National Cancer Institute®
Last Modified: September 1, 2002
UI - 12075196
AU - Rodu B; Cole P
TI - Smokeless tobacco use and cancer of the upper respiratory tract.
SO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002 May;93(5):511-5
AD - University of Alabama at Birmingham, AL 35294-0007, USA. firstname.lastname@example.org
The most recent epidemiologic review of the cancer risks associated with smokeless tobacco use appeared in 1986, when 10 studies were available. This review describes 21 published studies, 20 of which are of the case-control type. We characterize each study according to the specific anatomic sites and according to the type of smokeless tobacco products for which it provides relative risks of cancer. The use of moist snuff and chewing tobacco imposes minimal risks for cancers of the oral cavity and other upper respiratory sites, with relative risks ranging from 0.6 to 1.7. The use of dry snuff imposes higher risks, ranging from 4 to 13, and the risks from smokeless tobacco, unspecified as to type, are intermediate, from 1.5 to 2.8. The strengths and limitations of the studies and implications for future research are discussed.
UI - 11883562
AU - Smithwick L; Davis P; Dancer J; Hicks GS; Montague J
TI - Female laryngectomees' satisfaction with communication methods and speech-language pathology services.
SO - Percept Mot Skills 2002 Feb;94(1):204-6
AD - University of Arkansas for Medical Sciences, University of Arkansas at Little Rock, 72204, USA.
132 female laryngectomees responded to a questionnaire regarding satisfaction with their communication methods as postlaryngectomees and speech-language pathology services. Respondents were satisfied overall with their primary communication selection; however, most would like to try a method that produced a more feminine-sounding voice. 68% were satisfied with their speech-language pathology services.
UI - 11890339
AU - Gonzalez Aguilar O; Pardo HA; Vannelli A; Simkin DO; Rossi A; Rubino A;
TI - Simkin D Total laryngectomy: pre- and intrasurgical variables of infection risk.
SO - Int Surg 2001 Jan-Mar;86(1):42-8
AD - Department of Surgery, Marie Curie Hospital, Buenos Aires, Argentina.
Postoperative infection has influence on costs, quality of life, and outcome of the disease. It is suspected that post-total laryngectomy infections have increased in frequency and seriousness, because of the failure of the preservation protocol or the previous radiotherapy, making rescue surgery necessary. The objective of this study was to develop a predictive model of infection based on the pre- and intrasurgical variables considered risky. One hundred fifty five patients with E III-IV laryngeal cancer, with 24.8:1 male to female ratio (mean age, 58 years) who underwent total laryngectomy were evaluated for uni- and multivariate analysis of age, sex, histological grade, primary or recurrent disease, tobacco, alcohol, diabetes, tuberculosis/chronic emphysema, red and white cell counts, erythrosedimentation rate (ESR), albumin, chemotherapy, neck radiotherapy and/or previous surgery, confinement days, type and time of surgery, which were factors in the infection event. A predictive model of infection was developed and included albuminemia (<3.5 g%), >1 liter of alcohol daily, and exclusive surgery of the primary. The sensitivity was 90.5% and the specificity 68%. The variance reached 29.6%. The causes of infection were multiple, having analyzed only 30% of them. However, the resulting model was classified correctly in 83.2% of cases. A careful preoperative assessment, an adjusted planning of the surgery, an appropriate use of antibiotics, and a meticulous operative technique are needed to prevent infection.
UI - 12148851
AU - Lydiatt DD
TI - Medical malpractice and cancer of the larynx.
SO - Laryngoscope 2002 Mar;112(3):445-8
AD - Department of Otolaryngology, University of Nebraska Medical Center and Methodist Cancer Center, Omaha, USA. D.Lydiatt@unmc.edu
OBJECTIVE: To analyze the frequency, clinical characteristics, and legal outcomes of malpractice litigation initiated by patients with cancer of the larynx. STUDY DESIGN: Retrospective review of 23 jury verdict reports from 11 states. METHOD: Jury verdict reviews from 1976 to 1997 were obtained from a computerized legal database compiled from all state and federal civil court decisions. Reviews compile pertinent data on defendants, plaintiffs, verdict outcomes, indemnity payments, allegations of wrongdoing, and provide case summaries. RESULTS: Delays in diagnosis were alleged in 19 of 23 (83%) suits. Hoarseness was present in 10 of 19 (53%), a neck mass in 3 of 19 (16%), and no biopsy was taken in 11 of 19 (58%) of those delayed. Mean age was 47 years, with a peak incidence in the general population of 70 to 74 years. Laryngectomy was alleged to be a result or complication of delay in 12 of 19 (63%). Over half of the patients delayed received compensation, and over half of the defendants were in general practice. Outcome was poor with a 35% mortality and a total of 47% either dead of disease or alive with disease. Complications, incorrect diagnosis, and informed consent did not play a significant role in initiating litigation. CONCLUSIONS: The delayed diagnosis of cancer of the larynx associated with litigation is frequently seen in younger patients presenting with hoarseness or neck masses. These patients frequently have poor outcomes. Patients with symptoms of cancer of the larynx must be aggressively evaluated regardless of age. Risk management goals to prevent delays in diagnosis may help prevent subsequent litigation.
UI - 12148859
AU - Malzahn K; Dreyer T; Glanz H; Arens C
TI - Autofluorescence endoscopy in the diagnosis of early laryngeal cancer and its precursor lesions.
