1
|
Bishr MK, Banks J, Abdelaziz MS, Badawi M, Crane PW, Donigiewicz UJ, Elkorety M, Girgis M, Humphreys A, Isherwood J, Kahan J, Keelan S, Lindqvist EK, Nixon I, Sackey H, Sars C, Soliman H, Touqan N, Remoundos DD, Ahmed M. Multidisciplinary Management of Phyllodes Tumours and Breast Sarcoma: A Cross-sectional Survey of Clinical Practice across the UK and Ireland. Clin Oncol (R Coll Radiol) 2024; 36:e31-e39. [PMID: 38294995 DOI: 10.1016/j.clon.2023.10.050] [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: 08/11/2023] [Revised: 09/26/2023] [Accepted: 10/17/2023] [Indexed: 02/02/2024]
Abstract
AIMS Phyllodes tumours and breast sarcomas are uncommon tumours and their rarity poses significant challenges in diagnosis and management. This cross-sectional study was conducted to evaluate the multidisciplinary clinical practice for these tumours across the UK and Ireland, with the aim of identifying gaps in knowledge and providing direction for establishing national guidelines. MATERIALS AND METHODS An international survey was adapted and circulated to breast and/or sarcoma surgeons and oncologists in the UK and Ireland through national organisations. Multidisciplinary team (MDT) responses were analysed anonymously. RESULTS Twenty-eight MDTs participated in this study, predominately from high-volume units (85.5%). Although only 43% of the surveyed units were part of a trust that holds a sarcoma MDT, 68% of units managed malignant phyllodes and angiosarcoma, whereas 64.5% managed soft-tissue sarcoma of the breast. Across all subtypes, axillary surgery was recommended by 14-21% of the MDTs and the most recommended resection margins for breast surgery were 'no tumour on ink' in benign phyllodes (39%) and 10 mm in the remaining subtypes (25-29%). Immediate breast reconstruction was supported by 11-18% of MDTs for breast sarcoma subtypes, whereas 36% and 32% advocated this approach in benign and borderline phyllodes tumours, respectively. Adjuvant radiotherapy and chemotherapy were recommended by up to 29% and 11% of the MDTs, respectively. CONCLUSION The results of this study demonstrate a wide variation in clinical practice across the surveyed MDTs. As only 28 MDTs participated in our study, with under-representation from low-volume units, our results might be an underestimation of the variability in practice across the UK and Ireland. This multi-institutional study sheds light on controversial aspects in the management of phyllodes tumours and breast sarcoma, identifies the need for national guidelines to inform best practice, and calls for the centralisation of the management of breast sarcoma within specialist centres.
Collapse
Affiliation(s)
- M K Bishr
- The Royal Marsden NHS Foundation Trust, London, UK.
| | - J Banks
- The Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - M S Abdelaziz
- National Cancer Institute, Cairo University, Cairo, Egypt; University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - M Badawi
- East Sussex Healthcare Trust, Conquest Hospital, St Leonards-on-sea, UK
| | - P W Crane
- Queen Elizabeth II Hospital, Welwyn Garden City, UK
| | | | - M Elkorety
- West Hertfordshire Teaching Hospitals NHS Trust, Watford, UK
| | - M Girgis
- West Suffolk NHS Hospital, Bury St Edmunds, UK
| | - A Humphreys
- Northumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - J Isherwood
- Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - J Kahan
- Velindre Cancer Centre, Cardiff, UK
| | - S Keelan
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - E K Lindqvist
- Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Stockholm South General Hospital, Stockholm, Sweden
| | - I Nixon
- Management Science, Business School, Strathclyde University, Glasgow, UK; The Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - H Sackey
- Division of Cancer, Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital Stockholm, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - C Sars
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - H Soliman
- Kings' College Hospital, Orpington, UK
| | - N Touqan
- Manchester University NHS Foundation Trust, North Manchester General Hospital, Manchester, UK
| | - D D Remoundos
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M Ahmed
- University College London Hospitals NHS Foundation Trust, London, UK
| |
Collapse
|
2
|
Pace-Asciak P, Russell J, Solorzano C, Berber E, Singer M, Shaha AR, Khafif A, Angelos P, Nixon I, Tufano RP. The utility of parathyroid autofluorescence as an adjunct in thyroid and parathyroid surgery 2023. Head Neck 2023; 45:3157-3167. [PMID: 37807364 DOI: 10.1002/hed.27538] [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: 03/05/2023] [Revised: 08/27/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023] Open
Abstract
Thyroid and parathyroid surgery requires careful dissection around the vascular pedicle of the parathyroid glands to avoid excessive manipulation of the tissues. If the blood supply to the parathyroid glands is disrupted, or the glands are inadvertently removed, temporary and/or permanent hypocalcemia can occur, requiring post-operative exogenous calcium and vitamin D analogues to maintain stable levels. This can have a significant impact on the quality of life of patients, particularly if it results in permanent hypocalcemia. For over a decade, parathyroid tissue has been noted to have unique intrinsic properties known as "fluorophores," which fluoresce when excited by an external light source. As a result, parathyroid autofluorescence has emerged as an intra-operative technique to help with identification of parathyroid glands and to supplement direct visualization during thyroidectomy and parathyroidectomy. Due to the growing body of literature surrounding Near Infrared Autofluorescence (NIRAF), we sought to review the value of using autofluorescence technology for parathyroid detection during thyroid and parathyroid surgery. A literature review of parathyroid autofluorescence was performed using PubMED. Based on the reviewed literature and expert surgeons' opinions who have used this technology, recommendations were made. We discuss the current available technologies (image vs. probe approach) as well as their limitations. We also capture the opinions and recommendations of international high-volume endocrine surgeons and whether this technology is of value as an intraoperative adjunct. The utility and value of this technology seems promising and needs to be further defined in different scenarios involving surgeon experience and different patient populations and conditions.
