UI - 11978553
AU - Tjebbes GW; Kreijveld PA; Tilanus MG; Hordijk GJ; Slootweg PJ
P53 tumor suppressor gene mutations in laryngeal cancer and in recurrent
disease following radiation therapy.
SO - Oral Oncol 2002 Apr;38(3):296-300
AD - Department of Otorhinolaryngology (G05.101), University Hospital
Utrecht, PO box 85500, 3508 GA, Utrecht, The Netherlands.
In this study we performed p53 sequencing based mutation analysis in
laryngeal cancers and matched recurrent disease following irradiation.
The question is if irradiation affects the DNA and introduces or deletes
mutations so that p53 cannot be used as a clonal marker anymore. P53
mutations were identified in fresh-frozen laryngectomy specimens with
either primary laryngeal cancers, treated by surgery and irradiation
post-operative with local failure during follow-up, or with recurrent
laryngeal cancers following primary irradiation. In 21 tumors the p53
status was analyzed by direct sequencing full-length mRNA through
RT-PCR. DNA sequencing analysis of exons 2 through 11 was performed when
RNA isolation could not be performed. The marker mutation identified in
this way was detected by DNA sequencing of the corresponding exon in
formalin-fixed deparaffinized tumor biopsy samples in respectively
matched recurrent disease following surgery and irradiation or primary
tumor before irradiation. DNA sequencing analysis of the corresponding
exon of peripheral blood leukocytes excluded the presence of germline
mutations or polymorphisms. In 16 out of 21 tumors (71%), a mutation was
identified. Fifteen of these marker mutations were detected in the
matched tumor biopsy sample (94%). The only case lacking the marker
mutation probably was a second primary tumor. We conclude that we find
no direct evidence for induction or loss of p53 mutations following
irradiation. Consequently, p53 may be used as a diagnostic tool when
histological examination fails, for example in discriminating between
the presence of a second primary tumor in the same area versus recurrent
UI - 11957288
AU - Diouf R; Diallo BK; Tall A; Ndiaye IC; Kpemissi E; Dangou JM; Diop EM
[Cancers of the larynx: what therapeutic strategy to use in Senegal?]
SO - Dakar Med 1999;44(2):215-8
AD - Service d'O.R.L. et de Chirurgie Cervico-Faciale du CHU de Dakar,
The technical method's deficiency limits the respect of therapeutic
principles of cervico-facial oncology in our practice. In a period of 16
years, 116 patients, aged of 24 to 81 years, sex male in a majority have
had laryngectomy for extended cancer. In 88% of cases total laryngectomy
has been realized and in 12% of cases a partial laryngectomy has been
realized. In 101 patients, 87%, a neck dissection have been associated
to the laryngectomy. The post operative radiotherapy have been realized
in 51 patients. The immediate results are marked by the unexpected
arrival of pharyngeal fistula in 34 patients. 7 cases of death have been
noticed. The global survival have been 35% in 3 years and 30% in 5
years. The fatal cases have been loco-regional cases and occur during
the 18 first months. The surgery option, which is our choice, must be
maintained and the neck dissection more vigorous.
UI - 11718256
AU - Ferlito A; Shaha AR; Gavilan J; Buckley JG; Rinaldo A; Herranz J; Suarez
Is radiotherapy recommended after supraglottic laryngectomy?
SO - Acta Otolaryngol 2001 Oct;121(7):877-80
AD - Department of Otolaryngology-Head and Neck Surgery, University of Udine,
Policlinico Universitario, Italy. firstname.lastname@example.org
UI - 11791241
AU - Rifai M; Heiba MH; Salah H
Anterior commissure carcinoma II: the role of salvage supracricoid
SO - Am J Otolaryngol 2002 Jan-Feb;23(1):1-3
AD - Otorhinolaryngology Department, Kasr El-Aini School of Medicine, Cairo
University, 8 Hoda Shirawi Street, Bab El Louk, Postal Code 1111, Cairo,
Supracricoid laryngectomy (SCL) was performed for 45 cases of recurrent
anterior commissure carcinoma (ACC). The procedure involves excision of
the thyroid cartilage with the tumor-bearing mucosa and subsequent
anastomosis between the thyroid and cricoid cartilage. It is therefore
called cricohyoidopexy, or cricohyoidoepiglottopexy if the epiglottis is
also included in the excision. Rate of control of local spread at 2
years was 95.4%. Oncologic and functional results also indicate that SCL
is a suitable alternative to total laryngectomy in selected cases of
UI - 11894783
AU - Nakashima T; Yano G; Masuda A; Uemura T; Morita M
Argyrophilic nucleolar organizer regions as a prognostic indicator of
SO - Eur Arch Otorhinolaryngol 1994;251 Suppl 1():S76-9
AD - Department of Otolaryngology, National Kyushu Cancer Center, Notame
3-1-1, Minami-ku, Fukuoka 815, Japan.
