National Cancer Institute®
Last Modified: April 1, 2002
UI - 11836682
AU - Li F; Kang N; Li Y; He G; Lin C; Sun X; Gao H; Sun K
TI - [Homozygous deletion of p16 and p15 genes in laryngeal squamous cell carcinoma]
SO - Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2002 Feb;19(1):30-2
AD - Department of Medical Genetics, China Medical University, Shenyang, Liaoning, 110001 P. R. China. Fucaili@hotmail.com
OBJECTIVE: To assess the relationship of homozygous deletion status of p16 (MTS1/INK4a/CDKN2A), p15(MTS2/INK4b/CDKN2B) genes and laryngeal squamous cell carcinoma(LSCC) progression. METHODS: DNA was extracted from fresh tumors. Homozygous deletion of p16 exon 2(p16E2) in 80 cases of LSCC and p15 exon 2(p15E2) in 67 cases of LSCC were detected by the polymerase chain reaction technique. RESULTS: The p16E2 deletion rate in 80 cases was 12.5%(10/80); the p15E2 deletion rate in 67 cases was 11.94%(8/67); the p16E2 and p15E2 codeletion rate in 67 cases was 5.97%(4/67). CONCLUSION: Homozygous deletion of p16E2 and p15E2 is related with LSCC oncogenesis, and it may play a role to some extent in LSCC malignant progression.
UI - 11836691
AU - Zhang X; Wang L; Liu S; Ouyang X; Liang C
TI - [The relationship of p53 gene mutation to cell differentiation and metastasis of laryngeal squamous cell carcinoma]
SO - Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2002 Feb;19(1):61-3
AD - Department of Otorhinolaryngology, the Fourth Affiliated Hospital, Sichuan University, Chengdu, Sichuan, 610041 P. R. China. email@example.com
OBJECTIVE: To inquire about the relationship of p53 gene mutation to the histopathological findings and clinical manifestation in cases of laryngeal squamous cell carcinoma(LSCC). METHODS: The fresh samples from 60 cases of LSCC were examined. Polymerase chain reaction and silver staining-single strand conformation polymorphism (PCR-SSCP) and DNA direct sequencing were used to detect the mutation of p53 gene in exons 5-8. RESULTS: The mutation rates were 69.2% and 85.3% in patients at clinical stage I-II and stage III-IV respectively (P>0.05). In the well-, moderately- and poorly-differentiated cell of LSCC, the mutation rates were 52.9%, 83.3% and 94.7% respectively (P<0.05). The p53 gene mutation rate of LSCC patients with neck lymph-node metastasis was 96.4%, whereas that of patients without neck lymph-node metastasis was 62.5% (P<0.05). Twenty samples showed positive results in SSCP; 19 samples showed deletion and mutation in codons 125-292 by DNA direct sequencing. CONCLUSION: The mutation of p53 gene in exons 5-8 was closely related to cell differentiation and the neck lymph-node metastasis of LSCC, but it was not related to the clinical stages of the LSCC cases.
UI - 11860646
AU - Apostolopoulos K; Samaan R; Labropoulou E
TI - Experience with vertical partial laryngectomy with special reference to laryngeal reconstruction with cervical fascia.
SO - J Laryngol Otol 2002 Jan;116(1):19-23
AD - Department of Otolaryngology, General State Hospital of Nikea Piraeus, Greece. firstname.lastname@example.org
In this paper we report our experience of vertical partial laryngectomy using the superficial cervical fascia; we describe the technique and present the functional and oncological results of this method of treatment. A total of 42 patients with squamous cell carcinoma of the true vocal folds, in stage T(1) (n = 28) or T(2) (n = 14), were treated in our department using vertical partial laryngectomy during the decade 1987-1997. Nine patients had post-operative radiotherapy. The shortest follow-up time was three years. There were six recurrences in all, four in the larynx and two in the neck. All four of the laryngeal recurrences were treated with total laryngectomy and are doing well. Both the patients with neck metastases, who were treated with neck dissection, died. Permanent tracheotomy was necessary in one patient. There were no problems with aspiration. The recurrence rate was 14 per cent, the three-year survival index was 95.2 per cent and the three-year larynx preservation index was 90 per cent. According to our experience, vertical partial laryngectomy, using the method we describe, has a good functional and oncological result for stage T(1) and T(2) tumours.
UI - 11908337
AU - Righini C; Mouret P; Wu D; Blanchet C; Reyt E
TI - [Is hepatic ultrasonography necessary in the initial check-up of patients with squamous cell carcinoma of the upper respiratory and digestive tract?]
