1
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Alharbi AA, Alshehri FM, Albatly AA, Sah BR, Schmid C, Huber GF, Huellner MW. Correction to: [ 18F]Fluorocholine Uptake of Parathyroid Adenoma is Correlated with Parathyroid Hormone Level. Mol Imaging Biol 2023; 25:619. [PMID: 36810683 DOI: 10.1007/s11307-023-01802-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Abdullah A Alharbi
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - Fahad M Alshehri
- Department of Radiology, College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Abdulrahman A Albatly
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Bert-Ram Sah
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Christoph Schmid
- Department of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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2
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Ammann Y, Beutner U, Vital DG, Morand G, Broglie Daeppen MA, Born D, Stoeckli SJ, Huber GF. Impact of the new TNM Staging System (8th edition) on oral tongue cancers. Swiss Med Wkly 2021; 151:w20493. [PMID: 33934314 DOI: 10.4414/smw.2021.20493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AIM OF THE STUDY For tumours of the oral tongue, the most recent 8th edition of the AJCC/UICC staging system has introduced depth of infiltration (DOI) as a novel parameter. With this study we wanted to investigate its impact regarding this risk stratification compared with the preceding 7th edition. METHODS Between 2008 and 2017, 161 patients of two tertiary referral centres in Switzerland (Kantonsspital St. Gallen and University Hospital Zurich) with T1 N0 or T2 N0 tongue cancers were enrolled in this study. The primary tumours were restaged according to the 8th edition of the TNM classification. Kaplan-Meier curves for overall and disease-specific survival were calculated. RESULTS According to the 7th edition, of the 161 patients, 102 were staged after surgery as pT1 (stage I) and 59 as pT2 (stage II). According to the 8th edition, 36 patients (22.4%) were re-staged to a higher stage. Of these 36 patients, 8 (22.2%) experienced a recurrence, and 9 (25%) died. In the remaining, not re-staged group, 20 patients (16.0%) experienced a recurrence (p = 0.55) and 14 (11.2%) died (p = 0.025*). The 7th edition showed a statistically significant difference between pT1 and pT2 tumours for overall survival (p = 0.025), but not for disease-specific survival (p = 0.091), whereas the 8th edition was able to well discriminate between pT1, pT2 and pT3 for both overall (pT1 vs pT2, p = 0.016*; pT2 vs pT3, p = 0.031*) and disease-specific survival (pT1 vs pT2, p = 0.037*; pT2 vs pT3, p = 0.023*). CONCLUSION The recent TNM 8th edition provides a more accurate prediction of overall and disease-specific survival for this subgroup of patients. Hence, a more aggressive treatment should be considered for patients re-staged to pT3 due to depth of infiltration.
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Affiliation(s)
- Yanic Ammann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kantonsspital St. Gallen, Switzerland / Klinik für Chirurgie, Kantonsspital St. Gallen, Switzerland
| | - Ulrich Beutner
- Klinik für Chirurgie, Kantonsspital St. Gallen, Switzerland
| | - Domenic Gian Vital
- Klinik für Ohren-, Nasen und Halschirurgie, Universitätsspital Zürich, Switzerland
| | - Grégoire Morand
- Klinik für Ohren-, Nasen und Halschirurgie, Universitätsspital Zürich, Switzerland
| | | | - Diana Born
- Klinik für Pathologie, Kantonsspital St. Gallen, Switzerland
| | - Sandro J Stoeckli
- Klinik für Hals-Nasen-Ohrenheilkunde, Kantonsspital St. Gallen, Switzerland
| | - Gerhard F Huber
- Klinik für Hals-Nasen-Ohrenheilkunde, Kantonsspital St. Gallen, Switzerland
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3
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Rupp NJ, Nemes C, Rushing EJ, Huber GF, Freiberger SN. High-grade Salivary Gland Adenocarcinoma Harboring ETV6-NTRK3 Fusion: Defined by Morphology or Molecular Aberration? Head Neck Pathol 2021; 15:1082-1084. [PMID: 33544381 PMCID: PMC8385089 DOI: 10.1007/s12105-021-01297-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Niels J. Rupp
- grid.7400.30000 0004 1937 0650Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Schmelzbergstrasse 12, Zurich, 8091 Switzerland
| | - Constanze Nemes
- grid.413349.80000 0001 2294 4705Institute of Pathology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Elisabeth J. Rushing
- grid.7400.30000 0004 1937 0650Department of Neuropathology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Gerhard F. Huber
- grid.413349.80000 0001 2294 4705Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Sandra N. Freiberger
- grid.7400.30000 0004 1937 0650Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Schmelzbergstrasse 12, Zurich, 8091 Switzerland
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4
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Siano M, Dulguerov P, Broglie MA, Henke G, Putora PM, Simon C, Zwahlen D, Huber GF, Ballerini G, Beffa L, Giger R, Rothschild S, Negri SV, Elicin O. A Review of Controversial Issues in the Management of Head and Neck Cancer: A Swiss Multidisciplinary and Multi-Institutional Patterns of Care Study-Part 3 (Medical Oncology). Front Oncol 2019; 9:1127. [PMID: 31709187 PMCID: PMC6822020 DOI: 10.3389/fonc.2019.01127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/09/2019] [Indexed: 11/18/2022] Open
Abstract
Background: The Head and Neck Cancer Working Group of Swiss Group for Clinical Cancer Research (SAKK) has investigated the level of consensus (LOC) and discrepancy in everyday practice of diagnosis and treatment in head and neck cancer. Materials and Methods: An online survey was iteratively generated with 10 Swiss university and teaching hospitals. LOC below 50% was defined as no agreement, while higher LOC were arbitrarily categorized as low (51–74%), moderate (75–84%), and high (≥85%). Results: Any LOC was achieved in 62% of topics (n = 60). High, moderate, and low LOC were found in 18, 20, and 23%, respectively. Regarding Head and Neck Surgery, Radiation Oncology, Medical Oncology, and biomarkers, LOC was achieved in 50, 57, 83, and 43%, respectively. Conclusions: Consensus on clinical topics is rather low for surgeons and radiation oncologists. The questions discussed might highlight discrepancies, stimulate standardization of practice, and prioritize topics for future clinical research.
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Affiliation(s)
- Marco Siano
- Department of Medical Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Medical Oncology, Hôpital Riviera-Chablais, Vevey, Switzerland
| | - Pavel Dulguerov
- Department of Otorhinolaryngology, Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Guido Henke
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Paul Martin Putora
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian Simon
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - Daniel Zwahlen
- Department of Radiation Oncology, Cantonal Hospital Graubünden, Chur, Switzerland.,Department of Radiation Oncology, Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Giorgio Ballerini
- Department of Radiation Oncology, Clinica Luganese SA, Lugano, Switzerland
| | - Lorenza Beffa
- Department of Radiation Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Sacha Rothschild
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - Sandro V Negri
- Department of Otorhinolaryngology, Lindenhofspital, Bern, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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5
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Galiza Barbosa F, Riesterer O, Tanadini‐Lang S, Stieb S, Studer G, Pruschy M, Huber GF, Huellner MW, Stolzmann P, Veit‐Haibach P. Evaluation of 18F‐FDG PET/CT as an early imaging biomarker for response monitoring after radiochemotherapy using cetuximab in head and heck squamous cell carcinoma. Head Neck 2019; 42:163-170. [DOI: 10.1002/hed.25975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/17/2019] [Accepted: 09/17/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Oliver Riesterer
- Department of Radiation OncologyUniversity Hospital Zurich Zurich Switzerland
| | | | - Sonja Stieb
- Department of Radiation OncologyUniversity Hospital Zurich Zurich Switzerland
| | - Gabriela Studer
- Department of Radiation OncologyUniversity Hospital Zurich Zurich Switzerland
| | - Martin Pruschy
- Department of Radiation OncologyUniversity Hospital Zurich Zurich Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head & Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Martin W. Huellner
- Department Nuclear MedicineUniversity Hospital Zurich Zurich Switzerland
- Department of NeuroradiologyUniversity Hospital Zurich Zurich Switzerland
- University of Zurich Zurich Switzerland
| | - Paul Stolzmann
- Department Nuclear MedicineUniversity Hospital Zurich Zurich Switzerland
- Department of NeuroradiologyUniversity Hospital Zurich Zurich Switzerland
- University of Zurich Zurich Switzerland
| | - Patrick Veit‐Haibach
- Department Nuclear MedicineUniversity Hospital Zurich Zurich Switzerland
- Department of Diagnostic and Interventional RadiologyUniversity Hospital Zurich Zurich Switzerland
- University of Zurich Zurich Switzerland
- Joint Department Medical Imaging, Toronto General Hospital, University Health NetworkUniversity of Toronto Toronto Ontario Canada
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6
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Elicin O, Putora PM, Siano M, Broglie MA, Simon C, Zwahlen D, Huber GF, Ballerini G, Beffa L, Giger R, Rothschild S, Negri SV, Dulguerov P, Henke G. A Review of Controversial Issues in the Management of Head and Neck Cancer: A Swiss Multidisciplinary and Multi-Institutional Patterns of Care Study-Part 2 (Radiation Oncology). Front Oncol 2019; 9:1126. [PMID: 31709186 PMCID: PMC6822015 DOI: 10.3389/fonc.2019.01126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/09/2019] [Indexed: 11/21/2022] Open
Abstract
Background: The Head and Neck Cancer Working Group of Swiss Group for Clinical Cancer Research (SAKK) has investigated the level of consensus (LOC) and discrepancy in everyday practice of diagnosis and treatment in head and neck cancer. Materials and Methods: An online survey was iteratively generated with 10 Swiss university and teaching hospitals. LOC below 50% was defined as no agreement, while higher LOC were arbitrarily categorized as low (51–74%), moderate (75–84%), and high (≥85%). Results: Any LOC was achieved in 62% of topics (n = 60). High, moderate, and low LOC were found in 18, 20, and 23%, respectively. Regarding Head and Neck Surgery, Radiation Oncology, Medical Oncology, and biomarkers, LOC was achieved in 50, 57, 83, and 43%, respectively. Conclusions: Consensus on clinical topics is rather low for surgeons and radiation oncologists. The questions discussed might highlight discrepancies, stimulate standardization of practice, and prioritize topics for future clinical research.
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Affiliation(s)
- Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Paul Martin Putora
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Marco Siano
- Department of Medical Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Medical Oncology, Hôpital Riviera-Chablais, Vevey, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Christian Simon
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - Daniel Zwahlen
- Department of Radiation Oncology, Cantonal Hospital Graubünden, Chur, Switzerland.,Department of Radiation Oncology, Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Giorgio Ballerini
- Department of Radiation Oncology, Clinica Luganese SA, Lugano, Switzerland
| | - Lorenza Beffa
- Department of Radiation Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Sacha Rothschild
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - Sandro V Negri
- Department of Otorhinolaryngology, Lindenhofspital, Bern, Switzerland
| | - Pavel Dulguerov
- Department of Otorhinolaryngology, Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Guido Henke
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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7
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Broglie MA, Dulguerov P, Henke G, Siano M, Putora PM, Simon C, Zwahlen D, Huber GF, Ballerini G, Beffa L, Giger R, Rothschild S, Negri SV, Elicin O. A Review of Controversial Issues in the Management of Head and Neck Cancer: A Swiss Multidisciplinary and Multi-Institutional Patterns of Care Study-Part 4 (Biomarkers). Front Oncol 2019; 9:1128. [PMID: 31709188 PMCID: PMC6822019 DOI: 10.3389/fonc.2019.01128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The Head and Neck Cancer Working Group of Swiss Group for Clinical Cancer Research (SAKK) has investigated the level of consensus (LOC) and discrepancy in everyday practice of diagnosis and treatment in head and neck cancer. Materials and Methods: An online survey was iteratively generated with 10 Swiss university and teaching hospitals. LOC below 50% was defined as no agreement, while higher LOC were arbitrarily categorized as low (51-74%), moderate (75-84%), and high (≥85%). Results: Any LOC was achieved in 62% of topics (n = 60). High, moderate, and low LOC were found in 18, 20, and 23%, respectively. Regarding Head and Neck Surgery, Radiation Oncology, Medical Oncology, and biomarkers, LOC was achieved in 50, 57, 83, and 43%, respectively. Conclusions: Consensus on clinical topics is rather low for surgeons and radiation oncologists. The questions discussed might highlight discrepancies, stimulate standardization of practice, and prioritize topics for future clinical research.
