Small Cell Carcinoma in the Head and Neck

2019 ◽  
Vol 128 (11) ◽  
pp. 1006-1012 ◽  
Author(s):  
Takahiro Wakasaki ◽  
Ryuji Yasumatsu ◽  
Muneyuki Masuda ◽  
Mioko Matsuo ◽  
Akihiro Tamae ◽  
...  
Keyword(s):  
Head And Neck ◽  
Distant Metastasis ◽  
Radical Surgery ◽  
Survival Rates ◽  
Observation Time ◽  
Small Cell ◽  
Response To Treatment ◽  
Treatment Modalities ◽  
Disease Entities ◽  
Stage Ivb

Objectives: Small cell carcinomas in extrapulmonary sites (ESmCCs) are very rare. ESmCCs originating in the head and neck account for approximately 10% of all ESmCCs, and there are few reports about this disease. ESmCCs have an aggressive natural history characterized by widespread metastasis. The aim of this study was to investigate the characteristics and outcomes of patients with ESmCCs of the head and neck. Methods: The outcomes of 21 patients with ESmCCs of the head and neck treated between January 2001 and December 2015 at the authors’ hospital and associated facilities were reviewed. Results: There were 18 men and 3 women, and the median age was 74 years (range, 53-91 years). The tumor site was the larynx in 6 patients; the paranasal sinus in 5; the hypopharynx in 3; the oropharynx in 2; the nasopharynx in 2; and the oral cavity, salivary gland, and primary unknown in 1 patient each. The extent of the disease was staged as follows: stage I or II, 3 cases; stage III, 4 cases; stage IVA, 9 cases; stage IVB, 1 case; and stage IVC, 4 cases. The median observation time was 17 months (range, 1-103 months). Four patients (19%) had distant metastasis at initial treatment, and 13 patients (62%) developed distant metastasis within 3 years. Treatments were administered, including radical surgery (9 patients), radiation therapy (5 patients), chemoradiotherapy (7 patients), and chemotherapy (6 patients). The 1- and 3-year overall survival rates of patients were 56% and 37%, respectively. More than half of the patients died of distant metastasis. Conclusions: ESmCCs of the head and neck have a poor prognosis, similar to those of carcinomas in many other sites. Control of distant metastasis would contribute to improving the prognosis of ESmCCs of the head and neck. Further studies are required for better understanding these disease entities and their response to treatment modalities.

Extrapulmonary small cell carcinoma in head and neck

2015 ◽  
Vol 129 (S2) ◽  
pp. S83-S85 ◽  
Author(s):  
R Yasumatsu ◽  
T Nakashima ◽  
M Yamauchi ◽  
S Toh ◽  
S Komune
Keyword(s):  
Cell Carcinoma ◽  
Head And Neck ◽  
Small Cell Carcinoma ◽  
Neck Region ◽  
Small Cell ◽  
Response To Treatment ◽  
Treatment Modalities ◽  
Head And Neck Region ◽  
Disease Entities ◽  
Extrapulmonary Small Cell Carcinoma

AbstractPurpose:The management of extrapulmonary small cell carcinoma has not been standardised to date. This study reviewed the clinical course, management and survival outcomes of patients with extrapulmonary small cell carcinoma in the head and neck region.Methods:Nine patients with extrapulmonary small cell carcinoma in the head and neck were included in this study.Results:Five patients received radical surgery followed by adjuvant chemotherapy or radiotherapy or both. Two other patients were treated with chemotherapy consisting of CPT11 plus cisplatin or CPT11 plus cisplatin plus VP-16 three times. Two other patients received chemoradiotherapy consisting of S-1 or CPT11 plus cisplatin. The median overall survival was 14.5 months, with a three-year survival rate of 23.7 per cent.Conclusions:The prognosis of extrapulmonary small cell carcinoma is generally poor. Further prospective multicentre studies are required for better understanding of disease entities and response to treatment modalities.

