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Abramson Cancer CenterNCI CANCERLIT® Search: Pharyngeal Cancer - April 2002
National Cancer Institute®
Last Modified: April 1, 2002
Table of Contents
1
UI - 9881786
AU - Carinci F; Pelucchi S; Farina A; De Franciscis G; Calearo C
TI -
Extension as a prognostic factor in oropharyngeal cancer: largest
mucosal dimension compared with number of (sub)sites involved.
SO - Br J Oral Maxillofac Surg 1998 Dec;36(6):440-5
AD - Department of Maxillofacial Surgery, University of Ferrara, Italy.
We report a retrospective study of 64 patients with primary squamous
cell carcinoma of the oropharynx. The tumours were classified by the
UICC (Union Internationale Contre le Cancer) system and a New Tumour
Staging (NTS) system. Results showed a crude survival of 29% at 5 years.
The most important prognostic factor for survival rate was the tumour
(T) stage in both classifications. NTS recommendations that consider the
number of sites and subsites involved yield a better correlation between
survival and T stage. NTS also discriminates better between the T stages
than the UICC criteria.
2
UI - 10475660
AU - Brown JS
TI -
Re: Carinci et al. Extension as a prognostic factor in oro-pharyngeal
cancer: largest mucosal dimension compared with number of (sub) sites
involved.
SO - Br J Oral Maxillofac Surg 1999 Aug;37(4):330
3
UI - 10922176
AU - Carinci F; Farina A; Bovicelli A; Pelucchi S; Calearo C
TI -
Disease-specific survival for a new t-stage of oropharyngeal cancer.
SO - Br J Oral Maxillofac Surg 2000 Aug;38(4):402-4
4
UI - 11903375
AU - Goldsmith DB; West TM; Morton R
TI -
HLA associations with nasopharyngeal carcinoma in Southern Chinese: a
meta-analysis.
SO - Clin Otolaryngol 2002 Feb;27(1):61-7
AD - Department of Otolaryngology, Green Lane Hospital, Auckland, New
Zealand.
The literature relating to human leucocyte antigens (HLA) and
nasopharyngeal carcinoma (NPC) identifies conflicting ranges of possible
allelic associations. We aimed to clarify this by conducting a
systematic review to identify and quantify associations present across
all of the available studies. A literature search was performed and,
subsequently, a meta-analysis was performed on 13 published studies
using both fixed-effects and random-effects models when appropriate.
Evidence for positive associations between NPC and the HLA alleles A2,
B14 and B46 (P = 1.57 x 10-5, 1.13 x 10-3 and 6.38 x 10-5 respectively)
were found, and negative associations were identified for the alleles
A11, B13 and B22 (P = 5.42 x 10-3, 0.017 and 0.009). Whereas an
association between HLA-B13 or B22 and NPC has not been noted
previously, the results for HLA-A2, A11, B14 and B46 are in accordance
with published studies. There is evidence that specific allele subtypes
or combinations of alleles may carry particular risk for NPC.
5
UI - 11860647
AU - Barzan L; Talamini R; Politi D; Minatel E; Gobitti C; Franchin G
TI -
Squamous cell carcinoma of the hypopharynx treated with surgery and
radiotherapy.
SO - J Laryngol Otol 2002 Jan;116(1):24-8
AD - Otolaryngology Unit, Azienda Ospedaliera 'S. Maria degli Angeli',
Pordenone, Italy. luigibarzan@libero.it
A series of squamous cell carcinomas (SCC) of the hypopharynx treated
with combined surgery and radiotherapy is presented to highlight the
results of treatment at an early stage of disease. A retrospective
mono-institutional analysis was performed on 153 previously untreated
patients with SCC of the hypopharynx, seen between 1980 and 1995 at our
institution. Univariate and multivariate analyses were performed using
the Cox proportional hazard model. The overall five-year specific, and
non-specific, disease survival rates were 68 per cent (95 per cent
confidence interval, CI: 60-77) and 47 per cent (95 per cent CI: 39-56),
respectively. Compared with other series, this study is characterized by
treatment at an earlier stage, better prognosis, and a higher number of
multiple malignancies. Twenty-two per cent of hypopharyngeal SCCs were
diagnosed during the staging procedures for a different head and neck
SCC and 14 per cent during the follow-up for a previous tumour.
