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Luna-Ortiz K, Bautista-Pérez IJ, Luna-Peteuil Z, Martinez-Hernandez HJ. Carotid Artery Resection and Reconstruction due to Benign and Malignant Head and Neck Tumors. Indian J Otolaryngol Head Neck Surg 2023; 75:4216-4222. [PMID: 37974813 PMCID: PMC10645706 DOI: 10.1007/s12070-023-04068-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/20/2023] [Accepted: 07/06/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE Carotid resection for head and neck cancer is rare, and serious complications may arise since such cancer is frequently detected in advanced stages. The objective is to describe nine cases of carotid artery resection and reconstruction due to tumor invasion. METHODS The clinical records of nine patients who underwent carotid resection and reconstruction at our hospital were retrospectively reviewed. Carotid body tumors were evaluated with the aid of a vascular team in case carotid resection was necessary at the time of surgery. CT angiography to determine the status of the circle of Willis was performed in all patients who might undergo carotid resection and reconstruction in case of failure to restore cerebral blood flow and thus reduce possible sequelae due to ligation. RESULTS Of nine patients, 6 had carotid body tumors, 1 had a thyroid tumor of conglomerate lymph nodes, 1 had a larynx tumor of conglomerate lymph nodes, and 1 had a myofibroblastic tumor. There were no intraoperative cerebrovascular accidents. One patient (11.1%) had a cerebrovascular accident secondary to carotid hematoma in the intermediate postoperative period that required vascular graft removal. One patient (11.1%) died seven days after surgery following an ischemic cerebrovascular accident. Eight patients remain asymptomatic, and 1 patient with recurrence and metastasis. CONCLUSIONS Carotid resection remains a controversial issue in the treatment of advanced head and neck cancer. However, carotid resection and reconstruction are required for disease control, and complications such as thrombosis or vascular accidents may arise. Fortunately, this is a rare condition. We recommend carotid reconstruction for all patients in whom resection is required for tumor control. Ligation should be a last resort, as seen in the management of one of our patients.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, Mexico City, 14080 Tlalpan Mexico
- Department of General Surgery (Head and Neck Surgery, Hospital General “Manuel Gea Gonzalez”, Mexico City, México
| | - Irvint Joel Bautista-Pérez
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, Mexico City, 14080 Tlalpan Mexico
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Garcia-Ortega DY, Ortega Jiménez JA, Melendez-Fernandez AP, Álvarez-Cano A, Caro-Sanchez CHS, Vargas-Lara AK, Luna-Ortiz K. Does compartmental resection really impact retroperitoneal soft tissue sarcomas? A retrospective analysis from a Single Referral Center. Surg Oncol 2023; 51:101997. [PMID: 37832278 DOI: 10.1016/j.suronc.2023.101997] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/03/2023] [Accepted: 09/17/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND The treatment of choice for retroperitoneal soft tissue sarcomas (RPS) is surgical resection; the outcomes with more radical surgeries, notably compartmental resection, remains a subject of debate. Arguments against it, include the complexity of the technique and high morbidity. MATERIALS AND METHODS A retrospective analysis of cases treated in a single center from January 2010 to December 2019 is presented. Two time periods were evaluated: 2010-2015 and 2016-2019, corresponding to before and after the implementation of routine compartmentectomy. We evaluated the short- and long-term outcomes of compartmental resection compared to limited surgeries through a multivariate analysis of prognostic factors. RESULTS A total of 176 cases were included, of which 102 met the inclusion criteria. The sex distribution was similar. The average age was 52.9 years, and the average tumor size was 24.5 cm. The most frequent histology was liposarcoma (65.7%), followed by leiomyosarcoma (12.7%), and malignant peripheral nerve sheath tumor (8.8%). The median follow-up period was 40 months. We found a lower local recurrence in the group treated in the recent period (compartmentectomy) 42.3% vs 20% p = 0.007. The median overall survival (OS) was 38.7 months, and there was no difference in distant recurrence between the two time periods. Postoperative morbidity was higher in the recent period (25% vs 10% p 0.041), with no difference in 30-day mortality. CONCLUSIONS The implementation of extensive surgery, specifically compartmentectomy, for retroperitoneal sarcomas has been linked to reduced local recurrence. We recommend considering this surgical approach for RPS in alignment with current expert consensus guidelines, as highlighted by the updated TARPSWG consensus.
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Affiliation(s)
- Dorian Yarih Garcia-Ortega
- Surgical Oncology, Skin, Soft Tissue & Bone Tumors Department, National Cancer Institute, Mexico City, Mexico.
| | | | | | - Alethia Álvarez-Cano
- Surgical Oncology, Christus Muguerza Alta Especialidad, Monterrey, Nuevo Leon, Mexico
| | | | | | - Kuauhyama Luna-Ortiz
- Surgical Oncology Department of Head and Neck Surgery Department, National Cancer Institute, Mexico City, Mexico
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Bautista-Perez IJ, Luna-Peteuil Z, Pacheco-Molina C, Garcia-Ortega DY, Villavicencio-Valencia V, Luna-Ortiz K. Acrometastasis: The Tip of the Iceberg of Metastatic Disease from Thyroid Cancer. Two Cases Report. Indian J Otolaryngol Head Neck Surg 2023; 75:2263-2266. [PMID: 37636720 PMCID: PMC10447663 DOI: 10.1007/s12070-023-03555-1] [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: 01/20/2023] [Accepted: 01/31/2023] [Indexed: 02/16/2023] Open
Abstract
Acrometastasis, especially in the hands and fingers, is a rare clinical condition resulting from primary cancers such as lung, breast, kidney, and, rarely, thyroid cancer. Acrometastasis tends to be the tip of the iceberg in patients with extensive systemic disease, which could be regional, pulmonary, skeletal, neurological, or all of them combined. Even though these tumors are clearly visible and symptomatic, the diagnosis is usually misleading because such distal metastatic disease is not thought of at first. In general, systemic treatments should be given to any patient presenting digital acrometastasis. We describe two cases of papillary thyroid carcinoma and digital acrometastasis as a sign of advanced disease.
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Affiliation(s)
- Irvint Joel Bautista-Perez
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, 14080 Mexico City, Tlalpan Mexico
| | | | - Carlos Pacheco-Molina
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, 14080 Mexico City, Tlalpan Mexico
| | | | | | - Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, 14080 Mexico City, Tlalpan Mexico
- Department of General Surgery (Head and Neck Surgery), Hospital General “Manuel Gea Gonzalez” (Mexico), Mexico City, Tlalpan México
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Luna-Ortiz K, Luna-Peteuil Z, Bautista-Perez IJ, Ortiz KL. Transcervical Approach in a Thrice Recurrent Parapharyngeal Space Tumor. Indian J Otolaryngol Head Neck Surg 2023; 75:2285-2288. [PMID: 37636623 PMCID: PMC10447651 DOI: 10.1007/s12070-023-03569-9] [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: 01/10/2023] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
Parapharyngeal space tumors are rare and account for 0.5% of all head and neck tumors. Most of them are benign (95%), of which pleomorphic adenomas of the salivary gland are the most common. Due to their anatomical location, gaining surgical access while avoiding postoperative morbidity is the main limitation. We present the case of a 35-year-old male with a history of three transcervical resections of benign pleomorphic adenomas in the parapharyngeal space within the deep lobe of the parotid gland. The patient has been followed for more than ten years and maintains an adequate quality of life.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, 14080 Mexico City, México
- Department of General Surgery (Head and Neck Surgery), Hospital General “Manuel Gea Gonzalez”, Iași, México
| | | | - Irvint Joel Bautista-Perez
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, 14080 Mexico City, México
| | - Kuauhyama Luna Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, 14080 Mexico City, México
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Bautista-Pérez IJ, Luna-Peteuil Z, Garcia-Ortega DY, Luna-Ortiz K, Caro-Sanchez CHS. Desmoid Tumor of the Posterior Neck: A Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:1157-1161. [PMID: 37275005 PMCID: PMC10235322 DOI: 10.1007/s12070-022-03406-5] [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: 06/20/2022] [Accepted: 12/08/2022] [Indexed: 01/04/2023] Open
Abstract
Desmoid tumors are rare. They account for roughly 0.03% of all neoplasms and less than 3% of all soft tissue tumors. They are locally aggressive tumors with no known metastatic potential or dedifferentiation. A 29-year-old woman with no family history of neoplasms presented with a mass in the cervical region and moderate pain that had developed a year before. The patient underwent marginal resection of the bilateral posterior and lateral compartments of the neck. The histopathological report confirmed the diagnosis of desmoid tumor with nuclear positivity for beta-catenin. The patient received radiotherapy but did not show a favorable response; she has stable disease and takes colchicine at one-year follow-up.
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Affiliation(s)
- Irvint Joel Bautista-Pérez
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, Tlalpan, 14080 Mexico City, Mexico
| | | | | | - Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, Tlalpan, 14080 Mexico City, Mexico
- Department of General Surgery (Head and Neck Surgery), Hospital General “Manuel Gea Gonzalez”, Mexico City, Mexico
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Bautista-Pérez IJ, Luna-Peteuil Z, García-Ortega DY, Luna-Ortiz K. Conservative Treatment with CO 2 Laser for oral Mucosal Melanoma: A case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:1114-1116. [PMID: 37275030 PMCID: PMC10235408 DOI: 10.1007/s12070-022-03361-1] [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: 09/07/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Mucosal melanoma of the head and neck is a rare and aggressive malignancy with poor prognosis even after extensive resection. A 76-year-old male with melanoma of the hard palate underwent CO2 laser resection as a conservative treatment to preserve his quality of life. Six months after lumpectomy the patient was asymptomatic and had no tumor activity. Recurrence is the rule. Local or regional relapse occurs at any time and patients eventually die from distant metastasis.
