- Tipos de Cáncer
Tipos de Cáncer
Información sobre riesgo, prevención, detección, síntomas, diagnosis, tratamiento y apoyo para el cáncer.A a la Z - Tratamiento
Tratamiento del Cáncer
Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
- Riesgo de concer y prevencion
- Drogas de Cáncer
OncoLink se complace en ofrecer una amplia lista de lista completa de los agentes quimioterapéuticos más comúnmente usados??. Esta guía de referencia incluye información sobre la forma en que cada fármaco se administra, cómo funcionan, y los pacientes los efectos secundarios comunes pueden experimentar.
- Lidiando
Lidiando con el Cáncer
Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
- Profesionales de la salud
- Estudios Clínicos
Notas para enfermeros 
¿Cuál es mi riesgo? k? 
OncoPilot: Manejando su experiencia del cáncer 
OncoLink Cancer Blogs
Community Events Calendar 
Abramson Cancer Center 
NCI CANCERLIT® Search: Laryngeal Cancer - October 2001
National Cancer Institute®
Ultima Vez Modificado: 21 de noviembre del 2001
Table of Contents
1
UI - 21202880
AU - Stoeckli SJ; Guidicelli M; Schneider A; Huber A; Schmid S
TI -
Quality of life after treatment for early laryngeal carcinoma.
SO - Eur Arch Otorhinolaryngol 2001 Feb;258(2):96-9
AD - Clinic of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland.
stoeckli@orl.usz.ch
Radiotherapy and surgery for early laryngeal cancer achieve comparably
good results in patient survival, and the choice of treatment between
them is being influenced increasingly by the expected voice quality and
quality of life (QoL). The superiority of vocal function after
radiotherapy has been shown in previous objective voice assessment
studies. This study compared the QoL of long-term survivors after
endoscopic laser surgery or radiotherapy for early laryngeal carcinoma.
QoL was evaluated with two validated questionnaires: the global EORTC
QLQ-C30 and the head- and neck-specific EORTC QLQ-H&N35. A total of 62
patients were included. Among 56 patients completing the questionnaires
(90% completion rate) 40 were treated by endoscopic CO2 laser surgery
and 16 with radiation therapy. All 56 patients showed a good global QoL
with no significant difference between the two treatment modalities. The
head- and neck-specific evaluation revealed significantly better scores
for surgically treated patients in questions about swallowing of solid
food, xerostomia, and tooth problems, but no difference in questions
about voice quality. Both treatment modalities achieve good QoL after
treatment of early laryngeal tumors. Irradiated patients mainly complain
about xerostomia related problems. In contrast to objective measurements
long-term survivors after surgery do not rate their voice poorer than
irradiated patients. The EORTC questionnaires are validated and useful
tools in assessing QoL and should further be used in prospective trials.
2
UI - 21328264
AU - Motta G; Esposito E; Motta S; Testa D
TI -
[Microlaryngoscopy treatment of laryngeal dysplasia with CO2 laser]
SO - Acta Otorhinolaryngol Ital 2001 Feb;21(1):32-43
AD - Istituto di Patologia e Clinica Otorinolaringoiatrica, Universita di
Napoli Federico II.
Classification of laryngeal dysplasia, the most appropriate treatments
and criteria for evaluation of the results is still a highly
controversial issue. The objectives of the present study on the
treatment of laryngeal dysplasia lesions are to: 1) evaluate the
relative incidence of the various forms of dysplasia in relation to
grading of the histopathological findings; 2) establish the prognosis
for the various forms of dysplasia considered; 3) determine the results
achieved by the author's treatment protocol according to the
characteristics of the dysplasia; 4) critically evaluate the
classifications of laryngeal dysplasia found in the literature in view
of the results of the present study. The study involved 141 patients
with vocal cord dysplasia (134 men, 7 women; mean age: 56.2 years) who
had come under observation at the E.N.T. Dept. of the University of
the dysplasia was removed by CO2 laser microlaryngoscopy. Of the 141
patients 89 (63.2%) showed mild dysplasia, 14 (9.9%) moderate dysplasia,
20 (14.2%) severe dysplasia and 18 (12.7%) in situ carcinoma. The
five-year survival rate showed an overall actuarial survival of 89.1%
for all patients while the corrected actuarial survival was 98.5% and
local disease control was 86.1%. In 17 cases (12%) the dysplasia lesion
recurred, in 11 (7.8%) an infiltrating carcinoma arose. Recurrences in
the dysplasia were encountered in 9% of the patients with mild lesions,
7.1% of those with moderate dysplasia, 15% of the subjects with the
severe form and in 27.7% of those with in situ carcinoma. An
infiltrating carcinoma arose in 5.6% of the cases of mild lesion, in
7.1% of the medium dysplasias, 5% of the severe forms and in 22.2% of
those with in situ carcinoma. The recurrences and infiltrating
carcinomas were successfully treated with endoscopic CO2 laser surgery.
Only three cases (2.1%) required radical surgery (total laryngectomy):
these were patients who had not quit smoking and who had not adhered to
the planned follow-up. One of the latter patients died with widespread
metastases of the laryngeal cancer. The significantly higher incidence
of dysplasia recurrences (P = 0.028) and infiltrating carcinomas (P =
0.015) in those patients with in situ carcinoma shows that, when
preparing classification and determining prognosis, these pathologies
should be considered separately. Moreover, they require a particularly
precise follow-up. In conclusion, the following observations can be
drawn from the study: mild and moderate dysplasias are more frequent as
compared to severe dysplasia and carcinoma in situ; carcinoma in situ
should be distinguished for classification and prognosis from
dysplasias, considering their different clinical course and evolution;
CO2 laser surgery in these forms is a valid therapeutic approach for its
precision, the achievable results, the reduced discomfort to patients
and for its evident cost-effectiveness.
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
UI - 21338554
AU - Sasiadek M; Stembalska-Kozlowska A; Smigiel R; Krecicki T; Blin N;
TI -
Mirghomizadeh F
Microsatellite and chromosome instability in squamous cell laryngeal
carcinoma.