Collapse
Affiliation(s)
- P Pace-Asciak
- Department of Otolaryngology-Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - J Russell
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - C Solorzano
- Department of Surgery-Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University, Nashville, Tennessee, USA
| | - E Berber
- Department of Surgery-Division of Endocrine and Robotics, Cleveland Clinic, Ohio, USA
| | - M Singer
- Department of Otolaryngology-Head and Neck Surgery, The Henry Ford Cancer Institute, West, Michigan, USA
| | - A R Shaha
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A Khafif
- A.R.M. Center of Otolaryngology-Head and Neck Surgery, Assuta Medical Center, Affiliated with BenGurion University of the Negev, Tel Aviv, Israel
| | - P Angelos
- Department of Surgery-Division of Endocrine Surgery, The University of Chicago, Chicago, Illinois, USA
| | - I Nixon
- Department of Otolaryngology-Head and Neck Surgery, NHS Lothian, Edinburgh, UK
| | - R P Tufano
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
- Sarasota Memorial Health Care System Multidisciplinary Thyroid and Parathyroid Center, Florida, USA
| |
Collapse
|
3
|
Yeo JJY, Stewart K, Maniam P, Arman S, Srinivasan D, Wall L, MacNeill M, Strachan M, Nixon I. Neoadjuvant tyrosine kinase inhibitor therapy in locally advanced differentiated thyroid cancer: a single centre case series. J Laryngol Otol 2023; 137:1237-1243. [PMID: 36946096 DOI: 10.1017/s0022215123000506] [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] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Primary surgical resection remains the mainstay of management in locally advanced differentiated thyroid cancer. Tyrosine kinase inhibitors have recently shown promising results in patients with recurrent locally advanced differentiated thyroid cancer. This study discussed four patients with locally advanced differentiated thyroid cancer managed with tyrosine kinase inhibitors used prior to surgery in the 'neoadjuvant' setting. METHOD Prospective data collection through a local thyroid database from February 2016 identified four patients with locally advanced differentiated thyroid cancer unsuitable for primary surgical resection commenced on neoadjuvant tyrosine kinase inhibitor therapy. RESULTS All cases had T4a disease at presentation. Three cases tolerated tyrosine kinase inhibitor therapy for more than 14 months while the last case failed to tolerate treatment at 1 month. All patients subsequently underwent total thyroidectomy to facilitate adjuvant radioactive iodine treatment. Disease-specific survival remains at 100 per cent currently (range, 29-75 months). CONCLUSION Neoadjuvant tyrosine kinase inhibitors in locally advanced differentiated thyroid cancer can be effective in reducing primary tumour extent to potentially facilitate a more limited surgical resection for local disease control.