SO - Laryngoscope 2002 Mar;112(3):488-93
AD - Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Germany. email@example.com
OBJECTIVES: Because early detection and preoperative assessment of laryngeal cancer and its precursor lesions are essential for curative and function-preserving surgical treatment, autofluorescence endoscopy has been developed to gain more information about the biologic character of these lesions. The aim of the present study is to investigate a high, representative number of patients and to evaluate the diagnostic potential and the limitations of this method. METHODS: In a prospective study, 127 patients were investigated during microlaryngoscopy. A total of 111 patients were suspected of having precancerous or cancerous lesions, 12 had benign lesions, and 4 patients had normal epithelium. Autofluorescence was induced by filtered blue light (380-460 nm) of a xenon short arc lamp and processed by a CCD camera system (D-light-AF system; Storz, Tuttlingen, Germany). Autofluorescence endoscopic images were immediately assessed for diagnosis, correlated to the dysplasia grading system and compared with the histopathologic findings. RESULTS: Normal laryngeal mucosa displayed a typical green fluorescence signal. Moderate and high epithelial dysplasia, carcinoma in situ, and invasive carcinoma showed a diminished green fluorescence. False-negative results (n = 2) were the result of extreme hyperkeratosis. False positive cases (n = 8) either showed mild dysplasia with inflammatory reactions or scarring of the vocal folds. In 105 of 111 cases (94.6%), we found concordant results (sensitivity, 97.3%; specificity, 83.8%). CONCLUSION: Autofluorescence endoscopy facilitates the detection and delineation of precancerous lesions, carcinoma in situ, and microinvasive cancer of the larynx more accurately than clinical observation alone. Scarring, marked hyperkeratosis, and inflammation can limit the predictive value of the method.
UI - 12148871
AU - Kawaida M; Fukuda H; Kohno N
TI - Digital image processing of laryngeal lesions by electronic videoendoscopy.
SO - Laryngoscope 2002 Mar;112(3):559-64
AD - Department of Otolaryngology, Tokyo Metropolitan Ohtsuka Hospital, Japan.
OBJECTIVES: To present electronic videoendoscopy of the larynx with digital image processing and to discuss this endoscopic technique from the standpoint of diagnostic usefulness of laryngeal lesions. STUDY DESIGN: Electronic videoendoscopic evaluation of laryngeal lesions with digital image processing. METHODS: Seventy patients underwent electronic videoendoscopy without digital image processing and, subsequently, with the digital image processing function. Of these, 15 patients with white lesion of the vocal fold and laryngeal neoplasms were assessed in the study. Clinical assessments made before enhancement of digital image processing function were compared with those after enhancement in 15 patients. RESULTS: Of the 15 patients observed, the clinical diagnoses of two patients were changed after enhancement. Both patients underwent endolaryngeal microsurgery with histopathological examination of the removed lesions, which confirmed the definitive diagnosis. The clinical diagnoses of both patients after enhancement were compatible with histopathological diagnoses. CONCLUSIONS: The enhanced color images provided by this system are superior in both quality and resolution to those obtained by conventional flexible fiberoptic endoscopy with a video camera. This system should be a valuable tool for the diagnosis of laryngeal lesions.
UI - 12112558
AU - Almadori G; Galli J; Cadoni G; Bussu F; Maurizi M
TI - Human papillomavirus infection and cyclin D1 gene amplification in laryngeal squamous cell carcinoma: biologic function and clinical significance.
SO - Head Neck 2002 Jun;24(6):597-604
AD - Istituto di Clinica Otorinolaringoiatria, Policlinico "Agostino Gemelli," Largo Agostino Gemelli, 00168, Roma, Italy.
BACKGROUND: Human papillomavirus (HPV) infection is suspected to be a risk factor for head and neck, and in particular for laryngeal, carcinogenesis. Cyclin D1 gene (CCND1) overexpression and amplification have been shown to play a role as prognostic factors in many human cancers, among which are head and neck cancers. METHODS: A literature review of the role in head and neck cancers of HPV infection and CCND1 overexpression and amplification was undertaken. We have evaluated the extent of the current knowledge in this field under the light of recent acquisitions, in particular, about a correlation between HPV infection, a suspected risk factor, and CCND1 amplification, a frequent mutation (about 20% of laryngeal cancers) and a prognostic factor in laryngeal SCC. RESULTS AND DISCUSSION: The significant correlation between HPV infection and CCND1 amplification supports the hypothesis of the involvement of HPV infection in laryngeal carcinogenesis and suggests that HPV positive laryngeal cancers may constitute a different subset of tumors with a peculiar molecular pattern and thus with a different clinical behavior. HPV infection may be considered a synergistic risk factor with smoking and/or alcohol consumption to be investigated in heavy smokers and drinkers, thus contributing to the identification of patient at high-risk for the development of laryngeal cancer who should undergo strict follow-up and primary and secondary prevention. Copyright 2002 Wiley Periodicals, Inc.
UI - 12049827
AU - Chatrath P; Black M; Jani P; Albert DM; Bailey CM
TI - A review of the current management of infantile subglottic haemangioma, including a comparison of CO(2) laser therapy versus tracheostomy.
