scholarly journals Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
T. J. Phillips ◽  
B. N. Harris ◽  
M. G. Moore ◽  
D. G. Farwell ◽  
A. F. Bewley
Keyword(s):  
Head And Neck ◽  
Squamous Cell ◽  
Cell Cancer ◽  
Surgical Margin ◽  
Surgical Excision ◽  
Neck Surgery ◽  
Disease Specific Survival ◽  
Recommended Treatment ◽  
Primary Surgery ◽  
Disease Specific

Abstract Objective The recommended treatment for cutaneous squamous cell cancer (CuSCC) of the head and neck is Mohs surgical excision or wide local excision. Excision is recommended to a gross surgical margin of 4–6 mm however this is based on limited evidence and specify a goal histologic margin. The objective of this study was therefore to examine the reported histological margin distance following WLE of advanced CuSCC and its association with recurrence and survival. Study design Retrospective database review. Setting All patients included received treatment at UC Davis Department of Otolaryngology-Head and Neck Surgery and/or Radiation Oncology in Sacramento, California. Subjects and methods The patients included were treated for advanced CuSCC with primary surgery with or without adjuvant therapy. Kaplan Meier survival curves with log rank analysis were then performed to compare 5-year recurrence free survival, and disease-specific survival for patients with different margin distances. Results Total number of subjects was 92. The overall 5-year DSS and RFS was 68.8 and 51.0% respectively. When the pathological margin distance was ≥5 mm, 5-year disease specific survival was improved when compared to margin distance less than 5 mm (94.7 vs 60.7 p = 0.034). Conclusion The findings of this study suggest that a histologic margin of at least 5 mm may increase survival in advanced head and neck CuSCC patients.

scholarly journals Comparative efficacy and safety of radiotherapy/cetuximab versus radiotherapy/chemotherapy for locally advanced head and neck squamous cell carcinoma patients: a systematic review of published, primarily non-randomized, data

2020 ◽  
Vol 12 ◽  
pp. 175883592097535
Author(s):  
Mei Mei ◽  
Yu-Huan Chen ◽  
Tian Meng ◽  
Ling-Han Qu ◽  
Zhi-Yong Zhang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Neck Squamous Cell Carcinoma ◽  
Advanced Head ◽  
Disease Specific Survival ◽  
Efficacy And Safety ◽  
Disease Specific

Background: Cetuximab (CTX) has been approved to be administered concurrently with radiotherapy (RT) to treat locally advanced head and neck squamous cell carcinoma (HNSCC). The aim of this study was to assess the efficacy and safety of concurrent CTX with RT (ExRT). Method: The PubMed, Cochrane Library, EMBASE databases were systematically searched to find relevant articles. The combined hazard ratio (HR), risk ratio (RR) and 95% confidence interval were calculated to assess the efficacy and safety of ExRT in contrast to concurrent platinum-based chemotherapy with RT (ChRT). Results: In total, 32 articles with 4556 patients were included. The pooled HRs indicated that ExRT achieved an unfavorable overall survival (HR: 1.86, p < 0.0001), disease-specific survival (HR: 2.58, p = 0.002), locoregional control (HR: 1.94, p < 0.00001), and progression-free survival (HR: 2.04, p = 0.003) compared with ChRT for locally advanced HNSCC patients. In human papillomavirus-positive patient subgroups, ExRT showed inferior disease-specific survival (HR: 2.55, p = 0.009) and locoregional control (HR: 2.27, p < 0.0001) in contrast to ChRT. Additionally, ExRT increased the occurrence of mucositis (RR: 1.17, p < 0.005), skin toxicity (RR: 6.26, p < 0.00001), and infection (RR: 2.27, p = 0.04) compared with non-CTX groups (ChRT and RT), and was associated with lower incidence of anemia (RR: 0.35, p = 0.009), leukocytopenia (RR: 0.17, p < 0.0001), neutropenia (RR: 0.06, p < 0.0001), nausea/vomiting (RR: 0.23, p < 0.0001), and renal toxicity (RR: 0.14, p = 0.007). Conclusion: ChRT should remain the standard treatment for locally advanced HNSCC patients. ExRT was recognized as an effective alternative treatment for locally advanced HNSCC patients who experienced unbearable toxicities caused by non-CTX treatments.

scholarly journals Does age influence disease‐specific survival in patients with squamous cell carcinomas of the head and neck?

2020 ◽  
Vol 121 (7) ◽  
pp. 1058-1066
Author(s):  
Joan Lop ◽  
Cristina Valero ◽  
Jacinto García ◽  
Miquel Quer ◽  
Ian Ganly ◽  
...  
Keyword(s):  
Head And Neck ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Disease Specific Survival ◽  
Disease Specific

Synchronous and Metachronous Squamous Cell Carcinomas of the Head and Neck Mucosal Sites

2001 ◽  
Vol 19 (5) ◽  
pp. 1358-1362 ◽  
Author(s):  
Haldun Ş. Erkal ◽  
William M. Mendenhall ◽  
Robert J. Amdur ◽  
Douglas B. Villaret ◽  
Scott P. Stringer
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Head And Neck ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Thoracic Esophagus ◽  
Overall Survival Rate ◽  
Disease Specific Survival ◽  
Disease Specific