Concurrent Hyperfractionated Radiotherapy and Low-Dose Daily Carboplatin and Paclitaxel in Patients With Stage III Non–Small-Cell Lung Cancer: Long-Term Results of a Phase II Study

2005 ◽  
Vol 23 (6) ◽  
pp. 1144-1151 ◽  
Author(s):  
Branislav Jeremic ◽  
Biljana Milicic ◽  
Ljubisa Acimovic ◽  
Slobodan Milisavljevic
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Distant Metastasis ◽  
Low Dose ◽  
Survival Rates ◽  
Small Cell ◽  
High Grade ◽  
Small Cell Lung ◽  
Free Survival ◽  
Local Progression

PurposeTo investigate the feasibility and activity of hyperfractionated radiation therapy (Hfx RT) and concurrent chemotherapy (CT) consisting of low-dose, daily carboplatin and paclitaxel in patients with stage III non–small-cell lung cancer (NSCLC).Patients and MethodsSixty-four patients started their treatment on day 1 with 30 mg/m2of paclitaxel administered by 1-hour infusion. Hfx RT began on day 2 using 1.3 Gy bid to a total dose of 67.6 Gy and concurrent low-dose daily CT consisting of 25 mg/m2of carboplatin and 10 mg/m2of paclitaxel, both given Mondays to Fridays during RT course.ResultsObjective response rate was 83% and included complete response in 27 patients (42%) and partial response in 26 patients (41%). Ten patients (16%) had stable disease, whereas only one patient (2%) had progressive disease. The median survival time was 28 months, and 3- and 5-year survival rates were 37% and 26%, respectively. The median time to local progression was 26 months, and 3- and 5-year local progression-free survival rates were 37% and 33%, respectively. The median time to distant metastasis was 25 months, and 3- and 5- year distant metastasis-free survival rates were 37% and 31%, respectively. Acute high-grade (≥ grade 3) toxicity was hematologic (25%), esophageal (17%), bronchopulmonary (13%), and skin (9%). Late high-grade toxicity was infrequent.ConclusionThis combined Hfx RT/TC regimen produced results that are among the best ever reported and warrants further study in a prospective randomized fashion.

Neuroendocrine Carcinomas of the Upper Airways: A Small Case Series with Histopathological Considerations

2007 ◽  
Vol 93 (5) ◽  
pp. 499-503 ◽  
Author(s):  
Marco Capelli ◽  
Giulia Bertino ◽  
Patrizia Morbini ◽  
Chiara Villa ◽  
Stefano Zorzi ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Head And Neck ◽  
Small Cell Carcinoma ◽  
Radical Surgery ◽  
Neck Region ◽  
Small Cell ◽  
Upper Airways ◽  
Head And Neck Region ◽  
Poorly Differentiated ◽  
Neuroendocrine Carcinomas

Neuroendocrine carcinomas are rare tumors. In the head and neck region they are most common in the larynx, where they represent 0.5-1% of epithelial cancers. Diagnosis requires the recognition of the typical neuroendocrine architecture and morphology and the immunohistochemical confirmation of neuroendocrine differentiation. In the 1991 WHO classification laryngeal neuroendocrine carcinomas have been divided into carcinoids, atypical carcinoids, small cell carcinomas and paragangliomas. Atypical carcinoids in the head and neck region usually show an aggressive behavior analogous to poorly differentiated carcinomas, and are resistant to chemo- and radiotherapy. For this reason, it was recently proposed to change their designation to “moderately differentiated neuroendocrine carcinomas”. We present the clinical and histopathological features of 2 moderately differentiated neuroendocrine carcinomas of the larynx, one large cell poorly differentiated neuroendocrine carcinoma of the oropharynx, and one small cell carcinoma of the minor salivary glands of the tongue. The patient with small cell carcinoma was free from disease 26 months after radical surgery, while the other patients showed liver, lung and bone metastases 18, 26 and 24 months after the diagnosis despite radical surgery or concomitant intra-arterial chemotherapy and radiotherapy.