SO - Ann Otolaryngol Chir Cervicofac 2001 Dec;118(6):359-64
AD - Service ORL, CHU de Grenoble, BP 217, 38043 Grenoble. CRighini@chu-grenoble.fr
PURPOSE OF THE STUDY: The purpose of our study was to determine the position and value of ultrasound scan of the liver in the initial check-up of patients treated for a squamous cell carcinoma of the upper respiratory and digestive tract. MATERIAL AND METHODS: Our study is based on a retrospective review of 267 patients (249 males and 18 females) managed in the E.N.T. Department of Grenoble universitary hospital from 1993 to 1995 for a upper respiratory and digestive tract malignant tumor. No patient has been previously treated. The site of the primary tumor was: the oropharynx (108 cases), the hypopharynx (88 cases), the oral cavity (44 cases), the larynx (20 cases), the rhinopharynx (6 cases) and the cervical oesophagus (1 case). Endoscopic procedure with biopsy was performed for all the patients. Histologic examination revealed an invasive squamous cell carcinoma in all the cases. The complete check up included a ultrasound scan of the liver and a chest X-ray for all the patients. RESULTS: Ultrasound scan of the liver revealed one or several metastases in 4 cases (1.5%). The primary tumor was hypopharyngeal in 3 cases (2 stages III, 1 stage IV) and oropharyngeal in 1 case (stage III). In three cases, carcinoma was poorly differentiated. Ultrasound scan of the liver was doubtful for 8 patients (3%). The primary tumor was oropharyngeal in 6 cases (1 stage I, 3 stages III, 2 stages IV), laryngeal in 1 case (stage III) and hypopharyngeal in case (stage IV). In six cases carcinoma was well differentiated. All the complementary examinations concluded to a benign liver disease, with a mean diagnosis delay of 4 weeks for the 8 patients. The mean follow-up duration of the 8 patients was 22 months (range 9 to 42 months). None presented any metastases during the follow up. CONCLUSION: Our results compared with those of the literature revealed that ultrasound scan of the liver is a few specific examination which may be recommended for hypopharyngeal tumors, or for a large cervical adenopathy (N2 or N3), a poor differentiated tumor wherever the site of the primary tumor is.
UI - 11886348
AU - Kim MS; Sun DI; Park KH; Cho KJ; Park YH; Cho SH
TI - Paraglottic space in supracricoid laryngectomy.
SO - Arch Otolaryngol Head Neck Surg 2002 Mar;128(3):304-7
AD - Department of Otolaryngology-Head and Neck Surgery, Kangnam St Mary's Hospital, The Catholic University of Korea, Seoul, Korea 137-040. email@example.com
BACKGROUND: Paraglottic space (PGS) is a connective tissue compartment of the larynx and is important in the extension of laryngeal cancer. It communicates with the preepiglottic space superiorly and with the extralaryngeal region inferiorly through the gap within the cricothyroid membrane. Transglottic cancer of the larynx, which spreads within PGS, is characterized by a high incidence of laryngeal skeleton invasion and of cervical metastasis. Determining the correct stage of transglottic cancer of the larynx is difficult, leading to therapeutic failure of partial laryngectomy in some cases. OBJECTIVE: To clinically confirm a pathologically complete resection of PGS from the piriform sinus mucosa by supracricoid partial laryngectomy in laryngeal cancers involving PGS. MATERIALS AND METHODS: Eight patients with transglottic cancer whose cancer was confirmed clinically and pathologically at stages T2b or higher underwent supracricoid partial laryngectomy. During supracricoid partial laryngectomy, we performed a sharp dissection of PGS from the piriform sinus mucosa to obtain a complete resection margin while preserving the piriform sinus mucosa. Microscopic evaluation of the specimens was made for the invasion of PGS and the safe margin distance from the piriform sinus mucosa. RESULTS: Pathological cancer invasion of PGS was confirmed in 7 of 8 patients and a sufficient pathological margin from tumor invasion to the piriform sinus mucosa was obtained. The average safety margin was 10.3 mm. CONCLUSION: Supracricoid partial laryngectomy could be considered a safe surgical modality for cancers not extending to PGS.
UI - 11886352
AU - Taneja C; Allen H; Koness RJ; Radie-Keane K; Wanebo HJ
TI - Changing patterns of failure of head and neck cancer.
SO - Arch Otolaryngol Head Neck Surg 2002 Mar;128(3):324-7
AD - Department of Surgery, Roger Williams Medical Center, 825 Chalkstone Ave, Providence, RI 02908, USA.
BACKGROUND: With the increased use of neoadjuvant therapy for advanced stage squamous cell carcinoma of the head and neck, we have observed an apparent change in the pattern of failure from predominantly locoregional sites to distant metastases. We reviewed the patterns of failure in cancers of the oral cavity, oropharynx, and larynx at our institution during the last decade. OBJECTIVE: To determine whether there has been a significant change in the patterns of recurrence from the historical locoregional failure to distant sites, and whether this change is associated with the increased use of multimodality therapy. METHODS: We reviewed cancer registry data on patients with squamous cell carcinoma of the head and neck diagnosed between January 1, 1988, and December 31, 1999. Sites included the oral cavity and oropharynx (including the tongue, floor of mouth, retromolar trigone, gingiva, tonsil, and lip) and larynx. RESULTS: Among 432 patients with squamous cell carcinoma of the head and neck, 280 (65%) had oral cavity and oropharyngeal cancers, and 152 (35%) had laryngeal cancers. Overall, 19% developed locoregional recurrence, and 8% developed distant failure. Although locoregional failure for oral cavity and oropharyngeal squamous cell carcinoma decreased from 26% to 16% from 1988-1993 to 1994-1999, distant failure increased significantly from 3% to 8%. During these periods, multimodality therapy was used in 62% of oral cavity and oropharyngeal cancers, and this rate remained essentially unchanged. For laryngeal cancer, locoregional and distant failure remained stable at 18% and 9%, respectively. In these laryngeal cancers, the use of multimodality therapy decreased from 60% to 46%, but this difference was not statistically significant (P =.43). CONCLUSIONS: Although locoregional control in oral cavity and oropharyngeal cancers has improved significantly with the use of multimodality therapy, the incidence of distant failure has doubled. In laryngeal squamous cell carcinoma, the patterns of failure have not changed significantly.