Multivariate survival analysis of clinical and pathological factors
confirmed the clinical class of tumour (T) and node (N) and the nodal
capsular rupture as prognosticators of disease.
6
UI - 11860648
AU - Bahadur S; Thakar A; Mohanti BK; Lal P
TI -
Results of radiotherapy with, or without, salvage surgery versus
combined surgery and radiotherapy in advanced carcinoma of the
hypopharynx.
SO - J Laryngol Otol 2002 Jan;116(1):29-32
AD - Department of Otolaryngology, Head and Neck Surgery, All India Institute
of Medical Sciences, New Delhi, India.
There is considerable controversy surrounding the optimum treatment of
advanced hypopharyngeal cancers. Curative radiotherapy with surgical
salvage in reserve is an accepted protocol as is also a combined
treatment of surgery and radiotherapy. The present study is a
retrospective analysis of the survival results of 195 cases treated in a
single centre. The combined surgery and radiotherapy group comprised a
greater number of pyriform fossa and post-cricoid tumours whereas, the
curative radiotherapy group had a higher proportion of posterior
pharyngeal wall tumours. Actuarial two-year disease-free survival rates
were significantly better with combined treatment when results of stage
III and IV lesions (164 patients) of all sites are taken together, as
compared to those obtained with curative radiotherapy without salvage (p
= 0.000) or radiotherapy with surgical salvage for residual/recurrent
tumours (p = 0.0021).
7
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.
8
UI - 11886334
AU - Wei WI
TI -
The dilemma of treating hypopharyngeal carcinoma: more or less: Hayes
Martin Lecture.
SO - Arch Otolaryngol Head Neck Surg 2002 Mar;128(3):229-32
AD - Department of Surgery, University of Hong Kong Medical Centre, Queen
Mary Hospital, Pokfulam Road, Hong Kong Special Administrative Region,
China. hrmswwi@hkucc.hku.hk
The optimal therapy for hypopharyngeal carcinoma depends on its staging.
For early-stage disease, radiotherapy and surgery achieve similar
results. Radical surgery followed by radiotherapy is applicable in the
management of patients with advanced-stage disease. Chemoradiation
aiming to preserve the larynx can only be performed for selected
patients and in well-equipped institutions. Thorough understanding of
pathological behavior of hypopharyngeal carcinoma, its submucosal tumor
extension, and its high propensity to metastasize to cervical lymph
nodes allows head and neck surgeons to choose optimal surgical
treatment. Lymph node status determines the type of neck dissection
required while location and size of the primary tumor determine the
extent of resection and choice of reconstruction procedure. Adequate
tumor extirpation with less extensive and invasive procedures preserving
unaffected normal tissue contribute to more tumor control and less
morbidity.
9
UI - 11886344
AU - Fee WE Jr; Moir MS; Choi EC; Goffinet D
TI -
Nasopharyngectomy for recurrent nasopharyngeal cancer: a 2- to 17-year
follow-up.
SO - Arch Otolaryngol Head Neck Surg 2002 Mar;128(3):280-4
AD - Stanford University Medical School, Stanford, CA 94305-5328, USA.
wfee@stanford.edu
OBJECTIVE: To review the 2- to 17-year outcome of nasopharyngectomy
following local recurrence of nasopharyngeal carcinoma. DESIGN:
Retrospective review. SETTING: University medical center. PATIENTS:
Thirty-seven patients with biopsy-proven recurrent nasopharyngeal cancer
followed up for a minimum of 2 years after transpalatal, transmaxillary,
and/or transcervical resection with and without neck dissection.