scholarly journals Cancer Stem Cell Markers in Head and Neck Squamous Cell Carcinoma

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Aidan G. Major ◽  
Luke P. Pitty ◽  
Camile S. Farah
Keyword(s):  
Squamous Cell Carcinoma ◽  
Stem Cell ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Survival Rates ◽  
Neck Squamous Cell Carcinoma ◽  
Treatment Modalities ◽  
Stem Cell Markers ◽  
Cancer Stem Cell Markers

Head and neck squamous cell carcinoma (HNSCC) is one of the world’s top ten most common cancers. Current survival rates are poor with only 50% of patients expected to survive five years after diagnosis. The poor survival rate of HNSCC is partly attributable to the tendency for diagnosis at the late stage of the disease. One of the reasons for treatment failure is thought to be related to the presence of a subpopulation of cells within the tumour called cancer stem cells (CSCs). CSCs display stem cell-like characteristics that impart resistance to conventional treatment modalities and promote tumour initiation, progression, and metastasis. Specific markers for this population have been investigated in the hope of developing a deeper understanding of their role in the pathogenesis of HNSCC and elucidating novel therapeutic strategies.

scholarly journals Head and Neck Cancer a Single Institution Experience: King Abdulaziz University

2015 ◽  
Vol 22 (3) ◽  
pp. 9-17
Author(s):  
Rolina K Al-Wassia ◽  
Nisreen A. Awad ◽  
Shadi S. Al-Khayyat ◽  
Atlal M. Abusanad ◽  
Hani Z. Al-Marzouki ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Survival Rates ◽  
Treatment Modalities ◽  
Clinical Practices ◽  
Hospital Data ◽  
Intensity Modulated ◽  
Regional Control

The purpose of this study is to assess the loco-regional control and overall survival in head and neck cancer patients, as well as evaluate the clinical benefit of intensity-modulated radiotherapy implemented in 2011 at our Hospital. Data of 117 patients between 2007 and 2014 was reviewed retrospectively. Cumulative survival and disease control rates were calculated by Kaplan-Meier product-limit actuarial method. Loco-regional control and survival rates for intensity modulated and three-dimensional conformal radiotherapy were compared by a logistic regression test. After a median follow-up of 12 months, 53 (51%) patients who underwent radical radiotherapy were free of disease, 43 (42%) with disease, and seven (7%) unknown. During this time, 31 (26%) patients died from the disease. Using actuarial estimates for the two-year follow-up, this study found that significant gains in survival were obtained by switching treatment modalities. The benchmarking gives reassurance that our results are comparable to the best clinical practices internationally.  

Clinicopathologic predictors of distant metastasis in head and neck cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6086-6086
Author(s):  
F. C. Holsinger ◽  
W. Dong ◽  
N. Bekele ◽  
R. S. Weber ◽  
M. S. Kies ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Distant Metastasis ◽  
Proportional Hazards ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Primary Presentation

6086 Background: Despite advances in achieving improved locoregional control for patients with head and neck cancer (HNC), overall survival has not improved in the last 30 years. Several studies have implicated distant metastasis as a potential cause, hindering progress in the treatment of HNC. However, little is known about which patients fail systemically. We therefore sought to identify clinico-pathological factors that are associated with distant metastasis as the only cite of failure. Methods: We retrospectively studied 389 patients with head neck squamous cell carcinomas with distant metastases as the primary site of failure excluding all patients with locoregional recurrence and those receiving chemotherapy at primary presentation. The median follow up period was 5.3 years. An estimate of the risk of DM and DM free survival by prognostic factors was calculated using multivariate analysis and Cox proportional modeling. Results: Overall, 11% (43/389) of the patients developed DM. With univariate analysis, site of the tumor arising within the laryngopharynx, T stage (T3–4), N stage>2, and metastasis to level IV were significantly associated with DM. However, using Cox proportional hazards regression modeling, two clinicopathologic variables, N classification >N2b and diminishing degree of histologic differenention, were found to be most significantly associated with the development of systemic, distant metastasis. For patients staged as N2b or N2c, there was a relative risk (RR) of 6.13 (95% CI: 2.61 - 14.38; p < 0.0001) for developing DM. For patients staged as N3, the RR was 8.23 (95% CI: 2.39 - 28.38; p < 0.001). For patients with poorly differently HNSCC, RR was 11.01 (95% CI: 1.42 - 85.15; p = 0.022) Conclusions: Recognizing patients at primary presentation with tumors with the highest risk for the development of DM might le us to selectively treat them aggressively with systemic therapy to eradicate the tumor, thus improving overall survival rates. No significant financial relationships to disclose.