UI - 11884787
AU - Stadler A; Kontrus M; Kornfehl J; Youssefzadeh S; Bankier AA
TI - Tumor staging of laryngeal and hypopharyngeal carcinomas with functional spiral CT: comparison with nonfunctional CT, histopathology, and microlaryngoscopy.
SO - J Comput Assist Tomogr 2002 Mar-Apr;26(2):279-84
AD - Department of Radiology, University of Vienna, Vienna, Austria. firstname.lastname@example.org
PURPOSE: The purpose of this work was to compare nonfunctional and functional spiral CT in the tumor (T) staging of laryngeal and hypopharyngeal tumors and to correlate the CT results with microlaryngoscopy and postoperative pathology. METHOD: Twenty-six patients (3 women, 23 men) with clinically suspected laryngeal and hypopharyngeal tumors underwent both nonfunctional CT during quiet breathing and functional spiral CT during either a modified Valsalva (n = 19) or E phonation (n = 7) maneuver. CT slice thickness was 3 mm, table feed was 3 mm, and 40-80 ml of intravenous contrast material was administered at a flow of 1.5 ml/s. T stages as determined by nonfunctional and functional CT were compared and correlated with postoperative pathology or microlaryngoscopy. RESULTS: The T stages determined with functional CT were better correlated with postoperative pathology (rS = 0.88, p = 0.001) and microlaryngoscopy (rS = 0.77, p = 0.008) than T stages determined with nonfunctional CT (rS = 0.80, p = 0.001; and rS = 0.51, p = 0.13, respectively). Twelve of 26 patients (46%) had a lower T stage on functional than on nonfunctional CT. In 14 of 26 patients (54%), the T stage was identical with both modalities. In no patients was the T stage increased by functional CT. CONCLUSION: Functional CT appears to be more accurate than nonfunctional CT in the T staging of laryngeal and hypopharyngeal carcinomas. Functional CT also results in lower T stages than nonfunctional CT in a substantial number of patients.
UI - 11913679
AU - Laccourreye O; Veivers FD; Hans S; Brasnu FD; Garcia D; Laccourreye FL
TI - Metachronous second primary cancers after successful partial laryngectomy for invasive squamous cell carcinoma of the true vocal cord.
SO - Ann Otol Rhinol Laryngol 2002 Mar;111(3 Pt 1):204-9
AD - Department of Otorhinolaryngology-Head and Neck Surgery, Hopital Europeen Georges Pompidou, University of Paris V, France.
The current retrospective studies documented the incidence, sites of occurrence, risk factors, and outcome of metachronous second primary cancers (MSPCs) among an inception cohort of 410 patients with invasive squamous cell carcinoma of the true vocal cord successfully treated with partial laryngectomy at a single institution. The Kaplan-Meier actuarial life-table method was used to document the relationship between the incidence of MSPCs and survival data. Univariate analysis was performed for potential statistical relationships among the incidence of MSPCs, the site of occurrence, and different variables. The overall incidence of MSPCs was 23.9% (98/410). The 10-year actuarial survival estimate for MSPCs was 20.4%.The incidence curve of MSPCs was linear, resulting in a 2%/y rate of development for MSPCs. In univariate analysis, the only variable that demonstrated a statistical correlation with the incidence of MSPCs was smoking, with MSPCs being statistically more likely to occur in smokers than in nonsmokers (p = .04). The main sites of origin for MSPCs were the lung (25.5% of cases), other non-upper aerodigestive tract sites (32.7%), and the upper aerodigestive tract (41.8%). The 10-year actuarial estimates for MSPCs were 9.1% in the upper aerodigestive tract, 7.1% in sites other than the lung or upper aerodigestive tract, and 6.6% in the lung. The incidence curve for MSPCs was linear, whatever the site of origin, resulting in 1 %/y, 0.7%/y, and 0.6%/y rates of development for MSPCs in the upper aerodigestive tract, sites other than the lung or upper aerodigestive tract, and the lung, respectively. Survival was statistically reduced when an MSPC developed; the 10-year actuarial survival estimates were 76.8% in patients who did not develop an MSPC and 43.7% in patients who developed an MSPC (p < .0001). Overall, 68.4% of patients who developed an MSPC (67/98) died of this disease. The 10-year actuarial survival estimates were 24% for lung MSPCs, 43.7% for non-lung, non-upper aerodigestive tract MSPCs, and 63.4% for upper aerodigestive tract MSPCs.
UI - 11770144
AU - Al-Sebeih K; Manoukian J
TI - Systemic steroids for the management of obstructive subglottic hemangioma.
SO - J Otolaryngol 2000 Dec;29(6):361-6
AD - Department of Otolaryngology, Montreal Children's Hospital, McGill University, Quebec.
