scholarly journals Association between Histopathological Grading and Clinical Staging in Nasopharyngeal Carcinoma

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Sonya M Naomi ◽  
Yussy A Dewi ◽  
Hasrayati Agustina
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Head And Neck ◽  
Medical Records ◽  
Staging System ◽  
Neck Surgery ◽  
Clinical Staging ◽  
Cell Junction ◽  
Cross Sectional ◽  
Ajcc Staging ◽  
Histopathological Grading

Nasopharyngeal Carcinoma (NPC) is the most common cancer in head and neck. Grading of NPC is based on keratinization, growth, and cell junction, and it can be classified into well differentiated, moderately differentiated, poorly differentiated, and undifferentiated. On the other hand, the staging of NPC based on UICC/AJCC staging system is divided into Stage I-IVC. This classification is based on TNM that is related to the ability of cancer cells to invade normal cells. This study was conducted from May to June 2017 in Oncology Clinic of Otorhinolaryngology-Head and Neck Surgery Department and Pathology Anatomy Department of Hasan Sadikin General Hospital. This is an analytical correlative study with cross sectional design. The data is collected retrospectively from medical records of patients who are diagnosed as NPC with adequate grading and staging data. Incomplete medical records, multiple carcinoma, and recurrent carcinoma are excluded from this study. We find out that among 51 samples, predominant is Stage IVB NPC (37.3%) and undifferentiated grade NPC (76.5%). Statistical analysis shows that there is no significant association between grading and staging (r=0.275; p=0.159).This study concludes that there is no association between histopathological grading and clinical staging in nasopharyngeal carcinoma.Keywords: nasopharyngeal carcinoma, grading, staging

scholarly journals Acceptance and adoption of transoral robotic surgery in Germany

2021 ◽  
Author(s):  
Magis Mandapathil ◽  
Jens E. Meyer
Keyword(s):  
Robotic Surgery ◽  
Head And Neck ◽  
Neck Surgery ◽  
Transoral Robotic Surgery ◽  
Head And Neck Surgery ◽  
University Hospitals ◽  
Cross Sectional ◽  
Adoption Rate ◽  
Decision Making Processes ◽  
Sectional Analysis

Abstract Purpose Since its introduction over a decade ago, the use of robotic surgery (RS) in head and neck surgery has widely spread around the globe, with very differential adoption of this novel surgical technique in different parts of the world. In this study, we analyze the acceptance and adoption of robotic surgery in the head and neck in Germany. Materials and methods A cross-sectional analysis using a questionnaire evaluating the acceptance and adoption of RS was performed. Questionnaires were distributed to all chairmen /-women of Otorhinolaryngology, Head and Neck Surgery Departments in Germany. Results A total of 107 respondents completed the questionnaire (65.2%). At university hospitals, 71.4% of the respondents indicated that a robotic system was available, and 21.4% responded that robotic surgery was performed at their institution; 22.7% and 0.04%, respectively, at non-university hospitals. The overall adoption rate was 0.8%. The most common cases performed were TORS resection in the oropharynx. Main reasons for not adopting this technique were costs, lack of interest and available co-operations. Conclusion This study provides evidence of the extent of adoption of TORS in Germany; main perceived barriers to adoption are costs with lack of cost-covering reimbursement and insufficient co-operations with other disciplines as well as hospital administration resulting in a very low adoption rate of this technique over the past decade. Results from this study may assist in decision-making processes on adopting this technique in the future.

scholarly journals Enhanced Morbidity of Pectoralis Major Myocutaneous Flap Used for Salvage after Previously Failed Oncological Treatment and Unsuccessful Reconstructive Head and Neck Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Christiana Maria Ribeiro Salles Vanni ◽  
Leandro Luongo de Matos ◽  
Mário Paulo Faro Junior ◽  
Jossi Ledo Kanda ◽  
Cláudio Roberto Cernea ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Myocutaneous Flap ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Pectoralis Major ◽  
Pectoralis Major Myocutaneous Flap ◽  
Cross Sectional ◽  
Oncological Treatment ◽  
Major Complications

Introduction. The reconstruction of complex cervicofacial defects arising from surgical treatment for cancer is a real challenge for head and neck surgeons, especially in salvage reconstruction surgery and/or failed previous reconstruction. The pectoralis major myocutaneous flap (PMMF) has been widely used in these specific situations due to its reliability and low rate of failure or complications.Objectives. Identify factors that determine complications and influence the final outcome of the reconstructions with PMMF in salvage cancer surgery or in salvage reconstruction.Methods. A cross-sectional study design was used to evaluate a sample including 17 surgical patients treated over a period of ten years that met the inclusion criteria.Results. Reconstruction was successful in 13 cases (76.5%), with two cases of partial flap loss and no case of total loss. Complications occurred in 13 cases (76.5%) and were specifically related to the flap in nine instances (52.9%). An association was identified between the development of major complications and reconstruction of the hypopharynx () as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment (). The former condition is also associated with major reconstruction failure (). An even lower incidence of major complications was noted in patients under the age of 53 ().Conclusion. Older patients, with hypopharyngeal defects and submitted to previous surgery plus radiation therapy, presented a higher risk of complications and reconstruction failure with PMMF.

