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Chung CS, Wu CY, Lin YH, Lo WC, Cheng PC, Hsu WL, Liao LJ. Screening and surveillance of esophageal cancer by magnifying endoscopy with narrow band imaging improves the survival of hypopharyngeal cancer patients. Front Oncol 2024; 13:1221616. [PMID: 38322289 PMCID: PMC10844580 DOI: 10.3389/fonc.2023.1221616] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/31/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction Patients with head and neck cancer may develop a second primary neoplasm (SPN) of the esophagus due to field cancerization. This study investigated the impacts of esophageal cancer screening using magnifying endoscopy with narrow-band imaging (ME-NBI) on the outcomes of hypopharyngeal cancer patients. Methods Patients with hypopharyngeal cancer diagnosed from 2008 to 2021 in a tertiary hospital were reviewed retrospectively. Screening and surveillance using ME-NBI examination of the esophagus were divided into three patterns: (1) ME-NBI never performed or more than 6 months after diagnosis of index primary hypopharyngeal cancer, (2) ME-NBI within 6 months only, and (3) ME-NBI within 6 months and regular surveillance. Results A total of 261 were reviewed and 21 (8%) patients were in stage I, 20 (8%) in stage II, 27 (10%) in stage III, 116 (44%) in stage IVA, 65 (25%) in stage IVB, and 12 (5%) in stage IVC. Sixty-seven (26%) patients had SPN (50 esophagus, 10 oral cavity, 3 oropharynx, 2 nasopharynx, 1 larynx and 1 lung). Among esophageal SPN, 35 (70%) and 15 (30%) patients developed synchronous and metachronous neoplasia, respectively. In multivariate Cox regression analysis, advanced stages III and IV (compared with stages I and II, HR: 1.86, 1.18-2.95, p=0.008), ME-NBI examination of the esophagus received within 6 months and regular surveillance (HR: 0.53, 0.36-0.78, p=0.001) were independent factors affecting the overall survival of patients with hypopharyngeal cancer. Discussion Our findings demonstrated that screening and surveillance of esophageal SPN by ME-NBI improves the survival of patients with hypopharyngeal cancer.
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Affiliation(s)
- Chen-Shuan Chung
- Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Chia-Yun Wu
- Department of Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yu-Hsuan Lin
- Department of Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Master’s Program of Big Data Analysis in Biomedicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
| | - Ping-Chia Cheng
- Department of Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Wan-Lun Hsu
- Master’s Program of Big Data Analysis in Biomedicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Li-Jen Liao
- Department of Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
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Yeh P, Chang CM, Liao LJ, Wu CY, Hsieh CH, Shueng PW, Cheng PW, Lo WC. A predictive survival model for patients with stage IV oropharyngeal squamous cell carcinoma treated with chemoradiation. Eur Arch Otorhinolaryngol 2024; 281:369-377. [PMID: 37594545 DOI: 10.1007/s00405-023-08187-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/09/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE To evaluate the pre-treatment and post-treatment clinical factors associated with rate of survival at 1, 3, and 5 years in stage IV oropharyngeal cancer patients treated with concurrent chemoradiation with/without neoadjuvant chemotherapy. METHODS This retrospective cohort study involved 128 Stage IV oropharyngeal cancer patients that were treated at our tertiary referral center between 2008 and 2020. The pre-treatment and post-treatment clinical parameters including nutritional status and inflammatory markers were retrospectively reviewed. RESULTS The 5-year overall survival rate for all patients was 36.72%. The disease-specific survival (DSS) at 1-year and 3-year were 80% and 63%, whereas the disease-free survival (DFS) at 1-year and 3-year were 49% and 40%, respectively. In multivariate analyses, pretreatment hemoglobin (Hb) < 12 g/dL (hazard ratio [HR] 2.551, 95% confidence interval [CI] 1.366-4.762, p = 0.003), pretreatment systemic immune inflammation (SII) ≥ 1751 (HR 2.173, 95% CI 1.015-4.652, p = 0.046), and posttreatment systemic inflammation response index (SIRI) ≥ 261 (HR 2.074, 95% CI 1.045-4.115, p = 0.037) were independent indicators for worsened DSS. Pretreatment Hb < 12 g/dl (HR 1.692, 95% CI 1.019-2.809, p = 0.032), pretreatment SII ≥ 1751 (HR 1.968, 95% CI 1.061-3.650, p = 0.032), and posttreatment SII ≥ 1690 (HR 1.922, 95% CI 1.105-3.345, p = 0.021) were independent indicators for worsened DFS. A nomogram was developed using pretreatment Hb, pretreatment SII, and posttreatment SIRI to forecast DSS. CONCLUSIONS The pretreatment Hb, pretreatment SII, posttreatment SII, and posttreatment SIRI are associated with survival in patients with stage IV oropharyngeal cancers. The developed nomogram aids in survival prediction and treatment adjustment.
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Affiliation(s)
- Peng Yeh
- Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Pan Chiao District, 220, New Taipei City, Taiwan
| | - Chih-Ming Chang
- Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Pan Chiao District, 220, New Taipei City, Taiwan
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Pan Chiao District, 220, New Taipei City, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Chia-Yun Wu
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chen-Hsi Hsieh
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Radiology, Division of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Wei Shueng
- Department of Radiology, Division of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Pan Chiao District, 220, New Taipei City, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Pan Chiao District, 220, New Taipei City, Taiwan.
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan.
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Lu YF, Wu CY, Lo WC, Chiu YL, Shueng PW, Hsieh CH, Hsu CX, Kuo DY, Hou PY, Liao LJ. Postchemoradiotherapy systemic inflammation response index predicts treatment response and overall survival for patients with locally advanced nasopharyngeal cancer. J Formos Med Assoc 2023; 122:1141-1149. [PMID: 37202235 DOI: 10.1016/j.jfma.2023.05.003] [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: 02/02/2023] [Revised: 04/15/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND/PURPOSE To explore the clinical utility of the systemic inflammation response index (SIRI) in the prediction of patients with poor treatment response to concurrent chemoradiotherapy (CCRT) in locally advanced nasopharyngeal cancer (NPC). METHODS A total of 167 stage III-IVB (AJCC 7th edition) nasopharyngeal cancer patients who received CCRT were retrospectively collected. The SIRI was calculated using the following formula: SIRI = neutrophil count × monocyte count/lymphocyte count (109/L). The optimal cutoff values of the SIRI for noncomplete response were determined by receiver operating characteristic curve analysis. Logistic regression analyses were performed to identify factors predictive of treatment response. We used Cox proportional hazards models to identify predictors of survival. RESULTS Multivariate logistic regression showed that only the posttreatment SIRI was independently associated with treatment response in locally advanced NPC. A posttreatment SIRI≥1.15 was a risk factor for developing an incomplete response after CCRT (odds ratio 3.10, 95% confidence interval (CI): 1.22-9.08, p = 0.025). A posttreatment SIRI≥1.15 was also an independent negative predictor of progression-free survival (hazard ratio 2.38, 95% CI: 1.35-4.20, p = 0.003) and overall survival (hazard ratio 2.13, 95% CI: 1.15-3.96, p = 0.017). CONCLUSION The posttreatment SIRI could be used to predict the treatment response and prognosis of locally advanced NPC.
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Affiliation(s)
- Yueh-Feng Lu
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chia-Yun Wu
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Division of Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wu-Chia Lo
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
| | - Yen-Ling Chiu
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan; Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chen-Xiong Hsu
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Deng-Yu Kuo
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Pei-Yu Hou
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Li-Jen Liao
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.
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Yeh P, Lo WC, Chang CM. Man with worsening odynophagia. Emerg Med J 2023; 40:563-619. [PMID: 37487635 DOI: 10.1136/emermed-2022-212650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 07/26/2023]
Affiliation(s)
- Peng Yeh
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan City, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei City, Taiwan
| | - Chih-Ming Chang
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei City, Taiwan
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei City, Taiwan
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Cheng PC, Chang CM, Liao LJ, Hsieh CH, Shueng PW, Cheng PW, Lo WC. Ultrasound Is Beneficial to Determine Lymphadenopathy in Oral Cancer Patients after Radiotherapy. Diagnostics (Basel) 2023; 13:2409. [PMID: 37510156 PMCID: PMC10378444 DOI: 10.3390/diagnostics13142409] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
The present study aimed to investigate whether the addition of ultrasound (US) +/- fine needle aspiration (FNA) to magnetic resonance imaging (MRI) or computed tomography (CT) improves the diagnostic accuracy in assessing neck lymphadenopathy in oral cancer patients after neck irradiation. We retrospectively reviewed oral cancer patients who had neck lymphadenopathy after radiotherapy (RT) or chemoradiation therapy (CRT) from February 2008 to November 2019. The following diagnostic modalities were assessed: (1) MRI/CT, (2) MRI/CT with a post-RT US predictive model, and (3) MRI/CT with US + FNA. The receiver operating characteristic (ROC) curves were used to assess the diagnostic performance. A total of 104 irradiation-treated oral cancer patients who subsequently had neck lymphadenopathy were recruited and analyzed. Finally, there were 68 (65%) malignant and 36 (35%) benign lymphadenopathies. In terms of the diagnostic performance, the area under the ROC curves (C-statistics) was 0.983, 0.920, and 0.828 for MRI/CT with US + FNA, MRI/CT with a post-RT US predictive model, and MRI/CT, respectively. The addition of US to MRI/CT to evaluate cervical lymphadenopathy could achieve a better diagnostic accuracy than MRI/CT alone in oral cancer patients after neck irradiation.