Subglottic hemangioma is a recognized cause of paediatric upper airway obstruction. We present 14 patients with subglottic hemangioma treated between 1984 and 1997,4 of whom had associated extralaryngeal hemangiomatous lesions (28%). The degree of upper airway obstruction ranged between 20% and 90%. Patients with subglottic hemangioma who had obstruction of the laryngeal lumen more than 25% and those with obstructive symptoms were treated with systemic steroids. The patients were followed clinically, radiographically, and with repetitive bronchoscopies. Nine of 10 patients (90%) have responded clinically to systemic steroids. There were no major complications from the systemic steroid treatment. One patient developed a cushingoid face that was reversed after the cessation of steroid therapy. The purpose of this study is to show that systemic steroids, with or without short-term intubation after diagnostic bronchoscopy, can be used as a safe and effective alternative in the management of obstructive paediatric subglottic hemangiomas.
UI - 11770146
AU - Dobros W; Lackowska B; Rys J; Niezabitowski A; Stanisz-Wallis K;
TI - Olszewski E; Modrzejewski M DNA analysis of laryngeal carcinoma cells by flow cytometry: the histoclinical factors and their significance.
SO - J Otolaryngol 2000 Dec;29(6):371-6
AD - Department of Otolaryngology, Collegium Medicum, Jagiellonianian University, Cracow, Poland.
In patients suffering from several types of malignant tumours, changes in deoxyribonucleic acid (DNA) content are usually associated with poorer survival prognosis. In the present study, DNA content and clinical and histopathologic features were analyzed in patients suffering from laryngeal carcinoma, with a view to establishing the crucial prognostic factors. In the 5-year follow-up study, flow cytometry was used to analyze DNA content in the paraffin-embedded samples of laryngeal carcinoma tissue obtained from 90 patients who had undergone surgical treatment in the Department of Otolaryngology, Collegium Medicum, Jagiellonian University, Cracow, Poland, in 1987 and 1988. The group consisted of 59 and 31 patients with T3 and T4 tumours, respectively. In each case, neck dissection was carried out either on one or both sides. Metastases in regional lymph nodes were found in 26 patients. The disease-free 5-year survival rate was 55.6%. Among the investigated cases, there were 14 aneuploid and 76 diploid tumours. The treatment yielded the worst results, when the S-phase fraction (SPF) and proliferative index (PI) were equal to or higher than 15.8% and 16.0%, respectively. The values of SPF and PI index did not correlate, however, with the frequency of regional metastases. Univariate analysis revealed that tumour size (T stage), presence of lymph node metastases, age of patients (< or = 60, > 60), tumour differentiation, tumour front grading (<15 points, > or = 15), mode of infiltration, SPF, and PI were positively correlated with the actual survival rate. Presence of lymph node metastases (p = .0001) and the PI (p = .0067) were found to be the only independent prognostic factors when the Cox multivariate analysis was applied. The assessment of the PI by flow cytometry may effectively facilitate the selection of patients recommended for a more aggressive treatment.
UI - 11827585
AU - Mahlstedt K; Ussmuller J; Donath K
TI - Malignant sialogenic tumours of the larynx.
SO - J Laryngol Otol 2002 Feb;116(2):119-22
AD - Department of Audiology and Phoniatry, University Hospital Benjamin Franklin, Free University of Berlin, Germany. email@example.com
Laryngeal manifestations of malignant sialogenic neoplasias are rare. This paper documents the clinical features, treatment, biological behaviour and prognosis of 15 cases of malignant sialogenic tumours of the larynx that were reviewed in a retrospective clinical and histopathological study. The 15 cases of malignant sialogenic tumours of the larynx were diagnosed at the University Hospital, Eppendorf, over a period of 33 years (1965-1998). Forty per cent were adenoid cystic carcinomas, 33 per cent mucoepidermoid carcinomas and 27 per cent were poorly differentiated adenocarcinomas. Local tumour resection, if necessary in combination with bilateral neck dissection and post-operative radiotherapy, was associated with a five-year survival rate in 80 per cent of the mucoepidermoid carcinoma cases. Adenoid cystic carcinoma was associated with a less favourable five-year survival rate of 33 per cent. Low-differentiated adenocarcinomas were associated with the least favourable prognosis with a five-year survival rate (25 per cent). The prognosis for these tumours is thus poorer than for squamous cell carcinomas with the same localization and TNM status.
UI - 11868319
AU - Kruk-Zagajewska A; Piatkowski K; Wojtowicz JG; Kozak W
TI - [Value of estradiol, progesterone and cortisol binding globulin (CGB) in patients with laryngeal cancer]
SO - Otolaryngol Pol 2001;55(5):477-82
AD - Katedra i Klinika Otolaryngologii AM im. K. Marcinkowskiego w Poznaniu.
The unique feature of larynx cancer epidemiology is great discrepance between men and women morbidity. This difference may be explained not only by exposition to environmental factors but also to endogenous one, i.e. sex hormone levels. In 67 patients operated for larynx cancer there were simultaneously estimated the value of estradiol (E2), progesterone (Pg) and cortisol binding globulin (CBG) in blood serum. The radioimmunological assay (RIA) with specific antibodies and antigens signed by J125 was used. Value of hormones and binding globulin were examined by Spectria sets by Orion Diagnostica. The high value of estradiol and CBG in blood serum was observed. In meaningful number of patients we noted normal value of progesterone.
UI - 11868331
AU - Pabiszczak M; Banaszewski J; Szmeja Z; Szyfter K; Szyfter W
TI - [Comparison of DNA adducts between oral, pharyngeal and larynx cancer]
SO - Otolaryngol Pol 2001;55(5):551-4
AD - Klinika Otolaryngologii Katedry Chorob Ucha, Nosa, Gardla i Krtani AM im. K. Marcinkowskiego w Poznaniu.
