deregulated NDRG expression has not been fully established. In this study, NDRG1 relevance was assessed at gene and protein levels in 100 OSCC patients followed up by at least 10 years. Survival outcome was analyzed using a multivariable analysis. Tumor progression and metastasis was investigated in preclinical model using oral cancer cell lines (HSC3 and SCC25) treated with epidermal growth factor (EGF) and orthotopic mouse model of metastatic murine OSCC (AT84). We identified NDRG1 expression levels to be significantly lower in patients with metastatic tumors compared with patients with local disease only (P = 0.001). NDRG1 expression was associated with MMP-2, -9, -10 (P = 0.022, P = 0.002, P = 0.042, respectively) and BCL2 (P = 0.035). NDRG1 lower expression was able to predict recurrence and metastasis (log-rank test, P = 0.001). In multivariable analysis, the expression of NDRG1 was an independent prognostic factor (Cox regression, P = 0.013). In invasive OSCC cells, NDRG1 expression is diminished in response to EGF and this was associated with a potent induction of epithelial-mesenchymal transition phenotype. This result was further confirmed in an orthotopic OSCC mouse model. Together, this data support that NDRG1 downregulation is a potential predictor of metastasis and approaches aimed at NDRG1 signaling rescue can serve as potential therapeutic strategy to prevent oral cancer progression to metastasis.
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Affiliation(s)
- Jefferson Muniz de Lima
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Grégoire B Morand
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Departments of Medicine, Oncology, and Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Carolina Carneiro Soares Macedo
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Luciana Diesel
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Michael P Hier
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Alex Mlynarek
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Luiz P Kowalski
- AC Camargo Cancer Center and National Institute of Science and Technology on Oncogenomics (INCITO), Sao Paulo, Sao Paulo, Brazil
| | | | - Moulay A Alaoui-Jamali
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Departments of Medicine, Oncology, and Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sabrina Daniela da Silva
- Department of Otolaryngology Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Departments of Medicine, Oncology, and Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, QC, Canada
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23
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Stadler TM, Hüllner MW, Broglie MA, Morand GB. Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas. Sci Rep 2020; 10:16689. [PMID: 33028940 PMCID: PMC7542158 DOI: 10.1038/s41598-020-73914-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/24/2020] [Indexed: 11/09/2022] Open
Abstract
18-flurodesoxyglucose position emission tomography (FDG-PET) with computed tomography (CT) or magnetic resonance imaging (MRI) is a broadly accepted tool for pretherapeutic staging and post-therapeutic assessment of response. The prognostic value of sequential post-therapeutic FDG-PETs and the impact of change in metabolic activity has been scarcely reported so far. We hypothesized that an increase in metabolic activity (as measured by maximum standardized uptake value, SUVmax) would be predictive for recurrence. We retrospectively assessed all oral, oropharyngeal, laryngeal, and hypopharyngeal squamous cell carcinoma patients treated at the Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich between April 1st, 2010 and September 30th, 2018 (N = 337). After a negative post-treatment FDG-PET at 3 months, we measured the SUVmax of the local tumor area and the regional lymph nodes on follow-up FDG-PET at 9 months. We then correlated SUVmax difference between 9 and 3 months with tumor recurrence using Kaplan Meier analysis. During follow-up, 68 patients (20.2%) had local recurrence and 53 had regional recurrence (15.7%) at a median time of 9.0 (IQR 4.25-14) and 7.0 (IQR 5.25-23) months, respectively. An increase in local and/or regional SUVmax from the 3 months to the 9 months post-therapeutic FDG-PET resulted in a poorer recurrence-free survival (Log rank, P = 0.001, for both). An increase in local SUVmax between 3 and 9 months was associated with a hazard ratio of 4.17 for recurrence (95%CI 1.89-9.2, P = 0.0003). In conclusion, an increase in metabolic activity/SUVmax between two post-therapeutic FDG-PETs requires a histological examination as it is associated with tumor recurrence.
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Affiliation(s)
- Thomas M Stadler
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martin W Hüllner
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
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24
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Morand GB, Broglie MA, Schumann P, Huellner MW, Rupp NJ. Histometabolic Tumor Imaging of Hypoxia in Oral Cancer: Clinicopathological Correlation for Prediction of an Aggressive Phenotype. Front Oncol 2020; 10:1670. [PMID: 32984043 PMCID: PMC7481376 DOI: 10.3389/fonc.2020.01670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/28/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction Fluorodeoxyglucose-positron emission tomography (FDG-PET) is a widely used imaging tool for oral squamous cell carcinoma (OSCC). Preliminary studies indicate that quantification of tumor metabolic uptake may correlate with tumor hypoxia and aggressive phenotypes. Methods Retrospective review of a consecutive cohort of OSCC (n = 98) with available pretherapeutic FDG-PET/CT, treated at the University Hospital Zurich. Clinico-pathologico-radiological correlation between maximum standard uptake value (SUVmax) of the primary tumor, immunohistochemical staining for hypoxia-related proteins glucose transporter 1 (GLUT1) and hypoxia-inducible factor 1-alpha (HIF1a), depth of invasion (DOI), lymph node metastasis, and outcome was examined. Results Positive staining for GLUT1 and HIF1a on immunohistopathological analysis correlated with increased SUVmax on pretherapeutic imaging and with increased DOI (Kruskal–Wallis, P = 0.037, and P = 0.008, respectively). SUVmax and DOI showed a strong positive correlation (Spearman Rho, correlation coefficient = 0.451, P = 0.0003). An increase in SUVmax predicted nodal metastasis (Kruskal–Wallis, P = 0.017) and poor local control (log rank, P = 0.047). Conclusion In OSCC, FDG-PET-derived metabolic tumor parameter SUVmax serves as a surrogate marker for hypoxia and can be used to predict tumor aggressiveness, with more invasive phenotypes and poorer local control.
