National Cancer Institute®
Last Modified: March 1, 2002
1
UI - 9065641
AU - Issing WJ; Struck R; Naumann A
TI -
Positive impact of retinyl palmitate in leukoplakia of the larynx.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S105-9
AD - Department of Otorhinolaryngology, Klinikum Grosshadern,
Ludwig-Maximilians-Universitat, Munich, Germany.
Laryngeal leukoplakia can be a premalignant precursor of squamous cell
carcinoma, is often tobacco-related and can usually be readily monitored
by indirect laryngoscopy. One of the main motivations for using retinyl
palmitate in patients with persistent leukoplakia was to avoid general
anesthesia for elderly patients, who are considered to be high-risk
patients when direct larynoscopy is required for possible tissue biopsy.
Our study was the first to investigate the effectiveness and toxicity of
high-dose retinyl palmitate in the treatment of laryngeal leukoplakia.
Treatment was divided into two phases. In the first phase, all patients
underwent induction therapy with 300,000 IU/day of retinyl palmitate for
the 1st week, which was then adjusted up to 1,500,000 IU/day in the 5th
week in patients with resistant lesions. Patients whose lesions
progressed during this period were withdrawn from the study. In the
second phase, patients whose lesions responded to treatment or remained
stable were assigned to a maintenance therapy of 150,000 IU/day.
Complete remission was observed in 15 of 20 patients (75% of cases).
Partial response was seen in the remaining 5 patients, with 3 of the
patients relapsing. The median duration of treatment and follow-up was
18 months (range, 12-24 months). These results indicate that retinyl
palmitate has substantial activity in laryngeal leukoplakias. Since only
minor side effects were seen, the medication is an excellent candidate
as a preventive agent for laryngeal cancer.
2
UI - 9065642
AU - Dursun G; Keser R; Akturk T; Akiner MN; Demireller A; Sak SD
TI -
The significance of pre-epiglottic space invasion in supraglottic
laryngeal carcinomas.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S110-2
AD - Department of Ears, Nose and Throat, Ankara University Medical School,
Mebusevleri, Turkey.
It is widely accepted that tumoral invasion of the pre-epiglottic space
(PES) has a significant prognostic importance in supraglottic laryngeal
carcinomas. The lymphatics of the supraglottic larynx drain to cervical
lymph nodes via the PES. Since the supraglottic larynx is an
embryological unit that contains the PES, malignant lesions of this
region must be resected with en bloc surgery, including the PES. Tumors
with PES invasion are already considered to be T3 in TNM staging. The
purpose of this study was to review the clinical experience we have had
with these tumors at Ankara University. The study comprised 150 patients
with squamous cell carcinomas of the supraglottic larynx treated with
either partial or total laryngectomies. Findings suggested that PES
invasion occurred at early stages of supraglottic tumor progression.
Suprahyoid epiglottic lesions behaved less aggressively than tumors
originating from other supraglottic subsites and did not invade the PES
until advanced stages. PES invasion was not considered to be a
significant prognostic factor because the majority of the supraglottic
lesions studied demonstrated PES invasion regardless of cervical lymph
node metastases. Analysis of oncological and functional results revealed
that en bloc resection of the supraglottis with the PES was facilitated
by preservation of the hyoid bone.
3
UI - 9065643
AU - Zargi M; Smid L; Fajdiga I; Bubnic B; Lenarcic J; Oblak P
TI -
Detection and localization of early laryngeal cancer with laser-induced
fluorescence: preliminary report.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S113-6
AD - University Department of Otorhinolaryngology and Cervicofacial Surgery,
Ljubljana, Slovenia.
Differences in autofluorescence between normal and malignant tissues
offer new possibilities for detecting and localizing early laryngeal
carcinomas. In the present study imaging was performed using a specially
designed device that exploits differences in fluorescent properties of
normal and cancerous tissues without photodynamic drugs. Fluorescence
was induced by a helium-cadmium laser, captured by an image-intensified
camera and displayed on a video monitor after previous computerization.
Thirty patients were evaluated, of whom 18 had suspect malignancies.
Laryngoscopic appearances during standard microlaryngoscopy were
compared to fluorescence images, computerized fluorescence intensities
and histopathological findings. The experience from this study shows
that autofluorescence laryngoscopy may be a useful complementary method
for detecting laryngeal malignancies.
4
UI - 9065644
AU - Zbaren P; Becker M; Lang H
TI -
Staging of laryngeal cancer: endoscopy, computed tomography and magnetic
resonance versus histopathology.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S117-22
AD - Department of Otolaryngology, Head and Neck Surgery, Inselspital, Bern,
Switzerland.
An accurate pretherapeutic staging of laryngeal cancer is required for
optimal treatment planning and for evaluation and comparison of the
results of different treatment modalities. In this study, 45 consecutive
patients with neoplasms of the larynx, treated surgically, were included
in a prospective pretherapeutic staging protocol that included indirect
laryngoscopy, direct microlaryngoscopy, contrast-enhanced computed
tomography (CT) and Gd-DTPA-enhanced magnetic resonance imaging (MRI).
The surgical specimens were cut in whole-organ slices parallel to the
plane of the axial CT and MR images. The histologic findings were then
compared with clinical findings, CT and MRI. These findings showed that
clinical evaluation failed to identify tumor invasion of the laryngeal
cartilages and extralaryngeal soft tissues, resulting in a low staging
accuracy (55%). Many pT4 tumors were clinically understaged. The
combination of clinical/endoscopic evaluation and either CT or MRI
resulted in a significantly improved staging accuracy (80% vs 87%,
respectively). MRI was significantly more sensitive but less specific
than CT in detecting neoplastic cartilage invasion. MRI tended to
overestimate neoplastic cartilage invasion to possibly result in
overtreatment, while CT was found to underestimate neoplastic cartilage
invasion and could lead to inadequate therapeutic decisions.