Collapse
Affiliation(s)
- J J Y Yeo
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
| | - K Stewart
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
| | - P Maniam
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
| | - S Arman
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
| | - D Srinivasan
- Department of Oncology, Western General Hospital, Edinburgh, UK
| | - L Wall
- Department of Oncology, Western General Hospital, Edinburgh, UK
| | - M MacNeill
- Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - M Strachan
- Metabolic Unit, Western General Hospital, Edinburgh, UK
| | - I Nixon
- Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
| |
Collapse
|
4
|
Nixon I, Lindsay C. From Singles Leaders to Leadership as a Social Process: Introducing Distributed Leadership in Health and Care. Clin Oncol (R Coll Radiol) 2023; 35:e407. [PMID: 37003843 DOI: 10.1016/j.clon.2023.03.009] [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] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/15/2023] [Indexed: 03/31/2023]
Affiliation(s)
- I Nixon
- The Beatson West of Scotland Cancer Centre, Glasgow, UK; Business School, University of Strathclyde, Glasgow, UK
| | - C Lindsay
- Business School, University of Strathclyde, Glasgow, UK
| |
Collapse
|
5
|
McCabe H, Nixon I, Abraham A, Cowie F, Reeds H. PO-1420 iCARE: sarcoma patient radiotherapy experience during COVID-19. Radiother Oncol 2021. [PMCID: PMC8479300 DOI: 10.1016/s0167-8140(21)07871-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
6
|
Twigg JA, Anderson JM, Humphris G, Nixon I, Rogers SN, Kanatas A. Re: More evidences are needed in reducing the suicide risk in head and neck cancer patients. Br J Oral Maxillofac Surg 2021; 59:971-972. [PMID: 34304919 DOI: 10.1016/j.bjoms.2020.09.042] [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: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 10/22/2022]
Affiliation(s)
- J A Twigg
- Leeds Teaching Hospitals Trust and Leeds Dental Institute, United Kingdom.
| | | | - G Humphris
- University of St. Andrews, United Kingdom.
| | - I Nixon
- The Beatson West of Scotland Cancer Centre, United Kingdom; Strathclyde University, Glasgow, United Kingdom.
| | - S N Rogers
- University Hospital Aintree, United Kingdom; University of Liverpool, United Kingdom.
| | - A Kanatas
- Leeds Teaching Hospitals, United Kingdom; St James Institute of Oncology, United Kingdom; Leeds Dental Institute, United Kingdom.
| |
Collapse
|
7
|
Twigg J, Anderson J, Humphris G, Nixon I, Rogers S, Kanatas A. Best practice in reducing the suicide risk in head and neck cancer patients: a structured review. Br J Oral Maxillofac Surg 2020; 58:e6-e15. [DOI: 10.1016/j.bjoms.2020.06.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022]
|
8
|
Paterson C, McCrea I, Hay L, Allwood-Speirs S, Devlin L, Sankaralingam M, McLoone P, Wilson C, Grose D, James A, Lamb C, Rizwanullah M, Schipani S, Nixon I, Thomson M, McJury M, Foster J, Duffton A. EP-1137 DW MRI as biomarker of response during RT for intermed/high risk SCC oropharynx: a feasibility study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31557-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
9
|
Hulse K, Williamson A, Wilmot V, Chala N, Conn B, Gibb F, Nixon I. Evaluating the Impact of Changes to the AJCC/UICC Staging System for Differentiated Thyroid Cancer (DTC) on Patients in South East Scotland. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
10
|
Ibrahimpasic T, Ghossein R, Carlson DL, Nixon I, Palmer FL, Shaha AR, Patel SG, Tuttle RM, Shah JP, Ganly I. Outcomes in patients with poorly differentiated thyroid carcinoma. J Clin Endocrinol Metab 2014; 99:1245-52. [PMID: 24512493 DOI: 10.1210/jc.2013-3842] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Poorly differentiated thyroid cancer (PDTC) accounts for only 1-15% of all thyroid cancers. Our objective is to report outcomes in a large series of patients with PDTC treated at a single tertiary care cancer center. METHODS A total of 91 patients with primary PDTC were treated by initial surgery with or without adjuvant therapy at Memorial Sloan-Kettering Cancer Center from 1986 to 2009. Outcomes were calculated by the Kaplan-Meier method. Clinicopathological characteristics were compared for PDTC patients who died of disease to those who did not by the χ(2) test. Factors predictive of disease-specific survival (DSS) were calculated by univariate and multivariate analysis using the log rank and Cox proportional hazards method, respectively. RESULTS With a median follow-up of 50 months, the 5-year overall survival and DSS were 62 and 66%, respectively. The 5-year locoregional and distant control were 81 and 59%, respectively. Of 27 disease-specific deaths, 23 (85%) were due to distant disease. Age ≥ 45 years, pathological tumor size >4 cm, extrathyroidal extension, higher pathological T stage, positive margins, and distant metastases (M1) were predictive of worse DSS on univariate analysis. Multivariate analysis showed that only pT4a stage and M1 were independent predictors of worse DSS. CONCLUSIONS With appropriate surgery and adjuvant therapy, excellent locoregional control can be achieved in PDTC. Disease-specific deaths occurred due to distant metastases and rarely due to uncontrolled locoregional recurrence in this series.
