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Szewczyk M, Pazdrowski J, Pieńkowski P, Wojtera B, Więckowska B, Golusiński P, Golusiński W. A Matter of Margins in Oral Cancer-How Close Is Enough? Cancers (Basel) 2024; 16:1488. [PMID: 38672569 PMCID: PMC11048705 DOI: 10.3390/cancers16081488] [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: 03/21/2024] [Revised: 04/07/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
In patients with oral cancer, the risk factors for local, regional, and distant recurrence according to margin status have not been well established. We aimed to determine the risk factors for recurrence by margin status and to identify a margin cut-off point for improved survival in patients with close margins. We retrospectively reviewed adult patients treated at our centre from 2009 to 2021 for primary oral cancer. Margins were classified as positive (<1 mm), close (1 to 4.9 mm), or clear (>5 mm). Univariate and multivariate analyses were performed. A total of 326 patients (210 men) were included. The mean age was 59.1 years. Margin status was close (n = 168, 51.5%), clear (n = 83, 25.4%), or positive (n = 75, 23.0%). In the univariate analysis, positive surgical margins (HR = 7.53) had the greatest impact on distant failure. Positive surgical margins-without nodal involvement-had the greatest impact on the risk of distant failure. In the close margin group, the optimal cut-off for disease-free survival (AUC = 0.58) and overall survival (AUC = 0.63) was a deep margin > 3 mm, with survival outcomes that were comparable to the clear margin group. These finding suggest that margins < 5 mm may be sufficient in certain well-defined cases. Prospective studies are warranted to confirm these findings.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (J.P.); (P.P.); (B.W.); (W.G.)
- The Greater Poland Cancer Center, 61-866 Poznań, Poland
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (J.P.); (P.P.); (B.W.); (W.G.)
- The Greater Poland Cancer Center, 61-866 Poznań, Poland
| | - Piotr Pieńkowski
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (J.P.); (P.P.); (B.W.); (W.G.)
- The Greater Poland Cancer Center, 61-866 Poznań, Poland
| | - Bartosz Wojtera
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (J.P.); (P.P.); (B.W.); (W.G.)
- The Greater Poland Cancer Center, 61-866 Poznań, Poland
| | - Barbara Więckowska
- Department of Computer Science and Statistics, Poznań University of Medical Sciences, 61-701 Poznań, Poland;
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Góra, 65-417 Zielona Góra, Poland;
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (J.P.); (P.P.); (B.W.); (W.G.)
- The Greater Poland Cancer Center, 61-866 Poznań, Poland
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Szewczyk M, Pazdrowski J, Golusiński P, Więckowska B, Golusiński W. Oral cancer in young adults: should we approach these patients differently? Front Oncol 2024; 14:1297752. [PMID: 38646430 PMCID: PMC11026602 DOI: 10.3389/fonc.2024.1297752] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Objective The influence of age on treatment outcomes in oral cancer is unclear. We aimed to determine the prevalence of oral cancer in adults under age 45 and to compare treatment outcomes by age. Methods Retrospective study of 284 patients treated for oral cancer from 2010 to 2021. The primary analysis involved the full cohort stratified by age (< vs. ≥ 45y). The second analysis included all patients under age 45 (n=44) matched 1:1 by sex and stage to older patients (age 55-70). Results In the primary analysis, the only significant difference was more comorbidities in the older group (p<0.001). In the matched-pair analysis, older patients were more likely to be smokers (75% vs. 54%; p=0.045) and had more comorbidities (p=0.007). The mean PLR and NLR values were significantly higher in the younger group. Conclusions No significant differences were observed between age groups in disease stage or outcomes, suggesting that other variables are more important.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, The Greater Poland Cancer Center, Poznań, Poland
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, The Greater Poland Cancer Center, Poznań, Poland
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Góra, Zielona Góra, Poland
| | - Barbara Więckowska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznań University of Medical Sciences, The Greater Poland Cancer Center, Poznań, Poland
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Nowak R, Przywitowski S, Golusiński P, Olejnik A, Zawiślak E. Complications of Surgically Assisted Rapid Maxillary/Palatal Expansion (SARME/SARPE)-A Retrospective Analysis of 185 Cases Treated at a Single Center. J Clin Med 2024; 13:2053. [PMID: 38610817 PMCID: PMC11012378 DOI: 10.3390/jcm13072053] [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: 02/27/2024] [Revised: 03/19/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Objectives: The study aims to assess and classify complications in patients treated for maxillary transverse deficiency using surgically assisted rapid maxillary/palatal expansion (SARME/SARPE) under general anesthesia. The classification of the complications aimed to assess the difficulty of their treatment as well as estimate its real cost. Methods: The retrospective study covered 185 patients who underwent surgery for a skeletal deformity in the form of maxillary constriction or in which maxillary constriction was one of its components treated by a team of maxillofacial surgeons at one center (97 females and 88 males, aged 15 to 47 years, mean age 26.1 years). Complications were divided into two groups: early complications (up to 3 weeks after surgery) and late complications (>3 weeks after surgery). In relation to the occurrence of complications, we analyzed the demographic characteristics of the group, type of skeletal deformity (class I, II, III), presence of open bite and asymmetry, surgical technique, type and size of appliance used for maxillary expansion, as well as the duration of surgery. Results: In the study group, complications were found in 18 patients (9.73%). Early complications were found in nine patients, while late complications were also found in nine patients. Early complications include no possibility of distraction, palatal mucosa necrosis, perforation of the maxillary alveolar process caused by the distractor and asymmetric distraction. Late complications include maxillary incisor root resorption, no bone formation in the distraction gap, and maxillary incisor necrosis. None of the patients required prolonged hospitalization and only one required reoperation. Conclusions: Complications were found in 18 patients (9.73%). All challenges were classified as minor difficulties since they did not suppress the final outcome of the treatment of skeletal malocclusion. However, the complications that did occur required additional corrective measures. Surgically assisted rapid maxillary expansion, when performed properly and in correlation with the correct orthodontic treatment protocol, is an effective and predictable technique for treating maxillary constriction.
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Affiliation(s)
- Rafał Nowak
- Department of Otolaryngology and Maxillofacial Surgery, Institute of Medical Science, University of Zielona Góra, 65-046 Zielona Góra, Poland
| | - Szymon Przywitowski
- Face Surgery and Aesthetic Center, Pl. Powstańców Śląskich 1, 53-329 Wrocław, Poland
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, Institute of Medical Science, University of Zielona Góra, 65-046 Zielona Góra, Poland
| | - Anna Olejnik
- Face Surgery and Aesthetic Center, Pl. Powstańców Śląskich 1, 53-329 Wrocław, Poland
| | - Ewa Zawiślak
- Face Surgery and Aesthetic Center, Pl. Powstańców Śląskich 1, 53-329 Wrocław, Poland
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Ostrowska K, Niewinski P, Piotrowski I, Ostapowicz J, Koczot S, Suchorska WM, Golusiński P, Masternak MM, Golusiński W. Senescence in head and neck squamous cell carcinoma: relationship between senescence-associated secretory phenotype (SASP) mRNA expression level and clinicopathological features. Clin Transl Oncol 2024; 26:1022-1032. [PMID: 38175424 PMCID: PMC10981631 DOI: 10.1007/s12094-023-03364-6] [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: 04/30/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Cellular senescence is a state characterized by cell-cycle arrest and apoptotic resistance. Senescence in cancer may be induced by oncogenes or therapy. While cellular senescence might play an important role in protection against cancer development, elevated and uncontrolled senescent cells accumulation may promote carcinogenesis by secreting a collection of pro-inflammatory factors, collectively termed the senescence-associated secretory phenotype (SASP). MATERIAL AND METHODS We determined the gene expression at mRNA level of selected cellular senescence markers (p16 and LMNB1) and SASP factors (IL-6, IL-1b, CXCL-1 and TNF-α) in 72 cancerous tissues and 64 normal tissues obtained from patients with head and neck squamous cell carcinoma (HNSCC) and correlated this data with patients' clinical follow-up. RESULTS Our results indicate higher levels of selected SASP factors in cancerous compared to normal tissues. We presented the relationship between SASP factors expression at the transcript level and the progression of the disease. Moreover, we proposed CXCL1 as a candidate biomarker differentiating normal tissues from cancerous ones and IL1b expression as a molecular factor related to increased TNM stage. CONCLUSION Our primary study indicates that SASP expression may be associated with some clinicopathological features. However, a more detailed study is needed to present specific role of senescence-related mechanism and SASPs especially in tumor therapy response and in relation to the patient's immune system condition.
