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The Laryngoscope Jan 2018Core needle biopsy is an effective diagnostic tool widely used in many oncological diagnostic approaches. It provides an adequate tissue sample for histological... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES/HYPOTHESIS
Core needle biopsy is an effective diagnostic tool widely used in many oncological diagnostic approaches. It provides an adequate tissue sample for histological evaluation of architecture, which allows tumor grading and classification of malignant and benign tumors. This study aimed to provide an updated meta-analysis and systematic review of core needle biopsy in the salivary glands.
STUDY DESIGN
A literature search using PubMed, Embase, and the Cochrane Library through December 2016.
METHODS
Data on true positives, true negatives, false positives, and false negatives were extracted from the relevant articles. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. We calculated accuracy, sensitivity, and specificity with 95% confidence intervals (CIs) using random-effects models that considered both within- and between-study variations.
RESULTS
Our search included 10 observational studies. For core needle biopsy, the sensitivity and specificity for the diagnosis of salivary glands were 0.94 (95% CI: 0.92-0.96, I = 18.7%, χ P = .27) and 0.98 (95% CI: 0.97-0.99, I = 79.6%, χ P = .00), respectively. The area under the summary receiver operating characteristic curve was 0.98 (95% CI: 0.97-0.99). Seven hematomas, one case of temporary facial paralysis caused by local anesthesia, and no tumor seeding were reported from a total of 1,315 procedures.
CONCLUSIONS
Ultrasound core needle biopsy of salivary glands is an excellent diagnostic tool in terms of accuracy, technical performance, and safety profile.
LEVEL OF EVIDENCE
NA. Laryngoscope, 128:118-125, 2018.
Topics: Biopsy, Large-Core Needle; Humans; Image-Guided Biopsy; Salivary Gland Neoplasms; Ultrasonography, Interventional
PubMed: 28699165
DOI: 10.1002/lary.26764 -
Acta Oncologica (Stockholm, Sweden) Aug 2018Otitis media (OM) and associated hearing problems may be side effects to radiotherapy of the head and neck region and affect patient quality of life. The condition is... (Review)
Review
BACKGROUND
Otitis media (OM) and associated hearing problems may be side effects to radiotherapy of the head and neck region and affect patient quality of life. The condition is associated with the tumor location.
OBJECTIVE
To perform a systematic review concerning the present knowledge of the risk of OM after radiotherapy of the head and neck.
METHODS
A comprehensive search of PubMed and Embase was carried out between 1 October 2015 and 6 February 2017. The search strategy followed the PRISMA guideline for systematic reviews.
RESULTS
Of 597 articles 11 fulfilled the inclusion criteria. Seven were retrospective and four prospective. There were no randomized controlled trials. Eight studies concerned nasopharyngeal cancer. One study concerned cancer of the parotid gland and two studies concerned other locations of head and neck cancer. Meta-analysis could not be done due to heterogeneity between the studies. The incidence of OM varied considerably (range 8-29%).
CONCLUSIONS
The incidence of OM is high after radiotherapy of cancer of the upper head and neck area and the Eustachian tube (ET) irradiation dosage seems associated with development of OM, but the literature is poor. Research is needed to designate patients at risk of developing OM after radiotherapy. Preferably through analysis of dosage relationships between the ET and middle ear, and development of OM. Reporting of OM should be per ear and follow standardized protocols of middle ear assessment before and after radiotherapy. Furthermore, there is a need to find new ways to prevent and treat radiation-induced OME, preferably through randomized controlled trials.
Topics: Head and Neck Neoplasms; Humans; Incidence; Nasopharyngeal Neoplasms; Otitis Media with Effusion; Parotid Neoplasms; Radiotherapy
PubMed: 29698103
DOI: 10.1080/0284186X.2018.1468085 -
The Journal of Laryngology and Otology Jun 2023The extent of parotidectomy in the management of regional metastatic disease is controversial. This systematic review aimed to appraise data from studies evaluating... (Review)
Review
OBJECTIVE
The extent of parotidectomy in the management of regional metastatic disease is controversial. This systematic review aimed to appraise data from studies evaluating superficial and total parotidectomy in metastatic cutaneous squamous cell carcinoma and cutaneous malignant melanoma of the head and neck.
METHOD
A systematic search of PubMed, Embase and Cochrane Library was performed. The protocol was registered with Prospero (CRD42020217962).
