-
Oral Oncology Sep 2022The objective of this review was to determine the rate and risk factors of paratracheal lymph node (PTLN) involvement during total laryngectomy (TL) or total... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The objective of this review was to determine the rate and risk factors of paratracheal lymph node (PTLN) involvement during total laryngectomy (TL) or total pharyngolaryngectomy (TPL). In addition, we aimed to assess its prognostic significance in terms of survival and peristomal recurrence.
METHODS
A comprehensive electronic search was performed on PubMed, EMBASE, and CENTRAL databases. We searched for studies reporting outcomes of PTLN dissection during radical laryngeal surgery for squamous cell carcinoma of the larynx, hypopharynx or cervical oesophagus.
RESULTS
We included a total of ten studies (838 patients). The overall rate of PTLN dissection positivity was 18.6% (20.7% for primary TL, 8.7% for salvage TL). Random-effects meta-analysis identified T4 stage, N+ stage of the lateral neck, subglottis involvement and primary tumour arising from the hypopharynx or cervical oesophagus as significant risk factors for PTLN involvement.
CONCLUSIONS
This meta-analysis allowed to better define the risk of PTLN involvement during TL or TPL, in a bid to guide indication for PTLN dissection. There is a need for further large studies reporting rigorously the outcomes of PTLN dissection in order to establish stronger evidence-based recommendations.
Topics: Humans; Hypopharyngeal Neoplasms; Laryngeal Neoplasms; Laryngectomy; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Neck Dissection; Retrospective Studies
PubMed: 35830760
DOI: 10.1016/j.oraloncology.2022.106017 -
European Archives of... Dec 2022To investigate epidemiological, clinical and oncological outcomes of young patients with laryngeal cancer (LC).
OBJECTIVE
To investigate epidemiological, clinical and oncological outcomes of young patients with laryngeal cancer (LC).
METHODS
PubMed, Scopus and Cochrane Library were searched by three researchers for studies investigating epidemiological, clinical and oncological outcomes of patients with age < 40 years old and LC. The following outcomes were investigated with PRISMA criteria: age; ethnicity; gender; tobacco/alcohol habits; anatomical, pathological, therapeutic and survival features. Authors performed a bias analysis of papers and provided recommendations for future studies.
RESULTS
Seventeen papers published between 1982 and 2021 met our inclusion criteria, accounting for 928 patients with age < 40 years (female/male ratio: 2:5). There were on average 54.2 and 45.8% of smokers and drinkers. The tumor location mainly consisted of glottis (70.1%), supraglottis (27.7%) and subglottis (2.2%). Radiation therapy was the main therapeutic strategy used in young adults with LC. The 2-year overall survival ranged from 50 to 100% and depended on tumor stage, treatment, and cohort features. Four studies reported better overall survival in young compared with old adults, while there were no significant differences in three studies. There was an important heterogeneity between studies regarding the inclusion/exclusion criteria, epidemiological, clinical, pathological and treatment.
CONCLUSION
It was suggested that young patients with LC had lower proportion of smokers and drinkers and better overall survival compared with older but both data of the current literature and heterogeneity between studies limit us to draw definitive conclusions.
Topics: Young Adult; Humans; Male; Female; Adult; Laryngeal Neoplasms; Carcinoma, Squamous Cell; Glottis; Larynx; Cohort Studies
PubMed: 35652941
DOI: 10.1007/s00405-022-07466-9 -
International Journal of Pediatric... Dec 2019Croup is a common respiratory illness in children. It presents with a barky cough, stridor and hoarseness occurring secondary to inflammation of the subglottis and...
BACKGROUND
Croup is a common respiratory illness in children. It presents with a barky cough, stridor and hoarseness occurring secondary to inflammation of the subglottis and larynx. The clinical course of croup is well-described, however atypical presentations pose a diagnostic and management challenge.
OBJECTIVES
This case report and systematic review aims to synthesize the published literature on the definition, diagnosis and treatment of atypical croup.
STUDY SELECTION
Peer-reviewed journal publications in Ovid MEDLINE® and EMBASE from inception to January 1, 2019 in English, focusing on pediatric patients (<18 years of age) with diagnoses of atypical croup.
DATA EXTRACTION
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
Twelve studies involving 670 patients ranging from 6 months to 11 years of age presenting with atypical croup were selected. A variety of definitions of atypical croup were identified based on recurrence, duration of symptoms, severity, and etiology. Data on the incidence of atypical croup, the overall rates of intubation and tracheostomy, and patient characteristics leading to definitive airway management were not clearly characterized.
LIMITATIONS
All studies were case series, case reports or retrospective chart reviews.
CONCLUSIONS
Atypical croup is a poorly defined clinical entity that is used to describe recurrent, refractory, or croup-like illness that follows an uncharacteristic natural history. Our case presentation and accompanying literature review highlights the variable, but limited, information available on the diagnosis of atypical croup. Given the commonality of its use in clinical practice, we propose some guidelines around the use of the term 'atypical croup' as well as a management algorithm.
Topics: Child, Preschool; Croup; Hoarseness; Humans; Male; Recurrence; Respiratory Sounds; Retrospective Studies; Symptom Assessment; Terminology as Topic
PubMed: 31542653
DOI: 10.1016/j.ijporl.2019.109686