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Affiliation(s)
- Irvint Joel Bautista-Pérez
- Present Address: Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, 14080 Tlalpan, Ciudad de México, México
| | | | | | - Kuauhyama Luna-Ortiz
- Present Address: Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av San Fernando #22 Col. Sección XVI, 14080 Tlalpan, Ciudad de México, México
- Department of General Surgery (Head and Neck Surgery), Hospital General “Manuel Gea Gonzalez”, México City, México
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Luna-Ortiz K, Reynoso-Noverón N, Zacarías-Ramón LC, Luna-Peteuil Z, García-Ortega DY. Role of Neck Dissection in Organ-Preservation for Glottic Squamous Cell Carcinoma. Indian J Otolaryngol Head Neck Surg 2022; 74:5865-5870. [PMID: 36742477 PMCID: PMC9895741 DOI: 10.1007/s12070-021-02470-7] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/16/2021] [Indexed: 02/07/2023] Open
Abstract
The surgical approach to the neck in laryngeal cancer depends on the tumor site and stage. Clinical practice guidelines recommend elective neck dissection in ≥ T2 N0 and all supraglottic cancers; however, there is no evidence supporting these recommendations. The objective is to evaluate the results of bilateral elective neck dissection in patients with glottic cancer who underwent supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP). Thirty-five patients diagnosed with ≥ T2 N0 laryngeal squamous cell carcinoma (LSCC) in a single-center retrospective study. Right-sided neck dissections yielded 900 lymph nodes, none of which were positive for metastatic disease. Left-sided neck dissections yielded 949 lymph nodes, one of which was positive for malignancy. Prelaryngeal (Delphian) neck dissection was performed in all patients. Out of 50 lymph nodes removed; one was positive for malignancy. Median overall survival was 172 months, and the 60-month overall survival was 87.3%. The 60-month disease-specific survival was 97.1%. Bilateral neck dissection and Delphian node dissection showed a low rate of metastasis (2.8%). Radical neck dissection may thus represent overtreatment; however, this surgical procedure could be justified to prevent regional recurrences.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerologia (Mexico), Av. San Fernando # 22, Col. Sección XVI, 14080 Tlalpan Mexico CDMX, Mexico
- Department of Surgery (Head and Neck Surgey), Hospital General Manuel Gea Gonzalez (Mexico), Mexico City, Mexico
| | - Nancy Reynoso-Noverón
- Basic and Clinical Research, Instituto Nacional de Cancerología (Mexico), Av. San Fernando #22, Col. Sección XVI, 14080 Tlalpan, Mexico City, Mexico
| | - Luis C. Zacarías-Ramón
- Department of Head and Neck Surgery, Instituto Nacional de Cancerologia (Mexico), Av. San Fernando # 22, Col. Sección XVI, 14080 Tlalpan Mexico CDMX, Mexico
| | - Zelik Luna-Peteuil
- Universitatea de Medicinâ Si Farmacie Grigorie T. Popa IASI (visitor medical student), Mexico City, Mexico
| | - Dorian Y. García-Ortega
- Surgical Oncology, Instituto Nacional de Cancerología (Mexico), Av. San Fernando #22, Col. Sección XVI, 14080 Tlalpan, Mexico City, Mexico
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Nooromid M, De Martino R, Squizzato F, Benedetto F, De Caridi G, Chou EL, Conrad MF, Pantoja J, Abularrage C, Sorber R, Garcia-Ortega DY, Luna-Ortiz K, Eichler C, Zarkowsky D, Chia M, Kalluri A, Cohnert T, Szeberin Z, Grotemeyer D, Shalhub S, Fagg D, Jackson MJ, Charlton-Ouw K, Gombert A, Jacobs M, Boyd A, Motaganahalli R, Uceda D, Woo K, Eskandari MK. Surgical resection and graft replacement for primary inferior vena cava leiomyosarcoma: A multicenter experience. Eur J Vasc Endovasc Surg 2022. [DOI: 10.1016/j.ejvs.2022.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Garcia-Ortega DY, Ponce-Herrera D, Alvarez-Cano A, Caro-Sanchez C, Luna-Ortiz K. Preoperative Neutrophil to Lymphocyte Ratio (NLR), Lymphocyte to Monocyte Ratio (LMR), and Platelet to Lymphocyte Ratio (PLR) as Prognostic Markers in Patients With Retroperitoneal Liposarcoma. Surgery in Practice and Science 2022. [DOI: 10.1016/j.sipas.2022.100076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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García-Ortega DY, Álvarez-Cano A, Clara-Altamirano MA, Caro-Sánchez C, Ruvalcaba-González CDLC, Cortés-González CC, Luna-Ortiz K. Bone invasion in soft tissue sarcomas of the extremities: An underappreciated prognostic factor. Bone invasion in soft tissue sarcomas. Surg Oncol 2021; 40:101692. [PMID: 34864631 DOI: 10.1016/j.suronc.2021.101692] [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: 09/09/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Bone invasion is unfrequently reported in soft tissue sarcomas of the extremities (eSTS), it is difficult to assess preoperatively and its prognostic impact has not been extensively studied. The objective of this paper was to analyze the incidence and the clinical impact of histologically proven bone invasion in individuals with eSTS. METHODS A retrospective analysis was performed using the medical files patients who had eSTS and were treated between 2012 and 2016. A 5 years survival was estimated using the Kaplan-Meier method and a Cox proportional risk assessment. The outcomes of patients with and without bone invasion were compared. RESULTS 370 patients were included in the analysis. The median follow up was 25 months, the median age was 45 years (IQR 31-58). Bone invasion was found in 41 (11.08%). Median tumor size was 11.8 cm. The majority of individuals were diagnosed at stage IV (n = 116, 31.4%), followed by stage IIIB (n = 87, 23.5%). High histological grade was associated with worse OS (HR 2.23, CI 95% 1.36-3.65, p = 0.001). Absence of bone invasion was associated with better prognosis (HR 0.541, CI 95% 0.34-0.86, p = 0.009). OS was 27.3 vs 49.28 months. The disease-free survival (DFS) was 25.1 in bone invasion vs 45.23 without bone invasion. CONCLUSION Bone invasion in individuals with eSTS is an independent adverse prognostic factor associated with lower OS and DFS; although infrequently reported, bone invasion might be considered as part of the staging in the future.
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Affiliation(s)
| | | | | | | | | | | | - Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery Department. National Cancer Institute, Mexico City, Mexico
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11
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Nooromid M, De Martino R, Squizzato F, Benedetto F, De Caridi G, Chou EL, Conrad MF, Pantoja J, Abularrage C, Sorber R, Garcia-Ortega DY, Luna-Ortiz K, Eichler C, Zarkowsky D, Chia M, Kalluri A, Cohnert T, Szeberin Z, Grotemeyer D, Shalhub S, Fagg D, Jackson MJ, Charlton-Ouw K, Gombert A, Jacobs M, Boyd A, Motaganahalli R, Uceda D, Woo K, Eskandari MK. Surgical resection and graft replacement for primary inferior vena cava leiomyosarcoma: a multicenter experience. J Vasc Surg Venous Lymphat Disord 2021; 10:617-625. [PMID: 34271247 DOI: 10.1016/j.jvsv.2021.06.021] [Citation(s) in RCA: 6] [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] [Received: 01/26/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Primary leiomyosarcoma of the inferior vena cava (IVC) is best managed with surgical resection when technically feasible. However, consensus is lacking regarding the best choice of conduit and reconstruction technique. The aim of the present multicenter study was to perform a comprehensive assessment through the VLFDC (Vascular Low Frequency Disease Consortium) to determine the most effective method for caval reconstruction after resection of primary leiomyosarcoma of the IVC. METHODS A multicenter, standardized database review of patients who had undergone surgical resection and reconstruction of the IVC for primary leiomyosarcoma from 2007 to 2017 was performed. The demographics, periprocedural details, and postoperative outcomes were analyzed. RESULTS A total of 92 patients (60 women and 32 men), with a mean age of 60.1 years (range, 30-88 years) were treated. Metastatic disease was present in 22%. The tumor location was below the renal veins in 49 (53%), between the renal and hepatic veins in 52 (57%), and above the hepatic veins in 13 patients (14%). The conduits used for reconstruction included ringed polytetrafluoroethylene (PTFE; n = 80), nonringed PTFE (n = 1), Dacron (n = 1), autogenous vein (n = 1), bovine pericardium (n = 4), and cryopreserved tissue (n = 5). Complete R0 resection was accomplished in 73 patients (79%). In-hospital mortality was 2%, with a median length of stay of 8 days. The primary patency of PTFE reconstructed IVCs was 97% and 92% at 1 and 5 years, respectively, compared with 73% at 1 and 5 years for the non-PTFE reconstructed IVCs. The overall 1-, 3-, and 5-year survival for the entire cohort were 94%, 86%, and 65%, respectively CONCLUSIONS: The findings from our multi-institutional study have demonstrated that complete en bloc resection of IVC leiomyosarcoma with vascular surgical reconstruction in selected patients results in low perioperative mortality and is associated with excellent long-term patency. A ringed PTFE graft was the most commonly used conduit for caval reconstruction, yielding excellent long-term primary patency.
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Affiliation(s)
- Michael Nooromid
- Division of Vascular Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Vascular and Endovascular Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pa
| | - Randall De Martino
- Department of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
| | - Francesco Squizzato
- Department of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
| | - Filippo Benedetto
- Division of Vascular and Endovascular Surgery, University of Messina, Messina, Italy
| | - Giovanni De Caridi
- Division of Vascular and Endovascular Surgery, University of Messina, Messina, Italy
| | - Elizabeth L Chou
- Division of Vascular Surgery and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Mass
| | - Mark F Conrad
- Division of Vascular Surgery and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Mass
| | - Joe Pantoja
- Division of Vascular Surgery, Department of Surgery, David Geffen School of Medicine, Los Angeles, Calif
| | - Christopher Abularrage
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Md
| | - Rebecca Sorber
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Md
| | - Dorian Yarih Garcia-Ortega
- Department of Skin and Soft Tissue Tumors and Head and Neck, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Kuauhyama Luna-Ortiz
- Department of Skin and Soft Tissue Tumors and Head and Neck, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Charles Eichler
- Division of Vascular Surgery and Endovascular Therapy, University of California, San Francisco, San Francisco, Calif
| | - Devin Zarkowsky
- Division of Vascular Surgery and Endovascular Therapy, University of California, San Francisco, San Francisco, Calif
| | - Matthew Chia
- Division of Vascular Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Aravind Kalluri
- Division of Vascular Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Tina Cohnert
- Department of Vascular Surgery, Graz Medical University, Graz, Austria
| | - Zoltan Szeberin
- Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Dirk Grotemeyer
- Department of Vascular Surgery, Hopitaux Robert Schuman, Hopital Kirchberg, Luxembourg City, Luxembourg
| | - Sherene Shalhub
- Division of Vascular Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Wash
| | - Damen Fagg
- Department of Vascular Surgery, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Mark J Jackson
- Department of Vascular Surgery, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Kristofer Charlton-Ouw
- Department of Clinical Sciences, University of Houston College of Medicine and Gulf Coast Vascular, HCA Houston Healthcare, Gulf Coast Division, Houston, Tex
| | - Alexander Gombert
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Michael Jacobs
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - April Boyd
- Division of Vascular Surgery, Department of Surgery, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Raghu Motaganahalli
- Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Ind
| | - Domingo Uceda
- Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Ind
| | - Karen Woo
- Division of Vascular Surgery, Department of Surgery, David Geffen School of Medicine, Los Angeles, Calif
| | - Mark K Eskandari
- Division of Vascular Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.