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Affiliation(s)
- Kamila Ostrowska
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-866, Poznan, Poland.
- Radiobiology Laboratory, The Greater Poland Cancer Centre, 61-866, Poznan, Poland.
| | - Patryk Niewinski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-866, Poznan, Poland.
| | - Igor Piotrowski
- Radiobiology Laboratory, The Greater Poland Cancer Centre, 61-866, Poznan, Poland
| | - Julia Ostapowicz
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-866, Poznan, Poland
- Radiobiology Laboratory, The Greater Poland Cancer Centre, 61-866, Poznan, Poland
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866, Poznan, Poland
| | - Sabina Koczot
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-866, Poznan, Poland
| | - Wiktoria Maria Suchorska
- Radiobiology Laboratory, The Greater Poland Cancer Centre, 61-866, Poznan, Poland
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866, Poznan, Poland
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Góra, 65-417, Zielona Góra, Poland
| | - Michal Mateusz Masternak
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-866, Poznan, Poland
- College of Medicine, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, 32827, USA
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-866, Poznan, Poland
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Miśkiewicz-Orczyk K, Ścierski W, Lisowska G, Majewski W, Golusiński P, Misiołek M. Salvage surgery in laryngeal cancer after radiotherapy and partial surgery - comparative results. J Cancer Res Ther 2023; 19:579-584. [PMID: 37470578 DOI: 10.4103/jcrt.jcrt_1548_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Objective The study is a retrospective comparison of the usefulness of salvage surgery between a group of previously radiotherapy-treated patients (RTPs) and a group of patients who previously underwent partial surgery with both local and ± nodal recurrence. Study Design Retrospective study. Setting Multi-center academic hospital. Materials and Methods The former group was comprised 30 previously RTPs, whereas the latter group consisted of 20 patients after partial laryngeal surgery with optional subsequent adjuvant radiotherapy (PSPs). Treatment efficacy was compared in both groups in relation to overall survival (OS) and the locoregional control rate (LCR). Local and ± nodal recurrence was considered primary treatment failure. All patients underwent total laryngectomy. Results The updated 5-year OS in the PSPs was 31%, while the percentage of the updated 5-year LCR was 42%. In the RTPs the updated 5-year OS was 21%, and the percentage of 5-year LCR was 38%. No statistically significant differences were found in terms of the comparison of OS or the comparison of LCR results in both groups (P = 0.427, P = 0.704, respectively). Conclusions Based on the analysis, it was found that irrespective of the initial treatment, salvage surgery was associated with decreased survival and cure rates (by 50%) compared to the group of patients with advanced laryngeal cancer who underwent primary total laryngectomy.
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Affiliation(s)
- Katarzyna Miśkiewicz-Orczyk
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
| | - Wojciech Ścierski
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
| | - Grażyna Lisowska
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
| | - Wojciech Majewski
- Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Góra, Zielona Góra, Poland
| | - Maciej Misiołek
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
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Szewczyk M, Marszałek A, Golusiński P, Niewinski P, Kosińska A, Pazdrowski J, Dańczak-Pazdrowska A, Golusiński W. Does experience affect surgical margins in head and neck basal cell carcinoma? Otolaryngol Pol 2022; 76:1-6. [DOI: 10.5604/01.3001.0015.7117] [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: 11/13/2022]
Abstract
Purpose: The aim of our study was to evaluate the impact of surgical experience in a high volume head and neck surgery department on basal cell carcinoma margin status.
Methods: A retrospective analysis of 546 patients surgically treated for primary basal cell carcinoma of the head and neck region was done. Resections were performed by 4 specialists with equal experience in head and neck surgery and 4 ENT residents at the same level of surgical training. A margin of 3-5mm was chosen, according to guidelines.
Results: The study consisted of 304 males and 242 females, mean age of 69 (range 26 – 100). Most of the tumors were located on the nose (165 pts; 30,2%) and auricle (119; 21,7%). The most common histological subtype was nodular (119; 21,7%). Tumor size was up to 20mm in 394 cases (72%). Positive surgical margins were found in 112 cases (20,5%). There was no difference in terms of positive surgical margins between residents (19/119 cases; 15,9%) and specialists (93/426; 21,8%; p=0.161).
Conclusions: The results of our study have shown that adequate surgical training in dedicated head and neck surgery department is an efficient factor in obtaining free surgical margins in head and neck basal cell carcinoma.
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Affiliation(s)
- Mateusz Szewczyk
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Andrzej Marszałek
- Zakład Patologii Nowotworów. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Paweł Golusiński
- Kliniczny Oddział Otorynolaryngologii. Uniwersytet Zielonogórski
| | - Patryk Niewinski
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Agnieszka Kosińska
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Jakub Pazdrowski
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | | | - Wojciech Golusiński
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
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Piotrowski I, Zhu X, Saccon TD, Ashiqueali S, Schneider A, de Carvalho Nunes AD, Noureddine S, Sobecka A, Barczak W, Szewczyk M, Golusiński W, Masternak MM, Golusiński P. miRNAs as Biomarkers for Diagnosing and Predicting Survival of Head and Neck Squamous Cell Carcinoma Patients. Cancers (Basel) 2021; 13:cancers13163980. [PMID: 34439138 PMCID: PMC8392400 DOI: 10.3390/cancers13163980] [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: 07/07/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Head and Neck Squamous Cell Carcinoma (HNSCC) is the sixth most common cancer worldwide. It arises from the epithelium of the upper aerodigestive tract. Increasing evidence suggests that there is a significant role of microRNAs in HNSCC formation and progression. The aim of this study was to explore and compare the expression of HNSCC related miRNAs in tumor vs neighboring healthy tissue of HNSCC patients with tumors located in either the oral cavity, oropharynx, or larynx. Our results demonstrated that expression of these miRNAs was significantly different not only between healthy and tumor tissues, but also among tumor locations. Further analysis indicated that microRNA expression could be used to distinguish between tumor and healthy tissues, and prognose the overall survival of patients. Abstract Head and Neck Squamous Cell Carcinoma (HNSCC) is the sixth most common cancer worldwide. These tumors originate from epithelial cells of the upper aerodigestive tract. HNSCC tumors in different regions can have significantly different molecular characteristics. While many microRNAs (miRNAs) have been found to be involved in the regulation of the carcinogenesis and pathogenesis of HNSCC, new HNSCC related miRNAs are still being discovered. The aim of this study was to explore potential miRNA biomarkers that can be used to diagnose HNSCC and prognose survival of HNSCC patients. For this purpose, we chose a panel of 12 miRNAs: miR-146a-5p, miR-449a, miR-126-5p, miR-34a-5p, miR-34b-5p, miR-34c-5p, miR-217-5p, miR-378c, miR-6510-3p, miR-96-5p, miR-149-5p, and miR-133a-5p. Expression of these miRNAs was measured in tumor tissue and neighboring healthy tissue collected from patients diagnosed with HNSCC (n = 79) in either the oral cavity, oropharynx, or larynx. We observed a pattern of differentially expressed miRNAs at each of these cancer locations. Our study showed that some of these miRNAs, separately or in combination, could serve as biomarkers distinguishing between healthy and tumor tissue, and their expression correlated with patients’ overall survival.
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Affiliation(s)
- Igor Piotrowski
- Radiobiology Lab, Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (I.P.); (A.S.); (W.B.)
- Department of Electroradiology, Poznan University of Medical Sciences, ul. Garbary 15, 61-866 Poznan, Poland
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (X.Z.); (S.A.); (A.D.d.C.N.); (S.N.); (M.M.M.)
| | - Xiang Zhu
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (X.Z.); (S.A.); (A.D.d.C.N.); (S.N.); (M.M.M.)
| | - Tatiana Dandolini Saccon
- Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas 96010-610, Brazil;
| | - Sarah Ashiqueali
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (X.Z.); (S.A.); (A.D.d.C.N.); (S.N.); (M.M.M.)
| | - Augusto Schneider
- Faculdade de Nutrição, Universidade Federal de Pelotas, Pelotas 96010-610, Brazil;
| | - Allancer Divino de Carvalho Nunes
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (X.Z.); (S.A.); (A.D.d.C.N.); (S.N.); (M.M.M.)
| | - Sarah Noureddine
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (X.Z.); (S.A.); (A.D.d.C.N.); (S.N.); (M.M.M.)
| | - Agnieszka Sobecka
- Radiobiology Lab, Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (I.P.); (A.S.); (W.B.)
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.S.); (W.G.)
| | - Wojciech Barczak
- Radiobiology Lab, Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (I.P.); (A.S.); (W.B.)
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.S.); (W.G.)
| | - Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.S.); (W.G.)
