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National Cancer Institute®
Ultima Vez Modificado: 1 de marzo del 2002
UI - 9065641
AU - Issing WJ; Struck R; Naumann A
TI - Positive impact of retinyl palmitate in leukoplakia of the larynx.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S105-9
AD - Department of Otorhinolaryngology, Klinikum Grosshadern, Ludwig-Maximilians-Universitat, Munich, Germany.
Laryngeal leukoplakia can be a premalignant precursor of squamous cell carcinoma, is often tobacco-related and can usually be readily monitored by indirect laryngoscopy. One of the main motivations for using retinyl palmitate in patients with persistent leukoplakia was to avoid general anesthesia for elderly patients, who are considered to be high-risk patients when direct larynoscopy is required for possible tissue biopsy. Our study was the first to investigate the effectiveness and toxicity of high-dose retinyl palmitate in the treatment of laryngeal leukoplakia. Treatment was divided into two phases. In the first phase, all patients underwent induction therapy with 300,000 IU/day of retinyl palmitate for the 1st week, which was then adjusted up to 1,500,000 IU/day in the 5th week in patients with resistant lesions. Patients whose lesions progressed during this period were withdrawn from the study. In the second phase, patients whose lesions responded to treatment or remained stable were assigned to a maintenance therapy of 150,000 IU/day. Complete remission was observed in 15 of 20 patients (75% of cases). Partial response was seen in the remaining 5 patients, with 3 of the patients relapsing. The median duration of treatment and follow-up was 18 months (range, 12-24 months). These results indicate that retinyl palmitate has substantial activity in laryngeal leukoplakias. Since only minor side effects were seen, the medication is an excellent candidate as a preventive agent for laryngeal cancer.
UI - 9065642
AU - Dursun G; Keser R; Akturk T; Akiner MN; Demireller A; Sak SD
TI - The significance of pre-epiglottic space invasion in supraglottic laryngeal carcinomas.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S110-2
AD - Department of Ears, Nose and Throat, Ankara University Medical School, Mebusevleri, Turkey.
It is widely accepted that tumoral invasion of the pre-epiglottic space (PES) has a significant prognostic importance in supraglottic laryngeal carcinomas. The lymphatics of the supraglottic larynx drain to cervical lymph nodes via the PES. Since the supraglottic larynx is an embryological unit that contains the PES, malignant lesions of this region must be resected with en bloc surgery, including the PES. Tumors with PES invasion are already considered to be T3 in TNM staging. The purpose of this study was to review the clinical experience we have had with these tumors at Ankara University. The study comprised 150 patients with squamous cell carcinomas of the supraglottic larynx treated with either partial or total laryngectomies. Findings suggested that PES invasion occurred at early stages of supraglottic tumor progression. Suprahyoid epiglottic lesions behaved less aggressively than tumors originating from other supraglottic subsites and did not invade the PES until advanced stages. PES invasion was not considered to be a significant prognostic factor because the majority of the supraglottic lesions studied demonstrated PES invasion regardless of cervical lymph node metastases. Analysis of oncological and functional results revealed that en bloc resection of the supraglottis with the PES was facilitated by preservation of the hyoid bone.
UI - 9065643
AU - Zargi M; Smid L; Fajdiga I; Bubnic B; Lenarcic J; Oblak P
TI - Detection and localization of early laryngeal cancer with laser-induced fluorescence: preliminary report.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S113-6
AD - University Department of Otorhinolaryngology and Cervicofacial Surgery, Ljubljana, Slovenia.
Differences in autofluorescence between normal and malignant tissues offer new possibilities for detecting and localizing early laryngeal carcinomas. In the present study imaging was performed using a specially designed device that exploits differences in fluorescent properties of normal and cancerous tissues without photodynamic drugs. Fluorescence was induced by a helium-cadmium laser, captured by an image-intensified camera and displayed on a video monitor after previous computerization. Thirty patients were evaluated, of whom 18 had suspect malignancies. Laryngoscopic appearances during standard microlaryngoscopy were compared to fluorescence images, computerized fluorescence intensities and histopathological findings. The experience from this study shows that autofluorescence laryngoscopy may be a useful complementary method for detecting laryngeal malignancies.
UI - 9065644
AU - Zbaren P; Becker M; Lang H
TI - Staging of laryngeal cancer: endoscopy, computed tomography and magnetic resonance versus histopathology.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S117-22
AD - Department of Otolaryngology, Head and Neck Surgery, Inselspital, Bern, Switzerland.
An accurate pretherapeutic staging of laryngeal cancer is required for optimal treatment planning and for evaluation and comparison of the results of different treatment modalities. In this study, 45 consecutive patients with neoplasms of the larynx, treated surgically, were included in a prospective pretherapeutic staging protocol that included indirect laryngoscopy, direct microlaryngoscopy, contrast-enhanced computed tomography (CT) and Gd-DTPA-enhanced magnetic resonance imaging (MRI). The surgical specimens were cut in whole-organ slices parallel to the plane of the axial CT and MR images. The histologic findings were then compared with clinical findings, CT and MRI. These findings showed that clinical evaluation failed to identify tumor invasion of the laryngeal cartilages and extralaryngeal soft tissues, resulting in a low staging accuracy (55%). Many pT4 tumors were clinically understaged. The combination of clinical/endoscopic evaluation and either CT or MRI resulted in a significantly improved staging accuracy (80% vs 87%, respectively). MRI was significantly more sensitive but less specific than CT in detecting neoplastic cartilage invasion. MRI tended to overestimate neoplastic cartilage invasion to possibly result in overtreatment, while CT was found to underestimate neoplastic cartilage invasion and could lead to inadequate therapeutic decisions.