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Luna-Ortiz K, Reynoso-Noveron N, Zacarias-Ramon LC, Alvarez-Avitia M, Luna-Peteuil Z, Garcia-Ortega DY. Supracricoid Partial Laryngectomy With and Without Neoadjuvant Chemotherapy in Glottic Cancer. Laryngoscope 2021; 132:156-162. [PMID: 34173978 DOI: 10.1002/lary.29713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 04/06/2021] [Revised: 06/02/2021] [Accepted: 06/21/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To demonstrate that a group of patients who are not considered candidates for organ preservation can achieve organ preservation through neoadjuvant chemotherapy + surgery and to determine if there are differences regarding organ preservation, disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) after comparing such group with another one undergoing standard treatment. METHODS Patients with laryngeal cancer were retrospectively analyzed and divided into two groups. Group A included patients who were initially treated with supracricoid laryngectomy. Group B included patients with T3N0 glottic squamous cell carcinoma with arytenoid fixation. Patients were offered neoadjuvant chemotherapy. Both groups underwent bilateral selective neck dissection of lymph nodes (II-V) and intentional search of the Delphian lymph nodes. RESULTS Thirty-four patients were assigned to group A of surgery alone, and 16 patients were included in group B of induction chemotherapy. No statistical differences were found regarding sex, tumor localization, histological diagnosis, TNM staging, recurrence, or organ preservation. DFS, OS, and CSS at 60 months were the same in both groups. No statistical differences were found when comparing induction versus noninduction groups according to the T-stage in DFS, OS, and CSS. CONCLUSIONS Neoadjuvant chemotherapy allows to perform conservative surgery in patients with poor functional prognosis or who are not good candidates for organ preservation at first. We could perform safe surgery, and there was no more recurrence. Hence DFS is not modified (i.e., there was no more recurrence); consequently, OS and CSS are not affected. Neoadjuvant chemotherapy plus supracricoid partial laryngectomy-cricohyoidoepiglottopexy is an oncologically safe procedure that preserves basic functions such as breathing, phonation, and swallowing. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico City, Mexico.,Department of General Surgery (Head and Neck), Hospital Manuel Gea Gonzalez, Mexico City, Mexico
| | | | - Luis C Zacarias-Ramon
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Miguel Alvarez-Avitia
- Department of Clinical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Zelik Luna-Peteuil
- General Medicine, Universitatea de Medicinâ și Farmacie Grigore T. Popa, Iași, Romania
| | - Dorian Y Garcia-Ortega
- Department of Surgical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico
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García-Ortega DY, Clara-Altamirano MA, Martín-Tellez KS, Caro-Sánchez CHS, Álvarez-Cano A, Lino-Silva LS, Salcedo-Hernández RA, Ruvalcaba-González CDLC, Martínez-Said H, Luna-Ortiz K, Villavicencio-Valencia SV, Cuellar-Hubbe M. Epidemiological profile of soft tissue sarcomas of the extremities: Incidence, histological subtypes, and primary sites. J Orthop 2021; 25:70-74. [PMID: 33935434 DOI: 10.1016/j.jor.2021.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/08/2021] [Accepted: 03/28/2021] [Indexed: 01/14/2023] Open
Abstract
Background Soft tissue sarcomas (STS) are a heterogeneous group of rare tumours that represent less than 1% of all malignant, solid tumours in adults. There is limited epidemiological information regarding STS in Latin America. Therefore, the objective of this study is to present an epidemiological profile of these tumours observed at a single reference centre. Methods A retrospective study was carried out based on hospital records obtained from a registry of 879 patients with STS of the extremities who were treated at the National Cancer Institute of Mexico from January 1, 1994 to December 31, 2017. Epidemiological variables and relevant clinical data were collected. Five-year survival rates were analysed using Kaplan-Meier estimates, and a multivariate Cox proportional-hazards model measured associations. Results A total of 879 records were collected. The median age was 45 years (15-95 years), and the ratio of men to women was 1:1, with 433 men (49.3%), and 446 women (50.7%). The median tumour size was 11.4 cm (2-49 cm). The most prevalent histological variants were liposarcomas and synovial sarcomas. The lower limb was the most frequently affected extremity, with the thigh being the most common site followed by the leg. A majority of the patients were diagnosed at clinical stages IIIA-IV. Conclusions The data collected from the present cohort provides an overview of the epidemiological profile of STS at a single reference centre in Latin America, and allow comparison with global data.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Hector Martínez-Said
- National Cancer Institute (Instituto Nacional de Cancerología) Mexico City, Mexico
| | - Kuauhyama Luna-Ortiz
- National Cancer Institute (Instituto Nacional de Cancerología) Mexico City, Mexico
| | | | - Mario Cuellar-Hubbe
- National Cancer Institute (Instituto Nacional de Cancerología) Mexico City, Mexico
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Luna-Ortiz K, Dominguez-Malagon H, Corredor-Alonso GE, Reynoso-Noveron N, Herrera-Ponzanelli C, Luna-Peteuil Z, Zacarias-Ramon LC. Clinicopathological and immunohistochemical behavior of ductal carcinoma of the salivary and lacrimal gland in a Mexican Mestizo population. Eur Arch Otorhinolaryngol 2021; 279:327-333. [PMID: 33763743 DOI: 10.1007/s00405-021-06757-x] [Citation(s) in RCA: 1] [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: 02/28/2021] [Accepted: 03/13/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Salivary gland tumors are rare and include benign and malignant entities with different behavior and prognosis. Salivary gland carcinoma accounts for 0.2% of all cancers and 5-9% of head and neck carcinomas. We aim to describe the clinicopathological characteristics and discuss the immunohistochemical findings of salivary ductal carcinoma. METHODS We obtained 17 cases (2.3%) of salivary ductal carcinoma (SDC) from 727 patients with parotid tumors at our cancer center from a database covering a 22-year period (1996-2018). Two pathologists confirmed the diagnosis and excluded 6 cases. Eleven cases were assessed by immunohistochemistry (IHC) for HER2, estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR), mammaglobin, P53, GATA3, S100, cytokeratins (7,8,14,18, and 20), P63, PAX8, calponin, and SOX10. RESULTS Eleven SDC cases were in advanced stage, and 80% had metastasis. All cases were surgically treated, and 40% received different adjuvant chemotherapy regimens. we found that most patients were dead of disease. The histological and immunohistochemical analysis showed that 70% of cases were high-grade, 40% were positive for HER2, and 50% for AR. Moreover, a high Ki-67 proliferative index was detected in all cases. We observed luminal differentiation in 50% of cases. CONCLUSION SDC is a rare entity and survival is very poor. It is histologically similar to ductal carcinoma of the breast. However, important differences exist that help to distinguish them in case of synchronous cancers. The clinical behavior of SDC seems to be more aggressive and IHC analysis is useful for designing therapies.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico. .,Department of General Surgery (Head and Neck), Hospital Manuel Gea Gonzalez, Mexico City, Mexico.
| | - Hugo Dominguez-Malagon
- Department of Pathology, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Guillermo E Corredor-Alonso
- Department of Pathology, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Nancy Reynoso-Noveron
- Research Department at the Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Cesar Herrera-Ponzanelli
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Zelik Luna-Peteuil
- General Medicine, Universitatea de Medicinâ si Farmacie Grigorie T. Popa IASI, Iasi, Romania
| | - Luis C Zacarias-Ramon
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
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15
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Garcia-Ortega DY, Alvarez-Cano A, Clara-Altamirano MA, Martín-Tellez KS, Caro-Sánchez CHS, Ruvalcaba-Gonzalez CDLC, Martinez-Said H, Cuellar-Hubbe M, Luna-Ortiz K. Should metastatic lymph nodes be considered at the same clinical stage as distant metastasis in soft tissue sarcomas? Cancer Treat Res Commun 2020; 26:100268. [PMID: 33340903 DOI: 10.1016/j.ctarc.2020.100268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 11/08/2020] [Revised: 11/29/2020] [Accepted: 12/08/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Lymph node metastasis (LNM) in soft tissue sarcomas (STS) are uncommon, occurring in only 3% - 5% of all sarcomas, and are classified as Stage IV, along with distant metastasis (DM). This paper compares the prognosis of patients with lymphatic and DM, in extremity STS (eSTS). METHODS A retrospective study was carried out in a high-volume sarcoma center; 853 patients with eSTS sarcomas were identified and classified from January 1, 1997 to December 31, 2017. Cases with pathological confirmation of LNM were included. Five-year survival rates were analyzed using the Kaplan-Meier method and the Cox proportional hazards model. RESULTS LNM was present in 46 of the cases (5.4%), with an overall survival of 21 months (95% confidence interval [CI], 16.7 - 25.2), compared to 18 months (95% confidence interval [CI], 14.2 - 21.7) in those with only DM. Median recurrence-free survival was 21 months (95% confidence interval [CI], 19.7 - 22.4), vs. 20 months (95% confidence interval [CI], 16.2- 23.7), respectively. LNM only and DM only had also a similar OS of 21 months (95% CI 16.7-25.2) vs 18 months (95% CI 14.2-21.7. N1M1 cases had the worse median OS with 15 months (95% confidence interval [CI], 10.9-19.7) CONCLUSIONS: Overall survival and recurrence free survival in patients with lymph node disease and metastatic disease are similar. However prognosis is worse in N1M1. Use of systemic treatment in patients with LNM is not as common as in metastatic cases, this difference in treatment and the fact that prognosis is similar suggests that both biological behavior and effect of treatment have been underestimated. A subclassification of clinical stage IV might be the next step.