RESULTS
A total of five studies evaluated cutaneous malignant melanoma. Only one compared outcomes of superficial and total parotidectomy: they found higher parotid area recurrence following superficial parotidectomy. Seven studies reported outcomes following cutaneous squamous cell carcinoma; some studies found higher regional recurrence and reduced survival in total parotidectomy, but there was likely selection bias in these studies. Others found no difference in survival between superficial and total parotidectomy.
CONCLUSION
The effect of the extent of parotidectomy on outcomes is unclear in cutaneous malignant melanoma and cutaneous squamous cell carcinoma. This systematic review highlights the need for well-designed studies to direct better care.
Topics: Humans; Skin Neoplasms; Carcinoma, Squamous Cell; Parotid Neoplasms; Neoplasm Staging; Melanoma; Parotid Gland; Retrospective Studies; Neoplasm Recurrence, Local; Melanoma, Cutaneous Malignant
PubMed: 35912693
DOI: 10.1017/S0022215122001724 -
Head & Neck Mar 2021The prognostic importance of intraparotid lymph node metastasis (P+) in patients with primary parotid gland carcinoma is unclear. (Review)
Review
BACKGROUND
The prognostic importance of intraparotid lymph node metastasis (P+) in patients with primary parotid gland carcinoma is unclear.
METHODS
Nineteen retrospective and noncomparative cohort studies, published between 1992 and 2020, met the inclusion criteria and included 2202 patients for this systematic review.
RESULTS
The pooled prevalence of the P in adult patients in the unselected studies was 24.10% (95% confidence interval = 17.95-30.25). The number of P+ lymph nodes per patient was counted in only three studies and ranged from 1 to 11. The 5-year recurrence-free survival rate based on Kaplan-Meier analysis varied from 83% to 88% in P- patients compared to 36% to 54% in P+ patients. The average hazard ratio for tumor recurrence in patients with P+ compared to P- was 2.67 ± 0.58.
CONCLUSIONS
P+ is an independent negative prognostic factor in primary parotid gland cancer and should be included into the treatment planning.
Topics: Adult; Humans; Lymph Nodes; Lymphatic Metastasis; Neoplasm Recurrence, Local; Neoplasm Staging; Parotid Neoplasms; Prognosis; Retrospective Studies
PubMed: 33169420
DOI: 10.1002/hed.26541 -
Head & Neck Feb 2022We defined the occult nodal metastasis (ONM) rate of clinical node-negative salivary gland malignancies and examined the role of elective neck dissection (END).... (Meta-Analysis)
Meta-Analysis Review
We defined the occult nodal metastasis (ONM) rate of clinical node-negative salivary gland malignancies and examined the role of elective neck dissection (END). Meta-analysis querying four databases, from inception of databases to March 25th, 2020. Fifty-one studies with 11 698 patients were included. ONM rates were 64% for salivary ductal carcinoma (SDC), 51% for undifferentiated carcinoma, 34% for carcinoma ex-pleomorphic adenoma (CXPA), 32% for adenocarcinoma not otherwise specified (ANOS), 31% for lymphoepithelial carcinoma (LE), 20% for mucoepidermoid carcinoma, 17% for acinic cell carcinoma, and 17% for adenoid cystic carcinoma. T3/T4 tumors had a 2.3 times increased risk of ONM than T1/T2 tumors. High-grade tumors had a 3.8 times increased risk of ONM than low/intermediate-grade tumors. ONM rates were exceedingly high for T3/T4, high-grade, and undifferentiated, SDC, ANOS, CXPA, and LE tumors, indicating the potential role of END.
Topics: Carcinoma, Acinar Cell; Carcinoma, Adenoid Cystic; Carcinoma, Squamous Cell; Humans; Neck Dissection; Salivary Gland Neoplasms
PubMed: 34862810
DOI: 10.1002/hed.26923 -
European Journal of Surgical Oncology :... Sep 2009Primary adenocarcinomas of the parotid gland are rare and account for less than 5% of all head and neck malignant neoplasms. There is considerable variation in... (Comparative Study)
Comparative Study Review
BACKGROUND
Primary adenocarcinomas of the parotid gland are rare and account for less than 5% of all head and neck malignant neoplasms. There is considerable variation in biological behaviour within this group; low-grade tumours exhibit slow growth rates with minimal or no local invasion. High-grade tumours, however, show a high incidence of local recurrence and distant metastasis.