SO - Int J Pediatr Otorhinolaryngol 2002 Jun 17;64(2):143-57
AD - Department of Paediatric Otolaryngology, Great Ormond Street Hospital for Children, London WC1N 3JH, UK. firstname.lastname@example.org
OBJECTIVES: We reassessed the current practice and treatment options used in the management of subglottic haemangiomas (SGHs), including the place for open submucosal surgical excision, and have compared the results of different therapeutic modalities used for SGHs. METHODS: The two studies were conducted as separate exercises; (1) a retrospective review of 36 patients collected over a recent 8-year period to assess the current practice and treatment options in use; (2) a retrospective comparative study of a previous cohort of 51 patients with SGHs treated in one of four groups: (a) tracheostomy alone, (b) tracheostomy and CO(2) laser, (c) systemic steroids and CO(2) laser (no tracheostomy) and (d) intralesional steroid injection, CO(2) laser therapy, or both, followed by intubation. RESULTS: Systemic steroids were the most commonly used modality of treatment. Resolution of the SGH was achieved in 89% of cases at a mean follow up duration of 34 months. However, tracheostomy was required in 58% of cases, with a mean time from diagnosis to decannulation of 30 months. The time to resolution of SGHs does not appear to be reduced by laser therapy compared with treatment by tracheostomy alone. Intralesional steroid injection or laser therapy together with intubation was associated with avoidance of a tracheostomy in 66% of cases. Single-stage open surgical excision in two cases resulted in successful resolution of the SGH and discharge after a mean follow up period of 3 months. CONCLUSIONS: Despite the more widespread use of steroids and other treatment modalities, the requirement for tracheostomy has remained unchanged over the last 20 years. The use of laser therapy does not appear to confer any additional therapeutic benefit over and above tracheostomy alone in bringing about resolution of SGHs. Systemic steroids may reduce the size of the haemangioma but are associated with multiple adverse effects. The decision to use the above techniques must, therefore, be made in the light of these observations. Our early experience of single-stage excision suggests that this technique represents an exciting and promising surgical alternative, and its more widespread adoption may be the only way of further improving the outcome of patients with SGHs.
UI - 12044513
AU - Ecimovic P; Pompe-Kirn V
TI - Second primary cancers in laryngeal cancer patients in Slovenia, 1961-1996.
SO - Eur J Cancer 2002 Jun;38(9):1254-60
AD - Cancer Registry of Slovenia, Institute of Oncology, Zaloska cesta 2, SI-1000 Ljubljana, Slovenia. email@example.com
We analysed the incidence of second primary cancers (SPC) in male laryngeal cancer patients in Slovenia and their survival for the period of 1961-1996. Data were taken from the population-based Cancer Registry of Slovenia. The person-years approach was used and the risk for SPC was expressed as a standardised incidence ratio (SIR). Survival analysis was carried out using the Kaplan-Meier method. Of 2275 male patients, 369 developed SPC (16.2%, total SIR 2.83), most commonly in the head and neck region (SIR 6.07-15.97), lung (SIR 4.15), oesophagus (SIR 4.66), and bladder (SIR 3.0), which points to an important role of common risk factors of smoking and alcohol. SPC were diagnosed in significant excess up to 20 years after the diagnosis of laryngeal cancer. The median survival time from the diagnosis of laryngeal cancer was 3.25 years for patients without a SPC and 6.47 years for patients who developed a SPC. However, the median survival time from the diagnosis of a SPC was only 0.84 years. Patients with laryngeal cancer in Slovenia have a higher risk of developing a SPC than was reported in similar studies in Europe and the USA. This high risk is partly responsible for their relatively poor survival.
UI - 12015038
AU - Lei D; Pan X; Guo C; Xu F; Zhang L; Liu D; Luan X
TI - [Relationship between polymorphism of N-acetyltransferase 2 and genetic susceptibility to laryngeal carcinoma]
SO - Zhonghua Zhong Liu Za Zhi 2002 Mar;24(2):154-6
AD - Department of Otorhinolaryngology, Qilu Hospital, Shandong University, Jinan 250012, China.
OBJECTIVE: To investigate the relationship between polymorphism of N-acetyltransferase (NAT2) gene and genetic susceptibility to laryngeal carcinoma. METHODS: A case-control study on 62 laryngeal carcinoma patients and 56 controls was conducted. NAT2 alleles were differentiated by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) methods using originally created PCR primers and genomic DNA extracted from peripheral white blood cells. Genetic risk for NAT2 genotype was analyzed by smoking index (SI, cigarettes smoked per day x years of smoking). RESULTS: The frequency of NAT2 slow genotype was 80.6% in patients with laryngeal carcinoma and 60.7% in the controls, the difference of which was statistically significant (chi(2) = 5.70, P = 0.017). The odds ratios were 2.70 (95% CI 1.19 approximately 6.11). Among the individuals with NAT2 slow genotype at high level of cigarette smoking, there was a significantly higher risk of 5.64 (95% CI 1.77 approximately 17.92), while those at low level were considered the reference group (OR 1.38, 95% CI 0.42 approximately 4.52). CONCLUSION: NAT2 slow genotype increases the risk of susceptibility to laryngeal carcinoma. The combined effect of NAT2 slow genotype and exposure to smoking is observed during the development of laryngeal cancer.
UI - 12095562
AU - Johansen LV; Grau C; Overgaard J
TI - Supraglottic carcinoma: patterns of failure and salvage treatment after curatively intended radiotherapy in 410 consecutive patients.
