Carcinoma of the head and neck: a 5- to 20-year experience with preoperative chemotherapy, uncompromised surgery, and selective radiotherapy

Peripheral glutamate signaling in head and neck areas

The major excitatory neurotransmitter glutamate is also found in the periphery in an increasing number of nonexcitable cells. In line with this it became apparent that glutamate can regulate a broad array of peripheral biological responses, as well. Of particular interest is the discovery that glutamate receptor reactive reagents can influence tumor biology. However, the knowledge of glutamate signaling in peripheral tissues is still incomplete and, in the case of head and neck areas, is almost lacking. The roles of glutamate signaling pathways in these regions are manifold and include orofacial pain, periodontal bone production, skin and airway inflammation, as well as salivation. Furthermore, the interrelations between glutamate and cancers in the oral cavity, thyroid gland, and other regions are discussed. In summary, this review shall strengthen the view that glutamate receptor reagents may also be promising targets for novel therapeutic concepts suitable for a number of diseases in peripheral tissues. The contents of this review cover the following sections: Introduction; The "Glutamate System"; The Taste of Glutamate; Glutamate Signaling in Dental Regions; Glutamate Signaling in Head and Neck Areas; Glutamate Signaling in Head and Neck Cancer; A Brief Overview of Glutamate Signaling in Other Cancers; and Conclusion.

Cardiac metastasis after squamous cell carcinoma of the oral cavity: case report

A 58-year-old woman presented with respiratory problems 6 months after she had had a squamous cell carcinoma in the oral cavity resected. We found on computed tomography a large lesion in the cardiac muscle. There were no abnormalities in the electrocardiogram. The patient died 7 days later and necropsy confirmed a solitary metastasis in the myocardium that originated from a squamous cell carcinoma of the mouth.

Treatment of hypopharyngeal carcinoma: analysis of nationwide study in the Netherlands over a 10-year period

OBJECTIVE

To analyse different treatment strategies and treatment results of hypopharyngeal carcinoma in the Netherlands.

DESIGN

Retrospective study.

SETTING

Eight head and neck centres in the Netherlands.

PARTICIPANTS

A total of 893 patients were treated between 1985 and 1994. Patients were mostly treated with radiotherapy alone, combined surgery and radiotherapy and surgery alone.

RESULTS

The 5-year survival for the whole group was 26%. The 5-year survival for patients treated with curative intention was 32% and treated with palliative intention was 5%. The 5-year disease-free survival after radiotherapy alone was 37%, after surgery alone 41% and after combined therapy 47%. The role of chemotherapy could not be investigated because of a small number of patients treated with chemotherapy in this period.

CONCLUSION

Combined therapy with surgery and radiotherapy has a better survival for patients with a hypopharyngeal carcinoma in comparison with radiotherapy alone. The N-stage is more important for the prognosis than the T-stage.