OUTCOME: Clinical examination, magnetic resonance imaging, chest x-ray
examination, and liver function tests to determine re-recurrence;
unlimited follow-up. RESULTS: With a mean follow-up of 5.4 years, the
crude, 5-year, overall, free-of-disease survival rate was 52%, local
control at 5 years was 67%, and the 5-year actuarial survival rate was
60%. Survival by recurrent T stage (rT) was as follows: rT1, 73%; rT2,
40%; rT3, 14%; and rT4, 0%. Complications occurred in 54% and included 1
death from carotid artery injury and 1 patient with permanent pharyngeal
plexus paralysis with resultant dysphagia. The remaining patients had
transitory complications that spontaneously resolved, required further
surgery (closure of palate fistula, debridement, and reapplication of
skin graft), or required further medical therapy. CONCLUSIONS: The
results of this study are better than most published reports of
additional irradiation for rT1 and rT2 lesions. More recent radiation
studies that use radiosurgery or implants suggest promising early
results. A randomized prospective study comparing surgery with
additional irradiation for recurrent disease at the primary site is
warranted.
10
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.
11
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.
alfred.stadler@univie.ac.at
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.
12
UI - 11902350
AU - Barbosa P; Carneiro NS; de B; Brugnera A Jr; Zanin FA; Barros RA;
TI -
Soriano d
Effects of low-level laser therapy on malignant cells: in vitro study.
SO - J Clin Laser Med Surg 2002 Feb;20(1):23-6
AD - School of Dentistry, Universidade Federal da Bahia, Salvador, BA,
Brazil. albp@ufba.br
The aim of this study was to assess the effect of 635- and 670-nm laser
irradiation on H.Ep.2 cells in vitro using MTT. In addition to our
previous report on the effects of LLLT on the proliferation of laryngeal
carcinoma cells in which it was found that irradiaton H.Ep.2 cells with
670-nm laser results in increased cell proliferation, it was decided to
evaluate the effect of increased doses of laser light on these cells.
The cells, obtained from SCC of the larynx, were routinely processed
from defrost to the experimental condition. The cultures were kept
either at 5% or 10% of FBS. Twenty-four hours after transplantation, the
cells were irradiated with laser light (5-mW diode lasers; 635 and
670-nm; beam cross section approximately 1 mm) at local light doses
between 0.04 and 4.8.10(4) Jm(-2). For 670 nm, significant differences
in the proliferation were observed between the two concentrations of FBS
(p = 0.002) and between irradiated cultures and controls (p = 0.000).
Although the results were not significant, 635-nm irradiated cells also
proliferated more than nonirradiated ones. This occurred under both
conditions of nutrition. It is concluded, that irradiation with 670-nm
laser light applied at doses between 0.04 and 4.810(4) Jm(-2) could
significantly increase proliferation of laryngeal cancer cells.
13
UI - 11913680
AU - Plaza G; Manzanal AI; Fogue L; Santon A; Martinez-Montero JC; Bellas C
TI -
Association of Epstein-Barr virus and nasopharyngeal carcinoma in
Caucasian patients.
SO - Ann Otol Rhinol Laryngol 2002 Mar;111(3 Pt 1):210-6
AD - Otolaryngology Department, Ramon y Cajal Hospital, University of Alcala,
Madrid, Spain.
We evaluated the association of nasopharyngeal carcinoma (NPC) and
Epstein-Barr virus (EBV) in Spanish patients, and studied the expression
of EBV products (latent membrane protein-1 [LMP-1] and ZEBRA proteins)
by NPC cells and its possible prognostic value. In situ hybridization
(ISH) for EBV-encoded nonpolyadenylated RNAs (EBERs) and
immunohistochemical expression of LMP-1 and ZEBRA proteins by
immunohistochemistry were examined in formalin-fixed, paraffin-embedded
NPC specimens from 30 patients, and a survival analysis was done by the
Kaplan-Meier method. We detected EBERs by ISH in 96.67% of the NPC
cases, and detected expression of LMP-I in 43.33% of the NPC cases and
expression of ZEBRA protein in 6.67% of the NPC cases. We conclude that
ISH for expression of EBERs is an adequate method for detection of EBV
in NPC. LMP-1 is not frequently expressed in NPC cells (43.33%). Most
NPC cells carry a latent EBV infection. LMP-1 expression might have
worsened the prognosis of NPC in our series.
14
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.
15
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.
16
UI - 11919243
AU - Rischin D; Corry J; Smith J; Stewart J; Hughes P; Peters L
TI -
Excellent disease control and survival in patients with advanced
nasopharyngeal cancer treated with chemoradiation.