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Affiliation(s)
- Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Department of Communication Engineering, Asia Eastern University of Science and Technology, New Taipei City 22061, Taiwan
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Chih-Ming Chang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan 32003, Taiwan
- Medical Engineering Office, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
| | - Chen-Hsi Hsieh
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
| | - Pei-Wei Shueng
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan 32003, Taiwan
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Lo WC, Cheng PC, Hsu WL, Cheng PW, Liao LJ. A Novel Prediction Model Based on Quantitative Texture Analysis of Sonographic Images for Malignant Major Salivary Glandular Tumors. J Med Ultrasound 2023; 31:218-222. [PMID: 38025013 PMCID: PMC10668912 DOI: 10.4103/jmu.jmu_65_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/26/2022] [Accepted: 08/09/2022] [Indexed: 12/01/2023] Open
Abstract
Background The aim of this study was to compare multiple objective ultrasound (US) texture features and develop an objective predictive model for predicting malignant major salivary glandular tumors. Methods From August 2007 to May 2018, 144 adult patients who had major salivary gland tumors and subsequently underwent surgery were recruited for this study. Representative brightness mode US pictures were selected for texture analysis and used to develop a prediction model. Results We found that the grayscale intensity and standard deviation of the intensity were significantly different between malignant and pleomorphic adenomas. The contrast, inverse difference (INV) movement, entropy, dissimilarity, and INV also differed significantly between benign and malignant tumors. We used stepwise selection of predictors to develop an objective predictive model, as follows: Score = 1.138 × Age - 1.814 × Intensity + 1.416 × Entropy + 1.714 × Contrast. With an optimal cutoff of 0.58, the diagnostic performance of this model had a sensitivity, specificity, overall accuracy, and area under the curve of 83% (95% confidence interval [CI]: 74%-92%), 74% (65%-84%), 78% (72%-85%), and 0.86 (0.80-0.92), respectively. Conclusion We have developed a novel computerized diagnostic model based on objective US features to predict malignant major salivary gland tumor. Further improving the computer-aided diagnosis model might change the US examination for major salivary gland tumors in the future.
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Affiliation(s)
- Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
| | - Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Communication Engineering, Asia Eastern University of Science and Technology, New Taipei, Taiwan
| | - Wan-Lun Hsu
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
- Biomedical Engineering Office, Far Eastern Memorial Hospital, Taipei, Taiwan
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Liu CW, Lo WC. Enormous Asymptomatic Intraoral Sialolithiasis: A Case Report. Ear Nose Throat J 2023:1455613231181221. [PMID: 37329274 DOI: 10.1177/01455613231181221] [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] [Indexed: 06/19/2023] Open
Abstract
Sialolithiasis is one of the most common diseases of salivary glands. More than 80% of the sialoliths occur in the submandibular gland. While most of the calculi are less than 10 mm in size, 7.6% are larger than 15 mm and are classified as giant sialoliths. We demonstrate a rare case of asymptomatic giant sialolith in the left Wharton's duct with a total atrophy of the left submandibular salivary gland. A 48-year-old female patient presented with lumping sensation for 1 month. A left mouth floor mass was found accidentally during examination and was later revealed to be a painless sialolithiasis. Image study revealed a giant sialolith in the left Wharton's duct with duct dilatation and left submandibular gland total atrophy. She underwent transoral sialolithotomy with removal of a huge stone, measuring 3.5 × 1.4 cm in size. Sialolithiasis usually presents with typical symptoms of the involved salivary gland, and the size of calculi is usually less than 20 mm. This is a rare case report of an asymptomatic giant sialolith in the Wharton's duct, causing left submandibular salivary gland total atrophy, and its diagnosis and management.
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Affiliation(s)
- Chia-Wei Liu
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City
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Cheng PC, Kao YC, Lo WC, Cheng PW, Wu CY, Hsieh CH, Shueng PW, Wang CT, Liao LJ. Speech and Swallowing Rehabilitation Potentially Decreases Body Weight Loss and Improves Survival in Head and Neck Cancer Survivors. Dysphagia 2023; 38:641-649. [PMID: 35819528 DOI: 10.1007/s00455-022-10493-7] [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: 02/12/2022] [Accepted: 06/28/2022] [Indexed: 11/03/2022]
Abstract
This retrospective observational cohort study aims to assess the outcomes and associated factors in head and neck cancer (HNC) survivors with dysphagia, and to investigate the relationship between outcomes and speech and swallowing rehabilitation (SSR). We enrolled patients who were diagnosed with HNC between October 2016 and July 2018; we included 393 patients who developed dysphagia after definite treatment and were referred to speech-language pathologists (SLPs). We then classified patients into groups according to whether they received SSR. We used the clinical variables-including age, sex, site of malignancy, cancer stage, treatment modality, SSR, initial ECOG score, initial KPS, initial body weight (BW), and initial BMI-to evaluate the association between the percentage of BW change and overall survival (OS). There were 152 (39%) and 241 (61%) patients who received and did not receive SSR, respectively. In multivariate linear regression, SSR was significantly associated with percentage change in BW at 3 months post-treatment. Having SSR was positively associated with the percentage change in BW and decreased the BW loss [β coefficient (95% CIs) = 2.53 (0.92 to 4.14)] compared to having no SSR. In the multivariate Cox regression, SSR was an independent factor for OS. Compared to no SSR, the hazard ratio (95% CIs) for patients who received SSR was 0.48 (0.31 to 0.74). SSR helps to avoid BW loss and increases overall survival. HNC patients who develop dysphagia after treatment should be encouraged to participate in SSR.
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Affiliation(s)
- Ping-Chia Cheng
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City, 220, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Communication Engineering, Asia Eastern University of Science and Technology, New Taipei City, Taiwan
| | - Yih-Chia Kao
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City, 220, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City, 220, Taiwan
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City, 220, Taiwan
| | - Chia-Yun Wu
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chen-Hsi Hsieh
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Pei-Wei Shueng
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chi-Te Wang
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City, 220, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City, 220, Taiwan.
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.
- Medical Engineering Office, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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Cheng PC, Chang CM, Liao LJ, Hsieh CH, Shueng PW, Cheng PW, Lo WC. Ultrasound examination supporting CT or MRI in the evaluation of cervical lymphadenopathy in patients with irradiation-treated head and neck cancer. Open Med (Wars) 2023; 18:20230682. [PMID: 37069937 PMCID: PMC10105548 DOI: 10.1515/med-2023-0682] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 02/11/2023] [Accepted: 03/01/2023] [Indexed: 04/19/2023] Open
Abstract
In this study, we determined the diagnostic performance of adding ultrasound (US) with/without fine-needle aspiration cytology (FNAC) to computed tomography (CT)/magnetic resonance imaging (MRI) in evaluating neck lymphadenopathy (LAP) in patients with head and neck cancer treated with irradiation. We included 269 patients who had neck LAP after radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) resulting from cancers of the head and neck region between October 2008 and September 2018. The diagnostic methods consisted of the following: 1) CT/MRI alone, 2) CT/MRI combined with a post-RT US predictive model, and 3) CT/MRI combined with US + FNAC. We compared their diagnostic performance using receiver operating characteristic (ROC) curves. In total, 141 (52%) malignant and 128 (48%) benign LAPs were observed. Regarding the diagnostic accuracy, the area under the ROC curves was highest for the combined CT/MRI and US + FNAC (0.965), followed by the combined CT/MRI and post-RT US predictive model (0.906) and CT/MRI alone (0.836). Our data suggest that the addition of a US examination to CT/MRI resulted in higher diagnostic performance than CT/MRI alone in terms of diagnosing recurrent or persistent nodal disease during the evaluation of LAP in patients with irradiation-treated head and neck cancer.
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Affiliation(s)
- Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan (R.O.C.)
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
- Department of Communication Engineering, Asia Eastern University of Science and Technology, New Taipei City, Taiwan (R.O.C.)
| | - Chih-Ming Chang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan (R.O.C.)
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan (R.O.C.)
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan (R.O.C.)
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan (R.O.C.)
- Medical Engineering Office, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan (R.O.C.)
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan (R.O.C.)
| | - Po-Wen Cheng
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Wu-Chia Lo
- Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan (R.O.C.)
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banqiao Dist., New Taipei City 220, Taiwan (R.O.C.)
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10
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Lo WC, Chang CM, Cheng PC, Wen MH, Wang CT, Cheng PW, Liao LJ. The Applications and Potential Developments of Ultrasound in Oral Cancer Management. Technol Cancer Res Treat 2022; 21:15330338221133216. [PMID: 36254559 PMCID: PMC9580086 DOI: 10.1177/15330338221133216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Oral cancer is endemic and causes a great burden in Southern Asia. It is preferably treated by surgery with/without adjuvant radiotherapy (RT) or chemoradiation therapy, depending on the stage of the disease. Close or positive resection margin and cervical lymph node (LN) metastasis are important prognostic factors that have been presented to be related to undesirable locoregional recurrence and poor survival. Ultrasound (US) is a simple, noninvasive, time-saving, and inexpensive diagnostic modality. It can depict soft tissues very clearly without the risk of radiation exposure. Additionally, it is real-time and continuous image is demonstrated during the exam. Furthermore, the clinician can perform US-guided fine needle aspiration (FNA) or core needle biopsy (CNB) at the same time. US with/without US-guided FNA/CNB is reported to be of value in determining tumor thickness (TT), depth of invasion (DOI), and cervical LN metastasis, and in aiding the staging of oral cancer. DOI has a relevant prognostic value as reported in the eighth edition of the American Joint Committee on Cancer staging of oral cancer. In the present review, we describe the clinical applications of US in oral cancer management in different phases and potential applications in the future. In the pretreatment and surgical phase, US can be used to evaluate TT/DOI and surgical margins of oral cancer in vivo and ex vivo. The prediction of a malignant cervical LN (nodal metastasis) by the US-based prediction model can guide the necessity of FNA/CNB and elective neck dissection in clinical early-stage oral cancer. In the posttreatment surveillance phase, US with/without US-guided FNA or CNB is helpful in the detection of nodal persistence or LN recurrence, and can assess the possibility and extent of carotid artery stenosis after irradiation therapy. Both US elastography and US swallowing assessment are potentially helpful to the management of oral cancer.