- Department of Head and Neck Surgery, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.S.); (W.G.)
- Department of Head and Neck Surgery, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Michal M. Masternak
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (X.Z.); (S.A.); (A.D.d.C.N.); (S.N.); (M.M.M.)
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.S.); (W.G.)
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, 65-417 Zielona Gora, Poland
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, 61-701 Poznan, Poland
- Correspondence:
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Szewczyk M, Golusiński P, Pazdrowski J, Golusiński W. Prognostic Factors Associated with Successful Salvage Surgery in Recurrent Oral Cancer. Diagnostics (Basel) 2021; 11:diagnostics11061105. [PMID: 34204488 PMCID: PMC8234389 DOI: 10.3390/diagnostics11061105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/16/2021] [Revised: 06/08/2021] [Accepted: 06/15/2021] [Indexed: 11/21/2022] Open
Abstract
Most patients with recurrent oral cancer are not eligible for salvage surgery. Among those who are candidates for surgical salvage, failure rates are high. Given the potential negative impact of salvage surgery on quality of life (QoL)—particularly in unsuccessful interventions—the decision to operate must be weighed carefully. However, the variables associated with successful surgical salvage in oral cancer have not been clearly established. In the present retrospective study, we sought to determine the factors associated with disease recurrence and successful salvage surgery. We evaluated the following parameters in patients (n = 261) treated for primary oral cancer at our institution from 2010 to 2017: age; T/N status; perineurial invasion; lymphovascular invasion; extranodal extension; and margin status. In total, 36 patients (33%) were considered eligible for salvage surgery. Four variables were significantly associated with suitability for salvage surgery: early primary T stage, no primary neck disease (N0), no positive margins in the primary resection, and no adjuvant radiotherapy following primary resection. The only variable significantly associated with improved salvage outcomes was negative margin status after the primary tumor resection, underscoring the importance of margin status on treatment outcomes. Additional studies are needed to identify other factors associated with successful salvage surgery in order to better stratify patients according to the likelihood of success, thus potentially avoiding the negative impact on QoL in patients who undergo unsuccessful surgery.
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Affiliation(s)
- Mateusz Szewczyk
- The Greater Poland Cancer Center, Department of Head and Neck Surgery, Poznań University of Medical Sciences, Garbary 15, 61-866 Poznań, Poland; (J.P.); (W.G.)
- Correspondence: ; Tel.: +48-(60)-9540393
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Góra, Zyty 26, 65-046 Zielona Góra, Poland;
| | - Jakub Pazdrowski
- The Greater Poland Cancer Center, Department of Head and Neck Surgery, Poznań University of Medical Sciences, Garbary 15, 61-866 Poznań, Poland; (J.P.); (W.G.)
| | - Wojciech Golusiński
- The Greater Poland Cancer Center, Department of Head and Neck Surgery, Poznań University of Medical Sciences, Garbary 15, 61-866 Poznań, Poland; (J.P.); (W.G.)
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Dańczak-Pazdrowska A, Pazdrowski J, Polańska A, Basta B, Schneider A, Kowalczyk MJ, Golusiński P, Golusiński W, Adamski Z, Żaba R, Masternak MM. Profiling of microRNAs in actinic keratosis and cutaneous squamous cell carcinoma patients. Arch Dermatol Res 2021; 314:257-266. [PMID: 33813600 PMCID: PMC8918171 DOI: 10.1007/s00403-021-02221-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/12/2020] [Revised: 02/16/2021] [Accepted: 03/18/2021] [Indexed: 12/13/2022]
Abstract
Actinic keratosis (AK) is a common skin lesion often defined as premalignant with more evidence indicating it as early stage of cutaneous squamous cell carcinoma (cSCC). The AK may remain stable, transform towards incisive cSCC or in some cases revert spontaneously. Several different underlying conditions can increase risk of cSCC, however, advanced age represents major risk of AK and its progression towards cSCC indicating increased risk during chronological aging. Importantly, AK and cSCC are characterized by similar genetic profile, which lead researchers to search for novel biomarkers allowing early detection. As skin sampling is often invasive and causes scaring, in the current study, we investigated a novel approach to establish potential blood circulating genetic markers in patients diagnosed with AK and cSCC. Based on clinical diagnosis and dermoscopy, we recruited 13 patients with AK (divided into two groups: the first included patients with no more than three lesions, the second group included patients with at least ten lesions) and two additional individuals diagnosed with cSCC. Deep sequencing analysis of serum circulating miRNAs detected a total of 68 expressed miRNAs. Further analysis indicated 2 regulated miRNAs for AK cohort and 12 miRNAs for cSCC patients, while there were 26 miRNAs differentially regulated between cSCC and AK patients. There was also one commonly regulated miRNA between AK and cSCC patients and ten miRNAs that were regulated in cSCC when compared with both control and AK patients. We did not observe any differences between the AK groups. In conclusion, our analysis detected in circulation some miRNA that were previously recognized as important in AK, cSCC, and other type of skin cancer supporting this approach as potential non-invasive diagnosis of AK and cSCC.
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Affiliation(s)
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland.,Department of Head and Neck Surgery, The Greater Poland Cancer Centre, Poznan, Poland
| | - Adriana Polańska
- Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Brittany Basta
- College of Medicine, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA.,Barbara Davis Center for Diabetes, , University of Colorado School of Medicine, Aurora, CO, USA
| | - Augusto Schneider
- Faculdade de Nutrição, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Michał J Kowalczyk
- Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland
| | - Paweł Golusiński
- Department of Otolaryngolgy and Maxillofacial Surgery, University of Zielona Góra, Zielona Góra, Poland.,Department of Maxillofacial Surgey, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland.,Department of Head and Neck Surgery, The Greater Poland Cancer Centre, Poznan, Poland
| | - Zygmunt Adamski
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Ryszard Żaba
- Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland
| | - Michal M Masternak
- College of Medicine, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
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10
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Iocca O, Di Maio P, De Virgilio A, Pellini R, Golusiński P, Petruzzi G, Zocchi J, Pirola F, Janczak R, Golusiński W, Spriano G, Weinstein GS, Rassekh CH. Lymph node yield and lymph node ratio in oral cavity and oropharyngeal carcinoma: Preliminary results from a prospective, multicenter, international cohort. Oral Oncol 2020; 107:104740. [PMID: 32380357 DOI: 10.1016/j.oraloncology.2020.104740] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 02/26/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Recently, Lymph Node Yield (LNY) and Lymph Node Ratio (LNR) have emerged as prognostic indicators in head and neck cancer. However, there is a lack of data regarding the LNY and LNR values in the specific neck levels dissected and regarding the factors that influence these values. MATERIALS AND METHODS Preliminary results of the NCT03534778 trial are reported. LNY and LNR values were estimated for 100 patients with oral or oropharynx carcinoma, from November 1, 2018 to September 30, 2019. RESULTS Overall, the mean number of lymph nodes retrieved was 34.4 (95% confidence interval [CI] 31.6-37.3). LNY means and CI per single neck level were as follows: level I 5.5 lymph nodes harvested (95% CI 3.5-7.5), level II 15.4 (95% CI 10.6-20.2), level III 8.0 (95% CI 4.6-11.3), level IV 6.3 (95% CI 3.4-9.15), level V 6.3 (95% CI 3.6-9.0). cN+ patients had a higher number of lymph nodes retrieved, odds ratio (OR) 1.2 (95% CI 1.05-1.36). Smokers had less lymph nodes harvested, OR 0.78 (95% CI, 0.71-0.87). Mean LNR was 0.063 (95% CI 0.047-0.078). A multiple regression analysis showed that anatomic site, pN, smoking status and LNY statistically significantly predicted the LNR (p < 0.05) CONCLUSIONS: The LNY and LNR values are influenced by various demographic and pathological characteristics of the patient, such as the number of dissected levels, primary site, cN positivity, and smoking status.