Nucleolar organizer regions (NORs) were studied in surgically removed
specimens from 76 patients with squamous cell carcinomas of the larynx
using an argyrophilic (Ag) staining technique. The mean number of AgNORs
per nucleus was 4.3 +/- 1.38 (SD). The mean AgNOR number for T1 or T2
disease was statistically lower than that for T3 or T4 lesions (P <
0.05). The mean AgNOR number was lower in patients with N0 disease than
in patients with N1 or N2 or N3 tumors (P < 0.05). There was also a
statistically significant difference between the mean AgNOR number for
stage II and stage III disease (P < 0.01), for stage III and stage IV
disease (P < 0.05), but not for stage I and stage II disease. According
to the histological grading, there was a significant difference between
the mean AgNOR number for the well-differentiated and moderately
differentiated tumors (P < 0.05), and for the moderately differentiated
and poorly differentiated types (P < 0.01). These results suggest that
the number of AgNORs in the nucleus is a significant indicator of
UI - 12011128
AU - Mendenhall WM; Morris CG; Stringer SP; Amdur RJ; Hinerman RW; Villaret
DB; Robbins KT
Voice rehabilitation after total laryngectomy and postoperative
SO - J Clin Oncol 2002 May 15;20(10):2500-5
AD - Department of Radiation Oncology, Health Science Center, University of
Florida College of Medicine, PO Box 100385, Gainesville, FL 32610-0385,
PURPOSE: The purpose of this study was to evaluate voice rehabilitation
after laryngectomy and postoperative irradiation for patients with
squamous cell carcinoma of the larynx and hypopharynx. PATIENTS AND
a total laryngectomy and postoperative irradiation and had follow-up
from 3 to 188 months (median, 38 months). Three patients were lost to
follow-up at 63, 39, and 4 months after treatment. All other living
patients had follow-up for 2 years or longer. Twelve (7%) patients had
incomplete data pertaining to voice rehabilitation. RESULTS: Data
pertaining to voice rehabilitation were available at 2 to 3 years and
longer and 5 years and longer after treatment for 118 and 69 patients,
respectively. The methods of voice rehabilitation at 2 to 3 years and
longer and 5 years and longer were as follows: tracheoesophageal, 27%
and 19%; artificial larynx, 50% and 57%; esophageal, 1% and 3%;
nonvocal, 17% and 14%; and no data, 5% and 7%, respectively. CONCLUSION:
The most common form of voice rehabilitation after total laryngectomy
and postoperative radiation therapy is the artificial larynx. Although
the tracheoesophageal puncture is a technique frequently promoted by
clinicians as a superior method, a relatively small subset of patients
are successfully rehabilitated long-term. However, of those who undergo
a tracheoesophageal puncture, approximately half will use this method of
voice rehabilitation long term.
UI - 11997771
AU - Zeitels SM; Casiano RR; Gardner GM; Hogikyan ND; Koufman JA; Rosen CA;
Voice and Swallowing Committee, American Academy of Otolaryngology--Head
and Neck Surgery
Management of common voice problems: Committee report.
SO - Otolaryngol Head Neck Surg 2002 Apr;126(4):333-48
AD - Department of Otology and Laryngology, Harvard Medical School, and the
Division of Laryngology, Massachusetts Eye and Ear Infirmary, Boston, MA
02114, USA. email@example.com
OBJECTIVE: This report provides the reader with a state-of-the-art
update on a number of common voice problems that require phonosurgical
intervention. STUDY DESIGN AND SETTING: This multiauthor review is not a
position statement of the American Academy of Otolaryngology-Head and
Neck Surgery (AAOHNS) and may reflect institutional preference and/or
bias. It arose from a panel discussion at the AAOHNS meeting in 2000.
RESULTS: We provide a review of the genesis and management of
papillomatosis, dysplastic glottal epithelium, arytenoid granulomas,
Reinke's edema, and vocal-fold paralysis. CONCLUSIONS AND SIGNIFICANCE:
In the past decade, there has been a dramatic expansion of knowledge
regarding a variety of voice disorders and associated treatment. There
has been a convergence of basic science investigations in anatomy,
physiology, and pathology with clinical trials of treatment, both
surgical and nonsurgical. This information should provide the reader
with current insight into critical management issues of the
UI - 11997773
AU - Smith JC; Johnson JT; Myers EN
Management and outcome of early glottic carcinoma.
SO - Otolaryngol Head Neck Surg 2002 Apr;126(4):356-64
AD - Department of Otolaryngology, University of Pittsburgh School of
Medicine, The Eye and Ear Institute, PA 15213, USA. JCSmith@pitt.edu
OBJECTIVE AND STUDY DESIGN: We designed a retrospective study to analyze
treatment methods and outcomes for patients with lesions ranging from
carcinoma in situ to invasive T1 glottic squamous cell carcinoma.
Patients with nonsquamous cell carcinoma, verrucous variant of squamous
cell carcinoma, anterior commissure involvement, and T2 lesions were
excluded. SETTING: University of Pittsburgh School of Medicine, a
tertiary referral center. RESULTS: Fifty-four patients met the inclusion
criteria. Mean follow-up was 49 months (range 24 to 96 months).
Forty-eight of 54 (89%) were treated with endoscopic excision. Forty of
these 48 patients (83%) were successfully treated with endoscopic
excision(s) as the only treatment modality. Four patients had
persistence of disease despite multiple endoscopic excisions. Two of
these patients underwent hemilaryngectomy, 1 received radiation
treatment, and 1 received radiation therapy followed by a
hemilaryngectomy. Four patients had recurrence of disease. Two patients
with recurrence required radiation therapy and 2 patients required a
total laryngectomy. With the selective application of multiple
endoscopic excisions, radiation therapy, and more invasive operation,
100% of patients are without evidence of disease with a laryngeal
preservation rate of 96%. CONCLUSIONS: This study supports the use of
endoscopic excisional biopsy as the primary treatment modality for
lesions ranging from carcinoma in situ to invasive T1 glottic carcinoma.
This study also highlights the importance of close clinical follow-up
and the potential need for further treatment. By reserving open
operation and radiation therapy to selective cases, we successfully
treated all patients while limiting the disadvantages of radiation
therapy and more invasive operation to the minority of patients.
