scholarly journals Retrospective analysis of total laryngectomy with post-operative radiotherapy for CA larynx in a tertiary care centre: a case series

2019 ◽  
Vol 5 (3) ◽  
pp. 653
Author(s):  
S. Mohamed Siddique ◽  
G. Selvarajan
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Total Laryngectomy ◽  
Postoperative Radiotherapy ◽  
Tertiary Care ◽  
Case Series ◽  
Treatment Modalities ◽  
Pharyngocutaneous Fistula ◽  
Operative Care

<p class="abstract"><strong>Background:</strong> Squamous cell carcinoma is the most common malignancy of the larynx. Various treatment modalities are available. Recently, total laryngectomy is a viable option as primary treatment or salvage surgery after radiotherapy than organ preservation surgeries. The aim was to analyse the results of the patients with advanced laryngeal cancers treated with total laryngectomy and postoperative radiotherapy.</p><p class="abstract"><strong>Methods:</strong> It is a retrospective study from January 2015 to June 2018 with 16 patients with squamous cell carcinoma of larynx. Detailed history, examination, radiological, endoscopic evaluation of tumour, tissue biopsy proof and staging was done.  </p><p class="abstract"><strong>Results:</strong> Of the 16 patients (15 male and 1 female), 12 patients (75%) were primary cases and 4 patients (25%) were radiorecurrent. 14 patients (87%) had pre-operative tracheostomy done and 2 patients (13%) had undergone direct laryngectomy. All the 16 patients had transglottic growth. All the patients had undergone total laryngectomy with post-operative radiotherapy. No pharyngocutaneous fistula reported. One patient (6%) had neck edema. One patient (6%) had nodal recurrence.</p><p class="abstract"><strong>Conclusions:</strong> Total laryngectomy with post-operative radiotherapy affords a longer period of survival compared to radiotherapy alone. Minimal complications in our study are attributed to thorough pre-operative evaluation, meticulous surgical technique and post-operative care.</p><p class="abstract"> </p>

Salvage of Recurrence after Surgery and Adjuvant Therapy: A Multi-institutional Study

2019 ◽  
Vol 161 (1) ◽  
pp. 74-81 ◽  
Author(s):  
Joseph Zenga ◽  
Evan Graboyes ◽  
Tyler Janz ◽  
Virgina Drake ◽  
Eleni Rettig ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Adjuvant Therapy ◽  
Disease Control ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locoregional Recurrence ◽  
Salvage Surgery ◽  
Tertiary Care ◽  
Case Series ◽  
Positive Margins

ObjectivesTo determine the oncologic outcomes of patients undergoing salvage surgery for recurrent oral cavity squamous cell carcinoma (OCSCC) and oropharyngeal squamous cell carcinoma (OPSCC) after initial treatment with surgery and adjuvant therapy.Study DesignRetrospective case series with chart review.SettingFive academic tertiary care centers.Subjects and MethodsPatients included those with OCSCC and OPSCC who were initially treated with surgery and adjuvant therapy between 2000 and 2015 and underwent salvage surgery for local and/or regional recurrence.ResultsA total of 102 patients were included (76% OCSCC, 24% OPSCC). Five-year overall survival was 31% (95% CI, 21%-41%) and was significantly improved among patients with human papillomavirus–associated oropharyngeal tumors (hazard ratio [HR], 0.34; 95% CI, 0.11-0.98) and significantly worse for those with postoperative positive margins (HR, 2.65; 95% CI, 1.43-4.93). Adjuvant (chemo)reirradiation was not associated with disease control or survival regardless of margin status. Combined locoregional recurrence was significantly correlated with a positive margin resection (HR, 5.75; 95% CI, 1.94-17.01). Twenty-five patients (25%) underwent a second salvage surgical procedure, of whom 8 achieved long-term disease control.ConclusionPatients presenting with resectable recurrence after initial therapy with surgery and adjuvant therapy have a reasonable salvage rate when a negative margin resection can be attained. Patients with postoperative positive margins have poor survival outcomes that are not significantly improved with adjuvant (chemo)reirradiation. Those with combined locoregional recurrence are at particularly high risk for postoperative positive margins. The functional consequences of salvage surgery and its effect on quality of life are critical in decision making and require further investigation.

Supracricoid partial laryngectomy for non-squamous cell carcinoma of the larynx

2001 ◽  
Vol 115 (5) ◽  
pp. 388-392 ◽  
Author(s):  
David Veivers ◽  
Andréa de Vito ◽  
Kuauhyama Luna-Ortiz ◽  
Daniel Brasnu ◽  
Ollivier Laccourreye
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Total Laryngectomy ◽  
Case Series ◽  
Distant Metastases ◽  
Partial Laryngectomy ◽  
Potential Utility ◽  
Supracricoid Partial Laryngectomy ◽  
Carcinoma Of The Larynx

The objective of this paper was to evaluate the potential utility of supracricoid partial laryngectomies (SCPLS) for non-squamous cell carcinoma of the larynx. To illustrate our management of such tumours we present a case series based on six patients. Local control was achieved in five patients, with the sixth being salvaged by total laryngectomy and post-operative radiation therapy. Three of the six patients died of distant metastases. We concluded that supracricoid partial laryngectomies should become part of the armamentarium of the otolaryngologist - head and neck surgeon for non-squamous cell carcinoma of the larynx.