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Affiliation(s)
- Oreste Iocca
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano, MI, Italy.
| | - Pasquale Di Maio
- Giovanni Borea Civil Hospital, Department of Otolaryngology-Head and Neck Surgery, Sanremo, Italy
| | - Armando De Virgilio
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano, MI, Italy; Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Raul Pellini
- Department of Otolaryngology- Head Neck Surgery, Regina Elena National Cancer Institute, IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, Zielona Gora, Poland; Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznan, Poland
| | - Gerardo Petruzzi
- Department of Otolaryngology- Head Neck Surgery, Regina Elena National Cancer Institute, IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Jacopo Zocchi
- Department of Otolaryngology- Head Neck Surgery, Regina Elena National Cancer Institute, IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Francesca Pirola
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano, MI, Italy
| | - Radoslaw Janczak
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Giuseppe Spriano
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano, MI, Italy; Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Gregory S Weinstein
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Christopher H Rassekh
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
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11
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Di Maio P, Iocca O, De Virgilio A, Giudice M, Pellini R, D'Ascanio L, Golusiński P, Ricci G, Spriano G. Narrow band imaging in head and neck unknown primary carcinoma: A systematic review and meta-analysis. Laryngoscope 2019; 130:1692-1700. [PMID: 31714611 DOI: 10.1002/lary.28350] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 06/05/2019] [Revised: 09/06/2019] [Accepted: 09/19/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To estimate the diagnostic performance of Narrow Band Imaging (NBI) in patients with cervical metastasis from head and neck squamous cell carcinoma of unknown primary (SCCUP) origin. METHODS PubMed, Embase, and Scopus databases were systematically scrutinized up to July 1, 2019, looking for studies that encompassed the NBI in the SCCUP diagnostic work up. The main inclusion criteria for eligible articles for the meta-analysis were non-evidence of primary tumor after physical examination and conventional cross-section imaging before NBI assessment and the availability of complete data on the diagnostic accuracy of NBI. A set of random-effects model meta-analyses was then performed following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. RESULTS Five studies, conducted between January 2003 and September 2016, comprising 169 patients imaged with NBI, were included in the meta-analysis. The pooled sensitivity and specificity of NBI in patients with head and neck SCCUP was 0.83 (99% CI, 0.54-0.95) and 0.88 (99% CI, 0.55-0.97), respectively. The positive and negative likelihood ratios were 6.38 (99% CI, 1.6-25.44) and 0.06 (99% CI, 0.005-0.86). The pooled diagnostic odds ratio (DOR) was 82.15 (99% CI, 7.06-955). The overall detection rate of NBI was 0.35 (99% CI, 0.18-0.53), which allowed localization the primary tumor in 61 out of 169 patients, otherwise not detected by the usual diagnostic work-up. CONCLUSIONS Current available evidence suggests that NBI has a considerable diagnostic accuracy in patients affected by head and neck SCCUP. Laryngoscope, 130:1692-1700, 2020.
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Affiliation(s)
- Pasquale Di Maio
- Department of Otolaryngology-Head and Neck Surgery, Giovanni Borea Civil Hospital, Sanremo, Italy
| | - Oreste Iocca
- Humanitas Clinical and Research Center, Rozzano, Italy
| | | | - Marco Giudice
- Department of Otolaryngology-Head and Neck Surgery, Giovanni Borea Civil Hospital, Sanremo, Italy
| | - Raul Pellini
- Department of Otolaryngology-Head and Neck Surgery, IRCCS National Cancer Institute "Regina Elena", Rome, Italy
| | - Luca D'Ascanio
- Department of Otolaryngology-Head and Neck Surgery, Ospedali Riuniti Marche Nord Pesaro-Fano, Italy
| | - Paweł Golusiński
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, Zielona Gora, Poland.,Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznan, Poland
| | - Giampietro Ricci
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
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12
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Pazdrowski J, Dańczak‐Pazdrowska A, Polańska A, Kaźmierska J, Barczak W, Szewczyk M, Golusiński P, Adamski Z, Żaba R, Golusiński W. An ultrasonographic monitoring of skin condition in patients receiving radiotherapy for head and neck cancers. Skin Res Technol 2019; 25:857-861. [DOI: 10.1111/srt.12745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 06/27/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Jakub Pazdrowski
- Department of Head and Neck Surgery Poznan University of Medical Sciences Poznan Poland
- Department of Head and Neck Surgery The Greater Poland Cancer Centre Poznan Poland
| | | | - Adriana Polańska
- Department of Dermatology and Venereology Poznan University of Medical Sciences Poznan Poland
| | - Joanna Kaźmierska
- Radiotherapy Department II Greater Poland Cancer Center Poznan Poland
- Electroradiology Department University of Medical Sciences Poznan Poland
| | - Wojciech Barczak
- Department of Head and Neck Surgery Poznan University of Medical Sciences Poznan Poland
- Radiobiology Lab The Greater Poland Cancer Centre Poznan Poland
| | - Mateusz Szewczyk
- Department of Head and Neck Surgery Poznan University of Medical Sciences Poznan Poland
- Department of Head and Neck Surgery The Greater Poland Cancer Centre Poznan Poland
| | - Paweł Golusiński
- Department of Head and Neck Surgery Poznan University of Medical Sciences Poznan Poland
- Department of Head and Neck Surgery The Greater Poland Cancer Centre Poznan Poland
| | - Zygmunt Adamski
- Department of Dermatology Poznan University of Medical Sciences Poznan Poland
| | - Ryszard Żaba
- Department of Dermatology and Venereology Poznan University of Medical Sciences Poznan Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery Poznan University of Medical Sciences Poznan Poland
- Department of Head and Neck Surgery The Greater Poland Cancer Centre Poznan Poland
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13
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Szewczyk M, Marszałek A, Sygut J, Golusiński P, Golusiński W. Prognostic markers in salivary gland cancer and their impact on survival. Head Neck 2019; 41:3338-3347. [PMID: 31246357 DOI: 10.1002/hed.25857] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 01/20/2019] [Revised: 06/07/2019] [Accepted: 06/12/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The role of molecular markers in salivary gland carcinoma (SGC) is not well understood. We evaluated molecular marker expression and their prognostic value. METHODS Immunohistochemical analysis of 124 tumor specimens was performed to determine expression of androgen (AR), estrogen (ER), and progesterone (PR) receptors and epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER2), programmed death ligand 1 receptor (PD-L1), and PD-L1 in tumor-infiltrating mononuclear cell (TIMC). Survival outcomes (disease-free survival [DFS] and overall survival [OS]), pT and N classification, margin status, and treatment failure were assessed. RESULTS Most patients (78; 62.9%) had early-stage SGC. AR positivity and EGFR positivity were detected in 21.0% and 78.6%, respectively, of tumors. AR positivity and PD-L1 negativity were associated with locally advanced disease. PD-L1-negativity was associated with higher recurrence (38.5% vs 0%; P < .001) and worse DFS. OS and DFS were worse in patients with AR+ or HER2+ disease. CONCLUSIONS Several molecular markers-AR and HER2 positivity and PD-L1 negativity-were associated with worse clinical outcomes. Prospective, multi-institutional trials are needed to determine the prognostic value of these markers.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Center, Poznan, Poland
| | - Andrzej Marszałek
- Department of Cancer Pathology and Prophylaxis, Poznan University of Medical Sciences, Greater Poland Cancer Center, Poznan, Poland
| | - Jacek Sygut
- Department of Cancer Pathology and Prophylaxis, Poznan University of Medical Sciences, Greater Poland Cancer Center, Poznan, Poland
| | - Paweł Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Center, Poznan, Poland.,Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, Zielona Góra, Poland.,Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Center, Poznan, Poland
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14
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Słowińska M, Maciąg A, Dudzisz-Śledź M, Łasińska I, Świtaj T, Koseła-Paterczyk H, Bolewska A, Wróbel K, Golusiński P, Mackiewicz J, Rutkowski P, Owczarek W. Vismodegib in the treatment of basal cell carcinoma — Polish clinical experience in the frame of therapeutic program. Oncol Clin Pract 2019. [DOI: 10.5603/ocp.2018.0041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Szewczyk M, Pazdrowski J, Golusiński P, Dańczak-Pazdrowska A, Pawlaczyk M, Sygut J, Marszałek A, Golusiński W. Outdoor work as a risk factor for high-grade cutaneous squamous cell carcinoma of the head and neck. Postepy Dermatol Alergol 2018; 35:408-412. [PMID: 30206456 PMCID: PMC6130134 DOI: 10.5114/ada.2018.75841] [Citation(s) in RCA: 6] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/12/2017] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION While it is clear that individuals with outdoor occupations are at a significantly greater risk of developing cutaneous squamous cell carcinoma (cSCC), no previous studies have investigated the potential association between the tumour grade and occupation in this patient population. AIM To assess occupation as a risk factor for the development of high-grade cSCC. Secondarily, to determine the association between the tumour grade and other clinical characteristics. MATERIAL AND METHODS Retrospective analysis of 256 patients treated for head and neck cSCC at our institution in 2007-2016. The following patient characteristics and variables were assessed: age; sex; tumour location and grade; profession; and education level. A univariate analysis was performed to assess the association between each study variable and grade 3 tumour differentiation. RESULTS The following variables were significantly associated (p < 0.05) with grade 3 (G3) cSCC tumours: outdoor work vs. indoor work; primary school vs. high school education; and age. Additionally, patients with low-grade (G1) tumours were significantly younger (mean age: 72) than patients with high-grade (G3) tumours (mean age: 79) (p = 0.046). CONCLUSIONS To our knowledge, this is the first study to assess the variables associated with the tumour grade among outdoor workers. These findings suggest that outdoor workers who develop cSCC are at a greater risk of developing more aggressive cancers. These findings provide additional support for classifying cSCC as an occupational disease. Early education about the dangers of sun exposure during the first years of school is essential to minimize the risks of developing high-grade skin cancer.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Paweł Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
- Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Mariola Pawlaczyk
- Department of Gerontology and Geriatric Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Sygut
- Department of Cancer Pathology and Prophylaxis, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Andrzej Marszałek
- Department of Cancer Pathology and Prophylaxis, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
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16
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Szewczyk M, Golusiński P, Pazdrowski J, Pieńkowski P, Marszałek S, Sygut J, Golusiński W. Patterns of treatment failure in salivary gland cancers. Rep Pract Oncol Radiother 2018; 23:260-265. [PMID: 29991930 DOI: 10.1016/j.rpor.2018.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 01/17/2018] [Revised: 03/08/2018] [Accepted: 05/05/2018] [Indexed: 10/28/2022] Open
Abstract
Aim The purpose of the study was to publish our experience of salivary gland cancer treatment with large number of patients treated at a single institution. Background Salivary gland cancers are rare tumors of the head and neck representing about 5% of cancers in that region and about 0.5% of all malignancies. Due to the rarity of the disease, most of the studies regarding treatment outcome consist of low number of patients, thus making it difficult to draw conclusions. Material and methods 115 patients with primary salivary gland cancer were included in a retrospective study. The subsites of tumor were the parotid gland (58% patients), submandibular gland (19%) and minor salivary glands (23%). All patients underwent primary surgical resection. The following were collected: age, stage of the disease, T status, N status, grade of tumor, perineurial invasion, lymphovascular invasion, extracapsular spread, final histological margin status and postoperative treatment. Details of local, regional or distant recurrence, disease free survival and overall survival were included. Results The majority (65%) of patients presented in early stage, T1 and T2 tumors. 81% of patients were N0. Free surgical margins were achieved in 18% of patients, close in 28% patients and positive surgical margins in 54% (62) patients. Factors that significantly increased the risk of recurrence: T stage (p = 0.0006); N-positive status (p < 0.0001); advanced stage of the disease (p < 0.0001); high grade of tumor (p = 0.0007); PNI (p = 0.0061); LVI (p = 0.0022); ECS (p = 0.0136); positive surgical margins (p = 0.0022). On multivariate analysis, high grade of tumor and positive surgical margins remained significant independent adverse factors for recurrence formation. Conclusions This report shows a single institution results of oncological treatment in patients with malignant salivary gland tumors, where positive surgical margins strongly correlate with patients' worse outcome. Whether to extend the procedure, which very often requires sacrificing the nerve is still a question of debate.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery. Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
| | - Paweł Golusiński
- Department of Head and Neck Surgery. Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland.,Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery. Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
| | - Piotr Pieńkowski
- Department of Head and Neck Surgery. Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
| | - Sławomir Marszałek
- Department of Head and Neck Surgery. Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland.,Department of Rehabilitation in Internal Medicine, University School of Physical Education, Poznan, Poland
| | - Jacek Sygut
- Department of Cancer Pathology and Prophylaxis, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery. Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
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17
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Golusiński P, Pazdrowski J, Szewczyk M, Misiołek M, Pietruszewska W, Klatka J, Okła S, Kaźmierczak H, Marszałek A, Filas V, Schneider A, Masternak MM, Stęplewska K, Miśkiewicz-Orczyk K, Golusiński W. Is immunohistochemical evaluation of p16 in oropharyngeal cancer enough to predict the HPV positivity? Rep Pract Oncol Radiother 2017; 22:237-242. [PMID: 28461789 DOI: 10.1016/j.rpor.2017.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/10/2017] [Indexed: 01/05/2023] Open
Abstract
AIM Our goal was to determine the expression levels of p16 in the cohort of the OPSCC patients and evaluation of the pathological and clinical differences between these two groups including patients' survival. BACKGROUND HPV infection is the main causative factor of oropharyngeal cancer (OPSCC). Identification of HPV status in OPSCC requires positive evaluation of viral DNA integration into host cell however, p16 accumulation in the proliferating cell layers has been accepted as an alternative marker for HPV infection. MATERIAL AND METHODS The IHC staining for p16 has been performed in tumor tissue from 382 OPSCC patients. The sample was considered positive based on more than 70% of carcinoma tissue showing strong and diffused nuclear and cytoplasmic immunostaining. The clinicopathological characteristics of the patients including site, age, gender, tumor grade, tumor stage, the nodal status, smoking and survival have been analyzed when comparing p16 positive and p16 negative tumors. RESULTS Out of our cohort in 38.2% cases positive staining for p16 has been recorded. Our analysis did not indicate significant differences in the distribution of the p16 positive patients and age of the patients, stage of the disease. Among the patients who have presented with the N+ neck, there were significantly more p16 positive tumors than in the group with N0 neck (p = 0.0062). There was highly significant correlation between the expression of p16 and smoking (p < 0.0001). The significant difference in survival (p < 0.0001) with more favorable prognosis in the p16 positive group has been observed. CONCLUSIONS Overexpression of p16 is accepted as a surrogate diagnostic marker for detecting HPV infection in oropharyngeal cancer. However, one should remember about existence of the small subgroups of p16 positive but HPV negative tumors, with relatively worse prognosis. Immunostaining for p16, however useful on everyday basis, should be complemented with other techniques in terms of reliable identification of the HPV infection.
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Affiliation(s)
- Paweł Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Poznan, Poland.,Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznan, Poland
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Poznan, Poland
| | - Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Poznan, Poland
| | - Maciej Misiołek
- Department of Otolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Wioletta Pietruszewska
- Department of Otolaryngology and Laryngological Oncology, Medical University of Lodz, Poland
| | - Janusz Klatka
- Department of Otolaryngology and Laryngological Oncology, Medical University of Lublin, Poland
| | - Sławomir Okła
- Department of Otolaryngology and Head and Neck Surgery, Regional Cancer Center, Kielce, Poland
| | - Henryk Kaźmierczak
- Department of Otolaryngology, Ludwik Rydgier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Andrzej Marszałek
- Department of Oncologic Pathology and Prophylactics, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Poznan, Poland.,Department of Oncologic Pathology, Greater Poland Cancer Centre, Poznan, Poland
| | - Violetta Filas
- Department of Oncologic Pathology and Prophylactics, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Poznan, Poland.,Department of Oncologic Pathology, Greater Poland Cancer Centre, Poznan, Poland
| | - Augusto Schneider
- Department of Nutrition, Federal University of Pelotas, Pelotas, RS, Brazil.,University of Central Florida, Burnett School of Biomedical Sciences, College of Medicine, Orlando, FL, USA
| | - Michał M Masternak
- University of Central Florida, Burnett School of Biomedical Sciences, College of Medicine, Orlando, FL, USA
| | | | - Katarzyna Miśkiewicz-Orczyk
- Department of Otolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Poznan, Poland
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Golusiński W, Kubiak A, Trojanowski M, Korytowska A, Pietrysiak A, Manasterski J, Pychyński T, Golusiński P, Majchrzak E, Sówka M, Szewczyk M, Łuczewski Ł, Szybiak B, Malicki J. National Programme for Prevention and Early Detection of Head and Neck Cancer. Otolaryngol Pol 2017; 69:7-12. [PMID: 26388354 DOI: 10.5604/00306657.1161011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
550,000 new cases of cancer of the oral cavity and pharynx and 160,000 of larynx are diagnosed each year worldwide. It is estimated that each year because of head and neck cancer 400,000 of patients will die. Head and neck neoplasms are the tumors which, because of their location, secretly develop and produce uncharacteristic symptoms identical to those that accompany the banal infections of the upper respiratory tract. Results of treatment of patients with head and neck cancer in Poland are highly unsatisfactory. This is due to significant advancement of tumor at the moment of diagnosis. Therefore, raising awareness and improving knowledge of health care workers on head and neck cancers by creating access to prevention research is a priority that will ensure improvement in treatment outcomes in this group of tumors in Poland and abroad.