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Affiliation(s)
- Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Graduate Institute of Medicine, Yuan Ze University, Taoyuan,Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City
| | - Chih-Ming Chang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Department of Biomedical Engineering, National Yang-Ming University, Taipei
| | - Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City,Department of Biomedical Engineering, National Yang-Ming University, Taipei,Department of Communication Engineering, Asia Eastern University of Science and Technology, New Taipei City
| | - Ming-Hsun Wen
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei
| | - Chi-Te Wang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Department of Electrical Engineering, Yuan Ze University, Taoyuan
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei,Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City,Department of Electrical Engineering, Yuan Ze University, Taoyuan,Li-Jen Liao, MD, PhD, Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Banqiao, New Taipei 22061.
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11
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Lin PY, Cheng PC, Hsu WL, Lo WC, Hsieh CH, Shueng PW, Liao LJ. Risk of CVD Following Radiotherapy for Head and Neck Cancer: An Updated Systematic Review and Meta-Analysis. Front Oncol 2022; 12:820808. [PMID: 35719982 PMCID: PMC9198239 DOI: 10.3389/fonc.2022.820808] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 05/02/2022] [Indexed: 01/17/2023] Open
Abstract
Background The relative risk for cerebrovascular disease (CVD) is increased in patients with head and neck cancer (HNC) treated with radiotherapy (RT). However, the current relative risk for CVD following RT has not been well clarified. The purpose of this study was to analyze the effect of RT and update the risk of CVD following RT in HNC patients through a systematic review and meta-analysis. Material and Methods We conducted an online database search and systematic review of observational studies that reported on CVD and extracranial carotid stenosis in patients with HNC who had undergone RT. Articles published in Medline and PubMed from 1980 to 2021 were identified and collected. Results Of the forty-seven articles identified from PubMed and forty-four articles identified from 3 systematic reviews, twenty-two studies were included. We found that neck RT was a significant risk factor for CVD (HR 3.97, 95% CI: 2.89-5.45). Patients with HNC treated by RT had an increased OR (7.36, 95% CI: 4.13-13.11) for CVD, and approximately 26% (95% CI: 22%-31%) of HNC patients treated with RT were at risk for CVD with more than 50% reduction in carotid diameter. Conclusion The risk of CVD is increased in patients with HNC treated by RT, and recent improvements in RT techniques may have contributed to the decreased risk of CVD. These results suggest that regular follow-up and appropriate screening for CVD should be required for patients with HNC.
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Affiliation(s)
- Ping-Yi Lin
- Oral Maxillofacial Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.,Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Ping-Chia Cheng
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Wan-Lun Hsu
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Wu-Chia Lo
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Chen-Hsi Hsieh
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Wei Shueng
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Li-Jen Liao
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
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12
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Chung CS, Liao LJ, Wu CY, Lo WC, Hsieh CH, Lee TH, Liu CY, Kuo DY, Shueng PW. Endoscopic Screening for Second Primary Tumors of the Esophagus Among Head and Neck Cancer Patients. Front Oncol 2022; 12:906125. [PMID: 35747824 PMCID: PMC9209650 DOI: 10.3389/fonc.2022.906125] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 03/28/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Malignancies of the head and neck (HN) region and esophagus are among the most common cancers worldwide. Due to exposure to common carcinogens and the theory of field cancerization, HN cancer patients have a high risk of developing second primary tumors (SPTs). In our review of 28 studies with 51,454 HN cancer patients, the prevalence of SPTs was 12%. The HN area is the most common site of SPTs, followed by the lungs and esophagus, and 13% of HN cancer patients have been reported to have esophageal high-grade dysplasia or invasive carcinoma. The prognosis of HN cancer patients with concomitant esophageal SPTs is poor, and therefore identifying esophageal SPTs as early as possible is of paramount importance for risk stratification and to guide the treatment strategy. Image-enhanced endoscopy, especially using narrow-band imaging endoscopy and Lugol’s chromoendoscopy, has been shown to improve the diagnostic performance in detecting esophageal neoplasms at an early stage. Moreover, the early detection and minimally invasive endoscopic treatment of early esophageal neoplasm has been shown to improve the prognosis. Well-designed prospective studies are warranted to establish appropriate treatment and surveillance programs for HN cancer patients with esophageal SPTs.
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Affiliation(s)
- Chen-Shuan Chung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Li-Jen Liao
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Chia-Yun Wu
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Division of Medical Oncology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wu-Chia Lo
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
| | - Chen-Hsi Hsieh
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzong-His Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chao-Yu Liu
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Deng-Yu Kuo
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Pei-Wei Shueng
- Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Medical Device Innovation and Translation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- *Correspondence: Pei-Wei Shueng,
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13
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Lo WC, Chang CM, Wu CY, Hsieh CH, Shueng PW, Cheng PW, Liao LJ. A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation. BMC Cancer 2022; 22:615. [PMID: 35659619 PMCID: PMC9167527 DOI: 10.1186/s12885-022-09732-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background
To analyze clinical characteristics in the prediction of death within 1 year in advanced oropharyngeal cancer patients treated with chemoradiation.
Methods
One hundred forty-seven advanced oropharyngeal cancer patients who underwent curative-intent chemoradiation treatment were retrospectively enrolled. The pre-treatment clinical parameters including inflammatory markers were reviewed.
Results
The 1-year death rate for all patients was 29% [95% confidence interval (CI): 23–37%]. In multivariate logistic regression analysis, hemoglobulin (Hb) < 13.5 g/dl was an independent indicator of death within 1-year [Odds ratio (OR) 5.85, 95% CI 2.17–15.75, p < 0.001]. Systemic immune inflammation (SII) ≥ 1820 was also a significant factor for prediction of death within 1 year (OR 4.78, 95% CI 1.44–15.85, p = 0.011). We further used gander, age, Hb and SII to develop a nomogram to predict death within 1 year. The c-index of the model was 0.75 (95%CI 0.66–0.83). For patients with low nomogram score (< 14) versus high nomogram score (≥ 14), the 1-year and 2-year OS rates were 91 and 71% versus 53 and 29%, respectively. (p < 0.001). A difference in the disease persistence or recurrence rate between patients with high and low nomogram score was significant (73 and 28%, respectively; p < 0.001).
Conclusions
The pre-treatment Hb < 13.5 g/dl and SII ≥ 1820 are associated with higher risks of death within 1-year in patients with advanced oropharyngeal cancers. Nomogram can aid in patient counseling and treatment modality adjustment. The development of a more effective treatment protocol for patients with high nomogram score will be essential.
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14
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Huang CF, Liu SH, Ho TJ, Lee KI, Fang KM, Lo WC, Liu JM, Wu CC, Su CC. Quercetin induces tongue squamous cell carcinoma cell apoptosis via the JNK activation-regulated ERK/GSK-3α/β-mediated mitochondria-dependent apoptotic signaling pathway. Oncol Lett 2022; 23:78. [PMID: 35111247 PMCID: PMC8771640 DOI: 10.3892/ol.2022.13198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 12/08/2021] [Indexed: 11/19/2022] Open
Abstract
Tongue squamous cell carcinoma (SCC) is a most common type of oral cancer. Due to its highly invasive nature and poor survival rate, the development of effective pharmacological therapeutic agents is urgently required. Quercetin (3,3',4',5,7-pentahydroxyflavone) is a polyphenolic flavonoid found in plants and is an active component of Chinese herbal medicine. The present study investigated the pharmacological effects and possible mechanisms of quercetin on apoptosis of the tongue SCC-derived SAS cell line. Following treatment with quercetin, cell viability was assessed via the MTT assay. Apoptotic and necrotic cells, mitochondrial transmembrane potential and caspase-3/7 activity were analyzed via flow cytometric analyses. A caspase-3 activity assay kit was used to detect the expression of caspase-3 activity. Western blot analysis was performed to examine the expression levels of proteins associated with the MAPKs, AMPKα, GSK3-α/β and caspase-related signaling pathways. The results revealed that quercetin induced morphological alterations and decreased the viability of SAS cells. Quercetin also increased apoptosis-related Annexin V-FITC fluorescence and caspase-3 activity, and induced mitochondria-dependent apoptotic signals, including a decrease in mitochondrial transmembrane potential and Bcl-2 protein expression, and an increase in cytosolic cytochrome c, Bax, Bak, cleaved caspase-3, cleaved caspase-7 and cleaved poly (ADP-ribose) polymerase protein expression. Furthermore, quercetin significantly increased the protein expression levels of phosphorylated (p)-ERK, p-JNK1/2 and p-GSK3-α/β, but not p-p38 or p-AMPKα in SAS cells. Pretreatment with the pharmacological JNK inhibitor SP600125 effectively reduced the quercetin-induced apoptosis-related signals, as well as p-ERK1/2 and p-GSK3-α/β protein expression. Both ERK1/2 and GSK3-α/β inhibitors, PD98059 and LiCl, respectively, could significantly prevent the quercetin-induced phosphorylation of ERK1/2 and GSK3-α/β, but not JNK activation. Taken together, these results suggested that quercetin may induce tongue SCC cell apoptosis via the JNK-activation-regulated ERK1/2 and GSK3-α/β-mediated mitochondria-dependent apoptotic signaling pathway.
