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Acta Otorhinolaryngologica Italica :... Dec 2023Malignant minor salivary glands carcinomas (MiSGC) of the larynx and trachea are rare tumours and published evidence is sparse. We conducted a systematic review to... (Review)
Review
OBJECTIVES
Malignant minor salivary glands carcinomas (MiSGC) of the larynx and trachea are rare tumours and published evidence is sparse. We conducted a systematic review to describe shareable treatment strategies and oncological outcomes of these neoplastic entities.
METHODS
Full text English manuscripts published from January 1 2000 to December 14 2022 were included. Data on demographics, treatments and outcomes were collected. A pooled analysis of 5-year overall survival (OS) was performed.
RESULTS
Seventeen articles and 365 patients met the inclusion criteria. The most common subsites involved were subglottic and distal trachea. Adenoid cystic carcinoma was, by far, the most frequent histotype. The first-choice treatment strategy was surgery (86.8%), while adjuvant treatments were delivered in 57.4% of patients. Only 12.9% were treated with definitive radiotherapy with/without chemotherapy. The mean follow-up was 68.3 months. One hundred nine (34.9%) deaths were recorded and 62.4% were cancer-related. Five-year OS ranged from 20% to 100% and, at pooled analysis, it was 83% (range, 78-87%).
CONCLUSIONS
In case of MiSGC of the larynx and trachea, surgery remains the mainstay of treatment. Adjuvant treatments are frequently delivered. Survival estimates are good overall, but highly heterogeneous.
Topics: Humans; Trachea; Salivary Gland Neoplasms; Larynx; Carcinoma, Adenoid Cystic; Retrospective Studies; Treatment Outcome; Salivary Glands, Minor
PubMed: 37814980
DOI: 10.14639/0392-100X-N2635 -
Asian Pacific Journal of Cancer... Mar 2021Opium is among the most used substance of abuse worldwide. More than 50 million opium users are there worldwide, majority of whom are in Asia. Opium usage have been... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Opium is among the most used substance of abuse worldwide. More than 50 million opium users are there worldwide, majority of whom are in Asia. Opium usage have been reported to be associated with cancer. This study aimed to find the association between opium use or abuse and head and neck cancer.
METHODS
A systematic search was conducted in Medline, Scopus, Cochrane, and Google Scholar database for studies published from inception till 1st November 2019. Two authors independently reviewed the studies, did quality assessment, and extracted data in standardized data extraction form. Pooled estimate of OR for risk of head and neck cancer was calculated using random effects model using the method of DerSimonian and Laird, with the estimate of heterogeneity being taken from the inverse-variance model. Subgroup and sensitivity analysis were performed. The protocol was registered in PROSPERO (CRD42020156049).
RESULTS
Fourteen studies were included in data synthesis (11 case control studies and 3 cohort studies). Eleven case control studies were included in synthesizing the results for meta-analysis. Pooled odds ratio for risk of cancer among opium users for the 11-case control study was 3.85 (2.18-6.79). Heterogeneity was high (I-squared=92.0%, Tau-squared=0.88). There was no publication bias in the study. Subgroup analysis showed highest OR for pooled estimate for risk of laryngeal cancer (19.98 (11.04-36.15)).
CONCLUSION
There was almost four-fold rise in risk of head and neck cancer among opium users compared to non-users.
Topics: Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Head and Neck Neoplasms; Humans; Opium Dependence; Squamous Cell Carcinoma of Head and Neck
PubMed: 33773527
DOI: 10.31557/APJCP.2021.22.3.661 -
Therapeutic Advances in Medical Oncology 2020Multiple therapies including immune-checkpoint inhibitors are emerging as effective treatment for patients with recurrent or metastatic head and neck squamous cell...
Immune-checkpoint inhibitor plus chemotherapy conventional chemotherapy for treatment of recurrent or metastatic head and neck squamous cell carcinoma: a systematic review and network meta-analysis.
BACKGROUND
Multiple therapies including immune-checkpoint inhibitors are emerging as effective treatment for patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSSC). However, the optimal first-line and second-line treatments remains controversial.