Collapse
Affiliation(s)
- T Ibrahimpasic
- Departments of Head and Neck Surgery (T.I., I.N., F.L.P., A.R.S., S.G.P., J.P.S., I.G.) and Pathology (R.G.), Memorial Sloan-Kettering Cancer Center, New York, New York 10065; Department of Pathology (D.L.C.), Cleveland Clinic, Weston, Florida 33331; and Department of Endocrinology (R.M.T.), Memorial Sloan-Kettering Cancer Center, New York, New York 10065
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Conaglen P, Shan L, Webb D, Buratto E, Davis P, Yii M, Nixon I, Rosalion A, Newcomb A. Concomitant Epicardial Left Ventricular Lead Implantation in Cardiac Surgical Patients with Impaired Cardiac Function. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
12
|
Simo R, Nixon I, Tysome J, Balfour A, Jeannon JP. Modified extended Kocher incision for total thyroidectomy with lateral compartment neck dissection - a critical appraisal of surgical access and cosmesis in 31 patients. Clin Otolaryngol 2012; 37:395-8. [DOI: 10.1111/coa.12009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
13
|
Goh C, McLellan A, Prior D, Newcomb A, Dimitriou J, Rosalion A, Nixon I, Yii M. A Mid-Term Follow-Up of Surgical Ventricular Restoration Patients From the STICH Era. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
14
|
Chernichenko N, Lee N, Ibrahimpasic T, Nixon I, Ghossein R, Shaha A, Shah J, Patel S, Tuttle M, Ganly I. Role of Postoperative Radiotherapy in Management of Well Differentiated Thyroid Carcinoma with Gross Extrathyroidal Extension: Memorial Sloan-Kettering Cancer Center Experience. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
15
|
Pezier T, Nixon I, Pang L, Joshi A, Guerrero-Urbano T, Oakley R, Jeannon J, Simo R. IS PRE-OPERATIVE TRACHEOSTOMY A RISK FACTOR FOR POOR OUTCOME FOLLOWING TOTAL LARYNGECTOMY? Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70102-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
16
|
Nixon I, Ramsay S, MacKenzie K. Study of the Impact of Intensive Care Admission on Vocal Function. Clin Otolaryngol 2007. [DOI: 10.1111/j.1365-2273.2007.01419_13.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
17
|
Abstract
Teleconferencing can be used as part of the integrated management of head and neck cancer. An audit of the participants' views would suggest that the meeting is used in the management of complex head and neck issues.
Collapse
Affiliation(s)
- S A Savage
- West of Scotland Managed Clinical Network for Head and Neck Cancer, Glasgow, UK
| | | | | |
Collapse
|
18
|
Nixon I, Balaji N, Hilmy O, Fu B, Brown C. A prospective study comparing conventional methods against a structured method of gaining patients’ informed consent for tonsillectomy. Clin Otolaryngol 2005; 30:414-7. [PMID: 16232244 DOI: 10.1111/j.1365-2273.2005.01021.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE By providing junior members of medical staff with appropriate guidelines one can achieve an improved standard of informed consent for tonsillectomy, than is provided at present. DESIGN A prospective study of 138 consecutive patients. SETTING District General Hospital. PARTICIPANTS A total of 138 patients undergoing routine tonsillectomy split into two groups. Group A (n=87), the conventional group, gave consent in our unit's standard manner to various grades of doctors by using a hospital general surgical consent form. Most gave their consent as outpatients, while some consented on admission. Group B (n=51), the structured consent group, gave their consent in pre-admission clinic, to an SHO using a standardized tonsillectomy consent form and a structured interview technique. MAIN OUTCOME MEASURES A preoperative questionnaire regarding the knowledge of tonsillectomy. RESULTS Improvement of the awareness of the risks involved with tonsillectomy was achieved by the structured consent Group B; 82% of Group A were aware of postoperative pain compared with 94% of group B (P=0.04); 63% of group A were aware of infection compared with 82% of group B (P=0.02); 100% of group B had read the consent form before signing compared with 80% of group A (P<0.01). There was no statistical difference in the awareness of postoperative haemorrhage (91 versus 98%, P=0.15). CONCLUSION By providing junior medical staff with guidelines, senior staff retain responsibility for consent while improving the standard of informed consent for tonsillectomy.
Collapse
Affiliation(s)
- I Nixon
- Department of ENT, Southern General Hospital, Glasgow, UK.
| | | | | | | | | |
Collapse
|