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Affiliation(s)
- Chun-Fa Huang
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan, R.O.C
- Department of Nursing, College of Medical and Health Science, Asia University, Taichung 413, Taiwan, R.O.C
| | - Shing-Hwa Liu
- Institute of Toxicology, College of Medicine, National Taiwan University, Taipei 100, Taiwan, R.O.C
| | - Tsung-Jung Ho
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien 970, Taiwan, R.O.C
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien 970, Taiwan, R.O.C
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 970, Taiwan, R.O.C
| | - Kuan-I Lee
- Department of Emergency, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan, R.O.C
| | - Kai-Min Fang
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan, R.O.C
| | - Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan, R.O.C
| | - Jui-Ming Liu
- Department of Urology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan, R.O.C
| | - Chin-Ching Wu
- Department of Public Health, China Medical University, Taichung 404, Taiwan, R.O.C
| | - Chin-Chuan Su
- Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Changhua 500, Taiwan, R.O.C
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15
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Wu CY, Lin YH, Lo WC, Cheng PC, Hsu WL, Chen YC, Shueng PW, Hsieh CH, Liao LJ. Nutritional status at diagnosis is prognostic for pharyngeal cancer patients: a retrospective study. Eur Arch Otorhinolaryngol 2022; 279:3671-3678. [PMID: 35076744 DOI: 10.1007/s00405-021-07222-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Malnutrition in head and neck cancer (HNC) patients is associated with increased morbidity and mortality. Several nutrition indicators have been reported to be related to the prognosis of HNC. However, the prognostic effect of these multiple nutrition factors in HNC is not well elucidated. The aim of this study was to evaluate the prognostic effect of these factors, including the novel hemoglobin, albumin, lymphocyte, and platelet (HALP) score, for pharyngeal cancers. MATERIAL AND METHODS From 2008 to 2019, a total of 319 pharyngeal cancer patients were recruited. We collected adult patients with a diagnosis of nasopharyngeal carcinoma, oropharyngeal carcinoma and hypopharyngeal carcinoma. Patients who completed definite staging workup and treatment were selected for analysis. We traced nutritional and hematological parameters, including body mass index (BMI), albumin, and complete blood count, for survival analysis. RESULTS We found that multiple nutritional markers, including BMI, hemoglobin, albumin, prognostic nutritional index (PNI), nutritional risk index (NRI) and HALP score, were important predictors for pharyngeal cancers in univariate Cox regression analysis. In multivariate analysis, we found that the HALP score was still an independent factor (HR: 1.62, 1.13-2.32 for overall survival [OS]) after adjusting of gender, age, cancer site, clinical stage, and BMI. The PNI was the most important independent factor for OS (HR: 3.12, 2.18-4.47) and cancer-specific survival (HR: 2.88, 1.88-4.41) in multivariate analysis. CONCLUSION We found that multiple nutrition markers, including BMI, hemoglobin, albumin, PNI, NRI and HALP score, are important predictors for pharyngeal cancers. This is the first report confirming the prognostic effect of the HALP score for HNCs. Nutritional status at diagnosis should be given more attention in pharyngeal cancer patients.
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Affiliation(s)
- Chia-Yun Wu
- Department of Oncology and Hematology, Far Eastern Memorial Hospital, Taipei, Taiwan.,Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yu-Hsuan Lin
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Master's Program of Big Data Analysis in Biomedicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Wu-Chia Lo
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Otolaryngology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist.,, New Taipei City, 220, Taiwan.,Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
| | - Ping-Chia Cheng
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Otolaryngology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist.,, New Taipei City, 220, Taiwan
| | - Wan-Lun Hsu
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Yong-Chen Chen
- Master's Program of Big Data Analysis in Biomedicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Pei-Wei Shueng
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chen-Hsi Hsieh
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Li-Jen Liao
- Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan. .,Otolaryngology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist.,, New Taipei City, 220, Taiwan. .,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.
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16
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Chang CM, Lo WC, Young YH, Liao LJ, Wu PH, Cheng PC, Cheng PW. Evaluation of retrootolithic function using galvanic vestibular-evoked myogenic potentials in patients with benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 2021; 279:3415-3423. [PMID: 34562111 DOI: 10.1007/s00405-021-07094-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/14/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose is to investigate possible vestibulopathy in patients with benign paroxysmal positional vertigo (BPPV), inner ear tests, including cervical and ocular vestibular-evoked myogenic potentials (cVEMPs and oVEMPs) via various stimulation modes, were adopted. METHODS Fifty BPPV patients were enrolled in this study. All patients underwent pure tone audiometry, cVEMPs, oVEMPs, and caloric tests. The recurrence status, abnormal rates of inner ear tests, and the characteristic parameters of VEMPs, such as wave latencies and amplitudes, were analyzed. RESULTS In affected ears, the abnormal rates of acoustic cVEMPs, vibratory oVEMPs, galvanic cVEMPs, and galvanic oVEMPs were 62%, 28%, 36%, and 14%, respectively. The abnormalities of acoustic cVEMPs were significantly larger than those of vibratory oVEMPs, and acoustic/vibratory VEMPs had significantly higher abnormal rates than the corresponding galvanic VEMPs. CONCLUSION BPPV patients may have both otolithic and neural dysfunctions. Otolithic organ damage occurs more frequently than retrootolithic neural degeneration, and the saccular macula might have a greater extent of damage than the utricular macula.
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Affiliation(s)
- Chih-Ming Chang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
| | - Yi-Ho Young
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
- Medical Engineering Office, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Po-Hsuan Wu
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Communication Engineering, Oriental Institute of Technology, Taipei, Taiwan
| | - Ping-Chia Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
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Wu PH, Cheng PC, Chang CM, Lo WC, Cheng PW. Efficacy of Povidone-Iodine Nasal Irrigation Solution After Sinonasal Surgery: A Randomized Controlled Study. Laryngoscope 2021; 132:1148-1152. [PMID: 34397104 DOI: 10.1002/lary.29818] [Citation(s) in RCA: 4] [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: 06/30/2021] [Revised: 07/25/2021] [Accepted: 08/06/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the efficacy of postoperative nasal irrigation with povidone-iodine (PVP-I) solution in patients undergoing sinonasal surgery. STUDY DESIGN Single-blind, randomized controlled study. METHODS This is a prospective, single-blind, randomized controlled study. Patients with chronic rhinosinusitis (CRS) and hypertrophic inferior turbinates who underwent endoscopic sinus surgery (ESS) and inferior turbinate reduction were enrolled in the study. Patients were evaluated using the Taiwanese version of the 22-item Sino-Nasal Outcome Test (TWSNOT-22), rhinomanometry, endoscopic examination, and bacterial cultures. One week after the operation, patients were randomly assigned to either a 0.1% PVP-I nasal irrigation group or a control (normal saline) irrigation group. We then compared the two groups' results to illustrate the effects of nasal irrigation with PVP-I solution following sinonasal surgery. RESULTS Of the 55 patients that completed the study, 27 patients were in the PVP-I group and 28 were in the control group. In both groups, the TWSNOT-22 scores, Lund-Kennedy endoscopic scores, and total nasal resistance (TNR) all revealed significant improvements at 3 months postoperatively compared with preoperative measurements (all, P < .05). However, there were no significant differences between the two groups in TWSNOT-22, endoscopic, or TNR scores 3 months after the operation (all, P > .05). CONCLUSIONS A dilute 0.1% PVP-I nasal irrigation as a postoperative care modality after sinonasal surgery did not provide additional benefit compared with normal saline irrigation. LEVEL OF EVIDENCE 2 Laryngoscope, 2021.
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Affiliation(s)
- Po-Hsuan Wu
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Communication Engineering, Asia Eastern University of Science and Technology, New Taipei City, Taiwan
| | - Ping-Chia Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Chih-Ming Chang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.,Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
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Hsieh CH, Shueng PW, Wang LY, Liao LJ, Lo WC, Yeh HP, Chou HL, Wu LJ. Single-Institute Clinical Experiences Using Whole-Field Simultaneous Integrated Boost (SIB) Intensity-Modulated Radiotherapy (IMRT) and Sequential IMRT in Postoperative Patients With Oral Cavity Cancer (OCC). Cancer Control 2021; 27:1073274820904702. [PMID: 33047615 PMCID: PMC7791442 DOI: 10.1177/1073274820904702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This study aimed to review clinical experiences using whole-field simultaneous
integrated boost (SIB) intensity-modulated radiotherapy (IMRT) and sequential
IMRT in postoperative patients with oral cavity cancer (OCC). From November 2006
to December 2014, a total of 182 postoperative patients with OCC who underwent
either SIB-IMRT (n = 63) or sequential IMRT (n = 119) were enrolled
retrospectively and matched randomly according to multiple risk factors by a
computer. The differences were well balanced after patient matching
(P = .38). The median follow-up time was 65 months. For
patients treated with the SIB technique and the sequential technique, the
respective mortality rates were 36.8% and 20.0% (P = .04). The
primary recurrence rates were 26.3% and 10.0% (P = .02),
respectively. The respective marginal failure rates were 26.7% and 16.7%. A
multivariate logistic regression analysis showed that patients who received the
SIB technique had a 2.74 times higher risk of death than those who received the
sequential technique (95% confidence interval = 1.10-6.79, P =
.03). Sequential IMRT provided a significantly lower dose to the esophagus (5.2
Gy, P = .02) and trachea (4.6 Gy, P = .03)
than SIB-IMRT. For patients with locally advanced OCC, postoperative sequential
IMRT may overcome an unpredictable geographic miss, potentially with a lower
marginal failure rate in the primary area. Patients treated by sequential IMRT
show equal overall survival benefits to those treated by SIB-IMRT and a lower
mortality rate than those treated by SIB-IMRT. Additionally, a reduced dose to
the esophagus and trachea compared to sequential IMRT was noted.
