Surgical Treatment for Early Stage Glottic Carcinoma with Involvement of the Anterior Commissure

2017 ◽  
Vol 158 (2) ◽  
pp. 295-302 ◽  
Author(s):  
Philipp Wolber ◽  
David Schwarz ◽  
Thoralf Stange ◽  
Magdalene Ortmann ◽  
Matthias Balk ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Recurrence Rate ◽  
Squamous Cell ◽  
Early Stage ◽  
Anterior Commissure ◽  
Glottic Cancer ◽  
Recurrence Rates ◽  
Significant Difference

Objective Assessment of the value of transoral laser microsurgery (TLM) compared with open surgery (OS) for early stage squamous cell carcinoma of the glottic larynx with special regard to involvement of the anterior commissure (AC). Study Design Case series with chart review. Setting Tertiary care otolaryngology clinic. Subjects and Methods Review of clinicopathological data of all patients with previously untreated T1a, T1b, and T2 glottic squamous cell carcinoma of the larynx who were consecutively enrolled over a 10-year period (January 1, 1992, to December 31, 2002). Results Local recurrence rate was 20.4% (10 of 49) for TLM and 10.7% (3 of 28) for OS. Comparison of the TLM and OS groups regarding local recurrence rates revealed a significant difference only for tumors invading the AC ( P = .046). Within the TLM group, tumors with involvement of the AC showed a significantly higher recurrence rate (38.1%; 8 of 21) compared with tumors without involvement of the AC (7.1%; 2 of 28; P = .008). In the OS group, involvement of the AC revealed no significant difference ( P = .45). The overall survival in both groups was comparable in both groups (TLM, 93.9%; OS, 89.3%; P = .47). Conclusion TLM and OS are equally effective surgical treatments for early stage glottic cancer without involvement of the AC, with selection of treatment based on pretreatment endoscopy. However, TLM is associated with less morbidity. In case of invasion of the AC, OS yields lower recurrence rates.

Evaluation of Definitive Chemoradiotherapy Versus Radical Esophagectomy in Clinical T1bN0M0 Esophageal Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Ryoma Haneda ◽  
Eisuke Booka ◽  
Kenjiro Ishii ◽  
Hirotoshi Kikuchi ◽  
Yoshihiro Hiramatsu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Definitive Chemoradiotherapy ◽  
Radical Esophagectomy ◽  
Term Survival ◽  
Promising Alternative ◽  
Significant Difference

Abstract Background: The standard treatment for patients with clinical T1bN0M0 esophageal squamous cell carcinoma is radical esophagectomy. Definitive chemoradiotherapy is regarded as a treatment option, and good clinical outcome of this treatment has been reported. This study compared the efficacy of definitive chemoradiotherapy with radical esophagectomy.Methods: From January 2011 to December 2019, this study enrolled 68 consecutive patients. Patients were classified into two groups whether treated by surgery or definitive chemoradiotherapy. Survival outcome were compared and subsequent therapies after recurrence were also investigated.Results: Surgery was performed to 39 patients, and 29 patients received definitive chemoradiotherapy. No significant difference was noted in overall survival between two groups. However, the rate of 5-year recurrence free survival was significantly lower in definitive chemoradiotherapy group than that of surgery group (91.1% vs. 62.7%, Hazard ratio 3.976, 95% Confidence interval 1.076-14.696, p = 0.039). Patients who had local recurrence after definitive chemoradiotherapy received endoscopic submucosal dissection or photodynamic therapy as salvage therapies, and resulted in no disease progression and a good prognosis.Conclusions: Definitive chemoradiotherapy may become a promising alternative therapy comparable with radical esophagectomy in patients with clinical T1bN0M0 esophageal squamous cell carcinoma. Early detection of recurrence by frequent follow-up after definitive chemoradiotherapy is important to control disease within local recurrence, and salvage therapy for local lesions could contribute to long-term survival.

scholarly journals Depth of invasion (DOI) as a predictor of cervical nodal metastasis and local recurrence in early stage squamous cell carcinoma of oral tongue (ESSCOT)

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0202632 ◽  
Author(s):  
Muhammad Faisal ◽  
Muhammad Abu Bakar ◽  
Albash Sarwar ◽  
Mohammad Adeel ◽  
Fatima Batool ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Nodal Metastasis ◽  
Depth Of Invasion ◽  
Oral Tongue

Thyroid cartilage invasion in early-stage squamous cell carcinoma involving the anterior commissure

Head & Neck ◽  
2011 ◽  
Vol 34 (10) ◽  
pp. 1476-1479 ◽  
Author(s):  
Dana M. Hartl ◽  
Guillaume Landry ◽  
Stéphane Hans ◽  
Patrick Marandas ◽  
Odile Casiraghi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Anterior Commissure ◽  
Thyroid Cartilage ◽  
Cartilage Invasion

Prognostic Significance of BCL-2 Expression in Localized Squamous Cell Carcinoma of the Head and Neck