UI - 11965102
AU - Janot F; Rhein B; Koka VN; Wibault P; Domenge C; Bessede JP; Marandas P;
Schwaab G; Luboinski B
[Laryngeal Preservation with Induction Chemotherapy. Experience of two
GETTEC Centers, Between 1985 and 1995]
SO - Ann Otolaryngol Chir Cervicofac 2002 Feb;119(1):12-20
AD - Departement d'ORL et Chirurgie Cervico-Faciale, Institut Gustave Roussy,
39 rue Camille Desmoulins, 94805, Villejuif.
This is a retrospective study of laryngeal preservation in endolaryngeal
cancer with induction chemotherapy and radiotherapy for good responders.
Between 1985 and 1995, 104 patients were treated in Institut Gustave
Roussy (87 patients) and in Limoges (17 patients). The overall survival
for the whole population was 76% and 69% at 3 and 5 years respectively,
with a 36% rate of laryngeal preservation. In this retrospective series
of patients, the single prognostic factor affecting survival was
arytenoid mobility before treatment (66% and 55% at 3 years vs 85% and
82% at 5 years; p<0.004). Loco-regional failures were higher (33% vs
15%, p<0.03), and laryngeal preservation was lower (18% vs 51%) among
patients with a fixed arytenoid (49 pts), compared with patients with a
non fixed arytenoid (55 pts) ). The percentages of patients with a fixed
arytenoid could explain the conflicting results of the two randomized
studies of laryngeal preservation in laryngeal cancer.
UI - 11965103
AU - De Mones E; Hans S; Hartl DM; Laccourreye O; Brasnu D
[Carbon dioxide laser transoral microsurgery for glottic carcinoma in
SO - Ann Otolaryngol Chir Cervicofac 2002 Feb;119(1):21-30
AD - Service d'otorhinolaryngologie et de chirurgie de la face et du cou,
Hopital Europeen Georges Pompidou, Universite Paris V, 20 rue Leblanc.
OBJECTIVE: To evaluate the oncologic results of glottic carcinoma in
situ (CIS) treated with transoral carbon dioxide laser microsurgery.
METHODS: A retrospective review of 12 patients with glottic CIS
previously untreated, treated with carbon dioxide laser transoral
RESULTS: Initial and ultimate local control rates were 75%, and 100%,
respectively. Three local failures occurred: two glottic CIS were
treated by carbon dioxide laser transoral microsurgery, one squamous
cell glottic carcinoma was treated by supracricoid partial laryngectomy
with cricohyoidoepiglottopexy. The ultimate rate of laryngeal
preservation rate was 100%. CONCLUSIONS: Based on the material of this
study, recommended treatment for glottic CIS should be carbon dioxide
laser transoral microsurgery. Difficulties in endoscopic exposure of the
larynx is a contraindication. Further studies are necessary to confirm
these preliminary results.
UI - 11938842
AU - Yang X; Lei K
[The influence of changes in vocal cords' cover-body on their vibratory
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Dec;33(6):334-7
AD - Fifth People's Hospital, Shanghai 200240.
OBJECTIVE: To discuss the influence of changes in vocal cords'
cover-body on their vibratory pattern. METHODS: Fifty adult patients
with vocal polyps were observed by telescopic videolaryngostroboscopy
and detected by electroglottography (EGG). We examined the vocal cords'
vibratory pattern according to laryngostroboscopic image and discussed
the change of vocal cords' vibratory parameters and EGG curves. RESULTS:
The vocal cords' vibratory parameters and EGG curves changed with
different vocal polyps. All vocal polyps affect the regularity(REG),
amplitude (AMP), glottal closure(GLO) and mucosal wave(MUC) of
laryngostroboscopic image; the symmetry(SYM), REG and GLO bore linear
correlation to the notches in EGG curves, the REG and MUC bore linear
correlation to the steep changes; micro-polyps with pedicles reduced the
vibratory parameters CQ and F0, the main abnormalities were notches in
EGG curves; the changes in macro-polyps with pedicles were the same as
the micropolyps except increased CQ. All vocal polyps with wide bases
either single or bilateral, had increased CQ and F0, the main
abnormalities were steep in contact opening phase and flat in wave peak.
CONCLUSIONS: Studies with laryngostroboscopy and EGG revealed how the
vocal polyps affected vocal cords' cover-body, changed the vibratory
pattern of vocal cords, and factors regulating vocal cords' vibratory
UI - 11938851
AU - Wang B; Xia L; Shi Q
[DNA content, expression of proliferating cell nuclear antigen and
surgical margins in locally advanced laryngeal cancer]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Dec;33(6):361-3
AD - First Affiliated Hospital, Shanxi Medical University, Taiyuan 030001.
OBJECTIVE: To probe into the relationship between DNA content, PCNA and
prognosis. METHODS: Surgical margins in 34 patients with locally
advanced laryngeal cancers were observed by means of antibody to PCNA
and DNA content measurements. RESULTS: The results demonstrated that at
neoplasm margins of 1.0, 0.5, and 0 cm, PCNA indices were 8.62%, 17.76%
and 50.32% and DNA indices were 0.98, 1.082 and 1.436 respectively.
There is a significant difference between 1.0, 0.5 and 0 cm. CONCLUSION:
Moderate and severe atypical hyperplasia of epithelium (AHE) was
different from mild AHE and simple hyperplasia of epithelium in the
biologic behavior of fission, proliferation and so on and surgical
margins should be kept outside the area of moderate AHE.
UI - 11938852
AU - Li Q; Tu G; Tang P
[Preoperative radiation plus surgery vs. operation alone for laryngeal
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Dec;33(6):364-7
AD - Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing 100021.
