Head & Neck最新文献

{"title":"Patterns of nodal involvement for clinically N0 salivary gland carcinoma: refining the role of elective neck irradiation.","authors":"Valerie H Lau,&nbsp;Rony Aouad,&nbsp;D Gregory Farwell,&nbsp;Paul J Donald,&nbsp;Allen M Chen","doi":"10.1002/hed.23467","DOIUrl":"https://doi.org/10.1002/hed.23467","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to analyze the pattern of occult cervical lymph node metastasis among patients with clinically N0 salivary gland carcinoma.</p><p><strong>Methods: </strong>One hundred nineteen patients underwent primary surgery and ipsilateral neck dissection for clinically N0 carcinomas of the major and minor salivary glands. Eighty patients (67%) had parotid tumors. Distribution of T classification was: T1 (18%), T2 (28%), T3 (23%), and T4 (32%).</p><p><strong>Results: </strong>Twenty-five patients (21%) had pathological cervical disease. The incidence was highest among patients with adenocarcinoma (35%) and high-grade mucoepidermoid carcinoma (35%). The most common site of cervical lymph node metastasis was level II (71%), followed by level III (15%), and level IB (8%). On multivariate analysis, histological subtype was independently predictive of occult pathological lymph node metastasis (p < .001).</p><p><strong>Conclusion: </strong>The likelihood of occult cervical lymph node metastasis for patients with salivary gland carcinoma is driven predominantly by histological subtype. Implications for elective neck irradiation are discussed.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1435-9"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23467","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31735165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stomal recurrence: salvage surgery and reconstruction utilizing microvascular free tissue transfer.","authors":"Amy Pittman,&nbsp;Robert Lindau,&nbsp;Peter Andersen,&nbsp;Mark K Wax","doi":"10.1002/hed.23468","DOIUrl":"https://doi.org/10.1002/hed.23468","url":null,"abstract":"<p><strong>Background: </strong>Stomal recurrence in patients after laryngectomy has a poor prognosis. Studies performed using sternal resection with pectoralis flap reconstruction report <25% 2-year survival. The purpose of this study was to ascertain whether the use of larger resection with free flap reconstruction improves survival.</p><p><strong>Methods: </strong>Thirteen cases of stomal recurrence that underwent extended sternal resection and free flap reconstruction were identified and classified according to Sisson criteria. Postoperative morbidity, mortality, and survival were assessed.</p><p><strong>Results: </strong>Median survival was 10 months in patients with Sisson types I and II, with 37.5% 1-year and 25% 2-year survival. Median survival was 6 months in patients with Sisson types III and IV, with 40% 1-year and 0% 2-year survival. There were 2 perioperative deaths and a major morbidity rate of 45%.</p><p><strong>Conclusion: </strong>Salvage surgery using free flap reconstruction did not show improved survival rates compared with previously described techniques.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1431-4"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23468","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31735299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facelift approach for mandibular resection and reconstruction.","authors":"Bernardo Bianchi,&nbsp;Andrea Ferri,&nbsp;Silvano Ferrari,&nbsp;Chiara Copelli,&nbsp;Enrico Sesenna","doi":"10.1002/hed.23484","DOIUrl":"https://doi.org/10.1002/hed.23484","url":null,"abstract":"Mandibular resection is the mainstay in the treatment of several pathologies involving the jaw. When benign lesions are approached, a limited exposure and less invasive access considering the cosmetic outcome is desirable to reduce morbidity and increase patient's quality of life after surgery. The facelift approach is widely used for rhytidectomy, parotidectomy, and facial animation procedures, whereas its use for mandibular resection and reconstruction is not described yet.","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1497-502"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31700320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to letter to the editor regarding investigation of laryngeal basaloid squamous cell carcinoma prognosis.","authors":"Valerie Fritsch,&nbsp;Eric Lentsch","doi":"10.1002/hed.23769","DOIUrl":"https://doi.org/10.1002/hed.23769","url":null,"abstract":"To the Editor: I read with great interest the recent article by Fritsch and Lentsch, who investigated laryngeal basaloid squamous cell carcinoma (BSCC) prognosis using the populationbased cancer registries of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. Although the study by Fritsch and Lentsch is inevitably characterized by a potential bias relating to the fact that the cases of BSCC were diagnosed and treated by different teams and in different ways, the numerosity of the cases considered is remarkable. These studies are important, particularly those comparing the prognosis for head and neck BSCC as opposed to conventional squamous cell carcinoma (SCC) in site-matched and stage-matched settings, because numerous—but not all—investigators currently believe that head and neck BSCC is a significantly more aggressive lesion and carries a worse prognosis than the more commonly encountered SCC. Confirmation of the greater aggressiveness of head and neck BSCC visa-vis conventional SCC could rationally justify a more aggressive approach to their locoregional treatment and possibly the use of adjuvant chemotherapy in head and neck BSCC. However, because the mistakes made (and reiterated) in citations eventually have a significant