SO - Int J Radiat Oncol Biol Phys 2002 Jul 15;53(4):948-58
AD - Department of Experimental Clinical Oncology, Danish Cancer Society, Aarhus University Hospital, Aarhus, Denmark. firstname.lastname@example.org
PURPOSE: In a series of consecutive patients with squamous cell carcinoma of the supraglottic larynx, in which almost all were treated by primary radiotherapy, the study describes the path from diagnosis to cure or death, and evaluates the patterns of failure and the treatment of recurrences. METHODS AND MATERIALS: The analysis included 410 patients, 104 females and 306 males, treated between 1963 and 1991. Most patients were in Stage I (33%), and the remaining were in Stage II (18%), III (23%), and IV (26%). Primary intended curative treatment was delivered in 398 (radiotherapy, 394; surgery, 4) of 410 cases (98%). RESULTS: Initial radical treatment resulted in 173 cured patients and 225 patients with a recurrence. Curatively intended salvage could be applied in 158 patients: surgery in 154 patients (74 cured) and radiotherapy in 4 (none cured). Overall, 247 patients (60%) obtained tumor control, 179 (44%) without a laryngectomy. Sixty-three patients had a total laryngectomy, and five had a partial laryngectomy. The 5-year locoregional tumor control, disease-specific survival, and overall survival rates were 43%, 61%, and 47%, respectively. With a follow-up of 20 years posttreatment, 91 new primary malignant tumors were detected. CONCLUSIONS: Radiotherapy is effective in the treatment of supraglottic laryngeal carcinoma, and the patients have a relatively good prognosis. Many patients retained their larynx intact. Recurrence after primary radiotherapy can be treated by surgery, with a high success rate even in advanced stages. Development of second primary cancer is a growing problem.
UI - 12107532
AU - Jarmuz M; Golusinski W; Grenman R; Szyfter K
TI - Analysis of chromosome aberrations in cell lines derived from laryngeal cancer in relation to tumor progression.
SO - Eur Arch Otorhinolaryngol 2002 May;259(5):269-73
AD - Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland.
Cell lines provide a good model for studies on molecular and cellular events accompanying neoplastic transformation and cancer progression. The data in recent literature suggest an occurrence of repetitive chromosome aberrations that can be linked with particular stages of cancer. Ten cell lines derived from squamous cell carcinoma of the larynx at the University of Turku were karyotyped. The studied cell lines represented a variety of primary locations of the tumors, TNM staging and histological grading. Karyotyping was done by the classical cytogenetic technique with the application of GTG, QFQ and other banding techniques; some complex aberrations were analyzed by the FISH technique. The results document several numerical and structural aberrations. Attention was focused on the monosomy of chromosomes 13, 17 and 18, frequent deletions of the Y chromosome. Structural aberrations were frequently seen at chromosomes 1, 3, 4, 7, 8, 9 and 11, mostly as deletions (usually deletions of a whole arm), translocations, isochromosomes, duplications and marker chromosomes. The study is in progress and aims to find a correlation between particular aberrations and disease staging. At present, two observations seem to be firm: the amplification of the 11q13 region appeared in tumors with a short survival. However, the primary location of the tumor should be taken into account when considering 11q13 as a prognostic marker. The same is applicable for del(9p), which indicates an early stage of disease. Besides the frequent chromosome aberrations, attention should be paid to marker chromosomes that are potentially specific for laryngeal cancer.
UI - 12195745
AU - Finizia C; Palme C; Bergman B
TI - A longitudinal study of the Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer questionnaire in patients treated for laryngeal cancer.
SO - Acta Oncol 2002;41(3):262-8
AD - Department of Otorhinolaryngology, Sahlgrenska University Hospital, SE-431 80 Molndal, Sweden. email@example.com
A prospective longitudinal study was performed to investigate the sensitivity to change over time of the Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer questionnaire (S-SECEL), addressing communication dysfunction in patients with laryngeal cancer. Twenty-six consecutive patients attending a weekly tumour conference over a period of one year at Sahlgrenska University Hospital were included in the study prior to start of treatment. The patients answered four questionnaire repeatedly in the course of one year: the S-SECEL, the European Organization for Research and Treatment of Cancer (EORTC), the Core Quality of Life Core Questionnaire (QLQ-C30) supplemented by the Head and Neck cancer questionnaire module (QLQ-H&N35), and the Hospital Anxiety and Depression (HAD) scale. In addition, performance status was assessed. The S-SECEL questionnaire was well accepted by the patients, and compliance was satisfactory with a cumulative response rate of 88% at one year, supporting its feasibility in clinical settings. Repeated measures with the S-SECEL over one year demonstrated a significant decrease in voice and speech dysfunction. The correlation pattern over time between the S-SECEL and the EORTC and HAD questionnaires lent support to the construct validity of the S-SECEL and indicated that the questionnaire was sensitive to clinical change. The changes in S-SECEL correlated most strongly with changes in the EORTC QLQ-H&N35 speech scale, moderately with changes in the QLQ-C30 role and emotional functioning and global QoL scales, while the weakest correlations were with changes in physical functioning. The S-SECEL was sensitive to changes in communication dysfunction, with convergent and discriminant validity of longitudinal assessments, and with relevance for the quality of life of patients with laryngeal cancer receiving different treatment modalities.
UI - 10604426
AU - Bumpous JM
TI - Treatment of stage III and IV supraglottic carcinoma: should elderly patients undergo standard treatment protocols?
SO - Arch Otolaryngol Head Neck Surg 1999 Dec;125(12):1402-4; discussion 1406-7
AD - Department of Surgery, University of Louisville School of Medicine, KY 40292, USA.
UI - 12112536
AU - Kumamoto Y; Masuda M; Kuratomi Y; Toh S; Shinokuma A; Chujo K; Yamamoto
TI - T; Komiyama S "FAR" chemoradiotherapy improves laryngeal preservation rates in patients with T2N0 glottic carcinoma.
SO - Head Neck 2002 Jul;24(7):637-42
AD - Department of Otolaryngology, Faculty of Medicine, Kyushu University, Fukuoka 812-8582, Japan.
