Laryngeal cancer management in a small, rural, multidisciplinary team setting: 15-year review

AbstractBackground:The Cumberland Infirmary, Carlisle, serves a largely remote, rural population of 330 000. The aim of this study was to report the treatment and survival figures for patients treated for laryngeal cancer at this centre.Methods:The study included 209 consecutive patients with squamous cell carcinoma of the larynx diagnosed between 1996 and 2010 at the Cumberland Infirmary.Results:Disease-specific survival was 100 per cent for stage one, 76 per cent for stage two, 87 per cent for stage three and 46 per cent for stage four. In total, 76 patients (36 per cent) had a laryngectomy, either as primary treatment or as a salvage procedure.Conclusion:Our tumour-specific survival rate was very high, and this success may be due in part to high rates of surgical intervention. Survival data compared favourably with other centres, despite less radical radiotherapy regimes. Laryngeal cancer can be managed effectively in a small, relatively remote, multidisciplinary team setting.

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Sinonasal mucosal melanoma: treatment strategies and survival rates for a rare disease entity

Wiener klinische Wochenschrift ◽

10.1007/s00508-021-01847-6 ◽

2021 ◽

Author(s):

Alexandros Andrianakis ◽

Peter Kiss ◽

Markus Pomberger ◽

Axel Wolf ◽

Dietmar Thurnher ◽

...

Keyword(s):

Rare Disease ◽

Survival Data ◽

Survival Rates ◽

Delayed Diagnosis ◽

Distant Metastases ◽

Primary Treatment ◽

Mucosal Melanoma ◽

Disease Entity ◽

Improve Outcome ◽

Initial Symptoms

Summary Background Sinonasal mucosal melanoma (SNMM) is a rare disease entity comprising 0.4–1.3% of all melanomas. Surgery with free margins has been the primary treatment over decades. Neither the addition of radiotherapy nor chemotherapy could significantly improve outcome rates of this devastating malignancy. This study presents our clinical experience with SNMM over a 19-year period and summarizes the current body of literature on SNMM. Methods This retrospective analysis included 12 patients with SNMM treated from 2001 to 2019 at an academic center. Additionally, a literature review of the last 29 years on treatment and survival data of SNMM was conducted. Results Main initial symptoms were epistaxis and nasal obstruction. Of the patients 9 underwent endoscopic surgery, 6 received adjuvant therapy. 3 patients who did not undergo surgery, received chemoradiotherapy, radiotherapy alone, and chemotherapy alone, respectively. At the time of diagnosis 2 patients had distant metastases and 4 patients developed distant metastases during the course of the disease. Mean overall survival (OS) was 30.6 months, 3‑year and 5‑year OS were 25%, and 18.2%, respectively. Conclusion Unspecific symptoms and hidden anatomic locations lead to delayed diagnosis and increased rates of metastatic dissemination. Distant metastasis is the main treatment failure in SNMM. Surgery with free margins remains the primary treatment for SNMM. Adjuvant radiotherapy might improve local control in individual cases but efficient systemic therapy is needed to improve outcome rates. To evaluate and define more effective targeted treatment options and improve outcome rates, homogeneous data and prospective multicentric analysis are needed.

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Successful Treatment of Graves Disease in Pregnancy with Lugol's Iodine

Scottish Medical Journal ◽

10.1177/003693300004500107 ◽

2000 ◽

Vol 45 (1) ◽

pp. 20-21 ◽

Cited By ~ 1

Author(s):

A. Jamieson ◽

C.G. Semple

Keyword(s):

Drug Therapy ◽

Successful Treatment ◽

Surgical Intervention ◽

Antithyroid Drug ◽

Primary Treatment ◽

Graves Disease ◽

Lugol’S Iodine ◽

Organic Iodine ◽

Antithyroid Drug Therapy ◽

In Pregnancy

We report a case of Grave's disease in pregnancy complicated by intolerance of standard antithyroid drug therapy. We describe the success of prolonged use of organic iodine as a primary treatment prior to surgical intervention.

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Case-based review: conservative management of appendicitis – are we delaying the inevitable?

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13171221590296 ◽

2012 ◽

Vol 94 (4) ◽

pp. 232-234 ◽

Cited By ~ 6

Author(s):

S Davies ◽

A Peckham-Cooper ◽

A Sverrisdottir

Keyword(s):

Acute Appendicitis ◽

Conservative Management ◽

Surgical Intervention ◽

Primary Treatment ◽

Spontaneous Resolution ◽

Primary Treatment Modality ◽

Uncomplicated Appendicitis ◽

Recurrent Appendicitis ◽

Appendiceal Inflammation ◽

Surgical Presentation

Acute appendicitis is a common surgical presentation for which surgical intervention, an appendicectomy, has remained a largely unchallenged primary treatment modality. Traditionally, it has been felt that the pathophysiological progressive nature of appendicitis ultimately leads to perforation. A number of recent studies, however, suggest that the process of appendiceal inflammation may follow a more remitting nature with evidence indicating spontaneous resolution. It is hypothesised that the treatment of uncomplicated appendicitis may therefore be amenable to conservative management with antibiotics. This article aims to highlight some of the issues and challenges relating to the conservative management of acute appendicitis and further demonstrates potential diagnostic and treatment difficulties involved in managing the more unfamiliar condition of recurrent appendicitis.

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