OBJECTIVE: To study the validity of preoperative radiation in improving
the survival rate of laryngocarcinoma. METHODS: A prospective randomized
clinical trial was conducted with preoperative radiation plus surgery
(RS) as one group and surgery alone (SA) as the other group. The ages of
the patients were less than 75 years, and the operative types were
decided after clinical examination. The patients were divided into SA or
RS group by random. Doses of preoperative irradiation was 40 Gy. Three
hundred and seventy patients with laryngocarcinoma were treated, 215 in
the SA group; 155 in the RS group. All patients were followed up over
three years. RESULTS: In SA group, 3 years survival rate was 83.3%,
5-year survival rate 82.6%, 10-year survival rate 80.3%. In RS group,
3-year survival rate was 78.9%, 5-year survival rate 76.4%, 10-year
survival rate 68.6%. There is no statistically significant difference in
survival rates between the groups (P = 0.1); but, the 10-year survival
rate in SA group was better than that in RS group for the stage III and
IV supraglottic carcinomas, the former was 73.6% and the latter 63.5% (P
= 0.003). The 10-year survival rate for the patients with T3 and T4
supraglottic carcinomas who underwent total laryngectomy in SA group was
better than that in RS group. The former was 68% and the latter 50% (P =
0.0001). CONCLUSION: Preoperative radiotherapy with 40 Gy didn't
increase the survival rate of laryngeal carcinoma. The 10-year survival
of stages III and IV supraglottic carcinoma in combined treatment group
was lower than that in the surgery alone group.
UI - 11859976
AU - Teppo H; Koivunen P; Sipila S; Jokinen K; Hyrynkangas K; Laara E;
Pukkala E; Sovio U; Alho OP
Decreasing incidence and improved survival of laryngeal cancer in
SO - Acta Oncol 2001;40(7):791-5
AD - Department of Otorhinolaryngology, University of Oulu, Finland.
The decreasing incidence rate and improvement in survival of laryngeal
cancer patients in Finland are exceptions among western countries. A
descriptive study of these trends was conducted including both
nationwide population-based cancer registry data with 5 766 patients
diagnosed in 1956-1995 and regional hospital-based data from Northern
Finland, allowing classification into supraglottic and glottic cancers,
with 353 patients diagnosed in 1976-1995. In Finland, the age-adjusted
incidence rate among males decreased from 6.5 per 100 000 in 1956-1965
to 3.5 in 1986-1995, while in females the rate remained around 0.3 per
100 000. The rates in Northern Finland were slightly higher and the
supraglottic to glottic incidence ratio diminished from 1.4:1 in
1976-1985 to 0.5:1 in 1986-1995. The 5-year relative survival rate
improved in both Northern Finland and the whole country, most noticeably
among males and the elderly. In the data from Northern Finland, the
survival rate was more favourable in glottic (80%) than in supraglottic
cancer (64%). Considering the marked decrease in the incidence of the
less favourable supraglottic disease, the observed improvement in
survival was small.
UI - 11859977
AU - Luscher MS; Pedersen U; Johansen LV
Treatment outcome after laser excision of early glottic squamous cell
carcinoma--a literature survey.
SO - Acta Oncol 2001;40(7):796-800
AD - Department of Otorhinolaryngology, Aarhus University Hospital, Denmark.
Two treatment options are widely used for the cure of T1 glottic
squamous cell carcinoma: radiotherapy and surgical removal. There is
ongoing controversy about whether laser excision should be offered to
patients with T1 glottic carcinoma. The purpose of this study is to
present a review of studies dealing with treatment outcome after laser
excision of T1 glottic carcinoma. Eighteen original papers on outcomes
were identified. Recurrence rates ranged from 4% to 35%. The
disease-specific survival rate at 5 years was found to be from 89% to
100% and crude survival from 74% to 100%. Of the six studies dealing
with voice quality, radiation therapy was found to be more effective in
preservation of the voice in three, while in the other three studies, no
significant difference could be detected. With respect to costs of
treatment, in three out of four studies laser surgery was found to be
the more economical treatment option. Laser surgery seems to provide
comparably low recurrence rates and high disease-specific survival as
compared with radiotherapy. In T1 cancer, laser resection leaves the
patient with a poorer voice quality than is the case with radiation
therapy, but laser treatment seems to be the cheaper option.
UI - 11911285
AU - Luzar B; Poljak M; Marin IJ; Fischinger J; Gale N
Quantitative measurement of telomerase catalytic subunit (hTERT) mRNA in
laryngeal squamous cell carcinomas.
SO - Anticancer Res 2001 Nov-Dec;21(6A):4011-5
AD - Institute of Pathology, Medical Faculty University of Ljubljana,
We tested 30 laryngeal squamous cell carcinomas (LSCCs) and 30 matched
control laryngeal samples from the same patients for the presence of
human telomerase catalytic subunit (hTERT) mRNA by using the Roche
LightCycler Telo TAGGG hTERT Quantification kit. The hTERT index was
calculated to express the relative quantity levels of hTERT mRNA. hTERT
mRNA was detectable in 10 out of 30 (33%) laryngeal tissues covered by
normal and/or reactively hyperplastic laryngeal epithelium and 23 out of
30 LSCCs (77%). The mean hTERT indices were 0.15 for control
non-cancerous laryngeal samples, 0.57 for grade I, 2.35 for grade II and
3.72 for grade III LSCCs. LSCCs without detectable hTERT mRNA (23%)
tended to have lower grades of disease. No correlation was found between
the levels of hTERT mRNA and tumour size or locoregional lymph node
status. We believe that hTERT mRNA in normal and/or reactively
hyperplastic laryngeal epithelium originates from the stem cells and
corresponds to the self-renewal capacity of the squamous epithelium.