UI - 9065648
AU - Golusinski W; Olofsson J; Szmeja Z; Szyfter K; Szyfter W; Biczysko W;
TI - Hemminki K Alteration of p53 gene structure and function in laryngeal squamous cell cancer.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S133-7
AD - Department of Otolaryngology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
The p53 gene is known as an anti-oncogene that manifests its function by controlling the cell cycle and is responsible for apoptosis of cells with unrepaired DNA. An accelerated p53 protein synthesis is the first response of a cell following DNA damage. However, mutations of the p53 gene can disturb protein synthesis or may be responsible for synthesis of a changed protein unable to control the cell cycle. Laryngeal tissue specimens from 120 patients were tested by immunohistopathological staining to detect mutated wild-type p53 protein. It was found that p53-positive specimens correlated with TNM staging and histopathological grading. Another indication of entering the cell cycle and undertaking an active proliferation by laryngeal cells was shown by detection of proliferating cell nuclear antigen (PCNA) and Ki67 nuclear antigen, which appeared in proliferating cells (late G1, S-G2 and M phase), but was absent in resting cells. Scoring of the staining for p53 protein, PCNA and Ki67 correlated with each other. DNA from 40 specimens was then isolated, amplified by polymerase chain reaction and analysed by single-strand conformation polymorphism and DNA sequencing for mutation in the p53 gene. Fifteen DNA samples were found to be positive, while mutations were detected in exons 5-8 in 13 samples. The majority of mutations were found in tissue specimens from T3 and T4 tumors. A possible explanation is almost half was attributable to genotoxic effects of tobacco smoking. Changes in the p53 gene and its products may also reflect early changes in laryngeal carcinogenesis and be of prognostic value.
UI - 9065651
AU - Jahnke V; Strange R; Matthias C; Fryer A
TI - Glutathione S-transferase and cytochrome P450 genotypes as risk factors for laryngeal carcinoma.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S147-9
AD - Department of Otorhinolaryngology, Virchow-Klinikum, Humboldt University, Berlin, Germany.
While cigarette smoking and alcohol consumption have been linked to laryngeal squamous cell carcinoma (SCC), the role of genetic factors in determining individual susceptibility is unknown. We describe the role of allelism at the glutathione S-transferase GSTM1, GSTM3, GSTT1 and cytochrome P450 CYP1A1, CYP2E1, CYP2D6 loci in determining individual susceptibility to laryngeal SCC. Enzyme genotypes were determined using polymerase chain reaction and restriction enzyme digestion of leukocyte DNA collected from 269 patients with T1-T4 laryngeal carcinomas and 216 controls. While the frequencies of the heterozygote GSTM1 A/B genotype and the homozygote GSTM3 B/B genotype were statistically significantly lower in the patients with tumors than in controls, the frequency of the GSTT1 null genotype was higher in the patients than in controls. The data suggest that allelism at GST loci mediates susceptibility to SCC of the larynx. GSTM1 A/B and GSTM3 B/B appear to be associated with reduced risk, while GSTT1 null may confer increased risk. These findings are compatible with the view that genetic predisposition is important in determining risk for this cancer.
UI - 9065652
AU - Smid L; Strojan P; Budihna M; Skrk J; Vrhovec I; Zargi M; Kos J
TI - Prognostic value of cathepsins B, D and steffins A and B in laryngeal carcinoma.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S150-3
AD - University Department of Otorhinolaryngology and Cervicofacial Surgery, Ljubljana, Slovenia.
Concentrations of cathepsins A, D and stefins A and B were measured in primary tumor and adjacent normal tissue of 25 patients with laryngeal carcinoma. Median concentrations of both cathepsins and that of stefin B were significantly higher in tumor tissue than in their normal counterparts (cathepsins B and D, P < 0.0001; stefin B, P = 0.01), indicating their possible involvement in the process of tumor spread. Early (T1 and T2) tumors had lower concentrations of stefins A and B than locally advanced (T3 and T4) tumors (P = 0.04). Disease-free and disease-specific survival rates at 45 months were significantly better in patients with tumor concentrations of stefins above or equal to the cut-off values (stefin A, P = 0.001 and P = 0.004; stefin B, P = 0.048 and P = 0.008), indicating that these might be of prognostic value. The concentrations of cathepsins B and D did not correlate with survival.
UI - 9065653
AU - Namyslowski G; Klimala J; Kokocinska D; Misiolek M
TI - Squamous cell carcinoma antigen levels in patients with different stages of laryngeal cancer.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S154-6
AD - II ENT Department, Silesian Medical School, Zabrze, Poland.
An attempt was undertaken to evaluate the usefulness of squamous cell carcinoma antigen (SCC Ag) in different stages of squamous cell carcinoma of the larynx. Antigen levels were determined in blood serum before treatment in 25 patients with laryngeal cancer treated at the II ENT Department, Silesian Medical School in Zabrze. Ages were 39-65 years (mean, 56.6 years). Fifteen healthy volunteers of similar ages served as controls. SCC Ag was estimated by an enzyme-immunological method using the Abbot set. Increasing levels of SCC Ag were found in 14 patients (65%). The mean SCC Ag level before treatment in the tumor group was 2.93 +/- 0.23 ng/ml and 0.79 +/- 0.19 ng/ml in the control group (standard, 1.5 ng/ml). Mean SCC Ag levels depending on the clinical stage of disease were: stage I, 1.52 ng/ml; stage II, 2.16 ng/ml; stage III, 3.03 ng/ml; stage IV, 4.57 ng/ml. Differences in all groups were statistically significant when compared to the healthy controls (P < 0.05).