BACKGROUND: The appropriate treatment approach for patients with T2N0 laryngeal cancer remains highly controversial. Because radiotherapy alone is associated with a high risk of local recurrence, we have developed a triple combination treatment approach consisting of 5-fluorouracil (250 mg/day, i.v.), vitamin A (50,000 unit/day, i.m.) and external radiation (2.0 Gy/day), which we have termed "FAR therapy." METHODS: Patients with T2N0 glottic carcinoma were initially treated with 15 days of FAR therapy, which included a cumulative radiation dose of 30Gy (i.e., "30 Gy of FAR therapy"). Those patients who demonstrated a complete response either clinically or pathologically continued to receive further FAR therapy, with up to 60-70 Gy. All other patients received laryngectomy without any additional treatment. RESULTS: Ninety-five patients were treated according to this program, and most of the patients (98%) were able to complete this treatment course. Eighty-eight patients (93%) were treated with FAR therapy alone. The local control and ultimate local control rates were 91% (85 of 93), and 99% (92 of 93), respectively. The cumulative 5-year voice preservation and complete laryngeal preservation rates were 91% and 87%, respectively. The cumulative 5-year disease-specific survival rate was 97%. CONCLUSIONS: Because a high rate of laryngeal preservation was achieved without compromising disease-specific survival, our treatment approach based on FAR therapy may be promising for the treatment of patients with T2N0 glottic carcinoma. Copyright 2002 Wiley Periodicals, Inc.
UI - 12174930
AU - Dong Y; Sui L; Watanabe Y; Sugimoto K; Tokuda M
TI - Survivin expression in laryngeal squamous cell carcinomas and its prognostic implications.
SO - Anticancer Res 2002 Jul-Aug;22(4):2377-83
AD - The Department of Physiology, Kagawa Medical University, Kita-Gun, Japan.
We examined the expression of survivin using immunohistochemistry in 102 cases of laryngeal squamous cell carcinoma (LSCC). Overall, 65.7% (67 out of 102) of tumors were positive for survivin expression and significantly associated with tumor site, poor differentiation, tumor size, lymph node metastasis and advanced stage. Kaplan-Meier analysis showed that survivin expression was significantly associated with shorter disease-free and overall survival respectively. When survivin expression and clinical stage were combined, patients with both survivin-positive and advanced stage (III, IV) revealed poorer disease-free and overall survival when compared with the other cases (p = 0.0002 and p = 0.0002, respectively). Additionally, in early stage (I, II) cases, survivin expression also showed a significant prognostic trend for disease-free and overall survival (p = 0.0727 and p = 0.0701, respectively). By the multivariate analysis, tumor size, lymph node metastasis and survivin expression were independent prognostic factors both in disease-free and overall survival. These findings indicate that survivin expression is associated with unfavorable clinicopathological parameters and represents an independent marker for prognosis of LSCC.
UI - 12048160
AU - Qiu ZH; Wu CT; Lao MF; Pan LZ; Li YM
TI - Growth suppression and immunogenicity enhancement of Hep-2 or primary laryngeal cancer cells by adenovirus-mediated co-transfer of human wild-type p53, granulocyte-macrophage colony-stimulating factor and B7-1 genes.
SO - Cancer Lett 2002 Aug 28;182(2):147-54
AD - Beijing Institute of Radiation Medicine, 27 Taiping Road, Beijing 100850, P.R. China.
Co-transfer of immunomodulatory and antiproliferative genes may be the basis for new strategies to potentiate tumor regression. In this study, we evaluated the in vitro effect of the introduction of human wild-type p53, granulocyte-macrophage colony-stimulating factor (GM-CSF), and B7-1 genes via recombinant adenovirus on the growth and immunogenicity of Hep-2 or primary laryngeal cancer cells. By the introduction of wild-type p53 gene, the growth of Hep-2 cells was inhibited via enhanced apoptosis. By the introduction of GM-CSF and B7-1 genes, the immunogenicity of cancer cells was enhanced. Significant proliferation of tumor infiltrating lymphocytes (TILs) and tumor-specific cytotoxicity of cytotoxic T lymphocytes (CTLs) were induced in vitro. Furthermore, the combinative effect of GM-CSF and B7-1 was even more evident than that of any one of them singly. These results suggest that the co-transfer of human wild-type p53, GM-CSF and B7-1 genes into tumor cells via recombinant adenovirus may be further developed into a potential combination gene therapy strategy for cancer.
UI - 12199430
AU - Elci OC; Akpinar-Elci M; Blair A; Dosemeci M
TI - Occupational dust exposure and the risk of laryngeal cancer in Turkey.
SO - Scand J Work Environ Health 2002 Aug;28(4):278-84
AD - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, United States. firstname.lastname@example.org
OBJECTIVES: A hospital-based case-referent study was conducted to identify occupational risk factors for laryngeal cancer. In a previous report an association was found between laryngeal cancer and occupations with potential dust exposure; a job-exposure matrix was developed to aid further evaluation of laryngeal cancer risks from five occupational dust exposures. METHODS: Among 7631 cancer cases from the Okmeydani Hospital, Istanbul, between 1979 and 1984, 958 larynx cancer cases were identified among men. After exclusions, 940 laryngeal cancer cases and 1519 referents were available. A standardized questionnaire was used to obtain basic information on the patients. Seven-digit standard occupational and industrial codes were created to classify the job and industrial titles. A job-exposure matrix was developed for occupational dusts, including silica, asbestos, wood, cotton, and grain, and age-, smoking-, and alcohol-adjusted odds ratios (OR) and 95% confidence intervals (95% CI) were calculated to evaluate risks of laryngeal cancer. RESULTS: An excess of laryngeal cancer occurred for workers potentially exposed to silica and cotton dust, particularly for supraglottic cancer (OR 1.8, 95% CI 1.3-2.3, for silica and OR 1.6, 95% CI 1.1-2.5, for cotton dust), and there was a significant dose-response relationship with silica exposure. No relationship was found between laryngeal cancer and asbestos, grain, or wood dust exposures. CONCLUSION: Laryngeal cancer, especially supraglottic tumors, is associated with silica and cotton dust exposures in Turkey.