However, the greater quantity of h TERT mRNA in LSCCs is the result of
telomerase reactivation in the process of laryngeal carcinogenesis.
UI - 11911316
AU - Virtaniemi JA; Hirvikoski PP; Kumpulainen EJ; Johansson RT; Kosma VM
Surgical management of irradiation failures in T1-T2 squamous cell
carcinoma of the glottic larynx.
SO - Anticancer Res 2001 Nov-Dec;21(6A):4185-8
AD - Department of Otorhinolaryngology, University of Kuopio and Kuopio
University Hospital, Finland.
BACKGROUND: The purpose of this study was to analyse the results of
salvage surgery after failure of irradiation to control the primary
T1-T2 glottic cancer. MATERIALS AND METHODS: Ninety-eight patients with
T1 and T2 squamous cell cancer of the glottic larynx were treated with
curative intent by radiotherapy. The tumour recurred in 22 of the 98
(22%) patients. Surgical management consisted of total and frontolateral
laryngectomy. Survival rates were calculated from the date of the
salvage operation. RESULTS: Two of the 22 patients refused to undergo
salvage surgery and one patient had pulmonary metastasis. Of the 19
patients who underwent salvage surgery, 14 (74%) had total laryngectomy
and 5 (26%) had frontolateral laryngectomy. The operations were curative
in 15 (79%) of the 19 patients. The overall 5-year survival rate after
surgery was 78%. CONCLUSION: Stringent follow-up of patients with
irradiated T1 and T2 glottic laryngeal cancer is essential to permit a
UI - 11784266
AU - Munin MC; Rosen C
Use of laryngeal electromyography.
SO - Arch Otolaryngol Head Neck Surg 2002 Jan;128(1):91-2
UI - 11977351
AU - Klatka J; Skomra D
Nucleolar organizer regions in laryngeal cancer.
SO - Ann Univ Mariae Curie Sklodowska [Med] 2001;56():417-21
AD - Otolaryngology Department, Medical University of Lublin.
The purpose of this study was to estimate the prognostic value of the
AgNORs count per nucleus in laryngeal cancer. The sections of
diagnostic, formalin-fixed and paraffin-embedded specimens from 48
patients with T1-4 tumours were stained with silver nitrate for
visualization of NORs (AgNORs). The correlation between AgNORs score and
tumour clinicopathological features was estimated. The mean AgNOR number
per nucleus was 2.73 +/- 0.87 (range 1.48-4.38). The AgNOR counts did
not correlate with the stage of the disease, patient survival rate and N
stage. A significant correlation between the mean AgNORs number and
various stages of histological differentiation of carcinoma was observed
(p < 0.05).
UI - 12016041
AU - Sarini J; Bocciolini C; Fournier C; Penel N; Kara A; Van JT; Lefebvre JL
[Induction chemotherapy and larynx preservation: is such practice
SO - Bull Cancer 2002 Apr;89(4):411-7
AD - Departement de cancerologie cervico-faciale, Centre Oscar-Lambret, 3,
rue Frederic-Combemale, 59020 Lille Cedex.
BACKGROUND: Surgery followed by irradiation is considered to be the
standard treatment but require frequently a total laryngectomy.
Chemotherapy followed by irradiation is available in larynx and
hypopharynx squamous cell carcinoma (SCC) treatment. Are results
obtained in daily induction chemotherapy usefulness identical to results
obtained in larynx preservation studies? PATIENTS AND METHOD: We
conducted a retrospective study on patients treated at centre
Oscar-Lambret, Lille, from 1986 to 1995, by chemotherapy followed by
definitive radiotherapy or by surgery and radiotherapy for laryngeal or
hypopharyngeal cancer treatment. All patients were naive of previous
head and neck SCC and a surgical treatment, requiring total
laryngectomy, should be proposed with curative intent. Induction
chemotherapy associated cisplatin (100 mg/m2) on day 1 and
5-fluorouracil (5FU)(1,000 mg/m2) on days 1-4 or 1-5. Irradiation was
performed for responders (complete or partial > 50%). If case of
non-responder, patients underwent surgical treatment followed by
irradiation. We compared results obtained with patients enrolled in
clinical trial and with patients whom benefited from this protocol out
of trial. RESULTS: Hundred-eight patients were evaluable for purposes of
this study. Fifty-two patients were included in clinical trial (group 1)
while 56 patients (group 2) were not. There was no statistical
difference as regard neither to sex nor to node (palpable or not
palpable) and metastasis status between the groups. We found a higher
frequency of laryngeal tumour in group 2 (31 vs 17; p =.03). We observed
more stage III and less stage IV in group 1. For chemotherapy-related
toxic reactions, the exclusive statistical difference observed was
haematological toxicity grade III and IV after the second cycle (0 pt in
group 1 vs 8 pts in group 2; p =.02). After initial treatment, complete
response was achieved without statistical difference between the groups
(88.2% vs 78%; p =.27). A surgical procedure was performed in 46 cases
without difference according to the reference group and functional
larynx preservation was 55.8% (29/52) in group 1 and 53.6% (30/56) in
group 2. Whatever the group, causes of death were similarly distributed.
Cancer was the first cause of death in both groups. The overall survival
of the population (108 patients) was 81.5% at one year, 49.6% at 3 years
and 35.3% at 5 years with a median survival of 3 years. There was no
statistical difference between both groups. Some parameters influenced
the overall survival like T (p =.04), response to chemotherapy (p=.006),
extra capsular spread (p = 0.03) and response after completion
treatment. CONCLUSION: Induction chemotherapy is available for larynx
preservation but cannot be considered as a standard treatment.