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Affiliation(s)
- Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Pavel Dulguerov
- Department of Otorhinolaryngology, Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Guido Henke
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Marco Siano
- Department of Medical Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Medical Oncology, Hôpital Riviera-Chablais, Vevey, Switzerland
| | - Paul Martin Putora
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian Simon
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - Daniel Zwahlen
- Department of Radiation Oncology, Cantonal Hospital Graubünden, Chur, Switzerland.,Department of Radiation Oncology, Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Giorgio Ballerini
- Department of Radiation Oncology, Clinica Luganese SA, Lugano, Switzerland
| | - Lorenza Beffa
- Department of Radiation Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Sacha Rothschild
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - Sandro V Negri
- Department of Otorhinolaryngology, Lindenhofspital, Bern, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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8
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Dulguerov P, Broglie MA, Henke G, Siano M, Putora PM, Simon C, Zwahlen D, Huber GF, Ballerini G, Beffa L, Giger R, Rothschild S, Negri SV, Elicin O. A Review of Controversial Issues in the Management of Head and Neck Cancer: A Swiss Multidisciplinary and Multi-Institutional Patterns of Care Study-Part 1 (Head and Neck Surgery). Front Oncol 2019; 9:1125. [PMID: 31709185 PMCID: PMC6822016 DOI: 10.3389/fonc.2019.01125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/09/2019] [Indexed: 11/23/2022] Open
Abstract
Background: The Head and Neck Cancer Working Group of Swiss Group for Clinical Cancer Research (SAKK) has investigated the level of consensus (LOC) and discrepancy in everyday practice of diagnosis and treatment in head and neck cancer. Materials and Methods: An online survey was iteratively generated with 10 Swiss university and teaching hospitals. LOC below 50% was defined as no agreement, while higher LOC were arbitrarily categorized as low (51–74%), moderate (75–84%), and high (≥85%). Results: Any LOC was achieved in 62% of topics (n = 60). High, moderate and low LOC were found in 18, 20, and 23%, respectively. Regarding Head and Neck Surgery, Radiation Oncology, Medical Oncology, and biomarkers, LOC was achieved in 50, 57, 83, and 43%, respectively. Conclusions: Consensus on clinical topics is rather low for surgeons and radiation oncologists. The questions discussed might highlight discrepancies, stimulate standardization of practice, and prioritize topics for future clinical research.
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Affiliation(s)
- Pavel Dulguerov
- Department of Otorhinolaryngology, Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Guido Henke
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Marco Siano
- Department of Medical Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Medical Oncology, Hôpital Riviera-Chablais, Vevey, Switzerland
| | - Paul Martin Putora
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian Simon
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - Daniel Zwahlen
- Department of Radiation Oncology, Cantonal Hospital Graubünden, Chur, Switzerland.,Department of Radiation Oncology, Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Giorgio Ballerini
- Department of Radiation Oncology, Clinica Luganese SA, Lugano, Switzerland
| | - Lorenza Beffa
- Department of Radiation Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Sacha Rothschild
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - Sandro V Negri
- Department of Otorhinolaryngology, Lindenhofspital, Bern, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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9
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Abstract
Objective was to analyze the role of PD-L1 and its relation to demographic, patho-clinical and outcome parameters in salivary gland carcinoma (SGC) patients. Patients treated for salivary gland carcinomas between 1994 and 2010 were included. A retrospective chart review for baseline characteristics, pathohistological, clinical and outcome data was performed. Immunohistochemistry for PD-L1 was performed using tissue microarrays. PD-L1 expression was assessed in tumor cells and tumor-infiltrating immune cells (TIIC) and statistical analysis with regard to baseline and outcome data was performed. Expression of PD-L1 (by means ≥1% of the cells with PD-L1 positivity) was present in the salivary gland carcinoma cells of 17%, in the TIIC of 20% and in both tumor cells and TIIC of 10% the patients. PD-L1 expression in tumor cells and both tumor cells and TIIC was related to tumor grading (p = 0.035 and p = 0.031, respectively). A trend towards higher grading was also seen for PD-L1 expression in TIICs (p = 0.058). Patients with salivary duct carcinomas and PD-L1 expressing TIICs showed a significantly worse DFS and OS (p = 0.022 and p = 0.003, respectively), those with both tumor cells and TIIC expressing PD-L1 a significantly worse DFS (p = 0.030). PD-L1 expression is present in 17% and 20% of salivary gland carcinoma cells and TIIC. Ten percent of the patient showed a PD-L1 positivity in both tumor cells and TIIC. This is related to high tumor grading and therefore might be a negative prognostic factor.
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Affiliation(s)
- Domenic Vital
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland.
| | - Kristian Ikenberg
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland
| | - Holger Moch
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland
| | - Matthias Rössle
- Department of Pathology, Luzerner Kantonsspital, Spitalstrasse, CH-6000, Lucerne 16, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland
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10
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Werner J, Hüllner MW, Rupp NJ, Huber AM, Broglie MA, Huber GF, Morand GB. Predictive Value of Pretherapeutic Maximum Standardized Uptake Value (Suv max) In Laryngeal and Hypopharyngeal Cancer. Sci Rep 2019; 9:8972. [PMID: 31222167 PMCID: PMC6586936 DOI: 10.1038/s41598-019-45462-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/07/2019] [Indexed: 12/15/2022] Open
Abstract
The aim of the study was to evaluate whether pretherapeutic metabolic tumor parameters from 18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging could predict larynx preservation in laryngeal and hypopharyngeal cancer patients prior to primary chemoradiation. Tumor metabolic parameters [maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were retrospectively assessed in a consecutive cohort of laryngeal and hypopharyngeal cancer patients undergoing primary (chemo-)radiation. Main outcome measures were larynx preservation and survival. The study included 97 patients with a median follow-up of 32 months (IQR 20-54.5). For hypopharyngeal cancer, multivariable analysis showed that patients with a primary tumor's SUVmax > 9.5 entailed a higher risk of undergoing salvage pharyngolaryngectomy after chemoradiation (HR = 8.64, 95% CI = 1.1-67.3, P = 0.040). In laryngeal cancer, SUVmax did not predict the need for salvage laryngectomy. The only predictor for larynx preservation in laryngeal cancer patients was T-classification at initial diagnosis (HR = 6.67, 95% CI = 0.82-53.9, P = 0.039). In conclusion, SUVmax of primary tumor could be used as a predictor of larynx preservation prior to primary chemoradiation in hypopharyngeal cancer patients. This information may be important for patient counseling, as high SUVmax was correlated with reduced probability of larynx preservation. However, in laryngeal cancer patients, SUVmax does not seem to be predictive of outcome.
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Affiliation(s)
- Jonas Werner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martin W Hüllner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Alexander M Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
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11
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Rupp NJ, Umbricht CA, Pizzuto DA, Lenggenhager D, Töpfer A, Müller J, Muehlematter UJ, Ferraro DA, Messerli M, Morand GB, Huber GF, Eberli D, Schibli R, Müller C, Burger IA. First Clinicopathologic Evidence of a Non-PSMA-Related Uptake Mechanism for 68Ga-PSMA-11 in Salivary Glands. J Nucl Med 2019; 60:1270-1276. [PMID: 30737300 DOI: 10.2967/jnumed.118.222307] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 01/13/2019] [Indexed: 01/03/2023] Open
Abstract
The intense accumulation of prostate-specific membrane antigen (PSMA) radioligands in salivary glands is still not well understood. It is of concern for therapeutic applications of PSMA radioligands, because therapeutic radiation will damage these glands. A better understanding of the uptake mechanism is, therefore, crucial to find solutions to reduce toxicity. The aim of this study was to investigate whether the accumulation of PSMA-targeting radioligands in submandibular glands (SMGs) can be explained with PSMA expression levels using autoradiography (ARG) and immunohistochemistry (IHC). Methods: All patients gave written informed consent for further utility of the biologic material. The SMG of 9 patients, pancreatic tissue of 4 patients, and prostate cancer (PCA) lesions of 9 patients were analyzed. Tissue specimens were analyzed by means of PSMA-IHC (using an anti-PSMA-antibody and an immunoreactivity score system [IRS]) and ARG using 177Lu-PSMA-617 (with quantification of the relative signal intensity compared with a PSMA-positive standard). The SUVmax in salivary glands, pancreas, and PCA tissues were quantified in 60 clinical 68Ga-PSMA-11 PET scans for recurrent disease as well as the 9 primary tumors selected for ARG and IHC. Results: PCA tissue samples revealed a wide range of PSMA staining intensity on IHC (IRS = 70-300) as well as in ARG (1.3%-22% of standard). This variability on PCA tissue could also be observed in 68Ga-PSMA-11 PET (SUVmax, 4.4-16) with a significant correlation between ARG and SUVmax (P < 0.001, R 2 = 0.897). On IHC, ARG, and 68Ga-PSMA-11 PET, the pancreatic tissue was negative (IRS = 0, ARG = 0.1% ± 0.05%, SUVmax of 3.1 ± 1.1). The SMG tissue displayed only focal expression of PSMA limited to the intercalated ducts on IHC (IRS = 10-15) and a minimal signal on ARG (1.3% ± 0.9%). In contrast, all SMG showed a high 68Ga-PSMA-11 accumulation on PET scans (SUVmax 23.5 ± 5.2). Conclusion: Our results indicate that the high accumulation of PSMA radioligands in salivary glands does not correspond to high PSMA expression levels determined using ARG and IHC. These findings provide evidence, that the significant accumulation of PSMA radioligands in SMG is not primarily a result of PSMA-mediated uptake.
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Affiliation(s)
- Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zürich, University of Zürich, Switzerland
| | - Christoph A Umbricht
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Villigen-PSI, Switzerland
| | - Daniele A Pizzuto
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Daniela Lenggenhager
- Department of Pathology and Molecular Pathology, University Hospital Zürich, University of Zürich, Switzerland
| | - Antonia Töpfer
- Department of Pathology and Molecular Pathology, University Hospital Zürich, University of Zürich, Switzerland
| | - Julian Müller
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Urs J Muehlematter
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Daniela A Ferraro
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zürich, University of Zürich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland; and
| | - Daniel Eberli
- Department of Urology, University Hospital Zürich, University of Zürich, Switzerland
| | - Roger Schibli
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Villigen-PSI, Switzerland
| | - Cristina Müller
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Villigen-PSI, Switzerland
| | - Irene A Burger
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Switzerland
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12
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Romer CAE, Broglie Daeppen MA, Mueller M, Huber GF, Guesewell S, Stoeckli SJ. Long-term speech and swallowing function after primary resection and sentinel node biopsy for early oral squamous cell carcinoma. Oral Oncol 2019; 89:127-132. [PMID: 30732950 DOI: 10.1016/j.oraloncology.2018.12.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 12/16/2018] [Accepted: 12/25/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Analysis of long-term speech and swallowing function and subjective quality of life (QOL) after primary resection and sentinel node biopsy (SNB) in patients with early stage (cT1/T2) oral squamous cell carcinomas (OSCC). MATERIAL AND METHODS Eighty-one consecutive patients treated primarily by transoral resection without flap reconstruction and SNB for a cT1/T2 OSCC were included. Completion neck dissection (CND) was indicated in case of occult disease in the sentinel nodes. Adjuvant radiation (aRT) was administered according to the ultimate lymph node status. All patients showed no evidence of disease at time of analysis. Speech and swallowing function were assessed using standardized clinical examinations (11-item, articulation test) and validated questionnaires on subjective QOL (MDADI, FIGS). Median follow-up was 60 months (range 13-159 months) after initial treatment. RESULTS In all assessments for speech and swallowing, the entire study cohort achieved very high scores, with mean values located in the highest 10% of the scales. Neither tumor size nor site, age, pN-category, CND, and aRT had significant impact on functional outcomes and subjective QOL with the exception of lower scores in the global and physical scores of MDADI after CND or aRT, and articulation in the population over 60 years of age. CONCLUSION Transoral resection without reconstruction and SNB for early OSCC achieves excellent outcome with regard to speech, swallowing and subjective QOL.