5
UI - 9065648
AU - Golusinski W; Olofsson J; Szmeja Z; Szyfter K; Szyfter W; Biczysko W;
TI -
Hemminki K
Alteration of p53 gene structure and function in laryngeal squamous cell
cancer.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S133-7
AD - Department of Otolaryngology, Karol Marcinkowski University of Medical
Sciences, Poznan, Poland.
The p53 gene is known as an anti-oncogene that manifests its function by
controlling the cell cycle and is responsible for apoptosis of cells
with unrepaired DNA. An accelerated p53 protein synthesis is the first
response of a cell following DNA damage. However, mutations of the p53
gene can disturb protein synthesis or may be responsible for synthesis
of a changed protein unable to control the cell cycle. Laryngeal tissue
specimens from 120 patients were tested by immunohistopathological
staining to detect mutated wild-type p53 protein. It was found that
p53-positive specimens correlated with TNM staging and histopathological
grading. Another indication of entering the cell cycle and undertaking
an active proliferation by laryngeal cells was shown by detection of
proliferating cell nuclear antigen (PCNA) and Ki67 nuclear antigen,
which appeared in proliferating cells (late G1, S-G2 and M phase), but
was absent in resting cells. Scoring of the staining for p53 protein,
PCNA and Ki67 correlated with each other. DNA from 40 specimens was then
isolated, amplified by polymerase chain reaction and analysed by
single-strand conformation polymorphism and DNA sequencing for mutation
in the p53 gene. Fifteen DNA samples were found to be positive, while
mutations were detected in exons 5-8 in 13 samples. The majority of
mutations were found in tissue specimens from T3 and T4 tumors. A
possible explanation is almost half was attributable to genotoxic
effects of tobacco smoking. Changes in the p53 gene and its products may
also reflect early changes in laryngeal carcinogenesis and be of
prognostic value.
6
UI - 9065651
AU - Jahnke V; Strange R; Matthias C; Fryer A
TI -
Glutathione S-transferase and cytochrome P450 genotypes as risk factors
for laryngeal carcinoma.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S147-9
AD - Department of Otorhinolaryngology, Virchow-Klinikum, Humboldt
University, Berlin, Germany.
While cigarette smoking and alcohol consumption have been linked to
laryngeal squamous cell carcinoma (SCC), the role of genetic factors in
determining individual susceptibility is unknown. We describe the role
of allelism at the glutathione S-transferase GSTM1, GSTM3, GSTT1 and
cytochrome P450 CYP1A1, CYP2E1, CYP2D6 loci in determining individual
susceptibility to laryngeal SCC. Enzyme genotypes were determined using
polymerase chain reaction and restriction enzyme digestion of leukocyte
DNA collected from 269 patients with T1-T4 laryngeal carcinomas and 216
controls. While the frequencies of the heterozygote GSTM1 A/B genotype
and the homozygote GSTM3 B/B genotype were statistically significantly
lower in the patients with tumors than in controls, the frequency of the
GSTT1 null genotype was higher in the patients than in controls. The
data suggest that allelism at GST loci mediates susceptibility to SCC of
the larynx. GSTM1 A/B and GSTM3 B/B appear to be associated with reduced
risk, while GSTT1 null may confer increased risk. These findings are
compatible with the view that genetic predisposition is important in
determining risk for this cancer.
7
UI - 9065652
AU - Smid L; Strojan P; Budihna M; Skrk J; Vrhovec I; Zargi M; Kos J
TI -
Prognostic value of cathepsins B, D and steffins A and B in laryngeal
carcinoma.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S150-3
AD - University Department of Otorhinolaryngology and Cervicofacial Surgery,
Ljubljana, Slovenia.
Concentrations of cathepsins A, D and stefins A and B were measured in
primary tumor and adjacent normal tissue of 25 patients with laryngeal
carcinoma. Median concentrations of both cathepsins and that of stefin B
were significantly higher in tumor tissue than in their normal
counterparts (cathepsins B and D, P < 0.0001; stefin B, P = 0.01),
indicating their possible involvement in the process of tumor spread.
Early (T1 and T2) tumors had lower concentrations of stefins A and B
than locally advanced (T3 and T4) tumors (P = 0.04). Disease-free and
disease-specific survival rates at 45 months were significantly better
in patients with tumor concentrations of stefins above or equal to the
cut-off values (stefin A, P = 0.001 and P = 0.004; stefin B, P = 0.048
and P = 0.008), indicating that these might be of prognostic value. The
concentrations of cathepsins B and D did not correlate with survival.
8
UI - 9065653
AU - Namyslowski G; Klimala J; Kokocinska D; Misiolek M
TI -
Squamous cell carcinoma antigen levels in patients with different stages
of laryngeal cancer.
SO - Eur Arch Otorhinolaryngol 1997;254 Suppl 1():S154-6
AD - II ENT Department, Silesian Medical School, Zabrze, Poland.