SO - J Clin Oncol 2002 Apr 1;20(7):1845-52
AD - Division of Hematology and Medical Oncology, Peter MacCallum Cancer
Institute, Melbourne, Australia. drischin@petermac.unimelb.edu.au
PURPOSE: To determine the efficacy and safety of epirubicin, cisplatin,
and infusional fluorouracil (5-FU) chemotherapy followed by radiation
with concurrent cisplatin in patients with locally and/or regionally
advanced nasopharyngeal cancer. PATIENTS AND METHODS: Thirty-five
patients were treated with three cycles of induction chemotherapy with
epirubicin 50 mg/m(2) and cisplatin 75 mg/m(2) combined with
continuous-infusion 5-FU 200 mg/m(2) daily for 9 weeks, followed by
concurrent chemoradiation of 60 Gy in 2-Gy fractions with cisplatin 20
mg/m(2) daily for 5 days in weeks 1 and 6. RESULTS: Median age was 43
years, 74% had World Health Organization type III histology, and 91% had
stage IV disease (International Union Against Cancer, ed 4). All
patients received three cycles of induction chemotherapy, and 97%
completed chemoradiation. The estimated 4-year progression-free survival
rate was 81% (95% CI, 59% to 93%), and the estimated 4-year overall
survival rate was 90% (95% CI, 74% to 97%). Only two patients have had a
locoregional relapse by the close-out date despite the use of only 60
Gy. Induction chemotherapy was well tolerated, with 11% grade 3 or 4
stomatitis, 26% grade 3 vomiting, and no episodes of febrile
neutropenia. Acute toxicities of chemoradiation were as follows: 23%
grade 3 or 4 vomiting, 6% febrile neutropenia, 31% grade 3 mucositis,
and 23% grade 3 skin toxicity. The most prevalent grade 3 late effects
were xerostomia and hearing loss. CONCLUSION: This regimen was well
tolerated, can be delivered as planned, and has resulted in excellent
locoregional disease control and survival in patients with locally
advanced nasopharyngeal cancer.
17
UI - 11565907
AU - Li J; Tan C; Xiang Q; Zhang X; Ma J; Wang JR; Yang J; Li W; Shen SR;
TI -
Liang S; Li G
Proteomic detection of changes in protein synthesis induced by NGX6
transfected in human nasopharyngeal carcinoma cells.
SO - J Protein Chem 2001 Apr;20(3):265-71
AD - Cancer Research Institute, School of Xiangya Medicine, Central South
University, Changsha, China.
In the previous study, we cloned a new gene, named NGX6, related to
nasopharyngeal carcinoma (NPC) at 9p. To study its function in the
pathogenesis of NPC, we have investigated changes in protein synthesis
between NPC cell line HNE1 and that transfected with the gene. Using
high-resolution two-dimensional electrophoresis, we found that 22
protein spots showed variations that were significant and reproducible.
Analysis of matrix-assisted laser desorption/ionization time-of-flight
mass spectrometry and database searches identified seven proteins that
were upregulated and seven proteins that were downregulated. These
proteins included Fas, zinc-finger protein (ZNF), RAB, and Ah
receptor-interacting protein (AIP). The functional implications of the
identified proteins are discussed.
18
UI - 11801549
AU - Kwong J; Lo KW; To KF; Teo PM; Johnson PJ; Huang DP
TI -
Promoter hypermethylation of multiple genes in nasopharyngeal carcinoma.
SO - Clin Cancer Res 2002 Jan;8(1):131-7
AD - Department of Anatomical and Cellular Pathology, The Chinese University
of Hong Kong, Hong Kong SAR, People's Republic of China.