scholarly journals Clinical outcomes and patterns of failure of head and neck mucosal melanoma treated with multiple treatment modalities

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Qing-Qing Xu ◽  
Yan-Zhen Lai ◽  
Zi-Lu Huang ◽  
Zi-Yi Zeng ◽  
Ya-Ni Zhang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Targeted Therapy ◽  
Head And Neck ◽  
Distant Metastasis ◽  
Mucosal Melanoma ◽  
Treatment Modalities ◽  
Free Survival ◽  
Multiple Treatment ◽  
T Stage ◽  
N Stage

Abstract Objectives The study aims to analyze the clinical characteristics of head and neck mucosal melanoma (MMHN) and the effects of multiple treatment modalities on distant metastasis, recurrence and survival rates to provide a reference for the individualized treatment of MMHN. Methods We retrospectively reviewed 262 patients with stage III–IVb MMHN treated from March 1986 to November 2018 at our cancer center. Results The median follow-up time was 34.0 months (range 1–262 months). The 5-year overall survival (OS), distant metastasis-free survival (DMFS) and disease-free survival (DFS) probabilities were 37.7%, 30.2%, and 20.3%, respectively. The 5-year OS rates for patients with stage III, stage IVA, and stage IVB MMHN were 67.0%, 24.1% and 8.3%, respectively (P < 0.001). A total of 246 (93.9%) patients received surgery, 149 (56.9%) patients received chemotherapy, and 69 (26.3%) patients received immunologic/targeted therapy. A total of 106 (40.5%) patients were treated with radiotherapy: 9 were treated with preoperative radiotherapy, 93 were treated with postoperative radiotherapy, and 4 were treated with radiotherapy alone. In the multivariate Cox regression analysis, primary tumor site, T stage, and immunologic/targeted therapy were independent factors for OS (all P < 0.05). Irradiation technique, T stage, and N stage were independent prognostic factors for DMFS (all P < 0.05). T stage, N stage, and surgery were independent prognostic factors for DFS (all P < 0.05). Distant metastasis was observed in 107 of 262 patients (40.8%), followed by local [74 (28.2%)] and regional [52 (19.8%)] recurrence. Conclusions The main reason for treatment failure in MMHN is distant metastasis. Immunologic/targeted therapy and surgery are recommended to improve the survival of MMHN. The American Joint Committee on Cancer (AJCC) 8th edition staging system for MMHN does stage this disease effectively.

scholarly journals Correlating the treatment outcome with tumor staging, grading, and various treatment modalities in patients with esthesioneuroblastoma

2019 ◽  
Vol 08 (02) ◽  
pp. 124-126
Author(s):  
Shuchita Singh ◽  
Lavleen Singh ◽  
Richa Ranjan ◽  
Manoj Kumar Singh ◽  
Alok Thakar ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Tumor Staging ◽  
Treatment Plan ◽  
Survival Rates ◽  
Multimodality Treatment ◽  
Tumor Stage ◽  
Response To Treatment ◽  
Treatment Modalities ◽  
Prognostic Indicators ◽  
Management Protocol