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Affiliation(s)
- Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Polish Study Group of Head and Neck Cance
| | - Anna Kubiak
- Greater Poland Cancer Registry, Greater Poland Cancer Center
| | | | | | | | | | | | - Paweł Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Polish Study Group of Head and Neck Cancer
| | - Ewa Majchrzak
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Polish Study Group of Head and Neck Cancer
| | - Marcin Sówka
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Polish Study Group of Head and Neck Cancer
| | - Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Polish Study Group of Head and Neck Cancer
| | - Łukasz Łuczewski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Polish Study Group of Head and Neck Cancer
| | - Bartosz Szybiak
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Polish Study Group of Head and Neck Cancer
| | - Julian Malicki
- Greater Poland Cancer Centre, Electroradiology Department, Poznan University of Medical Sciences
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Golusińska-Kardach E, Kardach H, Golusiński P, Szybiak B, Majchrzak E, Szewczyk M, Sówka M, Sokalski J, Golusiński W. [Dental examination integral part of preventive testing head and neck cancers]. Przegl Lek 2016; 73:773-776. [PMID: 29689682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In recent years, in Poland and in Europe, we have seen a steady increase in the incidence of malignant tumors of the head and neck. On the basis of national cancer registries, the increase in new cases in the last ten years is over 15% and that worries epidemiologists and the medical community. Taken in Europe prevention programs aimed at reducing new cases. In Grater Poland from 2012 has initiated an innovative program for Early Detection of Cancer, Department of Head and Neck Surgery Medical University in Poznan and the Department of Health Marshal’s Office in Poznan. The aim of the study was to evaluate dental and oral hygiene habits analysis of patients reporting to the Programme for Early Detection of Head and Neck Cancer. The study conducted involved 678 patients reporting to the Department of Head and Neck Surgery in Grater Poland Cancer Center under the prevention of cancers of the head and neck. All patients underwent ENT assessment and standard dental examination assessing condition of teeth and oral mucosa. All patients were asked to fill out prepared questionnaire, which included questions concerning socio-economic conditions of the patient, hygiene habits and risk factors for oral cancer. Most of the patients participating in the study, 441 people (65.9%) smoke or smoked cigarettes. Smoking habit among female dominated. Within smokers responders declared, at the same time,consumption of alcohol at least three times a week; 192 people (81.1%). Almost half (49.8%) of all respondents reported consuming alcohol occasionally. Regular practice of oral sex with frequent change of partner, belonging to the high risk of head and neck cancer, were found in 21.9% of patients. During the assessment of oral hygiene was observed 155 patients (23.4%) correctly cleansing the teeth and oral cavity, while more than half (62.4%) did not abide rules of daily oral hygiene. The use of additional tools to correct hygienization (dental floss, interdental brushes, rinses the mouth) was recorded in 51.7% of patients. As a result, 85% of the patients of the head and neck cancer prevention program was found bad condition of the oral cavity, and dental procedures in 30% of patients were applied. Patients diagnosed with invasive cancer was in 19 cases. Results of this study indicate that, the dentist should be an integral part of interdisciplinary team treating patients with head and neck cancer, and regular dental care plays a key role in the early diagnosis of patients with head and neck cancer.
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Szewczyk M, Pazdrowski J, Golusiński P, Dańczak-Pazdrowska A, Łuczewski Ł, Marszałek S, Majchrzak E, Golusiński W. Basal cell carcinoma in farmers: an occupation group at high risk. Int Arch Occup Environ Health 2015; 89:497-501. [PMID: 26464316 PMCID: PMC4786594 DOI: 10.1007/s00420-015-1088-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 09/25/2015] [Indexed: 12/17/2022]
Abstract
Introduction Skin cancer is the most commonly diagnosed cancer type worldwide, and 80 % of skin cancers are basal cell carcinoma (BCC). The main risk factor for developing BCC is exposure to ultraviolet radiation (UVR), particularly high-dose exposure at a young age. Outdoor workers, particularly farmers, are at high risk of developing BCC. However, studies of BCC in this population are scant. Objective To comprehensively evaluate all cases of BCC of the head and neck region treated during the years 2007–2013 at our hospital in Poland, and to compare the tumour characteristics in farmers to non-farmers. Materials and methods Retrospective analysis of 312 patients treated for head and neck BCC during the study period (2007–2013). Results Most patients (198 cases; 63 %) were males, with 114 females (37 %). Median age was 73 years (range 32–96 years). The most common tumour location was the nose and cheek (114 pts; 37 %) followed by the auricle (82 pts; 26 %), lips (54 pts; 18 %), scalp (26 pts; 8 %), and eye (36 pts; 12 %). The most common disease stage on presentation was stage T2 (104 pts, 33 %), followed by stage T1 (79 pts; 25 %), stage T3 (89 pts; 28 %), and stage T4 (40 pts; 14 %). By occupation, farmers accounted for 33 % of all patients (102 of 312 pts). The most common tumour localisations in the farmer subgroup were the nose and cheek (50 pts; 49 %; p < 0.001; odds ratio [OR] 2.19; 95 % confidence interval [CI] 1.35–3.57), followed by the auricle (32 pts; 31 %), scalp (16 pts; 16 %), ocular region (3 pts; 3 %), and lips (1 pt; 1 %). Patients in the farmer group were significantly younger than non-farmers (62 vs. 73 years; p < 0.001; OR 0.90, 95 % CI 0.88–0.93). Farmers were significantly more likely to present disease recurrence (27 vs. 12 % of cases; p < 0.001; OR 5.94; 95 % CI 2.86–12.33). Conclusion The results highlight the increased incidence and risk of recurrence of BCC in farmers. It is therefore necessary to consider enhancing educational programmes and other preventative measures in this occupational group and to evaluate the effectiveness of such programmes.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland.
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland
| | - Paweł Golusiński
- Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland.,Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Dluga 1⁄2, 61-848, Poznan, Poland
| | | | - Łukasz Łuczewski
- Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland
| | - Sławomir Marszałek
- Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland.,Department of Rehabilitation in Internal Medicine, University School of Physical Education, Poznan, Poland
| | - Ewa Majchrzak
- Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Greater Poland Cancer Centre, Poznan University of Medical Sciences, Garbary 15, 61-866, Poznan, Poland
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Abstract
INTRODUCTION Head and neck cancers account for about 6% of all malignant tumors. Head and neck cancers are responsible for about 650,000 new cases and approximately 260,000 deaths in the world annually. About 50% of patients fail to achieve cure or relapse of cancer occurs despite intensive combined treatment. A small number of patients is eligible for re-treatment, and for most of them symptomatic treatment is used. Photodynamic therapy(PDT) may be an alternative these patients. PDT improves the quality of life in patients who are at the stage of the disease recognized as incurable according to present knowledge. MATERIALS AND METHODS Study group consisted of three patients treated in the Department of Head and Neck Surgery in Poznan due to recurrence of squamous cell carcinoma of the head and neck. Patients were qualified to the palliative PDT ( Photodynamic therapy)with Foscan. when other possibilities of treatment have been used up. RESULTS Two patients achieved a partial response (PR) by RECIST criteria. One patient achieved disease stabilization (SD). DISCUSSION Photodynamic therapy is a therapeutic option in the palliative treatment of patients with squamous cell carcinoma of the head and neck. The careful qualification of the patients for this type of treatment is very important. One should take into account the location of the tumor and its size. Great advantage of photodynamic therapy is that it can be used repeatedly. Treatment with photodynamic therapy should be performed in specialized centers because of the need of adequate technical facilities. PDT may improve the quality of life of selected patients with incurable cancer of the head and neck.