s993101@mailserv.cuhk.edu.hk
PURPOSE: The methylation profile of nasopharyngeal carcinoma (NPC) has
been investigated by a candidate gene approach. EXPERIMENTAL DESIGN:
Four NPC cell lines, 4 NPC xenografts, 33 NPC primary tumors, and 6
samples of normal nasopharyngeal epithelium were subjected to
methylation-specific PCR for analysis of promoter methylation of eight
cancer-related genes. These eight genes were RASSF1A, RARbeta2,
DAP-kinase, p16, p15, p14, MGMT, and GSTP1. The correlation between
methylation status of these genes and clinical features such as stage,
local-regional recurrence, distant metastasis, and survival has been
analyzed. RESULTS: The incidence of promoter methylation in NPC samples
was 84% for RASSF1A, 80% for RARbeta2, 76% for DAP-kinase, 46% for p16,
17% for p15, 20% for p14, 20% for MGMT, and 3% for GSTP1. No methylation
of these genes was detected in the six normal nasopharyngeal epithelium
samples. All NPC tumor samples in this study displayed aberrant
methylation in at least one of these eight genes. No significant
correlation between methylation status of these genes and clinical
parameters of the patients was found. CONCLUSIONS: A high frequency of
aberrant methylation of the 5' CpG island of the RASSF1A, RARbeta2,
DAP-kinase, and p16 genes in the present study was noted. Our findings
suggest that methylation of the genes in the critical pathways is common
in NPC.
19
UI - 11891944
AU - Chang Y; Cheng SD; Tsai CH
TI -
Chromosomal integration of Epstein-Barr virus genomes in nasopharyngeal
carcinoma cells.
SO - Head Neck 2002 Feb;24(2):143-50
AD - Graduate Institute of Microbiology, College of Medicine, National Taiwan
University, Number 1, Section 1, Jen-Ai Road, Taipei, Taiwan.
BACKGROUND: Little has been known about whether Epstein-Barr virus (EBV)
could persist in nasopharyngeal carcinoma (NPC) cells by chromosomal
integration, and no NPC cell line harboring integrated EBV has been
reported. In this study, we explored this issue through isolating
EBV-infected NPC cell clones generated from an in vitro infection system
and examining the configuration of EBV DNA in these cells. METHODS AND
RESULTS: EBV genomes were demonstrated in NPC cell clones using
polymerase chain reaction and Southern hybridization. Viral nuclear
antigens were also detected by use of an anticomplement
immunofluorescence assay and an immunoblotting assay. Gardella gel
analysis showed that two of the EBV-positive cell clones, H2B4 and
H2B17-7, harbored no extrachromosomal form of the viral genome.
Restriction analysis of EBV genomic termini indicated that EBV DNA in
these two cell clones was not circularized, and the viral genomes were
integrated into chromosomes as demonstrated by fluorescence in situ
hybridization. CONCLUSIONS: This is the first in vitro model of EBV
persistence in NPC cells by genomic integration, which represents a
unique state of virus-cell interaction. Using this model, investigation
into the association between EBV integration and chromosomal abnormality
in tumor cells will help to reveal the underlying biologic significance.
Copyright 2002 John Wiley & Sons, Inc.
20
UI - 11891948
AU - Ho CM; Ng WF; Lam KH; Wei WI; Yuen AP
TI -
Radial clearance in resection of hypopharyngeal cancer: an independent
prognostic factor.
SO - Head Neck 2002 Feb;24(2):181-90
AD - Department of Surgery, Kwong Wah Hospital, Hong Kong. hocm@ha.org.kh
BACKGROUND: The depth of infiltration of tumor is of particular
relevance in hypopharyngeal cancers, because most of them are seen late,
and extensive infiltration into the muscle wall and the cartilage are
not uncommon. METHODS: The resected specimens of hypopharyngeal cancers
were studied with whole-organ step-serial sectioning. The extent of
infiltration into the thickness of the wall and the radial clearance
were carefully documented. These parameters were correlated with the
tumor recurrence and survival rates. RESULTS: Most patients with
hypopharyngeal cancer had a minimal radial margin; the radial clearance
was <1 mm in 56% of the patients. Despite such a minimal margin, the
local recurrence rate was only 19% and occurred mainly in the upper and
lower resection margins. Radial clearance was an independent prognostic
factor for overall survival, disease-free survival, and nodal
recurrence-free survival on multivariate analysis. CONCLUSION: Radial
clearance is an important independent prognostic factor, and it is
recommended to be included in the routine pathologic reporting of the
resected specimen in hypopharyngeal cancer. Copyright 2002 John Wiley &
Sons, Inc.