The results concerning examination of DNA adducts in oral (23 patients), pharyngeal (23 patients) and larynx cancer (10 patients) subjects are presented. DNA adduct levels were compared in respect to anatomical structure (primary tumour location), number of cigarettes smoked, TNM stage, and age of patients. DNA was isolated from removed tissue (tumour and non-tumour surrounding tissue) using detergent/phenol extraction. 32P-postlabelling assay including nuclease P1-enhancement modification was applied. Aromatic DNA adducts were found in all studied tissues. Total DNA adduct levels (tumour and non-tumour tissues) was lowest in larynx cancer, higher in oral cancer and highest in pharyngeal cancer. There were no influence of age into formation of DNA adducts. The higher level of DNA adducts was found in tumour tissue of oral cancer in the group of smokers with metastasis into lymph nodes.
UI - 11868332
AU - Tomik J
TI - [Effectiveness of surgical treatment of laryngeal cancer depends on regional lymph node metastasis]
SO - Otolaryngol Pol 2001;55(5):557-8
AD - Katedra i Klinika Otolaryngologii CMUJ w Krakowie.
UI - 11920505
AU - Ranuncolo SM; Matos E; Loria D; Vilensky M; Rojo R; Bal de Kier Joffe E;
TI - Ines Puricelli L Circulating 92-kilodalton matrix metalloproteinase (MMP-9) activity is enhanced in the euglobulin plasma fraction of head and neck squamous cell carcinoma.
SO - Cancer 2002 Mar 1;94(5):1483-91
AD - Department of Cell Biology, Institute of Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires, Argentina.
BACKGROUND: Cancer lethality is usually the result of local invasion and metastasis of neoplastic cells from the primary tumor. Because of their ability to degrade extracellular matrix components (EMC), matrix metalloproteinases (MMPs) have been implicated in the breakdown of basement membranes and underlying stroma, thereby facilitating tumor growth and invasion. METHODS: The authors quantitated, by gelatin zymography and densitometric analysis, MMP activity in the euglobulin plasma fraction of 50 healthy controls and 91 head and neck squamous cell carcinoma (HNSCC) patients (51 from the larynx and 40 from the oropharynx). RESULTS: The median value for 92-kilodalton (kD) MMP (MMP-9) activity was increased significantly in laryngeal (Md 2.1 arbitrary units (AU)/mL plasma; range, 0.2-6.4) and oropharyngeal patients (Md 2.08 AU/mL; range, 0.0-5.0) with respect to the controls (Md 0.48 AU/mL; range, 0.0-1.8). Both groups of cancer patients showed a similar behavior. Multivariate analysis indicated that circulating 92-kD MMP activity was not predicted by the clinical-pathologic parameters such as tumor stage, histologic grade, and metastatic lymph nodes. There was no association between high levels of MMP-9 activity and either cigarette smoking or alcohol consumption, major risk factors for developing HNSCC. CONCLUSIONS: The authors found a significant increase of MMP-9 plasma activity both in laryngeal and oropharyngeal squamous cell carcinoma patients as compared with healthy controls. Further studies are necessary to establish its usefulness in the clinical management of these patients. Copyright 2002 American Cancer Society.
UI - 9328195
AU - Dosemeci M; Gokmen I; Unsal M; Hayes RB; Blair A
TI - Tobacco, alcohol use, and risks of laryngeal and lung cancer by subsite and histologic type in Turkey.
SO - Cancer Causes Control 1997 Sep;8(5):729-37
AD - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892-7364, USA.
Effects of tobacco smoking and alcohol use on risks of cancers of the larynx and lung have been evaluated extensively in industrialized countries. Few studies on the effect of these risk factors have been reported from developing countries. We conducted a case-control study to evaluate risks of laryngeal and lung cancers in men by subsite and cell type in relation to smoking and alcohol drinking in Turkey, a country where smoking and alcohol consumption patterns are different from those in industrialized countries. We identified 832 laryngeal and 1,210 lung cancer cases and 829 controls with information on smoking and alcohol use (amount and duration) and histologic cell type from an oncology treatment center of a Social Security Agency hospital in Istanbul, Turkey, admitted between 1979 and 1984. Both laryngeal and lung cancer showed significant associations with smoking and alcohol drinking, but no monotonic dose-response was obtained for alcohol drinking. Among smokers, the highest risks were observed in the supraglottis region of the larynx (odds ratio [OR] = 4.1) after adjustment for age and alcohol use. Among alcohol drinkers, the highest risks were observed in the glottis region of the larynx (OR = 1.7) after adjustment for age and smoking. In the analysis by the cell type of lung cancer among ever-smokers, small cell type showed the highest risk (OR = 5.4), while it showed no association with alcohol drinking. Cumulative cigarette use (pack-years) and number of cigarettes per day showed stronger associations than years smoked for both cancer sites. The relative risks of joint exposure to smoking and alcohol were 12.2 for laryngeal cancer and 14.1 for lung cancer among heavy smokers and heavy alcohol drinkers. This study provides epidemiologic evidence from Turkey that smoking and alcohol use are associated with risks of cancers of the larynx and lung.
UI - 11891957
AU - Coatesworth AP; MacLennan K
TI - Squamous cell carcinoma of the upper aerodigestive tract: the prevalence of microscopic extracapsular spread and soft tissue deposits in the clinically N0 neck.