SO - Int J Oncol 2001 Aug;19(2):401-5
AD - Department of Genetics, Medical University of Wroclaw, Marcinkowskiego
1, 50-368 Wroclaw, Poland. sasiadek@gen.am.wroc.pl
Head-and neck squamous cell carcinoma (HNSCC) represents almost 5% of
all malignancies in Europe. The aetiology of HNSCC is complex, with both
genetic and mutagenic factors involved. The aim of the present study was
to investigate the loss of heterozygosity (LOH), mainly at tumour
suppressor loci (using markers D1S2883, D2S123, D3S1611, D5S346, D7S501,
D8S254, TP53, NM23), microsatellite instability (BAT25, 26, 40) and
UI - 21396151
AU - Leon X; Quer M; Orus C; Lopez M; Gras JR; Vega M
TI -
Results of salvage surgery for local or regional recurrence after larynx
preservation with induction chemotherapy and radiotherapy.
SO - Head Neck 2001 Sep;23(9):733-8
AD - Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau,
Avda. San Antoni M(a) Claret, 167, Universitat Autonoma de Barcelona,
08025 Barcelona, Spain. xleon@hsp.santpau.es
BACKGROUND: After treatment of locally advanced laryngeal carcinomas
with induction chemotherapy and radiotherapy, some patients suffer a
local or regional failure of the tumor, and salvage surgery is required.
The aim of this study was to review the results of such salvage surgery
in this group of patients. METHODS: A retrospective study of a cohort of
110 patients diagnosed between 1989 and 1996 with a locally advanced
laryngeal carcinoma (T3-T4) treated with induction chemotherapy and
radiotherapy was performed. The results of salvage surgery in patients
with a local and/or regional failure of the treatment were analyzed.
RESULTS: Forty-two patients presented a local and/or a regional
recurrence of the tumor: 26 patients in the larynx, eight in the neck,
and a further eight in both in the larynx and the neck. Salvage surgery
was carried out in 28 patients (67%), consisting of total laryngectomies
with neck dissections (24 cases), endoscopic resection of the tumor (one
case), and radical neck dissections (three cases). Five-year adjusted
survival for the 42 patients was 38%. Five-year survival for the 28
patients treated with salvage surgery was 57%. Five patients had
postoperative complications: four had pharyngo-cutaneous fistulas and
one had wound infection. CONCLUSIONS: After a local and/or regional
recurrence, 67% of patients with advanced laryngeal carcinoma treated
with induction chemotherapy and radiotherapy were candidates to salvage
surgery. Five-year adjusted survival for this group of patients was 57%.
Copyright 2001 John Wiley & Sons, Inc.
UI - 21439134
AU - Kamijo T; Yokose T; Hasebe T; Yonou H; Hayashi R; Ebihara S; Ochiai A
TI -
Image analysis of microvessel surface area predicts radiosensitivity in
early-stage laryngeal carcinoma treated with radiotherapy.
SO - Clin Cancer Res 2001 Sep;7(9):2809-14
AD - Pathology Division, National Cancer Center Research Institute East,
Kashiwa, Chiba 277-8577, Japan.
PURPOSE: The tissue oxygenation level, which is theoretically governed
by distance from blood vessels, is one of the most important modulators
of the radiosensitivity of carcinoma. A computed image analysis system
for the detection of tissue oxygenation was developed to establish a
method of predicting radiosensitivity in early-stage laryngeal carcinoma
treated by curative radiotherapy. EXPERIMENTAL DESIGN: Microvessel
structures labeled with CD31 antigen were investigated in 55 patients
undergoing curative radiotherapy for T1 and T2 laryngeal carcinoma. We
calculated (a) microvessel density [(MVD) vessels/field] under a
microscope; (b) the ratio of the total microvessel number (TN):tumor
area (TA) [TN:TA; vessels/mm2]; (c) the ratio of the total microvessel
perimeter (TP):TA (TP:TA; mm/mm2); and (d) the ratio of tumor tissue
area >150 microm from microvessels (hypoxic ratio; %) as parameters of
tissue oxygenation in each whole biopsy specimen by using an image
analyzer. We compared each of these factors with radiosensitivity.
RESULTS: Mann-Whitney's U test revealed that tumors with a high MVD
(median, 42 vessels/field), high TN:TA ratio (median=40.9 vessels/mm2),
high TP:TA ratio (median, 2.92 mm/mm2), and low hypoxic ratio (median,
30.3%) had significantly greater radiosensitivity than tumors with a low
MVD, low TN:TA ratio, low TP:TA ratio or high hypoxic ratio (P = 0.002,
P = 0.0004, P < 0.0001, and P = 0.004, respectively). CONCLUSIONS:
Prediction of radiosensitivity on the basis of the TP:TA ratio can be
used as an efficient means of avoiding ineffective radiation,
complications after salvage surgery, and prolonged hospital stays.
UI - 20091982
AU - Chen RW; Avizienyte E; Roth S; Elivo I; Makittie AA; Aaltonen LM;
TI -
Aaltonen LA
PTEN and LKB1 genes in laryngeal tumours.
SO - J Med Genet 1999 Dec;36(12):943-4
UI - 21401855
AU - Stranadko EF; Garbuzov MI; Zenger VG; Nasedkin AN; Markichev NA; Riabov
TI -
MV; Leskov IV
[Photodynamic therapy of recurrent and residual oropharyngeal and
laryngeal tumors]
SO - Vestn Otorinolaringol 2001;(3):36-9
Photodynamic therapy (PDT) was given to 61 patients with recurrent
cancer of the tongue, oral mucosa, lower lip, oro- and nasopharynx,
larynx. Photosensitizers photogem and photosens of Russian produce were
employed. The radiation was given twice with the interval 24 and 48
hours, the exposure to light 3 to 30 min. The impact was external,
through the instrumental canal of the fibroscope, by intracavitary and
interstitial techniques. The response was assessed within 4-6 weeks
after the PDT course. The effect was observed in 95.1% patients. Its
duration ranged from 4 months to 5 years. Complete resorption of the
tumor was achieved in 57.4%. The treatment failed in 4.9% patients.
