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Acta Medica (Hradec Kralove) 2015The goal of this prospective study was to determine the frequency of micrometastases in patients with squamous cell carcinoma (SCC) of the oral cavity, pharynx and...
BACKGROUND
The goal of this prospective study was to determine the frequency of micrometastases in patients with squamous cell carcinoma (SCC) of the oral cavity, pharynx and larynx in whom elective neck dissection was indicated (cN0).
PATIENTS AND METHODS
A total of 12 patients (10 males and 2 females) were enrolled in the study. The age ranged 42-73 years (median 62 years). Elective neck dissection was performed in all patients (8 ipsilateral, 4 bilateral) and a total of 256 lymph nodes were removed and sent for microscopic examination.
RESULTS
The presence of tumor cells in cervical lymph nodes was found in 5/12 (42%) patients. Micrometastases of SCC were found in two patients and isolated tumor cells (ITC) in two other patients. In the remaining one patient with oropharyngeal SCC, a micrometastasis of papillary thyroid carcinoma (PTC) was detected. Positive lymph nodes were localized in level II in three patients with SCC of larynx, hypopharynx and tongue base, respectively, in level I in one patient with SCC of oral tongue and in level III in one patient with PTC.
CONCLUSION
Our results indicate that SCC of head and neck has a high potential for creating micrometastases which frequency is higher compared to clinically detected macrometastases. Therefore, elective neck dissection or radiotherapy of the neck should be considered in patients with high risk of occult metastases or micrometastases.
Topics: Carcinoma, Squamous Cell; Czech Republic; Female; Humans; Laryngeal Neoplasms; Lymph Node Excision; Male; Middle Aged; Mouth Neoplasms; Neck Dissection; Neoplasm Micrometastasis; Neoplasm Staging; Patient Care Planning; Pharyngeal Neoplasms; Predictive Value of Tests; Prognosis; Prospective Studies; Reproducibility of Results
PubMed: 26455568
DOI: 10.14712/18059694.2015.95 -
Radiobiologia, Radiotherapia 1989In a summary representation the therapeutic principles are shown applying radiotherapy in epithelial tumors of epi-, meso-, and hypopharynx on base of actual references... (Review)
Review
In a summary representation the therapeutic principles are shown applying radiotherapy in epithelial tumors of epi-, meso-, and hypopharynx on base of actual references in literature and own results. Especially by combination therapy a trend indicates improvement of therapeutic results.
Topics: Combined Modality Therapy; Humans; Pharyngeal Neoplasms; Survival Rate
PubMed: 2678228
DOI: No ID Found -
The Tohoku Journal of Experimental... Oct 2006We report a rare case of schwannoma arising from the retropharyngeal space. A 24-year-old man presented a 2-month-history of a foreign body sensation in the throat and...
We report a rare case of schwannoma arising from the retropharyngeal space. A 24-year-old man presented a 2-month-history of a foreign body sensation in the throat and gradually progressing dysphagia when he swallowed solids and liquids. The patient had no odynophagia, fever, or blood in his saliva. Computed tomographic scans and magnetic resonance images revealed a well-defined and oval mass, measuring about 40 mm x 20 mm in size, in the retropharyngeal space. Because the tumor existed in the retropharyngeal space and was the adequate size, the patient underwent trans-oral resection under the direct laryngoscope without the need for skin incision. On the basis of the histological findings, the tumor was diagnosed as a schwannoma. It was mostly composed of spindle cells arranged in short bundles and fascicles, with focal palisading of the nuclei. The neoplasm arising from the retropharyngeal space is quite rare, because of few anatomical structures in the space. The post-operative course was uneventful, and the patient is currently free from disease 30 months after surgery. Diagnosis, clinical behavior, and treatment of retropharyngeal schwannoma are reviewed from perusal of the literature. When schwannomas are located in the pharynx, they may cause foreign body sensation or dysphagia. Therefore, when a foreign body sensation in the larynx is present, a thorough diagnostic procedure should be performed to evaluate the morphology of the upper aerodigestive tract.
Topics: Adult; Humans; Male; Neurilemmoma; Pharyngeal Neoplasms
PubMed: 17023770
DOI: 10.1620/tjem.210.161 -
Il Valsalva Jun 1967
Topics: Adenocarcinoma; Female; Humans; Middle Aged; Neoplasm Metastasis; Pharyngeal Neoplasms
PubMed: 5609908
DOI: No ID Found -
Ear, Nose, & Throat Journal Jun 2020
Topics: Carcinoma, Squamous Cell; Female; Humans; Laryngeal Neoplasms; Laryngectomy; Larynx; Medical Illustration; Middle Aged; Neoplasm Recurrence, Local; Pharyngeal Neoplasms; Pharyngectomy; Pharynx; Postoperative Complications; Robotic Surgical Procedures
PubMed: 30966787
DOI: 10.1177/0145561319840144 -
Digestive Endoscopy : Official Journal... Jul 2021Management of diminutive pharyngeal neoplasms is controversial. Thus, we conducted a single-center, prospective pilot study to investigate the efficacy and safety of... (Clinical Trial)
Clinical Trial
BACKGROUND
Management of diminutive pharyngeal neoplasms is controversial. Thus, we conducted a single-center, prospective pilot study to investigate the efficacy and safety of endoscopic excision with cold forceps biopsy (CFB) of these lesions.
PATIENTS AND METHODS
Thirty-nine lesions endoscopically diagnosed with narrow-band imaging as pharyngeal neoplasms of 3 mm or smaller were excised with CFB using jumbo biopsy forceps (cap diameter 2.8 mm, jaw volume 12.4 mm ). The primary outcome was endoscopically determined local remnant/recurrence rate 3 months after CFB. The secondary outcomes were histopathologically determined local remnant/recurrence rate; risk factors associated with the endoscopic remnant/recurrence; and incidence of intraoperative or delayed bleeding and other adverse events.