SO - Head Neck 2002 Mar;24(3):258-61
AD - Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
BACKGROUND: With squamous cell carcinoma of the upper aerodigestive tract the presence or absence of neck metastases is the most important prognostic factor. This makes the histopathologic assessment of neck dissections of paramount importance. With the clinically N0 neck the prevalence of microscopic extracapsular spread and soft tissue deposits has not previously been described. METHODS: We have prospectively analyzed 96 elective neck dissections in 63 patients with upper aerodigestive tract squamous cell carcinoma and clinically N0 necks to assess the prevalence of microscopic extracapsular spread and soft tissue deposits. The dissections were separated peroperatively into nodal levels; these were sectioned at 6-microm sections and stained with H & E. RESULTS: Nineteen patients (30.2%) were upstaged to pN+ve. Twelve of these had microscopic extracapsular spread, which was 19.0% of the clinically N0 necks and 63.2% of the pN+ve. Five had soft tissue deposits, which was 7.9% of the clinically N0 necks. Fourteen patients had microscopic extracapsular spread and/or soft tissue deposits, which represented 22.2% of all necks examined and 73.7% of the pN+ve necks. CONCLUSIONS: Microscopic extracapsular spread and soft tissue deposits have a high prevalence in patients with clinically N0 necks. Extracapsular spread can occur at an early stage in metastasis from upper aerodigestive tract squamous cell carcinoma. Soft tissue deposits can also occur at an early stage. Soft tissue deposits may occur by the same process as lymph node metastasis with total effacement of the lymph node or may occur by some other process such as lymphatic tumor embolization. Copyright 2002 Wiley Periodicals, Inc.
UI - 11891958
AU - Cooley ML; Hoffman HT; Robinson RA
TI - Discrepancies in frozen section mucosal margin tissue in laryngeal squamous cell carcinoma.
SO - Head Neck 2002 Mar;24(3):262-7
AD - Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 5232 RCP, Iowa City, Iowa 52242-1009, USA.
BACKGROUND: Head and neck surgeons commonly request frozen sections. Practice patterns vary from laboratory to laboratory on how the tissue is used in performing the frozen section. Some pathologists wish to see all the material submitted by consuming it completely during frozen section, whereas others reserve some for permanent section. We wished to determine whether knowledge of margin status was initially inaccurate because of reserving tissue for permanent section. METHODS: Sixty-five laryngectomies (total and partial) with margin assessment enhanced by frozen section evaluation were studied. Forty-five laryngectomy specimens, generating 249 frozen sections in which a permanent section was prepared from tissue remaining from frozen section examination, were studied. RESULTS: Five of the 249 frozen sections contained a discrepancy between the frozen section and permanent section because of insufficient leveling of the frozen section block. These five discrepancies were called negative on frozen section, but permanent section revealed dysplasia (two cases of mild dysplasia, one case with moderate dysplasia, and one case with severe dysplasia) or carcinoma in situ (one case). Twenty laryngectomies in which the frozen section tissue was consumed at the time of frozen section generated 103 frozen sections. In eight of the frozen sections involving six cases, the diagnostic tissue was not present on one or two of the frozen section levels examined. CONCLUSIONS: We conclude that in examining margins for laryngeal squamous cell carcinoma the frozen section tissue should be completely sampled by examining several levels at the time of frozen section. This requires consuming or exhausting the frozen section tissue rather than reserving any remaining frozen tissue for a paraffin-embedded permanent section. Copyright 2002 Wiley Periodicals, Inc.
UI - 11821768
AU - Imauchi Y; Ito K; Takasago E; Nibu K; Sugasawa M; Ichimura K
TI - Stomal recurrence after total laryngectomy for squamous cell carcinoma of the larynx.
SO - Otolaryngol Head Neck Surg 2002 Jan;126(1):63-6
AD - Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, University of Tokyo, Japan. firstname.lastname@example.org
OBJECTIVE: Stomal recurrence after total laryngectomy is one of the most serious issues in the management of laryngeal carcinoma. The management of stomal recurrence, including chemotherapy, radiotherapy, and surgery, has been reported as unsatisfactory. STUDY DESIGN AND SETTING: From 1985 to 1995, 69 patients underwent total laryngectomy for the treatment of laryngeal cancer at the University of Tokyo Hospital. To identify the risk factors for stomal recurrence, we analyzed these patients according to various clinicopathological factors. RESULTS: Stomal recurrence developed in 6 of 69 patients who underwent total laryngectomy for laryngeal carcinoma. Statistical analysis reveals that primary site, preoperative tracheotomy, and paratracheal lymph node metastasis are significant risk factors for stomal recurrence. CONCLUSION: Intensive follow-up should be performed for patients with glottic carcinoma who had preoperative tracheotomy, paratracheal lymph node metastasis, or both to detect stomal recurrence at an early stage.
UI - 11936307
AU - Stewart BW; Semmler PC
TI - Sharp v Port Kembla RSL Club: establishing causation of laryngeal cancer by environmental tobacco smoke.