Endoscopic Partial Supraglottic Laryngectomies

2009 ◽  
Vol 141 (3) ◽  
pp. 374-381 ◽  
Author(s):  
Marc Remacle ◽  
Georges Lawson ◽  
Anastasios Hantzakos ◽  
Jacques Jamart
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tertiary Care ◽  
Case Series ◽  
University Hospital ◽  
Long Term Results ◽  
Type I ◽  
Swallowing Function ◽  
Supraglottic Squamous Cell Carcinoma

OBJECTIVE: The aim of this study was to evaluate long-term results of endoscopic surgery for supraglottic carcinoma. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care university hospital. SUBJECTS AND METHODS: From 1992 to 2004, 45 patients diagnosed with supraglottic squamous cell carcinoma (two Tis, nine T1N0, 27 T2N0, two T2N1, one T2N2, four T3N0) underwent different types of endoscopic supraglottic laryngectomies according to the European Laryngological Society (ELS) classification: three limited excision (type I); 27 medial without resection of the preepiglottic space (type IIb); one medial with resection of the preepiglottic space (type IIIa); three medial with resection of the preepiglottic space (type IIIb); nine lateral (type IVa); two lateral (type IVb). RESULTS: Overall survival was 93 ± 4 percent (SE) after three years and 89 ± 6 percent (SE) after five years. The median follow-up is 3.7 years. Patients with clinically N0 necks were found to have positive nodes in eight (19%) cases. Two cases of postoperative hemorrhage were controlled by electrocautery. All of the patients without previous treatment for larynx cancer regained swallowing function within five days to three weeks after surgery. Mean duration of hospitalization was 12.5 days. CONCLUSION: Endoscopic partial laryngectomies, as defined by the ELS classification, for selected supraglottic squamous cell carcinoma proved to be an excellent alternative to radiotherapy and open neck surgery.

Risk Factors for Laryngectomy for Dysfunctional Larynx After Organ Preservation Protocols: A Case-Control Analysis

2020 ◽  
pp. 019459982094770
Author(s):  
Michael P. Wu ◽  
Tessa Goldsmith ◽  
Allison Holman ◽  
Rachael Kammer ◽  
Anuraag Parikh ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Total Laryngectomy ◽  
Tertiary Care ◽  
Oral Intake ◽  
Case Control ◽  
Control Group ◽  
Control Analysis

Objective (1) To identify factors associated with severe dysfunctional larynx leading to total laryngectomy after curative treatment of head and neck squamous cell carcinoma and (2) to describe swallowing and voice outcomes. Study Design Retrospective single-institution case-control study. Setting Tertiary care referral center. Methods A 10-year chart review was performed for patients who had previously undergone radiation or chemoradiation for head and neck mucosal squamous cell carcinoma and planned to undergo total laryngectomy for dysfunctional larynx, as well as a control group of matched patients. Controls were patients who had undergone radiation or chemoradiation for mucosal squamous cell carcinoma but did not have severe dysfunction warranting laryngectomy; these were matched to cases by tumor subsite, T stage, and time from last treatment to video swallow study. Main outcomes assessed were postoperative diet, alaryngeal voice, pharyngeal dilations, and complications. Results Twenty-six patients were scheduled for laryngectomy for dysfunctional larynx, of which 23 underwent surgery. Originally treated tumor subsites included the larynx, oropharynx, hypopharynx, oral cavity, and a tumor of unknown origin. The median time from end of cancer treatment to laryngectomy was 11.5 years. All cases were feeding tube or tracheostomy dependent or both prior to laryngectomy. As compared with matched controls, cases were significantly less likely to have undergone IMRT (intensity-modified radiotherapy) and more likely to have pulmonary comorbidities. Eighty-nine percent of cases with follow-up achieved functional alaryngeal voice, and all were able to have oral intake. Conclusion Non-IMRT approaches and pulmonary comorbidities are associated with laryngectomy for dysfunction after radiation or chemoradiation.

scholarly journals Oncological outcomes in the management of cT1-T2 cN0 penile squamous cell carcinoma

2020 ◽  
Vol 15 (6) ◽  
Author(s):  
Juan Garisto ◽  
Madhur Nayan ◽  
Kamel Fadaak ◽  
Kathy Li ◽  
Advait Pandya ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Organ Preservation ◽  
Early Stage ◽  
Care Center ◽  
Tertiary Care ◽  
Oncological Outcome ◽  
Treatment Modalities ◽  
Tertiary Center