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Affiliation(s)
- C A E Romer
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland.
| | - M A Broglie Daeppen
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, Switzerland
| | - M Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland
| | - G F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, Switzerland
| | - S Guesewell
- Clinical Trials Unit, Kantonsspital St. Gallen, Switzerland
| | - S J Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland
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13
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Elicin O, Broglie MA, Fankhauser N, Stoeckli SJ, Pasche P, Reinhard A, Bongiovanni M, Huber GF, Morand GB, Soltermann A, Arnold A, Dettmer MS, Arnoux A, Stauffer E, Espeli V, Martucci F, Aebersold DM, Giger R. Comparison of contemporary staging systems for oropharynx cancer in a surgically treated multi‐institutional cohort. Head Neck 2018; 41:1395-1402. [DOI: 10.1002/hed.25574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 11/30/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University HospitalUniversity of Bern Bern Switzerland
| | - Martina A. Broglie
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Niklaus Fankhauser
- CTU Bern, and Institute of Social and Preventive Medicine (ISPM)University of Bern Bern Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
| | - Philippe Pasche
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of Lausanne Lausanne Switzerland
| | - Antoine Reinhard
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of Lausanne Lausanne Switzerland
| | - Massimo Bongiovanni
- Service of Clinical PathologyLausanne University Hospital, Institute of Pathology Lausanne Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Alex Soltermann
- Institute of Surgical PathologyUniversity Hospital of Zurich Zurich Switzerland
| | - Andreas Arnold
- Department of Otorhinolaryngology, Head and Neck SurgeryInselspital, Bern University Hospital Bern Switzerland
| | | | - André Arnoux
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital Aarau Aarau Switzerland
| | | | - Vittoria Espeli
- Oncology Institute of Southern Switzerland (IOSI) Bellinzona Switzerland
| | - Francesco Martucci
- Department of RadiooncologyOncology Institute of Southern Switzerland (IOSI) Bellinzona Switzerland
| | - Daniel M. Aebersold
- Department of Radiation Oncology, Inselspital, Bern University HospitalUniversity of Bern Bern Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck SurgeryInselspital, Bern University Hospital Bern Switzerland
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14
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Péus D, Kollias SS, Huber AM, Huber GF. Recurrent unilateral peripheral facial palsy in a patient with an enlarged styloid process. Head Neck 2018; 41:E34-E37. [DOI: 10.1002/hed.25384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/22/2018] [Accepted: 05/31/2018] [Indexed: 12/28/2022] Open
Affiliation(s)
- Dominik Péus
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Zurich; Zurich Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - Spyros S. Kollias
- Institute of Neuro-Radiology; University of Zurich; Zurich Switzerland
| | - Alexander M. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Zurich; Zurich Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Zurich; Zurich Switzerland
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15
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Meerwein CM, Pizzuto DA, Vital D, Morand GB, Stolzmann P, Huber GF, Huellner MW. Use of MRI and FDG-PET/CT to predict fixation of advanced hypopharyngeal squamous cell carcinoma to prevertebral space. Head Neck 2018; 41:503-510. [DOI: 10.1002/hed.25431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/24/2018] [Accepted: 09/21/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Christian M. Meerwein
- Department of Otorhinolaryngology, Head & Neck Surgery; University Hospital Zurich; Zurich Switzerland
| | - Daniele A. Pizzuto
- Department of Nuclear Medicine; University Hospital Zurich/University of Zurich; Zurich Switzerland
- Instituto di Medicina Nucleare, Università Cattolica del Sacro Cuore; Rome Italy
| | - Domenic Vital
- Department of Otorhinolaryngology, Head & Neck Surgery; University Hospital Zurich; Zurich Switzerland
| | - Grégoire B. Morand
- Department of Otorhinolaryngology, Head & Neck Surgery; University Hospital Zurich; Zurich Switzerland
| | - Paul Stolzmann
- Department of Nuclear Medicine; University Hospital Zurich/University of Zurich; Zurich Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology; Kantonsspital St. Gallen; St. Gallen Switzerland
| | - Martin W. Huellner
- Department of Nuclear Medicine; University Hospital Zurich/University of Zurich; Zurich Switzerland
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16
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Morand GB, Ikenberg K, Vital DG, Cardona I, Moch H, Stoeckli SJ, Huber GF. Preoperative assessment of CD44‐mediated depth of invasion as predictor of occult metastases in early oral squamous cell carcinoma. Head Neck 2018; 41:950-958. [DOI: 10.1002/hed.25532] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/31/2018] [Accepted: 09/28/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Kristian Ikenberg
- Institute of Pathology and Molecular PathologyUniversity Hospital Zurich Zurich Switzerland
| | - Domenic G. Vital
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Isabel Cardona
- Department of Otolaryngology, Head and Neck SurgeryMcGill University Montreal Québec Canada
| | - Holger Moch
- Institute of Pathology and Molecular PathologyUniversity Hospital Zurich Zurich Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
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17
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Vital D, Holzmann D, Huber GF, Moch H, Morand GB, Ikenberg K. PD-L1 is a positive prognostic factor in squamous cell carcinoma of the nasal vestibule. Rhinology 2018; 56:255-260. [PMID: 29466476 DOI: 10.4193/rhin17.215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Aim was to analyse the role of PD-L1 in squamous cell carcinomas of the nasal vestibule. Advanced squamous cell carcinoma of the nasal vestibule is a highly aggressive tumour. The role of PD-L1 expression is unclear in this tumour type. METHODOLOGY Forty-six patients diagnosed between 1995 and 2014 were analyzed. Baseline characteristics and outcome were correlated to immunohistochemical staining of PD-L1. PD-L1 positivity of tumour cells and tumour infiltrating immune cells (TIIC) was defined by any staining of more than 1% of the tumour cells. RESULTS PD-L1 expression was interpretable in 31 of 46 patients (67.4%). PD-L1 positivity was present in 14 (45.2%) patients tumour cells and 17 (54.8%) patients TIIC. PD-L1 positivity of tumour cells was associated with a favourable disease free survival (p=0.019). CONCLUSIONS Positivity for PD-L1 in tumour cells is a prognostic factor in squamous cell carcinoma of the nasal vestibule and might enable a patient-tailored treatment.
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Affiliation(s)
- D Vital
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - D Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - G F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - H Moch
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - G B Morand
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - K Ikenberg
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Zurich, Switzerland
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18
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Alharbi AA, Alshehri FM, Albatly AA, Sah BR, Schmid C, Huber GF, Huellner MW. [ 18F]Fluorocholine Uptake of Parathyroid Adenoma Is Correlated with Parathyroid Hormone Level. Mol Imaging Biol 2018; 20:857-867. [PMID: 29508264 DOI: 10.1007/s11307-018-1179-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE The aim of the study was to investigate the relationship between [18F]fluoromethyl-dimethyl-2-hydroxyethylammonium ([18F]FCh) positron emission tomography (PET) parameters, laboratory parameters, and postoperative histopathological results in patients with primary hyperparathyroidism (pHPT) due to parathyroid adenomas. PROCEDURES This retrospective study was conducted in 52 patients with biochemically proven pHPT. [18F]FCh-PET parameters (maximum standardized uptake value: SUVmax) in early phase (after 2 min) and late phase (after 50 min), metabolic volume, and adenoma-to-background ratio (ABR), preoperative laboratory results (PTH and serum calcium concentration), and postoperative histopathology (location, size, volume, and weight of adenoma) were assessed. Relationship of PET parameters, laboratory parameters, and histopathological parameters was assessed using the Mann-Whitney U test and Spearman correlation coefficient. MRI characteristics of parathyroid adenomas were also analyzed. RESULTS The majority of patients underwent a PET/MR scan, 42 patients (80.7 %); 10 patients (19.3 %) underwent PET/CT. We found a strong positive correlation between late-phase SUVmax and preoperative PTH level (r = 0.768, p < 0.001) and between late-phase ABR and preoperative PTH level (r = 0.680, p < 0.001). The surgical specimen volume was positively correlated with the PET/MR lesion volume (r = 0.659, p < 0.001). No significant association was observed between other [18F]FCh-PET parameters, laboratory parameters, and histopathological findings. Cystic adenomas were larger than non-cystic adenomas (p = 0.048). CONCLUSIONS [18F]FCh uptake of parathyroid adenomas is strongly correlated with preoperative PTH serum concentration. Therefore, the preoperative PTH level might potentially be able to predict success of [18F]FCh-PET imaging in hyperparathyroidism, with higher lesion-to-background ratios being expected in patients with high PTH. PET/MR is accurate in estimating the volume of parathyroid adenomas.
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Affiliation(s)
- Abdullah A Alharbi
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - Fahad M Alshehri
- Department of Neuroradiology, University Hospital Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland
| | - Abdulrahman A Albatly
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Bert-Ram Sah
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Christoph Schmid
- Department of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, Zurich, 8091, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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19
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Morand GB, Vital DG, Kudura K, Werner J, Stoeckli SJ, Huber GF, Huellner MW. Maximum Standardized Uptake Value (SUV max) of Primary Tumor Predicts Occult Neck Metastasis in Oral Cancer. Sci Rep 2018; 8:11817. [PMID: 30087375 PMCID: PMC6081470 DOI: 10.1038/s41598-018-30111-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/24/2018] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to investigate the predictability of occult lymph node metastasis using maximum standardized uptake value (SUVmax) in the primary tumor on pre-treatment 18-fluorodeoxyglucose positron emission tomography FDG-PET in oral squamous cell carcinoma (OSCC) patients who were clinically node negative (cN0) before surgery. A retrospective analysis of all patients treated at the University Hospital Zurich from 2007 to 2016 for OSCC with available pre-therapeutic FDG-PET was performed. We assessed the correlation of SUVmax of the primary tumors with the presence of occult nodal disease in the neck dissection specimen (pN+). The study included a total of 71 patients. In the nodal negative group (cN0/pN0), the median SUVmax of primary tumors was 9.0 (interquartile range (IQR) 7.4–13.9), while it was 11.4 (IQR 9.9–15.7) in the occult metastatic group (cN0/pN+). The difference was statistically significant (independent samples median test, P = 0.037). In a multivariable model, the only independent predictor of occult metastatic disease for cN0 patients was a SUVmax ≥ 9.5 (P = 0.028). Further, primary tumors with SUVmax ≥ 9.5 had a significantly higher risk of local recurrence (Log rank test, P = 0.020). In conclusion, we showed that higher SUVmax (≥9.5) of the primary tumor is associated with higher occurrence of occult metastatic nodal disease and worse local survival. High SUVmax of the primary tumor may encourage clinicians towards more aggressive treatment.