An attempt was undertaken to evaluate the usefulness of squamous cell
carcinoma antigen (SCC Ag) in different stages of squamous cell
carcinoma of the larynx. Antigen levels were determined in blood serum
before treatment in 25 patients with laryngeal cancer treated at the II
ENT Department, Silesian Medical School in Zabrze. Ages were 39-65 years
(mean, 56.6 years). Fifteen healthy volunteers of similar ages served as
controls. SCC Ag was estimated by an enzyme-immunological method using
the Abbot set. Increasing levels of SCC Ag were found in 14 patients
(65%). The mean SCC Ag level before treatment in the tumor group was
2.93 +/- 0.23 ng/ml and 0.79 +/- 0.19 ng/ml in the control group
(standard, 1.5 ng/ml). Mean SCC Ag levels depending on the clinical
stage of disease were: stage I, 1.52 ng/ml; stage II, 2.16 ng/ml; stage
III, 3.03 ng/ml; stage IV, 4.57 ng/ml. Differences in all groups were
statistically significant when compared to the healthy controls (P <
0.05).
9
UI - 11859976
AU - Teppo H; Koivunen P; Sipila S; Jokinen K; Hyrynkangas K; Laara E;
TI -
Pukkala E; Sovio U; Alho O P
Decreasing incidence and improved survival of laryngeal cancer in
Finland.
SO - Acta Oncol 2001;40(7):791-5
AD - Department of Otorhinolaryngology, University of Oulu, Finland.
heikki.teppo@oulu.fi
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.
10
UI - 11859977
AU - Luscher M S; Pedersen U; Johansen L V
TI -
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.
lyscher@mail1.stofanet.dk
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.
11
UI - 11860067
AU - Cohen-Kerem R; Lahat N; Elmalah I; Greenberg E; Resnick MB; Doweck I;
TI -
Rahat MA
Detection of cytokeratins in normal and malignant laryngeal epithelia by
means of reverse transcriptase-polymerase chain reaction.
SO - Ann Otol Rhinol Laryngol 2002 Feb;111(2):149-54
AD - Department of Otolaryngology-Head and Neck Surgery, Lady Davis Carmel
Medical Center, Rappaport Family Institute for Research in the Medical
Sciences, Faculty of Medicine, Technion-Israel Institute of Technology,
Haifa.
Cytokeratins (CKs) are a subgroup of intermediate filament proteins that
take part in forming the cytoskeleton. The epithelial cells in different
organs express distinct CKs, and this expression may be modified during
malignant transformation. Here we describe the use of reverse
transcriptase-polymerase chain reaction followed by Southern blotting to
determine the profile of expression of CKs in both normal and malignant
laryngeal samples. Thirty-six samples were subjected to histologic
examination and classified as 17 squamous cell carcinomas, 3 dysplastic
lesions, and 16 normal samples. CK8 and CK19 were expressed in almost
all samples, both cancerous and normal, and were therefore used to
verify the integrity of RNA. Expression of CK2, CK9, and CK20 was not
detected in any of the samples, normal or cancerous. CK15 and CK18
showed low sensitivity for detection of cancer (36.4% and 45.5%,
respectively). CK10 showed relatively high sensitivity (91%), but only
moderate specificity (69.2%). Only CK17 showed both high sensitivity and
specificity (91% and 92.3%, respectively; positive predictive value,
91%). We propose that CK17 may be considered a promising candidate to
use as a molecular marker for malignant transformation in laryngeal
squamous cell carcinoma.
12
UI - 11860071
AU - Lassaletta L; Garcia-Pallares M; Morera E; Salinas S; Bernaldez R;
TI -
Patron M; Gavilan J
Functional neck dissection for the clinically negative neck:
effectiveness and controversies.
SO - Ann Otol Rhinol Laryngol 2002 Feb;111(2):169-73
AD - Department of Otolaryngology, La Paz University Hospital, Madrid, Spain.
This study was performed to evaluate the effectiveness of functional
neck dissection in controlling metastasis to the clinically negative
(cN0) neck, focusing on recurrences in the pathologically negative (pN0)
neck and the role of extracapsular spread in the cN0 neck. A series of
172 patients (253 dissected fields) treated for cN0 laryngeal or
hypopharyngeal cancer with a 5-year minimum follow-up is presented.
Occult metastasis was observed in 30% of the patients. Extracapsular
spread was present in 39% of the positive nodes. The neck recurrence
rate was 5.2%. Surgical specimens from cases of neck recurrence in pN0
necks were reevaluated for micrometastasis by immunostaining with
antibody for cytokeratins. The immunohistochemical findings were
positive in 1 of 4 cases. Functional neck dissection provides good neck
control and survival rates for the cN0 neck. The accurate prognostic
significance of extracapsular spread in cN0 necks is still unknown.
Micrometastasis alone may be insufficient to explain recurrences in pN0
necks.
13
UI - 11808137
AU - Yoshino K; Ajiki W
TI -
[Figures of laryngeal cancer]
SO - Nippon Rinsho 2001 Nov;59 Suppl 7():314-21
AD - Department of Otolaryngology, Osaka Medical Center for Cancer and
Cardiovascular Diseases.
14
UI - 11872287
AU - Ii N; Fuwa N; Ando M; Itoh Y; Nomoto Y; Takeda K
TI -
DNA ploidy analysis performed prospectively using fresh tumor samples in
early glottic carcinoma treated with radiotherapy.