UI - 11859976
AU - Teppo H; Koivunen P; Sipila S; Jokinen K; Hyrynkangas K; Laara E;
TI - Pukkala E; Sovio U; Alho O P Decreasing incidence and improved survival of laryngeal cancer in Finland.
SO - Acta Oncol 2001;40(7):791-5
AD - Department of Otorhinolaryngology, University of Oulu, Finland. firstname.lastname@example.org
The decreasing incidence rate and improvement in survival of laryngeal cancer patients in Finland are exceptions among western countries. A descriptive study of these trends was conducted including both nationwide population-based cancer registry data with 5 766 patients diagnosed in 1956-1995 and regional hospital-based data from Northern Finland, allowing classification into supraglottic and glottic cancers, with 353 patients diagnosed in 1976-1995. In Finland, the age-adjusted incidence rate among males decreased from 6.5 per 100 000 in 1956-1965 to 3.5 in 1986-1995, while in females the rate remained around 0.3 per 100 000. The rates in Northern Finland were slightly higher and the supraglottic to glottic incidence ratio diminished from 1.4:1 in 1976-1985 to 0.5:1 in 1986-1995. The 5-year relative survival rate improved in both Northern Finland and the whole country, most noticeably among males and the elderly. In the data from Northern Finland, the survival rate was more favourable in glottic (80%) than in supraglottic cancer (64%). Considering the marked decrease in the incidence of the less favourable supraglottic disease, the observed improvement in survival was small.
UI - 11859977
AU - Luscher M S; Pedersen U; Johansen L V
TI - Treatment outcome after laser excision of early glottic squamous cell carcinoma--a literature survey.
SO - Acta Oncol 2001;40(7):796-800
AD - Department of Otorhinolaryngology, Aarhus University Hospital, Denmark. email@example.com
Two treatment options are widely used for the cure of T1 glottic squamous cell carcinoma: radiotherapy and surgical removal. There is ongoing controversy about whether laser excision should be offered to patients with T1 glottic carcinoma. The purpose of this study is to present a review of studies dealing with treatment outcome after laser excision of T1 glottic carcinoma. Eighteen original papers on outcomes were identified. Recurrence rates ranged from 4% to 35%. The disease-specific survival rate at 5 years was found to be from 89% to 100% and crude survival from 74% to 100%. Of the six studies dealing with voice quality, radiation therapy was found to be more effective in preservation of the voice in three, while in the other three studies, no significant difference could be detected. With respect to costs of treatment, in three out of four studies laser surgery was found to be the more economical treatment option. Laser surgery seems to provide comparably low recurrence rates and high disease-specific survival as compared with radiotherapy. In T1 cancer, laser resection leaves the patient with a poorer voice quality than is the case with radiation therapy, but laser treatment seems to be the cheaper option.
UI - 11860067
AU - Cohen-Kerem R; Lahat N; Elmalah I; Greenberg E; Resnick MB; Doweck I;
TI - Rahat MA Detection of cytokeratins in normal and malignant laryngeal epithelia by means of reverse transcriptase-polymerase chain reaction.
SO - Ann Otol Rhinol Laryngol 2002 Feb;111(2):149-54
AD - Department of Otolaryngology-Head and Neck Surgery, Lady Davis Carmel Medical Center, Rappaport Family Institute for Research in the Medical Sciences, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
Cytokeratins (CKs) are a subgroup of intermediate filament proteins that take part in forming the cytoskeleton. The epithelial cells in different organs express distinct CKs, and this expression may be modified during malignant transformation. Here we describe the use of reverse transcriptase-polymerase chain reaction followed by Southern blotting to determine the profile of expression of CKs in both normal and malignant laryngeal samples. Thirty-six samples were subjected to histologic examination and classified as 17 squamous cell carcinomas, 3 dysplastic lesions, and 16 normal samples. CK8 and CK19 were expressed in almost all samples, both cancerous and normal, and were therefore used to verify the integrity of RNA. Expression of CK2, CK9, and CK20 was not detected in any of the samples, normal or cancerous. CK15 and CK18 showed low sensitivity for detection of cancer (36.4% and 45.5%, respectively). CK10 showed relatively high sensitivity (91%), but only moderate specificity (69.2%). Only CK17 showed both high sensitivity and specificity (91% and 92.3%, respectively; positive predictive value, 91%). We propose that CK17 may be considered a promising candidate to use as a molecular marker for malignant transformation in laryngeal squamous cell carcinoma.
UI - 11860071
AU - Lassaletta L; Garcia-Pallares M; Morera E; Salinas S; Bernaldez R;
TI - Patron M; Gavilan J Functional neck dissection for the clinically negative neck: effectiveness and controversies.
SO - Ann Otol Rhinol Laryngol 2002 Feb;111(2):169-73
AD - Department of Otolaryngology, La Paz University Hospital, Madrid, Spain.