METHODS
We systematically searched databases and conducted a systematic review of phase II/III randomized controlled trials (RCTs) that compared two or more treatments for R/M HNSSC. Progression-free survival (PFS), overall survival (OS) and adverse events (AEs) ⩾3 with hazard ratios (HRs) were extracted and synthesized based on a frequentist network meta-analysis.
RESULTS
Twenty-six trials involving 8908 patients were included. Of first-line treatments, pembrolizumab plus cisplatin plus 5-fluorouracil is associated with significantly improved OS (P-score = 0.91) and TPEx ranked first for prolonging PFS (0.91). EXTREME plus docetaxel (0.18) ranked lowest for AEs ⩾3. Of second-line treatments, nivolumab was the highest-ranked treatment for prolonging OS (0.95), while buparlisib plus paclitaxel was the highest-ranked treatment for PFS (0.94). Subgroup analyses suggested that nivolumab was significantly associated with improvement of OS in patients with high PD-L1 expression (HR 0.55, 0.43-0.70), whereas its OS benefit is similar with conventional chemotherapy for those with low PD-L1 expression. Buparlisib plus paclitaxel showed the best OS benefit in subgroups of patients with HPV-negative status, and with oral cavity or larynx as primary tumor sites.
CONCLUSIONS
Pembrolizumab plus cisplatin plus 5-fluorouracil is likely to be the best first-line treatment when OS is a priority. Otherwise, TPEx should be the optimal first-line option due to its superior PFS prolongation efficacy, best safety profile, and similar OS benefit with pembrolizumab plus cisplatin plus 5-fluorouracil. Nivolumab appears to be the best second-line option with best OS prolongation efficacy and outstanding safety profile in the overall population. Future RCTs with meticulous grouping of patients and detailed reporting are urgently needed for individualized treatment.
PubMed: 33488783
DOI: 10.1177/1758835920983717 -
Journal of Medical Biochemistry Oct 2023This systematic literature review and meta-analysis investigated whether the red blood cell distribution (RDW) may predict survival outcomes in laryngeal cancer patients...
BACKGROUND
This systematic literature review and meta-analysis investigated whether the red blood cell distribution (RDW) may predict survival outcomes in laryngeal cancer patients undergoing curative treatment.
METHODS
We conducted an electronic search in Medline and Scopus using the keywords "red blood cell distribution width" OR "RDW" AND "laryngeal cancer" OR "larynx cancer" OR "laryngeal carcinoma" OR "larynx carcinoma," without time or language restrictions (up to February 2023), for identifying studies investigating the prognostic value of RDW in patients with any form of laryngeal cancer and with a primary endpoint that was set as survival rate and/or disease-free survival between 1 and 10 years after curative treatment. The research was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 reporting checklist.
PubMed: 38090509
DOI: 10.5937/jomb0-42947 -
Journal of Otolaryngology - Head & Neck... Sep 2019The objective of this study is to compare the oncologic outcomes of CO transoral laser microsurgery (TLM) and radiotherapy (RT) for treatment of T1 glottic carcinoma. (Comparative Study)
Comparative Study Meta-Analysis
BACKGROUND
The objective of this study is to compare the oncologic outcomes of CO transoral laser microsurgery (TLM) and radiotherapy (RT) for treatment of T1 glottic carcinoma.
METHODS
A literature search was conducted in the following databases: Medline/PubMed, Web of Science, EMBASE, and the Cochrane Library. Search results were screened, and publications comparing oncologic outcomes of T1N0M0 glottic carcinoma treated with TLM or RT were included. Data was extracted independently by two authors, and publication quality was graded according to the Oxford Centre for Evidence-based Medicine. Meta-analysis was performed for overall survival, disease specific survival, laryngeal preservation, and local control.