UI - 12168932
AU - Bergqvist M; Brodin O; Pouzon A; Linder A; Hesselius P; Blomquist E
TI - Radiation treatment of T1-T4 squamous cell carcinoma of the larynx: a retrospective analysis and long-term follow-up of 135 patients.
SO - Anticancer Res 2002 Mar-Apr;22(2B):1239-42
AD - Department of Oncology, University Hospital, Uppsala, Sweden.
PURPOSE: To evaluate the long-term outcome of radiation therapy for patients with histologically verified squamous cell glottic carcinoma. PATIENTS AND METHODS: A retrospective study was performed on patients who had received radiation treatment at the Department of Oncology, Uppsala University, Uppsala, Sweden, between 1978 and 1987 Patients with a documented follow-up for at least five years, or to time of death, were studied. Radiation treatment was delivered utilising daily fractions of 1.8-20 over 6-7 weeks, totalling 60-70 Gy. Patients whose tumours were not controlled by radiation therapy, or whose tumours recurred, were offered surgical intervention. RESULTS: The study included 135 patients. Five-year survival rates adjusted to death due to laryngeal carcinoma were: T1, 95%; T2, 87%; T3, 72% and T4, 25%. CONCLUSION: Primary radiotherapy achieves a high rate of cure for T1-T2 laryngeal carcinoma. Tumour-related morbidity and death continued beyond the standard five-year follow-up, especially for patients with T1/T2 laryngeal carcinomas.
UI - 11580231
AU - Vambutas A; DeVoti J; Pinn W; Steinberg BM; Bonagura VR
TI - Interaction of human papillomavirus type 11 E7 protein with TAP-1 results in the reduction of ATP-dependent peptide transport.
SO - Clin Immunol 2001 Oct;101(1):94-9
AD - Department of Otolaryngology, The Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA.
Human papillomaviruses (HPVs) cause benign and malignant epithelial tumors of the respiratory and genital mucosa. We previously reported that recurrent respiratory papillomas caused by HPV 6/11 express low levels of antibody-detectable TAP-1, the protein that transports peptides into the endoplasmic reticulum for assembly and presentation by MHC Class I, and that the extent of TAP-1 immunostaining is inversely related to the frequency of disease recurrence. We have now determined a mechanism for the reduction in TAP-1 detection. Anti-TAP-1 antibody immunoprecipitated very low amounts of protein from papilloma cells. However, immunoprecipitation of calreticulin, another member of the MHC I assembly complex, coprecipitated TAP-1 at levels comparable to those of uninfected cells. Immunoprecipitation of an HPV-positive cell line with either anti-TAP-1 or anti-calreticulin coprecipitated HPV E7 protein. Finally, purified HPV 11 E7 protein inhibited ATP-dependent peptide transport in vitro. We propose that the interaction of E7 with TAP-1 prevents TAP-1 antibody detection and efficient peptide transport, resulting in poor presentation of viral antigen on HPV-infected cells and thus failure to mount an effective immune-mediated prevention of disease recurrence. Copyright 2001 Academic Press.
UI - 12087738
AU - Cherepkova EV; Vladimirov BS; Burnashov VS; Musinov DR
TI - [Mental disorders in tumors of maxillary facial region and larynx]
SO - Zh Nevrol Psikhiatr Im S S Korsakova 2002;102(5):58-9
UI - 12169914
AU - Sessions DG; Lenox J; Spector GJ; Newland D; Simpson J; Haughey BH; Chao
TI - KS Management of T3N0M0 glottic carcinoma: therapeutic outcomes.
SO - Laryngoscope 2002 Jul;112(7 Pt 1):1281-8
AD - Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. email@example.com
BACKGROUND: The best therapeutic approach for the treatment of T3N0M0 (stage III) glottic carcinoma is controversial. METHOD: A retrospective study of Tumor Research Project data were performed using patients with T3N0M0 glottic squamous cell carcinoma treated with curative intent by at Washington University School of Medicine/Barnes-Jewish Hospital. RESULTS: Two hundred patients with T3N0M0 glottic carcinoma were treated using seven modalities: total laryngectomy (TL, n = 30), TL with neck dissection (TL/ND, n = 40), conservation surgery alone (CS, n = 22), radiation therapy alone (RT, n = 29), TL combined with RT (TL/RT, n = 31), TL and ND combined with RT (TL/ND/RT, n = 36), and CS combined with RT (CS/RT, n = 12). The overall 5-year observed survival rate (OS) was 54% and the 5-year disease-specific survival rate (DSS) was 67%. The 5-year DSS for the individual treatment modalities included TL, 65.4%; TL/ND, 76.5%; CS, 71.4%; RT, 56.5%, TL/RT, 51.9%; TL/ND/RT, 71.4%; and CS/RT, 80%. There was no significant difference in DSS for any individual treatment modality (P =.375). The overall local and regional control rate was 74% (148 of 200). The overall recurrence rate was 37.5% with recurrence at the primary site and in the neck of 19.5% and 11%, respectively. Recurrence was not related to treatment modality. The 5-year DSS after treatment of recurrent cancer (salvage rate) was 35.8%. The incidence of distant metastasis was 11% and for second primary cancers it was 19.5%. There was no statistically significant difference in survival between necks initially treated (72%, 5-y DSS) versus necks observed and later treated if necessary (70%, 5-y DSS) (P =.797). CONCLUSIONS: The seven treatment modalities had statistically similar recurrence, complication, and survival rates. Patients with clear surgical margins have a significant survival advantage compared with patients with close and involved margins. Because postoperative radiation therapy in patients with positive margins did not improve survival, formal re-resection of the site of the positive margin should be considered. In patients whose N0 neck was not treated electively, close follow-up observation with meticulous examinations combined with appropriate treatment for subsequent neck disease resulted in a similar survival rate compared with those patients whose N0 necks were treated initially. Six-year minimum follow-up is recommended for early identification of primary and neck recurrence and for discovering expected second primary cancers. Patients treated with RT and CS had statistically similar rates of survival, maintenance of voice, and acquired permanent tracheal stoma. CS is a valid alternative to RT in treating highly selected patients with T3N0 glottic carcinoma.