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Affiliation(s)
- Grégoire B Morand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Paul Schumann
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Martin W Huellner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
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25
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Stalder SA, Schumann P, Lanzer M, Hüllner MW, Rupp NJ, Broglie MA, Morand GB. Value of SUV max for the Prediction of Bone Invasion in Oral Squamous Cell Carcinoma. Biology (Basel) 2020; 9:biology9020023. [PMID: 32024247 PMCID: PMC7167854 DOI: 10.3390/biology9020023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/24/2020] [Accepted: 01/31/2020] [Indexed: 12/21/2022]
Abstract
In advanced oral squamous cell carcinoma (OSCC), accurate planning of surgical resection and reconstruction are crucial for outcome and postoperative function. For OSCC close to the maxilla or mandible, prediction of bone invasion is necessary. The aim of this study was to examine whether metabolic tumor imaging obtained by fluorodeoxyglucose positron emission tomography (FDG-PET) could enhance preoperative predictability of bone invasion. We performed an analysis of 84 treatment-naïve OSCCs arising from gum (upper and lower), hard palate, floor of mouth, and retromolar trigone treated at the University Hospital Zurich, Switzerland, who underwent wide local excision with free flap reconstruction between 04/2010 and 09/2018 and with available preoperative FDG-PET. Prediction of bone invasion by metabolic tumor imaging such as maximum standardized uptake value (SUVmax) was examined. On definitive histopathology, bone invasion was present in 47 of 84 cases (56%). The probability of bone infiltration increased with a higher pretherapeutic SUVmax in an almost linear manner. A pretherapeutic SUVmax of primary tumor below 9.5 ruled out bone invasion preoperatively with a high specificity (97.6%). The risk of bone invasion was 53.6% and 71.4% for patients with SUVmax between 9.5-14.5 and above 14.5, respectively. Patients with bone invasion had worse distant metastasis-free survival compared to patients without bone invasion (log-rank test, p = 0.032). In conclusion, metabolic tumor imaging using FDG-PET could be used to rule out bone invasion in oral cancer patients and may serve in treatment planning.
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Affiliation(s)
- Stephanie A. Stalder
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (S.A.S.); (M.A.B.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
| | - Paul Schumann
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
- Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (P.S.); (M.L.)
| | - Martin Lanzer
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
- Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (P.S.); (M.L.)
| | - Martin W. Hüllner
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Niels J. Rupp
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Martina A. Broglie
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (S.A.S.); (M.A.B.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
| | - Grégoire B. Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (S.A.S.); (M.A.B.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
- Correspondence: ; Tel.: +41-44-255-58-50; Fax: +41-44-255-45-56
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26
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Rüegg P, Morand GB, Kudura K, Rupp NJ, Hüllner MW, Broglie MA. Tumor cell viability in salvage neck dissections: Poor prognosis predicted by high postradiation nodal SUV max , p16-negativity, and low nodal shrinkage. Head Neck 2019; 42:660-669. [PMID: 31854495 DOI: 10.1002/hed.26045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/11/2019] [Accepted: 12/03/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND After primary chemoradiation in advanced oropharyngeal, laryngeal, and/or hypopharyngeal cancer, nodal disease may require a salvage neck dissection. However, salvage neck dissection is associated with increased morbidity and may only be necessary in case of persistence of viable tumor cells, which can be difficult to confirm and virtually impossible to exclude by fine needle aspiration cytology. We, therefore, aimed to identify predictive factors for the persistence of viable tumor cells in lymph node metastases from head and neck squamous cell cancer after chemoradiation. METHODS We performed a retrospective review of neck dissection specimens performed after primary (chemo-)radiation for oropharyngeal, laryngeal, or hypopharyngeal squamous cell carcinoma. All patients were treated at University Hospital Zurich from 2007 to 2016. RESULTS A total of 78 patients were included. Thirty-eight patients (48.7%) had viable tumor cells in their neck dissection sample. High postradiation nodal maximum standardized uptake value (SUVmax ), p16 negativity, and low nodal shrinkage were predictors of viable tumor cells in salvage neck dissections (Mann-Whitney U/chi-squared test, P < .001, P = .025, and P = .042, respectively). Patients with viable tumor cells showed a significantly worse locoregional recurrence-free survival, distant metastasis-free survival, and disease-specific survival (log-rank test, P < .001). CONCLUSIONS Viable tumor cells can be predicted by high residual metabolic activity in the lymph nodes, negative p16 status, and low nodal shrinkage. Viable tumor cells in neck dissection specimens are associated with a poor survival and provide important prognostic information.
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Affiliation(s)
- Pascal Rüegg
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Ken Kudura
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Martin W Hüllner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
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27
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Morand GB, Rupp NJ, Huellner MW, Gerber PA, Soyka MB, Broglie MA, Holzmann D. Transnasal-Transpterygoid Endoscopic Removal of an 18F-Choline-Avid Parathyroid Carcinoma Metastasis in the Skull Base. JAMA Otolaryngol Head Neck Surg 2019; 145:978-980. [PMID: 31436808 DOI: 10.1001/jamaoto.2019.2352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Grégoire B Morand
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- University of Zurich, Zurich, Switzerland.,Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Martin W Huellner
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Philipp A Gerber
- University of Zurich, Zurich, Switzerland.,Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Michael B Soyka
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
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Freiberger SN, Morand GB, Turko P, Wager U, Dummer R, Hüllner M, Holzmann D, Rupp NJ, Levesque MP. Morpho-Molecular Assessment Indicates New Prognostic Aspects and Personalized Therapeutic Options in Sinonasal Melanoma. Cancers (Basel) 2019; 11:cancers11091329. [PMID: 31500314 PMCID: PMC6770844 DOI: 10.3390/cancers11091329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/28/2019] [Accepted: 09/04/2019] [Indexed: 12/27/2022] Open
Abstract
Sinonasal melanoma is a rare subtype of melanoma and little is known about its molecular fingerprint. Systemic treatment options are limited, as targetable BRAF mutations are rare compared to cutaneous melanoma. Currently, metastatic sinonasal melanoma is being treated according to the guidelines of cutaneous melanoma. In this study, we investigated the molecular profile of 19 primary sinonasal melanomas, using a novel customized melanoma-specific next generation sequencing (NGS) panel (MelArray) of 190 genes. Results were correlated to histological and clinical features to further characterize this rare, aggressive type of melanoma and screen for prognostic markers and possible treatment options. Molecular profiles encompassed predominantly mutations in NRAS (25%), whereas KIT or BRAF p.V600 mutations were not detected. Tumor mutational burden was overall low. High level of copy number variations (CNVs) were associated with alterations in DNA-repair genes and shorter distant metastasis-free survival (p = 0.005). Monomorphic (vs. pleomorphic) morphology was found to be significantly associated with worse disease-specific survival (p < 0.001), however no correlation between morphology and molecular aberrations was found. A variety of alterations in different pathways were detected, justifying molecular testing and opening potential personalized treatment options in current study or compassionate use settings.