RESULTS
Sixteen studies were included in the meta-analysis, the majority being retrospective cohort studies with two prospective cohort studies. Included studies were rated as either Level II or III evidence. Meta-analysis favoured treatment with TLM for T1 glottic carcinoma patients for the following outcomes: overall survival (odds ratio [OR], 1.52; 95% confidence interval [CI], 1.07-2.14; P = 0.02), disease specific survival (OR, 2.70; CI, 1.32-5.54; P = 0.007), and laryngeal preservation (OR, 6.31; CI, 3.77-10.56; P < 0.00001). There was no difference in local control between TLM and RT in T1 glottic cancer (OR, 1.19; CI, 0.79-1.81; P = 0.40).
DISCUSSION
Our study provides a current and thorough comparison of TLM and RT outcomes in T1 glottic carcinoma. Limitations of our study include lack of randomized control trials, and non-randomized allocation of patients to treatment groups. Our meta-analysis suggests that TLM is the superior modality in terms of overall survival, disease specific survival, and laryngeal preservation. Future prospective randomized controlled studies are required for confirming these findings and developing appropriate clinical practice guidelines.
LEVEL OF EVIDENCE
2A; as per the Centre of Evidence Based Medicine.
Topics: Glottis; Humans; Laryngeal Neoplasms; Laser Therapy; Microsurgery; Natural Orifice Endoscopic Surgery; Survival Rate; Treatment Outcome
PubMed: 31481120
DOI: 10.1186/s40463-019-0367-2 -
Comparison between Primary and Secondary Tracheoesophageal Puncture Prosthesis: A Systematic Review.ORL; Journal For Oto-rhino-laryngology... 2017Since the introduction of tracheoesophageal puncture (TEP) and placement of voice prosthesis, this has become the method of choice to achieve speech rehabilitation after... (Comparative Study)
Comparative Study Meta-Analysis Review
INTRODUCTION
Since the introduction of tracheoesophageal puncture (TEP) and placement of voice prosthesis, this has become the method of choice to achieve speech rehabilitation after total laryngectomy.
OBJECTIVE
To compare the complications and success in speech rehabilitation of patients undergoing rehabilitation after primary and secondary TEP (TEP1 and TEP2) through a systematic review.
METHODS
The literature survey included research in MedLine, Scielo, Lilacs, Cochrane and Websco until June 2016.
RESULTS
The rate of leakage around the prosthesis was higher in TEP1 (22.5 vs. 6.9%, p = 0.03). There were higher rates of wound infection (9.1 vs. 3.9%) and tracheal stenosis (8.5 vs. 4.5%) in the TEP1 group compared to TEP2, however with no statistical significance. The evaluation of speech quality was not possible due to the heterogeneity of the studies.
CONCLUSION
There is a reduction in the risk of leakage around the prosthesis among TEP2 patients.
Topics: Esophagus; Humans; Laryngeal Neoplasms; Laryngectomy; Larynx, Artificial; Postoperative Complications; Prosthesis Failure; Prosthesis Implantation; Punctures; Trachea; Tracheal Stenosis; Tracheostomy
PubMed: 28768272
DOI: 10.1159/000477970 -
The International Journal of Biological... May 2015The aim of this systematic review was to determine the prognostic value of Bcl-2 immunostaining in patients affected by laryngeal squamous cell carcinoma. An appropriate... (Review)
Review
The aim of this systematic review was to determine the prognostic value of Bcl-2 immunostaining in patients affected by laryngeal squamous cell carcinoma. An appropriate search was conducted on PubMed to retrieve articles dealing with this topic. A double cross-check was performed on citations and full-text articles by 2 investigators independently to review all manuscripts and perform a comprehensive quality assessment. Of 115 abstracts identified, 15 articles were included. These studies reported on 1,150 patients with histologically confirmed diagnosis of laryngeal squamous cell carcinoma. Only a few studies showed a statistical correlation between Bcl-2 immunohistochemical expression and at least 1 of the clinical and histopathological parameters considered by the authors. Moreover, these findings were also discordant between them. Overall the studies analyzed suggested that Bcl-2 expression was statistically connected with N stage (2/14), grading (2/14), disease-free survival (3/14) and overall survival (5/14). Interestingly, all of the 3 studies investigating the relation between Bcl-2 and radioresistance showed significant results in terms of recurrence-free survival and overall survival. Our review strongly suggests that the immunohistochemical staining of Bcl-2 does not correlate with tumoral aggressiveness and prognosis of patients affected by laryngeal squamous cell carcinoma and treated with primary surgery. However, an interesting connection of this protein could be demonstrated with tumoral radioresistance. Further, high-quality prospective studies should be carried out to confirm this hypothesis.