UI - 21453546
AU - Teknos TN; Myers LL; Bradford CR; Chepeha DB
TI -
Free tissue reconstruction of the hypopharynx after organ preservation
therapy: analysis of wound complications.
SO - Laryngoscope 2001 Jul;111(7):1192-6
AD - Department of Otolaryngology-Head and Neck Surgery, Division of Head and
Neck Surgery, University of Michigan, Ann Arbor, Michigan 48109-0312,
USA. teknos@umich.edu
PURPOSE: Previous series have demonstrated a 77% rate of major wound
complications in salvage surgery of the larynx following organ
preservation protocols. The purpose of this study is to determine the
incidence of wound complications in these patients when microvascular
free tissue transfers are used for reconstruction of the hypopharynx.
DESIGN: Retrospective case series. SETTING: Academic tertiary care
center. PATIENTS AND METHOD: We reviewed the medical records of 42
patients with stage III and IV laryngeal squamous cell carcinoma treated
with an organ-sparing protocol consisting of induction chemotherapy
followed by definitive radiation therapy. Ten of these patients who
required surgical salvage were reconstructed using radial forearm free
tissue or lateral arm transfer and constitute the study group. MAIN
OUTCOME MEASURES: Wound complications. RESULTS: Wound complications
occurred in 2 patients (20%) undergoing free flap reconstruction of the
hypopharynx after organ preservation protocols, which was significantly
lower (P =.003) than previous reports using other forms of closure
and/or reconstruction. One patient in this study group had a small
pharyngocutaneous fistula that resolved with conservative therapy after
1 week. The other patient had a larger pharyngocutaneous fistula that
resolved over 3 weeks. The mean interval from completion of the
chemoradiation regimen to surgery was 21.3 months (range, 2-60 mo). The
average free tissue flap size was 94.3 cm(2) (range, 45-165 cm(2)).
Average harvest and ischemia times were 59 minutes (range, 41-87 min)
and 187.7 minutes (range, 120-240 min), respectively. All flaps
survived, and one patient had a minor donor site wound dehiscence. The
average hospital stay was 7.8 days. There were no mortalities in this
series. CONCLUSIONS: Our results suggest that free tissue transfer
reconstruction of the hypopharynx is the preferred method of
reconstruction following combined chemotherapy and radiation therapy
protocols. Surgical complications are significantly reduced and hospital
stays are minimized.
UI - 21453547
AU - Loos BM; Wieneke JA; Thompson LD
TI -
Laryngeal angiosarcoma: a clinicopathologic study of five cases with a
review of the literature.
SO - Laryngoscope 2001 Jul;111(7):1197-202
AD - Department of Otolaryngology-Head and Neck Surgery, Georgetown
University Medical Center, Washington, DC, USA.
OBJECTIVE: Primary laryngeal angiosarcoma (LA) is rare without a
reported series evaluating these tumors. STUDY DESIGN/METHODS: Five
patients with LA were retrospectively retrieved from the
Otorhinolaryngic Registry of the Armed Forces Institute of Pathology.
RESULTS: Three men and 2 women, aged 29 to 71 years, presented with
hoarseness (n = 4) and hemoptysis (n = 1). Two patients had previous
neck radiation. The tumors involved the supraglottis (n = 4) with a mean
size of 3.1 cm. Histologically, all tumors had anastomosing vascular
channels lined by remarkably atypical endothelial cells protruding into
the lumen, frequent atypical mitotic figures, and hemorrhage. All cases
tested (n = 4) demonstrated immunoreactivity with antibodies to Factor
VIII-RA and CD34. All patients had surgery followed by postoperative
radiation (n = 3 patients). Three patients died with disease (mean, 17
mo), whereas one patient is alive with no evidence of disease at 18
years. CONCLUSIONS: LA is a rare tumor, frequently associated with
previous radiation, usually involving the supraglottis with
characteristic histomorphologic and immunophenotypic features. LA has a
poor prognosis, making appropriate separation from other conditions
important.
UI - 21390913
AU - Jing H; Huang W; Qiu J
TI -
[Inhibitive effect of bcl-2 antisense oligodeoxynucleotide on Bcl-2
protein synthesis and cell proliferation in human laryngocarcinoma Hep-2
cells]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Feb;33(1):17-20
AD - Department of Otorhinolaryngology, Xijing Hospital, Fourth Military
Medical University, Xi'an 710032.
OBJECTIVES: To evaluate the role of bcl-2 antisense oligodeoxynucleotide
in the gene treatment of human laryngocarcinoma. METHODS: An antisense
oligodeoxynucleotide complementary to the initiation coden and the next
four codens of bcl-2 mRNA was synthesized with an automatic DNA
synthesizer. It was used to treat cultured Hep-2 cells to observe its
effect on cell proliferation. In situ hybridization method and
immunohistochemical technology were adopted to detect bcl-2 mRNA and
protein and explore the effect of bcl-2 antisense oligodeoxynucleotide
fragment on bcl-2 gene expression and protein synthesis and inhibition
of cell proliferation. RESULTS: Bcl-2 antisense oligodeoxynucleotide had
an obvious effect on bcl-2 mRNA, but inhibited Bcl-2 protein synthesis
significantly, the inhibitive rate had positive correlation with
concentration of antisense oligodeoxynucleotide and time of action.
Twenty mumol/L of antisense oligodeoxynucleotide could inhibit cell
proliferation effectively. CONCLUSIONS: It is suggested that bcl-2
antisense oligodeoxynucleotide might specifically inhibit bcl-2 protein
synthesis and cell proliferation in Hep-2 cells at translation level.
UI - 21390915
AU - Zhou L; Wang J; Huangfu M
TI -
[Long term results of Majer-Piquet's operation in the treatment of
laryngeal carcinoma]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Feb;33(1):24-6
AD - Department of Otolaryngology, Ren Ji Hospital, Shanghai Second Medical
University, Shanghai 200001.