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Affiliation(s)
- Sandra N Freiberger
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.
- University of Zurich, 8006 Zurich, Switzerland.
| | - Grégoire B Morand
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - Patrick Turko
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - Ulrich Wager
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.
- University of Zurich, 8006 Zurich, Switzerland.
| | - Reinhard Dummer
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - Martin Hüllner
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - David Holzmann
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.
- University of Zurich, 8006 Zurich, Switzerland.
| | - Mitchell P Levesque
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland.
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29
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Rupp NJ, Brada M, Skálová A, Bode B, Broglie MA, Morand GB, Rechsteiner M, Freiberger SN. New Insights into Tumor Heterogeneity: A Case of Solid-Oncocytic Epithelial-Myoepithelial Carcinoma of the Parotid Gland Harboring a HRAS and Heterogeneous Terminating ARID1A Mutation. Head Neck Pathol 2019; 14:554-558. [PMID: 31309433 PMCID: PMC7235098 DOI: 10.1007/s12105-019-01055-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 07/10/2019] [Indexed: 12/31/2022]
Abstract
Epithelial-myoepithelial carcinoma (EMC) can be a challenging diagnosis due to a lack of obvious invasion and bland cytology. We report an unusual case of a low-grade EMC with prominent fibrous stroma, an extensive solid-oncocytic differentiation and limited areas of morphological clearly identifiable characteristic biphasic (tubular) differentiation, clear cells and PAS-positive secretions/calcifications. Both areas were investigated by next generation sequencing (Oncomine comprehensive assay) and revealed a typical concordant HRAS p.Q61R mutation. An additional heterogeneous ARID1A (p.E672*) terminating mutation with loss of heterozygosity, which could be visualized predominantly in the solid-oncocytic differentiation by immunohistochemical loss of ARID1A protein expression, was found. This is the first case of an EMC of the salivary gland to be described with two separate tumor clones involving concordant HRAS and heterogeneous ARID1A mutations. The latter seem to be a "second hit" and was predominantly found in the solid-oncocytic differentiation, suggesting a potential morpho-molecular association.
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Affiliation(s)
- Niels J. Rupp
- grid.412004.30000 0004 0478 9977Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstr. 12, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
| | - Muriel Brada
- grid.412004.30000 0004 0478 9977Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstr. 12, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
| | - Alena Skálová
- grid.4491.80000 0004 1937 116XSikl’s Department of Pathology, Faculty of Medicine in Plzen, Charles University, Pilsen, Czech Republic
| | - Beata Bode
- grid.412004.30000 0004 0478 9977Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstr. 12, 8091 Zurich, Switzerland ,grid.9851.50000 0001 2165 4204Institute of Pathology Enge, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
| | - Martina A. Broglie
- grid.412004.30000 0004 0478 9977Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
| | - Grégoire B. Morand
- grid.412004.30000 0004 0478 9977Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
| | - Markus Rechsteiner
- grid.412004.30000 0004 0478 9977Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstr. 12, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
| | - Sandra N. Freiberger
- grid.412004.30000 0004 0478 9977Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstr. 12, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
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30
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Werner J, Hüllner MW, Rupp NJ, Huber AM, Broglie MA, Huber GF, Morand GB. Predictive Value of Pretherapeutic Maximum Standardized Uptake Value (Suv max) In Laryngeal and Hypopharyngeal Cancer. Sci Rep 2019; 9:8972. [PMID: 31222167 PMCID: PMC6586936 DOI: 10.1038/s41598-019-45462-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/07/2019] [Indexed: 12/15/2022] Open
Abstract
The aim of the study was to evaluate whether pretherapeutic metabolic tumor parameters from 18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging could predict larynx preservation in laryngeal and hypopharyngeal cancer patients prior to primary chemoradiation. Tumor metabolic parameters [maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were retrospectively assessed in a consecutive cohort of laryngeal and hypopharyngeal cancer patients undergoing primary (chemo-)radiation. Main outcome measures were larynx preservation and survival. The study included 97 patients with a median follow-up of 32 months (IQR 20-54.5). For hypopharyngeal cancer, multivariable analysis showed that patients with a primary tumor's SUVmax > 9.5 entailed a higher risk of undergoing salvage pharyngolaryngectomy after chemoradiation (HR = 8.64, 95% CI = 1.1-67.3, P = 0.040). In laryngeal cancer, SUVmax did not predict the need for salvage laryngectomy. The only predictor for larynx preservation in laryngeal cancer patients was T-classification at initial diagnosis (HR = 6.67, 95% CI = 0.82-53.9, P = 0.039). In conclusion, SUVmax of primary tumor could be used as a predictor of larynx preservation prior to primary chemoradiation in hypopharyngeal cancer patients. This information may be important for patient counseling, as high SUVmax was correlated with reduced probability of larynx preservation. However, in laryngeal cancer patients, SUVmax does not seem to be predictive of outcome.
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Affiliation(s)
- Jonas Werner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martin W Hüllner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Alexander M Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
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31
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Stadler TM, Morand GB, Rupp NJ, Freiberger SN, Broglie MA. [Benefits of Molecular Analyses in Thyroid Carcinoma]. Praxis (Bern 1994) 2019; 108:535-540. [PMID: 31185849 DOI: 10.1024/1661-8157/a003240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Benefits of Molecular Analyses in Thyroid Carcinoma Abstract. The widespread access to neck ultrasonography has led to high detection rates of thyroid nodules, whose vast majority will remain clinically silent. In daily practice it is a challenge to filter out the thyroid nodules that require medical attention. This is usually achieved by a combination of sonomorphologic criteria and fine-needle aspiration cytology. In recent years, there is a trend toward deescalation in diagnostic and therapeutic measures for thyroid nodules. Some authors even advocate active surveillance instead of surgical approaches for very low-risk thyroid carcinoma. This approach requires an accurate assessment of the malignant potential of each thyroid nodule. As recent studies have allowed better understanding of molecular pathogenesis of thyroid cancer, the mutational profile of thyroid nodules has emerged as a new tool for assessment of thyroid nodules. Its exact clinical application in daily routine remains, however, unclear.
