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Annals of Oncology : Official Journal... Nov 2020
Topics: Carcinoma, Squamous Cell; Follow-Up Studies; Head and Neck Neoplasms; Humans; Hypopharynx; Larynx; Mouth; Oropharynx
PubMed: 33239190
DOI: 10.1016/j.annonc.2020.07.011 -
Acta Otorhinolaryngologica Italica :... Oct 2006A correlation between laryngo-pharyngeal reflux and laryngeal carcinoma is currently debated. Chronic inflammation is a mutagen factor confirmed in the cancerogenesis of... (Review)
Review
A correlation between laryngo-pharyngeal reflux and laryngeal carcinoma is currently debated. Chronic inflammation is a mutagen factor confirmed in the cancerogenesis of various tumours. Aim of the present study was to evaluate, in an objective and consecutive way, with 24h multi-electrode pH-metry the presence of proximal and distal oesophageal reflux in patients presenting pre-cancerosis or squamous cell laryngeal and/or pharyngeal carcinomas. From our data, a strict correlation emerged between laryngo-pharyngeal reflux and neoplasias of the upper airways, documented through multi-electrode pH-metry. Data emerging from this study would seem to support the theory that the protracted exposure (> 20 years) to biliary reflux would represent a statistically significant added risk factor in the precancerous lesions and squamous pharyngo-laryngeal carcinoma as it occurs at oesophageal level. Moreover, a significant statistical association (p < 0.0001) emerged between laryngeal carcinoma and previous gastro-resection (odds ratio 3.8).
Topics: Carcinoma; Gastroesophageal Reflux; Humans; Laryngeal Neoplasms; Larynx; Pharynx
PubMed: 17345929
DOI: No ID Found -
European Archives of... Oct 2020To perform a systematic review of the literature available about the posterior pharyngeal wall squamous cell carcinomas, with a special focus on oncologic outcomes. (Review)
Review
OBJECTIVE
To perform a systematic review of the literature available about the posterior pharyngeal wall squamous cell carcinomas, with a special focus on oncologic outcomes.
METHODS
A comprehensive research was performed on PubMed/MEDLINE, Google Scholar, and Cochrane Library datasets for published studies meeting the established criteria. The last search was conducted on December 8, 2019.
RESULTS
Eleven studies were included in the review, for a total of 534 patients (median age 60.4; male: n = 359, 67.2%). Six of the studies evaluated the oncologic outcomes of primary surgery, while three studies focused on results achieved through primary radiotherapy. Two studies evaluated both surgery and radiotherapy outcomes for the treatment of early or advanced posterior pharyngeal wall carcinoma.
CONCLUSIONS
Primary surgery associated with adjuvant radiotherapy would seem to ensure better oncologic outcomes, especially for locally advanced tumors. Moreover, this systematic review showed that oro- and hypo-pharyngeal wall tumors are similar in terms of clinical and biological behavior.
Topics: Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Male; Middle Aged; Pharyngeal Neoplasms; Pharynx; Radiotherapy, Adjuvant
PubMed: 32361771
DOI: 10.1007/s00405-020-05990-0 -
World Journal of Surgical Oncology May 2020The most common sites of recurrence after liver transplantation for hepatocellular carcinoma (HCC) have been reported to be the liver, lung, bone, and adrenal glands,... (Review)
Review
BACKGROUND
The most common sites of recurrence after liver transplantation for hepatocellular carcinoma (HCC) have been reported to be the liver, lung, bone, and adrenal glands, but there have also been many reports of cases of multiple recurrence. The prognosis after recurrence is poor, with reported median survival after recurrence of HCC ranging from 9 to 19 months. Here, we report a case of long-term survival after recurrence of pharyngeal metastasis following living-donor liver transplantation (LDLT) for HCC within the Milan criteria, by resection of the metastatic region and cervical lymph node dissection.