OBJECTIVE: To investigate the long term results of Majer-Piquet's
operation in the treatment of glottic type of laryngeal carcinoma.
were T2N0M0 and 1 each for T2N1M0, T3N0M0, T3N1M0. RESULTS: In T1 cases,
2, 3 and 5 years survival rate were 95.8, 93.7 and 90.9% respectively,
while in T2 cases, 2, 3 and 5 years survival rate were 100%, 83.3% and
60% respectively. Decannulation rate was 96.9%. All patients could
finally take food by mouth without inspiration, and could speak as soon
as decannulated. By modifing the operative technique, the cases operated
on after 1994 got relatively better results in phonation. CONCLUSION:
Majer-Piquet's operation not only is effective in the treatment of T1,
T2 and some T3 glottic type of laryngeal carcinomas, but also can
satisfactorily reserve laryngeal function and improve the quality of
patient's life.
UI - 21453611
AU - Zacharek MA; Pasha R; Meleca RJ; Dworkin JP; Stachler RJ; Jacobs JR;
TI -
Marks SC; Garfield I
Functional outcomes after supracricoid laryngectomy.
SO - Laryngoscope 2001 Sep;111(9):1558-64
AD - Department of Otolaryngology Head and Neck Surgery, Wayne State
University School of Medicine, Detroit, Michigan 48201, USA.
OBJECTIVES: Local control and 5-year survival rates are similar for
patients undergoing total laryngectomy and supracricoid laryngectomy for
the treatment of advanced-stage laryngeal carcinoma. However,
comprehensive studies of functional outcomes after supracricoid
laryngectomy are lacking. STUDY DESIGN: Cohort study. METHODS: This
investigation provides objective voice laboratory data, skilled listener
impressions of voice samples, swallowing evaluations, and patient
self-perceptions of speech ability obtained from 10 supracricoid
laryngectomees. RESULTS: Results demonstrated variable acoustic and
speech aerodynamic disturbances, hoarse-breathy vocal quality, and
speech dysfluency. Patients' self-perceptions of voice revealed severe
dysphonia that induced certain emotional, physical, and functional
setbacks. However, blinded judges rated these individuals as possessing
intelligible speech and communication skills. All patients demonstrated
premature spillage of the bolus and varying degrees of laryngeal
penetration, aspiration, and retention during swallowing studies.
However, each patient used a compensatory strategy to protect the
airway. Voice and swallowing abilities appeared to depend on the
mobility of the arytenoid cartilages, base of tongue action, and
residual supraglottic tissue for the creation of a competent neoglottal
sphincter complex that vibrated during phonation efforts and protected
the airway during deglutition. CONCLUSIONS: Supracricoid laryngectomy
avoids the potential complications, limitations, and emotional problems
associated with a permanent tracheostoma. All patients demonstrated
intelligible voice and effective swallowing function postoperatively,
supporting supracricoid laryngectomy as a suitable alternative surgical
approach to the total laryngectomy in select patients.
UI - 21453603
AU - Lai JP; Tao ZD; Xiao JY; Chen XH; Zhao SP; Tian YQ; Betz CS
TI -
Microinvasive Nd:YAG laser therapy of early glottic carcinoma and its
effect on soluble interleukin-2 receptor, interleukin-2, and natural
killer cells.
SO - Laryngoscope 2001 Sep;111(9):1585-8
AD - Department of Otolaryngology, XiangYa Hospital, Hunan Medical
University, Changsha, Hunan, Peoples Republic of China.
jplai2000@yahoo.com
OBJECTIVE: To investigate the effectiveness of microinvasive Nd:YAG
laser therapy in human glottic Tis and T1 carcinomas, as well as its
effect on the cellular immune function of the tumor-bearing hosts. STUDY
DESIGN: We treated 34 patients with microinvasive Nd:YAG laser therapy
and evaluated its effect on the cellular immune function of the host.
METHODS: Thirty-four patients with glottic Tis or T1 squamous cell
carcinoma were treated with fiberoptic laryngoscopic Nd:YAG laser
surgery. Both before and after therapy, serum levels of soluble
interleukin-2 receptor (SIL-2R) and interleukin-2 (IL-2), as well as
natural killer (NK) cell activity, were determined by means of
double-antibody sandwich technique, tritiated
thymidine-deoxyribonucleoside incorporation, and iodine
125-uridine-deoxyribonucleoside release technique, respectively.
RESULTS: All 34 patients tolerated the procedure well. A 3- to 7-year
follow-up in a subgroup of 27 patients resulted in an estimated cure
rate of 85.2% (23 of 27 patients). In all 27 patients with a regular
follow-up, a subjective improvement of phonation was noted after therapy
to various degrees. In 74% (20 of 27 patients), voice and speech
subjectively recovered to almost normal levels. The post-therapy serum
levels of SIL-2R were significantly declined (P <.001), whereas those of
IL-2 and the NK activity were significantly elevated (P <.001) as
compared with those detected before therapy. CONCLUSIONS: Therapy with
fiberoptic laryngoscopic Nd:YAG laser surgery is simple, safe, effective
and only minimally invasive for patients with glottic Tis or T1
carcinoma. At the same time, it has an immunoenhancing effect on its
host.
UI - 21453626
AU - Dedo HH; Yu KC
TI -
CO(2) laser treatment in 244 patients with respiratory papillomas.
SO - Laryngoscope 2001 Sep;111(9):1639-44
AD - Department of Otolaryngology-Head and Neck Surgery, University of
California, San Francisco, San Francisco, California 94117, USA.
OBJECTIVE: Respiratory papillomas (RP) tend to recur and the difficulty
in eradicating the disease makes their treatment frustrating. Meticulous
CO(2) laser excisions every 2 months has been the most effective
treatment to date. This article analyzes the results of this plan in 244
patients with RP in the nose, nasopharynx, pharynx, hypopharynx, larynx,
trachea, lung parenchyma, and skin. METHODS: Two hundred forty-four
patients with recurrent RP were treated by the senior author with CO(2)
laser excisions and, in some cases, podophyllum and alpha interferon.
