Surgical treatment of squamous cell carcinoma of the hypopharynx: analysis of treatment results, failure patterns, and prognostic factors

2004 ◽  
Vol 118 (6) ◽  
pp. 443-449 ◽  
Author(s):  
Pen-Yuan Chu ◽  
Ling-Wei Wang ◽  
Shyue-Yih Chang
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Primary Tumour ◽  
Univariate Analysis ◽  
Disease Specific Survival ◽  
Failure Patterns ◽  
Disease Specific

Patients with squamous cell carcinoma of the hypopharynx (HPSCC) are often seen in advanced stages and have a poor prognosis. The authors analysed 104 patients who had HPSCC and underwent surgery as the primary treatment between 1986 and 1995 in their institute. Of the 104 patients, 83 patients (80 per cent) had advanced T3 or T4 staged and 64 patients (62 per cent) had cervical metastasis. Thirteen patients (13 per cent) had conservation surgery with laryngeal preservation and 69 patients (66 per cent) received post-operative radiotherapy. The five-year overall and disease-specific survival was 47 per cent and 62 per cent, respectively. Recurrence occurred in 38 patients (37 per cent), including 12 (12 per cent) with local, 22 (21 per cent) with regional, and 12 (12 per cent) with distant recurrence. Sixteen patients (15 per cent) had recurrence at multiple sites. The site and size of the primary tumour, neck biopsy before surgery, early post-operative complications, and pathological nodal stage were significant prognostic factors of disease-specific survival (DSS) in univariate analysis. Neck biopsy before surgery and site of primary tumour were significant factors in multivariate analysis. In conclusion, surgical treatment for the HPSCC patients has achieved good local-regional control and survival. Bilateral neck dissection for the tumour across the midline and avoiding neck biopsy before surgery may reduce regional recurrence.

scholarly journals Impact of submandibular gland preservation in neck management of early-stage buccal squamous cell carcinoma on locoregional control and disease-specific survival

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bo Gu ◽  
Qigen Fang ◽  
Yao Wu ◽  
Wei Du ◽  
Xu Zhang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Submandibular Gland ◽  
Squamous Cell ◽  
Locoregional Control ◽  
Disease Specific Survival ◽  
The Difference ◽  
Disease Specific

Abstract Background The feasibility of submandibular gland (SMG) preservation in oral squamous cell carcinoma (SCC) has occasionally been analyzed, but the differences in survival associated with the presence or absence of SMG preservation remain unknown. We aimed to prospectively evaluate the oncologic results of SMG preservation in cT1-2 N0 buccal SCC. Methods This was a prospective, non-randomized cohort study. Patients with surgically treated cT1-2 N0 buccal SCC were prospectively enrolled and divided into two groups based on the management of the SMG. Level 1b lymph nodes were categorized into six groups based on the positional relationship between the lymph node and the SMG. The main study endpoints were locoregional control (LRC) and disease-specific survival (DSS). Results A total of 31 of the 137 included patients underwent SMG-sparing neck dissection. Patients with SMG preservation were likely to be young persons. Superior metastasis occurred in 11 patients with a prevalence of 8.0%, followed by an anterior metastasis rate of 5.1%, and no metastases developed deeply or within the SMG. The 5-year LRC rates in the SMG-sparing and SMG-excision groups were 74 and 75%, respectively, and the difference was not significant (p = 0.970). The 5-year DSS rates in the SMG-sparing and SMG-excision groups were 74 and 69%, respectively, and the difference was not significant (p = 0.709). Conclusions SMG involvement was rare, and the superior group carried the highest risk for lymph node metastasis. SMG-sparing neck dissection is selectively suggested in cT1-2 N0 buccal SCC patients, and could avoid postoperative asymmetric appearance and dry mouth.

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.