SO - Int J Radiat Oncol Biol Phys 2002 Feb 1;52(2):415-9
AD - Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi,
Japan. ii-n@clin.med.mie-u.ac.jp
PURPOSE: The correlation between the DNA content, determined using fresh
tumor tissues, and the macroscopic presentation of the lesion was
studied prospectively in patients with T1 glottic carcinoma. METHODS AND
MATERIALS: DNA flow cytometry and fiber-optic endoscopic examination
were performed for 30 previously untreated patients with T1 glottic
carcinoma. The patients received radical radiotherapy at Aichi Cancer
Center Hospital. RESULTS: In regard to the type of lesion, 4 (80%) were
aneuploid, and 1 (20%) was diploid for the invasive type. There was a
tendency to show an invasive appearance in aneuploid tumors. With
respect to clinical outcome, there were 3 (43%) local recurrences among
the aneuploid tumors that invaded the entire length of one vocal cord, 0
(0%) for medium-sized lesions, and 1 (17%) for small lesions. Aneuploid
tumors showed a high correlation between lesion size and local control.
CONCLUSIONS: The correlation was not strong enough to conclude that DNA
content can replace the macroscopic presentation of the lesion. However,
the combination of DNA content and tumor size may help predict radiation
sensitivity.
15
UI - 11848533
AU - Pignataro L; Corsi MM; Sambataro G; Porcaro L; Tredici P; Broich G
TI -
Plasmatic cytokine network in patients with laryngeal carcinoma after
surgical treatment.
SO - Anticancer Res 2001 Sep-Oct;21(5):3621-5
AD - Clinica Otorinolaringoiatrica, Ospedale Maggiore I.R.C.C.S. Milano,
Italy. lorenzo.pignataro@unimi.it
Alterations in host immunity, inflammation, angiogenesis and metabolism
are all prominent clinical features in patients with laryngeal squamous
cell carcinoma (LSCC). Although the origin of the signals and mechanisms
underlying these responses are not well understood, their local and
systematic nature suggest that squamous cell carcinoma-produced
cytokines with proinflammatory and immunoregulatory activity may
contribute to the pathogenesis of LSCC. In order to gain a better
insight into the roles and relationships of the cytokines, we
investigated serum IL-6, IL-10 and IL-12 concentrations in LSCC patients
under baseline conditions and after surgery. In comparison with
controls, all the patients had higher plasma IL-10 concentrations before
surgical treatment (T0), while plasma IL-6 and IL-12 concentrations were
higher in 22 (84.6%) and 24 patients (92.3%). The differences in plasma
IL-6, IL-10 and IL-12 concentrations at T0 and T1 were statistically
significant (p<0.001, p<0.0046 and p<0.011). Our finding suggest that
plasma cytokines are overexpressed in LSCC patients. There was an
independent increase in plasma IL-6 levels before and after surgical
treatment. Furthermore, the up- and down-regulation of plasma IL-10 and
IL-12 suggest a regulatory relationship between them.
16
UI - 11848542
AU - Suarez-Alvarez B; Garcia Suarez MM; Arguelles ME; Sampedro A; Alvarez
TI -
Marcos C; Mira E; Van den Brul FA; Liu FT; Chowdhury PS; de los Toyos JR
Circulating IgG response to stromelysin-3, collagenase-3, galectin-3 and
mesothelin in patients with pharynx/larynx squamous cell carcinoma.
SO - Anticancer Res 2001 Sep-Oct;21(5):3677-84
AD - Servicio Cientifico Tenico de Citometria e Inmunotecnologia, Instituto
Universitario de Oncologia, Universidad de Oviedo, Madrid, Spain.
With the aim of identifying tumor-associated antigens that could be
potential markers and/or targets of diagnostic and/or therapeutic
approaches, we studied the occurrence of circulating IgG antibodies to
human stromelysin-3, collagenase-3, galectin-3 and mesothelin, by
Western blot against their purified recombinant forms, in the sera of 50
patients with pharynx/larynx squamous cell carcinoma (PLSCC), as well as
in the sera of 50 healthy blood donors. Overall, antibodies to
collagenase-3 were detected in 50% of all the cancer patients and 16% of
the blood donors examined; this percentage difference was statistically
significant (p = 0.00066). With respect to anti-galectin-3 antibodies,
the percentages were 32% and 18%, respectively, but they were not
statistically different (p = 0.16). Low levels of antibodies to
stromelysin-3 and to mesothelin were detected in sera from only two
cancer patients. No significant correlations were found in the present
study between the presence of antibodies to these proteins and tumor
site, clinical and T stages, lymph node involvement, DNA ploidy and
histological grade of differentiation of the primary tumors. To our
knowledge, this is the first report on the detection of circulating IgG
to collagenase-3 in cancer patients. Some of the percentages found here
in certain groups of patients are among the highest reported of
circulating antibodies to any tumor component studied so far. The
monitoring and the use of human antibodies to collagenase-3 could be of
diagnostic and therapeutic interest.
17
UI - 11843920
AU - Rafferty MA; Fenton JE; Jones AS
TI -
The history, aetiology and epidemiology of laryngeal carcinoma.
SO - Clin Otolaryngol 2001 Dec;26(6):442-6
AD - Department of Otolaryngology/Head and Neck Surgery, Liverpool
University, Liverpool, UK.
18
UI - 11843925
AU - Krecicki T; Zalesska-Krecicka M; Jelen M; Szkudlarek T; Horobiowska M
TI -
Expression of type IV collagen and matrix metalloproteinase-2 (type IV
collagenase) in relation to nodal status in laryngeal cancer.
SO - Clin Otolaryngol 2001 Dec;26(6):469-72
AD - Department of Otolaryngology, Medical University of Wroclaw, Poland.
krecicki@orl.am.wroc.pl
Laryngeal carcinoma has a lower incidence of neck metastases than other
malignant carcinomas of the head and neck region. However, some cases
are very aggressive, showing neck metastases even in the early stages.