This study was performed to evaluate the effectiveness of functional neck dissection in controlling metastasis to the clinically negative (cN0) neck, focusing on recurrences in the pathologically negative (pN0) neck and the role of extracapsular spread in the cN0 neck. A series of 172 patients (253 dissected fields) treated for cN0 laryngeal or hypopharyngeal cancer with a 5-year minimum follow-up is presented. Occult metastasis was observed in 30% of the patients. Extracapsular spread was present in 39% of the positive nodes. The neck recurrence rate was 5.2%. Surgical specimens from cases of neck recurrence in pN0 necks were reevaluated for micrometastasis by immunostaining with antibody for cytokeratins. The immunohistochemical findings were positive in 1 of 4 cases. Functional neck dissection provides good neck control and survival rates for the cN0 neck. The accurate prognostic significance of extracapsular spread in cN0 necks is still unknown. Micrometastasis alone may be insufficient to explain recurrences in pN0 necks.
UI - 11808137
AU - Yoshino K; Ajiki W
TI - [Figures of laryngeal cancer]
SO - Nippon Rinsho 2001 Nov;59 Suppl 7():314-21
AD - Department of Otolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases.
UI - 11872287
AU - Ii N; Fuwa N; Ando M; Itoh Y; Nomoto Y; Takeda K
TI - DNA ploidy analysis performed prospectively using fresh tumor samples in early glottic carcinoma treated with radiotherapy.
SO - Int J Radiat Oncol Biol Phys 2002 Feb 1;52(2):415-9
AD - Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi, Japan. firstname.lastname@example.org
PURPOSE: The correlation between the DNA content, determined using fresh tumor tissues, and the macroscopic presentation of the lesion was studied prospectively in patients with T1 glottic carcinoma. METHODS AND MATERIALS: DNA flow cytometry and fiber-optic endoscopic examination were performed for 30 previously untreated patients with T1 glottic carcinoma. The patients received radical radiotherapy at Aichi Cancer Center Hospital. RESULTS: In regard to the type of lesion, 4 (80%) were aneuploid, and 1 (20%) was diploid for the invasive type. There was a tendency to show an invasive appearance in aneuploid tumors. With respect to clinical outcome, there were 3 (43%) local recurrences among the aneuploid tumors that invaded the entire length of one vocal cord, 0 (0%) for medium-sized lesions, and 1 (17%) for small lesions. Aneuploid tumors showed a high correlation between lesion size and local control. CONCLUSIONS: The correlation was not strong enough to conclude that DNA content can replace the macroscopic presentation of the lesion. However, the combination of DNA content and tumor size may help predict radiation sensitivity.
UI - 11848533
AU - Pignataro L; Corsi MM; Sambataro G; Porcaro L; Tredici P; Broich G
TI - Plasmatic cytokine network in patients with laryngeal carcinoma after surgical treatment.
SO - Anticancer Res 2001 Sep-Oct;21(5):3621-5
AD - Clinica Otorinolaringoiatrica, Ospedale Maggiore I.R.C.C.S. Milano, Italy. email@example.com
Alterations in host immunity, inflammation, angiogenesis and metabolism are all prominent clinical features in patients with laryngeal squamous cell carcinoma (LSCC). Although the origin of the signals and mechanisms underlying these responses are not well understood, their local and systematic nature suggest that squamous cell carcinoma-produced cytokines with proinflammatory and immunoregulatory activity may contribute to the pathogenesis of LSCC. In order to gain a better insight into the roles and relationships of the cytokines, we investigated serum IL-6, IL-10 and IL-12 concentrations in LSCC patients under baseline conditions and after surgery. In comparison with controls, all the patients had higher plasma IL-10 concentrations before surgical treatment (T0), while plasma IL-6 and IL-12 concentrations were higher in 22 (84.6%) and 24 patients (92.3%). The differences in plasma IL-6, IL-10 and IL-12 concentrations at T0 and T1 were statistically significant (p<0.001, p<0.0046 and p<0.011). Our finding suggest that plasma cytokines are overexpressed in LSCC patients. There was an independent increase in plasma IL-6 levels before and after surgical treatment. Furthermore, the up- and down-regulation of plasma IL-10 and IL-12 suggest a regulatory relationship between them.
UI - 11848542
AU - Suarez-Alvarez B; Garcia Suarez MM; Arguelles ME; Sampedro A; Alvarez
TI - Marcos C; Mira E; Van den Brul FA; Liu FT; Chowdhury PS; de los Toyos JR Circulating IgG response to stromelysin-3, collagenase-3, galectin-3 and mesothelin in patients with pharynx/larynx squamous cell carcinoma.
SO - Anticancer Res 2001 Sep-Oct;21(5):3677-84
AD - Servicio Cientifico Tenico de Citometria e Inmunotecnologia, Instituto Universitario de Oncologia, Universidad de Oviedo, Madrid, Spain.
With the aim of identifying tumor-associated antigens that could be potential markers and/or targets of diagnostic and/or therapeutic approaches, we studied the occurrence of circulating IgG antibodies to human stromelysin-3, collagenase-3, galectin-3 and mesothelin, by Western blot against their purified recombinant forms, in the sera of 50 patients with pharynx/larynx squamous cell carcinoma (PLSCC), as well as in the sera of 50 healthy blood donors. Overall, antibodies to collagenase-3 were detected in 50% of all the cancer patients and 16% of the blood donors examined; this percentage difference was statistically significant (p = 0.00066). With respect to anti-galectin-3 antibodies, the percentages were 32% and 18%, respectively, but they were not statistically different (p = 0.16). Low levels of antibodies to stromelysin-3 and to mesothelin were detected in sera from only two cancer patients. No significant correlations were found in the present study between the presence of antibodies to these proteins and tumor site, clinical and T stages, lymph node involvement, DNA ploidy and histological grade of differentiation of the primary tumors. To our knowledge, this is the first report on the detection of circulating IgG to collagenase-3 in cancer patients. Some of the percentages found here in certain groups of patients are among the highest reported of circulating antibodies to any tumor component studied so far. The monitoring and the use of human antibodies to collagenase-3 could be of diagnostic and therapeutic interest.