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Affiliation(s)
- Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Domenic G Vital
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Ken Kudura
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Jonas Werner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Sandro J Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. .,Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
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20
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Meerwein CM, Nakadate M, Stolzmann P, Vital D, Morand GB, Zweifel DF, Huber GF, Huellner MW. Contrast-enhanced 18F-FDG-PET/CT for Differentiating Tumour and Radionecrosis in Head and Neck Cancer: Our experience in 37 Patients. Clin Otolaryngol 2018; 43:1594-1599. [PMID: 29974995 DOI: 10.1111/coa.13185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Christian M Meerwein
- Department of Otorhinolaryngology, Head& Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Masashi Nakadate
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Paul Stolzmann
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Domenic Vital
- Department of Otorhinolaryngology, Head& Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology, Head& Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Daniel F Zweifel
- University of Zurich, Zurich, Switzerland.,Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Gerhard F Huber
- University of Zurich, Zurich, Switzerland.,Department of Otorhinolaryngology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Martin W Huellner
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
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21
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Vital D, Ikenberg K, Moch H, Roessle M, Huber GF. The expression of the cancer testis antigen MAGE A4: A favorable prognostic biomarker in salivary gland carcinomas related to low tumor grading. Laryngoscope Investig Otolaryngol 2018; 3:182-190. [PMID: 30062133 PMCID: PMC6057220 DOI: 10.1002/lio2.160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/20/2018] [Accepted: 03/19/2018] [Indexed: 01/22/2023] Open
Abstract
Background Aim was to analyze the expression of different cancer testis antigens (CTA) and to assess its prognostic value in salivary gland carcinomas. Methods Patients with salivary gland carcinomas diagnosed 1994 to 2010 were included. Baseline characteristics, pathohistological, clinical, and outcome data were assessed. Tissue microarrays were constructed and immunohistochemistry for different CTA (NY-ESO1, NY-BR1, MAGE A1, MAGE A3, MAGE A4, MAGE C1/CT7, and MAGE C2/CT10) was performed. CTA expression was assessed and statistically correlated with pathological and outcome data. Results Expression rates of CTA in salivary gland tumors ranged from 0% to 40%. MAGE A4 expression was associated with a lower tumor grade tumor grading (P = .017), and a favorable recurrence-free (P = .003), disease-specific (P = .046) and overall survival (P = .028). Conclusions MAGE A4 is a highly significant prognostic marker in salivary gland carcinoma; its expression is associated with low-grade histology, a low rate of distant metastasis and a favorable survival. Level of Evidence 4.
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Affiliation(s)
- Domenic Vital
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital of Zurich, University of Zurich Zurich Switzerland
| | - Kristian Ikenberg
- Department of Pathology and Molecular Pathology University Hospital of Zurich, University of Zurich Zurich Switzerland
| | - Holger Moch
- Department of Pathology and Molecular Pathology University Hospital of Zurich, University of Zurich Zurich Switzerland
| | - Matthias Roessle
- University Hospital of Zurich, University of Zurich Zurich Switzerland.,Institute of Pathology, Kantonsspital Graubuenden Chur Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery Kantonsspital St. Gallen St. Gallen Switzerland
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22
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Finazzi T, Rordorf T, Ikenberg K, Huber GF, Guckenberger M, Garcia Schueler HI. Radiotherapy-induced anti-tumor immune response and immune-related adverse events in a case of recurrent nasopharyngeal carcinoma undergoing anti-PD-1 immunotherapy. BMC Cancer 2018; 18:395. [PMID: 29625593 PMCID: PMC5889609 DOI: 10.1186/s12885-018-4295-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/22/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Treatment of recurrent nasopharyngeal carcinoma is a challenging clinical problem. We report the case of a 46 year old male showing excellent response and signs of immunostimulation following re-re-irradiation for recurrent nasopharyngeal carcinoma under systemic treatment with pembrolizumab. CASE PRESENTATION Patient was first diagnosed with locoregionally advanced, non-keratinizing nasopharyngeal carcinoma in 2010. After achieving complete remission following induction chemotherapy and concurrent curative chemoradiation, the patient subsequently developed distant and locoregionally recurrent disease. He received various treatments (neck dissection, radiotherapy to a bony metastasis, palliative chemotherapy, stereotactic re-irradiation of local recurrence) before initiation of anti- PD-1 immunotherapy with pembrolizumab in January of 2016. Following marked local progression 6 months thereafter, we performed re-re-irradiation of the recurrent tumor after careful evaluation and treatment planning. While treatment was well tolerated, the patient subsequently developed marked clinical and radiological signs of immunostimulation with mucosal irritation and swelling of lacrimal and salivary glands as described in the report. Immunotherapy with pembrolizumab was reinitiated, with re- staging showing excellent response with regression of all tumorous lesions. At the time of this report, following near complete recovery of inflammatory symptoms, the patient remains in excellent condition and free from recurrence under treatment with pembrolizumab. CONCLUSIONS To our knowledge, we report the first observation of a combined effect of immunotherapy and radiotherapy in a patient with recurrent nasopharyngeal carcinoma. Demonstrating distinct signs of immunostimulation as well as excellent tumor response in a heavily pretreated patient progressing under anti-PD-1 immunotherapy, the case adds to the rising paradigm of an immunostimulatory effect of radiotherapy in patients undergoing treatment with immune checkpoint inhibitors.
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Affiliation(s)
- T Finazzi
- Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - T Rordorf
- Department of Oncology, University Hospital Zurich, Zurich, Switzerland
| | - K Ikenberg
- Department of Pathology, University Hospital Zurich, Zurich, Switzerland
| | - G F Huber
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - H I Garcia Schueler
- Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
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23
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Huber GF, Hüllner M, Schmid C, Brunner A, Sah B, Vetter D, Kaufmann PA, von Schulthess GK. Benefit of 18F-fluorocholine PET imaging in parathyroid surgery. Eur Radiol 2018; 28:2700-2707. [PMID: 29372312 DOI: 10.1007/s00330-017-5190-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To assess the additional diagnostic value of 18F-fluorocholine PET imaging in preoperative localization of pathologic parathyroid glands in clinically manifest hyperparathyroidism in case of negative or conflicting ultrasound and scintigraphy results. METHODS A retrospective, single-institution study of 26 patients diagnosed with hyperparathyroidism. In cases where ultrasound and scintigraphy failed to detect the location of an adenoma in order to allow a focused surgical approach, an additional 18F-fluorocholine PET scan was performed and its results were compared with the intraoperative findings. RESULTS A total of 26 patients underwent 18F-fluorocholine PET/CT (n = 11) or PET/MRI (n = 15). Adenomas were detected in 25 patients (96.2%). All patients underwent surgery, and the location predicted by PET hybrid imaging was confirmed intraoperatively by frozen section and adequate parathyroid hormone drop after removal. None of the patients needed revision surgery during follow-up. CONCLUSIONS These results demonstrate that 18F-fluorocholine PET imaging is a highly accurate method to detect parathyroid adenomas even in case of previous localization failure by other imaging examinations. KEY POINTS • With 18 F-fluorocholine PET imaging, parathyroid adenomas could be detected in 96.2%. • 18 F-fluorocholine imaging is a highly accurate method to detect parathyroid adenomas. • We encourage its use, where ultrasound fails to detect an adenoma.
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Affiliation(s)
- G F Huber
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
| | - M Hüllner
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - C Schmid
- Department of Endocrinology, Diabetology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - A Brunner
- Department of Endocrinology, Diabetology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - B Sah
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - D Vetter
- Department of General Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - P A Kaufmann
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - G K von Schulthess
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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24
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Morand GB, Anderegg N, Vital D, Ikenberg K, Huber GF, Soyka MB, Egger M, Holzmann D. Outcome by treatment modality in sinonasal undifferentiated carcinoma (SNUC): A case-series, systematic review and meta-analysis. Oral Oncol 2017; 75:28-34. [PMID: 29224819 DOI: 10.1016/j.oraloncology.2017.10.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/26/2017] [Accepted: 10/10/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Sinonasal undifferentiated carcinoma (SNUC) is an aggressive malignancy first described by Frierson et al. in 1986. As the tumor is very rare, current treatment recommendations are based on institutional case reports. We thus felt the need to perform a comprehensive systematic review and meta-analysis to investigate how treatment modalities are associated with survival. DESIGN Case-series, systematic review and meta-analysis METHODS: We searched the OvidMedline, OvidEmbase, Web of Science, Biosis, Scopus and the Cochrane Library database libraries. We extracted aggregate and individual patient data for statistical analysis. To study the association between treatment modalities and survival, we used random-effects meta-regression for the aggregate- and cox mixed-effects models. RESULTS 379 citations were found; 29 case series could be included in the final analysis, including a total number of 390 single patients (34.6% female). Median age at diagnosis was 52 years. 80.9% of patients presented with a T4 tumor and 16.0% with nodal metastasis at diagnosis. In individual patient data (IPD) meta-analysis, single modality (surgery alone or radiation alone) treatment was associated with reduced survival compared to double modality (surgery & radiation or chemoradiation) treatment (adjusted Hazard Ratio [aHR] 2.97, 95% ConfidenceInterval [1.41-6.27]) and compared to triple modality (surgery & radiation & chemotherapy) treatment (aHR 2.80 95%-CI 1.29-6.05 for triple vs. single modality). Triple modality treatment was not superior to double modality treatment. (aHR 1.06, 95%-CI 0.59-1.92). CONCLUSION Double and triple modality treatment are associated with improved survival over single modality but there is no evidence that triple modality is superior to double modality treatment.
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Affiliation(s)
- Grégoire B Morand
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland
| | - Nanina Anderegg
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland
| | - Domenic Vital
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland
| | - Kristian Ikenberg
- Department of Surgical Pathology, University Hospital Zurich, Switzerland
| | - Gerhard F Huber
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland
| | - Michael B Soyka
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland
| | - David Holzmann
- Department for Otorhinolaryngology - Head and Neck Surgery, University Hospital and University of Zurich, Switzerland.
