The underappreciated role of auriculotemporal nerve involvement in local failure following parotidectomy for cancer

Head & Neck ◽  
2020 ◽  
Vol 42 (11) ◽  
pp. 3253-3262
Author(s):  
Brian P. Swendseid ◽  
Ramez H. W. Philips ◽  
Neeta K. Rao ◽  
Richard A. Goldman ◽  
Adam J. Luginbuhl ◽  
...  
Keyword(s):  
Local Failure ◽  
Nerve Involvement ◽  
Auriculotemporal Nerve

Patterns of local failure after esophagectomy: role of adjuvant radiotherapy

2001 ◽  
Vol 51 (3) ◽  
pp. 261
Author(s):  
D. Khuntia ◽  
C.A. Reddy ◽  
T.W. Rice ◽  
D.J. Adelstein ◽  
J.P. Saxton ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Local Failure

Auriculotemporal Nerve Involvement in Parotid Bed Malignancy

2019 ◽  
Vol 128 (7) ◽  
pp. 647-653
Author(s):  
James D. Thompson ◽  
Gregory D. Avey ◽  
Aaron M. Wieland ◽  
Paul M. Harari ◽  
Tiffany A. Glazer ◽  
...  
Keyword(s):  
Nerve Involvement ◽  
Auriculotemporal Nerve

Local Failure Is Responsible for the Decrease in Survival for Patients With Breast Cancer Treated With Conservative Surgery and Postoperative Radiotherapy

1999 ◽  
Vol 17 (1) ◽  
pp. 101-101 ◽  
Author(s):  
André Fortin ◽  
Marie Larochelle ◽  
Jacques Laverdière ◽  
Sophie Lavertu ◽  
Daniel Tremblay
Keyword(s):  
Local Control ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Cox Model ◽  
Postoperative Radiotherapy ◽  
Distant Metastases ◽  
Conservative Surgery ◽  
Local Failure ◽  
The Difference

PURPOSE: The aim of the present study was to evaluate the role of local failure (LF) in the survival of patients treated with lumpectomy and postoperative radiotherapy and to investigate whether LF is not only a marker for distant metastasis (DM) but also a cause. METHODS: Charts of patients treated with breast conservative surgery between 1969 and 1991 were reviewed retrospectively. There were 2,030 patients available for analysis. The median duration of follow-up was 6 years. A Cox regression multivariate analysis was performed using LF as a time-dependent covariate. RESULTS: Local control (LC) was 87% at 10 years. Local failure led to poorer survival at 10 years than local control (55% v 75%, P < .00). In a Cox model, local failure was a powerful predictor of mortality. The relative risk associated with LF was 3.6 for mortality and 5.1 for DM (P < .00). In patients with LF, the rate of DM peaked at 5 to 6 years, whereas it peaked at 2 years for patients with LC. The mean time between surgery and DM was 1,050 days for patients without LF and 1,650 days for patients with LF (P < .00). CONCLUSION: Our results show that local failure is associated with an increase in mortality. The difference in the time distribution of distant metastasis for LF and LC could imply distinct mechanisms of dissemination. Local failure should be considered not only as a marker of occult circulating distant metastases but also as a source for new distant metastases and subsequent mortality.

scholarly journals Study of Unilateral Retinoblastoma With and Without Histopathologic High-Risk Features and the Role of Adjuvant Chemotherapy: A Children’s Oncology Group Study

2019 ◽  
Vol 37 (31) ◽  
pp. 2883-2891 ◽  
Author(s):  
Patricia Chévez-Barrios ◽  
Ralph C. Eagle ◽  
Mark Krailo ◽  
Jin Piao ◽  
Daniel M. Albert ◽  
...  
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Nerve Involvement ◽  
Nerve Invasion ◽  
Adjuvant Chemotherapy Regimen ◽  
Metastatic Risk ◽  
Not At Risk ◽  
Optic Nerve Involvement