RESULTS
Histological diagnosis of the 39 CFB-excised lesions were: 11 high-grade dysplasia (28.2%), 22 low-grade dysplasia (56.4%), two basal cell hyperplasia (5.1%) and four atypical squamous epithelium (10.3%).Twenty-seven patients (30 lesions) underwent follow-up endoscopy 3 months after CFB; the endoscopic and pathological local remnant/recurrence rate was 20% (6/30; 95% confidence interval (CI), 7.7-36.6%) and 16.7% (5/30; 95% CI, 5.6-34.7%), respectively. Location of the lesion in the hypopharynx was a significant risk factor associated with the endoscopic local remnant/recurrence (P = 0.049). No significant adverse events occurred.
CONCLUSIONS
Cold forceps biopsy with jumbo biopsy forceps appears to be a safe and effective technique for excising diminutive pharyngeal neoplasms. Although small, the excised lesions may have a remarkably high frequency of high-grade dysplasia. (Clinical trial registration number: UMIN000037980).
Topics: Biopsy; Humans; Neoplasm Recurrence, Local; Pharyngeal Neoplasms; Pilot Projects; Prospective Studies; Surgical Instruments
PubMed: 32920920
DOI: 10.1111/den.13838 -
Oral Oncology May 2013Chemoradiation is the treatment of choice for carcinomas of the pharynx and larynx with imminent loss of organ or function. However, the prognosis after CRT decreases...
Results of chemoselection with short induction chemotherapy followed by chemoradiation or surgery in the treatment of functionally inoperable carcinomas of the pharynx and larynx.
OBJECTIVES
Chemoradiation is the treatment of choice for carcinomas of the pharynx and larynx with imminent loss of organ or function. However, the prognosis after CRT decreases when salvage surgery becomes necessary. Single-cycle induction chemotherapy is therefore performed to identify patients who would benefit more from S than from CRT. The present study aims to evaluate the feasibility and effectiveness of this approach.
MATERIALS AND METHODS
Forty-seven patients received Induction Chemotherapy (IC) with docetaxel plus cisplatin or carboplatin and were subsequently assessed for tumor response. Responders achieving a ≥30% decrease in endoscopic tumor size and a ≥20% decrease in 18F-fluorodeoxyglucose uptake proceeded to primary Chemoradiation (CRT) and non-responders received surgery (S). Six weeks after CRT patients with residual tumors underwent secondary surgery (S).
RESULTS
Thirty eight patients were elected for CRT and 9 received S. A local control rate of 86.1% and disease-free survival of 80.4% was achieved at 2 years. Overall treatment time in CRT-patients >80 days was associated with inferior disease-free survival (p = 0.05), cause-specific survival (p = 0.02), overall survival (p = 0.01) and a trend to inferior local control (p = 0.07) at 2 years.
CONCLUSION
The strategy of selecting patients for CRT vs. S based on the response to IC achieves encouraging rates of disease control by surgery and CRT.
Topics: Adult; Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Carcinoma; Chemoradiotherapy; Cisplatin; Disease-Free Survival; Docetaxel; Endoscopy; Feasibility Studies; Female; Humans; Induction Chemotherapy; Laryngeal Neoplasms; Male; Middle Aged; Multimodal Imaging; Neoplasm Recurrence, Local; Neoplasm Staging; Organ Sparing Treatments; Pharyngeal Neoplasms; Positron-Emission Tomography; Remission Induction; Salvage Therapy; Survival Rate; Taxoids; Time Factors; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 23321550
DOI: 10.1016/j.oraloncology.2012.12.008 -
Acta Oto-laryngologica 1965
Topics: Diagnosis, Differential; Humans; Neoplasms; Neurilemmoma; Neurofibromatoses; Nose Neoplasms; Palatal Neoplasms; Pathology; Pharyngeal Neoplasms; Pharynx; Surgical Procedures, Operative; Tongue Neoplasms
PubMed: 14337962
DOI: 10.3109/00016486509126992 -
American Journal of Surgery Oct 1977
Topics: Adult; Aged; Female; Humans; Laryngectomy; Male; Middle Aged; Neck Dissection; New York; Pharyngeal Neoplasms; Pharyngectomy; Recurrence
PubMed: 911032
DOI: 10.1016/0002-9610(77)90383-x -
Clinical Otolaryngology and Allied... Feb 1994The first 100 consecutive free radial forearm flaps used in reconstruction for oral and pharyngeal cancer were investigated. Seven re-operations took place due to...
The first 100 consecutive free radial forearm flaps used in reconstruction for oral and pharyngeal cancer were investigated. Seven re-operations took place due to circulatory impairment of the flap. Two flaps underwent partial, and four total necrosis, one of those patients died of massive haemorrhage. Post-operative infection was significantly correlated to increased time between the last radiotherapy session and surgery. All but eight patients had post-operative impairment of swallowing and all but five patients had impairment of speech articulation or hypernasality. Post-operative time spent in hospital was a range of 12-122 days (mean 37 days). The 2-year survival rate was 70% and the 5-year survival rate was 45%.
Topics: Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Deglutition Disorders; Female; Forearm; Graft Survival; Humans; Length of Stay; Male; Middle Aged; Mouth Neoplasms; Necrosis; Neoplasm Staging; Pharyngeal Neoplasms; Reoperation; Speech Disorders; Speech Intelligibility; Surgical Flaps; Surgical Wound Infection; Survival Rate
PubMed: 8174297
DOI: 10.1111/j.1365-2273.1994.tb01143.x