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25
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Broglie MA, Stoeckli SJ, Sauter R, Pasche P, Reinhard A, de Leval L, Huber GF, Pezier TF, Soltermann A, Giger R, Arnold A, Dettmer M, Arnoux A, Müller M, Spreitzer S, Lang F, Lutchmaya M, Stauffer E, Espeli V, Martucci F, Bongiovanni M, Foerbs D, Jochum W. Impact of human papillomavirus on outcome in patients with oropharyngeal cancer treated with primary surgery. Head Neck 2017; 39:2004-2015. [DOI: 10.1002/hed.24865] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 03/09/2017] [Accepted: 05/22/2017] [Indexed: 12/15/2022] Open
Affiliation(s)
- Martina A. Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery; Kantonsspital St. Gallen; St. Gallen Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery; Kantonsspital St. Gallen; St. Gallen Switzerland
| | - Rafael Sauter
- Clinical Trials Unit; Kantonsspital St. Gallen; St. Gallen Switzerland
| | - Philippe Pasche
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital of Lausanne; Lausanne Switzerland
| | - Antoine Reinhard
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital of Lausanne; Lausanne Switzerland
| | - Laurence de Leval
- Department of Pathology; University Hospital of Lausanne; Lausanne Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital of Zurich; Switzerland
| | - Thomas F. Pezier
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital of Zurich; Switzerland
| | - Alex Soltermann
- Institute of Surgical Pathology; University Hospital of Zurich; Zurich Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery; Bern University Hospital; Inselspital Switzerland
| | - Andreas Arnold
- Department of Otorhinolaryngology, Head and Neck Surgery; Bern University Hospital; Inselspital Switzerland
| | - Matthias Dettmer
- Department of Pathology; Bern University Hospital; Inselspital Switzerland
| | - Andre Arnoux
- Department of Otorhinolaryngology, Head and Neck Surgery; Kantonsspital Aarau; Switzerland
| | - Martin Müller
- Department of Otorhinolaryngology, Head and Neck Surgery; Kantonsspital Aarau; Switzerland
| | | | - Florian Lang
- Department of Otorhinolaryngology, Head and Neck Surgery; Kantonsspital Fribourg; Switzerland
| | - Mathieu Lutchmaya
- Department of Otorhinolaryngology, Head and Neck Surgery; Kantonsspital Fribourg; Switzerland
| | | | - Vittoria Espeli
- Oncology Institute of Southern Switzerland (IOSI); Bellinzona Switzerland
| | - Francesco Martucci
- Department of Radiooncology; Oncology Institute of Southern Switzerland (IOSI); Bellinzona Switzerland
| | - Massimo Bongiovanni
- Department of Pathology; University Hospital of Lausanne; Lausanne Switzerland
| | - Diana Foerbs
- Institute of Pathology; Kantonsspital St. Gallen; Switzerland
| | - Wolfram Jochum
- Institute of Pathology; Kantonsspital St. Gallen; Switzerland
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26
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Vital D, Morand GB, Meerwein C, Laske RD, Steinert HC, Schmid C, Brown ML, Huber GF. Early Timing of Thyroidectomy for Hyperthyroidism in Graves’ Disease Improves Biochemical Recovery. World J Surg 2017; 41:2545-2550. [DOI: 10.1007/s00268-017-4052-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Vital D, Huber GF, Holzmann D, Moch H, Ikenberg K. The presence of aberrant p53 pattern is a negative prognostic predictor in squamous cell carcinoma of the nasal vestibule. Eur Arch Otorhinolaryngol 2017; 274:3503-3512. [PMID: 28669050 DOI: 10.1007/s00405-017-4659-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/23/2017] [Indexed: 12/20/2022]
Abstract
The aim of this study was to analyze the role of Ki-67, p53, and the "aberrant p53 pattern" in squamous cell carcinomas of the nasal vestibule. Patients between 1995 and 2014 were included. Baseline characteristics and outcome were analyzed with respect to immunohistochemical staining of Ki-67 and p53. "Aberrant p53 pattern" was represented by a moderate or strong staining of at least 60% of the tumor cells or a complete absence of immunoreactivity. Forty-six patients were included of whom 31 (67.4%) were available for Ki-67 and 32 (69.9%) for p53 immunohistochemistry. The "aberrant pattern" of p53 was present in 50% of the patients. While immunoreactivity for both Ki-67 and p53 was not related to each other or outcome, the "aberrant p53 pattern" was associated with a worse disease-free survival (p = 0.014). The "aberrant p53 pattern" is a negative prognostic factor in squamous cell carcinoma of the nasal vestibule and might enable a patient-tailored treatment.
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Affiliation(s)
- Domenic Vital
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - Holger Moch
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Kristian Ikenberg
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
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28
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Sekine T, Barbosa FDG, Delso G, Burger IA, Stolzmann P, Ter Voert EE, Huber GF, Kollias SS, von Schulthess GK, Veit-Haibach P, Huellner MW. Local resectability assessment of head and neck cancer: Positron emission tomography/MRI versus positron emission tomography/CT. Head Neck 2017; 39:1550-1558. [PMID: 28500749 DOI: 10.1002/hed.24783] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 11/28/2016] [Accepted: 02/08/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The purpose of this study was to compare the diagnostic accuracy of positron emission tomography (PET)/MRI with PET/CT for local resectability of head and neck cancer. METHODS Sequential contrast-enhanced PET/CT-MRI was performed in 58 patients referred for the staging or restaging of head and neck cancer. Tumors were assessed with PET/CT and PET/MRI for the presence of resectability-defining factors: T4b status (mediastinal invasion, invasion of the prevertebral space, and vascular encasement), and another 8 findings that would imply obstacles for surgical cure (invasion of the laryngeal cartilage, invasion of the preepiglottic fat pad, perineural spread, orbital invasion, bone infiltration, skull base invasion, dural infiltration, and invasion of the brachial plexus). RESULTS The sensitivity/specificity/accuracy of local resectability-defining factors of PET/CT and PET/MRI was 0.92/0.99/0.98 and 0.98/0.99/0.99 (P = .727), respectively, per lesion, and 0.96/0.87/0.91 and 0.96/0.90/0.93 (P = .687), respectively, per patient. CONCLUSION Both contrast-enhanced PET/MRI and contrast-enhanced PET/CT can serve as reliable examinations for defining local resectability of head and neck cancer.
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Affiliation(s)
- Tetsuro Sekine
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Zurich, Switzerland.,Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - Felipe de Galiza Barbosa
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Zurich, Switzerland
| | - Gaspar Delso
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Zurich, Switzerland.,GE Healthcare, Waukesha, Wisconsin
| | - Irene A Burger
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Zurich, Switzerland
| | - Paul Stolzmann
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Zurich, Switzerland
| | - Edwin E Ter Voert
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Zurich / University of Zurich, Zurich, Switzerland
| | - Spyros S Kollias
- Clinic of Neuroradiology, University Hospital Zurich / University of Zurich, Zurich, Switzerland
| | - Gustav K von Schulthess
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Zurich, Switzerland
| | - Patrick Veit-Haibach
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Zurich, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich / University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Zurich, Switzerland
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29
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Vital D, Holzmann D, Huber GF, Soyka MB, Moch H, Zimmermann DR, Ikenberg K. p16 INK4a : A surrogate marker of high-risk human papillomavirus infection in squamous cell carcinoma of the nasal vestibule. Head Neck 2017; 39:1392-1398. [PMID: 28371015 DOI: 10.1002/hed.24767] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/15/2017] [Accepted: 02/08/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The purpose of this study was to analyze the role of p16INK4a and the prevalence of human papillomavirus (HPV) in squamous cell carcinoma (SCC) of the nasal vestibule. METHODS Patients diagnosed from 1995 to 2014 were included in this study. Assessment of p16INK4a and HPV-DNA polymerase chain reaction (PCR) was performed and analyzed with respect to baseline, clinicopathological, and outcome parameters. The p16INK4a positivity was defined as unequivocal nuclear and cytoplasmic staining of ≥70% of the cells, whereas 50%-69% was considered to be a "borderline" result. RESULTS There were 46 patients with SCCs of the nasal vestibule, of whom 31 (67.4%) were available for p16INK4a and 30 (65.2%) for analysis of HPV. Expression of p16INK4a was present in 19.4% and showed coincidence with high-risk HPV (P < .001). Neither p16INK4a nor HPV-DNA had significant impact on outcome. CONCLUSION Significant immunoreactivity for p16INK4a was present in about one-fifth of the samples and figured as a surrogate marker of high-risk HPV infection. There was no influence on outcome.
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Affiliation(s)
- Domenic Vital
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland
| | - Michael B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, Zurich University Hospital and University of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland
| | - Holger Moch
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland
| | - Dieter R Zimmermann
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland
| | - Kristian Ikenberg
- Department of Pathology and Molecular Pathology, Zurich University Hospital and University of Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland
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30
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Dort JC, Farwell DG, Findlay M, Huber GF, Kerr P, Shea-Budgell MA, Simon C, Uppington J, Zygun D, Ljungqvist O, Harris J. Optimal Perioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction: A Consensus Review and Recommendations From the Enhanced Recovery After Surgery Society. JAMA Otolaryngol Head Neck Surg 2017; 143:292-303. [PMID: 27737447 DOI: 10.1001/jamaoto.2016.2981] [Citation(s) in RCA: 269] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. Objective To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Evidence Review Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic. The PubMed and Cochrane databases were initially searched to identify relevant publications on head and neck cancer surgery from 1965 through April 2015. Consistent key words for each topic included "head and neck surgery," "pharyngectomy," "laryngectomy," "laryngopharyngectomy," "neck dissection," "parotid lymphadenectomy," "thyroidectomy," "oral cavity resection," "glossectomy," and "head and neck." The final selection of literature included meta-analyses and systematic reviews as well as randomized controlled trials where available. In the absence of high-level data, case series and nonrandomized studies in head and neck cancer surgery patients or randomized controlled trials and systematic reviews in non-head and neck cancer surgery patients, were considered. An international panel of experts in major head and neck cancer surgery and enhanced recovery after surgery reviewed and assessed the literature for quality and developed recommendations for each topic based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. All recommendations were graded following a consensus discussion among the expert panel. Findings The literature search, including a hand search of reference lists, identified 215 relevant publications that were considered to be the best evidence for the topic areas. A total of 17 topic areas were identified for inclusion in the protocol for the perioperative care of patients undergoing major head and neck cancer surgery with free flap reconstruction. Best practice includes several elements of perioperative care. Among these elements are the provision of preoperative carbohydrate treatment, pharmacologic thromboprophylaxis, perioperative antibiotics in clean-contaminated procedures, corticosteroid and antiemetic medications, short acting anxiolytics, goal-directed fluid management, opioid-sparing multimodal analgesia, frequent flap monitoring, early mobilization, and the avoidance of preoperative fasting. Conclusions and Relevance The evidence base for specific perioperative care elements in head and neck cancer surgery is variable and in many cases information from different surgerical procedures form the basis for these recommendations. Clinical evaluation of these recommendations is a logical next step and further research in this patient population is warranted.
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Affiliation(s)
- Joseph C Dort
- Section of Otolaryngology, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta2Cancer Strategic Clinical Network, Alberta Health Services, Calgary, Alberta
| | - D Gregory Farwell
- Department of Otolaryngology, Division of Head and Neck Surgery, University of California Davis, Sacramento
| | - Merran Findlay
- Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Camperdown NSW, Australia
| | | | - Paul Kerr
- Department of Otolaryngology, Winnipeg, Manitoba
| | - Melissa A Shea-Budgell
- Cancer Strategic Clinical Network, Alberta Health Services, Calgary, Alberta7Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Christian Simon
- Department of Otolaryngology, Head and Neck Surgery, CHUV, University of Lausanne, Switzerland
| | | | - David Zygun
- Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta
| | - Olle Ljungqvist
- Department of Surgery, Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Jeffrey Harris
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta
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31
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Pézier TF, Widmer GM, Huber GF. Pneumo-thorax/mediastinum/(retro)peritoneum/ scrotum - a full house of complications following JET ventilation. Acta Otorhinolaryngol Ital 2017; 37:72-75. [PMID: 27070540 PMCID: PMC5384314 DOI: 10.14639/0392-100x-726] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 10/19/2015] [Indexed: 11/23/2022]
Abstract
We present a patient who presented to our clinic with airway obstruction secondary to oropharygeal cancer. He underwent emergent tracheostomy with JET ventilation, the latter resulting in a "full house" of barotraumatic complications including pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum and pneumo-scrotum. Free air, while sometimes dramatic as in our case, need not always be a cause for alarm and can often be managed expectantly. Our patient was treated with only a chest drain and otherwise made an uneventful recovery.
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Affiliation(s)
- T F Pézier
- ENT Clinic, University Hospital Zurich, Switzerland
| | - G-M Widmer
- ENT Clinic, University Hospital Zurich, Switzerland
| | - G F Huber
- ENT Clinic, University Hospital Zurich, Switzerland
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32
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Sekine T, de Galiza Barbosa F, Kuhn FP, Burger IA, Stolzmann P, Huber GF, Kollias SS, von Schulthess GK, Veit-Haibach P, Huellner MW. PET+MR versus PET/CT in the initial staging of head and neck cancer, using a trimodality PET/CT+MR system. Clin Imaging 2017; 42:232-239. [PMID: 28129606 DOI: 10.1016/j.clinimag.2017.01.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/19/2016] [Accepted: 01/10/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the diagnostic accuracy of PET+MR with PET/CT in the initial staging of head and neck cancer. MATERIALS AND METHODS Contrast-enhanced PET/CT+MR was performed in 27 patients with newly diagnosed head and neck cancer. PET/CT and PET+MR were evaluated separately, and the TNM stage and factors influencing treatment were assessed. RESULTS The TNM staging by PET+MR was comparable to PET/CT (T: p=0.331, N: p=0.453, M: p=0.034). The sensitivity/specificity/accuracy of treatment-influencing factors by PET/CT and PET+MR were 0.68/0.99/0.97, and 1.00/1.00/0.99, respectively. CONCLUSIONS Whole-body staging with PET+MR yields at least equal diagnostic accuracy as PET/CT in head and neck cancer.