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Affiliation(s)
- Paweł Golusiński
- Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej Uniwersytetu Medycznego w Poznaniu, Wielkopolskie Centrum Onkologii
| | - Bartosz Szybiak
- Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej Uniwersytetu Medycznego w Poznaniu, Wielkopolskie Centrum Onkologii
| | - Anna Wegner
- Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej Uniwersytetu Medycznego w Poznaniu, Wielkopolskie Centrum Onkologii
| | - Jakub Pazdrowski
- Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej Uniwersytetu Medycznego w Poznaniu, Wielkopolskie Centrum Onkologii
| | - Piotr Pieńkowski
- Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej Uniwersytetu Medycznego w Poznaniu, Wielkopolskie Centrum Onkologii
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Szewczyk M, Pazdrowski J, Golusiński P, Golusiński W. Delayed reconstruction of the upper digestive tract in a patient following total pharyngolaryngectomy with resection of the cervical oesophagus. Rep Pract Oncol Radiother 2015; 20:243-7. [PMID: 25949230 DOI: 10.1016/j.rpor.2014.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/23/2014] [Revised: 08/27/2014] [Accepted: 11/20/2014] [Indexed: 11/19/2022] Open
Abstract
Carcinoma of the hypopharynx is an uncommon disease, with an annual incidence of approximately 1 in 100,000. Post-cricoid carcinoma is more common in women and is not usually associated with tobacco and alcohol abuse. Reconstruction of large pharyngeal defects following surgery for squamous cell carcinoma is complex and often requires microvascular free tissue transfer to achieve the best oncological and functional outcomes. The most common complications of such procedures include fistulas and strictures of the neopharynx. Here, we describe a case of a female patient admitted to the Head and Neck Department at our hospital to undergo delayed reconstruction following pharyngolaryngectomy and removal of the cervical oesophagus. Several complications occurred during post-operative care, including stricture and skin dehiscence. At present, the patient is able to swallow saliva and is currently being prepared to return to a normal diet.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznan University of Medical Sciences Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
| | - Paweł Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland ; Department of Biology and Enviromental Studies, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
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Golusiński W, Wegner A, Trzeciak P, Golusiński P, Sówka M, Kopczyński A, Bromboszcz M, Marszałek A. [The expression assessment of the estrogen, progesterone and HER2 receptors in selected malignant tumors of the salivary glands]. Otolaryngol Pol 2013; 67:245-51. [PMID: 24021827 DOI: 10.1016/j.otpol.2013.04.002] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/01/2013] [Accepted: 04/08/2013] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The incidence of the malignant tumors of the salivary glands is relatelively low. However, rapid locoregional progression, distant metastases occurrence and high local recurrence rate occurring despite radical surgical treatment, significantly affect the outcome. Malignant tumors of the salivary glands are characterized by low radiosensitivity and poor response to systemic therapy. Therefore there is a need for new targeted therapies which may improve the prognosis. In some aspects, malignant tumors of the salivary glands are similar to breast cancers. Efficacy of hormonal replacement therapy and the treatment with the monoclonal antibody (trastuzumab) in the treatment of breast cancer is well known and confirmed. Criterion determining the qualification for treatment is the presence of hormone receptors and HER2 receptors in the tumor. AIM The aim of this study was to evaluate the expression of estrogen receptor, progesterone receptor and HER2 in selected salivary gland malignancies. MATERIALS AND METHODS Study group consisted of 51 patients with the salivary glands cancer. In the study group there were 42 tumors in the parotid gland, 7 tumors of the submandibular gland, 1 in the mucosa of the cheek and 1 tumor in the tongue. Histologically material comprised of muco-epidermoid carcinoma (10), adenoid-cystic carcinoma (8), salivary duct (7), adenocarcinoma (6), squamous cell carcinoma (6), mioepithelial carcinoma (5) and other (9). In all cases immunohistochemical analysis of the estrogen receptor, progesterone receptor and HER2 receptor was performed. RESULTS The expression of the estrogen receptor was found in 18% of tumors (9 patients). The expression of the progesterone receptor was found in 20% (10 patients). HER2 expression was found in 10% of tumors and was related to only one histological type of tumor - salivary duct carcinoma. CONCLUSION HER2 expression in malignant tumors of the salivary glands, especially in salivary duct carcinoma may be of use in future implementation of new targeted therapies based on monoclonal antibodies.
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Affiliation(s)
- Wojciech Golusiński
- Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny im. Karola Marcinkowskiego, Kierownik: prof. dr hab. Wojciech Golusiński, Poznań, Poland; Wielkopolskie Centrum Onkologii im. Marii Skłodowskiej-Curie, Kierownik: prof. dr hab. Julian Malicki, Poznań, Poland
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Majchrzak E, Cholewiński W, Szybiak B, Luczewski L, Sówka M, Golusiński P, Golusiński W. [Evaluation of the effectiveness of ¹⁸F-FDG-PET/CT examination of head and neck cancer--own experience]. Otolaryngol Pol 2013; 67:18-24. [PMID: 23374659 DOI: 10.1016/j.otpol.2012.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 10/20/2012] [Accepted: 10/24/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The aim of the study was to evaluate the usefulness of ¹⁸F-FDG-PET/CT in diagnosis of head and neck cancer. MATERIAL AND METHODS 60 ¹⁸F-FDG-PET/CT examinations were performed in 50 patients diagnosed and treated for head and neck cancer in Department of Head and Neck Surgery and Nuclear Medicine Department of The Greater Poland Cancer Centre in Poznan, Poland from 2007 to 2011. Patients were divided into 2 subgroups: CUP Syndrome patients (25 PET/CT exams) and patients being under control after treatment (35 PET/CT exams). RESULTS In the group of CUP Syndrome patients 6 PET/CT examinations were negative, in 7--possible primary tumor was indicated, in 10--only cervical lymph node metastases were diagnosed, in 2 cases--distant metastases occured. Within the second subgroup 14 PET/CT examinations were negative, 11 exams--indicated the recurrent disease, 2--cervical lymph node metastases and 8--distant metastases. The sensitivity and specificity of ¹⁸F-FDG-PET/CT in this study within the CUP Syndrome patients group were 100% and 55% respectively. The positive predictive value was 74%. The negative predictive value was 100%. The sensitivity and specificity of ¹⁸F-FDG-PET/CT in this study within the second group of patients were 88% and 66% respectively. The positive predictive value was 71%. The negative predictive value was 86%. CONCLUSIONS ¹⁸F-FDG-PET/CT is useful for staging of head and neck cancer, identification of an unknown primary tumor, delineation of the extent of regional lymph node involvement, detection of distant metastases and occasional synchronous primary tumor.
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Affiliation(s)
- Ewa Majchrzak
- Oddział Chirurgii Głowy i Szyi i Onkologii Laryngologicznej, Wielkopolskie Centrum Onkologii w Poznaniu, ul. Garbary 15, 61-866 Poznań, Poland.
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Pazdrowski J, Dańczak-Pazdrowska A, Golusiński P, Szybiak B, Silny W, Golusiński W. [The recurrence of facial basal cell carcinoma in patients treated at the Head and Neck Surgery Ward and Laryngological Oncology Clinic of the Greater Poland Cancer Centre in the years 2007-2010]. Otolaryngol Pol 2012; 66:185-90. [PMID: 22748679 DOI: 10.1016/s0030-6657(12)70767-9] [Citation(s) in RCA: 3] [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] [Received: 01/11/2011] [Accepted: 02/01/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The incidence of basal-cell carcinomas (BCC) in Europe is estimated at 10 cases per 100,000 people and is continuously increasing. Recurrent cases of BCC tend to have a more aggressive progression. The treatment methods include: conventional surgery, Mohs surgery, laser therapy, cryosurgery, curettage and radiotherapy. The recurrence of basalcell carcinoma depends on the method of treatment and ranges between 4% and 18%. In the case of recurrent BCC the treatment method of choice is margin control surgery. AIM OF THE STUDY The purpose of this paper is to conduct a retrospective analysis of patients with facial BCC treated with classic surgery and laser therapy as well as to present a strategy for action in the case of recurrence. MATERIAL AND METHODS The retrospective analysis was conducted on patients with diagnosed facial BCC, treated at the Head and Neck Surgery Ward and Laryngological Oncology Clinic of the Greater Poland Cancer Centre in the years 2007-2010. The research included 58 patients aged 56-80; 34 women and 24 men. RESULTS Out of 58 patients 8 had recurrent BCC - 4 cases after laser therapy (Group A), and 4 cases after classic surgery (Group B). In 2 cases from Group A and all cases from Group B further treatment involved removal of the recurrent tumour by margin control surgery and skin flap plastic surgery. In 2 remaining cases from Group A further CO(2) laser therapy was performed under local anaesthesia and analgosedation. This type of treatment was chosen due to general medical and cardiological concerns which disqualified the use of general anaesthesia and conventional surgery. So far no further local recurrent cases of BCC have been diagnosed, and the follow-up periods range from 4 to 26 months. CONCLUSION Recurrent cases of BCC are 10% more frequent in patients treated with cryosurgery or laser therapy without margin control than in patients who had the tumour removed by margin control surgery. Margin control surgery remains the method of choice in cases involving large tumours, recurrence or spread by invasion.
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Affiliation(s)
- Jakub Pazdrowski
- Oddział Chirurgii Głowy i Szyi i Onkologii Laryngologicznej Wielkopolskiego Centrum Onkologii.