AIM
The purpose of this paper is to analyse the important prognostic indicators for this cancer.
METHODS
A systematic review was performed involving 19 published studies from 1987 to 2005 which included 4631 patients. T stage, grade of tumour, N stage and adjuvant radiotherapy on overall (5 year) survival were analysed as prognostic indicators.
RESULTS
T stage (p=0.041, hazard ratio 1.8 (confidence interval 1.2-2.9)), N stage (p=0.05, hazard ratio 1.1 (0.2-1.8)), and high-grade (p=0.001, hazard ratio 2.1 (1.5-2.7)) were associated with a significantly worse survival. The effect of adjuvant radiotherapy was to improve overall survival: p=0.002, hazard ratio 2.9 (1.5-4.7). The mean 5 year survival for advanced high-grade parotid cancer was 35%.
CONCLUSION
High-grade advanced parotid cancers are associated with a poor survival. Adjuvant radiotherapy is indicated in these tumours and this improves survival.
Topics: Adenocarcinoma; Humans; Neoplasm Staging; Parotid Neoplasms; Prognosis; Radiotherapy, Adjuvant; Survival Analysis; Treatment Outcome
PubMed: 19027261
DOI: 10.1016/j.ejso.2008.10.009 -
Journal of Oral Pathology & Medicine :... Sep 2021The aim of the present systematic review was to analyze the available data regarding acinic cell carcinoma of the oral and maxillofacial region. (Review)
Review
BACKGROUND
The aim of the present systematic review was to analyze the available data regarding acinic cell carcinoma of the oral and maxillofacial region.
METHODS
A search strategy was performed using PubMed, Web of Science, Scopus, and Embase electronic databases.
RESULTS
Available data revealed a slight female preference (54.73%) and a mean age at diagnosis of 47.51 ± 19.85 years. The parotid glands (67.72%) were most frequently affected, and most cases were asymptomatic (69.54%). A microcystic histopathological pattern was reported in 21.56% of the cases, and the Periodic acid-Schiff was the staining method most frequently used, after the hematoxylin and eosin staining, in the tumors analyzed. The lesions were mainly treated by surgical removal (72.32%). Recurrence was reported in 81 cases (27.83%) and metastasis in 100 (42.91%). Statistical data analysis revealed that tumors located in major salivary glands and exhibiting high-grade histology were associated with local recurrence (P = .01). In addition, the patients older than 57 years, lesions with bone involvement, the high-grade tumors and the cases with a history of recurrence and metastasis were associated with a lower overall survival (P < .05).
CONCLUSION
By assembling all eligible cases in the literature, the present systematic review determined the most common clinicopathological profile of acinic cell carcinoma and the most relevant prognostic factors in a distinctly representative sample. The survey demonstrated the importance of considering the histopathological grading in order to better define the treatment for each case.
Topics: Carcinoma, Acinar Cell; Female; Humans; Neoplasm Recurrence, Local; Parotid Gland; Salivary Gland Neoplasms; Salivary Glands
PubMed: 33455041
DOI: 10.1111/jop.13159 -
Otolaryngology--head and Neck Surgery :... Apr 2015To determine the effectiveness of intraoperative facial nerve monitoring (FNM) in preventing immediate and permanent postoperative facial nerve weakness in patients... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To determine the effectiveness of intraoperative facial nerve monitoring (FNM) in preventing immediate and permanent postoperative facial nerve weakness in patients undergoing primary parotidectomy.
DATA SOURCES
PubMed-NCBI database from 1970 to 2014.
REVIEW METHODS
A systematic review and meta-analysis of the literature was conducted. Acceptable studies included controlled series that evaluated facial nerve function following primary parotidectomy with or without FNM (intraoperative nerve monitor vs control). Primary and secondary end points were defined as immediate postoperative and permanent facial nerve weakness (House-Brackmann score, ≥2), respectively.
RESULTS
After a review of 1414 potential publications, 7 articles met inclusion criteria, with a total of 546 patients included in the final meta-analysis. The incidence of immediate postoperative weakness following parotidectomy was significantly lower in the FNM group compared to the unmonitored group (22.5% vs 34.9%; P = .001). The incidence of permanent weakness was not statistically different in the long term (3.9% vs 7.1%; P = .18). The number of monitored cases needed to prevent 1 incidence of immediate postoperative facial nerve weakness was 9, given an absolute risk reduction of 11.7% This corresponded to a 47% decrease in the incidence of immediate facial nerve dysfunction (odds ratio, 0.53; 95% CI, 0.35 to 0.79; P = .002).