Topics: Carcinoma, Squamous Cell; Female; Genes, bcl-2; Humans; Immunohistochemistry; Laryngeal Neoplasms; Male; Prognosis
PubMed: 25588854
DOI: 10.5301/jbm.5000116 -
PloS One 2013Tumor hypoxia plays a fundamental role in resistance to therapy and disease progression. A number of studies have assessed the prognostic role of HIFs expression in head... (Review)
Review
BACKGROUND
Tumor hypoxia plays a fundamental role in resistance to therapy and disease progression. A number of studies have assessed the prognostic role of HIFs expression in head and neck cancer (HNC), but no consistent outcomes are reported.
METHODOLOGY
A systematical search was performed to search relevant literatures in PubMed, Web of Science and ISI Web of Knowledge databases. The patients' clinical characteristics and survival outcome were extracted. The correlation between HIFs expression and prognosis was analyzed.
PRINCIPAL FINDINGS
A total of 28 studies assessed the association between HIFs and HNC survival, the result showed that overexpressed HIFs was significantly associated with increase of mortality risk (HR = 2.12; 95% CI: 1.52-2.94; I(2) 74%). Subgroup analysis on different HIF isoforms with OS indicated that both HIF-1α and HIF-2α were associated with worse prognosis. The pooled HRs were 1.72(95% CI 1.34-2.20; I(2) 70.7%) and 1.79(95% CI: 1.42-2.27, I(2) 0%). Further subgroup analysis was performed by different geographical locations, disease subtype, stage, types of variate analysis and cut-off value. The results revealed that overexpressed HIF-1α was significantly associated with poor prognosis in Asian patients (HR = 2.34; 95% CI: 1.76-3.1; I(2) 48.9%), but not in European patients (HR = 1.13; 95% CI: 0.77-1.66; I(2) 78.3%). Furthermore, HIF-1α overexpression was significantly associated with worse OS in oral carcinoma (HR = 2.1; 95% CI: 1.11-3.97; I(2) 81.7%), nasopharyngeal carcinoma (HR = 2.07; 95% CI:1.23-3.49; I(2) 22.5%) and oropharynx carcinoma (HR = 1.76; 95% CI:1.05-2.97; I(2) 61%), but not in laryngeal carcinoma (HR = 1.38; 95% CI: 0.87-2.19; I(2) 62.5%). We also found that the prognostic value of HIF-1α overexpression existed only when using staining and percentage as positive definition (HR = 1.82; 95% CI 1.42-2.33; I(2) 9.9%).
CONCLUSIONS
This study showed that overexpressed HIFs were significantly associated with increase of mortality risk. Subgroup analysis revealed that overexpressed HIF-1α was significantly associated with worse prognosis of HNC in Asian countries. Additionally, HIF-1α had different prognostic value in different HNC disease subtypes.
Topics: Asia; Basic Helix-Loop-Helix Transcription Factors; Disease-Free Survival; Europe; Gene Expression Regulation, Neoplastic; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Mouth Neoplasms; Oropharyngeal Neoplasms; Survival Rate
PubMed: 24058651
DOI: 10.1371/journal.pone.0075094 -
BMC Cancer Jan 2014CD44 has been reported to be involved with tumor growth and metastasis and has also been implicated as a CSC marker in head and neck squamous cell cancer (HNSCC).... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
CD44 has been reported to be involved with tumor growth and metastasis and has also been implicated as a CSC marker in head and neck squamous cell cancer (HNSCC). However, the prognostic value of CD44 still remains controversial; hence, we investigated the correlation between CD44 and the clinicopathological features of HNSCC by meta-analysis.
METHODS
A comprehensive search was performed using PubMed, ISI web of Science and China National Knowledge Infrastructure (CNKI) up to April 2013. Only studies with immunohistochemical staining of HNSCC were considered. Data on TNM classification, tumor grade, disease free survival and 3- or 5-year overall survival rate were extracted.