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Affiliation(s)
- Tetsuro Sekine
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland; Department of Radiology, Nippon Medical School, Tokyo, Japan.
| | | | - Felix P Kuhn
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland; Clinic of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Irene A Burger
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland
| | - Paul Stolzmann
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland; Clinic of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, Switzerland
| | - Spyros S Kollias
- Clinic of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Gustav K von Schulthess
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland
| | - Patrick Veit-Haibach
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland
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Meerwein CM, Sekine T, Veit-Haibach P, Bredell MG, Huber GF, Huellner MW. Multi-slice SPECT/CT vs. lymphoscintigraphy and intraoperative gamma ray probe for sentinel node mapping in HNSCC. Eur Arch Otorhinolaryngol 2016; 274:1633-1642. [PMID: 27837418 DOI: 10.1007/s00405-016-4379-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
Abstract
To assess the diagnostic potential of multi-slice single-photon emission computed tomography/computed tomography (SPECT/CT) for preoperative sentinel node (SN) mapping in early stage head and neck squamous cell carcinoma (HNSCC). Retrospective case-control study including data of consecutive HNSCC patients treated between November 2011 and December 2015. The diagnostic accuracy of multi-slice SPECT/CT was assessed with regard to the gold standard intraoperative gamma ray detection probe, using McNemar's test and calculating the area under the ROC curve. Additionally, the hot spot yield of SPECT/CT and planar lymphoscintigraphy (LS) was compared. Compared to the intraoperative gold standard, SPECT/CT showed an overall positive predictive value of 60.3% [confidence interval (CI) 46.6-73.0%)], a negative predictive value of 96.3% (CI 93.6-98.1%), and an accuracy of 90.8% (CI 89.1-92.4%). SPECT/CT detected more hot spots than LS and provided detailed anatomical information as well as relevant additional findings with potential impact on further patient management. Sentinel lymph node biopsy proved to be a reliable and safe procedure with an excellent SN excision rate (97%). Multi-slice SPECT/CT is a highly accurate diagnostic test and matches the gold standard intraoperative gamma ray detection probe.
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Affiliation(s)
- C M Meerwein
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland. .,Division of Otorhinolaryngology, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
| | - T Sekine
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - P Veit-Haibach
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - M G Bredell
- Department of Craniomaxillo-Facial Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - G F Huber
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - M W Huellner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
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Kiessling SY, Soyka MB, Huber GF, Holzmann D, Laske RD. Delayed diagnosis of sinonasal lymphoma due to bilateral manifestation. Eur Arch Otorhinolaryngol 2016; 274:823-827. [PMID: 27581721 DOI: 10.1007/s00405-016-4275-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 08/18/2016] [Indexed: 01/03/2023]
Abstract
The objective of this study is to analyze the presenting symptoms, the time to correct diagnosis and outcome of a European patient cohort with sinonasal lymphoma focusing on unilateral vs. bilateral sinonasal involvement. In a retrospective setting in a European tertiary referral center, eleven patients (9 males, 2 females) with sinonasal lymphoma diagnosed between 2002 and 2015 were identified and divided into a unilateral and bilateral group according to their CT finding. Clinical findings on first presentation, the presence of B symptoms, the radiologic findings, overall survival and disease-specific survival were assessed. 55 % of the patients suffered from bilateral manifestation, which was associated with a delayed diagnosis (10 vs. 1.5 months, p < 0.05). B symptoms (67 vs. 0 %) and death of disease (50 vs. 0 %) were observed only in the bilateral group. Nasal NK/T-cell lymphoma was the most frequent diagnosis, followed by diffuse large B-cell lymphoma. Bilateral mucosal manifestation with B symptoms was shown to be common within the rare entity of sinonasal lymphomas and patients with bilateral sinonasal manifestation are at risk for a delayed diagnosis with worse outcome.
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Affiliation(s)
- Si-Young Kiessling
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstr. 24, 8091, Zurich, Switzerland
| | - Michael B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstr. 24, 8091, Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstr. 24, 8091, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstr. 24, 8091, Zurich, Switzerland
| | - Roman D Laske
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstr. 24, 8091, Zurich, Switzerland.
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Studer G, Huber GF, Holz E, Glanzmann C. Less may be more: nodal treatment in neck positive head neck cancer patients. Eur Arch Otorhinolaryngol 2016; 273:1549-56. [PMID: 25920604 PMCID: PMC4858567 DOI: 10.1007/s00405-015-3634-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 04/17/2015] [Indexed: 11/09/2022]
Abstract
Ongoing debates about the need and extent of planned neck dissection (PND), and required nodal radiation doses volumes lead to this evaluation. Aim was to assess nodal control after definitive intensity modulated radiation therapy (IMRT ± systemic therapy) followed by PND in our head neck cancer cohort with advanced nodal disease. Between 01/2005 and 12/2013, 99 squamous cell cancer HNC patients with pre-therapeutic nodal metastasis ≥3 cm were treated with definitive IMRT followed by PND. In addition, outcome in 103 patients with nodal relapse after IMRT and observation only (no-PND cohort) were analyzed. Prior to PND, PET-CT, fine needle aspirations, ultrasound and palpation were assessed regarding its predictive value. Patterns of nodal relapse were assessed in patients with isolated neck failure after definitive IMRT alone. 70/99 (70 %) PND specimens showed histopathological complete response (hCR), which translated into statistically significantly superior survival compared with partial response (hPR) with 4-year overall survival, disease specific survival and nodal control rates of 90/83/96 vs 67/60/78 % (p = 0.002/0.001/0.003). 1/99 patient developed isolated subsequent nodal disease. 64/2147 removed nodes contained viable tumor (3 %). Predictive information of the performed diagnostic investigations was not reliable. 17/70 hCR patients showed true negative findings in available three to four investigations (0/29 hPR). 27/103 no-PND patients developed isolated neck disease (26 %) with successful salvage in 21/24 [88 %, or 21/27 (78 %)]. Nearly all failures occurred in the prior nodal gross tumor volume area. A more restrictive approach regarding PND and/or nodal IMRT dose-volumes may be justified.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/radiotherapy
- Carcinoma, Squamous Cell/surgery
- Combined Modality Therapy/methods
- Female
- Head and Neck Neoplasms/drug therapy
- Head and Neck Neoplasms/mortality
- Head and Neck Neoplasms/radiotherapy
- Head and Neck Neoplasms/surgery
- Humans
- Lymphatic Irradiation
- Lymphatic Metastasis
- Male
- Middle Aged
- Neck Dissection
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/radiotherapy
- Neoplasm Recurrence, Local/surgery
- Radiotherapy, Intensity-Modulated
- Salvage Therapy
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Affiliation(s)
- Gabriela Studer
- />Department of Radiation Oncology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Gerhard F. Huber
- />Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Edna Holz
- />Department of Radiation Oncology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Christoph Glanzmann
- />Department of Radiation Oncology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
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Stoeckli SJ, Huebner T, Huber GF, Broglie MA. Technique for reliable sentinel node biopsy in squamous cell carcinomas of the floor of mouth. Head Neck 2016; 38:1367-72. [PMID: 27027415 DOI: 10.1002/hed.24440] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 12/22/2015] [Accepted: 02/02/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Applicability of sentinel node biopsy (SNB) for tumors of the floor of mouth (FOM) is controversial. METHODS Prospective evaluation of the accuracy of gamma-probe-guided superselective neck dissection of the preglandular triangle of level I for SNB in FOM squamous cell carcinoma (SCC) after preoperative lymphoscintigraphy and single photon emission CT (SPECT)/CT. RESULTS In total, 22 sentinel lymph nodes were harvested in level I. Eight of 22 (36%) were seen on lymphoscintigraphy and 11 (50%) on SPECT/CT. Eleven sentinel lymph nodes (50%) were only detected intraoperatively. In unilateral tumors, 20% were contralateral, and, in midline tumors, 93% showed bilateral level I sentinel lymph nodes. The false-negative rate was 8.3%, the negative predictive value was 96.4%, and the false-omission rate was 3.6%. The ultimate neck control rate, including salvage treatment, was 100%. CONCLUSION SNB in FOM can be reliably performed using the presented surgical technique. Level I exploration, bilaterally in midline tumors, is mandatory irrespective of the visualization of sentinel lymph nodes in other levels. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1367-1372, 2016.
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Affiliation(s)
- Sandro J Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Thomas Huebner
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Laske RD, Scholz I, Ikenberg K, Meerwein C, Vital DG, Studer G, Rössle M, Huber GF. Perineural Invasion in Squamous Cell Carcinoma of the Oral Cavity: Histology, Tumor Stage, and Outcome. Laryngoscope Investig Otolaryngol 2016; 1:13-18. [PMID: 28894798 DOI: 10.1002/lio2.4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2015] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES/HYPOTHESIS To analyze the impact of different types of perineural invasion (PNI) in squamous cell carcinoma (SCC) of the oral cavity on overall survival and recurrence rate, with a special focus on histologic subtypes and tumor stage. STUDY DESIGN Retrospective case-control study with clinicopathological analysis. METHODS Seventeen patients who received primary surgical treatment for SCC of the oral cavity with PNI were matched to a control group. In a histologic review, PNI was classified into subtypes according to an adapted Liebig classification. The term type A was used to describe tumor invasion into the nerve, whereas type B was used to describe circumferential growth around the nerve. Clinical charts were reviewed, and a Kaplan-Meier survival analysis was performed. RESULTS The recurrence-free survival rates were 47.1% versus 80.4% (PNI vs. matched control group, P < 0.05), 60.0% versus 94.1% (PNI in stage I and II disease vs. matched control group, P < 0.05) and 41.7% versus 73.5% (PNI in stage III and IV disease vs. matched control group, P < 0.05). In most cases (n = 9) of PNI, both histologic subtypes (type A and type B) were present. Five cases exclusively showed type A, and three cases exclusively showed type B. CONCLUSIONS Perineural invasion in early disease oral carcinoma has a particularly high impact on survival. Both histologic subtypes showed a significantly worse recurrence-free survival rate when compared to the control group. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Roman D Laske
- Department of Otorhinolaryngology Head and Neck Surgery
| | | | | | | | | | - Gabriela Studer
- Institute of Radiation Oncology, University Hospital of Zurich/University of Zurich
| | - Matthias Rössle
- Institute of Surgical Pathology, Kantonsspital Graubünden, Chur/University of Zurich Zurich Switzerland
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Schariatzadeh R, Pezier TF, Studer G, Schmid S, Huber GF. Does airway intervention before primary nonsurgical therapy for T3/T4 laryngeal squamous cell carcinoma impact on oncological or functional outcomes? Swiss Med Wkly 2015; 145:w14213. [PMID: 26715377 DOI: 10.4414/smw.2015.14213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
QUESTIONS UNDER STUDY Even today, some patients with laryngeal cancer present with airway obstruction necessitating an intervention in the form of either a tracheostomy or transoral laser debulking (TOL). Controversy exists as to whether such an intervention is a risk factor for poor oncological or functional outcome in patients who then undergo primary (chemo)radiotherapy. METHODS Retrospective chart review of all patients undergoing primary curative nonsurgical treatment for T3/T4 laryngeal squamous cell cancer at the University Hospital Zurich between 1981 and 2011. RESULTS A total of 29/114 patients had an airway intervention before initiation of (chemo)radiotherapy (21/29 tracheostomies, 8/29 TOL). Kaplan-Meier analysis showed no statistical difference in oncological outcomes between the groups with and without intervention (5 year overall survival: 52% vs 70%, disease specific survival: 73% vs 79%, recurrence free survival: 53% vs 63%). In functional terms, we report an overall functional larynx rate of 60%. CONCLUSIONS Airway intervention was not found to be a risk factor for poor oncological or functional outcome in this patient group.