UI - 11843920
AU - Rafferty MA; Fenton JE; Jones AS
TI - The history, aetiology and epidemiology of laryngeal carcinoma.
SO - Clin Otolaryngol 2001 Dec;26(6):442-6
AD - Department of Otolaryngology/Head and Neck Surgery, Liverpool University, Liverpool, UK.
UI - 11843925
AU - Krecicki T; Zalesska-Krecicka M; Jelen M; Szkudlarek T; Horobiowska M
TI - Expression of type IV collagen and matrix metalloproteinase-2 (type IV collagenase) in relation to nodal status in laryngeal cancer.
SO - Clin Otolaryngol 2001 Dec;26(6):469-72
AD - Department of Otolaryngology, Medical University of Wroclaw, Poland. firstname.lastname@example.org
Laryngeal carcinoma has a lower incidence of neck metastases than other malignant carcinomas of the head and neck region. However, some cases are very aggressive, showing neck metastases even in the early stages. In this study the expression of collagen IV and type IV collagenase (MMP-2) were examined immunohistologically in 50 patients with laryngeal carcinomas, and the results were compared with the incidence of neck metastases and other clinicopathological factors. The correlation between collagen IV expression and the existence of nodal metastases was statistically significant (P < 0.001). There was also significant correlation between collagen IV expression and the histological grading of the tumour. There was a tendency for samples with continuous collagen IV staining to have no matrix metalloproteinase-2 (MMP-2) immunoreactivity. No significant correlation was seen between MMP-2 protein expression and clinicopathological parameters although the correlation between MMP-2 and existence of nodal metastases was statistically borderline (P = 0.07). Multivariate analysis of the clinicopathological factors that may have an influence on the nodal status in laryngeal cancer revealed that, apart from T stage, collagen IV pattern in the basement membrane surrounding nests of carcinoma is an important prognostic factor.
UI - 11843932
AU - Homer JJ; Greenman J; Stafford ND
TI - The expression of vascular endothelial growth factor (VEGF) and VEGF-C in early laryngeal cancer: relationship with radioresistance.
SO - Clin Otolaryngol 2001 Dec;26(6):498-504
AD - Department of Otolaryngology-Head and Neck Surgery, University of Hull, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK.
Angiogenesis is essential for tumour growth and invasion. Vascular endothelial growth factor (VEGF) is a prime mediator of tumour angiogenesis. VEGF-C is a closely related protein that effects lymphatic endothelial cells and may be important in the process of lymphatic metastasis. The purpose of this study was to evaluate the expression of these cytokines in patients with T1 and T2a glottic, squamous cell carcinoma, in comparison with normal epithelial control tissue, to ascertain any association with radioresistance. Twenty-two tumours treated by radiotherapy (13 radiosensitive, nine radioresistant) and seven normal control tissues were studied. The minimum follow-up was 2 years after radiotherapy. Expression of VEGF and VEGF-C was evaluated by immunohistochemistry of formalin-fixed, paraffin-embedded biopsy specimens. Analysis was carried out using a quantitative computer image analyser. Both VEGF and VEGF-C were detectable in tumour and normal control specimens. There was increased expression in tumour specimens of both VEGF (P = 0.03) and VEGF-C (P < 0.001). In addition, the expression of VEGF-C was associated with tumours of higher histological grade (P = 0.021). There was, however, no difference in VEGF and VEGF-C expression between radioresistant and radiosensitive tumours. The expression of VEGF and VEGF-C is increased in early laryngeal squamous cell carcinoma (SCC). However, measuring the expression of these proteins cannot predict radioresistance in this tumour group.
UI - 11840592
AU - de Luis Roman D; Izaola O; Aller R
TI - [24-hour oral intake in patients with upper aerodigestive tumors]
SO - Nutr Hosp 2001 Nov-Dec;16(6):280-3
AD - Seccion de Endocrinologia y Nutricion Clinica, Hospital del Rio Hortega Valladolid, Espana. email@example.com
BACKGROUND: A lot of works have shown, alterations in oral intake of micro and macronutrients, in patients with upper aerodigestive tumors. The main aim of our work was to compare the daily intake in a group of patients with upper aerodigestive tumors versus a control group. METHODS: A group pf 35 patients with upper aerodigestive tumors were studied (8 oral cavity and 27 larynx). A group of 35 subjects were use as control group. In all patients the next parameters were taken; age, sex, smoking and alcohol consumption, type of tumors and a 24 hours oral intake questionnaire. RESULTS: Patients with upper aerodigestive tumors showed a high increase of calories intake (1545.3 +/- 359 cal/day vs 1264.4 +/- 240 cal/day; p < 0.05), carbohydrates intake (177.9 +/- 57.9 g/day vs 135.9 +/- 38.5 g/day; p < 0.05), total fats (58.2 +/- 18.4 g/day vs 45.9 +/- 15.4 g/day; p < 0.05) and saturated fats intake (19.4 +/- 7.7 g/day vs 11.9 +/- 6.1 g/day; p < 0.05). In micronutrients intake differences were detected, a low intake in tumoral patients of vitamin C (59.4 +/- 18.5 mg/day vs 141.5 +/- 83 mg/dia; p < 0.05), folic acid (116.5 +/- 56.3 mg/day vs 180.5 +/- 78.5 mg/day; p < 0.05), and vitamin B2 (1.53 +/- 0.5 mg/day vs 23.9 +/- 6.5 g/day; p < 0.05). In minerals intake we detected a low intake in tumoral patients of calcium (702.9 +/- 363 mg/day vs 942.4 +/- 327 mg/day; p < 0.05). CONCLUSIONS: Patients with upper aerodigestive tumors take a high amount of calories, saturated fats and carbohydrates, and a low intake of vitamin C, folic, vitamin B12 and calcium.