CASE PRESENTATION
A 47-year-old man with a Model End-stage Liver Disease (MELD) score of 11 underwent LDLT for HCC within the Milan criteria for liver cirrhosis associated with hepatitis B virus infection, with his 48-year-old elder brother as the living donor. One year and 10 months after liver transplantation, he visited a nearby hospital with a chief complaint of discomfort on swallowing. A pedunculated polyp was found in the hypopharynx, and biopsy revealed HCC metastasis. We performed pharyngeal polypectomy. Two years later, cervical lymph node metastasis appeared, and neck lymph node dissection was performed. Although recurrence subsequently occurred three times in the grafted liver, the patient is still alive 12 years and 10 months after recurrence of pharyngeal metastasis. He is now a tumor-free outpatient taking sorafenib.
CONCLUSION
It is necessary to recognize that the nasopharyngeal region is a potential site of HCC metastasis. Prognostic improvement can be expected with close follow-up, early detection, and multidisciplinary treatment, including radical resection.
Topics: Allografts; Biopsy; Carcinoma, Hepatocellular; Catheter Ablation; Chemotherapy, Adjuvant; Drug Combinations; End Stage Liver Disease; Hepatectomy; Humans; Liver; Liver Neoplasms; Liver Transplantation; Living Donors; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence, Local; Oxonic Acid; Pharyngeal Neoplasms; Pharynx; Positron Emission Tomography Computed Tomography; Sorafenib; Tegafur; Treatment Outcome
PubMed: 32466780
DOI: 10.1186/s12957-020-01873-0 -
Head & Neck Nov 2021To investigate a novel velopharyngeal squeeze maneuver (VPSM) and novel endoscopic pharyngeal contraction grade (EPCG) scale for the evaluation of pharyngeal motor...
Assessment of pharyngeal motor function using a novel velopharyngeal squeeze maneuver and a novel endoscopic pharyngeal contraction grade scale in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma.
BACKGROUND
To investigate a novel velopharyngeal squeeze maneuver (VPSM) and novel endoscopic pharyngeal contraction grade (EPCG) scale for the evaluation of pharyngeal motor function.
METHODS
During endoscopic examination of 77 post-irradiated nasopharyngeal carcinoma patients and control subjects, VPSM was rated and lateral pharyngeal wall movement graded with EPCG scale during swallowing. Pharyngeal constriction ratio (PCR) measured by videofluoroscopy was used for correlation.
RESULTS
VPSM and EPCG scale showed almost perfect intra-rater and inter-rater reliability (Kappa: >0.90). VPSM was present in 61% of patients suggesting good pharyngeal motor function. VPSM was predictive of EPCG scale (Wald statistic = 29.99, p < 0.001). EPCG scale also correlated strongly with PCR (r: 0.812) and was predictive for aspiration (odds ratio: 22.14 [95% CI 5.01-97.89, p < 0.001]).
CONCLUSIONS
VPSM and EPCG scale are two novel tools to assess pharyngeal motor function, and both correlate well with pharyngeal contractility and aspiration.
Topics: Deglutition; Deglutition Disorders; Humans; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Pharynx; Reproducibility of Results
PubMed: 34523766
DOI: 10.1002/hed.26871 -
The Laryngoscope Mar 2020In patients with head and neck carcinoma of unknown primary (HNCUP;pT0) following TORS-assisted workup, we have adopted a pharyngeal-sparing radiation therapy (PSRT)...
OBJECTIVE
In patients with head and neck carcinoma of unknown primary (HNCUP;pT0) following TORS-assisted workup, we have adopted a pharyngeal-sparing radiation therapy (PSRT) approach targeting only the at-risk neck and omitting treatment of the pharynx. We report outcomes following PSRT, and compare to institutional historical control subjects who received pharyngeal-targeted RT (PRT).
