R406 – Treatment of Squamous Cell Carcinoma of the Hypopharynx

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P179-P179
Author(s):  
Helma Maria Chedid ◽  
Carlos Neutzling Lehn

Problem Squamous cell carcinoma of the hypopharynx has been diagnosed at a late stage, including in developed countries, thus denoting worse prognosis. An association between surgery and radiotherapy is the standard treatment for advanced clinical stages. Our aim was to assess the clinical and treatment factors of tumors of the hypopharynx that were treated surgically and with postoperative radiotherapy. Methods This was a retrospective study on 174 patients, among whom two patients were in clinical stage (CS) I, four in CS II, 46 in CS III, and 122 in CS IV. Among these, 222 neck dissections were performed, of which 48 were bilateral. Statistic analysis: Kaplan-Meier methods. Results The mean follow-up was 31 months, and histological examinations showed that two patients were pT1, 15 pT2, 100 pT3 and 57 pT4. With regard to lymph nodes, 25 patients were pN0 and 149 patients were pN+. The disease-free survival in CS III was 75%, versus 28% in CS IV (p=0.001). The disease-free survival was 35% and the overall survival was 28%. Conclusion Surgical treatment for tumors of the hypopharynx occurred in advanced CS, with disease-free survival of 35%. Significance The overall survival and disease free-survival among patients with squamous cell carcinoma of the hypopharynx undergoing surgery.

OTO Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 2473974X1987507
Author(s):  
Kevin J. Kovatch ◽  
Joshua D. Smith ◽  
Andrew C. Birkeland ◽  
John E. Hanks ◽  
Rasha Jawad ◽  
...  

Objectives To report our institutional experience, management, and outcomes of cutaneous periauricular squamous cell carcinoma (SCC). Study Design Retrospective chart review. Setting Tertiary academic center. Subjects Patients undergoing treatment of cutaneous periauricular SCC from 2000 to 2016. Results A total of 112 patients had a median follow-up of 24.5 months, a mean ± SD age of 75.7 ± 10.6 years, and a strong male predominance (93.8%). Site distribution shows 87 (77.7%) auricular, 26 (23.2%) preauricular, and 10 (8.8%) postauricular lesions. Of auricular lesions, tumors involved the tragus (n = 3, 3.4%), helix/antihelix (n = 47, 54.0%), conchal bowl (n = 31, 35.6%), external auditory canal (n = 18, 16.1%), and lobule (n = 3, 3.4%). Most patients presented at stage I (52.7%) versus stages II (28.6%), III (6.3%), and IV (12.5%). Patients were largely treated surgically with primary tumor resection ranging from wide local excision to lateral temporal bone resection (± parotidectomy and neck dissection), with 17.0% and 5.4% receiving adjuvant radiation and chemoradiation, respectively. Metastatic spread was seen to the parotid (25.9%) and neck (26.8%), with most common cervical spread to level II. Overall survival, disease-specific survival, and disease-free survival at 3 years were 62%, 89%, and 56%, respectively. Nodal disease was associated with worse disease-specific survival ( P < .001) and disease-free survival ( P = .042). Pre- and postauricular sites were associated with worse overall survival ( P = .007) relative to auricular sites. Conclusion Among cutaneous SCC, periauricular subsites pose treatment challenges related to surrounding anatomy and represent a unique tumor population. The reported propensity toward recurrence and patterns of metastasis may better guide treatment of aggressive tumors to include regional nodal dissection.


2021 ◽  
Vol 28 (2) ◽  
pp. 1354-1365
Author(s):  
Chien-Ming Lo ◽  
Yu-Ming Wang ◽  
Yen-Hao Chen ◽  
Fu-Min Fang ◽  
Shun-Chen Huang ◽  
...  