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Affiliation(s)
| | | | | | | | | | | | - Hector Martinez-Said
- National Cancer Institute (Instituto Nacional de Cancerología) Mexico City, Mexico
| | - Mario Cuellar-Hubbe
- National Cancer Institute (Instituto Nacional de Cancerología) Mexico City, Mexico
| | - Kuauhyama Luna-Ortiz
- National Cancer Institute (Instituto Nacional de Cancerología) Mexico City, Mexico
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16
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Luna-Ortiz K, Gómez-Pedraza A, Anuwong A. Lessons Learned from the Transoral Endoscopic Thyroidectomy with Vestibular Approach (TOETVA) for the Treatment of Thyroid Carcinoma. Ann Surg Oncol 2019; 27:1356-1360. [PMID: 31749078 DOI: 10.1245/s10434-019-07899-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Early detection of thyroid carcinoma has become commonplace. Consequently, the endoscopic approach has become a widely used method. OBJECTIVE Our aim was to report our experience with the transoral endoscopic thyroidectomy vestibular approach (TOETVA). METHODS We reviewed the records of 46 patients who underwent TOETVA. Only patients with no regional lymph node metastases (N0) and fine needle aspiration biopsy-confirmed thyroid cancer were included. The surgical technique used was as described by Angkoon Anuwong. RESULTS Forty-six patients with a mean age of 43.6 years (range 17-71) were included (37 women and 9 men). The mean time of surgery was 207 min (range 95-345), and the conversion to open thyroidectomy rate was 13% (six cases). CONCLUSION TOETVA is an acceptable approach for thyroid carcinoma. Poorly differentiated cancer, as well as extrathyroidal extension, result in patients being unsuitable for TOETVA. It is imperative to identify the circumstances under which conversion to open thyroidectomy must take place.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico CDMX, Mexico.,Department of General Surgery (Head and Neck), Hospital General Manuel Gea Gonzalez, Mexico CDMX, Mexico
| | - Antonio Gómez-Pedraza
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico CDMX, Mexico.
| | - Angkoon Anuwong
- Department of Surgery, Police General Hospital, Faculty of Medicine, Siam University, Bangkok, Thailand
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17
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Hurtado-López LM, Gutiérrez-Román SH, Basurto-Kuba E, Luna-Ortiz K. Endoscopic transoral parathyroidectomy: Initial experience. Head Neck 2019; 41:3334-3337. [PMID: 31157933 DOI: 10.1002/hed.25828] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/22/2019] [Accepted: 05/22/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND We evaluate our initial experience of transoral vestibular approach parathyroidectomy (TOEPVA) for the treatment of primary hyperparathyroidism. METHODS We conducted a prospective study of patients with single parathyroid adenoma, using TOEPVA to perform the parathyroidectomy. The variables we analyzed were size, volume, and location of the adenoma, bleeding, identification, and preservation of the recurrent laryngeal nerve, injury to the mental nerve, and the effective cure rate, using measures of central tendency. RESULTS Our study included 21 women, with an average age of 43 years. The recurrent laryngeal nerve and mental nerve suffered no permanent damage, the average size of the adenoma was 26.6 mm, and a volume of 3.95 mL. We were able to identify the adenoma and cure the hyperparathyroidism in 20 of the patients (95.2%). CONCLUSIONS TOEPVA is viable and safe in who wish to avoid the cervical scar resulting for the patient with primary hyperparathyroidism.
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Affiliation(s)
| | | | - Erich Basurto-Kuba
- Thyroid Clinic, General Surgery Service, Hospital General de México, Mexico City, Mexico
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18
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Garcia-Ortega D, Alvarez-Cano A, Martinez-Said H, Luna-Ortiz K, Caro-Sanchez C, Cuellar-Hubbe M. Prognostic factors in synovial sarcoma. Experience of 173 cases in a high volume sarcoma center. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Luna-Ortiz K, Hidalgo-Bahena SC, Muñoz-Gutiérrez TL, Mosqueda-Taylor A. Tumors of the oral cavity: CO2 laser management. Med Oral Patol Oral Cir Bucal 2019; 24:e84-e88. [PMID: 30573713 PMCID: PMC6344001 DOI: 10.4317/medoral.22811] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Cancer of the oral cavity combined with oropharyngeal cancer is the sixth leading cause of death for cancer worldwide. Surgery remains the standard treatment for this disease in early clinical and locally advanced stages. Numerous studies have shown that laser management is useful for premalignant lesions in the oral cavity; however, there is no conclusive evidence that its use is appropriate in cancer of the oral cavity and that results are comparable with traditional surgery. The objective of this study is to determine cancer control after wide local resection with CO2 laser for oral malignant neoplasms. MATERIAL AND METHODS Retrospective study in patients with tumors of the oral cavity who were considered for surgical resection with CO2 laser from January 2006-December 2015. Demographic data, treatment modalities, histopathological diagnosis and clinical stage variables were obtained. All resections were done with the use of the microspot. Patients with cancer of the tongue were not included because a specific protocol for these patients does exist in our institution. RESULTS There were twenty patients, 10 male and 10 female with a average age of 58 years (range: 20-92 years). Mean age was 53.5 years for females and 63 years for males. Twelve (60%) patients are alive and disease free and four (20%) were lost free of disease. CONCLUSIONS CO2 laser is an acceptable surgical method for the management of small lesions in the oral cavity. We cannot rule out that small lesions of the oral cavity with positive neck could be managed in this manner, adding treatment to the neck, producing an adequate local regional control. However, this hypothesis requires additional studies.
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Affiliation(s)
- K Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerologia (Mexico), Av. San Fernando #22, Col. Sección XVI, Tlalpan Mexico,
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20
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García-Ortega DY, Álvarez-Cano A, Sánchez-Llamas LA, Caro-Sanchez CHS, Martínez-Said H, Luna-Ortiz K, Cuéllar-Hübbe M. Neutrophil/lymphocyte ratio is associated with survival in synovial sarcoma. Surg Oncol 2018; 27:551-555. [PMID: 30217318 DOI: 10.1016/j.suronc.2018.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 12/05/2017] [Revised: 07/01/2018] [Accepted: 07/15/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Synovial sarcoma is a rare malignant soft tissue tumor, more common in adolescents and young adults and entails a poor prognosis. Several good prognostic factors have been well established such as age less than 25, size less than 5 cm and absence of a poorly differentiated component. Inflammation has a well-established role in tumor proliferation and survival. The aim of this study was to investigate the prognostic significance of the neutrophil/lymphocyte ratio (NLR) in a large cohort of synovial sarcoma patients. METHODS Retrospective study of 169 consecutive patients. We analyzed the relation of preoperative NLR on disease-free survival (DFS) and overall survival (OS) using Kaplan-Meier curves and Cox proportional models. RESULTS Of the 169 patients included, there were 90(53.3%) females and 79(46.7%) males. Median age was 32yo (11-73). Median survival was 34.1 and mean disease-free survival was 21.4 months. Mean tumor size was 12.5 cm (1.2-77 cm). Applying receiver operating curve analysis, we determined a cut-off value of 3.5. In univariate and multivariate analysis, increased NLR was significantly associated with poor OS. A <3.5 NLR was an independent prognostic factor in all stages (p = 0.002). CONCLUSIONS NLR >3.5 was found to be a reliable prognostic factor in this cohort. Given its widespread availability, we believe it's use in clinical practice and further clinical trials should be considered.
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Affiliation(s)
| | | | | | | | | | | | - Mario Cuéllar-Hübbe
- Departent of Surgical Oncology, National Cancer Institute Mexico City, Mexico
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21
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Luna-Ortiz K, Villavicencio-Valencia V, Martinez Said H. Comparative study of head and neck mucosal melanoma in 66 patients vs 226 patients with cutaneous melanoma: A survival analysis. Clin Otolaryngol 2018; 43:691-696. [PMID: 28986955 DOI: 10.1111/coa.13000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2017] [Indexed: 12/12/2022]
Affiliation(s)
- K Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerologia, Mexico City, Mexico
- Department of General Surgery (Head & Neck), Hospital General Manuel Gea Gonzalez, Mexico City, Mexico
| | - V Villavicencio-Valencia
- Department of Skin and Soft Tissue Sarcomas and Melanomas, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - H Martinez Said
- Department of General Surgery (Head & Neck), Hospital General Manuel Gea Gonzalez, Mexico City, Mexico
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Navarro S, Carrillo JF, Garcia Ortega DY, Luna-Ortiz K. Alveolar sarcoma of the parapharyngeal space: A case report. Acta Otorrinolaringológica Española 2017; 68:241-243. [DOI: 10.1016/j.otorri.2016.11.002] [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] [Received: 10/14/2016] [Revised: 11/07/2016] [Accepted: 11/08/2016] [Indexed: 11/15/2022]
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Navarro S, Carrillo JF, Garcia Ortega DY, Luna-Ortiz K. Alveolar sarcoma of the parapharyngeal space: A case report. Acta Otorrinolaringologica (English Edition) 2017. [DOI: 10.1016/j.otoeng.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kim GY, Lawrence PF, Moridzadeh RS, Zimmerman K, Munoz A, Luna-Ortiz K, Oderich GS, de Francisco J, Ospina J, Huertas S, de Souza LR, Bower TC, Farley S, Gelabert HA, Kret MR, Harris EJ, De Caridi G, Spinelli F, Smeds MR, Liapis CD, Kakisis J, Papapetrou AP, Debus ES, Behrendt CA, Kleinspehn E, Horton JD, Mussa FF, Cheng SWK, Morasch MD, Rasheed K, Bennett ME, Bismuth J, Lumsden AB, Abularrage CJ, Farber A. New predictors of complications in carotid body tumor resection. J Vasc Surg 2017; 65:1673-1679. [PMID: 28527929 DOI: 10.1016/j.jvs.2016.12.124] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/10/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study examined the relationship between two new variables, tumor distance to base of skull (DTBOS) and tumor volume, with complications of carotid body tumor (CBT) resection, including bleeding and cranial nerve injury. METHODS Patients who underwent CBT resection between 2004 and 2014 were studied using a standardized, multi-institutional database. Demographic, perioperative, and outcomes data were collected. CBT measurements were determined from computed tomography, magnetic resonance imaging, and ultrasound examination. RESULTS There were 356 CBTs resected in 332 patients (mean age, 51 years; 72% female); 32% were classified as Shamblin I, 43% as Shamblin II, and 23% as Shamblin III. The mean DTBOS was 3.3 cm (standard deviation [SD], 2.1; range, 0-10), and the mean tumor volume was 209.7 cm3 (SD, 266.7; range, 1.1-1642.0 cm3). The mean estimated blood loss (EBL) was 257 mL (SD, 426; range, 0-3500 mL). Twenty-four percent of patients had cranial nerve injuries. The most common cranial nerves injured were the hypoglossal (10%), vagus (11%), and superior laryngeal (5%) nerves. Both Shamblin grade and DTBOS were statistically significantly correlated with EBL of surgery and cranial nerve injuries, whereas tumor volume was statistically significantly correlated with EBL. The logistic model for predicting blood loss and cranial nerve injury with all three variables-Shamblin, DTBOS, and volume (R2 = 0.171, 0.221, respectively)-was superior to a model with Shamblin alone (R2 = 0.043, 0.091, respectively). After adjusting for Shamblin grade and volume, every 1-cm decrease in DTBOS was associated with 1.8 times increase in risk of >250 mL of blood loss (95% confidence interval, 1.25-2.55) and 1.5 times increased risk of cranial nerve injury (95% confidence interval, 1.19-1.92). CONCLUSIONS This large study of CBTs demonstrates the value of preoperatively determining tumor dimensions and how far the tumor is located from the base of the skull. DTBOS and tumor volume, when used in combination with the Shamblin grade, better predict bleeding and cranial nerve injury risk. Furthermore, surgical resection before expansion toward the base of the skull reduces complications as every 1-cm decrease in the distance to the skull base results in 1.8 times increase in >250 mL of blood loss and 1.5 times increased risk of cranial nerve injury.