In this study the expression of collagen IV and type IV collagenase
(MMP-2) were examined immunohistologically in 50 patients with laryngeal
carcinomas, and the results were compared with the incidence of neck
metastases and other clinicopathological factors. The correlation
between collagen IV expression and the existence of nodal metastases was
statistically significant (P < 0.001). There was also significant
correlation between collagen IV expression and the histological grading
of the tumour. There was a tendency for samples with continuous collagen
IV staining to have no matrix metalloproteinase-2 (MMP-2)
immunoreactivity. No significant correlation was seen between MMP-2
protein expression and clinicopathological parameters although the
correlation between MMP-2 and existence of nodal metastases was
statistically borderline (P = 0.07). Multivariate analysis of the
clinicopathological factors that may have an influence on the nodal
status in laryngeal cancer revealed that, apart from T stage, collagen
IV pattern in the basement membrane surrounding nests of carcinoma is an
important prognostic factor.
19
UI - 11843932
AU - Homer JJ; Greenman J; Stafford ND
TI -
The expression of vascular endothelial growth factor (VEGF) and VEGF-C
in early laryngeal cancer: relationship with radioresistance.
SO - Clin Otolaryngol 2001 Dec;26(6):498-504
AD - Department of Otolaryngology-Head and Neck Surgery, University of Hull,
Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK.
Angiogenesis is essential for tumour growth and invasion. Vascular
endothelial growth factor (VEGF) is a prime mediator of tumour
angiogenesis. VEGF-C is a closely related protein that effects lymphatic
endothelial cells and may be important in the process of lymphatic
metastasis. The purpose of this study was to evaluate the expression of
these cytokines in patients with T1 and T2a glottic, squamous cell
carcinoma, in comparison with normal epithelial control tissue, to
ascertain any association with radioresistance. Twenty-two tumours
treated by radiotherapy (13 radiosensitive, nine radioresistant) and
seven normal control tissues were studied. The minimum follow-up was 2
years after radiotherapy. Expression of VEGF and VEGF-C was evaluated by
immunohistochemistry of formalin-fixed, paraffin-embedded biopsy
specimens. Analysis was carried out using a quantitative computer image
analyser. Both VEGF and VEGF-C were detectable in tumour and normal
control specimens. There was increased expression in tumour specimens of
both VEGF (P = 0.03) and VEGF-C (P < 0.001). In addition, the expression
of VEGF-C was associated with tumours of higher histological grade (P =
0.021). There was, however, no difference in VEGF and VEGF-C expression
between radioresistant and radiosensitive tumours. The expression of
VEGF and VEGF-C is increased in early laryngeal squamous cell carcinoma
(SCC). However, measuring the expression of these proteins cannot
predict radioresistance in this tumour group.
20
UI - 11840592
AU - de Luis Roman D; Izaola O; Aller R
TI -
[24-hour oral intake in patients with upper aerodigestive tumors]
SO - Nutr Hosp 2001 Nov-Dec;16(6):280-3
AD - Seccion de Endocrinologia y Nutricion Clinica, Hospital del Rio Hortega
Valladolid, Espana. ddlr@pulso.com
BACKGROUND: A lot of works have shown, alterations in oral intake of
micro and macronutrients, in patients with upper aerodigestive tumors.
The main aim of our work was to compare the daily intake in a group of
patients with upper aerodigestive tumors versus a control group.
METHODS: A group pf 35 patients with upper aerodigestive tumors were
studied (8 oral cavity and 27 larynx). A group of 35 subjects were use
as control group. In all patients the next parameters were taken; age,
sex, smoking and alcohol consumption, type of tumors and a 24 hours oral
intake questionnaire. RESULTS: Patients with upper aerodigestive tumors
showed a high increase of calories intake (1545.3 +/- 359 cal/day vs
1264.4 +/- 240 cal/day; p < 0.05), carbohydrates intake (177.9 +/- 57.9
g/day vs 135.9 +/- 38.5 g/day; p < 0.05), total fats (58.2 +/- 18.4
g/day vs 45.9 +/- 15.4 g/day; p < 0.05) and saturated fats intake (19.4
+/- 7.7 g/day vs 11.9 +/- 6.1 g/day; p < 0.05). In micronutrients intake
differences were detected, a low intake in tumoral patients of vitamin C
(59.4 +/- 18.5 mg/day vs 141.5 +/- 83 mg/dia; p < 0.05), folic acid
(116.5 +/- 56.3 mg/day vs 180.5 +/- 78.5 mg/day; p < 0.05), and vitamin
B2 (1.53 +/- 0.5 mg/day vs 23.9 +/- 6.5 g/day; p < 0.05). In minerals
intake we detected a low intake in tumoral patients of calcium (702.9
+/- 363 mg/day vs 942.4 +/- 327 mg/day; p < 0.05). CONCLUSIONS: Patients
with upper aerodigestive tumors take a high amount of calories,
saturated fats and carbohydrates, and a low intake of vitamin C, folic,
vitamin B12 and calcium.
21
UI - 11119136
AU - Kendall CH
TI -
Leiomyoma with atypical cells (atypical leiomyoma) in the larynx.
SO - Histopathology 2000 Nov;37(5):475-6
22
UI - 11868476
AU - Palacios E; Friedlander PL
TI -
Chondrosarcoma of the larynx.
SO - Ear Nose Throat J 2002 Feb;81(2):83
AD - Department of Radiology, Louisiana State University Health Sciences
Center, New Orleans, USA.