21
UI - 11891950
AU - Braakhuis BJ; Tabor MP; Leemans CR; van der Waal I; Snow GB; Brakenhoff
TI -
RH
Second primary tumors and field cancerization in oral and oropharyngeal
cancer: molecular techniques provide new insights and definitions.
SO - Head Neck 2002 Feb;24(2):198-206
AD - Department of Otolaryngology/Head and Neck Surgery, Vrije Universiteit
Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Second primary tumors (SPTs) are a significant problem in treating oral
and oropharyngeal squamous cell carcinoma and have a negative impact on
survival. In most studies the definition of SPT is based on the criteria
of Warren and Gates, published in 1932. These criteria, however, are
ill-defined and lead to confusion. Recent molecular studies have shown
that a tumor can be surrounded by a mucosal field consisting of
genetically altered cells. Furthermore, evidence has been provided that
SPTs (defined by classical criteria) can share some or even all genetic
markers with the index tumor, indicating that both tumors have arisen
from a common cell clone. We propose that these secondary neoplastic
lesions should not be considered SPTs, implying that the present concept
of SPT needs revision. This review describes a novel classification of
the secondary tumors that develop after treatment of a carcinoma in the
oral cavity or oropharynx. On the basis of the molecular analysis of the
tumors and the genetically altered mucosal field in between, we propose
definitions for a "true SPT," a local recurrence, a "SFT" (second field
tumor derived from the same genetically altered mucosal field as the
primary tumor), and a metastasis. Considering the etiologic differences
of these lesions, we believe that an accurate molecular definition is
essential to make headway with the clinical management of oral and
oropharyngeal cancer. Copyright 2002 John Wiley & Sons, Inc.
22
UI - 11898144
AU - Huang HY; Wilkie DJ; Schubert MM; Ting LL
TI -
Symptom profile of nasopharyngeal cancer patients during radiation
therapy.
SO - Cancer Pract 2000 Nov-Dec;8(6):274-81
AD - University of Washington, Department of Biobehavioral Nursing and Health
Systems, Box 357266, Seattle, WA 98195-7266, USA.
PURPOSE: This prospective, longitudinal study was aimed to describe the
prevalence, severity, and pattern of symptoms over the course of
radiation therapy in persons with nasopharyngeal carcinoma and to
explore symptom severity by treatment modality. DESCRIPTION OF STUDY:
Thirty-seven patients completed this study, and 46% received
chemotherapy before radiation therapy. A self-reported radiation symptom
checklist and an objective mucositis assessment tool were used weekly to
document oropharyngeal, skin, nose or ear, or more general side effects,
and mucositis. RESULTS: Oropharyngeal problems were the most severe
complaints during radiation therapy. All patients experienced dry mouth,
taste change, difficulty in swallowing, difficulty in opening their
mouths, hoarseness, sore throat, and observable mucositis. Most reported
moderate-to-severe dry mouth, difficulty in swallowing, and sore throat
from weeks 3 through 7. Skin problems were not prominent until week 4.
Patients also lost an average of 3.9 kg during the therapy. Sequential
chemotherapy and radiation therapy was associated with more severe
oropharyngeal problems than radiation therapy alone, but no significant
differences in other problems were found. CLINICAL IMPLICATIONS: Despite
recognition of the oropharyngeal side effects associated with
irradiation, effective management protocols for such symptoms have not
been implemented in the studied institution. The frequency and intensity
of the symptoms reported indicate an urgent need for increased vigilance
about radiation-related side effects and pain management. As well,
patient education about expected side effects may help mitigate the
anxiety that patients experience when these symptoms occur.
23
UI - 11891953
AU - Chen MH; Chang AR; Lo SY
TI -
The usefulness of cytodiagnosis and DNA cytometry on nasopharyngeal
brush smears for the diagnosis of nasopharyngeal carcinoma.
SO - Head Neck 2002 Mar;24(3):223-7
AD - Department of Pathology, Shantou University Medical College, 22 Xinling
Road, Shantou 515031, P. R. China.