UI - 11868476
AU - Palacios E; Friedlander PL
TI - Chondrosarcoma of the larynx.
SO - Ear Nose Throat J 2002 Feb;81(2):83
AD - Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, USA.
UI - 11769998
AU - Mallet Y; Chevalier D; Darras JA; Wiel E; Desaulty A
TI - Near total laryngectomy with epiglottic reconstruction. our experience of 65 cases.
SO - Eur Arch Otorhinolaryngol 2001 Nov;258(9):488-91
AD - CHRU, Lille, France.
From 1980 to 1998, 65 patients whose glottic lesions were classified T1 or T2 were operated with a reconstructive anterior frontal laryngectomy with epiglottoplasty such as described by Tucker (Arch Otolaryngol Head Neck Surg 115:1341-1344). This procedure consists of resection of the two vocal cords, in some cases one arytenoid, the anterior commissure with a part of the thyroid cartilage, the anterior part of both false vocal cords, and of 1 cm of the subglottis. The epiglottis is grasped downward to close the larynx. There were no per or postoperative deaths. Our functional results confirm those reported in the previous publications. The mean time of removal of the nasogastric tube was about 12 days and the patients were generally satisfied about their residual voice. Decannulation was performed after satisfactory peroral feeding, generally about 2 weeks postoperatively. Three patients only required subsequent procedures which can be considered due to functional failures. There were four recurrences, which means a 5-year actuarial local control rate of 94%. This operation takes place as part of our surgical treatment policy of laryngeal carcinomas, considering that this surgery is like an extensive frontolateral laryngectomy. In case of an infiltrating tumor or in case of invasion to the arytenoid cartilage, we perform a supracricoid partial laryngectomy with crico-hyoido-epiglottopexy (the Majer-Piquet's procedure).
UI - 11775526
AU - Wolf GT
TI - Options for preserving the larynx in patients with advanced laryngeal and hypopharyngeal cancer.
SO - Ear Nose Throat J 2001 Dec;80(12):897-901
AD - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, 1904 Taubman Center, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0312, USA. firstname.lastname@example.org
The introduction of newer surgical and combined-modality approaches to organ preservation in patients with advanced laryngeal or hypopharyngeal cancer is the most exciting clinical frontier in head and neck cancer treatment today. The use of these techniques at other sites, the exploration of improved methods for patient selection and tumor assessment, and the development of newer combination regimens will need to be rigorously studied in future clinical trials. In all these efforts, the major focus must remain on improving survival. This article reviews the latest developments in organ-preservation strategies and techniques for patients with advanced laryngeal or hypopharyngeal cancer.
UI - 11843727
AU - Aslan I; Baserer N; Yazicioglu E; Oysu C; Tinaz M; Kiyak E; Biliciler N
TI - Near-total laryngectomy for laryngeal carcinomas with subglottic extension.
SO - Arch Otolaryngol Head Neck Surg 2002 Feb;128(2):177-80
AD - Department of Otorhinolaryngology, Faculty of Medicine, Istanbul University, Kardelen 4-5 D: 3, 81120 Atasehir Istanbul, Turkey. email@example.com
OBJECTIVE: To investigate whether Pearson classic near-total laryngectomy is a sensible surgical treatment modality for laryngeal carcinomas with subglottic extension. DESIGN: Retrospective analysis of patients treated by near-total laryngectomy in a university hospital that is an academic tertiary health care center. PARTICIPANTS AND INTERVENTION: Medical and computer records of 135 patients who were treated by near-total laryngectomy for laryngeal and hypopharyngeal carcinomas between April 1, 1989, and June 30, 2000, were searched thoroughly, and the final outcomes were confirmed by telephone contact. MAIN OUTCOME MEASURES: Survival rates of the patients with laryngeal carcinomas with subglottic extension treated by near-total laryngectomy were compared with those of the patients with malignancies of other laryngeal regions given the same treatment. RESULTS: Of the 135 patients in the study, 74 were available for determination of 5-year survival. The rate was 65.8% (27/41) for transglottic tumors, 53.8% (7/13) for supraglottic tumors, and 20.0% (4/20) for tumors with subglottic extension. Only 3 of 16 patients with laryngeal carcinomas with supraglottic or transglottic localization died of local recurrence; the rest of the deaths were from regional recurrence or distant metastasis. However, 6 of 13 patients with subglottic extension died of local recurrence, 5 of peristomal recurrence, and only 2 of distant metastasis. CONCLUSIONS: Success was directly related to adherence to precise indications in cancer surgery. While near-total laryngectomy is an effective and reliable treatment modality in laryngeal cancer surgery, its effectiveness in laryngeal cancers with subglottic extension is debatable. These subglottic lesions should be treated by total laryngectomy, which is a more radical surgery.