507 NEOADJUVANT AND ADJUVANT CHEMOTHERAPIES FOR PATIENTS WHO UNDERWENT RESECTION FOR SQUAMOUS CELL CARCINOMA CF THE THORACIC ESOPHAGUS

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
J Liu ◽  
Y Wang
Keyword(s):  
Squamous Cell Carcinoma ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Univariate Analysis ◽  
Entire Group ◽  
Thoracic Esophagus ◽  
Term Survival

Abstract   The efficacy of neo-adjuvant chenmotherapy (NCT) and adjuvant chemotherapy (ACT) for squamous cell carcinoma (SCC) of the esophagus has not been fully expounded. This study analyzed the prognostic factors of patients who underwent esophagectomy for SCC of the thoracic esophagus, specially focused on NCT and ACT. Methods From January 2008 to January 2016, 1075 consecutive patients underwent esophgagectomy for stage T3-T4 SCC of the thoracic esophagus. Propensity-score matching (PSM) analyses were conducted in patients who underwent NCT, surgery alone (SA) and ACT. After PSM, there were 83 patients in NCT, 249 patients in SA and 249 patients in ACT group. Postoperative outcomes and prognostic factors of patients in the three groups were analyzed. Univariate analysis was performed using the Kaplan–Meier method and multivariate analysis using the Cox proportional hazard model. Differences were considered to be statistically significant when P &lt; 0.05. Results The incidence of main postoperative complications was 9.6% (8/83) in NCT group compared to 6.8% (34/498) in SA and ACT groups (P = 0.834). In NCT group, 20 patients (24.1%) were downstaged by NCT and 63 patients (75.9%) remained stable. The 3-year survival rate of the entire group was 51.0%, and the 5-year survival rate was 33.4%. The 5-year survival rate was 32.2% in NCT group, 50.9% in ACT, and 19.5% in SA patients. In univariate analysis, both NCT and ACT were associated with long-term survival. In multivariate analysis, however, ACT rather than NCT was independent prognostic factor. Conclusion This study supports the use of postoperative ACT for patients with stage T3 or T4 SCC of the thoracic esophagus, but the effect of NCT needs further study.

scholarly journals Clinical Efficacy and Safety of Apatinib for Maintenance Treatment in Patients with Advanced Esophageal Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Guohui Liu ◽  
Chunbo Wang ◽  
Mingyan E
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Efficacy ◽  
Squamous Cell ◽  
Maintenance Treatment ◽  
Adverse Reactions ◽  
Remission Rate ◽  
Univariate Analysis

Abstract Background: To investigate the clinical efficacy,safety and prognostic factors of the therapy that apatinib is used for maintenance treatment in patients with advanced esophageal squamous cell carcinoma. Methods: We select 46 patients with advanced esophageal squamous cell carcinoma treated with radiotherapy and chemotherapy in our hospital from January 2017 to February 2019, all of them were treatment with apatinib. Analysis the clinical efficacy, adverse reactions and prognostic factors. Meanwhile, the expression of patients’VEGFR-2、NF-kB was detected by immunohistochemical SABC method,and the microvessel density and microlymphatic tube density were counted.Analysis of the relationship between indicators and MVD, MLVD counts and the efficacy of apatinib.Results: We found that oral treatment of apatinib in VEGFR-2、NF-kB positive group was better than that in negative group. The partial remission rate of patients was 26.09%; the disease control rate was 67.39%.The main adverse reactions were hypertension (60.87%); hand and foot syndrome (34.77%); proteinuria (36.96%). The degree of adverse reactions was mainly grade 1~2. The median progression-free survival was 3.7 months and the median overall survival was 7.2 months. Log-Rank univariate analysis showed that the degree of adverse reactions and ECOG score were related to OS in patients with advanced esophageal squamous cell carcinoma.Cox multivariate regression analysis showed that the degree of adverse reactions and ECOG score were independent factors affecting OS in patients with advanced esophageal squamous cell carcinoma.Conclusion: Positive expression of VEGFR-2 and NF-kB can be used as a biological reference target for targeted treatment of oral apatinib. Apatinib has a certain clinical effect in the maintenance treatment of advanced esophageal squamous cell carcinoma patients after treatment, with mild adverse reactions and high safety.

scholarly journals Institutional Experience of Treatment and Outcomes for Cutaneous Periauricular Squamous Cell Carcinoma

OTO Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 2473974X1987507
Author(s):  
Kevin J. Kovatch ◽  
Joshua D. Smith ◽  
Andrew C. Birkeland ◽  
John E. Hanks ◽  
Rasha Jawad ◽  
...  
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Disease Free Survival ◽  
Disease Specific Survival ◽  
Free Survival ◽  
Institutional Experience ◽  
Disease Free ◽  
Disease Specific