Demographics, initial distribution of papillomas, number of operations
performed on each patient, and current results were evaluated. RESULTS:
Careful laser excisions of RPs every 2 months achieved "remission" of
disease (no visible RP on indirect or often direct laryngoscopy 2 mo
after last removal) in 37% of patients, "clearance" of the disease
process (no RP clinically apparent for 3 y after last removal) in 6%,
and "cure" (no clinical recurrence for 5 y after last removal) in 17%.
Juvenile-onset RP tends to follow a more aggressive course than
adult-onset RP. Four patients (1.6%) developed malignant transformation
of their papillomas. Except for ones in lung parenchyma, RP in areas
other than the true vocal cords tend to be cleared faster because
aggressive removal does not cause hoarseness. Lung parenchyma RPs are
eventually fatal because of pulmonary failure from abscesses and cysts
resulting from a lack of effective treatment. CONCLUSION: Frequent and
meticulously performed CO(2) laser excisions can achieve significant
voice and airway improvement, and some clinical "cures." However,
effective antiviral medicines and/or immunologic agents are needed to
achieve true cures with elimination of all human papilloma virus 6 and
11 viruses.
UI - 21445103
AU - Wolf GT
TI -
Commentary: phase III trial to preserve the larynx: induction
chemotherapy and radiotherapy versus concurrent chemotherapy and
radiotherapy versus radiotherapy--intergroup trial R91-11.
SO - J Clin Oncol 2001 Sep 15;19(18 Suppl):28S-31S
AD - Department of Otolaryngology-Head and Neck Surgery, University of
Michigan Health System, Ann Arbor, MI 48109-0312, USA.
UI - 21295693
AU - Aaltonen LM; Chen RW; Roth S; Makitie AA; Rihkanen H; Vaheri A; Aaltonen
TI -
LA
Role of TP53 P72R polymorphism in human papillomavirus associated
premalignant laryngeal neoplasm.
SO - J Med Genet 2001 May;38(5):327
UI - 21449114
AU - Sourvinos G; Rizos E; Spandidos DA
TI -
p53 Codon 72 polymorphism is linked to the development and not the
progression of benign and malignant laryngeal tumours.
SO - Oral Oncol 2001 Oct;37(7):572-8
AD - Laboratory of Virology, Medical School, University of Crete, Heraklion,
Crete, Greece.
The p53 codon 72 polymorphism, resulting in either an arginine or a
proline residue has been proposed to affect the susceptibility of p53
protein to human papilloma virus (HPV) E6-mediated degradation in vitro.
However, there are controversial results from several clinical studies
in various human tumours. The purpose of our study was to investigate
the significance of this p53 genotype with respect to the risk of
neoplasia development in Greek patients with benign and malignant
laryngeal tumours. Furthermore, we searched for an association between
p53 alleles and the presence of HPV in the same series of samples. We
found a significant statistical association in the distribution of p53
genotypes between laryngeal lesions and normal samples (P<0.001).
Allelic analysis of the patients with both benign and malignant tumours
revealed a striking over-representation of the homozygous p53Arg allele
compared to normal population (P<0.0003). HPV was detected in only 3
laryngeal samples (1 benign and 2 malignant tumours). This is the first
study correlating the p53 codon 72 polymorphism in laryngeal tumours.
Our results provide evidence that this p53 polymorphism may be
implicated at the early stages of the disease and concerns
predisposition to premalignant laryngeal lesions rather than to
progression from benign tumour toward malignancy. Moreover, we
demonstrate that the p53Arg homozygous genotype affects the
predisposition for laryngeal tumours while the heterozygous status does
not. The low incidence of HPV infection suggests that it is not a major
oncogenic factor in the development of laryngeal tumours but may have
synergistic action with specific genotypes of p53 gene.
UI - 20059574
AU - Bentzen JK; Hansen HS; Nielsen HW
TI -
The prognostic importance of volume-weighted mean nuclear volume,
mitotic index, and other stereologically measured quantitative
parameters in supraglottic laryngeal carcinoma.
SO - Cancer 1999 Dec 1;86(11):2222-8
AD - Department of Radiotherapy and Oncology, University Hospital in Herlev,
Herlev, Denmark.
BACKGROUND: Stereologically measured mean nuclear volume has been proven
to have prognostic importance in several types of cancer, such as
malignant melanoma and carcinomas of the breast, oral region, bladder,
and uterine cervix. The main purpose of the current study was to
investigate the possible prognostic importance of mean nuclear volume
and mitotic index in carcinoma of the supraglottic larynx. METHODS: The
study was performed with a stratified, random sample of 113 patients
from a well-defined group of 386 patients with supraglottic laryngeal
carcinoma treated with radiotherapy at the Finsen Institute in
Copenhagen. Histologic sections from pretreatment biopsies were used to
estimate the following parameters: mean nuclear volume (Vv(3)(0)),
mitotic index (MI), number of nuclei per mm(2) (QA), mean nuclear
profile area (Anuc), and the area fraction of nuclei in cancer tissue
(AA). The geometric means of the parameters were used as cutoff points
in a single factor and in a multivariate survival analysis with relapse
free survival as the primary endpoint. RESULTS: The geometric means of
the measured parameters were (Vv(3)(0)) = 480 micro(3), QA = 3630
nuclei/micro(2) cancer tissue, MI = 0.48 mitosis/100 nuclei, AA = 0.21,
and Anuc = 57.9 micro(2). CONCLUSIONS: None of the stereologically
estimated parameters proved to have prognostic importance, whereas tumor
size, and lymph node status did. The method of adaptive, stratified,
random sampling used in this study can save a great deal of work and is
highly recommended by the authors. Copyright 1999 American Cancer
Society.
UI - 21301908
AU - Spector GJ
TI -
Distant metastases from laryngeal and hypopharyngeal cancer.