BACKGROUND: To assess the usefulness of combining cytodiagnosis and DNA
cytometry on nasopharyngeal brush samples for the detection of
nasopharyngeal carcinoma (NPC). METHODS: DNA ploidy analysis was
undertaken on 66 nasopharyngeal brush samples that had been previously
evaluated cytologically. RESULTS: Cytodiagnosis and ploidy analysis
demonstrated a sensitivity of 66% and 55%, respectively. Both techniques
had a specificity of 100% for NPC cases that were histologically
confirmed. The negative predictive values for cytodiagnosis and ploidy
analysis were 29% and 24%, respectively. CONCLUSIONS: The sensitivity
and specificity for cytodiagnosis were not improved by the addition of
DNA ploidy analysis. Furthermore, combining the two techniques did not
confer any significant advantage compared with the use of cytology and
DNA ploidy alone. The relatively low negative predictive values are a
significant limitation, and combining cytodiagnosis and ploidy analysis
on nasopharyngeal brush samples cannot be recommended for the detection
of NPC. Copyright 2002 Wiley Periodicals, Inc.
24
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.
25
UI - 11891961
AU - Nieuwenhuis EJ; Castelijns JA; Pijpers R; van den Brekel MW; Brakenhoff
TI -
RH; van der Waal I; Snow GB; Leemans CR
Wait-and-see policy for the N0 neck in early-stage oral and
oropharyngeal squamous cell carcinoma using ultrasonography-guided
cytology: is there a role for identification of the sentinel node?
SO - Head Neck 2002 Mar;24(3):282-9
AD - Department of Otolaryngology/Head and Neck Surgery, Vrije Universiteit
Medical Center, P. O. Box 7057, 1007 MB Amsterdam, The Netherlands.
BACKGROUND: Management of the N0 neck in patients with head and neck
squamous cell carcinoma (SCC) remains controversial. We describe the
outcome of patients who underwent transoral tumor excision and a
wait-and-see policy for the neck staged N0 by ultrasonography-guided
cytology (USgFNAC). Because selection of lymph nodes for USgFNAC is
currently based on size criteria, we investigated the additional value
of sentinel node (SN) identification. METHODS: The outcome of 161
patients with T1-T2 oral/oropharyngeal SCC was determined. In a subgroup
of 39 patients the SN was identified and aspirated in addition. RESULTS:
SN identification and aspiration was possible in 38 of 39 patients but
without decreasing the false-negative rate of USgFNAC. During follow-up
(12-99 months) 34 of 161 (21%) patients developed lymph node metastases.
After therapeutic neck dissection and postoperative radiotherapy, 27 of
34 (79%) could be salvaged (88% regional control). CONCLUSIONS:
Wait-and-see seems justified in case of negative USgFNAC. Strict
follow-up with USgFNAC is required. SN identification and aspiration is
feasible but did not improve lymph node selection. Copyright 2002 Wiley
Periodicals, Inc.
26
UI - 11920470
AU - Talmi YP; Horowitz Z; Bedrin L; Wolf M; Chaushu G; Kronenberg J; Pfeffer
TI -
MR
Quality of life of nasopharyngeal carcinoma patients.
SO - Cancer 2002 Feb 15;94(4):1012-7
AD - Department of Otolaryngology-Head and Neck Surgery, the Chaim Sheba
Medical Center, Tel Hashomer and the Tel Aviv University Sackler School
of Medicine, Tel Aviv, Israel. talmi@attglobal.net
BACKGROUND: Quality of life (QOL) issues in patients with head and neck
carcinoma are of importance beyond the incidence of these tumors because
of the impact of the disease and its treatment on external appearance
and function of the upper aerodigestive tract. Nasopharyngeal carcinoma
(NPC) patients comprise a unique subgroup in whom, to our knowledge, QOL
has not been studied directly. METHODS: Adult patients with NPC treated
during the past 15 years at the Chaim Sheba Medical Center with a
minimum follow-up of 6 months were included in the current study.