UI - 11870663
AU - Jacob SE; Sreevidya S; Chacko E; Pillai MR
TI - Cellular manifestations of human papillomavirus infection in laryngeal tissues.
SO - J Surg Oncol 2002 Mar;79(3):142-50
AD - Department of Pathology, Medical College Hospital, Kerala State, India.
BACKGROUND AND OBJECTIVES: Although epidemiologic studies have suggested human papillomavirus (HPV) to be an etiological agent in laryngeal carcinogenesis, little is known on the cellular manifestations of HPV infection in these tumors. In this study, we investigated the frequency of HPV infection in various neoplastic and non-neoplastic laryngeal tissue and its association with expression of the proliferating cell nuclear antigen (PCNA) and the tumor suppressor protein p53. METHODS: Tissues were analyzed by polymerase chain reaction (PCR) for the presence of HPV and by immunocytochemistry for the expression of p53 and PCNA. RESULTS: None of the six normal laryngeal tissues showed the presence of HPV. Thirteen out of the 16 papillomas were positive for HPV, while 15 out of the 44 invasive cancers were HPV positive. PCNA expression increased as the lesion progressed through increasing histological abnormality (r = 0.64400, P = 0.00000). The correlation between the type of laryngeal neoplasm and p53 accumulation was significant (r = 0.54839, P = 0.00000). Significant correlation was also evident between presence of HPV and p53 accumulation (r = 0.34259, P = 0.00424) and PCNA expression (r = 0.036024, P = 0.00266) indicating that HPV positive tumors showed significant p53 accumulation and increased proliferation.There was also correlation between p53 and PCNA expression (r = 0.67475, P = 0.00000) indicating that in all tumors with p53 accumulation, there was a corresponding increase in PCNA expression. CONCLUSIONS: The results suggests that changes in p53 and PCNA expression may be associated with HPV infection, and could play a role in laryngeal carcinogenesis. Copyright 2002 Wiley--Liss, Inc.
UI - 11783094
AU - Wang D; Zhang W; Xiong M
TI - [The clinical usefulness of helical CT multiplanar reformation, three-dimensional reconstruction and virtual laryngoscopy in laryngeal and hypopharyngeal carcinomas]
SO - Zhonghua Zhong Liu Za Zhi 2001 May;23(3):230-3
AD - Department of Radiology, Air Force General Hospital, Beijing 100036, China.
OBJECTIVE: To evaluate the clinical applications of helical CT multiplanar reformation (MPR), three-dimensional reconstruction (3D) and virtual laryngoscopy (CTVL) in laryngeal and hypopharyngeal carcinoma. METHODS: Axial helical CT scan was performed in 24 patients with laryngeal or hypopharyngeal carcinoma, meanwhile MPR, 3D and CTVL were performed on each patient. The results were compared with the fiberoptic laryngoscopic and surgical findings. RESULTS: Axial helical CT combined with MPR images, the accuracy of preoperative tumor staging and detection of metastatic lymph nodes were both 96%. In 25% of the cases, MPR was more informative than axial images about the extent of tumor invasion. The 3D image three-dimensionally displayed the extent of tumor invasion, and its relation to blood vessels and airway. On CTVL, the location, size and extent of intraluminal tumors of the larynx and hypopharynx when observed from above corresponded well with those observed under laryngoscope. In 4 patients, CTVL observed from below, demonstrated the relationship between the tumor and vocal cords and anterior commissure inaccessible to fiberoptic laryngoscopy. CONCLUSION: Helical CT axial scanning combined with MPR, 3D and CTVL images, can provide more comprehensive information about laryngeal and hypopharyngeal carcinoma.
UI - 11902488
AU - Akcay F; Taysi S; Uslu C; Dogru Y; Gumustekin K
TI - Levels of soluble intercellular adhesion molecule-1 and total sialic acid in serum of patients with laryngeal cancer.
SO - Jpn J Clin Oncol 2001 Dec;31(12):584-8
AD - Department of Biochemistry, School of Medicine, Ataturk University, Erzurum, Turkey. firstname.lastname@example.org
BACKGROUND: Adhesion molecules have been implicated in tumor progression. In this study, we aimed to investigate serum soluble intercellular adhesion molecule-1 (sICAM-1) and total sialic acid (TSA) levels in laryngeal carcinoma and correlate their levels with the cancer stage. METHOD: The sera from 35 patients with laryngeal cancer (10 at stage II, 12 at stage III and 13 at stage IV) were extracted before treatment. The concentrations of sICAM-1 and TSA were measured by enzyme-linked immunoassay and the thiobarbituric acid method, respectively and compared with those from a healthy control group (n = 34). RESULTS: Mean serum sICAM-1 and TSA levels were found to be higher in the total patient group (the lowest level belonging to stage II) than in the control group (p < 0.001, control versus total patient group). As the stage of the disease increased, higher levels of sICAM-1 and TSA were determined. The correlations between TSA and sICAM-1 became more significant as the stage of the disease increased (r= 0.67, p < 0.05 in stage II, r= 0.86, p < 0.001 in stage III and r = 0.90, p < 0.001 in stage IV). CONCLUSION: These data reveal that the significant correlations between sICAM-1 and TSA in laryngeal cancer, more prominent at advanced stage, might reflect the similar nature of these molecules, which function as adhesion molecules.
UI - 11751491
AU - Almadori G; Cadoni G; Cattani P; Galli J; Bussu F; Ferrandina G; Scambia
TI - G; Fadda G; Maurizi M Human papillomavirus infection and epidermal growth factor receptor expression in primary laryngeal squamous cell carcinoma.