CONCLUSION
In primary cases of parotidectomy, intraoperative FNM decreases the risk of immediate postoperative facial nerve weakness but does not appear to influence the final outcome of permanent facial nerve weakness.
Topics: Facial Nerve; Facial Nerve Injuries; Humans; Intraoperative Neurophysiological Monitoring; Parotid Diseases; Parotid Gland; Parotid Neoplasms
PubMed: 25628369
DOI: 10.1177/0194599814568779 -
Journal of Oncology 2021Radiation-induced toxicity represents a crucial concern in oncological treatments of patients affected by head and neck neoplasms, due to its impact on survivors'... (Review)
Review
UNLABELLED
Radiation-induced toxicity represents a crucial concern in oncological treatments of patients affected by head and neck neoplasms, due to its impact on survivors' quality of life. Published reports suggested the potential of radiomics combined with machine learning methods in the prediction and assessment of radiation-induced toxicities, supporting a tailored radiation treatment management. In this paper, we present an update of the current knowledge concerning these modern approaches.
MATERIALS AND METHODS
A systematic review according to PICO-PRISMA methodology was conducted in MEDLINE/PubMed and EMBASE databases until June 2019. Studies assessing the use of radiomics combined with machine learning in predicting radiation-induced toxicity in head and neck cancer patients were specifically included. Four authors (two independently and two in concordance) assessed the methodological quality of the included studies using the Radiomic Quality Score (RQS). The overall score for each analyzed study was obtained by the sum of the single RQS items; the average and standard deviation values of the authors' RQS were calculated and reported.
RESULTS
Eight included papers, presenting data on parotid glands, cochlea, masticatory muscles, and white brain matter, were specifically analyzed in this review. Only one study had an average RQS was ≤ 30% (50%), while 3 studies obtained a RQS almost ≤ 25%. Potential variability in the interpretations of specific RQS items could have influenced the inter-rater agreement in specific cases.
CONCLUSIONS
Published radiomic studies provide encouraging but still limited and preliminary data that require further validation to improve the decision-making processes in preventing and managing radiation-induced toxicities.
PubMed: 34211551
DOI: 10.1155/2021/5566508 -
Toxins Dec 2023This systematic review investigates the effect of botulinum neurotoxin (BoNT) therapy on cancer-related disorders. A major bulk of the literature is focused on BoNT's... (Review)
Review
This systematic review investigates the effect of botulinum neurotoxin (BoNT) therapy on cancer-related disorders. A major bulk of the literature is focused on BoNT's effect on pain at the site of surgery or radiation. All 13 published studies on this issue indicated reduction or cessation of pain at these sites after local injection of BoNTs. Twelve studies addressed the effect of BoNT injection into the pylorus (sphincter between the stomach and the first part of the gut) for the prevention of gastroparesis after local resection of esophageal cancer. In eight studies, BoNT injection was superior to no intervention; three studies found no difference between the two approaches. One study compared the result of intra-pyloric BoNT injection with preventive pyloromyotomy (resection of pyloric muscle fibers). Both approaches reduced gastroparesis, but the surgical approach had more serious side effects. BoNT injection was superior to saline injection in the prevention of esophageal stricture after surgery (34% versus 6%, respectively, = 0.02) and produced better results (30% versus 40% stricture) compared to steroid (triamcinolone) injection close to the surgical region. All 12 reported studies on the effect of BoNT injection into the parotid region for the reduction in facial sweating during eating (gustatory hyperhidrosis) found that BoNT injections stopped or significantly reduced facial sweating that developed after parotid gland surgery. Six studies showed that BoNT injection into the parotid region prevented the development of or healed the fistulas that developed after parotid gland resection-parotidectomy gustatory hyperhidrosis (Frey syndrome), post-surgical parotid fistula, and sialocele. Eight studies suggested that BoNT injection into masseter muscle reduced or stopped severe jaw pain after the first bite (first bite syndrome) that may develop as a complication of parotidectomy.
Topics: Humans; Botulinum Toxins, Type A; Sweating, Gustatory; Gastroparesis; Pain; Neoplasms
PubMed: 38133193
DOI: 10.3390/toxins15120689