SO - Med J Aust 2002 Feb 4;176(3):113-6
AD - South East Sydney Public Health Unit, Randwick, NSW. email@example.com
A New South Wales Supreme Court jury has decided that environmental tobacco smoke (ETS) can cause or materially contribute to the development of laryngeal cancer. Evidence presented that ETS may cause or materially contribute to laryngeal cancer included the molecular genetics of tobacco-smoke-induced carcinogenesis, and two relevant epidemiological studies. The plaintiff's exposure to ETS was established indirectly, on the basis of occupational history involving work as a bar attendant in licensed premises. The jury's decision seems likely to encourage other "passive smoking" cases, and may result in measures to reduce occupational exposure to ETS.
UI - 11920651
AU - Rajaee-Behbahani N; Schmezer P; Ramroth H; Burkle A; Bartsch H; Dietz A;
TI - Becher H Reduced poly(ADP-ribosyl)ation in lymphocytes of laryngeal cancer patients: results of a case-control study.
SO - Int J Cancer 2002 Apr 10;98(5):780-4
AD - Division of Toxicology and Cancer Risk Factors, Deutsches Krebsforschungszentrum, Heidelberg, Germany.
Poly(ADP-ribose) polymerase (PARP), a nuclear enzyme that is catalytically activated by DNA strand breaks, plays a complex role in DNA repair. Using NAD(+) as a precursor, it catalyzes the formation of ADP-ribose polymers, which are attached to various proteins. Defects in DNA repair pathways have been associated with increased risks for cancer in humans. We investigated whether differences in the activity of PARP are associated with the risk for laryngeal cancer. In a case-control study on genetic, lifestyle and occupational risk factors for laryngeal cancer, PARP activity was assessed as DNA damage-induced poly(ADP-ribose) formation in human peripheral blood lymphocytes by quantitative immunofluorescence analysis. Polymer formation was determined as the cellular response to bleomycin, a well-known inducer of DNA strand breaks, in lymphocytes from 69 laryngeal cancer patients and 125 healthy controls. The frequency of bleomycin-induced polymer formation, measured as mean pixel intensity, was significantly lower in cases (74.6, SE = 3.7) than in controls (94.5, SE = 3.5) and not influenced by smoking, age or sex. There was no significant difference between cases (59.1, SE = 5.2) and controls (50.5, SE = 3.7) in basal polymer formation (in cells not treated with bleomycin). When the highest tertile of polymer formation was used as the reference, the odds ratio for the lowest tertile of bleomycin-induced polymer formation was 3.79 (95% confidence interval 1.37-10.47, p = 0.01). Peripheral blood lymphocytes from laryngeal cancer patients thus showed significantly less bleomycin-induced poly(ADP-ribose) formation. Our results suggest that a reduced capacity of somatic cells to synthesize poly(ADP-ribose) might be associated with an increased risk for laryngeal cancer. The underlying mechanism remains to be investigated. Copyright 2002 Wiley-Liss, Inc.
UI - 8625044
AU - Russo A; Bazan V; Gebbia N; Pizzolanti G; Tumminello FM; Dardanoni G;
TI - Ingria F; Restivo S; Tomasino RM; Leto G Flow cytometric DNA analysis and lysosomal cathepsins B and L in locally advanced laryngeal cancer. Relationship with clinicopathologic parameters and prognostic significance.
SO - Cancer 1995 Nov 15;76(10):1757-64
AD - Institute of Otorhinolaringology B, School of Medicine, University of Palermo, Italy.
BACKGROUND. The traditional factors of locally advanced laryngeal squamous cell carcinoma (LSCC) have limited predictive value for the identification of high risk patients. Therefore, it is extremely important to define prognostic factors that identify the more aggressive types. Reliable and reproducible prognostic indicators are being investigated to help clinicians identify high risk groups and address more rational treatment. METHODS. Flow cytometric DNA ploidy and S-phase fraction (SPF) measurements were performed on frozen tumor tissues from a consecutive series of 71 patients with Stage III and IV LSCC. Lysosomal cathepsin B and L activity levels were determined biochemically in matched paired sets of tumor tissue and normal mucosa samples. RESULTS. By univariate analysis, lymph node positivity, poor histologic differentiation, DNA aneuploidy, high SPF, and high tumor/mucosa ratio of cathepsin B activity were significantly related to risk of relapse, whereas only DNA aneuploidy and high SPF proved to be significantly related to risk of death. Multivariate analysis showed that high histologic grade and high SPF values (> 15.1%) were independent prognostic factors related to risk of relapse (relative risk [RR] = 3.54; 95% confidence limits [CL] = 1.05-12.0; and RR = 4.22; CL = 1.54-11.6, respectively), whereas only high SPF was related to risk of death (RR = 3.63; CL = 1.17-11.3). CONCLUSIONS. S-phase fraction is an independent predictor of relapse free and overall survival in patients with locally advanced LSCC. On the basis of these findings, SPF should be used in addition to other established prognostic factors to refine the prognostic assessment of these patients further. More studies are needed for a better evaluation of the prognostic significance of DNA ploidy and that of lysosomal cysteine proteinases in these tumors.
UI - 11299783
AU - Osmak M; Svetic B; Gabrijelcic-Geiger D; Skrk J
TI - Drug-resistant human laryngeal carcinoma cells have increased levels of cathepsin B.