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Affiliation(s)
- Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, 46608Far Eastern Memorial Hospital, New Taipei City, Taiwan, R.O.C. (Republic of China).,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C. (Republic of China).,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C. (Republic of China)
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, 46608Far Eastern Memorial Hospital, New Taipei City, Taiwan, R.O.C. (Republic of China).,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C. (Republic of China)
| | - Li-Ying Wang
- Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan, R.O.C. (Republic of China).,School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, R.O.C. (Republic of China)
| | - Li-Jen Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, R.O.C. (Republic of China).,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan, R.O.C. (Republic of China)
| | - Wu-Chia Lo
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan, R.O.C. (Republic of China)
| | - Hsin-Pei Yeh
- Division of Radiation Oncology, Department of Radiology, 46608Far Eastern Memorial Hospital, New Taipei City, Taiwan, R.O.C. (Republic of China)
| | - Hsiu-Ling Chou
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan, R.O.C. (Republic of China).,School of Nursing, National Yang-Ming University, Taipei, Taiwan, R.O.C. (Republic of China).,Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, R.O.C. (Republic of China)
| | - Le-Jung Wu
- Division of Radiation Oncology, Department of Radiology, 46608Far Eastern Memorial Hospital, New Taipei City, Taiwan, R.O.C. (Republic of China)
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19
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Wu CH, Lo WC, Liao LJ, Kao YC, Wang CT. Vocal Fold Steroid Injection for Benign Vocal Lesions in Professional Voice Users. J Voice 2021; 37:472.e1-472.e6. [PMID: 33707029 DOI: 10.1016/j.jvoice.2021.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Current treatments for benign vocal lesions consist mainly voice therapy and phonomicrosurgery. However, these options are not always suitable for professional voice users because of their tight performance schedule and limited time for voice rest. This study investigated vocal fold steroid injection (VFSI) as an alternative treatment. STUDY DESIGN Matched case series. METHODS We retrospectively enrolled 28 professional voice users (i.e., singers, actors and news anchors) who received VFSI for vocal nodules and polyps in an office setting of a tertiary teaching hospital. Outcomes were evaluated using videolaryngostroboscopy (VLS), the 10-item Voice Handicap Index (VHI-10), maximum phonation time, and acoustic and perceptual analyses before and 1 month after VFSI. Study results were compared with 56 patients of nonprofessional voice users (i.e., routine or high occupational vocal demands), matched in a 1:2 ratio by age, sex, and treatment date. RESULTS After VFSI, VLS revealed substantial lesion resolution in 82% professional voice users. One professional voice user developed a self-limited vocal fold hematoma after VFSI. VHI-10 scores in the professional group decreased from 21 to 14 points, compared with 23 to 16 points in the non-professional group, demonstrating a significant within-group effect (P < 0.01, GEE) and a nonsignificant between-group effect (P = 0.86). Other outcomes also improved significantly after VFSI (P < 0.05), without significant differences between the two groups. CONCLUSION VFSI can be an effective and safe alternative treatment for professional voice users with benign vocal lesions.
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Affiliation(s)
- Chien-Hao Wu
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Yi-Chia Kao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Special Education, University Of Taipei, Taipei, Taiwan
| | - Chi-Te Wang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan; Department of Special Education, University Of Taipei, Taipei, Taiwan.
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20
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Cheng PC, Chang CM, Liao LJ, Cheng PW, Lo WC. The outcomes and decision-making process for neck lymph nodes with indeterminate fine-needle aspiration cytology. PLoS One 2021; 16:e0246437. [PMID: 33539457 PMCID: PMC7861456 DOI: 10.1371/journal.pone.0246437] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 01/19/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives This study aims to propose a cytological classification, to evaluate predictive factors of the final malignancy, and to suggest a proper management strategy for neck lymph nodes (LNs) with indeterminate cytology. Methods Patients who had neck lymphadenopathy with indeterminate cytology between 2007 and 2017 were analyzed retrospectively in a tertiary medical center. Cytological classification was conducted according to the cytological descriptions. We examined the clinical characteristics according to the final diagnosis of the neck lymphadenopathy. Results According to the final diagnoses, there were 142 malignant and 95 benign neck LNs among 237 patients. Multivariate analyses using a stepwise logistic regression model showed that cytological classification [p < 0.001, OR = 5.67 (3.48–9.23)], prior history of malignancy [p = 0.01, OR = 2.97 (1.26–6.99)], long axis [p = 0.01, OR = 3.06 (1.33–7.06)], short-to-long axis (S/L) ratio [p = 0.047, OR = 2.15 (1.01–4.57)] and internal echogenicity [p = 0.01, OR = 2.72 (1.26–5.86)] were independent predictors of malignancy. Conclusions In patients who have neck LNs with indeterminate cytology, a cytological classification and four other predictors (prior history of malignancy, long axis ≥ 1.93 cm, S/L ratio ≥ 0.64 and heterogeneity of internal echogenicity) are statistically associated with the risk of malignancy and helpful in guiding further management.
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Affiliation(s)
- Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Chih-Ming Chang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan (R.O.C.)
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan (R.O.C.)
- Medical Engineering Office, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
- * E-mail:
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21
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Hung WC, Lo WC, Fang KM, Cheng PW, Wang CT. Longitudinal Voice Outcomes Following Serial Potassium Titanyl Phosphate Laser Procedures for Recurrent Respiratory Papillomatosis. Ann Otol Rhinol Laryngol 2020; 130:363-369. [PMID: 32847376 DOI: 10.1177/0003489420950374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Repeated surgical interventions are usually required to control recurrent respiratory papillomatosis (RRP), but at considerable risk of worsened postoperative voice quality. Potassium titanyl phosphate (KTP) laser has been reported to effectively manage RRP; however, voice quality after repeated procedures has not been investigated. METHODS This study recruited 16 patients with RRP treated using KTP laser between 2013 and 2019. KTP laser procedures were performed under general anesthesia via direct suspension laryngoscope or under local anesthesia via flexible endoscope, depending on the need for pathological proof, patient tolerance, and lesion size and location. Disease control was investigated by videolaryngostroboscopy. Voice outcome was evaluated using a 10-item voice handicap index (VHI-10), acoustic and perceptual analyzes. RESULTS We reviewed the medical records of 11 male and 5 female patients with RRP (age range: 23-73 years). Five patients received KTP laser once, six patients received it 2 to 5 times, and five patients received 6 to 15 procedures. Median VHI-10 decreased from 28.3 to 12.0 points after the initial procedure and were maintained at 10.1 to 11.0 points following subsequent procedures (P < .01, generalized estimating equation). Acoustic and perceptual analysis of voice quality also revealed significant improvements (P < .01), which remained stable even after 6 to 10 KTP laser procedures. Minor adverse events included slight fibrotic change of vocal folds and glottic web, but these did not significantly alter postoperative voice quality. CONCLUSION This longitudinal follow-up study revealed that serial KTP laser procedures can effectively control RRP while preserving phonatory function and maintaining adequate voice quality. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Wei-Chen Hung
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei
| | - Kai-Min Fang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei
| | - Chi-Te Wang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei.,Department of Special Education, University of Taipei, Taipei.,Department of Otolaryngology, National Taiwan University College of Medicine, Taipei.,Department of Electrical Engineering, Yuan Ze University, Taoyuan.,Department of Otolaryngology Head and Neck Surgery, National Taiwan University Hospital, Taipei
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22
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Liao LJ, Wang CT, Huang TW, Cheng PW, Lo WC. Ultrasound-guided-fine-needle Aspiration Drainage and Percutaneous Ethanol Injection for Benign Neck Cysts. J Med Ultrasound 2020; 28:225-229. [PMID: 33659161 PMCID: PMC7869730 DOI: 10.4103/jmu.jmu_111_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/10/2020] [Accepted: 02/12/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Ultrasound-guided-fine-needle aspiration drainage (US-FNAD) and US-percutaneous ethanol injection (US-PEI) have been widely used in the management of benign neck cysts. However, the long-term results of US-FNAD and US-PEI are not well elucidated. Methods: We retrospectively collated patients under neck US examinations from March 2007 to December 2017 and investigated the recurrence after US-FNAD and US-PEI. Univariate and multivariate Cox regression analyses were used to assess significant risk factors for recurrence after US-FNAD. Results: A total of 1075 patients were recruited, and their age was 50 ± 15 (mean ± standard deviation) years. A total of 862 patients had thyroid cysts, 118 patients had thyroglossal duct cysts (TGDC), twenty patients had branchial cleft cysts, 64 patients had parotid sialocysts, and 11 patients had plunging ranulas. Majority of the patients (97%, 1037/1075) reported significant symptom improvement immediately. However, 38% of the patients had recurrence with a median 3-year follow-up period. In a multivariate Cox regression analysis with adjustment for age and gender, plunging ranula (hazard ratio [HR]: 2.44, 95% confidence interval [CI]: 1.19–4.99) and lateral dimension size ≥ 0.8 cm (HR: 1.32, 95% CI: 1.04–1.67) after US-FNAD were independent risk factors for recurrence. There were 15 male and 19 female patients who received US-PEI therapy after repeated US-FNAD, of whom 23 patients had thyroid cysts, 6 had plunging ranulas, 4 had TGDC, and one had a branchial cleft cyst. The overall success rate was 94% (32/34), with a median follow-up period of 1.6 years. Two recurrent symptomatic patients had plunging ranulas. Some patients stated mild pain (21%, 7/34) and swelling sensation (26%, 9/34) after the injection. No major complications, such as vocal fold paresis or airway compression, were found. Conclusion: US-FNAD is an effective tool in the management of benign neck cysts with a 38% recurrence rate. Plunging ranulas have the highest rate of recurrence after FNAD. US-PEI is effective for most recurrent neck cysts after repeated US-FNAD.