23
UI - 11769998
AU - Mallet Y; Chevalier D; Darras JA; Wiel E; Desaulty A
TI -
Near total laryngectomy with epiglottic reconstruction. our experience
of 65 cases.
SO - Eur Arch Otorhinolaryngol 2001 Nov;258(9):488-91
AD - CHRU, Lille, France.
From 1980 to 1998, 65 patients whose glottic lesions were classified T1
or T2 were operated with a reconstructive anterior frontal laryngectomy
with epiglottoplasty such as described by Tucker (Arch Otolaryngol Head
Neck Surg 115:1341-1344). This procedure consists of resection of the
two vocal cords, in some cases one arytenoid, the anterior commissure
with a part of the thyroid cartilage, the anterior part of both false
vocal cords, and of 1 cm of the subglottis. The epiglottis is grasped
downward to close the larynx. There were no per or postoperative deaths.
Our functional results confirm those reported in the previous
publications. The mean time of removal of the nasogastric tube was about
12 days and the patients were generally satisfied about their residual
voice. Decannulation was performed after satisfactory peroral feeding,
generally about 2 weeks postoperatively. Three patients only required
subsequent procedures which can be considered due to functional
failures. There were four recurrences, which means a 5-year actuarial
local control rate of 94%. This operation takes place as part of our
surgical treatment policy of laryngeal carcinomas, considering that this
surgery is like an extensive frontolateral laryngectomy. In case of an
infiltrating tumor or in case of invasion to the arytenoid cartilage, we
perform a supracricoid partial laryngectomy with
crico-hyoido-epiglottopexy (the Majer-Piquet's procedure).
24
UI - 11775526
AU - Wolf GT
TI -
Options for preserving the larynx in patients with advanced laryngeal
and hypopharyngeal cancer.
SO - Ear Nose Throat J 2001 Dec;80(12):897-901
AD - Department of Otolaryngology-Head and Neck Surgery, University of
Michigan Health System, 1904 Taubman Center, 1500 E. Medical Center Dr.,
Ann Arbor, MI 48109-0312, USA. gregwolf@umich.edu
The introduction of newer surgical and combined-modality approaches to
organ preservation in patients with advanced laryngeal or hypopharyngeal
cancer is the most exciting clinical frontier in head and neck cancer
treatment today. The use of these techniques at other sites, the
exploration of improved methods for patient selection and tumor
assessment, and the development of newer combination regimens will need
to be rigorously studied in future clinical trials. In all these
efforts, the major focus must remain on improving survival. This article
reviews the latest developments in organ-preservation strategies and
techniques for patients with advanced laryngeal or hypopharyngeal
cancer.
25
UI - 11843727
AU - Aslan I; Baserer N; Yazicioglu E; Oysu C; Tinaz M; Kiyak E; Biliciler N
TI -
Near-total laryngectomy for laryngeal carcinomas with subglottic
extension.
SO - Arch Otolaryngol Head Neck Surg 2002 Feb;128(2):177-80
AD - Department of Otorhinolaryngology, Faculty of Medicine, Istanbul
University, Kardelen 4-5 D: 3, 81120 Atasehir Istanbul, Turkey.
ismetaslan@istanbul.edu.tr
OBJECTIVE: To investigate whether Pearson classic near-total
laryngectomy is a sensible surgical treatment modality for laryngeal
carcinomas with subglottic extension. DESIGN: Retrospective analysis of
patients treated by near-total laryngectomy in a university hospital
that is an academic tertiary health care center. PARTICIPANTS AND
INTERVENTION: Medical and computer records of 135 patients who were
treated by near-total laryngectomy for laryngeal and hypopharyngeal
carcinomas between April 1, 1989, and June 30, 2000, were searched
thoroughly, and the final outcomes were confirmed by telephone contact.
MAIN OUTCOME MEASURES: Survival rates of the patients with laryngeal
carcinomas with subglottic extension treated by near-total laryngectomy
were compared with those of the patients with malignancies of other
laryngeal regions given the same treatment. RESULTS: Of the 135 patients
in the study, 74 were available for determination of 5-year survival.
The rate was 65.8% (27/41) for transglottic tumors, 53.8% (7/13) for
supraglottic tumors, and 20.0% (4/20) for tumors with subglottic
extension. Only 3 of 16 patients with laryngeal carcinomas with
supraglottic or transglottic localization died of local recurrence; the
rest of the deaths were from regional recurrence or distant metastasis.
However, 6 of 13 patients with subglottic extension died of local
recurrence, 5 of peristomal recurrence, and only 2 of distant
metastasis. CONCLUSIONS: Success was directly related to adherence to
precise indications in cancer surgery. While near-total laryngectomy is
an effective and reliable treatment modality in laryngeal cancer
surgery, its effectiveness in laryngeal cancers with subglottic
extension is debatable. These subglottic lesions should be treated by
total laryngectomy, which is a more radical surgery.
26
UI - 11870663
AU - Jacob SE; Sreevidya S; Chacko E; Pillai MR
TI -
Cellular manifestations of human papillomavirus infection in laryngeal
tissues.
SO - J Surg Oncol 2002 Mar;79(3):142-50
AD - Department of Pathology, Medical College Hospital, Kerala State, India.