PURPOSE To prospectively determine the prevalence of high-risk histopathologic features (HRFs) in patients with unilateral retinoblastoma who undergo enucleation and to evaluate the role of chemotherapy in preventing recurrences. PATIENTS AND METHODS Children newly diagnosed with enucleated unilateral retinoblastoma were enrolled prospectively. After central histopathology review, patients with specific HRFs received chemotherapy; others were observed. Primary end points were event-free survivals (EFS). RESULTS Of the 331 patients enrolled during 2005 to 2010, 321 eligible patients had central histopathologic review. Discordance between central review and contributing institutions occurred in 23% of patients with HRFs and in 17% of patients without HRFs. Postlaminar optic nerve involvement was present in 53 patients; 42 had massive posterior uveal invasion (≥ 3 mm); 15 had concomitant peripapillary 3 mm or greater choroid and postlaminar optic nerve involvement; and 15 had focal (< 3 mm) choroidal concomitant with lamina or prelamina optic nerve involvement. Two-year EFS for patients with HRFs requiring adjuvant chemotherapy was 0.96 (95% CI, 0.89 to 0.98), and 2-year EFS for patients without HRFs for which observation was indicated was 0.99 (95% CI, 0.96 to 1.0). The 2-year EFS for all patients was 0.98 (95% CI, 0.96 to 0.99). CONCLUSION Adequate handling and interpretation of histopathology of eyes with retinoblastoma is necessary to assign metastatic risk. Concomitant less than 3 mm choroidal and any prelaminar/laminar optic nerve invasion show no recurrence and may warrant no adjuvant chemotherapy. In contrast, concomitant greater than 3 mm peripapillary choroidal invasion and 1.5 mm or greater of postlaminar optic nerve invasion have the poorest outcomes, supporting the need for a more intensive adjuvant chemotherapy regimen for this subgroup. Strict criteria for adjuvant therapy may improve outcomes of children who undergo enucleation at diagnosis and may avoid unnecessary adjuvant chemotherapy for those who are not at risk for recurrence.

scholarly journals Role of paroxysmal depolarization in focal seizure activity

2019 ◽  
Vol 122 (5) ◽  
pp. 1861-1873 ◽  
Author(s):  
Andrew K. Tryba ◽  
Edward M. Merricks ◽  
Somin Lee ◽  
Tuan Pham ◽  
SungJun Cho ◽  
...  
Keyword(s):  
Microelectrode Array ◽  
Seizure Activity ◽  
Dual Role ◽  
Local Failure ◽  
Oscillatory Activity ◽  
Strong Increase ◽  
Focal Seizures ◽  
Array Measurements ◽  
Cellular Marker

We analyze the role of inhibition in sustaining focal epileptic seizure activity. We review ongoing seizure activity at the mesoscopic scale that can be observed with microelectrode arrays as well as at the macroscale of standard clinical EEG. We provide clinical, experimental, and modeling data to support the hypothesis that paroxysmal depolarization (PD) is a critical component of the ictal machinery. We present dual-patch recordings in cortical cultures showing reduced synaptic transmission associated with presynaptic occurrence of PD, and we find that the PD threshold is cell size related. We further find evidence that optically evoked PD activity in parvalbumin neurons can promote propagation of neuronal excitation in neocortical networks in vitro. Spike sorting results from microelectrode array measurements around ictal wave propagation in human focal seizures demonstrate a strong increase in putative inhibitory firing with an approaching excitatory wave, followed by a sudden reduction of firing at passage. At the macroscopic level, we summarize evidence that this excitatory ictal wave activity is strongly correlated with oscillatory activity across a centimeter-sized cortical network. We summarize Wilson–Cowan-type modeling showing how inhibitory function is crucial for this behavior. Our findings motivated us to develop a network motif of neurons in silico, governed by a reduced version of the Hodgkin–Huxley formalism, to show how feedforward, feedback, PD, and local failure of inhibition contribute to observed dynamics across network scales. The presented multidisciplinary evidence suggests that the PD not only is a cellular marker or epiphenomenon but actively contributes to seizure activity. NEW & NOTEWORTHY We present mechanisms of ongoing focal seizures across meso- and macroscales of microelectrode array and standard clinical recordings, respectively. We find modeling, experimental, and clinical evidence for a dual role of inhibition across these scales: local failure of inhibition allows propagation of a mesoscopic ictal wave, whereas inhibition elsewhere remains intact and sustains macroscopic oscillatory activity. We present evidence for paroxysmal depolarization as a mechanism behind this dual role of inhibition in shaping ictal activity.

Role of dactinomycin in the improved survival of children with Wilms' tumor

JAMA ◽  
1966 ◽  
Vol 195 (12) ◽  
pp. 1005-1009 ◽  
Author(s):  
D. J. Fernbach
Keyword(s):  
Wilms Tumor
Sign in / Sign up

Export Citation Format

Share Document