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Affiliation(s)
- Thomas M Stadler
- 1 Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Universitätsspital Zürich
| | - Grégoire B Morand
- 1 Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Universitätsspital Zürich
| | - Niels J Rupp
- 2 Institut für Pathologie und Molekularpathologie, Universitätsspital Zürich
| | - Sandra N Freiberger
- 2 Institut für Pathologie und Molekularpathologie, Universitätsspital Zürich
| | - Martina A Broglie
- 1 Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Universitätsspital Zürich
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32
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Rupp NJ, Umbricht CA, Pizzuto DA, Lenggenhager D, Töpfer A, Müller J, Muehlematter UJ, Ferraro DA, Messerli M, Morand GB, Huber GF, Eberli D, Schibli R, Müller C, Burger IA. First Clinicopathologic Evidence of a Non-PSMA-Related Uptake Mechanism for 68Ga-PSMA-11 in Salivary Glands. J Nucl Med 2019; 60:1270-1276. [PMID: 30737300 DOI: 10.2967/jnumed.118.222307] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 01/13/2019] [Indexed: 01/03/2023] Open
Abstract
The intense accumulation of prostate-specific membrane antigen (PSMA) radioligands in salivary glands is still not well understood. It is of concern for therapeutic applications of PSMA radioligands, because therapeutic radiation will damage these glands. A better understanding of the uptake mechanism is, therefore, crucial to find solutions to reduce toxicity. The aim of this study was to investigate whether the accumulation of PSMA-targeting radioligands in submandibular glands (SMGs) can be explained with PSMA expression levels using autoradiography (ARG) and immunohistochemistry (IHC). Methods: All patients gave written informed consent for further utility of the biologic material. The SMG of 9 patients, pancreatic tissue of 4 patients, and prostate cancer (PCA) lesions of 9 patients were analyzed. Tissue specimens were analyzed by means of PSMA-IHC (using an anti-PSMA-antibody and an immunoreactivity score system [IRS]) and ARG using 177Lu-PSMA-617 (with quantification of the relative signal intensity compared with a PSMA-positive standard). The SUVmax in salivary glands, pancreas, and PCA tissues were quantified in 60 clinical 68Ga-PSMA-11 PET scans for recurrent disease as well as the 9 primary tumors selected for ARG and IHC. Results: PCA tissue samples revealed a wide range of PSMA staining intensity on IHC (IRS = 70-300) as well as in ARG (1.3%-22% of standard). This variability on PCA tissue could also be observed in 68Ga-PSMA-11 PET (SUVmax, 4.4-16) with a significant correlation between ARG and SUVmax (P < 0.001, R 2 = 0.897). On IHC, ARG, and 68Ga-PSMA-11 PET, the pancreatic tissue was negative (IRS = 0, ARG = 0.1% ± 0.05%, SUVmax of 3.1 ± 1.1). The SMG tissue displayed only focal expression of PSMA limited to the intercalated ducts on IHC (IRS = 10-15) and a minimal signal on ARG (1.3% ± 0.9%). In contrast, all SMG showed a high 68Ga-PSMA-11 accumulation on PET scans (SUVmax 23.5 ± 5.2). Conclusion: Our results indicate that the high accumulation of PSMA radioligands in salivary glands does not correspond to high PSMA expression levels determined using ARG and IHC. These findings provide evidence, that the significant accumulation of PSMA radioligands in SMG is not primarily a result of PSMA-mediated uptake.
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Affiliation(s)
- Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zürich, University of Zürich, Switzerland
| | - Christoph A Umbricht
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Villigen-PSI, Switzerland
| | - Daniele A Pizzuto
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Daniela Lenggenhager
- Department of Pathology and Molecular Pathology, University Hospital Zürich, University of Zürich, Switzerland
| | - Antonia Töpfer
- Department of Pathology and Molecular Pathology, University Hospital Zürich, University of Zürich, Switzerland
| | - Julian Müller
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Urs J Muehlematter
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Daniela A Ferraro
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zürich, University of Zürich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland; and
| | - Daniel Eberli
- Department of Urology, University Hospital Zürich, University of Zürich, Switzerland
| | - Roger Schibli
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Villigen-PSI, Switzerland
| | - Cristina Müller
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Villigen-PSI, Switzerland
| | - Irene A Burger
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
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Stadler TM, Morand GB, Schmid S, Broglie MA. Congenital fistula of the fourth branchial arch: Report of case with long-lasting misdiagnosis. Clin Case Rep 2019; 7:295-298. [PMID: 30847192 PMCID: PMC6389478 DOI: 10.1002/ccr3.1965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/18/2018] [Accepted: 11/23/2018] [Indexed: 12/31/2022] Open
Abstract
Fourth branchial arch anomalies are extremely rare. The anatomic course of the fourth branchial arch fistula usually determines the delay in diagnosis. High clinical suspicion should be given to reoccurring neck infections in infants and young adults. Diagnosis is obtained by direct laryngoscopy.
