scholarly journals Mucoepidermoid carcinoma of the head and neck: CRTC1/3 MAML 2 translocation and its prognosticators

2021 ◽  
Author(s):  
Stijn van Weert ◽  
Birgit I. Lissenberg-Witte ◽  
Elisabeth Bloemena ◽  
C. René Leemans
Keyword(s):  
Head And Neck ◽  
Mucoepidermoid Carcinoma ◽  
Survival Benefit ◽  
Fusion Gene ◽  
Late Onset ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Distant Recurrence ◽  
Primary Diagnosis ◽  
Fish Analysis

Abstract Purpose Mucoepidermoid carcinoma (MEC) of the head and neck is a prevalent malignant salivary gland tumour with a reported good outcome. The aim of this study was to report the outcome in our centre. Methods A retrospective chart analysis with survival analyses was performed combined with fluorescence in situ hybridization (FISH) analysis to assess CRTC1/3 MAML 2 fusion gene presence. Results Sixty-four cases of MEC were identified. Median age at presentation was 51.4 years with a predominance for parotid gland involvement. Five, 10- and 20- year disease-free survival was 98%, 90% and 68%, respectively. Overall survival was 94%, 90% and 64%, respectively. Local recurrence was seen up to 14 years after primary diagnosis; distant metastases were diagnosed up to 17 years later. The overall recurrence rate was less than 20 per cent. CRTC1/3 MAML 2 fusion gene presence showed no survival benefit. Conclusion MEC of the head and neck has a favorable outcome with the exception of high-grade MEC. PNI and nodal involvement are not rare. CRTC1/3 MAML 2 fusion gene presence showed no survival benefit. The tendency for late onset of loco-regional and distant recurrence should not be underestimated.

scholarly journals Reducing Uncertainties About the Effects of Chemoradiotherapy for Cervical Cancer: A Systematic Review and Meta-Analysis of Individual Patient Data From 18 Randomized Trials

2008 ◽  
Vol 26 (35) ◽  
pp. 5802-5812 ◽  
Keyword(s):  
Cervical Cancer ◽  
Survival Benefit ◽  
Randomized Trials ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Late Toxicity ◽  
Tumor Stage ◽  
Distant Recurrence ◽  
Patient Data

BackgroundAfter a 1999 National Cancer Institute (NCI) clinical alert was issued, chemoradiotherapy has become widely used in treating women with cervical cancer. Two subsequent systematic reviews found that interpretation of the benefits was complicated, and some important clinical questions were unanswered.Patients and MethodsWe initiated a meta-analysis seeking updated individual patient data from all randomized trials to assess the effect of chemoradiotherapy on all outcomes. We prespecified analyses to investigate whether the effect of chemoradiotherapy differed by trial or patient characteristics.ResultsOn the basis of 13 trials that compared chemoradiotherapy versus the same radiotherapy, there was a 6% improvement in 5-year survival with chemoradiotherapy (hazard ratio [HR] = 0.81, P < .001). A larger survival benefit was seen for the two trials in which chemotherapy was administered after chemoradiotherapy. There was a significant survival benefit for both the group of trials that used platinum-based (HR = 0.83, P = .017) and non–platinum-based (HR = 0.77, P = .009) chemoradiotherapy, but no evidence of a difference in the size of the benefit by radiotherapy or chemotherapy dose or scheduling was seen. Chemoradiotherapy also reduced local and distant recurrence and progression and improved disease-free survival. There was a suggestion of a difference in the size of the survival benefit with tumor stage, but not across other patient subgroups. Acute hematologic and GI toxicity was increased with chemoradiotherapy, but data were too sparse for an analysis of late toxicity.ConclusionThese results endorse the recommendations of the NCI alert, but also demonstrate their applicability to all women and a benefit of non–platinum-based chemoradiotherapy. Furthermore, although these results suggest an additional benefit from adjuvant chemotherapy, this requires testing in randomized trials.

scholarly journals Hyperfractionated Radiotherapy with Concurrent Cisplatin/5-Fluorouracil for Locoregional Advanced Head and Neck Cancer: Analysis of 105 Consecutive Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
David Zaboli ◽  
Marietta Tan ◽  
Hrishikesh Gogineni ◽  
Spencer Lake ◽  
Katherine Fan ◽  
...  
Keyword(s):  
Head And Neck ◽  
Medical Center ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Female Gender ◽  
Second Primary ◽  
Advanced Head ◽  
Hyperfractionated Radiotherapy ◽  
T4 Stage ◽  
Second Primary Malignancies