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Affiliation(s)
- Gloria Y Kim
- University of Michigan Health System, Ann Arbor, Mich; UCLA Health System, Los Angeles, Calif
| | | | - Rameen S Moridzadeh
- UCLA Health System, Los Angeles, Calif; NYU Langone Medical Center, New York, NY
| | | | | | | | | | | | | | | | | | | | | | | | - Marcus R Kret
- Colorado Cardiovascular Surgical Associates, Denver, Colo
| | - E John Harris
- Stanford University School of Medicine, Stanford, Calif
| | | | | | - Matthew R Smeds
- University of Arkansas for Medical Sciences, Little Rock, Ark
| | | | | | | | - Eike S Debus
- University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Joshua D Horton
- NYU Langone Medical Center, New York, NY; Medical University of South Carolina, Charleston, SC
| | - Firas F Mussa
- NYU Langone Medical Center, New York, NY; Columbia University, New York, NY
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Luna-Ortiz K, Navarro-Santiesteban S, Villavicencio-Valencia V, Salcedo-Hernandez RA, Lino-Silva LS, Delgado JA. Primary laryngeal sarcomas in a Mexican population: Case series of eleven cases. Clin Otolaryngol 2017; 42:1389-1392. [PMID: 28429517 DOI: 10.1111/coa.12889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/27/2022]
Affiliation(s)
- K Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico City, Mexico.,Department of General Surgery (Head and Neck), Hospital General Manuel Gea Gonzalez, Mexico City, Mexico
| | - S Navarro-Santiesteban
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | - R A Salcedo-Hernandez
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - L S Lino-Silva
- Department of Pathology, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - J A Delgado
- Centro Medico de Occidente, IMSS, Guadalajara, Mexico
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Luna-Ortiz K, Aguilar-Romero M, Villavicencio-Valencia V, Zepeda-Castilla E, Vidrio-Morgado H, Peteuil N, Mosqueda-Taylor A. Comparative study between two different staging systems (AJCC TNM VS BALLANTYNE'S) for mucosal melanomas of the Head & Neck. Med Oral Patol Oral Cir Bucal 2016; 21:e425-30. [PMID: 27031071 PMCID: PMC4920455 DOI: 10.4317/medoral.21132] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/30/2016] [Indexed: 01/31/2023] Open
Abstract
Background Mucosal melanoma (MM) of head and neck (H &N) is a rare entity with a quite poor prognosis. Ballantyne’s staging system has been commonly used since 1970. In the 7th edition of the AJCC Staging Manual a new chapter for the staging of TNM Classification system for mucosal melanoma (MM) of the head and neck (H &N) has been introduced to reflect the particularly aggressive biological behavior of this neoplasm. The aim of this study was to analyze and compare among Ballantyne’s staging system vs TNM H &N in terms of overall survival (OS) and disease-free survival (DFS) in a consecutive population of patients with MM in a cancer centre. Material and Methods Descriptive analysis of demographic, clinical and pathological variables of MM of the Head & Neck were performed. We compared the survival curves for both systems according to the Kaplan-Meier method using the Log-rank test. Results An up-staging migration effect from Ballantyne’s localized disease to moderately and very advanced disease according to AJCC staging system. The 5-year DFS and OS for Ballantyne’s Localized Disease and AJCC Stage III were 31% and 36% vs. 47% and 50%, respectively. For locoregional disease the 5-year DFS / OS were 5% / 10% for Bal-lantyne’s system vs. 13.8% / 17.8% and 0 / 0% for AJCC Stages IVA and IVB, respectively. Conclusions In this series, the TNM staging system for MM of the H &N predicted better the prognosis of the disease when comparing with Ballantyne’s system. Key words:Head and neck, mucosal melanoma, AJCC TNM, Ballantynes´s staging system.
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Affiliation(s)
- K Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerologia, Av. San Fernando # 22 Col. Seccion XVI,Tlalpan, Mexico D.F. 14080,
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Garcia-Ortega DY, Villa-Zepeda O, Martinez-Said H, Cuellar-Hübbe M, Luna-Ortiz K. Oncology outcomes in Retroperitoneal sarcomas: Prognostic factors in a Retrospective Cohort study. Int J Surg 2016; 32:45-9. [PMID: 27268726 DOI: 10.1016/j.ijsu.2016.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 02/16/2016] [Revised: 05/29/2016] [Accepted: 06/02/2016] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Retroperitoneal sarcomas are a rare group of malignant soft tissue tumors with a generally poor prognosis. The aim of the study was to define the demographic characteristics and prognostic factors for patients with retroperitoneal sarcomas (RPS) in a Tertiary Referral Center at Mexico. METHODS A retrospective study of patients with RPS treated from January 2005 to December 2012 at the National Cancer Institute at Mexico. Patient, tumor and treatment variables were analyzed including use of adjuvant therapy and survival status. Survival and local recurrence curves were estimated using the Kaplan-Meier method. RESULTS Ninety-five patients with a mean age of 47 years with retroperitoneal sarcoma were included. Median follow-up was 25 months (range 1-108 months). The average tumor size was 23.7 cm. Histology, 58 (61.1%) were liposarcoma, 14 (14.7%), leiomyosarcomas and 23 (24.2%) were from other histologies. In 64 (67.4%) patients were high-grade malignancies. The median survival was 51 months for patients with complete resection, 25.1 months for those with incomplete resection, and 4.4 months for those with unresectable tumors. Complete resection (p = 0.0001), and liposarcoma (p = 0.03) were prognostic factors for overall survival. CONCLUSION In this study of patients with retroperitoneal, complete resection and liposarcoma histology are prognostic factors related to the disease-free and overall survival. Patients approached with curative intent should undergo aggressive attempts at complete surgical resection.
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Affiliation(s)
- Dorian Yarih Garcia-Ortega
- Department of Skin and Soft Tissue Tumors, Instituto Nacional de Cancerologia (México), Av. San Fernando #22, Col. Sección XVI, Tlalpan, Mexico D.F., 14080, Mexico
| | - Oscar Villa-Zepeda
- Department of Skin and Soft Tissue Tumors, Instituto Nacional de Cancerologia (México), Av. San Fernando #22, Col. Sección XVI, Tlalpan, Mexico D.F., 14080, Mexico
| | - Héctor Martinez-Said
- Department of Skin and Soft Tissue Tumors, Instituto Nacional de Cancerologia (México), Av. San Fernando #22, Col. Sección XVI, Tlalpan, Mexico D.F., 14080, Mexico
| | - Mario Cuellar-Hübbe
- Department of Skin and Soft Tissue Tumors, Instituto Nacional de Cancerologia (México), Av. San Fernando #22, Col. Sección XVI, Tlalpan, Mexico D.F., 14080, Mexico
| | - Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerologia (México), Av. San Fernando #22, Col. Sección XVI, Tlalpan, Mexico D.F., 14080, Mexico.
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Abstract
OBJECTIVE: To describe clinical and demographic characteristics of the parapharyngeal space tumors and assess surgical approaches used to treat them at our institution. METHODS: A retrospective and descriptive study of the parapharyngeal space tumors, excluding paragangliomas, treated from June 1991 to October 2002 in a cancer center. The study population included 21 patients, 8 men and 13 women, average age of 41 years (range, 20 to 70 years). Fine needle biopsy was done in 5 (24%) patients. Computed tomography (CT) was performed in all patients, and only a few required magnetic resonance image (MRI). RESULTS: Surgical approaches included transcervical alone or in combination with parotidectomy, transoral, or transmandibular (mandibular swing) approach. Laminectomy and segmentary approaches were also performed in 1 patient each. Sixteen (76%) patients had benign lesions and 5 (24%) had malignant tumors. Neurogenic tumors represented 57% of all tumors. Mean tumor size was of 6.7 cm (range, 3 to 11 cm). Six (29%) patients received adjuvant radiotherapy. Complications occurred in 6 (29%) patients, 4 (19%) of which were nervous injuries associated with peripheral nerve sheath tumors. Median disease-free follow-up survival was 33 months (range, 2 to 184 months) despite being an heterogeneous group of histologies. CONCLUSION: Parapharyngeal space is a rare location for head and neck tumors. Cervical approach should be the first choice for large tumors; transoral approach is reserved for tumors less than 3 cm. Conversion to mandibular swing approach when the cervical approach is not offering proper exposure for tumor resection is indicated. Preoperative histologic diagnosis is not required. Nevertheless, CT scan should always be performed in order to exclude paragangliomas, distinguish prestyloid from poststyloid lesions, and to assess the extension of the tumor as well as its relationship with adjacent structures.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, at the Instituto Nacional de Cancerología, Tlalpan, Mexico.