Patients were mailed the revised University of Washington quality of
life (UW-QOL) questionnaire and data pertaining to their disease were
recorded. Patients with recurrent disease or another malignancy or those
whose present status could not be ascertained were excluded from the
study. QOL scores were analyzed based on treatment, disease stage, and
patient age. RESULTS: Twenty-eight patients of 35 disease-free patients
(80%) responded to the questionnaire sent to patients meeting the study
criteria. The mean score for general health was 3.1 (range, 1-5). Pain
was not a significant factor. Other domains without noteworthy problems
were speech and shoulder disability. The majority of patients described
their appearance as normal or with minor changes, and questions
concerning activity, recreation/entertainment, employment, and
swallowing all scored > 70 (range, 0-100). Dry mouth, chewing, and ear
problems were of major concern with the majority of patients and
affected the QOL indices. Nevertheless, the overall mean QOL score of
these patients was rated as "good" (4.2 on a scale of 1-6). CONCLUSIONS:
In the current study, patients with NPC reported ear problems,
difficulties in chewing, and dry mouth but their overall QOL appeared to
be good. Ear problems such as secretory otitis media should be
recognized at the time of presentation and treated. Conformal
radiotherapy techniques sparing the salivary glands and temporal bone
most likely will be useful in reducing the morbidity associated with
treatment. Copyright 2002 American Cancer Society. DOI
10.1002/cncr.10342
27
UI - 11908366
AU - Sciubba JJ
TI -
Oral precancer and cancer: etiology, clinical presentation, diagnosis,
and management.
SO - Compend Contin Educ Dent 2000 Oct;21(10A):892-8, 900-2; quiz 903
AD - Dental and Oral Medicine, Johns Hopkins Medical Center, Baltimore,
Maryland, USA.
Oral and oropharyngeal cancers represent 3% of all cancers in the United
States annually, with nearly 50% of people diagnosed with oral and
oropharyngeal cancers dying as a result of the disease. Because the
dental practitioner is in an ideal position for recognizing any
abnormality of the oral mucosa, he or she is involved in the battle
against oral cancer by helping establish the diagnosis at an early
stage. This article presents the clinical appearance, explains the
origins, and describes steps for the management of oral precancer and
cancer.
28
UI - 11917277
AU - Buntzel J; Glatzel M; Kuttner K; Weinaug R; Frohlich D
TI -
Amifostine in simultaneous radiochemotherapy of advanced head and neck
cancer.
SO - Semin Radiat Oncol 2002 Jan;12(1 Suppl 1):4-13
AD - Department of Otolaryngology, Zentralklinikum Suhl gGmbH, Suhl, Germany.
The authors discuss the results of 3 studies of their group reflecting
the possible role of amifostine in simultaneous radiochemotherapy (RCT)
of advanced head and neck cancer. In a controlled phase II trial (1995
through 1996), 39 patients were included in this pilot investigation. A
control group (n = 14) received simultaneous RCT of the head and neck
region with an irradiation dose of 60 Gy and 2 cycles of carboplatin
(700 mg/m(2) cumulative dose). Twenty-five patients received the same
basic therapy and an additional 500-mg dose of amifostine before each
chemotherapy. Amifostine was administered less than 45 minutes before
the end of radiotherapy. The authors observed a dramatic reduction of
typical radiotherapy-associated toxicities (mucositis, xerostomia, loss
of taste, dysphagia). The hematologic side effects (leukocytopenia,
anemia, thrombocytopenia) also were decreased significantly. The overall
survival rate and locoregional control of both groups were comparable
after 12 months. In a controlled intensification trial (1997 through
1999), the authors included 76 consecutive patients (69 men, 7 women)
with pharyngeal cancer (oropharynx, n = 33; hypopharynx, n = 43). The
tumors were characterized as unresectable and locally advanced without
distant metastasis. All patients received a conventional radiotherapy
(2-Gy single dose, daily fractionation) up to doses of 60 Gy and an
additional 10 Gy as a boost in the tumor-infiltrated region. A dose of
carboplatin, 70 mg/m(2), was given to a group of 45 patients on days 1
through 5 and 29 through 33 of radiotherapy (RCT arm). The resulting
cumulative dose was 700 mg/m(2). A group of 31 patients (RCTintens arm)
received the same dose of carboplatin on days 1 through 5, 22 through
26, and 43 through 47 or 1 through 5, 15 through 19, 29
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