UI - 12169915
AU - Bron L; Pasche P; Brossard E; Monnier P; Schweizer V
TI - Functional analysis after supracricoid partial laryngectomy with cricohyoidoepiglottopexy.
SO - Laryngoscope 2002 Jul;112(7 Pt 1):1289-93
AD - Department of Otolaryngology-Head and Neck Surgery, CHUV, Lausanne, Switzerland.
OBJECTIVES: To assess prospectively speech and swallowing function in a series of 17 patients after supracricoid partial laryngectomy with cricohyoidoepiglottopexy. STUDY DESIGN: Retrospective study. METHODS: From 1983 to 1996, 69 patients at Department of Otolaryngology-Head and Neck Surgery, CHUV (Lausanne, Switzerland) underwent a supracricoid partial laryngectomy with cricohyoidoepiglottopexy. Seventeen of them (25%) could be contacted and accepted participation in a functional evaluation that included a questionnaire to document their present nutritional status and diet. A formal voice evaluation was also performed, which included psychoacoustic evaluation of vocal qualities, fundamental frequency parameters, phonation intensity range, phonatory quotient (vital capacity divided by maximum phonation time), and a laryngeal video laryngoscopy performed with a rigid endoscope. RESULTS: Median postoperative follow-up was 66 months (range, 12-152 mo). Nine of 17 patients (53%) recovered a normal diet with no increased incidence of aspirations. Seven of 17 had minor limitations such as no peanuts, dry bread, or rice. Two of 17 patients were restricted to pureed food. Assessment of voice showed a clearly decreased mean fundamental frequency at 70.1 Hz (normal range, 121-211 Hz) and a narrowed frequency range of phonation with a mean value of 8.8 semitones (normal value, 27). Forty-two percent of the patients went back to their normal professional life after the operation. Among the 10 who did not, 3 (16%) retired and 7 actually had to give up their profession, because of the modification of their voice or general asthenia and age close to retirement. CONCLUSION: Restoration of laryngeal function after supracricoid partial laryngectomy with cricohyoidoepiglottopexy is satisfactory. Although most of the patients seem to recover normal swallowing function, severe voice alterations appear to be inevitable.
UI - 12172244
AU - Wolf GT; Bradford CR; Urba S; Smith A; Eisbruch A; Chepeha DB; Teknos
TI - TN; Worden F; Dawson L; Terrell JE; Hogikyan ND Immune reactivity does not predict chemotherapy response, organ preservation, or survival in advanced laryngeal cancer.
SO - Laryngoscope 2002 Aug;112(8 Pt 1):1351-6
AD - Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan 48109-0312, USA.
OBJECTIVE: To determine whether pretreatment lymphocyte subpopulations correlate with tumor response to induction chemotherapy as part of an organ preservation treatment approach in patients with advanced laryngeal cancer. STUDY DESIGN: A prospective clinical trial in patients with advanced laryngeal cancer was undertaken to determine whether the frequency of late salvage laryngectomy and overall survival could be improved using one cycle of neoadjuvant chemotherapy to select patients for organ preservation. Pretreatment peripheral blood lymphocyte subpopulations for CD3, CD4, CD8, NK, and B cells were correlated with tumor response to induction chemotherapy, larynx preservation, and survival, to determine whether immune parameters could be useful in patient selection. METHODS: The study setting was a tertiary referral academic health center. Studied were 53 patients with stage III (42%) or IV (57%) larynx cancer. Most patients had supraglottic cancers (73%) and positive clinical nodes (51%). Sixty-eight percent had greater than 50% tumor response after one cycle of induction chemotherapy and then received concurrent chemoradiation and two cycles of adjuvant chemotherapy. Lymphocyte subpopulations were measured in 39 patients. Mean follow-up was 23.3 months (range, 5-61 mo). RESULTS: A total of 18 (34%) patients underwent laryngectomy. Only 4 cases were late salvage resections (13-35 mo after treatment). Fourteen cases were planned surgery after initial chemotherapy. Of the lymphocyte subpopulations measured, CD8 levels were significantly lower in stage IV patients and tended to be lower in patients with successful organ preservation. However, no significant differences in lymphocyte subpopulations were found among responders and nonresponders to chemotherapy. Overall survival was 88%. CONCLUSIONS: One cycle of neoadjuvant chemotherapy was effective in selecting patients for organ preservation. The regimen of definitive concurrent and adjuvant chemotherapy was associated with an unexpectedly high 2-year survival rate. Lymphocyte subsets were not significant predictors of responding patients or survival. Further study of other biological markers useful in selecting patients for organ preservation are needed.