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Luna-Ortiz K, Villa-Zepeda O, Carrillo J, Molina-Frias E, Gomez-Pedraza A. Parapharyngeal Space Tumor: Submandibular Approach Without Mandibulotomy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.12.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Luna-Ortiz K, Villavicencio-Valencia V, Rodríguez-Falconi A, Peteuil N, Mosqueda-Taylor A. Adenoid Cystic Carcinoma in a Mexican Population. J Maxillofac Oral Surg 2015; 15:236-42. [PMID: 27298548 DOI: 10.1007/s12663-015-0827-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 04/30/2015] [Accepted: 07/23/2015] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To analyze the demographic data, clinical behavior, management (surgery/radiotherapy), disease-free survival (DFS) and overall survival (OS) in Mexican Mestizos with adenoid cystic carcinoma (ACC). MATERIAL AND METHODS A retrospective study comprising all cases with histologic diagnosis of ACC of the head and neck treated from 1986 to 2012. RESULTS There were 101 cases (69 women and 32 men), with a mean age of 50 years; mean evolution time before diagnosis was 25 months (range 1-180 months). Most tumors involved maxillary sinus (25.8 %), followed by hard palate (15.9 %) and parotid gland (10.9 %). Surgery was the treatment in 81 cases (80.2 %), radiotherapy alone in 3 cases (3 %), chemo-radiotherapy in 4 cases (4 %) and 13 cases (12.9 %) did not receive any treatment. Post-surgery adjuvant radiotherapy was used in 58 cases (57.4 %); 6 cases (5.9 %) had adjuvant chemo-radiotherapy after surgery and 37 (36.6 %) cases did not receive any adjuvant treatment. Mean follow-up time was 52 months (range 1-288 months). Histologic patterns were cribriform (50.5 %), solid (28.7 %), and tubular (11.9 %) types. OS was 57.6 % and 42.3 % at 5 and 10 years respectively. DFS was 57.8 % at 5 years and 49.7 % at 10 years. CONCLUSIONS Initial management in most cases within this series was surgery followed by radiotherapy. There is more to learn about real benefits of molecular therapies. There were no significant differences in DFS and OS depending on site of involvement. OS did not show statistically significant differences amongst patients with positive and negative lymph nodes.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Departament of Head and Neck Surgery, Instituto Nacional de Cancerología, México, USA ; Department of General Surgery, Hospital General Dr. Manuel Gea Gonzalez, México, USA
| | | | | | - Nathalie Peteuil
- Universidad Nacional Autonoma de Mexico, Facultad de Psicologia, México, USA
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Garcia-Ortega DY, Gomez-Pedraza A, Luna-Ortiz K. Parapharyngeal space lipomatosis with secondary dyspnea, disphagia and disphonia. Int J Surg Case Rep 2015; 15:54-6. [PMID: 26318127 PMCID: PMC4601961 DOI: 10.1016/j.ijscr.2015.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 05/22/2015] [Revised: 08/10/2015] [Accepted: 08/11/2015] [Indexed: 12/03/2022] Open
Abstract
Parapharyngeal space tumors are a small percentage of all head and neck neoplasms. Due to their anatomic location, they represent a therapeutic challenge. To our knowledge, 11 cases of parapharyngeal lipomatous tumors have been reported in the literature. We presented a case of a 48 year old male with chief complaints of dyspnea, dysphagia and dysphonia was found to have a parapharyngeal space tumor. He was scheduled to undergo lumpectomy and neck exploration Open neck surgery is considered the gold-standard of treatment. It is important to bear in mind the lipomas of the parapharyngeal space to establish an accurate diagnosis and implement timely, appropriate treatment in order to avoid future complications and reduce morbidity and mortality.
Introduction Parapharyngeal space tumors are a small percentage of all head and neck neoplasms. Due to their anatomic location, they represent a therapeutic challenge. To our knowledge, 11 cases of parapharyngeal lipomatous tumors have been reported in the literature. Case A 48 year old male with chief complaints of dyspnea, dysphagia and dysphonia was found to have a parapharyngeal space tumor. He was scheduled to undergo lumpectomy and neck exploration. Discussion Benign tumors represented 70% of all cases. Open neck surgery is considered the gold-standard of treatment. Conclusion It is important to bear in mind the lipomas of the parapharyngeal space to establish an accurate diagnosis and implement timely, appropriate treatment in order to avoid future complications and reduce morbidity and mortality.
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Affiliation(s)
- Dorian Yarih Garcia-Ortega
- Department of Skin and Soft Tissue Tumors and Department of Head and Neck at the Instituto Nacional de Cancerología(México), Av San Fernando #22 Col Sección XVI, Tlalpan Distrito Federal CP 14080, Mexico.
| | - Antonio Gomez-Pedraza
- Department of Skin and Soft Tissue Tumors and Department of Head and Neck at the Instituto Nacional de Cancerología(México), Av San Fernando #22 Col Sección XVI, Tlalpan Distrito Federal CP 14080, Mexico
| | - Kuauhyama Luna-Ortiz
- Department of Skin and Soft Tissue Tumors and Department of Head and Neck at the Instituto Nacional de Cancerología(México), Av San Fernando #22 Col Sección XVI, Tlalpan Distrito Federal CP 14080, Mexico
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Yáñez-Barraza KL, Domínguez-Malagon HR, Mosqueda-Taylor A, Cano-Valdez AM, Luna-Ortiz K. Synchronic nasopharyngeal and intraparotid warthin tumors: A case report and literature review. J Clin Exp Dent 2014; 6:e435-9. [PMID: 25593670 PMCID: PMC4282915 DOI: 10.4317/jced.51441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 12/30/2013] [Accepted: 05/01/2014] [Indexed: 11/05/2022] Open
Abstract
Warthin tumor is the second most frequent benign salivary gland tumor after pleomorphic adenoma; it occurs almost exclusively in the parotid gland and peri-parotideal lymph nodes, although it may rarely present in other locations. It may be multicentric and bilateral in a small percentage of cases. Nasopharyngeal Warthin tumor is very rare, and the presence of a synchronic WT involving nasopharynx and parotid is an exceptional event, as it has been described only twice in the literature. In this article we report an additional case of a synchronic Warthin tumor and review the related literature. Key words:Warthin tumor, synchronic WT, multicéntrico, nasopharynx.
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Affiliation(s)
| | | | | | | | - Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerologia. México City
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Aslan ZAT, Granados-García M, Luna-Ortiz K, Guerrero-Huerta FJ, Gómez-Pedraza A, Namendys-Silva SA, Meneses-García A, Ordoñez-Mosquera JM. Anaplastic thyroid cancer: multimodal treatment results. Ecancermedicalscience 2014; 8:449. [PMID: 25114721 PMCID: PMC4118732 DOI: 10.3332/ecancer.2014.449] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Indexed: 11/06/2022] Open
Abstract
Background Anaplastic thyroid cancer is a rare and lethal disease. It accounts for 1–2% of thyroid malignancies, but specific mortality is higher than 90%. It is an aggressive locoregional disease with a high metastatic capacity. There is no agreement with regards to the best treatment. We analysed the results of treatment in a mestizo population treated in the National Cancer Institute (Mexico). Methods We reviewed 1,581 files of thyroid carcinomas; of these, 29 (1.83%) had anaplastic thyroid carcinoma. Demographic variables, clinical manifestations, tumour characteristics, and treatments were analysed. Results The median age was 64.5 ± 13.2 years. Females were more affected (female/male ratio: 2.6:1); 21 cases occurred in women (72.4%), and eight in males (27.6%). The most common manifestations were neck enlargement (93.10%) and hoarseness (71.31%). The median tumour size was 8 cm (range: 4–20 cm). The percentage of cases which presented in clinical stage IVA was 10.3%, with 62.1% presenting in clinical stage IVb and 27.6% presenting in clinical stage VIc. Complete resection (R0) (p = 0.05), radiation doses of higher than 33.1 Gy (p = 0.04), and multimodal therapy were associated with better survival. Surgery plus radiotherapy with or without systemic treatment (p = 0.006). The median overall survival was 119 days (IC 95%, 36.3–201.6). Six-month, one-year and two-year survival was 37.9%, 21% and 13%, respectively. Conclusion Complete surgical resection is associated with better survival but is very difficult to achieve due to aggressive biological behaviour. Multimodal therapy is associated with better survival and a better quality of life. There is a need for more effective systemic treatments as extensive surgical resections have little overall benefit in highly invasive and metastatic disease.
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Luna-Ortiz K, Cano-Valdez AM, da Cunha IW, Mosqueda-Taylor A. Synovial sarcoma of the larynx treated by supraglottic laryngectomy: case report and literature review. Ear Nose Throat J 2014; 92:E20-6. [PMID: 23904312 DOI: 10.1177/014556131309200717] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We describe a case of synovial sarcoma of the larynx, and we discuss the use of fluorescence in situ hybridization (FISH) in confirming the diagnosis. The patient was a 21-year-old woman who presented with a recurrence of a previously resected supraglottic tumor of the aryepiglottic folds. A horizontal supraglottic laryngectomy was performed, and the 0.5-cm tumor was resected. Histopathologic study suggested that it was a biphasic malignant tumor compatible with a synovial sarcoma. The diagnosis of synovial sarcoma was confirmed by FISH immunohistochemistry with the use of an SYT break-apart probe. The patient recovered satisfactorily, but at follow-up 5 years and 4 months later, tumoral activity was evident in the left side of the neck. A biopsy found that 5 lymph nodes contained a metastasis of the synovial sarcoma. Again, a bilateral neck dissection was performed, and it revealed that 16 of 16 right-side nodes and 36 of 36 left-side nodes were negative. Two months later, the patient received 46 Gy of radiotherapy in 23 sessions. She remained free of disease during 2 more years of follow-up. Synovial sarcoma of the larynx is a rare entity. Organ preservation seems to be indicated in these cases. The histologic diagnosis may be difficult. In this case, the identification of a genetic mutation corroborated the diagnosis.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, México City, México.