Nevertheless, results should be reproduced in daily practice with
experimented teams as found with non included patient's results. The
long-term side effects of such protocols should be evaluated. Recent
publication, on increase postoperative infection after chemotherapy,
should be evaluated in clinical trial. If confirmed, cost effectiveness
of such complication must be integrated in larynx preservation
protocols. Larynx preservation remains an interesting point of view for
patients but stay an optional procedure and not a reference.
UI - 11683351
AU - Homma A; Furuta Y; Oridate N; Nakano Y; Yagi K; Nagahashi T; Fukuda S;
Correlation of clinicopathological parameters and biological markers
related to apoptosis and proliferative activity with a clinical outcome
in squamous cell carcinoma of the larynx treated with concurrent
SO - Auris Nasus Larynx 2001 May;28 Suppl():S87-94
AD - Department of Otolaryngology, Hokkaido University School of Medicine,
Sapporo, Japan. firstname.lastname@example.org
OBJECTIVE: This study was designed to determine whether biological
markers related to apoptosis or proliferative activity are associated
with the clinical outcome in patients with squamous cell carcinoma (SCC)
of the larynx treated with concurrent chemoradiotherapy. METHODS:
Immunostaining with antibodies specific to p53, bcl-2, bax, and MIB-1
was performed to evaluate expression of these proteins in
formalin-fixed, paraffin-embedded specimens of 59 patients treated with
concurrent chemoradiotherapy (carboplatin, 100 mg/m2, four to six times
every week; total radiation dose of 40-65 Gy over 4-6.5 weeks). RESULTS:
Multivariate analysis indicated that nodal status was a significant
indicator of overall survival (OS: P = 0.001). Patients with bcl-2
positive tumors had better OS than those with bcl-2 negative tumors in
both univariate (P = 0.002) and multivariate analyses (P < 0.001 ). In
the univariate analysis, a considerable difference in OS was observed
among the expressions of bax (P = 0.077), MIB-1 proteins (P = 0.071).
and OS. but the difference was not statistically significant.
CONCLUSION: This study indicates that nodal status is the major
prognostic tactor in patients with SCC of the larynx treated with
concurrent chemoradiotherapy. These results provide useful information
for predicting prognosis. Further analysis of biological factors is
needed to evaluate the value as predictive markers.
UI - 11683352
AU - Nagahashi T; Fukuda S; Homma A; Yagi K; Furuta Y; Inuyama Y
Concurrent chemotherapy and radiotherapy as initial treatment for stage
II supraglottic squamous cell carcinoma.
SO - Auris Nasus Larynx 2001 May;28 Suppl():S95-8
AD - Department of Otolaryngology, Hokkaido University School of Medicine,
Sapporo, Japan. email@example.com
OBJECTIVE: To evaluate the efficacy and safety of concurrent carboplatin
(CBDCA) and radiotherapy for laryngeal carcinoma. we investigated
survival rates and laryngeal preservation rates in patients with this
treatment modality and those with radiation therapy only. METHODS: We
underwent chemotherapy with CBDCA and conventional radiotherapy
concurrently to 17 patients with untreated stage II (T2NOM0)
mg/m2) was administered intravenously once a week concurrently with
radiotherapy (2.5 Gy/fr, 4 times a week). At the dose of 40 Gy, the
results were evaluated, and some of the patients underwent planned
surgery and others continued the radiotherapy up to 65 Gy. RESULTS:
Overall 5-year survival rate by Kaplan-Meier method was 81.1%. Actual
laryngeal preservation rate was 76.0%. Toxicity over grade III was
noticed in two patients. Compared with 14 cases of historical controls,
which were treated by radiation therapy alone between 1988 and 1990, the
cases with concurrent radiotherapy and chemotherapy had statistically
significant advantage in overall successful laryngeal preservation rate
(P < 0.05), whereas the two groups were not significantly different in
the overall 5-year survival rate.
UI - 11677841
AU - de Campora E; Radici M; de Campora L
[Glottic-hypoglottic laryngectomy in the treatment of laryngeal tumors]
SO - Acta Otorhinolaryngol Ital 2001 Jun;21(3):151-5
AD - Ospedale Generale S. Giovanni Calibita, Fatebenefratelli, Divisione di
Otorinolaringoiatria, Isola Tiberina, Roma.
Subglottic cancers and glottic cancers with subglottic extension are
considered extremely serious because they are not easily detected and
are normally quite advanced when diagnosed. Furthermore these cancers
spread rapidly beyond the larynx to the lymph nodes (cervical and
recurrential chains). Total laryngectomy is elective surgery in the
treatment of subglottic cancer. However, in selected cases, small tumors
may also be treated successfully with partial glottic-subglottic
laryngectomy. The aim of this paper is to present a personal experience
with partial surgery in the treatment of subglottic cancer. The surgical
operation consists of the resection of both vocal cords, the subglottic
region and the cricoid cartilage with the proximal tracheal rings. The
larynx is reconstructed through a tracheal-thyroid approach. The
surgical technique is illustrated and the authors' experience discussed.
UI - 11820561
AU - Lazarczyk B; Moniuszko T; Kosztyla-Hojna B; Lachowicz M; Rogowski M;
Assessment of the ability of mononuclear blood cells to produce
IFN-gamma in patients with laryngeal cancer.
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():106-7
AD - Department of Otolaryngology, Medical Academy of Bialystok, Poland.