Abstract Objective: Although till date no management protocol for esthesioneuroblastoma (ENB) has been standardized due to tumor rarity, still multimodality approach shows better treatment outcomes as compared to surgery alone. The objective of this study was to analyze the clinicopathological spectrum of ENB and to correlate treatment response with tumor staging, histopathological grading, and various treatment modalities. Materials and Methods: Twenty-one consecutive patients with biopsy-proven ENB were studied and evaluated for response to treatment in the form of complete tumor resolution. Results were analyzed and correlated with stage and grade of tumor and form of therapy received. Results: There was male preponderance (3.2:1) with age ranging between 7 and 63 years (median of 25 years). Survival rates significantly dropped with increasing tumor stage (63.6% in stages A and B vs. 30% in stages C and D) and grade (100% in Grades 1 and 2 vs. 31.25% in Grades 3 and 4). The recurrence rate was 80% in surgery alone group, which came down to 43.7% if surgery was supplemented with other modalities. In cases where multimodality treatment plan was used, endoscopic procedures fared equally as open surgical procedures. Conclusion: Hyam’s grade and Kadish stage are important prognostic indicators of treatment outcome, with survival rates dropping with increasing tumor stage and grade. Multimodality treatment protocols have improved the disease outcome, making endoscopic surgery equivalent to radical surgeries regarding result outcomes and giving other advantages such as better cosmesis, less treatment-related morbidities, decreased hospital stay, and better cost-effectiveness.

scholarly journals Melioidosis of the Head and Neck: A Case Series from Eastern India

2020 ◽  
Vol 12 (3) ◽  
pp. 36-45
Author(s):  
Srujana Mohanty ◽  
Saurav Sarkar ◽  
Baijayantimala Mishra
Keyword(s):  
Head And Neck ◽  
Burkholderia Pseudomallei ◽  
Case Series ◽  
Neck Region ◽  
Treatment Modalities ◽  
Eastern India ◽  
Fatal Disease ◽  
Head And Neck Region ◽  
Disease Prognosis ◽  
Disease Entities

Melioidosis is an emerging entity in India. Though it is a potentially fatal disease, prognosis is excellent with early detection and appropriate management, especially of localized infections like abscesses of the head and neck area. We report nine cases of focal abscesses in the head and neck region due to Burkholderia pseudomallei, the causative agent of melioidosis, presenting to our hospital within a span of two-and-half years. Since melioidotic abscesses in the cervicofacial and head and neck region are likely to be confused with cold abscesses caused by Mycobacterium tuberculosis in a tuberculosis-endemic country like India, increased vigilance is necessary because of the widely divergent treatment modalities of the two disease entities.

Circulating and disseminated tumour cells in head and neck cancer

2015 ◽  
Vol 129 (9) ◽  
pp. 826-830 ◽  
Author(s):  
A T Harris ◽  
S Derbyshire ◽  
J Wilson ◽  
C Loh ◽  
A J Kinshuck ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Treatment Options ◽  
Tumour Cells ◽  
Neck Squamous Cell Carcinoma ◽  
Response To Treatment ◽  
Treatment Modalities ◽  
Disseminated Tumour Cells

AbstractBackground:Multimodal treatment options in head and neck squamous cell carcinoma have allowed for greater control of locoregional disease, but this has not translated into a significant overall survival advantage for patients. This is partially because these treatment modalities have no influence over the rate of development of distant metastases.Objective:This article summarises the current methods of detecting circulating and disseminated tumour cells. It also discusses how these cells can offer prognostic value in head and neck squamous cell carcinoma, and considers questions posed by the identification of these cells.Methods:A literature search of relevant journal articles was performed using ScienceDirect and PubMed databases, and a general article search was conducted using the online search engine Google.Results and conclusion:The evidence presented in this article indicates that circulating tumour cells and disseminated tumour cells may be clinically useful as prognostic markers or in the assessment of response to treatment in head and neck squamous cell carcinoma.

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