RESULTS
Thirty studies with 2102 patients met the inclusion criteria for the meta-analysis. Fifteen studies used anti-pan-CD44 antibody, 9 used anti-CD44-v6 antibody, 2 used anti-CD44-v3 and 2 used anti-CD44s antibody, 1 used anti-CD44-v9, and 1 used anti-CD44-v6,-v3 and -v4-5 simultaneously. The total percentage of CD44 expression was 57.8%, with 49.3% in oral cancer patients, 66.4% in pharynx and 54.7% in larynx cancer patients expressing CD44. No significant correlation between clinical features and CD44 expression was revealed for oral cancer patients, but CD44 was shown to be associated with advanced T categories (larynx: RR = 1.33, 95% CI 1.01-1.76; larynx & pharynx RR = 1.21, 95% CI 1.08-1.35), worse N categories (larynx: RR = 2.53, 95% CI 1.99-3.21; larynx & pharynx RR = 1.95, 95% CI 1.35-2.82), higher tumor grades (larynx & pharynx RR = 1.71, 95% CI 1.04-2.79) and 5-year OS rates (larynx: RR = 0.62, 95% CI 0.47-0.83; larynx & pharynx RR = 0.66, 95% CI 0.47-0.94) in patients with laryngeal and pharyngolaryngeal cancer. In stratified analysis, pan-CD44 and CD44-v6 expression were both correlated with 5-year OS rate of patients with laryngeal (CD44: RR = 0.66, 95% CI 0.46-0.95; CD44-v6 RR = 0.53, 95% CI 0.37-0.77) and pharyngolaryngeal cancer (CD44: RR = 0.56, 95% CI 0.34-0.93; CD44-v6 RR = 0.53, 95% CI 0.37-0.77).
CONCLUSIONS
Our analysis suggested that CD44 is related to worse T category, N category, tumor grade and prognosis, in pharyngeal and laryngeal cancer, but no clear association was revealed between CD44 expression and oral cancer.
Topics: Biomarkers, Tumor; Carcinoma, Squamous Cell; Disease-Free Survival; Head and Neck Neoplasms; Humans; Hyaluronan Receptors; Immunohistochemistry; Neoplasm Grading; Neoplasm Staging; Odds Ratio; Predictive Value of Tests; Risk Factors; Squamous Cell Carcinoma of Head and Neck; Survival Analysis; Time Factors
PubMed: 24410905
DOI: 10.1186/1471-2407-14-15 -
Journal of Clinical Medicine Feb 2019The aim of this systematic review with meta-analysis was to investigate the available literature on transoral approaches in the treatment of hypopharyngeal squamous cell... (Review)
Review
The aim of this systematic review with meta-analysis was to investigate the available literature on transoral approaches in the treatment of hypopharyngeal squamous cell carcinoma, with a special focus on transoral robotic surgery (TORS). A systematic review was conducted according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) check-list, and 15 studies were included. Five of the included studies evaluated TORS, while ten studies focused on transoral laser microsurgery (TLM) for the treatment of early or advanced stage hypopharyngeal cancer. Overall, survival rates of TLM and TORS studies, analyzed together in the cumulative meta-analysis, were 66.4% (95% confidence interval (CI) 54.3%⁻76.7%) at 36+ months of follow up. The TORS subgroup showed a higher cumulative survival rate (85.5%, 95% CI 55.8%⁻96.5%) compared to TLM (58.5%, 95% CI 46.6%⁻69.6%). Cumulative data showed that 29.3% (95% CI 24.0%⁻35.3%) of deaths were attributable to cancer. The results were similar between TLM and TORS studies. The larynx function preservation cumulative rate was 94.3% (95% CI 91.8%⁻96.1%). The results were similar among the two subgroups. The present review supports the use of transoral approaches in the treatment of hypopharyngeal cancer. TORS is oncologically sound and provides excellent functional results with low complication rates.
PubMed: 30781660
DOI: 10.3390/jcm8020256