SO - ORL J Otorhinolaryngol Relat Spec 2001 Jul-Aug;63(4):224-8
AD - Department of Otolaryngology--Head and Neck Surgery, Washington
University, St. Louis, MO 63110, USA. spectorg@msnotes.wustl.edu
A retrospective tumor registry analysis of patients with squamous cell
carcinoma (SCC) of the larynx and hypopharynx who were treated with
curative intent in the Department of Otolaryngology--Head and Neck
Surgery at Washington University School of Medicine and Barnes Hospital
sex and tumor differentiation did not affect the incidence of distant
metastases. The overall incidence of distant metastases was 8.5%
(217/2,550 patients) with the following distribution: glottis 4.4%,
supraglottis 3.6%, subglottis 14%, aryepiglottic fold 16%, pyriform
sinus 17% and posterior hypopharynx 17.6%. The overall 5-year
disease-specific survival for distant metastases was 6.4%. Distant
metastases were related to advanced local disease (T3 + T4), lymph node
metastases at presentation (N+), tumor location (hypopharynx) and
locoregional tumor recurrence (p < or = 0.028). A meta-analysis of
variables which predispose to a higher incidence of distant metastases
indicate that tumor location (hypopharynx > larynx), advanced primary
disease (T3 + T4), regional disease (N+), locoregional recurrences, and
advanced regional metastases (N2 + N3) are statistically significant.
Copyright 2001 S. Karger AG, Basel
UI - 21418645
AU - Amilibia E; Juan A; Nogues J; Manos M; Monfort JL; Dicenta M
TI -
[Neoplastic invasion of laryngeal cartilage: diagnosis by computed
tomography]
SO - Acta Otorrinolaringol Esp 2001 Apr;52(3):207-10
AD - Servicio de Otorrinolaringologia, Ciudad Sanitaria y Universitaria de
Bellvitge, Hospitalet del Llobregat, Barcelona.
The diagnostic of the laryngeal cartilage neoplastic invasion plays an
important role in the accurate staging of the laryngeal carcinoma and
its treatment. To evaluate the accuracy of the CT diagnosing cartilage
involvement, the present study is reported. 127 patients with carcinoma
of the larynx and hipopharynx T3-T4, surgical treated between 1993 and
1997 at Ciudad Sanitaria y Universitaria de Bellvitge, are
retrospectively studied. TC presents an a accuracy of 78%, a specificity
of 91% and a sensitivity of 54% in the diagnostic of laryngeal cartilage
invasion of the laryngeal and hipopharyngeal carcinoma.
UI - 21418646
AU - Pinilla M; Gonzalez FM; Lopez-Cortijo C; Vicente J; Gorriz C; Laguna D;
TI -
De la Fuente R; Vergara J
[Cervical lymph node involvement in laryngeal carcinoma: a retrospective
study of 430 cases]
SO - Acta Otorrinolaringol Esp 2001 Apr;52(3):213-8
AD - Servicio de O.R.L. Clinica Puerta de Hierro, Universidad Autonoma de
Madrid.
Cervical lymph node involvement in laryngeal tumors could be a market
impact on the disease prognosis. We performed a retrospective study of
430 patients who underwent surgery to treat laryngeal carcinoma in our
center over a 10-year period. The objective was to correlate clinical
and pathological lymph node involvement with the site of origin and size
of the tumor, the treatment and its impact on patient survival. We
observed a significantly greater incidence of lymph node involvement in
tumors originating from supraglottis, with a rate of occult lymph node
metastases of 31%. Patients with lymphadenopathy that remained
undetected in the absence of surgical treatment and those with
nonmetastatic lymphadenopathy presented similar 5-year survival rates,
83% y 98% respectively. However, the 5-year survival decreased to 24% in
the presence of metastatic lymph node involvement. These results support
the proposal that treatment of laryngeal carcinoma should include the
region of the cervical nodes as well.
UI - 21418406
AU - Lahoz Zamarro MT; Galve Royo F; Martinez Subias J; Laguia Perez M
TI -
[Distant metastases in patients with advance laryngeal carcinoma]
SO - Acta Otorrinolaringol Esp 2001 May;52(4):307-11
AD - Servicio de O.R.L., Hospital Obispo Polanco de Teruel.
Patients with advanced stage cancer larynx have a higher risk of
development of distant metastases which means a bad prognosis. In our
study we try to identify risk factors with the idea of involve to all of
these patients in more aggressive systemic therapy protocols. Data of 57
patients surgically treated, with squamous pharyngolaryngeal carcinoma,
stage III and IV, are evaluated. Advanced T stage or more extensive neck
disease more often caused distant metastases (p < 0.05), and also the
histological evidence of tumor invasion in three or more cervical nodes
(p = 0.02), and poorly differentiated tumors (p < 0.05). Tumor site,
surface area in cm, presence of ulceration, and loco-regional uncontrol
were not associated with distant metastases.
UI - 21453579
AU - Major MS; Bumpous JM; Flynn MB; Schill K
TI -
Quality of life after treatment for advanced laryngeal and
hypopharyngeal cancer.
SO - Laryngoscope 2001 Aug;111(8):1379-82
AD - Division of Otolaryngology, Department of Surgery, University of
Louisville School of Medicine, Louisville, KY 40292, U.S.A.
OBJECTIVES: To compare health-related quality of life measures after
treatment for advanced (stages III and IV) laryngeal and hypopharyngeal
cancers. STUDY DESIGN: Retrospective chart review and patient response
to Health Status Questionnaire-12 (HSQ-12). METHODS: Our study included
54 patients identified from the Tumor Registry of the University of
Louisville Brown Cancer Center who were diagnosed and treated between
1995 and 2000. Demographics, tumor data, and treatment information were
obtained from the Tumor Registry database. Questionnaires were mailed to
all patients and included telephone follow-up. Comparative data and
responses were analyzed for the 24 patients who responded to the survey.
RESULTS: Fifteen patients were treated with chemotherapy and radiation
therapy (CRT). Six patients underwent surgery with postoperative
radiation therapy (SRT). The remaining three patients were treated with
radiation therapy but were not used in this analysis. The average
follow-up was 35 months after treatment. The CRT and SRT groups were
statistically similar regarding age, sex, duration of follow-up, tumor
grade, and tumor stage. Laryngeal primary tumors were more common in the
SRT group than in the CRT group (P =.005). Eight domains were assessed
by the HSQ-12: physical functioning, role-physical, bodily pain, health
perception, energy/fatigue, social functioning, role-mental, and mental
health. No statistical differences were found between the CRT and SRT
groups, except for role limitations attributable to physical health (P
=.007). CONCLUSIONS: These results indicate that only one of eight
domains differs significantly between treatment groups when using the
HSQ-12. Two-year survival end-point analysis of global health assessment
may represent a simplified and meaningful way to compare treatment
modalities in patients with advanced-stage head and neck cancer.