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Affiliation(s)
- Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.,Biomedical Engineering Office, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Chi-Te Wang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Biomedical Engineering Office, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Tsung-Wei Huang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
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23
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Lo WC, Chang CM, Wang CT, Cheng PW, Liao LJ. A Novel Sonographic Scoring Model in the Prediction of Major Salivary Gland Tumors. Laryngoscope 2020; 131:E157-E162. [PMID: 32108341 DOI: 10.1002/lary.28591] [Citation(s) in RCA: 4] [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: 12/03/2019] [Revised: 01/19/2020] [Accepted: 02/07/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To create a sonographic scoring model in the prediction of major salivary gland tumors and to assess the utility of this predictive model. STUDY DESIGN Retrospective case series, academic tertiary referral center. METHODS Two hundred fifty-nine patients who underwent ultrasound (US), US-guided needle biopsies, and subsequent operations were enrolled. These data were used to build a predictive scoring model and the model was validated by 10-fold cross-validation. RESULTS We constructed a sonographic scoring model by multivariate logistic regression analysis: 2.08 × (boundary) + 1.75 × (regional lymphadenopathy) + 1.18 × (shape) + 1.45 × (posterior acoustic enhancement) + 2.4 × (calcification). The optimal cutoff score was 3, corresponding to 70.2% sensitivity, 93.9% specificity, and 89.6% overall accuracy. The mean areas under the receiver operating characteristic curve (c-statistic) in 10-fold cross-validation was 0.90. CONCLUSIONS The constructed predictive scoring model is beneficial for patient counseling under US exam and feasible to provide us the guidance on which kind of needle biopsy should be performed in major salivary gland tumors. LEVEL OF EVIDENCE 3b Laryngoscope, 131:E157-E162, 2021.
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Affiliation(s)
- Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Chih-Ming Chang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Chi-Te Wang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.,Medical Engineering Office, Far Eastern Memorial Hospital, New Taipei City, Taiwan
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Cheng PC, Lo WC, Chang CM, Huang TW, Cheng PW, Liao LJ. The outcome and decision-making of extracapsular dissection for benign superficial lobe parotid tumours: Our experience in 144 patients. Clin Otolaryngol 2019; 45:151-155. [PMID: 31755650 DOI: 10.1111/coa.13480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/24/2019] [Accepted: 11/17/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Chih-Ming Chang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.).,Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan (R.O.C.)
| | - Tsung-Wei Huang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.).,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan (R.O.C.)
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.).,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan (R.O.C.).,Medical Engineering Office, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
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25
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Lin YH, Wang CT, Lin FC, Liao LJ, Lo WC, Cheng PW. Treatment Outcomes and Adverse Events Following In-Office Angiolytic Laser With or Without Concurrent Polypectomy for Vocal Fold Polyps. JAMA Otolaryngol Head Neck Surg 2019; 144:222-230. [PMID: 29346486 DOI: 10.1001/jamaoto.2017.2899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance In-office angiolytic laser procedures have been used successfully as an alternative treatment for vocal fold polyps; little is known in detail about the treatment outcomes and adverse events. Objective To examine the outcomes and incidence rates of adverse events associated with in-office angiolytic laser procedures with or without concurrent polypectomy as an alternative treatment for vocal fold polyps. Design, Setting, and Participants Retrospective cohort study at a tertiary medical center. We identified 114 consecutive patients with vocal polyps who underwent in-office angiolytic laser treatments between January 1, 2014, and August 31, 2016. After the exclusion of 17 with missing or incomplete data, 97 were enrolled. Interventions In-office 532-nm laser procedures with or without concurrent polypectomy. Main Outcomes and Measures Between 1 and 2 months after the surgical procedures, we collected the following outcome data: videolaryngostroboscopy, perceptual rating of voice quality, acoustic analysis, maximal phonation time, and subjective rating of voice quality using a visual analogue scale and 10-item voice handicap index. Results This study enrolled 97 patients (mean [SD] age, 45.6 [11.3] years; 48 [49%] male). The mean duration of symptoms was 10.1 months (range, 1-60 months). Twenty-nine patients (30%) had angiolytic laser procedures only, while 68 (70%) received laser with concurrent polypectomy. Both treatment modalities offered significant improvements. Only 1 patient (1%) receiving angiolytic laser with concurrent polypectomy underwent another treatment session, so this group had significantly less need for multiple treatments than those receiving laser treatment alone (6 [21%]; effect size, -1.57; 95% CI, -2.77 to -0.36). We identified 8 adverse events (8% of the cases): vocal fold edema (n = 5), vocal hematoma (n = 2), and vocal ulceration (n = 1). Patients treated with laser plus concurrent polypectomy had significantly fewer adverse events than those treated with angiolytic laser alone (2 [3%] vs 6 [21%]; effect size, 1.20; 95% CI, 0.26 to 2.13). Conclusions and Relevance In-office angiolytic laser procedures can be an effective alternative treatment for vocal polyps, although with possible need for multiple treatment sessions and occasional occurrence of minor postoperative adverse events. Concurrent polypectomy following laser coagulation allows less laser energy delivery and reduces the risk of postoperative adverse events and the need for additional treatment sessions.
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Affiliation(s)
- Yu-Hsuan Lin
- Department of Otolaryngology-Head and Neck Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Te Wang
- Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, National Taiwan University College of Medicine, Taipei, Taiwan.,Master's Program of Speech and Language Pathology, Department of Special Education, University of Taipei, Taipei, Taiwan
| | - Feng-Chuan Lin
- Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan
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Chou HL, Shueng PW, Liao LJ, Hsu CX, Kuo DY, Lo WC, Hou PY, Wang LY, Chou SF, Hsieh CH. Prophylactic NS-21 maintains the skin moisture but does not reduce the severity of radiation dermatitis in patients with head and neck cancer: a randomized control trial. Radiat Oncol 2019; 14:90. [PMID: 31146741 PMCID: PMC6543645 DOI: 10.1186/s13014-019-1302-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 12/18/2018] [Accepted: 05/22/2019] [Indexed: 12/22/2022] Open
Abstract
Background To evaluate the practicality of NS-21 cream with regard to its skin-related toxicity in patients with head and neck cancer (HNC) who are undergoing concurrent chemoradiation therapy (CCRT) or radiotherapy (RT). Methods Between July 2015 and November 2017, 30 HNC patients who underwent RT or CCRT were randomly allocated to receive either NS-21 or control treatment on their irradiated skin three times per day, starting at the initiation of RT or CCRT and ending 2 weeks after the completion of RT or until the appearance of grade 3 acute radiation dermatitis (ARD). Dermatitis was recorded weekly according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Skin humidity was monitored by a digital moisture meter. The generalized estimating equation (GEE) and logit link function method were used for statistical analysis. Results No serious adverse events were observed in either group. Itching dermatitis occurred on the right lower neck in one patient of the NS-21 group during the 3rd week of CCRT, but the severity was mild. The median skin moisture value at the time of the final treatment was significantly different between the study and control groups (30.6 vs. 27.3, p = 0.013). Additionally, there was an inverse relationship between skin moisture and ARD grade (B = -0.04, p = 0.005). The incidence of ARD at the time of the last treatment was not significantly different between the study and control groups (6.7% vs 26.7%, p = 0.165). The risk of grade 3 ARD for skin that had received an irradiation dose of 47–70 Gy was higher than that of skin that had received an irradiation dose ≤46 Gy (OR = 31.06, 95% CI =5.95–162.21, p < 0.001). Nevertheless, the risk of ARD was not significantly different between the groups (OR = 0.38, 95% CI = 0.08–1.74, p = 0.212). Conclusions NS-21 was well tolerated and effective for the maintenance of skin moisture; however, there was no statistically significant reduction in the risk of ARD in HNC patients undergoing RT or CCRT when compared with HNC patients in the control group. Trial registration The study was approved by the Institutional Review Board of Far Eastern Memorial Hospital (FEMH-IRB, 104048-F), Registered 1st June 2015,
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Affiliation(s)
- Hsiu-Ling Chou
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,School of Nursing, National Yang-Ming University, Taipei, Taiwan.,Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Chen-Xiong Hsu
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Deng-Yu Kuo
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Pei-Yu Hou
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan
| | - Li-Ying Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - San-Fang Chou
- Department of Medical Research, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan. .,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Liao LJ, Hsu WL, Lo WC, Cheng PW, Shueng PW, Hsieh CH. Health-related quality of life and utility in head and neck cancer survivors. BMC Cancer 2019; 19:425. [PMID: 31064331 PMCID: PMC6505071 DOI: 10.1186/s12885-019-5614-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 04/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background This study seeks to assess quality of life (QOL) and utility scores of head and neck cancer survivors. Methods We compared QOL as indicated by EORTC QLQ-C30, QLQ-H&N35, utility scores by time trade off (TTO) with previous published reference values and tested series characteristics related to global QOL and utility. Results A total of 127 patients were recruited. Of the patients, 102 (80%) completed the utility assessment. Cancer survivors had lower scores compared with norm values. Patients without a spouse had a lower utility than those with a spouse. Patients with a low annual family income also had lower global QOL and utility scores (p < 0.05). Other factors were not significantly related to QOL and utility scores. Conclusion Disease and treatment of head and neck cancer lead to disability and poor health-related QOL and utility. Economic status may contribute to health-related QOL and utility, while marital status is related to utility for head and neck cancer patients.
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Affiliation(s)
- Li-Jen Liao
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Wan-Lun Hsu
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan. .,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Abstract
A tracheotomy is a basic operation for the otorhinolaryngologist. According to reports from the United States and from our experience, there has been a steady decline in the number of tracheostomies performed by young resident doctors. Due to concerns for inadequate training of young residents, we developed a tracheotomy course consisting of a lecture, a live animal model, and questionnaires. The aim of this study was to evaluate the effectiveness of this training model. Twelve volunteer resident doctors joined the training course and, following a lecture by a senior surgeon, practiced tracheostomies with a 4-month-old female swine weighing 32 kg. We recorded the procedure time, blood loss, and complications. The doctors' procedural competence was recorded using questionnaires before and after the training. All operations were completed within 30 minutes, and the blood loss was less than 5 ml. There were no serious acute complications. After the training, young residents had improved scores on surgical landmark recognition, overall procedural competence, confidence in performing the procedure, and understanding of the surgical procedures and equipment (P < .05). Our findings reveal that an animal model-based tracheotomy course is an effective training model for young resident doctors.