SO - Anticancer Res 2001 Jan-Feb;21(1A):481-3
AD - Department of Molecular Genetics, Ruder Boskovic Institute, Bijenicka cesta 54, HR-10000 Zagreb, Croatia. firstname.lastname@example.org
In our previous work we showed that the drug-resistance of cervical carcinoma, laryngeal carcinoma and glioblastoma cells may be accompanied by increased levels of tumor markers for invasion and metastasis (i.e. urokinase-type plasminogen activator, plasminogen activator inhibitor type 1, and/or cathepsin D). In the present study we examined the concentration of cathepsins B, L and H in three drug-resistant clones isolated from human laryngeal carcinoma (HEp2). The basal levels of cathepsins B, L and H were determined by enzyme linked immunoabsorbent assay (ELISA). Our results showed that all three clones had an increased level of cathepsin B (in two clones an almost 4-fold increase was determined). The level of cathepsin L was altered (increased) only in VK2 clone, while the levels of cathepsin H were similar in parental cells and drug-resistant clones. Thus, our results suggest that drug-resistance may be accompanied by an increased level of cathepsin B, i.e. tumor associated protease, involved in invasion and metastasis.
UI - 11911285
AU - Luzar B; Poljak M; Marin I J; Fischinger J; Gale N
TI - 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, Slovenia. email@example.com
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 J A; Hirvikoski P P; Kumpulainen E J; Johansson R T; Kosma V
TI - M 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 successful salvage.
UI - 11767474
AU - Enin IP; Zaets VN; Iagoda NL; Karpov VP; Sivovolova NA; Morenko VM
TI - [Immediate short- and long-term results of rehabilitation of children with laryngeal papillomatosis]
SO - Vestn Otorinolaringol 2001;(6):33-7
The authors review their 30-year experience with rehabilitation of children with laryngeal papillomatosis. A total of 212 patients at the age from 9 months to 15 years have been treated. Immediate, short- and long-term results of different combined surgical and conservative treatments are compared. The authors hold that the papillomatous tissue should be eliminated completely, therefore, during surgery under anesthesia endolaryngeal removal of the papillomas should be combined with monopolar coagulation of their residual tissues. The combined surgery should be immediately followed by etiopathogenetic conservative treatment. The highest effect was achieved with autoserum administration according to the scheme. In combined rehabilitation of such children local etiopathogenetic treatment is preferable.
UI - 11926913
AU - Guler G; Sarac S; Uner A; Karabulut E; Ayhan A; Hiroshi O
TI - Prognostic value of CD44 variant 6 in laryngeal epidermoid carcinomas.
SO - Arch Otolaryngol Head Neck Surg 2002 Apr;128(4):393-7
AD - Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
BACKGROUND: CD44 variant exon 6 (v6) belongs to a family of transmembrane glycoproteins involved in cell adhesion. OBJECTIVES: To determine the prognostic role of CD44v6 in laryngeal cancer and to examine its relation with other clinicopathologic prognostic factors. DESIGN: A retrospective cohort study was designed with 93 laryngeal cancer cases. They were selected randomly from patients treated with laryngectomy between January 1, 1983, and December 31, 1993. SETTING: Faculty of Medicine, Hacettepe University, Ankara, Turkey. PATIENTS: The ages of the patients ranged from 31 to 73 years. Eighty-eight patients were men and 5 were women. Three had stage I, 33 had stage II, 27 had stage III, and 30 had stage IV disease at the time of surgery. INTERVENTION: Histological sections of tumors and metastatic lymph nodes were reevaluated for several histopathological factors. Sections were stained using anti-CD44v6 monoclonal antibody by immunohistochemical methods. RESULTS: CD44v6 expression was seen only in the lower one third of the normal squamous epithelium but in all layers of dysplasia and in situ carcinoma. Besides a general evaluation of tumor staining, immunostaining was evaluated separately for cell groups located in the center of neoplastic islands (nonbasal cells), at the periphery of the neoplastic islands (basal cells), and at the infiltration zones (marginal cells). Decreased disease-free survival was noted when there was extensive staining in the general evaluation and in cases with extensive staining in marginal and nonbasal cells (P =.03). Using Cox regression analysis, the greatest dimension of the largest metastatic lymph node and extensive expression of CD44v6 in nonbasal tumor cells were independent prognostic factors. CONCLUSION: Our results suggest that CD44v6 expression is an important prognostic factor in laryngeal cancer.
UI - 11893260
AU - Holland JM; Arsanjani A; Liem BJ; Hoffelt SC; Cohen JI; Stevens KR Jr
TI - Second malignancies in early stage laryngeal carcinoma patients treated with radiotherapy.
SO - J Laryngol Otol 2002 Mar;116(3):190-3
AD - Department of Radiation Oncology, Oregon Health Sciences University, Portland, Oregon 97201-3098, USA. firstname.lastname@example.org
A retrospective review of 240 patients with T1/T2 squamous cell carcinomas of the larynx was performed. Seventy-two per cent had glottic primaries, 27 per cent had supraglottic tumours and one per cent had subglottic disease. Sixty-nine per cent presented with T1 disease and 31 per cent had T2 staged tumours. All patients were treated with definitive radiotherapy between 1973 and 1997. With a median follow-up of 68 months, 68 patients (28 per cent) have developed 72 other cancers. Ten of 68 presented with synchronous primaries (15 per cent). Thirty per cent of glottic patients and 25 per cent of the supraglottic/subglottic patients developed second cancers. The most frequent second malignancy was lung cancer: 28/72 (39 per cent). Fifteen patients developed second head and neck cancers (21 per cent). Other second primary sites included oe