Impact of Completion Lymphadenectomy on Quality of Life for Head and Neck Cutaneous Melanoma

2021 ◽  
pp. 019459982110074
Author(s):  
Janice L. Farlow ◽  
Scott A. McLean ◽  
Nithin Peddireddy ◽  
Carol R. Bradford ◽  
Kelly M. Malloy ◽  
...  
Keyword(s):  
Lymph Node ◽  
Head And Neck ◽  
Neck Dissection ◽  
Cutaneous Melanoma ◽  
Short Form ◽  
Tertiary Care ◽  
Lymph Node Biopsy ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sf 36

Objective Recent randomized data suggest that completion lymph node dissection after a positive sentinel lymph node biopsy (SLNB) improves locoregional control but does not improve survival for melanoma patients. Locoregional recurrences of head and neck cutaneous melanoma (HNCM) may result in significant morbidity. A better understanding of morbidity is thus important to inform decisions about whether to pursue completion neck dissection (ND). Study Design Cross-sectional study. Setting Academic tertiary care hospital. Methods Clinical data were collected for patients with HNCM seen between 2016 and 2019 who were at least 1-year disease free. Each patient completed the Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (SLANSS), Neck Dissection Impairment Index, and SF-36 (Short Form–36). Scores were compared by surgical treatment: wide local excision (WLE) only, SLNB, and ND. Univariate and multivariable regression was performed. Results Of 474 patients, 140 returned questionnaires (29.5% response rate; WLE, n = 49; SLNB, n = 76; ND, n = 15). No significant differences in SLANSS or Neck Dissection Impairment Index scores were found between the WLE and SLNB groups. SLANSS scores differed by 2 SD ( P = .001) in the ND cohort, which had a 36% rate of neuropathy. Neck impairment was worse by 1 SD ( P = .01) in the ND cohort. No differences were found in SF-36 domains. Conclusion Neuropathy and neck impairment are components of morbidity after ND. These risks must be balanced with potential morbidity of locoregional recurrence in HNCM.

scholarly journals QUALITY OF LIFE AFTER PRIMARY PCI IN PAKISTANI POPULATION – DOES IT REALLY CHANGE?

2021 ◽  
Vol 54 (3) ◽  
pp. 224-229
Author(s):  
Rajesh Kumar ◽  
Ali Ammar ◽  
Jehangir Ali Shah ◽  
Tahir Saghir ◽  
Ashok Kumar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Tertiary Care ◽  
Bodily Pain ◽  
Coronary Intervention ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sf 36

Objectives: To evaluate the quality of life (QOL) after percutaneous coronary intervention (PCI) using short-form health survey (SF-36) questionnaire at a tertiary care hospital in Pakistan. Methodology: It was a cross-sectional study conducted at a tertiary care cardiac center in Pakistan. A total of 433 adult patients who undergone PCI at least six months before were included. The QOL was assessed using Urdu translated version of SF-36 questionnaire. QOL scores were computed on eight domains role physical (RP), role emotional (RE), bodily pain (BP), physical function (PF), mental health (MH), vitality, general health perception (GHP), and social function (SF) along with two summary scores for mental (MCS) and physical component (PPS). Results: The highest mean score was reported for BP (73.8±19.7) followed by PF (61.7±24.3). In comparison to a year before, 52.9% and 24.7% rated their QOL somewhat better and much better respectively. Score for PF, RE, and RF were significantly higher in male, while, vitality was higher for female. Score of PPS was significantly higher for male whereas MCS score was higher for female. An increasing trend, with respect to patients’ perception of QOL compared to an year ago, was observed on five out of eight domains namely GHP, PF, RP, RE, and BP. Conclusion: Improved QOL, compared to a year ago, is reported by most of the patients. An acceptable (>50) mean score was observed on most of the QOL domains of SF-36 and it was found to be positively related to the patient stated degrees of QOL.

scholarly journals Quality of life in individuals with cervical dystonia before botulinum toxin injection in a Brazilian tertiary care hospital

2011 ◽  
Vol 69 (6) ◽  
pp. 900-904 ◽  
Author(s):  
Mariana Ribeiro Queiroz ◽  
Hsin Fen Chien ◽  
Egberto Reis Barbosa
Keyword(s):  
Quality Of Life ◽  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Rating Scale ◽  
Short Form ◽  
Tertiary Care ◽  
Residual Effect ◽  
Care Hospital ◽  
Sf 36