Introduction: Squamous cell carcinoma (SCC) of the penis is a rare disease comprising 1% of all male cancer. Options for the management of cT1-T2 cN0 penile SCC include partial penectomy (PP), considered the standard, and brachytherapy (BT), which offers acceptable local disease control and organ preservation. The purpose of our study was to assess and describe the oncological outcome for both treatments in a tertiary care center. Methods: We performed a contemporary retrospective study of patients with early-stage penile cancer treated surgically or by BT at a tertiary center between 2000 and 2016. Demographic, management, and followup data were obtained from an institutional database. Descriptive statistics and survival analysis using Kaplan-Meier plots were calculated. Local and regional recurrences were compared in both groups (BT vs. PP). Results: A total of 51 patients with cT1-T2N0 penile SCC treated with BT (35) and PP (16) were analyzed. Median followup was 37.1 (13.9–68) and 25.4 months (18–52.3) for the BT and PP group, respectively. Recurrence developed in seven (20%) patients treated with BT. Median time to recurrence was 35.2 months (range 2.9–95.8). No recurrences were reported in patients treated with PP. Forty-four (86.2%) patients were alive with no evidence of disease at the last followup. Overall survival was 62.7%. Complications after primary tumor treatment were urethral stenosis (15.7%), penile necrosis (7.8%), and local infection (2%). Conclusions: PP provides acceptable local control with organ preservation in early-stage penile SCC. BT was able to offer organ preservation in 69% of men. Future prospective studies are needed to compare other organ-conserving treatment modalities with PP.

scholarly journals Local Chemotherapy as an Adjuvant Treatment in Unresectable Squamous Cell Carcinoma: What Do We Know So Far?

2021 ◽  
Vol 28 (4) ◽  
pp. 2317-2325
Author(s):  
Luigi Bennardo ◽  
Francesco Bennardo ◽  
Amerigo Giudice ◽  
Maria Passante ◽  
Stefano Dastoli ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Gold Standard ◽  
Systemic Chemotherapy ◽  
Standard Treatment ◽  
Case Reports ◽  
Case Series ◽  
Surgical Removal ◽  
Local Chemotherapy

Background: Squamous cell carcinoma (SCC) is one of the most common cancers involving skin and oral mucosa. Although this condition’s gold-standard treatment is the surgical removal of the lesions, the physician must propose alternative treatments in some cases due to the patient’s ineligibility for surgery. Among the available alternative therapies, local chemotherapy may represent an initial treatment in combination with radiotherapy or systemic chemotherapy due to the low frequency of side-effects and the lack of necessity for expensive devices. Methods: In this paper, we review all available literature in various databases (PubMed, Scopus-Embase, Web of Science), proposing local chemotherapy as a treatment for cutaneous and oral SCC. Exclusion criteria included ocular lesions (where topical treatments are common), non-English language, and non-human studies. Results: We included 14 studies in this review. The majority were case reports and case series describing the treatment of non-resectable localized SCC with either imiquimod or 5-fluorouracil. We also analyzed small studies proposing combination treatments. Almost all studies reported an excellent clinical outcome, with a low risk of relapses in time. Conclusions: Resection of the lesion remains the gold-standard treatment for SCC. When this approach is not feasible, local chemotherapy may represent a treatment alternative, and it may also be associated with radiotherapy or systemic chemotherapy.

scholarly journals Pembrolizumab in vaginal and vulvar squamous cell carcinoma: a case series from a phase II basket trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeffrey A. How ◽  
Amir A. Jazaeri ◽  
Pamela T. Soliman ◽  
Nicole D. Fleming ◽  
Jing Gong ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Phase Ii ◽  
Squamous Cell ◽  
Single Agent ◽  
Case Series ◽  
Predictive Biomarkers ◽  
Vulvar Squamous Cell Carcinoma ◽  
Metastatic Setting ◽  
Progression Of Disease

AbstractVaginal and vulvar squamous cell carcinoma (SCC) are rare tumors that can be challenging to treat in the recurrent or metastatic setting. We present a case series of patients with vaginal or vulvar SCC who were treated with single-agent pembrolizumab as part of a phase II basket clinical trial to evaluate efficacy and safety. Two cases of recurrent and metastatic vaginal SCC, with multiple prior lines of systemic chemotherapy and radiation, received pembrolizumab. One patient had significant reduction (81%) in target tumor lesions prior to treatment discontinuation at cycle 10 following confirmed progression of disease with new metastatic lesions (stable disease by irRECIST criteria). In contrast, the other patient with vaginal SCC discontinued treatment after cycle 3 due to disease progression. Both patients had PD-L1 positive vaginal tumors and tolerated treatment well. One case of recurrent vulvar SCC with multiple surgical resections and prior progression on systemic carboplatin had a 30% reduction in her target tumor lesions following pembrolizumab treatment with a PD-L1 positive tumor. Treatment was discontinued for grade 3 mucositis after cycle 5. Pembrolizumab may provide some clinical benefit to some patients with vaginal or vulvar SCC and is overall safe to utilize in this population. Future studies are needed to evaluate the efficacy of pembrolizumab in these rare tumor types and to identify predictive biomarkers of response.

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