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Pazdrowski J, Łuczewski Ł, Synowiec T, Golusiński P, Pieńkowski P, Chęciński P, Golusiński W. [Early surgical revision as a salvage procedure in the anterolateral thigh flap failure prevention--case report]. Otolaryngol Pol 2012; 66:301-5. [PMID: 22890537 DOI: 10.1016/j.otpol.2012.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 12/23/2011] [Accepted: 12/28/2011] [Indexed: 10/28/2022]
Abstract
Microsurgical free flaps are considered state of the art in head and neck reconstruction after composite tumor resections. The anterolateral thigh (ALT) flap is frequently used in ablative head and neck surgery, providing superior functional and aesthetic restoration with a minor donor-site morbidity. However, flap failures do occur occasionally, vascular obstruction within first 24 postoperative hours is one of the main reasons of flap compromise. We present a case report of an early surgical exploration as a successful salvage procedure for ALT flap used for reconstruction of the massive scalp excision due to basal cell carcinoma.
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Affiliation(s)
- Jakub Pazdrowski
- Oddział Chirurgii Głowy i Szyi i Onkologii Laryngologicznej, Wielkopolskie Centrum Onkologii im. Marii Skłodowskiej-Curie w Poznaniu, Poland
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Pazdrowski J, Synowiec T, Golusiński PJ, Golusiński P, Pieńkowski P, Łuczewski Ł, Luczewski L, Chęciński P, Chęciński P, Golusiński W. [Our experience in the use of anterolateral thigh flap for reconstruction of the head and neck neoplasms]. Otolaryngol Pol 2012; 66:51-5. [PMID: 22381016 DOI: 10.1016/s0030-6657(12)70750-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 09/04/2011] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Free flaps with vascular anastomosis have been widely used in clinical practice for more than 30 years. They are standard in reconstructive surgery following extensive resections caused by neoplasms of the head and neck. The anterolateral thigh flap (ALT) constitutes very good reconstructive material due to the long vascular pedicle, the appropriate diameter of vessels, the large skin island plane, and thickness depending on requirements. MATERIAL The own material comprises 5 patients who have had extensive neoplastic infiltrations removed at different anatomic locations within the area of healthy tissue. RESULTS Reconstructions have been conducted using a microvascular thigh flap (ALT). All of the operated patients are under constant supervision. The observation period ranges from 2 to 3 months. No recurrence of the neoplastic process or graft rejection has been observed in any of the patients.
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Affiliation(s)
- Jakub Pazdrowski
- Oddział Chirurgii Głowy i Szyi i Onkologii Laryngologicznej, Wielkopolskie Centrum Onkologii im. Marii Skłodowskiej-Curie w Poznaniu.
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Pazdrowski J, Piotr P, Kordylewska M, Wegner A, Golusiński P, Golusiński W. Value of intraoperative ultrasonography in tonsil cancer. Rep Pract Oncol Radiother 2010; 15:60-3. [PMID: 24376925 DOI: 10.1016/j.rpor.2010.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/30/2009] [Revised: 02/26/2010] [Accepted: 04/13/2010] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The exact assessment of a tonsil carcinoma's size is often difficult because of the tumour's submucosal extension and deep infiltration. AIM The aim of the study is to assess the usefulness of intraoperative ultrasonography in tonsil cancer. MATERIAL Twenty patients with carcinoma of the tonsil were included in the study (squamous cell carcinoma keratosis - 12, squamous cell carcinoma akeratosis - 6, diffuse large B cell lymphoma - 1, neoplasma malignum microcellulare - 1). METHOD Transcutaneous, endoscopic, and intraoperative ultrasonography were performed using a linear 7.5 MHz probe. RESULTS The difference in the results was statistically significant between palpation examination and intraoperative ultrasonographic examination, between transcutaneous ultrasonographic examination and intraoperative ultrasonographic examination, and between endoscopic ultrasonographic examination and intraoperative ultrasonographic examination in tonsil tumours. Generally, tumour size assessed by intraoperative ultrasonography was more advanced than those assessed by other methods. CONCLUSIONS Intraoperative ultrasonography is a safe, non-invasive method, which can be repeated at every stage of surgery. There were no contraindications or side effects. In all cases histological margins corresponded to sonographic margins. Intraoperative ultrasonography provides a quick and reliable orientation during resection of tonsil carcinoma.
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Affiliation(s)
- Jakub Pazdrowski
- Department of Head and Neck Surgery and Laryngological Oncology, Greater Poland Cancer Centre, Poland
| | - Pieńkowski Piotr
- Department of Head and Neck Surgery and Laryngological Oncology, Greater Poland Cancer Centre, Poland
| | - Magdalena Kordylewska
- Department of Head and Neck Surgery and Laryngological Oncology, Greater Poland Cancer Centre, Poland
| | - Anna Wegner
- Department of Head and Neck Surgery and Laryngological Oncology, Greater Poland Cancer Centre, Poland
| | - Paweł Golusiński
- Department of Head and Neck Surgery and Laryngological Oncology, Greater Poland Cancer Centre, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery and Laryngological Oncology, Greater Poland Cancer Centre, Poland ; Poznań University of Medical Sciences, Poland
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Wegner A, Waśniewska E, Golusiński W, Golusiński P. Assessment of extracellular matrix proteins (laminin and fibronectin) in adenoid cystic carcinoma of salivary gland using morphometric method. Rep Pract Oncol Radiother 2007. [DOI: 10.1016/s1507-1367(10)60074-0] [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: 11/24/2022] Open
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Golusiński W, Golusiński P, Stańczak J, Kłosin J. [Ki67, p53 and cyclin D1 in the squamous cell carcinoma of head and neck]. Otolaryngol Pol 2004; 58:777-84. [PMID: 15603389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The difficult cancer development and the insufficient knowledge of the biology of the existing cancers lead for the constant search for the new techniques of diagnosis. The aim of this study was to analyze the selected prognostic factors such as p53, Ki67 and cyclin D1 in patients with head and neck cancer in connection with histological differentiation (G), TNM classification and the clinical advancement of the disease (S). The material comprised of the tissue specimens from 32 patients with squamous cell carcinomas of head and neck, who underwent the primary surgery. The immunohistochemical study was performed with avidin-biothin method. A 5-point grading system was adopted to assess the level of the immunohistochemical staining of the carcinoma cells. Through our study we found a statistically significant correlation between the staining intensity of carcinoma cells for p53, Ki67, cyclin D1 and the TNM classification and the clinical advancement of the disease (S). Such correlation for the histological differentiation (G) has not been observed. We think that the immunohistochemical techniques may constitute an important supplement of evaluation of the malignancy in the squamous cell carcinomas of head and neck.
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Zeromski J, Lawniczak M, Galbas K, Jenek R, Golusiński P. Expression of CD56/N-CAM antigen and some other adhesion molecules in various human endocrine glands. Folia Histochem Cytobiol 1998; 36:119-25. [PMID: 9773295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
CD56/N-CAM antigen, 140 kDa isoform of neural cell adhesion molecule (N-CAM) has been previously traced by some of us in follicular epithelium of human thyroid by immunohistochemistry. The reaction product was cell membrane bound, being stronger in hyperactive thyroid as compared to colloid goiter. In the current study, CD56 was searched in other endocrine glands and their tumors including parathyroids, adrenal cortex and parafollicular C cells of the thyroid (TT cell line). The antigen was also examined in the tissue extracts of endocrine and nonendocrine organs by dot blot immunoassay and anti CD56 monoclonal antibody. Besides, some other cell adhesion molecules (CAMs) were looked for in the tissues and cells tested. It has been found that CD56 is expressed in all zones of adrenal cortex, albeit in various intensity. The reaction was cell membrane bound in cortical hyperplasia and adenoma but cytoplasmic in the carcinoma of adrenal cortex. Other endocrine tissues and cells tested were devoid of CD56. Presence of CD56 antigen could be confirmed by dot blot assay with 3M KCl and NP40 extracts of both, thyroid and adrenal glands. Apart from CD56 some other CAMs could be traced in thyroid cell membranes including CD44, VLA-3 integrin and E-cadherin, what was not the case in the adrenal cortex. In parathyroids and parathyroid adenoma, diffuse immunostaining of E-cadherin and irregular, focal expression of CD44 was observed. These results show, apart from CD56, abundance of other CAMs in the thyroid gland and their relative scarcity in other endocrine tissues tested.
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Affiliation(s)
- J Zeromski
- Department of Immunopathology, University of Medical Sciences, Poznań, Poland
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Dzwonkowski P, Golusiński P. [Leiomyoma of the prostate]. Wiad Lek 1983; 36:1461-3. [PMID: 6666122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Kościński T, Zabłocki M, Skowrońska U, Błazejewski M, Golusiński P, Grajkowska J. [Clinical assessment of symptoms and surgical treatment of colonic neoplasms]. Pol Przegl Chir 1978; 50:309-13. [PMID: 673953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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