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Affiliation(s)
- Thomas M. Stadler
- Department of Otorhinolaryngology ‐ Head and Neck SurgeryUniversity Hospital ZurichZurichSwitzerland
| | - Grégoire B. Morand
- Department of Otorhinolaryngology ‐ Head and Neck SurgeryUniversity Hospital ZurichZurichSwitzerland
| | - Stephan Schmid
- Department of Otorhinolaryngology ‐ Head and Neck SurgeryUniversity Hospital ZurichZurichSwitzerland
| | - Martina A. Broglie
- Department of Otorhinolaryngology ‐ Head and Neck SurgeryUniversity Hospital ZurichZurichSwitzerland
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34
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Elicin O, Broglie MA, Fankhauser N, Stoeckli SJ, Pasche P, Reinhard A, Bongiovanni M, Huber GF, Morand GB, Soltermann A, Arnold A, Dettmer MS, Arnoux A, Stauffer E, Espeli V, Martucci F, Aebersold DM, Giger R. Comparison of contemporary staging systems for oropharynx cancer in a surgically treated multi‐institutional cohort. Head Neck 2018; 41:1395-1402. [DOI: 10.1002/hed.25574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 11/30/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University HospitalUniversity of Bern Bern Switzerland
| | - Martina A. Broglie
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Niklaus Fankhauser
- CTU Bern, and Institute of Social and Preventive Medicine (ISPM)University of Bern Bern Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
| | - Philippe Pasche
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of Lausanne Lausanne Switzerland
| | - Antoine Reinhard
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of Lausanne Lausanne Switzerland
| | - Massimo Bongiovanni
- Service of Clinical PathologyLausanne University Hospital, Institute of Pathology Lausanne Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Alex Soltermann
- Institute of Surgical PathologyUniversity Hospital of Zurich Zurich Switzerland
| | - Andreas Arnold
- Department of Otorhinolaryngology, Head and Neck SurgeryInselspital, Bern University Hospital Bern Switzerland
| | | | - André Arnoux
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital Aarau Aarau Switzerland
| | | | - Vittoria Espeli
- Oncology Institute of Southern Switzerland (IOSI) Bellinzona Switzerland
| | - Francesco Martucci
- Department of RadiooncologyOncology Institute of Southern Switzerland (IOSI) Bellinzona Switzerland
| | - Daniel M. Aebersold
- Department of Radiation Oncology, Inselspital, Bern University HospitalUniversity of Bern Bern Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck SurgeryInselspital, Bern University Hospital Bern Switzerland
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35
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Meerwein CM, Pizzuto DA, Vital D, Morand GB, Stolzmann P, Huber GF, Huellner MW. Use of MRI and FDG-PET/CT to predict fixation of advanced hypopharyngeal squamous cell carcinoma to prevertebral space. Head Neck 2018; 41:503-510. [DOI: 10.1002/hed.25431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/24/2018] [Accepted: 09/21/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Christian M. Meerwein
- Department of Otorhinolaryngology, Head & Neck Surgery; University Hospital Zurich; Zurich Switzerland
| | - Daniele A. Pizzuto
- Department of Nuclear Medicine; University Hospital Zurich/University of Zurich; Zurich Switzerland
- Instituto di Medicina Nucleare, Università Cattolica del Sacro Cuore; Rome Italy
| | - Domenic Vital
- Department of Otorhinolaryngology, Head & Neck Surgery; University Hospital Zurich; Zurich Switzerland
| | - Grégoire B. Morand
- Department of Otorhinolaryngology, Head & Neck Surgery; University Hospital Zurich; Zurich Switzerland
| | - Paul Stolzmann
- Department of Nuclear Medicine; University Hospital Zurich/University of Zurich; Zurich Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology; Kantonsspital St. Gallen; St. Gallen Switzerland
| | - Martin W. Huellner
- Department of Nuclear Medicine; University Hospital Zurich/University of Zurich; Zurich Switzerland
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36
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Morand GB, Ikenberg K, Vital DG, Cardona I, Moch H, Stoeckli SJ, Huber GF. Preoperative assessment of CD44‐mediated depth of invasion as predictor of occult metastases in early oral squamous cell carcinoma. Head Neck 2018; 41:950-958. [DOI: 10.1002/hed.25532] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/31/2018] [Accepted: 09/28/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Kristian Ikenberg
- Institute of Pathology and Molecular PathologyUniversity Hospital Zurich Zurich Switzerland
| | - Domenic G. Vital
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Isabel Cardona
- Department of Otolaryngology, Head and Neck SurgeryMcGill University Montreal Québec Canada
| | - Holger Moch
- Institute of Pathology and Molecular PathologyUniversity Hospital Zurich Zurich Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
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37
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Vital D, Holzmann D, Huber GF, Moch H, Morand GB, Ikenberg K. PD-L1 is a positive prognostic factor in squamous cell carcinoma of the nasal vestibule. Rhinology 2018; 56:255-260. [PMID: 29466476 DOI: 10.4193/rhin17.215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Aim was to analyse the role of PD-L1 in squamous cell carcinomas of the nasal vestibule. Advanced squamous cell carcinoma of the nasal vestibule is a highly aggressive tumour. The role of PD-L1 expression is unclear in this tumour type. METHODOLOGY Forty-six patients diagnosed between 1995 and 2014 were analyzed. Baseline characteristics and outcome were correlated to immunohistochemical staining of PD-L1. PD-L1 positivity of tumour cells and tumour infiltrating immune cells (TIIC) was defined by any staining of more than 1% of the tumour cells. RESULTS PD-L1 expression was interpretable in 31 of 46 patients (67.4%). PD-L1 positivity was present in 14 (45.2%) patients tumour cells and 17 (54.8%) patients TIIC. PD-L1 positivity of tumour cells was associated with a favourable disease free survival (p=0.019). CONCLUSIONS Positivity for PD-L1 in tumour cells is a prognostic factor in squamous cell carcinoma of the nasal vestibule and might enable a patient-tailored treatment.
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Affiliation(s)
- D Vital
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - D Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - G F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - H Moch
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - G B Morand
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - K Ikenberg
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Zurich, Switzerland
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Morand GB, Vital DG, Kudura K, Werner J, Stoeckli SJ, Huber GF, Huellner MW. Maximum Standardized Uptake Value (SUV max) of Primary Tumor Predicts Occult Neck Metastasis in Oral Cancer. Sci Rep 2018; 8:11817. [PMID: 30087375 PMCID: PMC6081470 DOI: 10.1038/s41598-018-30111-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/24/2018] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to investigate the predictability of occult lymph node metastasis using maximum standardized uptake value (SUVmax) in the primary tumor on pre-treatment 18-fluorodeoxyglucose positron emission tomography FDG-PET in oral squamous cell carcinoma (OSCC) patients who were clinically node negative (cN0) before surgery. A retrospective analysis of all patients treated at the University Hospital Zurich from 2007 to 2016 for OSCC with available pre-therapeutic FDG-PET was performed. We assessed the correlation of SUVmax of the primary tumors with the presence of occult nodal disease in the neck dissection specimen (pN+). The study included a total of 71 patients. In the nodal negative group (cN0/pN0), the median SUVmax of primary tumors was 9.0 (interquartile range (IQR) 7.4–13.9), while it was 11.4 (IQR 9.9–15.7) in the occult metastatic group (cN0/pN+). The difference was statistically significant (independent samples median test, P = 0.037). In a multivariable model, the only independent predictor of occult metastatic disease for cN0 patients was a SUVmax ≥ 9.5 (P = 0.028). Further, primary tumors with SUVmax ≥ 9.5 had a significantly higher risk of local recurrence (Log rank test, P = 0.020). In conclusion, we showed that higher SUVmax (≥9.5) of the primary tumor is associated with higher occurrence of occult metastatic nodal disease and worse local survival. High SUVmax of the primary tumor may encourage clinicians towards more aggressive treatment.