METHODS
Between 2009 and 2018, 172 patients underwent TORS-assisted endoscopy as part of their workup for HNCUP. Following TORS, 54 patients had pT0 disease, of which 45 received RT. Forty-nine percent received PSRT and 51% received PRT.
RESULTS
No statistically significant differences existed between the PSRT and PRT groups with respect to overall nodal distribution, p16 positivity (55% vs. 43%, P = .12), neck dissection rates (77% vs. 65%, P = .51), and administration of chemotherapy (55% vs. 65%, P = .55). Median follow-up for PSRT and PRT groups were 24 and 28 months, respectively (P = .04). Two-year RFS was 86% and 74% for PSRT and PRT patients, respectively (log-rank P = .30). Three and six patients recurred after PSRT and PRT, respectively. Two-year OS for PSRT and PRT patients was 91% and 74%, respectively (log-rank P = .31). Compared to PRT, PSRT was associated with statistically significantly less: grade 2+ mucositis (18% vs. 91%, P < .01), new opioid requirement (27% vs. 91%, P < .01), mean weight loss during RT (6.2 lbs vs. 17.4 lbs, P < .01), feeding tube placement during RT (5% vs. 43%, P < .01), and treatment-related unplanned hospitalizations (9% vs. 39%, P = .04).
CONCLUSION
Following TORS-assisted management of patients with pT0 HNCUP, we observed reduced toxicity following PSRT compared to PRT without apparent compromise of disease cure.
LEVEL OF EVIDENCE
Level 3 evidence, retrospective review comparing cases and controls Laryngoscope, 130:691-697, 2020.
Topics: Carcinoma; Case-Control Studies; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Neck; Neoplasms, Unknown Primary; Organ Sparing Treatments; Organs at Risk; Pharyngeal Diseases; Pharynx; Postoperative Period; Radiation Injuries; Retrospective Studies; Robotic Surgical Procedures; Treatment Outcome
PubMed: 31411747
DOI: 10.1002/lary.28200 -
Surgical Endoscopy May 2024Since patients with pharyngeal squamous cell carcinoma (SCC) often have multiple pharyngeal lesions, evaluation of pharyngeal lesions before endoscopic resection (ER) is...
INTRODUCTION
Since patients with pharyngeal squamous cell carcinoma (SCC) often have multiple pharyngeal lesions, evaluation of pharyngeal lesions before endoscopic resection (ER) is important. However, detailed endoscopic observation of the entire pharyngeal mucosa under conscious sedation is difficult. We examined the usefulness of endoscopic surveillance with narrow band imaging (NBI) and lugol staining for detection of pharyngeal sublesions during ER for pharyngeal SCC under general anesthesia (endoscopic surveillance during treatment; ESDT).
METHODS
From January 2021 through June 2022, we examined 78 patients who were diagnosed with superficial pharyngeal SCC and underwent ER. They underwent the ESDT and for patients who were diagnosed with new lesions of pharyngeal SCC or high-grade dysplasia (HGD) that were not detected in the endoscopic examination before treatment, ER were performed simultaneously for new lesions and the main lesions. The primary endpoint of this study was the detection rate of new lesions of pharyngeal SCC or HGD in the ESDT.
RESULTS
Fifteen of the 78 patients were diagnosed as having undetected new pharyngeal lesions in the ESDT and 10 (12.8%) (95% CI 6.9-22.2%) were histopathologically confirmed to have new lesions of pharyngeal SCC or HGD. Among the 13 lesions of SCC or HGD, 8 were found by NBI observation; however, 5 were undetectable using NBI but detectable by lugol staining. All of the 13 lesions had endoscopic findings of pink color sign on lugol staining.
CONCLUSIONS
Endoscopic surveillance for pharyngeal sublesions during ER for pharyngeal SCC is feasible and useful.