Objective. We reviewed a cohort of patients with previously untreated locoregional advanced head and neck squamous cell carcinoma (HNSCC) who received a uniform chemoradiotherapy regimen.Methods. Retrospective review was performed of 105 patients with stage III or IV HNSCC treated at Greater Baltimore Medical Center from 2000 to 2007. Radiation included 125 cGy twice daily for a total 70 Gy to the primary site. Chemotherapy consisted of cisplatin (12 mg/m2/h) daily for five days and 5-fluorouracil (600 mg/m2/20 h) daily for five days, given with weeks one and six of radiation. All but seven patients with N2 or greater disease received planned neck dissection after chemoradiotherapy. Primary outcomes were overall survival (OS), locoregional control (LRC), and disease-free survival (DFS).Results. Median followup of surviving patients was 57.6 months. Five-year OS was 60%, LRC was 68%, and DFS was 56%. Predictors of increased mortality included age ≥55, female gender, hypopharyngeal primary, and T3/T4 stage. Twelve patients developed locoregional recurrences, and 16 patients developed distant metastases. Eighteen second primary malignancies were diagnosed in 17 patients.Conclusions. The CRT regimen resulted in favorable outcomes. However, locoregional and distant recurrences cause significant mortality and highlight the need for more effective therapies to prevent and manage these events.

Impact of the number of cautionary/unsuitable risk factors on outcomes following accelerated partial breast irradiation.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 146-146
Author(s):  
John Ben Wilkinson ◽  
Jessica Wobb ◽  
Chirag Shah ◽  
Ashley Fowler ◽  
Christina Mitchell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Risk Groups ◽  
Distant Recurrence ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Increased Risk ◽  
The Impact

146 Background: Current guidelines for APBI stratify appropriateness of treatment outside of a clinical trial. Limited data are available, however, regarding the impact of the number of risk factors (RFs) per patient on clinical outcomes. Methods: 692 patients were treated with APBI at a single institution between 10/1992 and 10/2011. Patients were stratified by the ASTRO guidelines as suitable, cautionary, and unsuitable. Outcomes including ipsilateral/contralateral breast tumor recurrence (IBTR/CBTR), regional recurrence (RR), distant metastases (DM), disease-free survival (DFS), cause specific survival (CSS), and overall survival (OS) were evaluated by risk group and number of RFs. Results: Median follow-up was 5.2 years (range: 0-18.3).Distribution within CP risk-groups was suitable: 240, cautionary: 343, and unsuitable: 109 patients. Increased IBTR (2.0% v. 0.6%, p=0.03), DM (6.5% v. 1.5%, p=0.02), and decreased DFS (92% v. 98%, p=0.01) were noted for patients with 2+ cautionary RFs (n=115) vs. 1 RF (n=228). Those with 2+ unsuitable RFs had higher RR (7.7% v. 1.7%, p=0.05). Pooled analysis revealed increased IBTR/RR for patients with 3+ combined cautionary/unsuitable RFs vs. 2 or fewer combined RFs (Table). Univariate analysis showed increased DM with increasing tumor size/T-stage (p<0.01), ER negativity (p=0.04), LVSI (p=0.01), + LN (p<0.01), and increasing number of RFs (p<0.01). No single RF was associated with an increased risk of local recurrence on UVA. Conclusions: Three or more cautionary or unsuitable APBI RFs is associated with higher local, regional, and distant recurrence. Patients with fewer than 3 total RFs have a 98% locoregional control at 5 years and likely remain good candidates for APBI. Future attempts to risk stratify patients may need to account for the number of RF present in order to appropriately classify patients. [Table: see text]

HER-2/neu in tissue and serum at time of primary diagnosis of breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11500-e11500 ◽  
Author(s):  
M. Dresse ◽  
D. Mayr ◽  
V. Heinemann ◽  
S. Kahlert ◽  
I. Bauerfeind ◽  
...  
Keyword(s):  
Breast Cancer ◽  
False Negative ◽  
Distant Metastases ◽  
Primary Diagnosis ◽  
Breast Cancer Tissue ◽  
Cancer Tissue ◽  
Fish Analysis ◽  
Breast Cancer Patients ◽  
Her 2 ◽  
Diagnostic Capacity