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Affiliation(s)
- Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Domenic G Vital
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Ken Kudura
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Jonas Werner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Sandro J Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. .,Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
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Meerwein CM, Nakadate M, Stolzmann P, Vital D, Morand GB, Zweifel DF, Huber GF, Huellner MW. Contrast-enhanced 18F-FDG-PET/CT for Differentiating Tumour and Radionecrosis in Head and Neck Cancer: Our experience in 37 Patients. Clin Otolaryngol 2018; 43:1594-1599. [PMID: 29974995 DOI: 10.1111/coa.13185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Christian M Meerwein
- Department of Otorhinolaryngology, Head& Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Masashi Nakadate
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Paul Stolzmann
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Domenic Vital
- Department of Otorhinolaryngology, Head& Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology, Head& Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Daniel F Zweifel
- University of Zurich, Zurich, Switzerland.,Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Gerhard F Huber
- University of Zurich, Zurich, Switzerland.,Department of Otorhinolaryngology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Martin W Huellner
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
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Affiliation(s)
- Niels J. Rupp
- 0000 0004 1937 0650grid.7400.3Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Schmelzbergstrasse 12, 8091 Zurich, Switzerland
| | - Beata Bode
- 0000 0004 1937 0650grid.7400.3Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Schmelzbergstrasse 12, 8091 Zurich, Switzerland
| | - Martina A. Broglie
- 0000 0004 1937 0650grid.7400.3Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - Grégoire B. Morand
- 0000 0004 1937 0650grid.7400.3Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
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Morand GB, Lambercy K, Guilcher P, Sandu KB. Congenital pharyngeal webs: Treatment of a rare clinical entity by endoscopic CO 2 laser approach. Int J Pediatr Otorhinolaryngol 2017; 102:123-126. [PMID: 29106858 DOI: 10.1016/j.ijporl.2017.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 10/19/2022]
Abstract
IMPORTANCE Oesophageal inlet stenosis can promote dysphagia and aspiration. We report the cases of syndromic children with congenital pharyngeal webs successfully treated with endoscopic CO2 laser. OBSERVATIONS Pharyngeal webs were excised with CO2 laser (Ultrapulse mode) and resurfaced using mucosal advancement flaps to avoid restenosis and/or formation of secondary synechia. This led to a significant enlargement of the oesophageal inlet, which was documented immediately postoperatively and the clinical improvement of dysphagia and decreased aspiration persisted at distant follow-up. CONCLUSION AND RELEVANCE Pharyngeal webs are congenital anomalies that can be safely and effectively corrected with endoscopic treatment.
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Affiliation(s)
- Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Lausanne (CHUV), Lausanne, Switzerland; Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
| | - Karma Lambercy
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Lausanne (CHUV), Lausanne, Switzerland
| | - Pierre Guilcher
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Lausanne (CHUV), Lausanne, Switzerland
| | - Kishore B Sandu
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Lausanne (CHUV), Lausanne, Switzerland
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Morand GB, Anderegg N, Vital D, Ikenberg K, Huber GF, Soyka MB, Egger M, Holzmann D. Outcome by treatment modality in sinonasal undifferentiated carcinoma (SNUC): A case-series, systematic review and meta-analysis. Oral Oncol 2017; 75:28-34. [PMID: 29224819 DOI: 10.1016/j.oraloncology.2017.10.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/26/2017] [Accepted: 10/10/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Sinonasal undifferentiated carcinoma (SNUC) is an aggressive malignancy first described by Frierson et al. in 1986. As the tumor is very rare, current treatment recommendations are based on institutional case reports. We thus felt the need to perform a comprehensive systematic review and meta-analysis to investigate how treatment modalities are associated with survival. DESIGN Case-series, systematic review and meta-analysis METHODS: We searched the OvidMedline, OvidEmbase, Web of Science, Biosis, Scopus and the Cochrane Library database libraries. We extracted aggregate and individual patient data for statistical analysis. To study the association between treatment modalities and survival, we used random-effects meta-regression for the aggregate- and cox mixed-effects models. RESULTS 379 citations were found; 29 case series could be included in the final analysis, including a total number of 390 single patients (34.6% female). Median age at diagnosis was 52 years. 80.9% of patients presented with a T4 tumor and 16.0% with nodal metastasis at diagnosis. In individual patient data (IPD) meta-analysis, single modality (surgery alone or radiation alone) treatment was associated with reduced survival compared to double modality (surgery & radiation or chemoradiation) treatment (adjusted Hazard Ratio [aHR] 2.97, 95% ConfidenceInterval [1.41-6.27]) and compared to triple modality (surgery & radiation & chemotherapy) treatment (aHR 2.80 95%-CI 1.29-6.05 for triple vs. single modality). Triple modality treatment was not superior to double modality treatment. (aHR 1.06, 95%-CI 0.59-1.92). CONCLUSION Double and triple modality treatment are associated with improved survival over single modality but there is no evidence that triple modality is superior to double modality treatment.
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Affiliation(s)
- Grégoire B Morand
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland
| | - Nanina Anderegg
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland
| | - Domenic Vital
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland
| | - Kristian Ikenberg
- Department of Surgical Pathology, University Hospital Zurich, Switzerland
| | - Gerhard F Huber
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland
| | - Michael B Soyka
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland
| | - David Holzmann
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland.