Topics: Humans; Male; Female; Pharyngeal Neoplasms; Prospective Studies; Aged; Middle Aged; Narrow Band Imaging; Carcinoma, Squamous Cell; Mucous Membrane; Iodides; Aged, 80 and over; Endoscopic Mucosal Resection; Pharynx
PubMed: 38466423
DOI: 10.1007/s00464-024-10747-5 -
Head & Neck Apr 2016Infection with Helicobacter pylori (H. pylori) plays a role in the development of gastric carcinoma. However, there is controversy as to whether H. pylori infection... (Review)
Review
BACKGROUND
Infection with Helicobacter pylori (H. pylori) plays a role in the development of gastric carcinoma. However, there is controversy as to whether H. pylori infection increases laryngeal or pharyngeal cancers.
METHODS
We managed a systematic review of researches related to H. pylori infection in laryngeal or pharyngeal carcinomas, distributed up to December 2014. Odds ratios (ORs) and 95% confidence intervals (CIs) were assessed by random effects models or according to heterogeneity I(2) .
RESULTS
Eleven studies were involved in the meta-analysis. Overall, H. pylori infection was significantly higher in the study group compared with the normal control group (OR = 2.87; 95% CI = 1.71-4.84; I(2) = 67.1; p < .0001, random effects analysis). The ORs for laryngeal carcinoma were 3.28 (95% CI = 1.91-5.63; I(2) = 58; p < .0001, random effects model). The ORs for pharyngeal cancer were 1.35 (95% CI = 0.86-2.12; p = .188, random effects model).
CONCLUSION
This study supported the proposition that infection with H. pylori was related to laryngeal carcinoma, specifically in the hospital-based control group and diagnosed by polymerase chain reaction (PCR) or enzyme-linked immunosorbent assay (ELISA). Nevertheless, no significant relationship was discovered between H. pylori infection and pharyngeal cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2291-E2296, 2016.
Topics: Helicobacter Infections; Helicobacter pylori; Humans; Laryngeal Neoplasms; Larynx; Pharynx; Stomach Neoplasms
PubMed: 26316145
DOI: 10.1002/hed.24214 -
Oral Oncology Apr 2021
Topics: Adult; Carcinoma, Adenoid Cystic; Female; Humans; Palatine Tonsil
PubMed: 33376056
DOI: 10.1016/j.oraloncology.2020.105135 -
ORL; Journal For Oto-rhino-laryngology... 2018The concept of neck dissection (ND) in the management armamentarium of head and neck squamous cell carcinoma has evolved throughout the years. Nowadays, ND becomes more...
INTRODUCTION
The concept of neck dissection (ND) in the management armamentarium of head and neck squamous cell carcinoma has evolved throughout the years. Nowadays, ND becomes more functional.
METHODOLOGY
A retrospective study of 865 patients was performed at Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital to investigate the feasibility of selective ND (SND). All patients with squamous cell carcinoma of the pharynx and larynx who received primary radiation and underwent salvage ND were included in the study.
RESULT
A total of 29 NDs were analyzed. In 17 neck sides, viable metastases were found (58%), whereas in the other 12 specimens there were no viable metastases. In 16 of the 17 necks (94%), the metastases were located either in level II, III, or IV or in a combination of these 3 levels. Level V was involved in only 1 case (6%).
CONCLUSION
It is well justified to perform a salvage SND (levels II, III, and IV) for pharyngeal and laryngeal carcinoma after primary radiation. In carefully selected cases of supraglottic and oropharyngeal carcinoma, a superselective ND also appears as an efficient option.
Topics: Adult; Aged; Carcinoma, Squamous Cell; Feasibility Studies; Head and Neck Neoplasms; Humans; Laryngeal Neoplasms; Larynx; Middle Aged; Neck; Neck Dissection; Neoplasm Recurrence, Local; Netherlands; Pharyngeal Neoplasms; Pharynx; Retrospective Studies; Salvage Therapy; Squamous Cell Carcinoma of Head and Neck; Treatment Outcome
PubMed: 29428959
DOI: 10.1159/000486371