e11500 Aim: HER2 in breast cancer tissue is a marker of high prognostic and predictive relevance. Soluble HER-2, the extracellular domain of the HER-2/neu receptor which is shed into the blood, has been suggested to be a helpful tumor marker. We investigated whether there exists a relationship between the concentration of HER-2/neu Shed Antigen in serum (s-HER-2/neu) and HER- 2/neu in breast cancer tissue and whether this relationship could be used for diagnostic purposes. Patients and Methods: s-HER- 2/neu was measured at time of primary diagnosis in the pretherapeutical (presurgical) sera of 525 breast cancer patients with known HER- 2/neu-status in breast cancer tissue. 33 of the patients (6,3%) revealed to have distant metastases (M1). The HER-2/neu- status in tumor tissue was determined by immunhistochemistry, followed by subsequent FISH analysis in case of score 2+. Dako-Score 3+ or 2+ and geneamplification in FISH analysis were regarded as HER-2/neu-positive. HER-2/neu shed antigen was analysed by Immunoassay. Results: For patients without distant metastases (M0) as well as patients with distant metastases (M1) we observed a correlation of s-HER-2/neu with HER-2/neu-status. The median s-HER-2/neu-concentrations were 11.7 ng/ml (13.2 ng/ml) for the HER-2/neu-negative resp. -positive patients in the M0 group (p<0,001) and 11.9 ng/ml (16,0 ng/ml) in the M1 group (p=0,01). In 492 M0-patients we performed a ROC-analysis in order to investigate the diagnostic capacity of s-HER-2/neu concerning its predictive value for the HER-2/neu-status: using a cut off value of 30 ng/ml the HER-2/neu-status was always positive, corresponding to a specificity of 100% and a sensitivity of 7.7 %. Conclusions: There is a correlation between high s-HER-2/neu-values and a positive HER-2/neu-status. Pretherapeutical s-HER- 2/neu-values ≥30 ng/ml were only observed in HER-2/neu-positive patients. HER-2/neu shed antigen in serum can add up to the HER-2/neu-status and might reveal false-negative tissue findings. [Table: see text]

scholarly journals Investigation of Recurrent Cases of Head and Neck Cancer after Initial Treatment

2019 ◽  
Vol 02 (01) ◽  
pp. e11-e17
Author(s):  
Ryosuke Kitoh ◽  
Kentaro Mori ◽  
Shin-ichi Usami
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Clinical Examination ◽  
Neck Cancer ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Primary Treatment ◽  
Regional Recurrence ◽  
Pet Ct

AbstractThe optimal follow-up strategy for patients with head and neck cancer after primary treatment is still under debate. This study aimed to review the data of patients with recurrence and evaluate our follow-up strategy. Patients with head and neck cancer who underwent surgery or chemoradiotherapy as the primary treatment between 2012 and 2016 were enrolled. All the patients were carefully followed up at our institution via intensive clinical examination and routine computed tomography (CT) and positron emission tomography (PET)/CT. Recurrence was detected in 20 of the patients treated by surgery and 25 of 96 patients treated by chemoradiotherapy. In more than 90% of the patients, recurrence occurred within 2 years of the primary treatment. Among the patients with recurrence, 11 showed local recurrence, 17 showed regional recurrence, and 17 others showed distant metastasis. In almost all patients with distant metastases, recurrence was detected using CT or PET/CT, whereas among the patients with local or regional recurrence, recurrence was detected based on the patients' complaints and their clinical examination results. Only salvage surgery was observed to be associated with disease-free survival after recurrence. Thus, analysis of the recurrence patterns and appropriate surveillance can result in improved salvage treatment for patients with recurrence.

scholarly journals Long-term oncologic outcomes of transanal TME compared with transabdominal TME for rectal cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jae Young Moon ◽  
Min Ro Lee ◽  
Gi Won Ha
Keyword(s):  
Rectal Cancer ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Distant Recurrence ◽  
Oncologic Outcomes ◽  
Cochrane Library ◽  
Transanal Total Mesorectal Excision ◽  
Random Effects Models ◽  
The Cochrane Library