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Salcedo-Hernández RA, Luna-Ortiz K, Lino-Silva LS, Herrera-Gómez Á, Villavicencio-Valencia V, Tejeda-Rojas M, Carrillo JF. Conjunctival melanoma: survival analysis in twenty-two Mexican patients. Arq Bras Oftalmol 2014; 77:155-8. [DOI: 10.5935/0004-2749.20140040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 04/22/2014] [Indexed: 11/20/2022] Open
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Domínguez-Malagón HR, González-Conde E, Cano-Valdez AM, Luna-Ortiz K, Mosqueda-Taylor A. Expression of hormonal receptors in osteosarcomas of the jaw bones: clinico-pathological analysis of 21 cases. Med Oral Patol Oral Cir Bucal 2014; 19:e44-8. [PMID: 24121902 PMCID: PMC3909431 DOI: 10.4317/medoral.18729] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 08/16/2012] [Accepted: 03/16/2013] [Indexed: 11/23/2022] Open
Abstract
Background: Sexual hormones have an important role in many hormone-dependant tumors like breast and prostate carcinomas, and also a relationship has been found with bone metabolism and bone tumors. Some studies have demonstrated that the expression of hormonal receptors (HR) in osteosarcomas (OS) of long bones is associated with gender, histological grade, histological type, and possibly may be connection with pathogenesis and evolution. However, to our knowledge there are no studies of HR in osteosarcomas of craniofacial bones (OS-CF).
Objectives: To assess the expression of hormonal receptors in OS-CF.
Material and Methods: Twenty one cases of OS-CF were included in this study. Clinical outcome was obtained from clinical charts. Histological sections were reviewed, and immunohistochemistry studies for estrogen, progesterone and androgen receptors were performed.
Results: A striking female predominance was found (2:1), with a median age of 35 years. The predominant type of OS was osteoblastic (52.4%), and histological grade was high in 86%. Follow-up was obtained in 13 cases and ranged from 6 to 118 months (median 29 months). There were 8 patients (61.5%) dead or alive with progressive disease in the last follow up. Negative expression of HR was found in 19/21 cases; one showed weak nuclear expression for estrogen receptor, and another for androgen receptor. Progesterone receptor was negative in all cases.
Conclusions: OS-CF mostly affected females, most of them were of the osteoblastic type and of high grade. Hormonal expression was practically negative in osteosarcoma of craniofacial bones.
Key words:Osteosarcoma, jaws, estrogen, progesterone, androgen receptors.
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Affiliation(s)
- Hugo R Domínguez-Malagón
- Instituto Nacional de Cancerología, Department of Pathology, Av. San Fernando Núm. 22, Col Sección XVI, México D.F. CP 14080,
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Luna-Ortiz K, Gómez-Pedraza A, Mosqueda-Taylor A. Soft palate preservation after tumor resection with transoral laser microsurgery. Med Oral Patol Oral Cir Bucal 2013; 18:e445-8. [PMID: 23229273 PMCID: PMC3668871 DOI: 10.4317/medoral.18634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 07/08/2012] [Accepted: 08/08/2012] [Indexed: 11/30/2022] Open
Abstract
Background: Management and preservation of the soft palate is dependent on clinical stage and tumor histology. However, available literature is scarce regarding the palate preservation with the use of laser CO2.
Objectives: We report the results obtained after management with laser surgery and soft palate preservation in three patients with salivary gland neoplasms.
Method: Three patients with minor salivary gland tumors were treated by means of transoral laser microsurgery. All tumors were assessed using magnetic resonance imaging. All tumors were >3 cm. Soft palate function was preserved and reconstruction was performed with primary closure. Patients began oral feeding the same day and were discharged after 24 h.
Conclusions: Transoral laser microsurgery is recommended for treatment of soft palate tumors. This treatment can be considered a better option when compared with other modalities such as radio- or chemoradiotherapy which require a longer time of treatment, are more expensive and tend to produce significant toxicity.
Key words:Laser CO2, neoplasms, salivary gland.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Departamento de Cirugía de Cabeza y Cuello, Instituto Nacional de Cancerología, Mexico, DF, México
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Ortega-Gutiérrez C, Luna-Ortiz K, Villavicencio-Valencia V, Herrera Gómez A, Téllez-Palacios D, Contreras-Buendía M. [Hypothyroidism incidence after multimodal treatment for laryngeal cancer]. CIR CIR 2012; 80:448-450. [PMID: 23351449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Hypothyroidism following total laryngectomy or radiotherapy treatment for laryngeal cancer is not a rare event, especially in advanced stages. There are no reports on the incidence of hypothyroidism in patients who received chemotherapy and radiotherapy. The objective of this study is to determine the incidence of thyroid dysfunction in a group of patients with laryngeal cancer who underwent surgery as sole treatment, total laryngectomy or radiotherapy alone, and patients with combined treatment: surgery plus radiotherapy, concomitant chemoradiation therapy and chemoradiation therapy plus salvage surgery. METHODS A prospective study of patients diagnosed with laryngeal cancer whose serum TSH and T4 levels were evaluated in a serial fashion. RESULTS 70 patients with laryngeal cancer were studied; the average age at diagnosis was 70.2 years. Male patients were more affected, with a men-women ratio of 3.6:1. Glottic localization was the most frequent (44%). 64% of tumors were locally advanced carcinomas and 51% received multimodal treatment. 45 patients (63%) were diagnosed with hypothyroidism; 49% of the patients with subclinical hypothyroidism, and 51% with clinical hypothyroidism. CONCLUSIONS Hypothyroidism is a complication following treatment for laryngeal cancer. It is recommended to evaluate the thyroid function periodically for timely detection.
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Affiliation(s)
- César Ortega-Gutiérrez
- Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología, México, DF, Mexico.
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Salcedo-Hernández RA, Lino-Silva LS, Cantú de León D, Pérez-Montiel MD, Luna-Ortiz K. Ovarian undifferentiated carcinoma with voluminous mesenteric presentation. Int J Surg Case Rep 2012; 3:551-4. [PMID: 22922357 DOI: 10.1016/j.ijscr.2012.07.004] [Citation(s) in RCA: 2] [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] [Received: 06/27/2012] [Revised: 07/09/2012] [Accepted: 07/13/2012] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION About 5% of ovarian cancers are so poorly differentiated and difficult to classify that they are called undifferentiated carcinomas and usually have disseminated disease at presentation. Extra pelvic debulking it is difficult to complete. PRESENTATION OF CASE We report a case of a rare ovarian tumor presented as a large mesenteric tumor of 14cm diameter in a 73 years old woman. DISCUSSION Undifferentiated carcinomas are usually large, solid with hemorrhage and necrosis, bilateral and most are difficult to classify histologically. Rarely are pure, generally identified through the extensive sampling of lesions, some other components of surface epithelial carcinoma and usually the predominant element is the latter. Cases with predominantly undifferentiated component are rare. CONCLUSION The treatment and diagnostic approach is the same as for other high-grade epithelial tumors of the ovary, but in this particular case the differential diagnosis and diagnostic approach is that of a mesenteric tumor.
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Luna-Ortiz K, Güemes-Meza A, Villavicencio-Valencia V, Mosqueda-Taylor A. Upper lip malignant neoplasms. A study of 59 cases. Med Oral Patol Oral Cir Bucal 2012; 17:e371-6. [PMID: 22143714 PMCID: PMC3475642 DOI: 10.4317/medoral.17501] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [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: 01/23/2011] [Accepted: 03/23/2011] [Indexed: 11/08/2022] Open
Abstract
Objectives: To present the demographic data, clinico-pathologic features and therapeutic outcome of a series of upper lip malignancies.
Study Design: Retrospective study at a single Cancer Institution in Mexico City during a 14-year period.
Results: There were 59 cases, (30 males and 29 females); age range: 14 to 106 years (mean: 73 yr.). Antecedents of ultraviolet light and tobacco exposure were found in 20 (33.9%) and 16 cases (27%) respectively. There were 35 squamous cell carcinomas (59.3%), 19 basal cell carcinomas (32.2%) and one case each (1.7%) of adenocarcinoma NOS, adenoid cystic carcinoma, angiosarcoma, Merkel cell carcinoma and melanoma. There were 14 cases in stage I (23.7%), 14 in stage II (23.7%), 3 in stage III (5.1%) 14 in stage IV (23.7%) and 14 were not classified (23.7%). There were no significant differences with respect to the overall survival curve and the disease-free survival curve among surgical treatment and radiotherapy. In addition, there was not statistically significant difference in the overall survival and disease-free survival among squamous cell carcinoma and basal cell carcinoma cases with respect to the type of treatment.
Conclusions: Upper lip malignant neoplasms are infrequent lesions. The present series describes the main clinico-pathological features in a hospital-based population in Mexico city and demonstrates some differences with respect to those found in the lower lip.
Key words:Upper lip, neoplasms, basal cell carcinoma, squamous cell carcinoma, melanoma.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, México.
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Salcedo-Hernández RA, Lino-Silva LS, Luna-Ortiz K. Maxillary Sinus Sarcomas: Epidemiological and Clinicopathological Experience of 25 Years in a National Reference Cancer Center. Indian J Otolaryngol Head Neck Surg 2012; 66:359-64. [PMID: 26396944 DOI: 10.1007/s12070-012-0522-9] [Citation(s) in RCA: 5] [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: 10/26/2011] [Accepted: 02/10/2012] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to report our experience with malignant soft tissue tumors of the maxillary sinus in the period between 1985 to 2010. This is a retrospective case study in a tertiary cancer center setting. Review of patient's records and new evaluation of pathological specimens were made for 20 patients (14 men and 6 women) still met present criteria. After review the most common histological diagnoses were malignant peripheral nerve sheath tumor and malignant fibrous histiocytoma. There are male sex predilection, the median age was 38.9 years; 95% of tumors were >5 cm, 80% were high grade, 0% have metastatic disease at the diagnosis and the tumors were initially treated by surgical resection had better survival (p = 0.02). We present the results of a one of the larger series published to date in maxillary sinus sarcomas where analyzed the clinicopathological characteristics of 20 cases.
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Affiliation(s)
| | - Leonardo Saúl Lino-Silva
- Departamento de Patología Oncológica, Instituto Nacional de Cancerología, Avenida San Fernando No. 22, Colonia Sección XVI, 14080 México, DF Mexico
| | - Kuauhyama Luna-Ortiz
- Departamento de Cirugía de Cabeza y Cuello, Instituto Nacional de Cancerología, México, DF Mexico
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Luna-Ortiz K, Ortega-Gutierrez C, Dominguez-Malagon H, Mosqueda-Taylor A. Extraosseous osteosarcoma in the neck. Auris Nasus Larynx 2011; 39:333-6. [PMID: 21873010 DOI: 10.1016/j.anl.2011.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 07/27/2011] [Accepted: 07/28/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Extraosseous osteosarcoma arising in the head and neck region is an exceptional finding, with a few isolated cases informed in the literature. We report a new case of a large high-grade extraosseous osteosarcoma located in the neck. CASE PRESENTATION A 74 year-old woman with a tumor on the right side of the neck was treated by complete surgical resection. The histopathological diagnosis was osteoblastic extraosseous osteosarcoma. PET-CT scan disclosed no evidence of disease in other areas. Patient received adjuvant radiotherapy and after 3 months of follow-up tumor activity was detected in the cavernous sinus and the patient died of disease one month later. CONCLUSION Extraosseous osteosarcoma in head and neck region is exceptional, and incisional biopsy is the only method to establish a diagnosis and the one to differentiate it from other bone-producing soft tissue tumors. Surgery is the gold standard for treatment of extraosseous osteosarcoma.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerologia, México.