OBJECTIVE: The purpose of this study was to evaluate quality of life (QoL) in a Brazilian population of individuals with cervical dystonia (CD) without effect of botulinum toxin (BTx) or with only residual effect of BTx, and identify possible physical and social aspects that affect their QoL. METHOD: Sixty five out of sixty seven consecutive patients with CD were assessed with two instruments: Short-form Health Survey with 36 questions (SF-36) and Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). RESULTS: Severity of CD (TWSTRS) correlated moderately with two SF-36 subscale: role-physical (r= -0.42) and body pain (r= -0.43). Women also scored worse in two subscale of SF-36: vitality (p<0.05) and mental-health (p<0.005). CONCLUSION: Severity of CD and gender (female) were the main factors related to a worse QoL perception. These findings may help health professionals to predict which characteristics could lead to worse QoL, and therefore, better target their interventions to lessen the burden caused by CD.

Benefits of initial CT staging before sentinel lymph node biopsy in patients with head and neck cutaneous melanoma

Head & Neck ◽  
2017 ◽  
Vol 39 (11) ◽  
pp. 2301-2310 ◽  
Author(s):  
Anna Hafström ◽  
Maria Silfverschiöld ◽  
Simon S. Persson ◽  
Michelle Kanne ◽  
Christian Ingvar ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Head And Neck ◽  
Cutaneous Melanoma ◽  
Lymph Node Biopsy ◽  
Node Biopsy

scholarly journals Quality of life among caregivers of thalassaemic children, attending at Thalassaemia control unit of a rural tertiary care hospital, in a sub-Himalayan district of West Bengal

2022 ◽  
Vol 8 (4) ◽  
pp. 163-168
Author(s):  
Tushar Kanti Saha ◽  
Kallol Bhandari ◽  
Eashin Gazi ◽  
Arup Jyoti Rout ◽  
Samir Dasgupta
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Short Form ◽  
Tertiary Care ◽  
Control Unit ◽  
Abnormal Development ◽  
Care Hospital ◽  
Physical And Mental Health ◽  
Cross Sectional

Thalassaemia is a disease of abnormal development of red blood cells which manifests as anaemia. This chronic disease may cause mental, social, financial burdens on the families, care givers and also on health care system.To assess the quality of life (QOL) of the caregivers of thalassaemic children and to identify the predictors of quality of their physical and mental health.Institution based descriptive cross-sectional study conducted in the Thalassaemia Control Unit (TCU) of North Bengal Medical College (NBMC) from December 2018 to April 2019. Total 136 caregivers of children (≤12 years) with thalassaemia were included by complete enumeration method. Physical and mental health of the caregivers were reported in Short Form-36 (SF-36) Health Survey. Collected data were entered into MS-Excel, analysed with the help of SPSS (Version 22).Mean age of caregivers was 34.3 (SD ± 1.4 years). Most of caregivers were female (89%) and had educational qualification up to Primary school (45.6%). Majority (70.6%) of the caregivers were the mothers of the children. Most of the study participants (60.3%) had favourable Physical health Component Summary (PCS) but 64.7% of the caregivers had unfavourable Mental health component Summary (MCS). Educational status was found to be the predictor for PCS but age and relationship with the child were the predictors for MCS.Counselling, psychotherapy, social support for family members or caregivers of the thalassaemic children and community involvement with their full participation should be emphasized to reduce stigma related to thalassaemia.

scholarly journals Sentinel Lymph Node Biopsy in Head and Neck Cutaneous Malignant Melanoma

2019 ◽  
Vol 77 (2) ◽  
pp. 129-133
Author(s):  
Ana Marta António ◽  
Cecília Moura ◽  
Carina Semedo ◽  
Sandra Bitoque ◽  
Mariluz Martins ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Head And Neck ◽  
Cutaneous Melanoma ◽  
Primary Melanoma ◽  
Lymph Node Biopsy ◽  
Superficial Spreading ◽  
Node Biopsy ◽  
Head And Neck Melanoma