1997 ◽  
Vol 106 (6) ◽  
pp. 445-450 ◽  
Author(s):  
Philip Grey ◽  
Prashant Chawla ◽  
Michael Friedman ◽  
T. K. Venkatesan ◽  
David D. Caldarelli ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Early Stage ◽  
Prognostic Significance ◽  
Second Primary ◽  
Tissue Samples ◽  
Poor Outcome ◽  
Significant Difference

This study was conducted to determine whether Bcl-2 overexpression in localized squamous cell carcinoma of the head and neck (SCCHN) might serve as a marker for tumors unlikely to respond to standard treatment. Tissue samples from 33 patients undergoing surgery or irradiation for early-stage SCCHN during the years 1977 to 1992 were stained for Bcl-2. All patients had either T1N0 lesions of the oral cavity, pharynx, or larynx or T1 NO or T2N0 lesions of the true vocal cords. Of the 33 patients, 26 remained disease-free after at least 3 years of follow-up; the remaining 7 patients developed either tumor recurrence or a second primary tumor, 4 of which were fatal. Twelve patients had tissue specimens staining positive for Bcl-2; 6 of these patients had a poor outcome, and 6 had a good outcome. The relationship between poor outcome and overexpression of Bcl-2 in tumor cells was statistically significant (p =.0047 by Fisher's exact test). For tumors overexpressing Bcl-2, there was no significant difference in recurrence rate between those undergoing surgery and those undergoing radiotherapy as the primary mode of treatment. The overexpression of Bcl-2 in early lesions in this study predicted a cure rate of 50%, as opposed to the generally expected 90%, suggesting that Bcl-2 is a significant prognostic indicator in early SCCHN. Future studies will determine if altering the treatment will improve outcome in these patients.

Early stage squamous cell carcinoma of the lower lip: predictive factors for recurrence

2016 ◽  
Vol 130 (4) ◽  
pp. 369-372 ◽  
Author(s):  
Y Ozkul ◽  
M Songu ◽  
A Imre ◽  
E Tunc ◽  
Z Ozkul ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Clinicopathological Parameters ◽  
Lower Lip ◽  
Neck Metastasis ◽  
Tumour Thickness

AbstractObjective:This study aimed to evaluate the effect of tumour thickness on other clinicopathological parameters in early stage lower lip squamous cell carcinoma.Methods:Forty-six consecutive patients with lower lip squamous cell carcinoma were included in the study. Demographic, clinical and pathological data were retrospectively collected.Results:The mean follow-up period for all patients was 32.0 ± 18.9 months. Forty-four tumours were staged as T1 and two were T2. Twelve patients underwent neck dissection. Two patients presented with neck metastasis in the follow-up period. Four patients (8.7 per cent) had local recurrence. Correlation analysis revealed a significant relationship between microscopic tumour thickness and local tumour recurrence (r = 0.328, p = 0.045).Conclusion:Surgical margin control is important to prevent local recurrence, especially in thicker tumours. In addition, neck metastasis is rare in early stage lower lip squamous cell carcinoma. A ‘wait and see’ policy might be preferred in early stage T1 lower lip squamous cell carcinoma cases.

RASSF1A and KRAS Expression in Oral Leukoplakia with Dysplasia and in Squamous Cell Carcinoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Costa V ◽  
◽  
El Achkar VNR ◽  
Ribeiro MP ◽  
Tristao SS ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Critical Role ◽  
Disease Free Survival ◽  
Oral Leukoplakia ◽  
Control Group ◽  
Significant Difference ◽  
Kras Protein

The aim of this study is to investigate the role of RASSF1A and KRAS protein immunoexpression in Oral Leukoplakia with Epithelial Dysplasia (OLD) and in Oral Squamous Cell Carcinoma (OSCC). Immunohistochemical staining for RASSF1A and KRAS was performed and a semiquantitative analysis was applied to samples of the Control Group (CG, n=20), OLD (n=39), and OSCC (n=100). No significant difference was observed between RASSF1A immunoexpression and OLP and OSCC groups (p>0.05). KRAS expression was higher in OSCC than in OLP and CG (p<0.05). No association was observed between RASSF1A or KRAS expression and alcohol/tobacco use or clinicopathological features (p>0.05) in the OSCC group. Also, patients with OSCC who presented KRAS overexpression had a worse disease-free survival rate (p=0.04). RASSF1A expression was similar in OLD and OSCC groups, suggesting that it plays a critical role in the early stage of OSCC. KRAS expression was higher in OSCC when compared with normal and dysplastic tissues, showing that KRAS expression increases with malignant progression.