Abstract Background Transanal total mesorectal excision (TaTME) appears to have favorable surgical and pathological outcomes. However, the evidence on survival outcomes remains unclear. We performed a meta-analysis to compare long-term oncologic outcomes of TaTME with transabdominal TME for rectal cancer. Methods PubMed, EMBASE, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random-effects models. Outcome measures were overall survival (OS), disease-free survival (DFS), and local and distant recurrence. Results We included 11 nonrandomized studies that examined 2,143 patients for the meta-analysis. There were no significant differences between the two groups in OS, DFS, and local and distant recurrence with a RR of 0.65 (95% CI 0.39–1.09, I2 = 0%), 0.79 (95% CI 0.57–1.10, I2 = 0%), 1.14 (95% CI 0.44–2.91, I2 = 66%), and 0.75 (95% CI 0.40–1.41, I2 = 0%), respectively. Conclusion In terms of long-term oncologic outcomes, TaTME may be an alternative to transabdominal TME in patients with rectal cancer. Well-designed randomized trials are warranted to further verify these results.

scholarly journals Interleukin-33-Enhanced CXCR4 Signaling Circuit Mediated by Carcinoma-Associated Fibroblasts Promotes Invasiveness of Head and Neck Cancer

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3442
Author(s):  
Yu-Chun Lin ◽  
Wen-Yen Huang ◽  
Tsai-Yu Lee ◽  
Yi-Ming Chang ◽  
Su-Feng Chen ◽  
...  
Keyword(s):  
Head And Neck ◽  
Cancer Cell ◽  
Cancer Progression ◽  
Molecular Mechanisms ◽  
Disease Free Survival ◽  
Interleukin 33 ◽  
Cxcr4 Signaling ◽  
Regulatory Circuit ◽  
Carcinoma Associated Fibroblasts ◽  
Self Production

Despite recent advances, treatment for head and neck squamous cell carcinoma (HNSCC) has limited efficacy in preventing tumor progression. We confirmed previously that carcinoma-associated fibroblasts (CAF)-induced interleukin-33 (IL-33) contributed to cancer progression. However, the molecular mechanisms underlying the complex communication network of the tumor microenvironment merited further evaluation. To simulate the IL-33-induced autocrine signaling, stable clones of IL-33-overexpressing HNSCC cells were established. Besides well-established IL-33/ST2 and SDF1/CXCR4 (stromal-derived factor 1/C-X-C motif chemokine receptor 4) signaling, the CAF-induced IL-33 upregulated CXCR4 via cancer cell induction of IL-33 self-production. The IL-33-enhanced-CXCR4 regulatory circuit involves SDF1/CXCR4 signaling activation and modulates tumor behavior. An in vivo study confirmed the functional role of IL-33/CXCR4 in tumor initiation and metastasis. The CXCR4 and/or IL-33 blockade reduced HNSCC cell aggressiveness, with attenuated invasions and metastases. Immunohistochemistry confirmed that IL-33 and CXCR4 expression correlated significantly with disease-free survival and IL-33-CXCR4 co-expression predicted a poor outcome. Besides paracrine signaling, the CAF-induced IL-33 reciprocally enhanced the autocrine cancer-cell self-production of IL-33 and the corresponding CXCR4 upregulation, leading to the activation of SDF1/CXCR4 signaling subsequent to cancer progression. Thus, targeting the IL-33-enhanced-CXCR4 regulatory circuit attenuates tumor aggressiveness and provides a potential therapeutic option for improving the prognosis in HNSCC patients.

scholarly journals Clinical significance of tumor-stroma ratio in head and neck cancer: a systematic review and meta-analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alhadi Almangush ◽  
Rasheed Omobolaji Alabi ◽  
Giuseppe Troiano ◽  
Ricardo D. Coletta ◽  
Tuula Salo ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Clinical Significance ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Tumor Stroma ◽  
Free Survival ◽  
Hematoxylin And Eosin ◽  
Meta Analyses

Abstract Background The clinical significance of tumor-stroma ratio (TSR) has been examined in many tumors. Here we systematically reviewed all studies that evaluated TSR in head and neck cancer. Methods Four databases (Scopus, Medline, PubMed and Web of Science) were searched using the term tumo(u)r-stroma ratio. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. Results TSR was studied in nine studies of different subsites (including cohorts of nasopharyngeal, oral, laryngeal and pharyngeal carcinomas). In all studies, TSR was evaluated using hematoxylin and eosin staining. Classifying tumors based on TSR seems to allow for identification of high-risk cases. In oral cancer, specifically, our meta-analysis showed that TSR is significantly associated with both cancer-related mortality (HR 2.10, 95%CI 1.56–2.84) and disease-free survival (HR 1.84, 95%CI 1.38–2.46). Conclusions The assessment of TSR has a promising prognostic value and can be implemented with minimum efforts in routine head and neck pathology.

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