Objective: For patients with esophageal squamous cell carcinoma, preoperative chemoradiotherapy followed by planned esophagectomy is used as a curative treatment modality. However, the impact of radiotherapy dose remains undefined. Method: A total of 141 patients with stage III esophageal squamous cell carcinoma (ESCC; as defined by the 7th American Joint Committee on Cancer), receiving preoperative chemoradiotherapy followed by esophagectomy between 2000 and 2015 at Kaohsiung Chang Gung Memorial Hospital, Taiwan, were retrospectively reviewed. The radiotherapy dose of preoperative chemoradiotherapy (36 Gy before 2009 and 50–50.4 Gy after 2009) and other clinicopathological parameters were collected and correlated with the response to chemoradiotherapy and treatment outcome. Result: Of these 141 patients, the radiotherapy dose was 36 Gy in 59 (42%) patients and 50 Gy in 82 (58%) patients. A complete pathological response was noted in 12 (20%) of 59 patients receiving 36 Gy radiotherapy, and 37 (45%) of 82 patients receiving 50 Gy radiotherapy (p = 0.002). The three-year overall survival and disease-free survival rates were 31% and 25% in patients receiving 36 Gy radiotherapy, and 54% and 46% in patients receiving 50–50.4 Gy radiotherapy, respectively (p = 0.023 for overall survival; p = 0.047 for disease-free survival). Multivariate analysis showed that a higher radiotherapy dose was associated with increased pathological complete response (p = 0.003, hazard ratio: 3.215), better overall survival (p = 0.024, hazard ratio: 1.585), and superior disease-free survival (p = 0.049, hazard ratio: 1.493). However, higher radiotherapy doses revealed more surgical complications, including acute respiratory distress syndrome (p = 0.048) and anastomosis leaks (p = 0.004). Conclusion: For patients with locally advanced ESCC, preoperative chemoradiotherapy with higher radiotherapy doses led to increased pathologic complete response rates and improved survival.


1997 ◽  
Vol 15 (9) ◽  
pp. 3111-3120 ◽  
Author(s):  
P Hirvikoski ◽  
E Kumpulainen ◽  
J Virtaniemi ◽  
R Johansson ◽  
H Haapasalo ◽  
...  

PURPOSE To investigate the prognostic significance of p53 expression and proliferation markers in primary laryngeal squamous cell carcinoma. PATIENTS AND METHODS Primary tumors for analyses were obtained from 103 patients, with complete follow-up data. All patients were treated between the years 1975 and 1990. The expression of p53 was analyzed with monoclonal D07 antibody and proliferative activity with Ki-67 (MIB-1) and PCNA (monoclonal 19A2) antibodies. Volume corrected mitotic (M/V) index and histological grade were determined in hematoxylin and cosin-stained slides. RESULTS Sixty-eight percent of the tumors overexpressed p53. During a median follow-up of 62 months, 41 (40%) of patients relapsed. In univariate analysis site of the primary tumor, stage, p53 expression, histologic grade, and M/V index were significant predictors of disease-free survival. In multivariate analysis, only M/V index was a statistically significant predictor of disease-free survival. Overall survival was significantly better for those overexpressing p53 (10-year cumulative survival rate 68% v 44%, P = .004). In multivariate analysis, M/ V index (P = .02), p53 (P = .02), and stage (P = .007) were statistically significant predictors of overall survival. When this analysis includes stratification according to the type of treatment received, M/V index (P = .007), stage (P = .0002), and p53 (P = .006) were even more significant predictors of overall survival. No association between p53 status and proliferative activity was found. CONCLUSION Overexpression of p53 is associated with favorable disease-free and overall survival in laryngeal squamous cell carcinoma. It may also have an independent prognostic value in laryngeal cancer. M/V index, p53 overexpression, and stage predict with significant accuracy the 10-year overall survival.


2018 ◽  
Vol 132 (12) ◽  
pp. 1102-1109
Author(s):  
S M Adnan Ali ◽  
S Naeem ◽  
Y Mirza ◽  
N Zahid ◽  
M S Awan

AbstractObjectiveIn Pakistan, oral cancer ranks as the most common malignancy in males and the second most common malignancy in females. Cyclooxygenase-2 has been explored as an agent of carcinogenesis in oral and other neoplasms. This study aimed to observe the expression of cyclooxygenase-2 in oral squamous cell carcinoma, and to correlate the expression with patients’ clinical features and overall and disease-free survival.MethodsImmunohistochemistry for cyclooxygenase-2 was performed on a total of 100 oral squamous cell carcinoma formalin-fixed, paraffin-embedded blocks. Expression was correlated with patients’ clinicopathological variables and overall and disease-free survival.ResultsCyclooxygenase-2 was overexpressed in 55 per cent of oral squamous cell carcinoma patients. Overexpression was correlated with overall survival (p = 0.013) and disease-free survival (p = 0.001) on univariate analysis. However, on multivariate analysis, cyclooxygenase-2 was associated with only disease-free survival (p = 0.044) and not overall survival (p = 0.208).ConclusionExpression of cyclooxygenase-2 is associated with poorer overall survival and higher rates of recurrence in oral squamous cell carcinoma patients.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Huang ◽  
Xiang Wang ◽  
Xue Zhang ◽  
Weijie Chen ◽  
Lijuan Luan ◽  
...  