The Role of Pathological Margin Distance and Prognostic Factors After Primary Surgery in Squamous Cell Carcinoma of the Vulva

2018 ◽  
Vol 28 (3) ◽  
pp. 623-631 ◽  
Author(s):  
Macit Arvas ◽  
Ilker Kahramanoglu ◽  
Tugan Bese ◽  
Hasan Turan ◽  
Isik Sozen ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Recurrence Rate ◽  
Squamous Cell ◽  
Disease Free Survival ◽  
Older Age ◽  
Free Survival ◽  
Disease Free

ObjectiveThe aim of this study was to determine the impact of clear surgical margin distance and other factors associated with the recurrence and survival of patients with squamous cell carcinoma of the vulva.Methods/MaterialsA total of 107 patients operated for vulvar carcinoma from 1996 to 2016 were included in the analysis. Patients were divided into subgroups with clear pathological margin of 2 mm or less, greater than 2 to less than 8 mm, and 8 mm or greater for the analysis of the prognostic impact of the clear margin distance. Data were analyzed using the Kaplan-Meier method and Cox proportional hazards regression.ResultsThe median age of the patients was 66 years. The median follow-up was 69 months. The labia majora and/or labia minora were the most common sites of involvement. Radical local excision and radical vulvectomy were performed in 96 and 11 patients, respectively. Thirty-nine patients received adjuvant radiotherapy. The overall recurrence rate was 46%. At 231 months, the actuarial local recurrence rate was 18.6%. Patients with clear pathological margin of 2 mm or less had significantly higher local recurrence risk. Five-year disease-free survival was 32.7%. Older age and adjuvant chemotherapy were found as independent prognostic factors for disease-free survival.ConclusionOur data suggest that a more than 2 mm tumor-free margins is associated with better local control. In addition, older age is an independent prognostic factor for survival.

Final results following exclusive chemotherapy for selected patients with squamous cell carcinoma of the laryngopharynx

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6039-6039
Author(s):  
C. Holsinger ◽  
V. Bassot ◽  
D. Brasnu ◽  
O. Laccourreye
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Induction Chemotherapy ◽  
Local Control ◽  
Squamous Cell ◽  
Local Therapy ◽  
Local Control Rate ◽  
Oncologic Outcomes ◽  
Glottic Cancer

6039 Purpose: To determine the long-term oncologic outcomes for patients with squamous cell carcinoma (SCC) of the laryngopharynx treated with exclusive chemotherapy after complete clinical response to induction chemotherapy. Materials and Methods: After platin-based induction chemotherapy, selected patients with a complete clinical and histologic response were treated exclusively with additional chemotherapy and observed closely. The rates of overall survival, disease control, and organ preservation were calculated. Results: Survival at 1- and 5-years was 94.5% and 60.2%, respectively. Main causes of death were metachronous second primaries (27) and intercurrent disease (23) than local recurrence (10), distant metastasis, (9) and nodal recurrence (4). The 1-, 3- and 5- year Kaplan-Meier local control estimates were 73.5%, 53.3%, and 50.3%, respectively. No variable was associated with local recurrence using a multivariate analysis. Salvage treatment resulted in an observed final 85.6% local control rate and varied from 96% in patients with glottic cancer to 71% in patients with tumor originating from other locations. Overall, this treatment approach was well-tolerated: 30 patients (20%) experienced grade 3 toxicity; two patients (1.4%) had grade 4 toxicity events. Overall, chemotherapy allowed for successful modulation of local therapy in 66% of patients (96/146). Conclusions: For selected patients, exclusive chemotherapy does not significantly impact survival and maintains function in a majority of patients. Most remarkable, platin-based chemotherapy permitted us to modulate and to diminish the extent of local therapy. Future work should be directed to identify markers of response and resistance to identify which patients are best suited for this approach. No significant financial relationships to disclose.

scholarly journals Hypofractionated Radiotherapy in the Treatment of Early Glottic Carcinoma

2011 ◽  
Vol 2 (3) ◽  
pp. 138-143 ◽  
Author(s):  
Raza Hussain ◽  
Sarah Jamshed ◽  
Uzma Majeed ◽  
Shahid Hameed ◽  
Arif Jamshed ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Treatment Time ◽  
Early Stage ◽  
Anterior Commissure ◽  
Voice Quality ◽  
Locoregional Control ◽  
Hypofractionated Radiotherapy ◽  
Glottic Carcinoma

ABSTRACT Introduction Given the high probability of cure, the aims of treatment are cure, laryngeal preservation and good voice quality while making effective use of available resources. In this study we analyze locoregional control (LRC) and survival following hypofractionated radiotherapy in early stage glottic squamous cell carcinoma treated at Shaukat Khanum Memorial Cancer Hospital and Research Center. Materials and methods Between October 2003 and June 2009, 87 patients with early glottic squamous cell carcinoma were treated with hypofractionated radiotherapy. All patients were included in the study (M: 94%; F:6%). Median age was 60 years (range: 21-81 years). Sixty-six percent of patients were smokers. AJCC stage was T1 in 95% and T2 in 5% of the patients. Radiotherapy dose was 55 Gy in 20 fractions over 4 weeks. All patients were treated on cobalt-60. Median radiotherapy treatment time was 28 days (range: 23-35 days). Results The LRC rate after primary radiotherapy at 5 years was 91% (95% CI: 88-94%). The 5 years overall and disease-specific survival was 86% (95% CI: 81 and 91%) and 97% (CI 95%: 95 and 99%) respectively. Patients with T1a and T1b disease had LRC rates of 95 and 88% (p = 0.32). The LRC rates for patients with and without anterior commissure involvement at 5 years were 80 and 96% (p = 0.02) respectively. Conclusion Hypofractionated radiotherapy 55 Gy in 20 fractions is comparable to conventional fractionation schedules in terms of locoregional control and survival while offering potential for optimizing resources usage.

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