scholarly journals CORRELATION OF KI67 LEVEL TO METASTATIC EVENTS IN NASOPHARYNGEAL CARCINOMA

2020 ◽  
Vol 2 (02) ◽  
pp. 31-34
Author(s):  
Eriza ◽  
Ermalinda Kurnia ◽  
Denny Satria Utama
Keyword(s):  
Cell Proliferation ◽  
Nasopharyngeal Carcinoma ◽  
Correlation Analysis ◽  
Correlation Coefficient ◽  
Distant Metastases ◽  
Abdominal Ultrasound ◽  
Neck Surgery ◽  
Cross Sectional ◽  
Ki67 Expression ◽  
Positive Correlation

Introduction Nasopharyngeal carcinoma (KNF) is a malignant squamous cell tumor occurring in the nasopharyngeal epithelial region where the cuboid epithelium is transformed into squamous cells. One of the typical signs of malignancy is uncontrolled cell proliferation. K67 is an immunohistochemical (IHC) test to assess cell proliferation activity. Increased Ki67 expression is associated with increased mitotic activity in cell proliferation. Objective To determine the correlation of ki67 expression to regional and distant metastases events of nasopharyngeal carcinoma at KNF in Dr. Mohammad Hoesin Palembang. Methods This cross-sectional study was conducted on 31 subjects of KNF patients who had been diagnosed in Oncology Division of Department of Ear Nose and Throat Head Neck Surgery, then performed immunohistochemistry inspection of KI67 in Department of Anatomical Pathology of Dr. Mohammad Hoesin Palembang. The subjects were collected consecutive sampling from October to December 2017 and performed other tests for staging such as computer tomography, chest x ray and abdominal ultrasound. Results In the Ki67 level correlation analysis of the incidence of metastasis in nasopharyngeal carcinoma, the correlation coefficient was 0.98 with very strong correlation strength and the positive correlation was not statistically significant (p=0.599). However, in Ki67 level correlation analysis of histopathology result of nasopharyngeal carcinoma was found correlation coefficient of 0.385 and positive correlation which was statistically significant (p=0.032). Conclusion Ki67 levels of metastatic occurrence in nasopharyngeal carcinoma have no statistically significant correlation. However, Ki67 level on histopathological results of nasopharyngeal carcinoma and Ki67 immunoreactivity with primary tumor has a statistically significant correlation.

scholarly journals Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

Oncotarget ◽  
2017 ◽  
Vol 8 (41) ◽  
pp. 70586-70594 ◽  
Author(s):  
Min Kang ◽  
Pingting Zhou ◽  
Guisheng Li ◽  
Haolin Yan ◽  
Guosheng Feng ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Intensity Modulated Radiotherapy ◽  
Staging System ◽  
Intensity Modulated ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

scholarly journals Readability of the American, Canadian, and British Otolaryngology–Head and Neck Surgery Societies’ Patient Materials

2021 ◽  
pp. 019459982110332
Author(s):  
Joo Hyun Kim ◽  
Elysia Grose ◽  
Justine Philteos ◽  
David Forner ◽  
Christopher W. Noel ◽  
...  
Keyword(s):  
Patient Education ◽  
Head And Neck ◽  
Grade Level ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Reading Level ◽  
Head And Neck Surgery ◽  
Cross Sectional ◽  
Patient Comprehension ◽  
Reading Grade Level

Objective Patient education materials across 3 national English otolaryngology–head and neck surgery (OHNS) societies: the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS), the Canadian Society of Otolaryngology–Head and Neck Surgery (CSOHNS), and Ear, Nose, and Throat United Kingdom (ENT UK) were examined to determine whether they are written at a level suitable for patient comprehension. Study Design Cross-sectional study. Setting Online patient materials presented through OHNS national societies. Methods Readability was calculated using the Flesch-Kincaid Grade Level, Flesch-Kincaid Reading Ease Score, and Simple Measure of Gobbledygook Index. All public patient education materials available through the CSOHNS, AAO-HNS, and ENT UK websites were assessed. Patient education materials were grouped into categories by subspecialty. Results In total, 128 patient materials from the 3 societies were included in the study. All 3 societies required a minimum grade 9 reading comprehension level to understand their online materials. According to Flesch-Kincaid Grade Level, the CSOHNS required a significantly higher reading grade level to comprehend the materials presented when compared to AAO-HNS (11.3 vs 9.9; 95% CI, 0.5-2.4; P < .01) and ENT UK (11.3 vs 9.4; 95% CI, 0.9-2.9; P < .01). Patient education materials related to rhinology were the least readable among all 3 societies. Conclusion This study suggests that the reading level of the current patient materials presented through 3 national OHNS societies are written at a level that exceeds current recommendations. Promisingly, it highlights an improvement for the readability of patient materials presented through the AAO-HNS.