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Vital D, Morand GB, Meerwein C, Laske RD, Steinert HC, Schmid C, Brown ML, Huber GF. Early Timing of Thyroidectomy for Hyperthyroidism in Graves’ Disease Improves Biochemical Recovery. World J Surg 2017; 41:2545-2550. [DOI: 10.1007/s00268-017-4052-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Morand GB, da Silva SD, Mlynarek AM, Black MJ, Payne RJ, Hier MP. Clinicopathological relevance of antithyroglobulin antibodies in low-risk papillary thyroid cancer. Clin Otolaryngol 2017; 42:1130-1134. [PMID: 28128522 DOI: 10.1111/coa.12835] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The extent of initial surgical management in papillary thyroid cancer (PTC) is controversial. We examined whether the presence of perioperative antithyroglobulin antibodies (TGA) could predict long-term recurrence and occurrence of adverse features among a homogenous group of patients with PTC. METHODS The clinical features of patients with PTC treated at a single institution (Jewish General Hospital, McGill University, Montreal, Canada) were obtained from the medical records, and all clinicopathologic information was reviewed. Only low-risk PTC without clinical evidence of nodal disease before surgery and treated with 30 mCi of radioactive iodine was included in the study. RESULTS The chart review retrieved 361 patients with a median follow-up of 85.0 months (Q25-Q75 73-98). Forty-two (11.6%) patients had presence of perioperative TGA. Perioperative TGAs were associated with present extrathyroidal extension (P=.005), unsuspected nodal disease (P=.001) and autoimmune thyroiditis (P<.0001). Overall, 17 (4.7%) patients experienced locoregional recurrence. Perioperative TGAs were a significant predictor of recurrence in univariable (P=.021) but not in multivariable analysis (P=.13). CONCLUSION Presence of perioperative TGAs is associated with aggressive histological features and the presence of thyroiditis. Detection of TGA perioperatively may encourage surgeons to consider more extensive initial surgery.
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Affiliation(s)
- G B Morand
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada.,Departments of Medicine and Oncology, Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - S D da Silva
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada.,Departments of Medicine and Oncology, Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - A M Mlynarek
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - M J Black
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - R J Payne
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - M P Hier
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
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Venara-Vulpe II, Morisod B, Morand GB, Zerlauth JB, Simon C. [Percutaneous embolization and ultrasound scissors for removal of a carotid body tumor]. HNO 2016; 64:917-921. [PMID: 27858099 DOI: 10.1007/s00106-016-0283-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Paragangliomas are highly vascularized usually benign neoplasms originating from the sympathoadrenal and parasympathetic paraganglia of the autonomic nervous system. When resectable, the management of these tumors consists of surgical ablation preceded by transarterial embolization. The aim of this article is to describe a novel treatment strategy combining intralesional percutaneous embolization with dissection using ultrasound scissors. The case of a 74-year-old women presenting with a Shamblin type III carotid body paraganglioma is presented. The combined approach of percutaneous embolization and ultrasound scissors permitted complete resection of the tumor with preservation of both the internal and external carotid artery, without postoperative cranial nerve deficits and with minimal blood loss. Preoperative intralesional embolization with a liquid embolic agent less than 24 h prior to surgical intervention in combination with ultrasound scissors appears to be an excellent strategy for surgical management of carotid body paragangliomas.
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Affiliation(s)
- I I Venara-Vulpe
- Klinik für Otorhinolaryngologie, Hals- und Gesichtschirurgie, Universitätsspital Lausanne (CHUV), Bugnon 21, 1006, Lausanne, Schweiz
| | - B Morisod
- Klinik für Otorhinolaryngologie, Hals- und Gesichtschirurgie, Universitätsspital Lausanne (CHUV), Bugnon 21, 1006, Lausanne, Schweiz
| | - G B Morand
- Klinik für Otorhinolaryngologie, Hals- und Gesichtschirurgie, Universitätsspital Lausanne (CHUV), Bugnon 21, 1006, Lausanne, Schweiz
| | - J-B Zerlauth
- Klinik für diagnostische und interventionelle Radiologie, Universitätsspital Lausanne (CHUV), Lausanne, Schweiz
| | - C Simon
- Klinik für Otorhinolaryngologie, Hals- und Gesichtschirurgie, Universitätsspital Lausanne (CHUV), Bugnon 21, 1006, Lausanne, Schweiz.
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Madana J, Laliberté F, Morand GB, Yolmo D, Black MJ, Mlynarek AM, Hier MP. Computerized tomography based tumor-thickness measurement is useful to predict postoperative pathological tumor thickness in oral tongue squamous cell carcinoma. J Otolaryngol Head Neck Surg 2015; 44:49. [PMID: 26573595 PMCID: PMC4647627 DOI: 10.1186/s40463-015-0089-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 08/31/2015] [Indexed: 12/21/2022] Open
Abstract
Background Tumor thickness has been shown in oral tongue squamous cell carcinoma (OTSCC) to be a predictor of cervical metastasis. The postoperative histological measurement is certainly the most accurate, but it would be of clinical interest to gain this information prior to treatment planning. This retrospective study aimed to compare the tumor thickness measurement between preoperative, CT scan, and surgical specimens . Methods We retrospectively included 116 OTSCC patients between 2001 and 2013. Thickness was measured on computer tomography imaging and again surgical specimens. Results The median age was 66 years. 62.8 % of patients were smokers with a mean of 31.4 pack-years. Positive nodal disease was reported in 41.2 %. Mean follow-up time was 33.1 months. The correlation between CT scan-based tumor thickness and surgical specimens based thickness was significant (Spearman rho = 0.755, P < 0.001). Conclusion Tumor thickness assessed by CT scan may provide an accurate estimation of true thickness and can be used in treatment planning.
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Affiliation(s)
- J Madana
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada, H3T 1E2.
| | - Frederick Laliberté
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada, H3T 1E2.
| | - Grégoire B Morand
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada, H3T 1E2.
| | - Deeke Yolmo
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada, H3T 1E2.
| | - Martin J Black
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada, H3T 1E2.
| | - Alex M Mlynarek
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada, H3T 1E2.
| | - Michael P Hier
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada, H3T 1E2.
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Madana J, Morand GB, Alrasheed A, Gabra N, Laliberté F, Barona-Lleó L, Yolmo D, Black MJ, Sultanem K, Hier MP. Clinical parameters predicting development of pulmonary malignancies in patients treated for head and neck squamous cell carcinoma. Head Neck 2015; 38 Suppl 1:E1277-80. [PMID: 26514270 DOI: 10.1002/hed.24210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 06/21/2015] [Accepted: 07/09/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND As the locoregional control rates in head and neck squamous cell carcinoma (HNSCC) have increased, these patients may suffer distant metastasis in a higher proportion of cases. Clinicopathological characteristics allowing prediction of high-risk profile would allow adapting posttreatment surveillance to individual risk. METHODS A retrospective review of all patients with HNSCC treated at the Jewish General Hospital, McGill University, Montreal, Quebec, Canada, between 1999 and 2008 was conducted for this study. RESULTS The study included 428 patients with a mean follow-up of 65 months (±SEM 1.7). Eighty patients (18.6%) developed pulmonary malignancy during follow-up. In multivariate Cox-regression analysis, locoregional failure and current smoking were associated with higher risk of pulmonary malignancy (p < .001 and p = .008, respectively). CONCLUSION Locoregional failure and smoking persistence are predictors of pulmonary malignancy in patients with HNSCC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1277-E1280, 2016.