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Affiliation(s)
- Ping-Chia Cheng
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Tsung-Yi Cho
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Wan-Lun Hsu
- 2 Genomics Research Center, Academia Sinica, Taipei
| | - Wu-Chia Lo
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei.,3 Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei
| | - Chi-Te Wang
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Po-Wen Cheng
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei
| | - Li-Jen Liao
- 1 Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei.,4 Department of Electrical Engineering, Yuan Ze University, Taoyuan
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Hsieh CH, Chou HL, Shueng PW, Hsu CX, Kuo DY, Liao LJ, Lo WC, Wang LY, Hsiao CH. A double-blind, randomized pilot study of NS-21 in the prevention of radiation dermatitis for patients with head and neck cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.6065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Deng-Yu Kuo
- Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Li-Jen Liao
- Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wu-Chia Lo
- Far Eastern Memorial Hospital, New Taipei City, Taiwan
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Liao LJ, Lo WC, Hsu WL, Cheng PW, Wang CP. Assessment of pain score and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy of thyroid nodules. J Pain Res 2018; 11:61-66. [PMID: 29343981 PMCID: PMC5749542 DOI: 10.2147/jpr.s148088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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] [Indexed: 11/24/2022] Open
Abstract
Objective The aim of this study was to evaluate pain scores and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules without and with local anesthesia (LA). Materials and methods The US-FNAB procedure was performed on 183 patients with and without LA. One puncture was made for solid nodules, and if patients could tolerate it, a two-puncture technique was used for nodules with a cystic change. Four-point verbal rating scores were assessed by a nursing assistant after completion of US-FNAB. To be an adequate specimen, at least six groups of follicular cells are required, and each group should contain at least 10 cells. Results Immediately after US-FNAB, 92% of patients with LA and 80% without LA reported no or mild pain (p=0.01). Most patients tolerated the procedure well, with no pain (82.5%) reported 5 minutes after the procedure. In univariate logistic regression, irregular boundary (odds ratio [OR]: 2.52, 95% confidence interval [CI]: 1.04–6.06, p=0.04), calcification (OR: 2.86, 95% CI: 1.06–7.76, p=0.04), and LA (OR: 0.35, 95% CI: 0.15–0.86, p=0.02) were significantly associated with immediate moderate or severe pain. Specimen adequacy was significantly associated with age (OR: 0.95, 95% CI: 0.92–0.97, p<0.01), heterogeneous echo-texture (OR: 1.76, 95% CI: 1.23–5.17, p=0.01), predominate solid architecture (OR: 2.78, 95% CI: 1.42–5.41, p<0.01), and the use of LA (OR: 3.34, 95% CI: 1.70–6.56, p<0.01). In multivariate logistic regression, patients receiving LA had lower risk of moderate or severe pain (OR: 0.25, 95% CI: 0.09–0.67, p=0.01) and higher chances of specimen adequacy (OR: 4.84, 95% CI: 2.17–10.7, p<0.01) compared to patients who did not receive LA. Conclusion US-FNAB is a safe procedure, and most patients report no pain 5 minutes after the procedure. The use of LA was associated with lower immediate pain scales and higher specimen adequacy.
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Affiliation(s)
- Li-Jen Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital
| | - Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital
| | | | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital
| | - Cheng-Ping Wang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
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Lo WC, Wu CT, Wang CP, Yang TL, Lou PJ, Ko JY, Chang YL. The Pretreatment Neutrophil-to-Lymphocyte Ratio is a Prognostic Determinant of T3–4 Hypopharyngeal Squamous Cell Carcinoma. Ann Surg Oncol 2017; 24:1980-1988. [DOI: 10.1245/s10434-017-5865-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Indexed: 12/11/2022]
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Lo WC, Fung GPG, Cheung PCH. Factors associated with multi-disciplinary case conference outcomes in children admitted to a regional hospital in Hong Kong with suspected child abuse: a retrospective case series with internal comparison. Hong Kong Med J 2017; 23:454-61. [DOI: 10.12809/hkmj164960] [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: 11/05/2022] Open
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Lo WC, Wu CT, Lee HC, Young YH, Chang YL, Cheng PW. Evaluation of geranylgeranylacetone against cisplatin-induced ototoxicity by auditory brainstem response, heat shock proteins and oxidative levels in guinea pigs. Neurotoxicol Teratol 2017; 61:29-35. [PMID: 28344103 DOI: 10.1016/j.ntt.2017.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 02/25/2017] [Accepted: 03/21/2017] [Indexed: 11/28/2022]
Abstract
This study aims to assess whether geranylgeranylacetone (GGA) could reduce ototoxicity induced by cisplatin through upregulation of not only heat shock protein(HSP)-70, but also HSP-27 and HSP-40, and to study if GGA would reduce cisplatin-induced increase in oxidative stress. 48 guinea pigs were used in this study and treated with the following regimen: 0.5% CMC (sodium carboxymethyl cellulose) control for 7days, GGA (600mg/kg/d) for 7days, a combination of GGA (600mg/kg) for 7days and then one dose of 10mg/kg cisplatin (GGA+Cis), and a combination of CMC for 7days and then 10mg/kg cisplatin (cisplatin group). Auditory brainstem response (ABR) measurement was performed in each animal at time before treatment and 7days after the last dose. Additionally, HSPs, nitric oxide (NO), and lipid peroxidation (LPO) levels in cochlear membranous tissues were assessed. The mean ABR thresholds in the cisplatin group were significantly (p<0.05) increased when compared to the other three groups. In guinea pigs receiving both GGA and cisplatin, the mean threshold shift (TS) were smaller (p<0.05) than those of the cisplatin group, but larger (p<0.05) than those of the CMC control or GGA only group with statistical significance. Compared to the GGA only group or the group treated with GGA+Cis, the cisplatin group had the highest (p<0.05) oxidative stress (NO and LPO levels), and the lowest (p<0.05) mean HSPs expression levels. It can be concluded that GGA attenuate ototoxicity induced by cisplatin through upregulation of HSP-27, -40, and -70. Moreover, increased oxidative stress induced by cisplatin in the cochlea membranous tissue could be reduced by pre-treatment of GGA.
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Affiliation(s)
- Wu-Chia Lo
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Chen-Tu Wu
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Pathology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hillary Chiao Lee
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Yi-Ho Young
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yih-Leong Chang
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Pathology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.
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Lo WC, Wu CT, Wang CP, Yang TL, Lou PJ, Ko JY, Chang YL. Lymph Node Ratio Predicts Recurrence and Survival for Patients with Resectable Stage 4 Hypopharyngeal Cancer. Ann Surg Oncol 2017; 24:1707-1713. [PMID: 28130622 DOI: 10.1245/s10434-017-5770-1] [Citation(s) in RCA: 8] [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] [Received: 11/23/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND This study aimed to investigate the clinicopathologic prognostic predictors of stage 4 hypopharyngeal cancer and to extend the traditional tumor-node-metastasis classification system to advance its predictive ability. METHODS The study enrolled 120 patients with pathologically stage 4 hypopharyngeal cancer treated with pharyngolaryngectomy and neck dissection between 2001 and 2007. RESULTS The study showed a 5-year overall survival (OS) of 44.6%, a disease-specific survival (DSS) of 51.6%, and a disease-free survival (DFS) of 48% for all the patients. In the multivariate analysis, a lymph node (LN) ratio of 0.113 or higher was a significant poor prognostic factor for OS (hazard ratio [HR] 1.89; 95% confidence interval [CI] 1.17-3.05; p = 0.009), DSS (HR 2.17; 95% CI 1.29-3.64; p = 0.003), and DFS (HR, 2.24; 95% CI 1.12-4.52; p = 0.024) in stage 4 hypopharyngeal cancer. In addition, pretreatment neutrophil-lymphocyte ratio, lymphovascular invasion, and margin status also were predictors of survival outcomes. Furthermore, the study found that disease recurrence differed significantly between the patients with a LN ratio of 0.113 or higher (68.2%) and those with a LN ratio lower than 0.113 (39.5%) (p = 0.002). CONCLUSIONS A LN ratio of 0.113 or higher is a strong predictor of disease recurrence and survival for patients with stage 4 hypopharyngeal cancer.