impact on the international medical literature, I have to point out that, in their reference number 22, Fritsch and Lentsch misquote the content of a study conducted by our group in this field. In the investigation concerned, the 9 BSCCs considered did not all arise in the larynx (but 5 in the larynx, 3 in the tongue, and 1 in the tonsil), whereas another study by our group analyzed the prognostic role of the apoptosis inhibitor protein survivin in 9 consecutive cases of laryngeal BSCC, and, in this latter series, the diseasespecific survival (DSS) was 55.6%. In speaking about the prognosis for BSCC of the head and neck, it is extremely important to be accurate about the site involved by the primary lesion. In fact, a more recent study by Fritsch and Lentsch concluded that the DSS of patients treated for laryngeal BSCC was significantly lower than for patients with conventional SCC on multivariate analysis, but patients with oropharyngeal BSCC had a higher DSS than those with oropharyngeal conventional SCC (reported data source: Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, September 2005; size of the populations considered: 1083 head and neck BSCCs, 66,929 conventional SCC).","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1527-8"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23769","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32349657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strangling technique to treat large cervicofacial venous malformations: a preliminary report.","authors":"Giacomo Colletti,&nbsp;Valeria Colombo,&nbsp;Raul Mattassi,&nbsp;Alice Frigerio","doi":"10.1002/hed.23585","DOIUrl":"https://doi.org/10.1002/hed.23585","url":null,"abstract":"<p><strong>Background: </strong>Surgical removal of large cervicofacial venous malformations might be hampered by massive intraoperative bleeding. Moreover, these lesions often insinuate within normal surrounding tissue, making complete resection impossible without causing significant morbidity.</p><p><strong>Methods: </strong>Two patients affected by facial venous malformations nonresponsive to sclerotherapy underwent surgery. Bleeding and critical branching of the facial nerve within the lesion prevented the surgeons from proceeding with the removal. The unresectable malformation was decompressed by means of a number of nonresorbable stitches from the surface of the lesion to the periosteum, tailoring a permanent pressure dressing.</p><p><strong>Results: </strong>Outcomes at 12-month follow-up were stable, with good cosmetic results and satisfaction reported by both patients. No long-term side effects related to the procedure were observed.</p><p><strong>Conclusion: </strong>Decompression of large venous malformations by means of a strangling technique might represent a safe and effective procedure for those cases where a removal cannot be accomplished.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"E94-8"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31986997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic role of epidermal growth factor receptor in nasopharyngeal carcinoma: a meta-analysis.","authors":"Wei Sun,&nbsp;Guoxian Long,&nbsp;Junfeng Wang,&nbsp;Qi Mei,&nbsp;Dongbo Liu,&nbsp;Guoqing Hu","doi":"10.1002/hed.23481","DOIUrl":"https://doi.org/10.1002/hed.23481","url":null,"abstract":"<p><strong>Background: </strong>Various studies have assessed the prognostic value of epidermal growth factor receptor (EGFR) overexpression in nasopharyngeal carcinoma (NPC), but their results remain controversial.</p><p><strong>Methods: </strong>Studies published up to January 2013 were collected. A total of 16 studies involving 1179 patients were reviewed. A meta-analysis was performed to clarify the prognostic role of EGFR in patients with NPC. The combined hazard ratio (HR) and 95% confidence interval (CI) were estimated using fixed-effects or random-effects models.</p><p><strong>Results: </strong>EGFR overexpression had significantly poor effect on overall survival (OS; HR, 1.86; 95% CI, 1.25-2.77), disease-free survival (DFS; HR, 2.25; 95% CI, 1.66-3.04) and locoregional control (HR, 2.93; 95% CI, 1.71-5.02). However, the association between EGFR overexpression and distant metastasis-free survival was not statistically significant (HR, 1.39; 95% CI, 0.72-2.67).</p><p><strong>Conclusion: </strong>EGFR overexpression can be a prognostic factor for patients with NPC.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1508-16"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31700006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of palliative care for patients with head and neck cancer through the eyes of next of kin: impact of an Expert Center.","authors":"Marinella P J Offerman,&nbsp;Jean F A Pruyn,&nbsp;Maarten F de Boer,&nbsp;Quirine C P Ledeboer,&nbsp;Jan J van Busschbach,&nbsp;Robert J Baatenburg de Jong,&nbsp;Lilly-Ann van der Velden","doi":"10.1002/hed.23489","DOIUrl":"https://doi.org/10.1002/hed.23489","url":null,"abstract":"<p><strong>Background: </strong>Literature is scarce on the palliative care experiences of patients with head and neck cancer. We report our experience in this patient population after the establishment of our Expert Center.</p><p><strong>Methods: </strong>We administered a questionnaire to 40 surviving relatives of patients with head and neck cancer after the establishment of our Expert Center and compared the results to a similar group of patients with head and neck cancer before the establishment of our Expert Center.</p><p><strong>Results: </strong>Since the establishment of our Expert Center, we found: an improved evaluation of the psychosocial support offered; better contact between head and neck surgeons, the patients, and families; and improvement in the quantity of information in the palliative phase. Some relatives, however, reported that patients received treatment against their wishes and life was not made as comfortable as possible.