Introduction: Sentinel lymph node biopsy (SLNB) is the standard of care for cutaneous melanoma, including head and neck melanoma. The aim of this study was to analyze and characterize SLNB in a population of head and neck melanoma patients. Methods: A unicentric, retrospective study on patients with cutaneous head and neck melanoma who underwent SLNB in the Department of Head and Neck Surgery at the Portuguese Institute of Oncology (IPO) Lisbon between January 2010 and December 2017 was performed. The location of primary melanoma, the identification of SLN, the number of the excised SLN, its lymphatic basin origin and the presence of infraclinic metastasis were analysed. Results:  Ninety-eight patients were eligible to undergo SLNB during the observation period. The most frequent locations of primary melanoma were the scalp (24.5%) and the auricular and periauricular region (23.5%) and the most frequent variants were the superficial spreading melanoma (40.8%) and nodular melanoma (30.6%). SLNB was successfully executed in 78 patients (79.6%). A mean of 3.8 lymph-nodes per patient were excised and in 16.7% SLN were excised in more than one lymphatic basin. The SLN were identified in parotid region (39.8%), level II (29.5%) and level V (18.2%). SLN metastases were detected in 13 patients (16.7%). Conclusion: Surgical approach of head and neck cutaneous melanoma is particularly complex. The redundancy of lymphatic system, the multiple SLN and SLN basins influence the SLNB success and may contribute to high rates of false-negatives with its prognostic implications. All patients should be carefully monitored.  

Melanoma nodal management in Ontario following ASCO/SSO guidelines.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e21054-e21054
Author(s):  
Steven Latosinsky ◽  
Salimah Shariff ◽  
Britney Allen
Keyword(s):  
Lymph Node ◽  
Head And Neck ◽  
Cutaneous Melanoma ◽  
Surgical Oncology ◽  
Lymph Node Biopsy ◽  
Administrative Databases ◽  
Ontario Cancer Registry ◽  
Younger Age ◽  
Melanoma Patients ◽  
American Society

e21054 Background:Methods:Results: Conclusions:The American Society of Clinical Oncology and Society of Surgical Oncology (ASCO/SSO) published a joint guideline in 2012 regarding indications for sentinel lymph node biopsy (SLNB) in cutaneous melanoma. The guideline supported completion lymph node dissection (CLND) for all patients with a positive SLNB. We examined the rates and predictors of SLNB and CLND for melanoma patients in Ontario (population 13.6 million) following guideline publication. Methods: We used the Ontario Cancer Registry (OCR) to identify cutaneous melanoma patients diagnosed in 2013. Patient records were linked to prospectively maintained health administrative databases to obtain details for each patient including surgical procedures. Results: We identified 3298 melanoma patients from Ontario in 2013 of which 1,973 (59.8%) could be analyzed. The majority, 1,227 (62.2%) had a local excision alone, while 746 (37.8%) had a SLNB. SLNB was performed on T1, T2, T3 and T4 primary melanomas in 13.9%, 67.8%, 62.6% and 47.2% of cases respectively. Receipt of a SLNB was positively associated with a younger age (< 80), higher T stage, and non-head and neck primary in multivariate analysis. Of the patients who received a SLNB 136 (18.2%) were found to be node positive. A CLND was performed in 82 (60.3%) of these patients. Conclusions: In Ontario only two-thirds of intermediate thickness melanomas (T2, T3) received a SLNB as recommended by the ASCO/SSO guidelines. Utilization was lower for head and neck patients and higher for younger (< 80 years) patients. Use of CLND for positive SLNB was also low relative to the guidelines.

scholarly journals Primary excision margins, sentinel lymph node biopsy, and completion lymph node dissection in cutaneous melanoma: a clinical practice guideline

2019 ◽  
Vol 26 (4) ◽  
Author(s):  
F. C. Wright ◽  
L. H. Souter ◽  
S. Kellett ◽  
A. Easson ◽  
C. Murray ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Head And Neck ◽  
Systematic Reviews ◽  
Cutaneous Melanoma ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Primary Literature ◽  
Excision Margins

Background  For patients who are diagnosed with early-stage cutaneous melanoma, the principal therapy is wide surgical excision of the primary tumour and assessment of lymph nodes. The purpose of the present guideline was to update the 2010 Cancer Care Ontario guideline on wide local excision margins and sentinel lymph node biopsy (SLNB), including treatment of the positive sentinel node, for melanomas of the trunk, extremities, and head and neck.Methods  Using Ovid, the MEDLINE and EMBASE electronic databases were systematically searched for systematic reviews and primary literature evaluating narrow compared with wide excision margins and the use of SLNB for melanoma of the truck and extremities and of the head and neck. Search timelines ran from 2010 through week 25 of 2017.Results  Four systematic reviews were chosen for inclusion in the evidence base. Where systematic reviews were available, the search of the primary literature was conducted starting from the end date of the search in the reviews. Where systematic reviews were absent, the search for primary literature ran from 2010 forward. Of 1213 primary studies identified, 8 met the inclusion criteria. Two randomized controlled trials were used to inform the recommendation on completion lymph node dissection.Key updated recommendations include:■ Wide local excision margins should be 2 cm for melanomas of the trunk, extremities, and head and neck that exceed 2 mm in depth.■ SLNB should be offered to patients with melanomas of the trunk, extremities, and head and neck that exceed 0.8 mm in depth.■ Patients with sentinel node metastasis should be considered for nodal observation with ultrasonography rather than for completion lymph node dissection.Conclusions  Recommendations for primary excision margins, sentinel lymph node biopsy, and completion lymph node dissection in patients with cutaneous melanoma have been updated based on the current literature.