In the present study, we aimed to investigate the clinical and prognostic values of CDK4 amplification and improve the risk stratification in patients with esophageal squamous cell carcinoma. CDK4 amplification was analyzed by fluorescence in situ hybridization using tissue microarray consisting of representative tissues of 520 patients with esophageal squamous cell carcinoma, and its correlation with clinicopathological features and clinical outcomes were evaluated. CDK4 amplification was found in 8.5% (44/520) of patients with esophageal squamous cell carcinoma. CDK4 amplification was negatively correlated with disease progression (P = 0.003) and death (P = 0.006). Patients with CDK4 amplification showed a significantly better disease-free survival (P = 0.016) and overall survival (P = 0.023) compared with those patients without CDK4 amplification. When patients were further stratified into I–II stage groups and III–IV stage groups, CDK4 amplification was significantly associated with both better disease-free survival (P = 0.023) and overall survival (P = 0.025) in the I–II stage group rather than the III–IV stage group. On univariate and multivariate analysis, invasive depth and CDK4 amplification were associated with disease-free survival and overall survival. Taken together, CDK4 amplification was identified as an independent prognostic factor for survival, which could be incorporated into the tumor–node–metastasis staging system to refine risk stratification of patients with esophageal squamous cell carcinoma.


2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 33-33
Author(s):  
Kenichi Kamachi ◽  
Soji Ozawa ◽  
Akihito Kazuno ◽  
Hiroyasu Makuuchi ◽  
Junya Oguma ◽  
...  

33 Background: Elevated neutrophil to lymphocyte ratio (NLR) reflects patients’ inflammation status and closely relates to tumor progression. The aim of this study was to evaluate the clinical significance of the preoperative NLR in patients who undergo an esophagectomy for esophageal squamous cell carcinoma. Methods: A total of 340 patients who underwent an esophagectomy for esophageal squamous cell carcinoma between 2003 and 2008 were retrospectively reviewed. The NLR ≥ 3 was considered to be elevated and the patients were divided into two groups. The overall and disease-free survival curves of the two NLR groups were determined using the Kaplan-Meier method and were compared using a log-rank test. A cox proportional hazards regression analysis was used for the univariate and multivariate analyses. Results: The study included 306 males and 34 females. Seventy-two patients (21%) had an elevated NLR. The 5-year overall survival for patients with high NLR was significantly worse than that for patients with normal NLR (41% vs 69%, p < 0.001). The 5-year disease-free survival for patients with high NLR was significantly worse than that for patients with normal NLR (41% vs 59%, p < 0.001). In multivariate analysis, a high NLR (HR 1.76, 95% CI 1.19-2.60, p = 0.005), an upper tumor location (HR 1.97, 95% CI 1.18-3.30, p = 0.010), an advanced T stage (HR 2.71, 95% CI 1.70-4.31, p < 0.001), and a larger number of metastatic lymph nodes (HR 4.38, 95% CI 1.18-3.30, p < 0.001) were independent predictors of poor overall survival. Conclusions: Our results suggested that the elevated preoperative NLR predicts poor overall and disease-free survival after an esophagectomy for esophageal squamous cell carcinoma.


2019 ◽  
Vol 160 (6) ◽  
pp. 1042-1047 ◽  
Author(s):  
Alvaro Sánchez Barrueco ◽  
Fernando González Galán ◽  
José Miguel Villacampa Aubá ◽  
Gonzalo Díaz Tapia ◽  
Sofía Fernández Hernández ◽  
...  

Objective (1) To identify p16 protein in laryngeal squamous cell carcinoma (LSCC) specimens and to correlate it with the presence of human papillomavirus (HPV) found in these specimens from a previous study. (2) To analyze p16 impact on 10-year overall and disease-free survival. Study Design Retrospective case series with oncologic database chart review. Setting Academic tertiary care hospital. Subjects A total of 123 samples of LSCC (taken from the glottis only) from patients treated with primary surgical resection between 1977 and 2005. Methods p16 protein expression was analyzed through immunohistochemistry and compared with the presence of HPV established in our previous studies. Results were compared with histologic, clinicopathologic, and survival parameters, with a 10-year follow-up. Results Of the samples, 39.02% were positive for p16, but only 11.38% were positive for both p16 and HPV. The p16+ cohort showed a significant improvement in disease-free survival ( P = .0022); statistical significance was not achieved for overall survival. p16+ cases had fewer relapses over time, with no relapses after a 2-year follow-up. Age at the time of diagnosis and tobacco consumption were the only epidemiologic factors that influenced overall survival. Conclusion The expression of p16 protein was a beneficial prognostic factor for disease-free survival among patients with LSCC of the glottis, with no relapses after a 2-year follow-up.


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