</p><p><strong>Conclusion: </strong>Important aspects of palliative care, such as psychosocial support and contact between patient and surgeon, have been improved since the establishment of our Expert Center.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1459-66"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31701115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective study of 583 neck dissections in oral cancers: implications for clinical practice.","authors":"Gouri H Pantvaidya,&nbsp;Pooja Pal,&nbsp;Abhishek D Vaidya,&nbsp;Prathamesh S Pai,&nbsp;Anil K D'Cruz","doi":"10.1002/hed.23494","DOIUrl":"https://doi.org/10.1002/hed.23494","url":null,"abstract":"<p><strong>Background: </strong>Determining the level of nodal metastases may help decrease the extent of neck dissections and reduce morbidity.</p><p><strong>Methods: </strong>A prospective study of neck dissections in patients with oral cancer was conducted. Each nodal level was delineated, sent for histopathology, and reported level-wise. Incidence of overall and isolated metastatic nodes at different levels was calculated. Logistic regression was used to find factors predicting metastases to levels IIB and V.</p><p><strong>Results: </strong>Five hundred eighty-three neck dissections were prospectively evaluated. A total of 95.7% metastases occurred at levels I to IV. Overall incidence of metastases to levels IIB and V was 3.8% and 3.3%, respectively. Multivariate analysis revealed IIA positivity as an independent predictive factor for metastases to both IIB and V.</p><p><strong>Conclusion: </strong>This study of lymph node mapping in patients with oral cancer showed a predictable pattern of lymph node metastasis according to primary site. Selective neck dissection (levels I-IV) in patients with oral cancers may be adequate. Determining status of level IIA is important to guide dissection of levels IIB and V.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1503-7"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31699432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent chemoradiotherapy with nedaplatin plus paclitaxel or fluorouracil for locoregionally advanced nasopharyngeal carcinoma: Survival and toxicity.","authors":"Jianhua Xu,&nbsp;Xia He,&nbsp;Kong Cheng,&nbsp;Wenjie Guo,&nbsp;Xiuhua Bian,&nbsp;Xuesong Jiang,&nbsp;Lanfang Zhang,&nbsp;Shengfu Huang","doi":"10.1002/hed.23487","DOIUrl":"https://doi.org/10.1002/hed.23487","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to review the survival and toxicity in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT) and concurrent nedaplatin plus paclitaxel or fluorouracil (NP or NF).</p><p><strong>Methods: </strong>A total of 155 patients with locoregionally advanced NPC seen at our institution between January 2008 and December 2010 were retrospectively reviewed. Seventy-nine cases (51%) were treated with IMRT and concurrent NP chemotherapy, and 76 cases (49%) were treated with IMRT and concurrent NF regimen. Survival and toxicity were reported.</p><p><strong>Results: </strong>The 3-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival (PFS), and overall survival (OS) rates were 90.3% and 87.8%, 79.7% and 81.1%, 77.3% and 71.1%, and 81.6% and 83.7% for the NF and NP group, respectively. The results were comparable to that of the cisplatin-based regimens. Acute and late toxicities were acceptable.</p><p><strong>Conclusion: </strong>IMRT with concurrent nedaplatin-based chemotherapy achieved comparable survival with acceptable toxicity to those of the cisplatin-based regimens in the treatment of locoregionally advanced NPC.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1474-80"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23487","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31700035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TNM staging compared with a new clinicopathological model in predicting oral tongue squamous cell carcinoma survival.","authors":"Oluwafunmilola T Okuyemi,&nbsp;Jay F Piccirillo,&nbsp;Edward Spitznagel","doi":"10.1002/hed.23486","DOIUrl":"https://doi.org/10.1002/hed.23486","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the prognostic impact of comorbidity and of demographic and pathological factors on oral tongue squamous cell carcinoma (SCC) survival, and to compare the prognostic performance of a new clinicopathological model against the routinely used TNM staging.</p><p><strong>Methods: </strong>We conducted a retrospective study of demographic, clinical, and pathological information of 166 patients with oral tongue SCC. Cox regression was used for multivariate analysis, model building, and model discriminatory analysis.</p><p><strong>Results: </strong>Comorbidity had the most significant impact on overall survival (OS; log-rank test, chi-square  =  36.34; p  <  .0001). Comorbidity, tumor dimension >2 cm, and presence of extracapsular spread (ECS) or vascular invasion were independent predictors of survival. A clinicopathological model based on these 4 variables (chi-square  =  60.23; p  <  .0001) was better (c-statistic  =  0.736) at predicting survival compared to pathological TNM staging (c-statistic = 0.645).</p><p><strong>Conclusion: </strong>Comorbidity combined with tumor dimension, ECS, and vascular invasion provide a better prediction of oral tongue SCC survival than TNM staging alone.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1481-9"},"PeriodicalIF":2.9,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31701255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}