scholarly journals A review of the 8th edition of the AJCC staging system for oropharyngeal cancer according to HPV status

2020 ◽  
Vol 277 (9) ◽  
pp. 2407-2412 ◽  
Author(s):  
Piotr Machczyński ◽  
Ewa Majchrzak ◽  
Patryk Niewinski ◽  
Joanna Marchlewska ◽  
Wojciech Golusiński
Keyword(s):  
Oropharyngeal Cancer ◽  
Staging System ◽  
Cancer Staging ◽  
Nodal Metastasis ◽  
Clinical Staging ◽  
Previous Edition ◽  
Hpv Status ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

Abstract Background The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has increased substantially in recent decades, particularly p16-positive human papillomavirus (HPV)-related OPSCC, which has risen by 50% in western countries. HPV-positivity is the most favourable non-anatomic predictor of oropharyngeal cancer outcomes, which underscores the importance of incorporating this variable into the cancer staging system. Methods In the present article, we review the differences between the 7th and 8th editions of the AJCC staging system, with particular focus on the role of HPV-positivity in patients with head and neck cancer. Results In the previous edition (7th edition) of the AJCC/UICC manual, HPV status and its correlation with nodal metastasis were not considered, thereby leading to incorrect lymph node (N) staging and, potentially, inadequate treatment and worse outcomes. The 8th edition of the AJCC manual addresses these issues, providing more accurate discrimination between groups and better risk stratification in patients with HPV-positive OPSCC. In the future, additional adjustments are likely to be needed, such as unification of the pathological and clinical staging models. Conclusions The new staging system is substantially more accurate than the previous system and should be widely adopted in routine clinical practice.

scholarly journals Machine Learning Analysis of Image Data Based on Detailed MR Image Reports for Nasopharyngeal Carcinoma Prognosis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Chunyan Cui ◽  
Shunxin Wang ◽  
Jian Zhou ◽  
Annan Dong ◽  
Fei Xie ◽  
...  
Keyword(s):  
Machine Learning ◽  
Nasopharyngeal Carcinoma ◽  
Clinical Application ◽  
Scoring System ◽  
Image Data ◽  
Staging System ◽  
Clinical Staging ◽  
Mr Image ◽  
Free Survival ◽  
New Machine

We aimed to assess the use of automatic machine learning (AutoML) algorithm based on magnetic resonance (MR) image data to assign prediction scores to patients with nasopharyngeal carcinoma (NPC). We also aimed to develop a 4-group classification system for NPC, superior to the current clinical staging system. Between January 2010 and January 2013, 792 patients with recent diagnosis of NPC, who had MR image data, were enrolled in the study. The AutoML algorithm was used and all statistical analyses were based on the 10-fold test. Primary endpoints included the probabilities of overall survival (OS), distant metastasis-free survival (DMFS), and local-region relapse-free survival (LRFS), and their sum was recorded as the final voting score, representative of progression-free survival (PFS) for each patient. The area under the receiver operating characteristic (ROC) curve generated from the MR image data-based model compared with the tumor, node, and metastasis (TNM) system-based model was 0.796 (P=0.008) for OS, 0.752 (P=0.053) for DMFS, and 0.721 (P=0.025) for LRFS. The Kaplan-Meier (KM) test values for II/I, III/II, IV/III groups in our new machine learning-based scoring system were 0.011, 0.010, and <0.001, respectively, whereas those for II/I, III/II, IV/III groups in the TNM/American Joint Committee on Cancer (AJCC) system were 0.118, 0.121, and <0.001, respectively. Significant differences were observed in the new machine learning-based scoring system analysis of each curve (P<0.05), whereas the P values of curves obtained from the TNM/AJCC system, between II/I and III/II, were 0.118 and 0.121, respectively, without a significant difference. In conclusion, the AutoML algorithm demonstrated better prognostic performance than the TNM/AJCC system for NPC. The algorithm showed a good potential for clinical application and may aid in improving counseling and facilitate the personalized management of patients with NPC. The clinical application of our new scoring and staging system may significantly improve precision medicine.

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