SO - Clin Cancer Res 2001 Dec;7(12):3988-93
AD - Institute of Otolaryngology, Catholic University of the Sacred Heart, Largo A. Gemelli, 8, Rome 00168, Italy. email@example.com
PURPOSE: This study was designed to add new data about laryngeal carcinogenesis, a multistep process in which chemical and/or viral agents induce and promote successive alterations in growth factor-linked signal transmission pathways, genetic instability, and mutations in key genes involved in cell growth control. Epidemiological evidence suggests that human papillomavirus (HPV) infection may be associated with the development of laryngeal cancer. EXPERIMENTAL DESIGN: In this report, we have analyzed the prevalence of HPV infection and epidermal growth factor receptor (EGFR) expression in a series of 42 laryngeal squamous cell carcinomas by PCR with HPV consensus primers and by a radioligand receptor assay, respectively. RESULTS: HPV DNA was detected in 15 of 42 (35.7%) tumors, and it belonged almost exclusively to the highly oncogenic HPV-16, HPV-18, and HPV-33 genotypes. At analysis by Mann-Whitney nonparametric statistical test, EGFR level was found to be significantly higher in HPV-infected than in HPV-negative cases (T = 440; P = 0.002). EGFR overexpression (EGFR-positive status >6 fmol/mg protein, the arbitrary cutoff value chosen) was found in 20 of 42 (47.6%) tumors, and it was associated with HPV infection in a statistically significant extent (chi(2) = 4.686; P = 0.03). CONCLUSIONS: Viral oncoproteins have been shown to induce a perturbation of the cell response to signals for growth and differentiation; these findings confirm that enhanced EGFR expression and activation in laryngeal squamous cell carcinoma may occur also as a consequence of HPV infection and support the hypothesis of an involvement of HPV infection in laryngeal carcinogenesis.
UI - 11889399
AU - Gallo A; de Vincentiis M; Manciocco V; Simonelli M; Fiorella ML; Shah JP
TI - CO2 laser cordectomy for early-stage glottic carcinoma: a long-term follow-up of 156 cases.
SO - Laryngoscope 2002 Feb;112(2):370-4
AD - Department of Otolaryngology, "La Sapienza" University, Rome, Italy. firstname.lastname@example.org
OBJECTIVES: To define when laser resection of early-stage glottic carcinoma is indicated and to compare the results obtained by laser surgery with other therapeutic options. STUDY DESIGN: Retrospective Department of Otorhinolaryngology at "La Sapienza" University. We provide analysis of indications, techniques, and oncologic results of this study. METHODS: Glottic tumors were treated with type III, type IV, and type Va cordectomies according to the classification of endoscopic cordectomies proposed by the European Laryngological Society in 2000. RESULTS: The results are summarized as follows: all patients with carcinoma in situ Tis are free of disease with local control rate at 3 years of 100%; 2 died of other causes without evidence of local recurrence with an overall survival rate at 3 years of 83.2%. Of the 117 patients with stage T1a cancer, 110 are free of disease at 3 years with local control rate of 94%; 4 patients died of other causes without evidence of local recurrence with an overall survival rate of 96.5%. Of the 22 patients with stage T1b cancer, 20 are free of disease at 3 years with a local control rate of 91%; 1 patient died of other causes without evidence of local recurrence with an overall survival rate at 3 years of 95.4%. CONCLUSIONS: According to our experience, we can conclude that endoscopic laser surgery is an efficacious and cost-effective treatment for early stage glottic cancer.
UI - 11889400
AU - Pradhan SA; D'Cruz AK; Pai PS; Mohiyuddin A
TI - Near-total laryngectomy in advanced laryngeal and pyriform cancers.
SO - Laryngoscope 2002 Feb;112(2):375-80
AD - Head and Neck Services, Tata Memorial Hospital, Parel, Mumbai, India. email@example.com
OBJECTIVE: To demonstrate the oncologic and physiological safety of near-total laryngectomy (NTL), its success in voice conservation, and its versatility for use in extensive resections that necessitate pharyngoplasty, and even in post-radiation recurrences. STUDY: In this study of 137 cases of NTL for cancer of the larynx (45 cases) and pyriform (92 cases), 86.9% were stage T3/T4 and 60.6% were N+. A total of 8.8% had extended pharyngeal resections necessitating patch pharyngoplasty (ENTLP). In 10.9% cases, NTL was used as salvage of post-radiation failures. Concurrent neck dissection was performed in 99 cases. RESULTS: A total of 70.1% was alive and disease-free at the last follow-up ranging from 12 months to 104 months (median, 35 mo). A total of 7.3% had local/locoregional recurrences and 11.7% had purely regional recurrences. The local control rate for post-radiation salvage with NTL was 93.3%. A total of 88.6% developed communicable speech, and the speech success rate was 100% in 12 cases of ENTLP. Complications included major wound dehiscence with total shunt breakdown in 2 cases (1.5%), pharyngeal leak requiring surgical intervention in 7 cases (3.6%), significant aspiration through the shunt necessitating completion laryngectomy in 1 case (0.7%), and complete shunt stenosis in 9 cases (6.6%). CONCLUSION: The study shows that NTL is an oncologically safe voice conservation procedure in advanced, lateralized laryngeal and pyriform cancers treated not only per primum, but also in carefully selected post-radiation failures. It has a high success rate of speech development even in those cases requiring extensive pharyngeal resections. Major complications were acceptably low.
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