scholarly journals Endoscopic Septoturbinoplasty among Patients Undergoing Surgery in the Department of Otolaryngology-Head and Neck of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (244) ◽  
pp. 1229-1233
Author(s):  
Nain Bahadur Mahato ◽  
Meera Bista ◽  
Bhuwan Bhandari ◽  
Rosi Pradhan
Keyword(s):  
Confidence Interval ◽  
Head And Neck ◽  
Nasal Obstruction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Symptom Evaluation

Introduction: Septoplasty without turbinoplasty is one of the main reasons for failure of procedure in case of deviated nasal septum with inferior turbinate hypertrophy. Septoturbinoplasty is the procedure of choice for complete treatment. The main objective is to find out the prevalence of endoscopic septoturbinoplasty among patients undergoing surgery in Department of Otolaryngology-Head and Neck of a tertiary care hospital. Methods: This was a descriptive cross-sectional study in Department of Otolaryngology-Head and Neck Surgery done over a period of 1 year duration from 1st August 2020 to 31st July 2021 among 1248 patients who underwent surgery in the department. Ethical Approval was taken from Institutional Review Committee of Kathmandu Medical College and Teaching Hospital (Reference number: 2207202004). A convenience sampling technique was used. Two different techniques, Microdebrider Assisted Turbinoplasty and Outfracture with Submucosal Diathermy were used in surgery. Nasal Obstruction and Symptom Evaluation Scale questionnaire was used pre and postoperatively for data collection. Data were analyzed in Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated, with frequency, percentage, mean and standard deviations. Results: Out of 1248 patients, about 92 (7.37%) patients (4.95-10.14 at 95% Confidence Interval) underwent septoturbinoplasty. The mean Nasal Obstruction and Symptom Evaluation Scale before surgery was 75.21±6.19. Conclusions: The prevalence of septoturbinoplasty in our study is similar to other studies done in similar settings. We found almost complete resolution of breathing problems following endoscopic septoturbinoplasty, hence improving quality of life.

scholarly journals Trans-oral Extra Tonsillar Approach of Styloidectomy for Treatment of Eagle’s Syndrome among Operated Cases of the Department of Otolaryngology-Head and Neck Surgery at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (240) ◽  
Author(s):  
Deepak Regmi ◽  
Rachana Baidhya ◽  
Ashik Rajak ◽  
Sangita Shrestha ◽  
Meera Bista
Keyword(s):  
Head And Neck ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Head And Neck Surgery ◽  
Care Hospital ◽  
Sectional Study ◽  
Eagle’S Syndrome ◽  
Cross Sectional

Introduction: Eagle’s syndrome is a poorly understood clinical entity that has variable presentations like recurrent throat pain or foreign body sensation, dysphagia, or facial pain. With a confirmed diagnosis, a surgical approach is considered appropriate for its treatment. This study aims to find out the prevalence of trans-oral extra tonsillar approach of styloidectomy among the operated cases of Department of Otolaryngology-Head and Neck Surgery at a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among 1,475 who underwent surgery at the Department of Otolaryngology-Head and Neck Surgery in a tertiary care center of Nepal between July 2018 to September 2020 after receiving the ethical clearance from the Institutional Review Committee (Reference number: 0106201802). Convenience sampling was done and data was entered in Statistical Package for the Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 1,475 patients enrolled in the study, 24 (1.62%) patients (95% Confidence Interval= 0.97-2.26) underwent trans-oral extra tonsillar approach of surgery for Eagle’s syndrome during the study duration. Conclusions: The prevalence of styloidectomy among the operated cases of our study is low in comparison to other studies done in similar settings. Transoral extra tonsillar approach can be considered as a novel approach for surgical removal of the styloid process in Eagle’s Syndrome.

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