BACKGROUND AND OBJECTIVES: Although epidemiologic studies have suggested
human papillomavirus (HPV) to be an etiological agent in laryngeal
carcinogenesis, little is known on the cellular manifestations of HPV
infection in these tumors. In this study, we investigated the frequency
of HPV infection in various neoplastic and non-neoplastic laryngeal
tissue and its association with expression of the proliferating cell
nuclear antigen (PCNA) and the tumor suppressor protein p53. METHODS:
Tissues were analyzed by polymerase chain reaction (PCR) for the
presence of HPV and by immunocytochemistry for the expression of p53 and
PCNA. RESULTS: None of the six normal laryngeal tissues showed the
presence of HPV. Thirteen out of the 16 papillomas were positive for
HPV, while 15 out of the 44 invasive cancers were HPV positive. PCNA
expression increased as the lesion progressed through increasing
histological abnormality (r = 0.64400, P = 0.00000). The correlation
between the type of laryngeal neoplasm and p53 accumulation was
significant (r = 0.54839, P = 0.00000). Significant correlation was also
evident between presence of HPV and p53 accumulation (r = 0.34259, P =
0.00424) and PCNA expression (r = 0.036024, P = 0.00266) indicating that
HPV positive tumors showed significant p53 accumulation and increased
proliferation.There was also correlation between p53 and PCNA expression
(r = 0.67475, P = 0.00000) indicating that in all tumors with p53
accumulation, there was a corresponding increase in PCNA expression.
CONCLUSIONS: The results suggests that changes in p53 and PCNA
expression may be associated with HPV infection, and could play a role
in laryngeal carcinogenesis. Copyright 2002 Wiley--Liss, Inc.
27
UI - 11783094
AU - Wang D; Zhang W; Xiong M
TI -
[The clinical usefulness of helical CT multiplanar reformation,
three-dimensional reconstruction and virtual laryngoscopy in laryngeal
and hypopharyngeal carcinomas]
SO - Zhonghua Zhong Liu Za Zhi 2001 May;23(3):230-3
AD - Department of Radiology, Air Force General Hospital, Beijing 100036,
China.
OBJECTIVE: To evaluate the clinical applications of helical CT
multiplanar reformation (MPR), three-dimensional reconstruction (3D) and
virtual laryngoscopy (CTVL) in laryngeal and hypopharyngeal carcinoma.
METHODS: Axial helical CT scan was performed in 24 patients with
laryngeal or hypopharyngeal carcinoma, meanwhile MPR, 3D and CTVL were
performed on each patient. The results were compared with the fiberoptic
laryngoscopic and surgical findings. RESULTS: Axial helical CT combined
with MPR images, the accuracy of preoperative tumor staging and
detection of metastatic lymph nodes were both 96%. In 25% of the cases,
MPR was more informative than axial images about the extent of tumor
invasion. The 3D image three-dimensionally displayed the extent of tumor
invasion, and its relation to blood vessels and airway. On CTVL, the
location, size and extent of intraluminal tumors of the larynx and
hypopharynx when observed from above corresponded well with those
observed under laryngoscope. In 4 patients, CTVL observed from below,
demonstrated the relationship between the tumor and vocal cords and
anterior commissure inaccessible to fiberoptic laryngoscopy. CONCLUSION:
Helical CT axial scanning combined with MPR, 3D and CTVL images, can
provide more comprehensive information about laryngeal and
hypopharyngeal carcinoma.
28
UI - 11902488
AU - Akcay F; Taysi S; Uslu C; Dogru Y; Gumustekin K
TI -
Levels of soluble intercellular adhesion molecule-1 and total sialic
acid in serum of patients with laryngeal cancer.
SO - Jpn J Clin Oncol 2001 Dec;31(12):584-8
AD - Department of Biochemistry, School of Medicine, Ataturk University,
Erzurum, Turkey. fakcay32@hotmail.com
BACKGROUND: Adhesion molecules have been implicated in tumor
progression. In this study, we aimed to investigate serum soluble
intercellular adhesion molecule-1 (sICAM-1) and total sialic acid (TSA)
levels in laryngeal carcinoma and correlate their levels with the cancer
stage. METHOD: The sera from 35 patients with laryngeal cancer (10 at
stage II, 12 at stage III and 13 at stage IV) were extracted before
treatment. The concentrations of sICAM-1 and TSA were measured by
enzyme-linked immunoassay and the thiobarbituric acid method,
respectively and compared with those from a healthy control group (n =
34). RESULTS: Mean serum sICAM-1 and TSA levels were found to be higher
in the total patient group (the lowest level belonging to stage II) than
in the control group (p < 0.001, control versus total patient group). As
the stage of the disease increased, higher levels of sICAM-1 and TSA
were determined. The correlations between TSA and sICAM-1 became more
significant as the stage of the disease increased (r= 0.67, p < 0.05 in
stage II, r= 0.86, p < 0.001 in stage III and r = 0.90, p < 0.001 in
stage IV). CONCLUSION: These data reveal that the significant
correlations between sICAM-1 and TSA in laryngeal cancer, more prominent
at advanced stage, might reflect the similar nature of these molecules,
which function as adhesion molecules.
29
UI - 11751491
AU - Almadori G; Cadoni G; Cattani P; Galli J; Bussu F; Ferrandina G; Scambia
TI -
G; Fadda G; Maurizi M
Human papillomavirus infection and epidermal growth factor receptor
expression in primary laryngeal squamous cell carcinoma.