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Affiliation(s)
- René Schariatzadeh
- Dept. of Otorhinolaryngology, Head & Neck surgery, University Hospital Zürich, Switzerland
| | - Thomas F Pezier
- Dept. of Otorhinolaryngology, Head & Neck surgery, University Hospital Zürich, Switzerland
| | - Gabriela Studer
- Dept. Radiation Oncology, University Hospital Zürich, Switzerland
| | | | - Gerhard F Huber
- Dept. of Otorhinolaryngology, Head & Neck surgery, University Hospital Zürich, Switzerland
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Pietsch C, de Galiza Barbosa F, Hüllner MW, Schmid DT, Haerle SK, Huber GF, Studer G, Hany TF, Veit-Haibach P. Combined PET/CT-perfusion in patients with head and neck cancers might predict failure after radio-chemotherapy: a proof of concept study. BMC Med Imaging 2015; 15:60. [PMID: 26714448 PMCID: PMC4696250 DOI: 10.1186/s12880-015-0102-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 12/14/2015] [Indexed: 11/16/2022] Open
Abstract
Background [18F]FDG-PET/CT imaging is broadly used in head and neck cancer (HNSCC) patients. CT perfusion (CTP) is known to provide information about angiogenesis and blood-flow characteristics in tumors. The aim of this study was to evaluate the potential relationship of FDG-parameters and CTP-parameters in HNSCC preand post-therapy and the potential prognostic value of a combined PET/CT with CTP. Methods Thirteen patients with histologic proven HNSCC were prospectively included. All patients underwent a combined PET/CT with integrated CTP before and after therapy. Pre- and post-therapeutic data of CTP and PET of the tumors were compared. Differences were tested using Spearman’s rho test and Pearson’s correlation. A p-value of p <0.05 was considered statistically significant. Correlations were calculated using Pearson’s correlation. Bootstrap confidence intervals were calculated to test for additive confidence intervals. Results Three patients died due to malignancy recurrence, ten patients were free of recurrence until the end of the follow-up period. Patients with recurrent disease had significantly higher initial CTP-values compared to the recurrence-free patients: BFpre 267.4 (171.2)ml/100 mg/min, BVpre 40.9 (8.4)ml/100 mg and MTTpre 8.2 (6.1)sec. No higher SUVs initially but significantly higher TLG compared to patients without recurrence were found. Post-therapeutic PET-values differed significantly between the two groups: SUVmaxpost 6.0 (3.2), SUVmeanpost 3.6 (2.0) and TLG 21751.7 (29794.0). Conclusion In our proof of concept study, combined PET/CT with integrated CTP might show complementary prognostic data pre- and post chemo-radiotherapy. CTP may be used to predict local tumor recurrence, while FDGPET/CT is still needed for whole-body staging.
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Affiliation(s)
- Carsten Pietsch
- Department of Nuclear Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, 8091, Zuerich, Switzerland. .,University of Zurich, Zurich, Switzerland.
| | - Felipe de Galiza Barbosa
- Department of Nuclear Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, 8091, Zuerich, Switzerland.
| | - Martin W Hüllner
- Department of Nuclear Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, 8091, Zuerich, Switzerland. .,University of Zurich, Zurich, Switzerland.
| | - Daniel T Schmid
- Department of Nuclear Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, 8091, Zuerich, Switzerland. .,University of Zurich, Zurich, Switzerland.
| | - Stephan K Haerle
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
| | - Gerhard F Huber
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
| | - Gabriela Studer
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
| | - Thomas F Hany
- Department of Nuclear Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, 8091, Zuerich, Switzerland. .,University of Zurich, Zurich, Switzerland.
| | - Patrick Veit-Haibach
- Department of Nuclear Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, 8091, Zuerich, Switzerland. .,Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
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Schilling C, Stoeckli SJ, Haerle SK, Broglie MA, Huber GF, Sorensen JA, Bakholdt V, Krogdahl A, von Buchwald C, Bilde A, Sebbesen LR, Odell E, Gurney B, O'Doherty M, de Bree R, Bloemena E, Flach GB, Villarreal PM, Fresno Forcelledo MF, Junquera Gutiérrez LM, Amézaga JA, Barbier L, Santamaría-Zuazua J, Moreira A, Jacome M, Vigili MG, Rahimi S, Tartaglione G, Lawson G, Nollevaux MC, Grandi C, Donner D, Bragantini E, Dequanter D, Lothaire P, Poli T, Silini EM, Sesenna E, Dolivet G, Mastronicola R, Leroux A, Sassoon I, Sloan P, McGurk M. Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer. Eur J Cancer 2015; 51:2777-84. [PMID: 26597442 DOI: 10.1016/j.ejca.2015.08.023] [Citation(s) in RCA: 220] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/22/2015] [Accepted: 08/23/2015] [Indexed: 01/18/2023]
Abstract
PURPOSE Optimum management of the N0 neck is unresolved in oral cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis. The object of this study was to establish whether the technique was both reliable in staging the N0 neck and a safe oncological procedure in patients with early-stage oral squamous cell carcinoma. METHODS An European Organisation for Research and Treatment of Cancer-approved prospective, observational study commenced in 2005. Fourteen European centres recruited 415 patients with radiologically staged T1-T2N0 squamous cell carcinoma. SNB was undertaken with an average of 3.2 nodes removed per patient. Patients were excluded if the sentinel node (SN) could not be identified. A positive SN led to a neck dissection within 3 weeks. Analysis was performed at 3-year follow-up. RESULTS An SN was found in 99.5% of cases. Positive SNs were found in 23% (94 in 415). A false-negative result occurred in 14% (15 in 109) of patients, of whom eight were subsequently rescued by salvage therapy. Recurrence after a positive SNB and subsequent neck dissection occurred in 22 patients, of which 16 (73%) were in the neck and just six patients were rescued. Only minor complications (3%) were reported following SNB. Disease-specific survival was 94%. The sensitivity of SNB was 86% and the negative predictive value 95%. CONCLUSION These data show that SNB is a reliable and safe oncological technique for staging the clinically N0 neck in patients with T1 and T2 oral cancer. EORTC Protocol 24021: Sentinel Node Biopsy in the Management of Oral and Oropharyngeal Squamous Cell Carcinoma.
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Affiliation(s)
- Clare Schilling
- Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK
| | - Sandro J Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery Kantonsspital St Gallen, Switzerland
| | - Stephan K Haerle
- Department of Head and Neck Surgery, University of Basel, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery Kantonsspital St Gallen, Switzerland
| | - Gerhard F Huber
- Department of Otolaryngology University Hospital Zurich, Switzerland
| | - Jens Ahm Sorensen
- Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark
| | - Vivi Bakholdt
- Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark
| | | | - Christian von Buchwald
- Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Anders Bilde
- Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Lars R Sebbesen
- Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Edward Odell
- Head and Neck/Oral Pathology, King's College London, Guys and St Thomas NHS Trust, London, UK
| | - Benjamin Gurney
- Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK
| | - Michael O'Doherty
- Department of Nuclear Medicine, Guys and St Thomas NHS Trust, London, UK
| | - Remco de Bree
- Department of Otolaryngology Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Elisabeth Bloemena
- Department of Pathology, VU University Medical Centre and Academic Centre of Dentistry Amsterdam, The Netherlands
| | - Geke B Flach
- Department of Otolaryngology Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Pedro M Villarreal
- Department of Maxillofacial Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Julio Alvarez Amézaga
- Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain
| | - Luis Barbier
- Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain
| | - Joseba Santamaría-Zuazua
- Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain
| | - Augusto Moreira
- Department of Head and Neck Surgery, Instituto Portugues de Oncologia do Porto, Portugal
| | - Manuel Jacome
- Department of Head and Neck Surgery, Instituto Portugues de Oncologia do Porto, Portugal
| | | | - Siavash Rahimi
- Department of Histopathology, San Carlo Hospital Rome, Italy
| | | | - Georges Lawson
- Department of Head and Neck Surgery, CHU Dinant Godinne, Université Catholique de Louvain, Belgium
| | - Marie-Cecile Nollevaux
- Department of Head and Neck Surgery, CHU Dinant Godinne, Université Catholique de Louvain, Belgium
| | - Cesare Grandi
- Department of Otolaryngology, Ospedale S. Chiara, Trento, Italy
| | - Davide Donner
- Department of Nuclear Medicine, Ospedale S. Chiara, Trento, Italy
| | - Emma Bragantini
- Department of Surgical Pathology, Ospedale S. Chiara, Trento, Italy
| | - Didier Dequanter
- Department of Maxillofacial Surgery CHU de Charleroi Belgium, Belgium
| | - Philippe Lothaire
- Department of Maxillofacial Surgery CHU de Charleroi Belgium, Belgium
| | - Tito Poli
- Department of Maxillofacial Surgery, Azienda Ospedaliera, Universitaria of Parma, Italy
| | - Enrico M Silini
- Department of Pathology Azienda Ospedaliera Universitaria of Parma, Italy
| | - Erinco Sesenna
- Department of Maxillofacial Surgery, Azienda Ospedaliera, Universitaria of Parma, Italy
| | - Giles Dolivet
- Department of Head and Neck Surgery Centre Alexis Vautrin, Vandoeuvre Les Nancy, France
| | - Romina Mastronicola
- Department of Head and Neck Surgery Centre Alexis Vautrin, Vandoeuvre Les Nancy, France
| | - Agnes Leroux
- Department of Pathology Centre Alexis Vautrin, Vandoeuvre Les Nancy, France
| | | | - Philip Sloan
- Department of Cellular Pathology, Newcastle University Hospital, UK
| | - Mark McGurk
- Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK.