The ability of mononuclear blood cells (PBMC), derived from patients
with cancer of the larynx, to produce IFN-gamma in vitro was assessed in
this paper. Thirty patients (27 male, 3 female) were qualified to the
study. Their mean age was 65 (range: 41 to 78 years), tumour sizes found
in the group were from T2 to T4, levels of pathologic malignancy G2 or
G3. The percentage rates different blood cells phenotypes (CD3+, CD3+
HLADR+, CD4+, CD8+, CD14+ HLADR+, CD19+, CD56+) were evaluated by means
of flow cytometry (Coulter EPICS XL). The control group consisted of 20
healthy blood donors. PBMC were derived by centrifugation of heparinized
venous blood on Lymphoprep gradient according to Boyum method. Double
cell cultures were performed for 24 hours with antibody anti-CD3 or
recombinant interleukins 12 (rhIL-12) or 18 (rhIL-18). The statistic
analysis was based on Student t and Mann-Whitney's test with
significancy at p<0.05. A significant decrease in the production of
IFN-gamma by PBMC in patients with laryngeal cancer after stimulation
with antiCD3 (p=0.018), rhIL-12 (p=0.027), rhIL-18 (p=0.016) was found
in comparison with the controls. The results suggest a decreased
production of IFN-gamma in patients with cancer of the larynx.
UI - 11820574
AU - Kosztyla-Hojna B; Rogowski M; Lazarczyk B; Pepinski W
Voice creating aspect after horizontal laryngectomy and chordectomy in
patients with carcinoma of the larynx.
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():133-5
AD - Department of Otolaryngology, Medical Academy, Bialystok, Poland.
Voice quality was assessed in 55 patients with the laryngeal carcinoma.
A quality of voice was examined in 18 patients before and after
chordectomy and in 37 patients before and after supraglottic surgery.
Subjective and objective spectrography methods were applied to evaluate
dysphony. The larynx was examined by indirect larngoscopy and
videolaryngostroboscopy (VLSS). Significant voice pathology was found in
patients before surgery when compared with the normal group. A change of
voice colour was found, which was manifested in spectrography by
decreased in formant levels, especially F3 and F4 in patients after
supraglottic surgery. Dysphagia and longer tracheostomy were temporary
complications after the surgery and resulted in further phoniatric
rehabilitation. Early phoniatric rehabilitation after chordectomy helped
to achieve subjective and objective improvement of voice quality in
patients after surgery. Good voice quality in patients after chordectomy
is due to preserved structure and increased levels F1, F2, F3, and F4
formants in spectrography.
UI - 11820575
AU - Kosztyla-Hojna B; Rogowski M; Pepinski W; Rutkowski R; Lazarczyk B
Voice analysis after the partial laryngectomy in patients with the
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():136-8
AD - Department of Otolaryngology, Medical Academy, Bialystok, Poland.
The paper presents 170 cases of patients with the larynx carcinoma after
the partial laryngectomy. According to the procedure which we used,
vertical, horizontal and subtotal supraglottis laryngectomies were
distinguished. Voice pattern was analysed with the use of subjective and
objective spectrography. The lowest degree of dysphonia was found in
patients after the horizontal laryngectomy, while the highest degree
dysphonia in those after subtotal supraglottis laryngectomy.
UI - 11820576
AU - Kosztyla-Hojna B; Rogowski M; Pepinski W; Rutkowski R; Moniuszko T;
Evaluation of the voice function after the supraglottis subtotal
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():139-41
AD - Department of Otolaryngology, Medical Academy, Bialystok, Poland.
Voice quality was analysed in 39 patients with the larynx carcinoma
after the supraglottis subtotal laryngectomy. Voice pattern was analysed
with the use of subjective and objective spectrography before and after
the surgery. A deteriorated voice quality was found after the surgery.
The spectrographic examination revealed decreased frequency levels of
the formants F3 and F4 and the presence of a noise component generated
in the glottis area.
UI - 11820581
AU - Woinska-Rojecka T; Chodynicki S; Chyczewski L; Rzewnicki I
CD44 glycoprotein as a prognostic factor in laryngeal cancer.
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():150-1
AD - Department of Otolaryngology, Medical Academy, Bialystok, Poland.
An association between cell adhesion molecules expression in neoplastic
tissues and cancer progression has been the focus of many recent
studies. In certain tumours down-regulation of CD44 expression has been
linked to the poor prognosis. The aim of the study was to evaluate CD44
expression and to determine the correlation between CD44 expression and
the clinicopathological features of laryngeal cancer. The group
consisted of 80 patients with primary laryngeal cancer. Tissue samples
were taken from removed tumour mass during surgical treatment, CD44
expression was assessed by immunohistochemical method. The
down-regulation of CD44 expression significantly correlated with a
shorter disease-free survival (p<0.05). Our results suggest that CD44
expression may be useful as a prognostic marker in laryngeal cancer.
UI - 11859280
AU - Chodynicki S; Lazarczyk B; Woinska-Rojecka T; Poludniewska B; Luczaj J;
Tynkiewicz J; Olszewska E
Modified neck dissections--efficiency of surgical treatment and clinical
SO - Med Sci Monit 2002 Feb;8(2):CR93-5
AD - Department of Otolaryngology, Medical University, Sklodowskiej-Curie
24a, 15-276 Bialystok, Poland.
BACKGROUND: The evaluation of affected lymph node number, the site of
metastatic lymph nodes, and spread of neoplastic infiltration beyond the
lymph capsule is considered useful in prognosis. The aim of the study
was to estimate the frequency of neck nodal metastases occurrence
depending on the site of origin, the grade of larynx cancer progression,
and clinical condition of neck lymph nodes. MATERIAL/METHODS: The study
comprised 315 patients with larynx cancer who underwent surgery in
1994-1999. Laryngectomy was the most frequent procedure, performed in
254 patients, while partial laryngectomy was performed in 61 patients.