SO - Clin Cancer Res 2001 Dec;7(12):3988-93
AD - Institute of Otolaryngology, Catholic University of the Sacred Heart,
Largo A. Gemelli, 8, Rome 00168, Italy. iclot@rm.unicatt.it
PURPOSE: This study was designed to add new data about laryngeal
carcinogenesis, a multistep process in which chemical and/or viral
agents induce and promote successive alterations in growth factor-linked
signal transmission pathways, genetic instability, and mutations in key
genes involved in cell growth control. Epidemiological evidence suggests
that human papillomavirus (HPV) infection may be associated with the
development of laryngeal cancer. EXPERIMENTAL DESIGN: In this report, we
have analyzed the prevalence of HPV infection and epidermal growth
factor receptor (EGFR) expression in a series of 42 laryngeal squamous
cell carcinomas by PCR with HPV consensus primers and by a radioligand
receptor assay, respectively. RESULTS: HPV DNA was detected in 15 of 42
(35.7%) tumors, and it belonged almost exclusively to the highly
oncogenic HPV-16, HPV-18, and HPV-33 genotypes. At analysis by
Mann-Whitney nonparametric statistical test, EGFR level was found to be
significantly higher in HPV-infected than in HPV-negative cases (T =
440; P = 0.002). EGFR overexpression (EGFR-positive status >6 fmol/mg
protein, the arbitrary cutoff value chosen) was found in 20 of 42
(47.6%) tumors, and it was associated with HPV infection in a
statistically significant extent (chi(2) = 4.686; P = 0.03).
CONCLUSIONS: Viral oncoproteins have been shown to induce a perturbation
of the cell response to signals for growth and differentiation; these
findings confirm that enhanced EGFR expression and activation in
laryngeal squamous cell carcinoma may occur also as a consequence of HPV
infection and support the hypothesis of an involvement of HPV infection
in laryngeal carcinogenesis.
30
UI - 11889399
AU - Gallo A; de Vincentiis M; Manciocco V; Simonelli M; Fiorella ML; Shah JP
TI -
CO2 laser cordectomy for early-stage glottic carcinoma: a long-term
follow-up of 156 cases.
SO - Laryngoscope 2002 Feb;112(2):370-4
AD - Department of Otolaryngology, "La Sapienza" University, Rome, Italy.
andrea.gallo@uniroma1.it
OBJECTIVES: To define when laser resection of early-stage glottic
carcinoma is indicated and to compare the results obtained by laser
surgery with other therapeutic options. STUDY DESIGN: Retrospective
Department of Otorhinolaryngology at "La Sapienza" University. We
provide analysis of indications, techniques, and oncologic results of
this study. METHODS: Glottic tumors were treated with type III, type IV,
and type Va cordectomies according to the classification of endoscopic
cordectomies proposed by the European Laryngological Society in 2000.
RESULTS: The results are summarized as follows: all patients with
carcinoma in situ Tis are free of disease with local control rate at 3
years of 100%; 2 died of other causes without evidence of local
recurrence with an overall survival rate at 3 years of 83.2%. Of the 117
patients with stage T1a cancer, 110 are free of disease at 3 years with
local control rate of 94%; 4 patients died of other causes without
evidence of local recurrence with an overall survival rate of 96.5%. Of
the 22 patients with stage T1b cancer, 20 are free of disease at 3 years
with a local control rate of 91%; 1 patient died of other causes without
evidence of local recurrence with an overall survival rate at 3 years of
95.4%. CONCLUSIONS: According to our experience, we can conclude that
endoscopic laser surgery is an efficacious and cost-effective treatment
for early stage glottic cancer.
31
UI - 11889400
AU - Pradhan SA; D'Cruz AK; Pai PS; Mohiyuddin A
TI -
Near-total laryngectomy in advanced laryngeal and pyriform cancers.
SO - Laryngoscope 2002 Feb;112(2):375-80
AD - Head and Neck Services, Tata Memorial Hospital, Parel, Mumbai, India.
pradhansultan@hotmail.com
OBJECTIVE: To demonstrate the oncologic and physiological safety of
near-total laryngectomy (NTL), its success in voice conservation, and
its versatility for use in extensive resections that necessitate
pharyngoplasty, and even in post-radiation recurrences. STUDY: In this
study of 137 cases of NTL for cancer of the larynx (45 cases) and
pyriform (92 cases), 86.9% were stage T3/T4 and 60.6% were N+. A total
of 8.8% had extended pharyngeal resections necessitating patch
pharyngoplasty (ENTLP). In 10.9% cases, NTL was used as salvage of
post-radiation failures. Concurrent neck dissection was performed in 99
cases. RESULTS: A total of 70.1% was alive and disease-free at the last
follow-up ranging from 12 months to 104 months (median, 35 mo). A total
of 7.3% had local/locoregional recurrences and 11.7% had purely regional
recurrences. The local control rate for post-radiation salvage with NTL
was 93.3%. A total of 88.6% developed communicable speech, and the
speech success rate was 100% in 12 cases of ENTLP. Complications
included major wound dehiscence with total shunt breakdown in 2 cases
(1.5%), pharyngeal leak requiring surgical intervention in 7 cases
(3.6%), significant aspiration through the shunt necessitating
completion laryngectomy in 1 case (0.7%), and complete shunt stenosis in
9 cases (6.6%). CONCLUSION: The study shows that NTL is an oncologically
safe voice conservation procedure in advanced, lateralized laryngeal and
pyriform cancers treated not only per primum, but also in carefully
selected post-radiation failures. It has a high success rate of speech
development even in those cases requiring extensive pharyngeal
resections. Major complications were acceptably low.
32
UI - 11889403
AU - Baer S; Casaubon L; Schwartz MR; Marcogliese A; Younes M