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Morand GB, Fellmann J, Laske RD, Weisert JU, Soltermann A, Zbinden R, Probst R, Huber GF. Detection ofHelicobacter pyloriin patients with head and neck cancer: Results from a prospective comparative study combining serology, polymerase chain reaction, and rapid urease test. Head Neck 2015; 38:769-74. [DOI: 10.1002/hed.23958] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 12/14/2022] Open
Affiliation(s)
- Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Jonas Fellmann
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Roman D. Laske
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Jan U. Weisert
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Alex Soltermann
- Institute of Surgical Pathology, University Hospital Zurich; Switzerland
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich; Switzerland
| | - Rudolf Probst
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
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Müller J, Hüllner M, Strobel K, Huber GF, Burger IA, Haerle SK. The value of (18) F-FDG-PET/CT imaging in oral cavity cancer patients following surgical reconstruction. Laryngoscope 2015; 125:1861-8. [PMID: 25892275 DOI: 10.1002/lary.25326] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/06/2015] [Accepted: 03/23/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Follow-up of patients with oral cavity squamous cell carcinoma (OCSCC) after tumor resection and reconstruction with tissue transfer is challenging. We compared contrast-enhanced computed tomography (ceCT), (18) F-fluorodeoxyglucose-positron emission tomography combined with noncontrast enhanced CT ((18) F-FDG-PET/CT), and (18) F-FDG-PET combined with ceCT ((18) F-FDG-PET/ceCT) to determine the accuracy for detection of residual/recurrent disease after flap reconstruction for OCSCC. STUDY DESIGN AND METHODS Two readers (R1, R2) retrospectively reviewed a total of 27 (18) F-FDG-PET/ceCT scans in patients after resection of stage II to IV OCSCC. They recorded the presence of local persistence/recurrence (LR), lymph node metastasis, or distant metastasis independently for ceCT, (18) F-FDG-PET/CT, and (18) F-FDG-PET/ceCT. Histological workup, imaging follow-up, or clinical follow-up served as the standard of reference. Maximum standardized uptake value (SUVmax) was evaluated to discriminate between physiological uptake and LR. RESULTS The highest accuracy to detect LR was achieved with (18) F-FDG-PET/ceCT, with a sensitivity/specificity of 88%/89% and 88%/79% for R1 and R2, respectively, as compared to ceCT with 75%/79% for R1 and 88%/68% for R2 and (18) F-FDG-PET/CT with 88%/58% for both R1 and R2. Receiver-operating-characteristic analysis determined a cutoff value for SUVmax of 7.2, yielding a sensitivity and specificity of 75% and 94%, respectively, to distinguish LR from physiological (18) F-FDG uptake. CONCLUSION (18) F-FDG-PET/ceCT seems to be the most reliable tool for locoregional surveillance of OCSCC patients after resection and reconstruction. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Julian Müller
- Department of Medical Radiology, Division of Nuclear Medicine
| | - Martin Hüllner
- Department of Medical Radiology, Division of Nuclear Medicine
- Department of Medical Radiology, Clinic of Neuroradiology
| | - Klaus Strobel
- Department of Radiology and Nuclear Medicine, Lucerne Cantonal Hospital, Lucerne
| | - Gerhard F Huber
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich
| | - Irene A Burger
- Department of Medical Radiology, Division of Nuclear Medicine
| | - Stephan K Haerle
- Department of Otolaryngology-Head and Neck Surgery, Microvascular Reconstruction, University Hospital Basel, Basel, Switzerland
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Denoth S, Broglie MA, Haerle SK, Huber GF, Haile SR, Soltermann A, Jochum W, Stoeckli SJ. Histopathological mapping of metastatic tumor cells in sentinel lymph nodes of oral and oropharyngeal squamous cell carcinomas. Head Neck 2014; 37:1477-82. [DOI: 10.1002/hed.23782] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 03/07/2014] [Accepted: 05/28/2014] [Indexed: 12/16/2022] Open
Affiliation(s)
- Seraina Denoth
- Department of Otorhinolaryngology, Head and Neck Surgery; Kantonsspital St. Gallen; Switzerland
| | - Martina A. Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery; Kantonsspital St. Gallen; Switzerland
| | - Stephan K. Haerle
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Sarah R. Haile
- Clinical Trials Unit; Kantonsspital St. Gallen; Switzerland
| | - Alex Soltermann
- Department of Clinical Pathology; University Hospital of Zurich; Switzerland
| | - Wolfram Jochum
- Institute of Pathology, Kantonsspital St. Gallen; Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery; Kantonsspital St. Gallen; Switzerland
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Matoscevic K, Graf N, Pezier TF, Huber GF. Success of salvage treatment: a critical appraisal of salvage rates for different subsites of HNSCC. Otolaryngol Head Neck Surg 2014; 151:454-61. [PMID: 24894422 DOI: 10.1177/0194599814535183] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Despite advances in interdisciplinary treatment protocols, the chance of cure for recurrent head and neck squamous cell carcinoma (HNSCC) following failed primary therapy is poor and often entails a high morbidity. Recurrence rates vary widely in the literature depending on tumor localization, primary tumor stage, and treatment modality, and only a minority of patients can be salvaged. STUDY DESIGN Historical cohort study. SETTING This study valuates the outcomes of patients treated for recurrent squamous cell carcinoma of the larynx, pharynx, and oral cavity in the largest tertiary referral center of Switzerland to find predictors for survival in salvage surgery with curative intent. SUBJECTS AND METHODS Included were 176 consecutive patients with recurrent disease after primary curative treatment of HNSCC, in locations mentioned previously. Kaplan-Meier survival analyses with log-rank testing were performed depending on T and N stage, gender, treatment, and location of first relapse to evaluate the impact on overall survival, disease specific survival, and recurrence free survival. RESULTS Overall successful salvage rates were 49.2% for laryngeal recurrence, 35.1% for oral cavity, 32.7% for oropharyngeal, and a mere 17.4% for hypopharyngeal recurrences. Predictive factors for better outcome were location of recurrence, female gender, lymph node status, and extent of salvage treatment. CONCLUSION In case of recurrent disease, laryngeal cancers showed the best salvage rates, whereas in hypopharyngeal relapses, very few patients could be successfully salvaged. Patients therefore should be carefully selected and counseled for salvage treatment according to patient motivation, age, type of previous treatment, surgical resectability, and exclusion of distant recurrence.
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Affiliation(s)
- Katja Matoscevic
- Clinic of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | | | - Thomas F Pezier
- Clinic of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Gerhard F Huber
- Clinic of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
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Broglie MA, Soltermann A, Haile SR, Huber GF, Stoeckli SJ. Human papilloma virus and survival of oropharyngeal cancer patients treated with surgery and adjuvant radiotherapy. Eur Arch Otorhinolaryngol 2014; 272:1755-62. [PMID: 24880469 DOI: 10.1007/s00405-014-3099-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 05/08/2014] [Indexed: 10/25/2022]
Abstract
Impact of p16 protein, a surrogate marker for human papilloma virus induced cancer, p53 and EGFR as well as clinical factors on survival in a patient cohort with oropharyngeal squamous cell carcinoma (OPSCC) treated by surgical resection and adjuvant radiotherapy (RT) ± concomitant chemotherapy (CT). This is a retrospective analysis of patient's charts and tumor tissue. 57 patients were consecutively included and their tumor tissue assembled on a tissue microarray following immunohistochemical analysis. Survival times were estimated by means of Kaplan-Meier analysis. The importance of clinical and immunohistochemical factors for outcome was estimated by cox proportional hazard models. With 88% 5-year overall survival, 91% 5-year disease-specific survival and 91% 5-year disease-free survival, respectively, we found excellent survival rates in this surgically treated patient cohort of mainly advanced OPSCC (93% AJCC stage III or IV). The only factors positively influencing survival were p16 overexpression as well as p53 negativity and even more pronounced the combination of those biomarkers. Survival analysis of patients classified into three risk categories according to an algorithm based on p16, smoking, T- and N-category revealed a low, intermediate and high-risk group with significant survival differences between the low and the high-risk group. Patients with OPSCC can be successfully treated by surgery and adjuvant RT ± CT with a clear survival benefit of p16 positive, p53 negative patients. We recommend considering a combination of immunohistochemical (p16, p53) and clinical factors (smoking, T- and N-category) for risk stratification.
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Affiliation(s)
- Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland,
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Pézier TF, Kastrinidis N, Widmer GM, Huber GF, Probst R. Fatally invasive actinomycosis masquerading as a tonsillar carcinoma. Head Neck 2014; 36:E129-30. [DOI: 10.1002/hed.23659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2014] [Indexed: 11/11/2022] Open
Affiliation(s)
- Thomas F. Pézier
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Frauenklinikstrasse 24 CH-8091 Zurich Switzerland
| | - Nikos Kastrinidis
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Frauenklinikstrasse 24 CH-8091 Zurich Switzerland
| | - Gian-Marco Widmer
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Frauenklinikstrasse 24 CH-8091 Zurich Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Frauenklinikstrasse 24 CH-8091 Zurich Switzerland
| | - Rudolf Probst
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Frauenklinikstrasse 24 CH-8091 Zurich Switzerland
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Vital D, Morand G, Huber GF, Studer G, Holzmann D. Outcome in squamous cell carcinoma of the nasal vestibule: a single center experience. Head Neck 2014; 37:46-51. [PMID: 24898621 DOI: 10.1002/hed.23549] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/23/2013] [Accepted: 10/31/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The purpose of this study was to analyze the outcome of squamous cell carcinomas (SCCs) of the nasal vestibule and to identify factors predicting recurrence. METHODS All patients treated between 1995 and 2012 were included in this study. Outcome was analyzed with respect to modality of therapy, age, sex, tobacco consumption, staging, surgical margins, and histological differentiation pattern. RESULTS Thirty patients were included. Fourteen patients (47%) were found with T4, 1 patient (3%) with T3, 7 patients (23%) with T2, and 8 patients (27%) with T1 disease. Twenty-one patients (70%) were treated surgically. Six patients (29%) needed postoperative radiation because of insufficient surgical margins. Radiation was the first-line treatment in 9 patients (30%). Surgically treated patients with surgical margins <3 mm had significantly more locoregional recurrence compared to those with sufficient resections. CONCLUSION Advanced T4 carcinomas show a high recurrence rate. Insufficient surgical margins are the main predictor for a locoregional recurrence and should be avoided.
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Affiliation(s)
- Domenic Vital
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
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Meerwein C, Pézier TF, Beck-Schimmer B, Schmid S, Huber GF. Airway management in head and neck cancer patients undergoing microvascular free tissue transfer: delayed extubation as an alternative to routine tracheotomy. Swiss Med Wkly 2014; 144:w13941. [PMID: 24610153 DOI: 10.4414/smw.2014.13941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
QUESTIONS UNDER STUDY The aim of this study was to evaluate two practices of airway management in patients undergoing head and neck cancer (HNC) resection and microvascular free tissue transfer (MFTT), and to assess the advantages and disadvantages of the two approaches. METHODS Patients undergoing a delayed extubation approach (NO-TRACH group) and patients undergoing primary tracheotomy (PRIM-TRACH group) were retrospectively evaluated in terms of perioperative and postoperative outcome measures. RESULTS Not performing routine tracheotomy was safe and no perioperative airway complications occurred. NO-TRACH patients were extubated after 1.1 ± 0.9 days (mean ± standard deviation) and secondary tracheotomy was necessary in three patients (13%). NO-TRACH patients revealed decreased duration of surgery (p <0.05) and showed trends to earlier resumption of oral feeding and decreased length of hospitalisation. Flap complication rates were similar in both groups, with an overall flap survival rate of 97.5% (n = 39/40). CONCLUSIONS With appropriate postoperative care, carefully selected patients undergoing major HNC resections with MFTT can be safely managed without routine tracheotomy.
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Meerwein C, Vital D, Greutmann M, Schmid C, Huber GF. [Total thyroidectomy in patients with amiodarone-induced hyperthyroidism: when does the risk of conservative treatment exceed the risk of surgery?]. HNO 2014; 62:100-5. [PMID: 24549509 DOI: 10.1007/s00106-013-2806-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Amiodarone plays a pivotal role in the treatment of ventricular and supraventricular arrhythmias. However, amiodarone-induced hyperthyroidism (AIH) is one of the most feared complications, which necessitates interdisciplinary treatment and careful balancing of the risks of conservative treatment against those of total thyroidectomy. In this article we discuss the pharmacological aspects of amiodarone and its diverse effects on the thyroid. Furthermore, we present diagnostic and therapeutic strategies and report our positive experiences with total thyroidectomy in patients with AIH. Particularly in patients for whom continuation of amiodarone treatment is compulsory, a well-timed total thyroidectomy is a reliable therapeutic option, with minimal complication rates and immediate amelioration of symptoms.
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Affiliation(s)
- C Meerwein
- Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Universitätsspital Zürich, Frauenklinikstr. 24, 8091, Zürich, Schweiz
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Kuhn FP, Hüllner M, Mader CE, Kastrinidis N, Huber GF, von Schulthess GK, Kollias S, Veit-Haibach P. Contrast-Enhanced PET/MR Imaging Versus Contrast-Enhanced PET/CT in Head and Neck Cancer: How Much MR Information Is Needed? J Nucl Med 2014; 55:551-8. [DOI: 10.2967/jnumed.113.125443] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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