There were 630 bilateral neck dissections; type I of modified radical
surgery in 27 cases, type II in 45 cases, and type III in 558 cases.
RESULTS: Neck nodal metastases were detected most rarely in cases of
glottic cancer (16%), and most frequently in transglottic cancer (56%).
Most frequently, the nodal metastases affected the II level of the lymph
node groups regardless of the site. Recurrences to the neck lymph nodes
were observed in 3.3% of the cases where the removed lymph nodes did not
reveal any metastatic changes in histopathological examinations.
CONCLUSIONS: Postoperative results of the neck lymph node
histopathological examination point to the necessity of lymphadenectomy
in the II-V levels. Selective lymphadenectomy is not advisable due to
the possibility of metastases to all levels of the neck lymph nodes
regardless of the primary tumor site.
UI - 12017338
AU - Dong Y; Sui L; Watanabe Y; Sugimoto K; Tokuda M
Aberrant expression of cyclin A in laryngeal squamous cell carcinoma.
SO - Anticancer Res 2002 Jan-Feb;22(1A):83-9
AD - Department of Physiology, Kagawa Medical University, Kita-gun, Japan.
The expression of cyclin A protein was retrospectively investigated in
102 patients with human laryngeal squamous cell carcinoma (LSCC) by
using immunohistochemistry. Out of 102 tumors, 41 (40.2%) exhibited
positive-staining in cancer cells with this antibody. No association
between cyclin A overexpression and the patients' clinicopathological
parameters was found. However, cyclin A overexpression was significantly
associated with CDK2 and PCNA expression (p = 0.01 and p = 0.001,
respectively). Kaplan-Meier analysis showed that patients with
overexpression of cyclin A were associated with poor disease-free
survival (p = 0.046), but it was not associated with overall survival (p
= 0.106). Additionally, patients with both lymph node metastasis and
cyclin A overexpression were significantly associated with worse
disease-free survival (p < 0.0001). The multivariate analysis showed
that tumor size, lymph node metastasis and cyclin A overexpression are
significantly independent prognostic factors of disease-free survival.
These findings suggest that cyclin A overexpression is associated with
recurrence of LSCC.
UI - 11692964
AU - Lahoz Zamarro MT; Martinez Subias J; Galve Royo A; Prieto Andres P
[Mortality in advanced stage laryngeal cancer]
SO - Acta Otorrinolaringol Esp 2001 Aug-Sep;52(6):494-500
AD - Servicio de Otorrinolaringologia, Hospital Obispo Polanco, Teruel.
Patients with advanced laryngeal carcinoma present a high mortality rate
due to locoregional recurrence, distant metastases and second cancer. We
present a report about the most important prognostic factors in
mortality in patients included in III and IV stages. The most important
are the presence of metastatic lymph nodes (p = 0.001), extracapsular
spread (p = 0.002) and N stage (p = 0.005).
UI - 12012961
AU - Timbo SK; Konipo-Togola F; Mohamed AA; Keita MA; Sacko HB; Traore L
[Laryngeal papillomatosis in Mali. Apropos of 19 cases collected at the
Gabriel Toure Hospital of Bamako]
SO - Bull Soc Pathol Exot 2002 Mar;95(1):31-3
AD - Service ORL, Hopital Gabriel Toure, BP 267, Bamako, Mali.
From 1994 to 1999, 19 cases of laryngeal papillomatosis were observed.
The sex-ratio M/F was 0.9 and the mean age 10 years. The motive for
consulting was dyspnoea for 45% of the cases and in all these cases
resulted in emergency tracheotomy. The only available means of
intervention was peeling under general anaesthesia. An
anatomopathological examination could be carried out for only 63.1% of
cases. Prevalence of the disease has been under-estimated for reasons of
late diagnosis and the inaccessibility to health structures for some
UI - 12043214
AU - Chatani M
[Current status of radiation therapy--evidence-based medicine (EBM) of
radiation therapy. Radiotherapy for pharyngeal and laryngeal cancer]
SO - Nippon Igaku Hoshasen Gakkai Zasshi 2002 Mar;62(4):126-31
AD - Department of Radiology, Osaka Rosai Hospital.
Radiation therapy is the first choice of treatment for early pharyngeal
and laryngeal cancers, especially those of the glottic larynx and
nasopharynx. For advanced lesions without distant metastasis, more
intensive treatments, i.e., chemoradiotherapy, multiple fractions per
day, and conformal radiotherapy are introduced to improve local control
and survival. However, the level of evidence-based medicine is different
for each treatment modality. In this review, recent reports of
radiotherapy for pharyngeal and laryngeal cancer are introduced from the
point of view of the evidence level.
UI - 12043218
AU - Suzuki G; Hayabuchi N; Toda Y; Suefuji H; Ogo E; Nakajima T
[Laser-radiation therapy for T2N0M0 laryngeal-glottic cancer]
SO - Nippon Igaku Hoshasen Gakkai Zasshi 2002 Mar;62(4):151-5
AD - Department of Radiology, School of Medicine, Kurume University.
PURPOSE: To evaluate the laser-radiation combined therapy for T2N0M0
laryngeal-glottic cancer in order to preserve the larynx. METHODS AND
MATERIALS: The subjects consisted of 52 patients with T2N0M0
laryngeal-glottic cancer treated with laser-radiation combined therapy
between 1980 and 1999. Patients ranged in age from 40-88 years, with a
median of 70 years, and included 51 men and one woman. During this
period, treatment was administered with different radiation devices(60Co
or 4 MV-X ray), and 40-72 Gy (median, 60 Gy) of