UI - 12172264
AU - Prescher A; Schick B; Stutz A; Brors D
TI - Laryngeal prostatic cancer metastases: an underestimated route of metastases?
SO - Laryngoscope 2002 Aug;112(8 Pt 1):1467-73
AD - Institute of Anatomy, University Hospital and School of Medicine (RWTH) Aachen, Aachen, Germany.
OBJECTIVE: Despite the high rate of metastases in advanced prostatic cancer, only 12 reports with 13 cases of laryngeal metastases in prostatic cancer have been given in the literature since the first description by Schmorl in 1908. A histopathological study was undertaken to clarify the obvious controversial clinical experience of multiple metastases in prostatic cancer but rare observations of laryngeal involvement. STUDY DESIGN: Postmortem laryngeal examination in advanced prostatic cancer. METHODS: Six patients with prostatic cancer and tumor spread to different organs but without clinical symptoms of laryngeal involvement were available for postmortem analysis. Gross anatomical inspection of the inner and outer surfaces of the removed larynx, horizontal slices of the larynx, and subsequent histological investigations including immunohistochemical analysis were used to search for metastases. RESULTS: Macroscopic evaluation of the whole-larynx specimens did not lead to suspicion of laryngeal metastases. Interestingly, in all six larynx specimens of patients with metastatic prostatic cancer, laryngeal tumor infiltration was detected by macroscopic inspection of horizontal slices and proven histologically. Tumor infiltration ranged from focal micrometastases in the hematopoietic tissue of the ossified laryngeal skeleton to partial destruction of the external and/or internal osseous or cartilaginous lamina of the laryngeal skeleton. CONCLUSIONS: The larynx is more often affected in metastatic prostatic cancer disease than is suggested by clinical experience. Because prostatic cancer metastasis starts in the hematopoietic areas of the ossified laryngeal skeleton, macroscopic evaluation of the whole larynx fails to detect metastases. Detecting laryngeal involvement requires horizontal slices and histological analysis.
UI - 12192539
AU - Maleno I; Lopez-Nevot MA; Cabrera T; Salinero J; Garrido F
TI - Multiple mechanisms generate HLA class I altered phenotypes in laryngeal carcinomas: high frequency of HLA haplotype loss associated with loss of heterozygosity in chromosome region 6p21.
SO - Cancer Immunol Immunother 2002 Sep;51(7):389-96
AD - Departamento de Analisis Clinicos, Hospital UniversitarioVirgen de las Nieves, Universidad de Granada, Avd. Fuerzas Armadas 2, 18014 Granada, Spain.
Major histocompatibility complex (MHC) class I loss or downregulation in cancer cells is a major immune escape route used by a large variety of human tumors to evade anti-tumor immune responses mediated by cytotoxic T lymphocytes. Multiple mechanisms are responsible for such HLA class I alterations. However, the precise frequency of these molecular defects has not been clearly determined in tumors derived from specific tissues. To analyze such defects we aim to define the major HLA class I-altered phenotypes in different tumor types. In this paper we report on HLA class I expression in 70 laryngeal carcinomas. We used immunohistological techniques with a highly selective panel of anti-HLA monoclonal antibodies (mAb), and polymerase chain reaction (PCR) microsatellite amplification of previously selected microsatellite markers (STR) located in chromosome 6 and 15. DNA was obtained from microdissected tumor tissues and surrounding stroma to define the loss of heterozygosity (LOH) associated with chromosome 6p21. Our results showed that LOH in chromosome 6 produced HLA haplotype loss (phenotype II) in 36% of the tumors. In addition, HLA class I total loss (phenotype I) was found in 11%; HLA A or B locus downregulation (phenotype III) was detected in 20%; and HLA class I allelic loss (phenotype IV) in 10% of all cases. We sometimes observed two or more associated mechanisms in the same HLA-altered phenotype, such as LOH and HLA total loss in phenotype I. In only 23% of tumors it was not possible to identify any HLA class I alteration. We conclude that the combination of immunohistological techniques and molecular analysis of tumor DNA obtained from microdissected tumor tissues provides a means for the first time of determining the actual frequency of the major HLA class I-altered phenotypes in laryngeal carcinomas.
UI - 12051135
AU - Mahlstedt K; Blaschke T; Kramer KD; Gross M
TI - [Parelectric spectroscopy for noninvasive diagnosis of laryngeal tissue]
SO - Biomed Tech (Berl) 2002 Apr;47(4):70-5
AD - Klinik fur Audiologie und Phoniatrie, Universitatsklinikum Benjamin Franklin, Freie Universitat Berlin.
Under the influence of an external electrical field, every biological tissue displays characteristic parelectric properties that can be recorded by radiofrequency spectroscopy in a noninvasive contact mode. Parelectric spectroscopy was investigated for its utility as a complementary noninvasive diagnostic procedure in examinations of the larynx, in particular in terms of its ability to differentiate tissue properties. Parelectric spectroscopy was performed in 10 patients submitted to surgical ablation of vocal cord neoplasia under local or insufflation anaesthesia. Measurements were obtained in the area of the neoplasia, and in macroscopically normal tissue in the corresponding vocal cord. In all cases, intra-individual comparison with normal vocal cord tissue revealed lower dipole density and reduced mobility of the affected vocal cord. In addition, the difference between normal and pat