Objectives To report our institutional experience, management, and outcomes of cutaneous periauricular squamous cell carcinoma (SCC). Study Design Retrospective chart review. Setting Tertiary academic center. Subjects Patients undergoing treatment of cutaneous periauricular SCC from 2000 to 2016. Results A total of 112 patients had a median follow-up of 24.5 months, a mean ± SD age of 75.7 ± 10.6 years, and a strong male predominance (93.8%). Site distribution shows 87 (77.7%) auricular, 26 (23.2%) preauricular, and 10 (8.8%) postauricular lesions. Of auricular lesions, tumors involved the tragus (n = 3, 3.4%), helix/antihelix (n = 47, 54.0%), conchal bowl (n = 31, 35.6%), external auditory canal (n = 18, 16.1%), and lobule (n = 3, 3.4%). Most patients presented at stage I (52.7%) versus stages II (28.6%), III (6.3%), and IV (12.5%). Patients were largely treated surgically with primary tumor resection ranging from wide local excision to lateral temporal bone resection (± parotidectomy and neck dissection), with 17.0% and 5.4% receiving adjuvant radiation and chemoradiation, respectively. Metastatic spread was seen to the parotid (25.9%) and neck (26.8%), with most common cervical spread to level II. Overall survival, disease-specific survival, and disease-free survival at 3 years were 62%, 89%, and 56%, respectively. Nodal disease was associated with worse disease-specific survival ( P < .001) and disease-free survival ( P = .042). Pre- and postauricular sites were associated with worse overall survival ( P = .007) relative to auricular sites. Conclusion Among cutaneous SCC, periauricular subsites pose treatment challenges related to surrounding anatomy and represent a unique tumor population. The reported propensity toward recurrence and patterns of metastasis may better guide treatment of aggressive tumors to include regional nodal dissection.

Experience of cetuximab in the salvage treatment for recurrent/metastatic oral squamous cell carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16006-e16006
Author(s):  
Jin-Ching Lin ◽  
Shih-An Liu ◽  
Chen-Chi Wang ◽  
Ching-Ping Wang
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Response Rate ◽  
Karnofsky Performance Status ◽  
Univariate Analysis ◽  
Disease Extent

e16006 Background: We investigated the efficacy, toxicity, and prognostic factors of salvage chemotherapy plus cetuximab in patients with recurrent/metastatic oral squamous cell carcinoma (OSCC). Methods: A total of 30 patients with recurrent/metastatic OSCC were treated by an outpatient weekly multi-drug combination chemotherapy plus cetuximab 400 mg/m2 loading in day 1, then 250 mg/m2 every week. The major chemotherapy regimen consisted of MEMOCLUB (methotrexate 30 mg/m2 d1, epirubicin 30 mg/m2 d1, alternating with mitomycin-C 4 mg/m2 d8, oncovin 1 mg/m2 d8, cisplatin 25 mg/m2 d8, leucovorin 120 mg/m2 d8, 5-fluorouracil 1000 mg/m2 d8, and bleomycin 10 mg/m2 d8) or GV (gemcitabine 1000mg/m2 d1, and vinorelbine 25 mg/m2 d8). Results: Baseline characteristics are as followings: median age=45 (range 32-73); male/female=28/2; Karnofsky performance status 80%/70%/60%/50%=7/18/3/2. Most patients had heavily treated history — first recurrence in 11 cases, second recurrence in 6, and third or more recurrence in 13. The disease extent consists of 25 (83.3%) locoregional recurrences, 3 (10.0%) distant metastasis, and 2 (6.7%) locoregional + metastatic diseases. Grade 3/4 toxicity included leucopenia (46.7%), anemia (33.3%), thrombocytopenia (6.7%), mucositis (6.7%) and skin rashes (20.0%). We obtained a high overall response rate of 66.7% (7 CR, 13 PR, 6 SD, 3 PD, and 1 unevaluable). So far, there are 22 deaths and 8 alive. The overall survival time ranges from 48-1365 days with a median of 312 days. One-year overall survival rate is 49%. Two favorable prognostic factors were found by univariate analysis- disease extent (locoregional vs. distant disease, HR=0.1509, 95%CI=0.0008-0.0592) and tumor response (CR+PR vs. SD+PD, HR=0.2255, 95%CI=0.0277-0.2984). Conclusions: Cetuximab plus weekly outpatient multi-drug chemotherapy has a high response rate and encouraging survival with acceptable toxicity in recurrent/metastatic OSCC patients.

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