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Luna-Ortiz K, Campos-Ramos E, Pasche P, Mosqueda-Taylor A. Oral mucosal melanoma: conservative treatment including laser surgery. Med Oral Patol Oral Cir Bucal 2011; 16:e381-5. [PMID: 20711113 DOI: 10.4317/medoral.16.e381] [Citation(s) in RCA: 8] [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: 03/28/2010] [Accepted: 04/28/2010] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To discuss the convenience of laser surgery as optimal treatment for melanoma of the oral mucosa. PATIENTS AND METHODS A retrospective evaluation of four patients with primary oral melanomas treated at a single Cancer Institution in Mexico City. RESULTS Two patients were treated with resection of the melanoma with CO2 laser together with extraction of the involved dental organs and curettage of the alveolar walls. These two cases had melanoma in situ with multiple isolated foci. The third patient had a lesion with vertical growth, who was submitted to partial maxillectomy along with selective dissection of bilateral neck levels I-V with a negative report and the fourth patient had a history of oral nodular melanoma and presented with lymph node metastasis. According to follow-up status, there was no distant metastasis in any of the patients reported here. CONCLUSION In our experience, conservative management with CO2 laser is adequate for melanomas of the oral mucosa with extraction of the dental organs and curettage of the alveoli to achieve complete surgical resection microscopically without sacrifice of the quality of life. Management of the neck is controversial. We recommend selective therapeutic resection of the neck only if it is found to be clinically positive. Elective dissection has not shown to have an impact in overall survival.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av. San Fernando 22, Col. Sección XVI, 14080 Mexico, D.F., Mexico.
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Luna-Ortiz K, Villavicencio-Valencia V, Pasche P, Lavin-Lozano A, Herrera-Gómez Á. Cáncer de laringe en pacientes menores de 40 años comparado con mayores de 40 años: análisis de pares. Acta Otorrinolaringológica Española 2011; 62:113-8. [DOI: 10.1016/j.otorri.2010.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 08/06/2010] [Accepted: 09/03/2010] [Indexed: 10/18/2022]
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Luna-Ortiz K, Villavicencio-Valencia V, Pasche P, Lavin-Lozano A, Herrera-Gómeza Á. Laryngeal cancer in patients younger vs older than 40 years old: a matched-paired analysis. Acta Otorrinolaringologica (English Edition) 2011. [DOI: 10.1016/s2173-5735(11)70020-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Luna-Ortiz K, Campos-Ramos E, Villavicencio-Valencia V, Contreras-Buendía M, Pasche P, Gómez AH. Vertical partial hemilaryngectomy with reconstruction by false cord imbrication. ANZ J Surg 2010; 80:358-63. [PMID: 20557512 DOI: 10.1111/j.1445-2197.2010.05280.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND To evaluate global survival, disease-free period, complications, evolution and function in vertical partial hemilaryngectomy (VPHL) plus reconstruction with false cord. METHODS Descriptive and retrospective study. In aertiary care medical center in Mexico City. Eight patients with early diagnosis of early glottic cancer (T1 and T2), treated with VPHL plus reconstruction with false cord imbrication. RESULTS Fifty percent of the patients were clinical stage I, 37.5% stage II and 12.5% stage III. Nasogastric tube was not placed and oral feeding was reinitiated within 3 days on average. Tracheostomy was removed after an average of 2.1 days. Average hospital stay was 3.3 days. Average of the PSS-HNC (Performance Status for Head and Neck Cancer) and Karnofsky Performance Status evaluation was 91 to 97 and 100 at 1 year of evaluation. Voice evaluation demonstrated normal voice in 87.5% of patients. Intensity was below normal with improvement on annual evaluation. Global survival was 100% and disease-free period was 71% at 3 years. CONCLUSIONS VPHL with reconstruction by false cord imbrication is an excellent therapeutic option for early glottic cancers. Multiple functional advantages are demonstrated without sacrificing oncological control as well as providing an audible and intelligible voice. In cases of recurrence, various management options are available.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología (México), Mexico City, Mexico.
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Luna-Ortiz K, Villavicencio-Valencia V, Carmona-Luna T, Cano-Valdez AM, Herrera Gómez A. Resección de tumor de cuerpo carotideo con LigaSure®. Acta Otorrinolaringológica Española 2010; 61:6-11. [DOI: 10.1016/j.otorri.2009.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Accepted: 07/11/2009] [Indexed: 10/20/2022]
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Mosqueda-Taylor A, Cano-Valdéz AM, Ruiz-González JDS, Ortega-Gutiérrez C, Luna-Ortiz K. Hybrid salivary gland tumor of the upper lip or just an adenoid cystic carcinoma? Case report. Med Oral Patol Oral Cir Bucal 2010; 15:e43-7. [PMID: 19680176 DOI: 10.4317/medoral.15.e43] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Accepted: 05/08/2009] [Indexed: 11/05/2022] Open
Abstract
UNLABELLED A 65 year-old male patient with a one year-duration tumoral growth located in the upper lip was diagnosed on incisional biopsy as epithelial-myoepithelial carcinoma. After wide surgical excision the histopathological analysis revealed the lesion was composed predominantly (>90%) of adenoid cystic carcinoma. In new sections it was found a very small and isolated area of adenoid cystic carcinoma at the bottom of the incisional biopsy. As surgical margins were free of lesion, no adjuvant treatment was given. The occurrence of a transitory ischaemic attack at 36 months of follow-up led to a neurological and MRI evaluation, which disclosed a well-defined 3.5 x 3 cm lesion suggestive of metastasis, located on the right temporal area. The lesion was surgically removed and a histopathological diagnosis of neurocysticercosis was rendered. After 40 months of follow-up there is no evidence of recurrence. CONCLUSION True hybrid tumors of salivary glands are rare and treatment in each case should be done according to the component with the higher aggressiveness. However, the occurrence of epithelial-myoepithelial carcinoma areas within an adenoid cystic carcinoma seems to be a frequent finding, and because both lesions share a common origin, some authors consider that this may not be a true hybrid neoplasm but a variant of the latter.
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Luna-Ortiz K, Pasche P, Tamez-Velarde M, Villavicencio-Valencia V. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy in patients with radiation therapy failure. World J Surg Oncol 2009; 7:101. [PMID: 20021681 PMCID: PMC2801667 DOI: 10.1186/1477-7819-7-101] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [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: 04/27/2009] [Accepted: 12/19/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To assess functional results, complications, and success of larynx preservation in patients with recurrent squamous cell carcinoma after radiotherapy. METHODS From a database of 40 patients who underwent supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) from June 2001 to April 2006, eight patients were treated previously with radiotherapy due to squamous cell carcinoma of the glottic region and were treated for recurrence at the site of the primary cancer. RESULTS SCPL with CHEP was performed in six men and two women with a mean age of 67 years due to recurrence and/or persistence at a mean time of 30 months postradiotherapy (in case #8 after concomitant chemoradiotherapy). Bilateral neck dissection at levels II-V was performed in six patients. Only case #8 presented metastasis in one node. In case #5, Delphian node was positive. It was possible to preserve both arytenoids in five cases. Definitive surgical margins were negative. Complications were encountered in seven patients. Follow-up was on average 44 months (range: 20-67 months). Organ preservation in this series was 75%, and local control was 87%. Overall 5-year survival was 50%. CONCLUSIONS In selected patient with persistence and/or recurrence after radiotherapy due to cancer of the larynx, SCPL with CHEP seems to be feasible with acceptable local control and toxicity. Complications may occur as in previously non-irradiated patients. These complications must be treated conservatively to avoid altering laryngeal function.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av, San Fernando #22, Tlalpan, Mexico, D,F,, 14080, Mexico.
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Herrera-Gómez A, Villavicencio-Valencia V, Rascón-Ortiz M, Luna-Ortiz K. Demographic data of laryngeal cancer at the Instituto Nacional de Cancerología in Mexico City. CIR CIR 2009; 77:353-357. [PMID: 19944022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND We undertook this study to describe the demographic data of patients with laryngeal cancer treated at the Instituto Nacional de Cancerología in Mexico City. METHODS We retrospectively reviewed the clinical files from 1986 to 2002, revealing 500 patients. RESULTS Included were 452 men (90.4%) and 48 women (9.6%) (M:F ratio--10.6:1). Average age of patients was 62.37 years. The highest incidence of patients was among those aged 56 to 70 years. Smoking and alcoholism were present in most patients from this series. The cardinal symptom of presentation was dysphonia in 458 patients (91.6%). The mean evolution time of symptomatology was 11.6 months. The most common localization of the tumor was the glottis (61.6%). One hundred forty two patients (28.4%) presented early-stage tumors (T1-T2) and 354 patients (70.8%) presented with late-stage tumors (T3-T4). Clinically, 165 patients (33.0%) presented adenopathies and 13 patients (2.6%) had metastases at the time of diagnosis; 483 patients (96.6%) presented with invasive epidermoid cancer. Of these, 325 patients received treatment. One hundred forty six patients (44.9%) presented local recurrence, in nine patients (2.8%) there was regional recurrence, and one patient (0.3%) recurred with a distant tumor. Adequate control of the primary tumor was achieved with the established treatment in 169 patients (52%). verage survival time of the 325 treated patients was 38 months. CONCLUSIONS Cancer of the larynx is a potentially curable entity. In any patient with major dysphonia of >1 month evolution, a differential diagnosis of cancer must be made. The survival prognosis for patients with cancer of the larynx is determined by the initial clinical stage.
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Affiliation(s)
- Angel Herrera-Gómez
- Departamento de Cirugía Oncológica, Instituto Nacional de Cancerología, México, D.F., Mexico
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