PURPOSE: The present study presents the experience at the University of Florida with synchronous and metachronous squamous cell carcinomas of the head and neck mucosal sites. PATIENTS AND METHODS: This study included 1,112 patients with squamous cell carcinomas of the oropharynx, hypopharynx, and supraglottic larynx treated with radiation therapy with curative intent from 1964 to 1997. All patients had follow-up for at least 2 years. No patients were lost to follow-up. RESULTS: The overall survival rate was 45% and the disease-specific survival rate was 67% at 5 years after initial diagnosis of carcinoma of the head and neck mucosal sites. Seventy-seven patients (7%) presented with synchronous carcinomas of the head and neck mucosal sites and 103 patients (9%) developed metachronous carcinomas of the head and neck mucosal sites at 0.6 to 21.7 years (median, 3.6 years). The overall survival rate was 31%, and the disease-specific survival rate was 50% at 5 years after metachronous carcinomas of the head and neck mucosal sites. Seven patients (1%) developed metachronous carcinomas of the thoracic esophagus at 1 to 11.1 years (median, 2.8 years), 15 patients (1%) presented with synchronous carcinomas of the lung, and 83 patients (7%) developed metachronous carcinomas of the lung at 0.6 to 17.6 years (median, 3.5 years). CONCLUSION: Development of synchronous and metachronous squamous cell carcinomas of the head and neck mucosal sites are in part responsible for failure to improve overall survival rates for patients with squamous cell carcinomas of the head and neck mucosal sites, justifying rigorous follow-up and studies on chemoprevention.

Impact of pre-operative body mass index in head and neck cancer patients undergoing microvascular reconstruction

2017 ◽  
Vol 131 (11) ◽  
pp. 972-976 ◽  
Author(s):  
D-J Hyun ◽  
Y-H Joo ◽  
M-S Kim
Keyword(s):  
Body Mass Index ◽  
Survival Rate ◽  
Head And Neck ◽  
Body Mass ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Microvascular Reconstruction ◽  
Disease Specific Survival ◽  
Neck Squamous Cell Cancer ◽  
Disease Specific

AbstractObjectives:To analyse the relationship of pre-operative body mass index with surgical complications and oncological outcomes in patients undergoing microvascular reconstruction for head and neck squamous cell cancer.Method:A retrospective review was conducted of 259 patients who underwent microvascular free flap reconstruction after head and neck ablative surgery.Results:Mean body mass index was 22.48 kg/m2. There were no correlations between body mass index and: flap failure (p = 0.739), flap ischaemia (p = 0.644), pharyngocutaneous fistula (p = 0.141) or wound infection (p = 0.224). The five-year disease-specific survival rate was 63 per cent. On univariate analysis, the five-year disease-specific survival rate was significantly correlated with pre-operative body mass index, based on Kaplan–Meier survival curves (p = 0.028). The five-year disease-specific survival rates in underweight, normal weight, overweight and obese groups were 47 per cent, 55 per cent, 65 per cent and 80 per cent, respectively.Conclusion:Pre-operative body mass index was a useful predictor for recurrence and survival in patients who underwent microvascular reconstruction for head and neck squamous cell cancer.

Tumor-Infiltrating Lymphocytes in Patients With Advanced Laryngeal Cancer Undergoing Bioselection

2021 ◽  
pp. 019459982110137
Author(s):  
Molly E. Heft Neal ◽  
Joshua D. Smith ◽  
Andrew C. Birkeland ◽  
Catherine T. Haring ◽  
Steven B. Chinn ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Induction Chemotherapy ◽  
Neck Cancer ◽  
Tertiary Care ◽  
Tumor Infiltrating Lymphocytes ◽  
Care Hospital ◽  
Disease Specific Survival ◽  
Infiltrating Lymphocytes ◽  
Disease Specific

Objective Bioselection to assess tumor response after induction chemotherapy has been introduced as an alternative treatment strategy to total laryngectomy for patients with advanced larynx squamous cell carcinoma (LSCC). Tumor-infiltrating lymphocytes (TILs) have proven to serve as prognostic biomarkers in head and neck cancer but have not been evaluated as a way to select patients for treatment paradigms. The aim of this study is to evaluate the role of pretreatment TILs in patients with advanced LSCC undergoing the bioselection paradigm. Study Design Retrospective study. Setting Tertiary care hospital. Methods Patients with advanced LSCC treated with bioselection and available tissue were included (N = 76). Patients were stratified into CD8-low and CD8-high cohorts by using the median TIL count. Kaplan-Meier survival analysis and multivariate cox regression were performed with SPSS version 26 (IBM). Results After controlling for tobacco use, tumor site, and stage, a high CD8 TIL count was an independent predictor of improved 5-year disease-specific survival (hazard ratio, 0.17 [95% CI, 0.03-0.84]; P = .03). CD8 TIL counts did not predict response to induction chemotherapy; however, subgroup analysis of patients treated with chemoradiation therapy revealed that CD8 TIL count was significantly associated with degree of response ( P = .012). Conclusion These findings support prior data published by our group showing that TILs are predictive of disease-specific survival in patients with head and neck cancer. CD8 TIL counts were significantly associated with degree of clinical response after induction chemotherapy. These results suggest that pretreatment assessment of tumor-infiltrating CD8 cells could be useful in selecting patients.

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