UI - 21453597
AU - Parsons DS; Bothwell MR
TI -
Powered instrument papilloma excision: an alternative to laser therapy
for recurrent respiratory papilloma.
SO - Laryngoscope 2001 Aug;111(8):1494-6
AD - Department of Otolaryngology-Head and Neck Surgery, University of
Missouri Hospital and Clinics, MA 314 One Hospital Drive, Columbia, MO
65212, U.S.A.
UI - 21439831
AU - Behrman A; Abramson AL; Myssiorek D
TI -
A comparison of radiation-induced and presbylaryngeal dysphonia.
SO - Otolaryngol Head Neck Surg 2001 Sep;125(3):193-200
AD - Schein Voice and Laryngeal Center, Department of Otolaryngology and
Communicative Disorders, Long Island Jewish Medical Center, Albert
Einstein College of Medicine, New Hyde Park, New York 11040, USA.
abehrman@lij.edu
OBJECTIVE: The goal of this study was to assess voice after radiotherapy
compared with patients with presbylaryngeal dysphonia. STUDY DESIGN AND
SETTING: Prospective assessment of 20 patients aged 60+ years who
remained free of disease longer than 1 year after radiotherapy for T1
squamous cell carcinoma and retrospective review of 46 patients aged 60+
with presbylaryngeal dysphonia, conducted at a tertiary care, academic
hospital. Assessment data included videostroboscopy, spectrography,
voice range profile, and Voice Handicap Index. RESULTS: Eighty percent
of the radiotherapy patients reported a voice disorder. Acoustic data
and functional measures reflected similar limitations and abnormalities
for both groups. A high incidence of glottal gap in all patients may
have been associated with increased mucosal stiffness in the
radiotherapy group and vocal fold atrophy in the presbylaryngeal group.
CONCLUSION: Patient perception and functional outcome of voice were
similar for both groups, despite differences in etiology of abnormal
vocal fold vibratory behavior. SIGNIFICANCE: Radiotherapy in older
individuals may yield dysphonia that is no greater than that caused by
normal aging.
UI - 21475684
AU - Bron LP; Soldati D; Zouhair A; Ozsahin M; Brossard E; Monnier P; Pasche
TI -
P
Treatment of early stage squamous-cell carcinoma of the glottic larynx:
endoscopic surgery or cricohyoidoepiglottopexy versus radiotherapy.
SO - Head Neck 2001 Oct;23(10):823-9
AD - Department of ENT and Head and Neck Surgery, the Centre Hospitalier
Universitaire Vaudois, av Bugnon 46, CH-1011, Lausanne, Switzerland.
BACKGROUND: Both surgery and radiotherapy are recognized treatments of
T1-T2 squamous cell carcinoma of the larynx. We retrospectively analyze
and compare the oncological outcome of patients treated in a single
institution, either by endoscopic surgery or partial supracricoid
laryngectomy versus radiation therapy. METHODS: The medical records of
156 patients treated between 1983 and 1996 with either surgery (n = 75)
or radiotherapy (n = 81) were reviewed. Male to female ratio, median
age, and T-stage distribution were comparable. RESULTS: With a median
follow-up time of 59 months, the 5-year cause-specific survival rate of
93% was identical for both groups. The actuarial incidence of
metachronous second primaries was 7% at 5 years. Local control at 5
years remained 84% after surgery and 77% after radiotherapy. Anterior
commissure infiltration was shown to represent a negative predictive
factor of local control for radiotherapy (p =.01). Salvage treatment
brought ultimate local control to 96% of patients after surgery and 94%
after radiation therapy with long-term laryngeal preservation rate
altered significantly (p =.05) in the group of patients who received
radiotherapy (90.1% vs 97.4%). CONCLUSION: The treatment of laryngeal
cancer is always a compromise between oncological efficiency and
preservation of function. Our data suggest that, assuming proper
selection of patients, radiation therapy and surgery yield similar local
control and survival rates. The functional disadvantages after surgery
are moderate and clearly counterbalanced by a significant decrease in
long-term laryngeal preservation rate after radiotherapeutic treatment.
Copyright 2001 John Wiley & Sons, Inc. Head Neck 23: 823-829, 2001.
UI - 21475690
AU - Lawson G; Jamart J; Remacle M
TI -
Improving the functional outcome of Tucker's reconstructive
laryngectomy.
SO - Head Neck 2001 Oct;23(10):871-8
AD - Department of ENT - Head and Neck Surgery, Louvain University Hospital
at Mont-Godinne, B-5530 Yvoir, Belgium.
BACKGROUND: The goal of reconstructive laryngectomy addressing glottic
carcinoma, as described by Tucker, is twofold: achieve local control and
preserve as much as possible the physiological laryngeal function.
METHODS: The study consisted of long-term assessment of oncological,
deglutitory, and vocal outcome in 34 patients following Tucker's
reconstructive laryngectomy. Postoperative follow-up included
fiberscopic examination, videoradiography, and voice assessment after
speech rehabilitation. RESULTS: The 5-year overall survival rate was 92%
+/- 5%. Fiberscopic examination and videoradiography contributed to
observing and understanding the rehabilitation process and impairment to
its progress. Two main compensatory movements were identified: the
anticipatory backward movement of the tongue base (50%) and the
anticipatory upward laryngeal motion (15%). Both movements occurred
simultaneously at the beginning of the pharyngeal stage of the swallow
(35%). The median duration prior to tracheostomy tube removal was 14
days. Swallowing of solids resumed on day 9 (median), and liquid intake
(water and soup) resumed on day 12 (median). The median duration of
hospitalization was 16 days. Following speech rehabilitation, the latest
follow-up visit measured as follows: the mean conversational voice
intensity at 64 dB (range, 57-79 dB); the mean maximum intensity at 87
dB (range, 78-96 dB); the minimum intensity at 54 dB (range, 45-65 dB);
the mean maximum phonation time at 16 seconds (range, 10-29 seconds);
and the mean phonation quotient at 284 mL/second (range, 205-341
mL/second). According to our classification, voice spectral analysis
revealed 19 class-III patients, 12 class-II patients, and three class-I
patients. CONCLUSION: Tucker's reconstructive laryngectomy is reliable
in terms of both the oncological and functional outcome. Fiberscopic
examination and videoradiography are two complementary methods for
assessing postoperative deglutition. Copyright 2001 John Wiley & Sons,
Inc. Head Neck 23: 871-878, 2001.