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Affiliation(s)
- Jeevanandham Madana
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University, Detroit, Michigan
| | - Grégoire B Morand
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Abdulaziz Alrasheed
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Nathalie Gabra
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Frédérick Laliberté
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Luz Barona-Lleó
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University, Detroit, Michigan
| | - Deeke Yolmo
- Department of E.N.T, Darjeeling District Hospital, Darjeeling, India
| | - Martin J Black
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Khalil Sultanem
- Department of Radiation Oncology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Michael P Hier
- Department of Otolaryngology - Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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Morand GB, Fellmann J, Laske RD, Weisert JU, Soltermann A, Zbinden R, Probst R, Huber GF. Detection ofHelicobacter pyloriin patients with head and neck cancer: Results from a prospective comparative study combining serology, polymerase chain reaction, and rapid urease test. Head Neck 2015; 38:769-74. [DOI: 10.1002/hed.23958] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 12/14/2022] Open
Affiliation(s)
- Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Jonas Fellmann
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Roman D. Laske
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Jan U. Weisert
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Alex Soltermann
- Institute of Surgical Pathology, University Hospital Zurich; Switzerland
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich; Switzerland
| | - Rudolf Probst
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
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Alaoui-Jamali MA, Morand GB, da Silva SD. ErbB polymorphisms: insights and implications for response to targeted cancer therapeutics. Front Genet 2015; 6:17. [PMID: 25699077 PMCID: PMC4316710 DOI: 10.3389/fgene.2015.00017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/14/2015] [Indexed: 12/14/2022] Open
Abstract
Advances in high-throughput genomic-scanning have expanded the repertory of genetic variations in DNA sequences encoding ErbB tyrosine kinase receptors in humans, including single nucleotide polymorphisms (SNPs), polymorphic repetitive elements, microsatellite variations, small-scale insertions and deletions. The ErbB family members: EGFR, ErbB2, ErbB3, and ErbB4 receptors are established as drivers of many aspects of tumor initiation and progression to metastasis. This knowledge has provided rationales for the development of an arsenal of anti-ErbB therapeutics, ranging from small molecule kinase inhibitors to monoclonal antibodies. Anti-ErbB agents are becoming the cornerstone therapeutics for the management of cancers that overexpress hyperactive variants of ErbB receptors, in particular ErbB2-positive breast cancer and non-small cell lung carcinomas. However, their clinical benefit has been limited to a subset of patients due to a wide heterogeneity in drug response despite the expression of the ErbB targets, attributed to intrinsic (primary) and to acquired (secondary) resistance. Somatic mutations in ErbB tyrosine kinase domains have been extensively investigated in preclinical and clinical setting as determinants for either high sensitivity or resistance to anti-ErbB therapeutics. In contrast, only scant information is available on the impact of SNPs, which are widespread in genes encoding ErbB receptors, on receptor structure and activity, and their predictive values for drug susceptibility. This review aims to briefly update polymorphic variations in genes encoding ErbB receptors based on recent advances in deep sequencing technologies, and to address challenging issues for a better understanding of the functional impact of single versus combined SNPs in ErbB genes to receptor topology, receptor-drug interaction, and drug susceptibility. The potential of exploiting SNPs in the era of stratified targeted therapeutics is discussed.
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Affiliation(s)
- Moulay A Alaoui-Jamali
- Departments of Medicine and Oncology, Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University Montreal, QC, Canada
| | - Grégoire B Morand
- Departments of Medicine and Oncology, Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University Montreal, QC, Canada ; Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University Montreal, QC, Canada
| | - Sabrina Daniela da Silva
- Departments of Medicine and Oncology, Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University Montreal, QC, Canada ; Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University Montreal, QC, Canada
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da Silva SD, Morand GB, Alobaid FA, Hier MP, Mlynarek AM, Alaoui-Jamali MA, Kowalski LP. Epithelial-mesenchymal transition (EMT) markers have prognostic impact in multiple primary oral squamous cell carcinoma. Clin Exp Metastasis 2014; 32:55-63. [PMID: 25433796 DOI: 10.1007/s10585-014-9690-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 11/24/2014] [Indexed: 12/24/2022]
Abstract
Multiple primary tumors can occur in up to 35 % of the patients with head and neck cancer, however its clinicopathological features remain controversial. Deregulation of epithelial-mesenchymal transition (EMT) signaling has been associated with aggressive malignancies and tumor progression to metastasis in several cancer types. This study is the first to explore EMT process in multiple primary oral squamous cell carcinomas (OSCC). Immunohistochemical analysis of E-cadherin, catenin (α, β, and γ), APC, collagen IV, Ki-67, cyclin D1, and CD44 were performed in a tissue microarray containing multiple representative areas from 102 OSCC patients followed-up by at least 10 years. Results were analysed in relation to clinicopathological characteristics and survival rates in patients presenting multiple primary tumors versus patients without second primary tumors or metastatic disease. Significant association was observed among multiple OSCCs and protein expression of E-cadherin (P = 0.002), β-catenin (P = 0.047), APC (P = 0.017), and cyclin D1 (P = 0.001) as well as between lymph nodes metastasis and Ki-67 staining (P = 0.021). OSCCs presenting vascular embolization were associated with negative β-catenin membrane expression (P = 0.050). There was a significantly lower survival probability for patients with multiple OSCC (log-rank test, P < 0.0001), for tumors showing negative protein expression for E-cadherin (log-rank test, P = 0.003) and β-catenin (log-rank test, P = 0.031). Stratified multivariate survival analysis revealed a prognostic interdependence of E-cadherin and β-catenin co-downexpression in predicting the worst overall survival (log-rank test, P = 0.007). EMT markers have a predicted value for invasiveness related to multiple primary tumors in OSCC and co-downregulation of E-cadherin and β-catenin has a significant prognostic impact in these cases.
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Affiliation(s)
- Sabrina Daniela da Silva
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, Segal Cancer Centre and Lady Davis Institute for Medical Research, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada,
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