UI - 92352041
AU - Strome S; Strome M
TI -
Laryngeal transplantation: ethical considerations.
SO - Am J Otolaryngol 1992 Mar-Apr;13(2):75-7
AD - Joint Center for Otolaryngology, Brigham & Women's Hospital, Boston, MA.
UI - 21321242
AU - de Gier HH; Knegt PP; de Boer MF; Meeuwis CA; van der Velden LA;
TI -
Kerrebijn JD
CO2-laser treatment of recurrent glottic carcinoma.
SO - Head Neck 2001 Mar;23(3):177-80
AD - Department of Otorhinolaryngology/Head and Neck Surgery, University
Hospital Rotterdam, The Netherlands.
BACKGROUND: Evaluation of the results of CO2 laser treatment of
recurrent glottic carcinoma after radiotherapy. METHODS: Records of all
patients treated in the University Hospital Rotterdam and the Dr. Daniel
den Hoed Cancer Center between 1980 and 1996 by CO2 laser for recurrent
glottic carcinoma were studied. RESULTS: Forty patients were treated by
laser surgery. Average follow-up was 77 months. Twenty-three patients
(58%) had another recurrence develop after laser surgery. Three were
cured by a second laser procedure. Therefore, 20 patients (50%) were
successfully treated with laser surgery. In 23 patients the recurrence
did not extend into the anterior commissure; in 57% a total laryngectomy
could be avoided. In 17 patients the recurrence did extend into the
anterior commissure; in 41% a total laryngectomy was avoided.
CONCLUSION: Most patients with recurrent carcinoma of the larynx after
radiotherapy can be cured by laser surgery if the tumor does not extend
into the anterior commissure.
UI - 21321247
AU - Hosal SA; Myers EN
TI -
How I do it: closure of tracheoesophageal puncture site.
SO - Head Neck 2001 Mar;23(3):214-6
AD - Department of Otolaryngology, Hacettepe University School of Medicine,
Ankara, Turkey.
BACKGROUND: Tracheoesophageal voice prosthesis is highly effective in
providing speech after total laryngectomy. Although it is a safe method,
tracheoesophageal fistulas occasionally need to be closed, usually at
the request of the patient, because of leakage through an enlarging
fistula. We present our technique for closure of tracheoesophageal
fistula. METHODS: An incision is made at the mucocutaneous junction of
the stoma from the 9 to the 3-o'clock position. Tracheoesophageal space
is dissected down to and beyond the fistula. The tracheoesophageal tract
is divided. The esophageal mucosa is closed with inverted sutures. After
multiple layer closure of the esophageal fistula, the tracheal mucosa is
closed with everted sutures. RESULTS: This technique has been used in
nine patients. Eight were successful. The remaining patient had
radiation therapy failure. CONCLUSION: This method of closure is simple
and effective for those patients who require permanent closure of the
tracheoesophageal fistula.
UI - 21292231
AU - Russolo M
TI -
[Correlation between resection margin status and local recurrence in
surgery of laryngeal carcinoma]
SO - Acta Otorhinolaryngol Ital 2000 Dec;20(6):395-9
AD - Clinica Otorinolaringoiatrica, Universita di Trieste.
UI - 21292232
AU - Galli V; Testa D; Polce M
TI -
[Significance of surgical radicality as presupposition of therapeutic
success]
SO - Acta Otorhinolaryngol Ital 2000 Dec;20(6):400-6
AD - Clinica Otorinolaringoiatria, Universita di Napoli Federico II.
UI - 21292233
AU - Almadori G; Galli J; Cadoni G; Bussu F; Scarano E; Maurizi M
TI -
[Prospects and therapeutic decisions in the light of biological findings
in laryngeal cancer]
SO - Acta Otorhinolaryngo
Cancer Types
Bone Cancer
Brain Tumors
Breast Cancer
Carcinoid Tumors
Endocrine System Cancers
Gastrointestinal Cancers
Gynecologic Cancers
Head and Neck Cancers
Leukemia
Lung Cancers
Lymphomas
Myelomas
Pediatric Cancers
Penile Cancer
Prostate Cancer
Sarcomas
Skin Cancers
Testicular Cancer
Thyroid Cancer
Urinary Tract Cancers
OncoLink Vet
Cancer Treatment
Biologic Therapy
Bone Marrow Transplants
Chemotherapy
Clinical Trials
Complementary Medicine
Gene Therapy
General Treatment Concerns
Hormone Therapy
PDT Center
Proton Therapy
Radiation Oncology
Surgical Oncology
Targeted Therapies
Vaccine Therapies
Cancer Support
Caregivers
Hospice Care and Bereavement
Nutrition and Cancer
Sexuality & Fertility
Side Effects
Support
Survivorship
Exercise and Cancer
Cancer Resources
Cancer News
OncoLink University
Nurses' Notes
Conferences
Newly Diagnosed Patients
Causes and Prevention
Legal and Financial Information for Patients
LGBT Resources
NCI Resources
Global Resources
Cancer Resource List
Resources for Young Adults
OncoLink Media Library
OncoLink TV
Book, Music and Video Reviews
Ask the Experts
Brown Bag Chat
Tracy's Corner
About OncoLink
About OncoLink
Giving to OncoLink
Contact Information
Usage Policy
Editorial Board
How to Partner with OncoLink
Link to OncoLink
Mission Statement