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Affiliation(s)
- Wu-Chia Lo
- Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, 100, Taiwan.,Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Chen-Tu Wu
- Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, 100, Taiwan.,Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Cheng-Ping Wang
- Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, 100, Taiwan.,Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tsung-Lin Yang
- Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pei-Jen Lou
- Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jeng-Yuh Ko
- Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yih-Leong Chang
- Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, 100, Taiwan. .,Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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Liao LJ, Cho TY, Cheng PW, Wang CT, Lo WC, Huang TW. Submental Ultrasonography in Diagnosing Severe Obstructive Sleep Apnea Syndrome. J Med Ultrasound 2016. [DOI: 10.1016/j.jmu.2016.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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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Chung CS, Lo WC, Wen MH, Hsieh CH, Lin YC, Liao LJ. Long Term Outcome of Routine Image-enhanced Endoscopy in Newly Diagnosed Head and Neck Cancer: a Prospective Study of 145 Patients. Sci Rep 2016; 6:29573. [PMID: 27387103 PMCID: PMC4937417 DOI: 10.1038/srep29573] [Citation(s) in RCA: 10] [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: 02/01/2016] [Accepted: 06/20/2016] [Indexed: 12/16/2022] Open
Abstract
Synchronous second primary tumors (SPTs), especially esophageal squamous cell neoplasia (ESCN), in patients with head and neck squamous cell carcinoma (HNSCC) are not uncommon. Image-enhanced endoscopy (IEE) screening may identify SPTs while there is no evidence to support its benefit. We prospectively recruited an adult cohort with newly-diagnosed HNSCC for IEE screening of upper gastrointestinal (UGI) tract neoplasia. 145 HNSCC patients were recruited. 22 (15.2%) patients had synchronous UGI tract neoplasia, including 20 ESCNs and 2 gastric adenocarcinoma. At a median follow-up of 2.72 (±1.73) years, the 3-year overall survival (OS) rate was 0.71. HNSCC patients with synchronous ESCN/UGI tract neoplasia had poorer prognosis than those without (multivariate analysis, hazard ratio [HR] 2.75/2.79, 95% confidence interval [CI] 1.11~6.82/1.15~6.80, p = 0.03/0.02). HNSCC patients with advanced (stage III&IV) ESCN had worst survivals (p < 0.001). Among those with synchronous ESCNs, hypopharyngeal cancers were associated with poorer prognosis when compared with oral cancers (HR 2.36, 95% CI 1.08~5.15, p = 0.03). IEE screening for UGI SPTs in HNSCC patients could be used for risk stratification and prognosis prediction. HNSCC patients with advanced ESCN had the worst prognosis. Further studies are needed to demonstrate the survival benefits from IEE screening.
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Affiliation(s)
- Chen-Shuan Chung
- Departments of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,College of Medicine, Far Eastern Memorial Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Wu-Chia Lo
- Departments of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ming-Hsun Wen
- Departments of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chen-Hsi Hsieh
- Departments of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Medicine, Far Eastern Memorial Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chin Lin
- Departments of Medical Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Li-Jen Liao
- Departments of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
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Lo WC, Cheng PW, Wang CT, Shueng PW, Hsieh CH, Chang YL, Liao LJ. The Effect of Radiotherapy on Ultrasound-Guided Fine Needle Aspiration Biopsy and the Ultrasound Characteristics of Neck Lymph Nodes in Oral Cancer Patients after Primary Treatment. PLoS One 2016; 11:e0149346. [PMID: 26954569 PMCID: PMC4783113 DOI: 10.1371/journal.pone.0149346] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/29/2016] [Indexed: 02/07/2023] Open
Abstract
Objectives To investigate the effect of radiotherapy (RT) on ultrasound-guided fine needle aspiration (USgFNA) and sonographic characteristics in the assessment of cervical lymph nodes (LNs) in oral squamous cell carcinoma (OSCC) patients after primary treatment. Materials and Methods 88 treated OSCC patients underwent 111 USgFNAs of the neck LNs after US evaluation. Among them, 48 USgFNAs were performed on 40 patients following RT and 63 USgFNAs on 48 patients without previous RT. The results of USgFNA and the US characteristics were compared between these two groups. Results USgFNA had a sensitivity of 88.0%, specificity of 91.4%, positive predictive value (PPV) of 88.0%, negative predictive value (NPV) of 91.4% and accuracy of 90.0% in patients without previous RT, and a sensitivity of 97.1%, specificity of 83.3%, PPV of 94.3%, NPV of 90.9% and accuracy of 93.5% in those with previous neck RT. The ranges of the short-axis and long-axis length were 13.3 ± 8.0 mm (mean ± SD) versus 17.8 ± 9.1 mm, and 18.6 ± 9.0 mm versus 24.4 ± 10.9 mm for recurrent LNs from patients with, versus without, previous RT (both ps < 0.05), respectively. 76.5% (26/34) of the recurrent nodes after RT and 48% (12/25) of the recurrent nodes without previous RT exhibited an irregular margin (p < 0.05). Additionally, irradiated recurrent LNs had a significantly decreased percentage of discernable calcification compared with non-irradiated recurrent nodes (48% versus 20.6%, p < 0.05). Conclusions RT had influence on sonographic characteristics but no influence on USgFNA in diagnosing recurrent LNs in treated OSCC patients.
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Affiliation(s)
- Wu-Chia Lo
- Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Oriental Institute of Technology, Taipei, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Oriental Institute of Technology, Taipei, Taiwan
| | - Chi-Te Wang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Yih-Leong Chang
- Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan
- * E-mail: (YLC); ; (LJL)
| | - Li-Jen Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- * E-mail: (YLC); ; (LJL)
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Chang CM, Jaw FS, Lo WC, Fang KM, Cheng PW. Three-dimensional analysis of the accuracy of optic and electromagnetic navigation systems using surface registration in live endoscopic sinus surgery. Rhinology 2016; 54:88-94. [DOI: 10.4193/rhino15.131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background: This study presents the first report in the same patients on the time efficiency of surface registration as well as the navigational accuracy using optic and electromagnetic tracking systems. Methods: Thirty patients with bilateral chronic paranasal pansinusitis underwent endoscopic sinus surgery. After surface registration, the surgeries were performed on one side using optic navigation guidance and on the other side using electromagnetic navigation guidance. The intraoperative measurements performed included the time taken for the surface registration and surgical procedure on each side, as well as the navigation errors at the different locations. Results: The time for surface registration was significantly longer in the optic navigation group than the electromagnetic group. A comparison of the navigation errors along the 3 axes showed that the deviation in the medial-lateral direction was significantly less than that in the anterior-posterior and cranial-caudal directions in the optic navigation group as well as the electromagnetic group. Conclusions: The procedure for surface registration in both optic and electromagnetic guidance is efficient and convenient. The accuracy of both navigation systems is comparable and within acceptable ranges for clinical use. In addition, the best accuracy was measured in the medial-lateral direction compared with the other two axes.
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Hsieh CH, Shueng PW, Wang LY, Huang YC, Liao LJ, Lo WC, Lin YC, Wu LJ, Tien HJ. Impact of postoperative daily image-guided intensity-modulated radiotherapy on overall and local progression-free survival in patients with oral cavity cancer. BMC Cancer 2016; 16:139. [PMID: 26906330 PMCID: PMC4763418 DOI: 10.1186/s12885-016-2165-9] [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: 05/26/2015] [Accepted: 02/14/2016] [Indexed: 11/17/2022] Open
Abstract
Background We compared the outcome of patients who received non-image-guided intensity-modulated radiotherapy (IMRT) with those who received helical tomotherapy (HT), a daily image-guided radiotherapy (IGRT), after surgery for oral cavity cancer (OCC). Methods During the period November 2006 to December 2013, a total of 152 postoperative OCC patients underwent either IMRT (n = 79) or daily IGRT (n = 73) 4 to 6 weeks after surgery. Patients in the IMRT group received 6 MV photon beams to 7 fields and those in the IGRT group received daily fractions of 1.8 or 2 Gy on five consecutive days. Results Patients who received daily IGRT had higher 5-year overall survival than those who received IMRT (87 % versus 48 %, p = 0.015). The local progression-free survival rate was also higher in patients who received IGRT (85 % versus 58 %, p = 0.006). More patients in the IGRT group completed the package of overall treatment time in ≤ 13 weeks and completed their course of radiation therapy in ≤ 8 weeks than patients in the IMRT group (89 % versus 68 %, p = 0.002; 84 % versus 58 %, p = 0.001), respectively. The rate of local failure in the primary tumor area was 24.0 % in the IMRT group and 6.8 % in the IGRT group. Among patients with primary local failure, the marginal failure rate was 52.6 % in the IMRT group and 0 % in the IGRT group. Conclusions For patients with locally advanced OCC, postoperative IGRT results in better overall survival, better local progression-free survival, less marginal failure and shorter overall treatment time than postoperative non-image-guided IMRT.
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Affiliation(s)
- Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan. .,Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan.,Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan.,Oriental Institute of Technology, New Taipei City, Taiwan
| | - Li-Ying Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Chuen Huang
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Yu-Chin Lin
- Division of Medical Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Le-Jung Wu
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan
| | - Hui-Ju Tien
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan
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Chung CS, Lo WC, Lee YC, Wu MS, Wang HP, Liao LJ. Image-enhanced endoscopy for detection of second primary neoplasm in patients with esophageal and head and neck cancer: A systematic review and meta-analysis. Head Neck 2015; 38 Suppl 1:E2343-9. [DOI: 10.1002/hed.24277] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 05/13/2015] [Accepted: 09/12/2015] [Indexed: 12/16/2022] Open
Affiliation(s)
- Chen-Shuan Chung
- Department of Internal Medicine; Far Eastern Memorial Hospital; Banciao District New Taipei City Taiwan
- College of Medicine; Fu Jen Catholic University; New Taipei City Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology; Far Eastern Memorial Hospital; Banciao District New Taipei City Taiwan
| | - Yi-Chia Lee
- Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Hsiu-Po Wang
- Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology; Far Eastern Memorial Hospital; Banciao District New Taipei City Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health; National Taiwan University; Taipei Taiwan
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Lo WC, Chang CM, Liao LJ, Wang CT, Young YH, Chang YL, Cheng PW. Assessment of D-methionine protecting cisplatin-induced otolith toxicity by vestibular-evoked myogenic potential tests, ATPase activities and oxidative state in guinea pigs. Neurotoxicol Teratol 2015. [PMID: 26219586 DOI: 10.1016/j.ntt.2015.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To date, inadequate study has been devoted to the toxic vestibular effects caused by cisplatin. In addition, no electrophysiological examination has been conducted to assess cisplatin-induced otolith toxicity. The purposes of this study are thus two-fold: 1) to determine whether cervical vestibular-evoked myogenic potentials (VEMPs) and ocular VEMPs are practical electrophysiological methods of testing for cisplatin-induced otolith toxicity and 2) to examine if D-methionine (D-met) pre-injection would protect the otolith organs against cisplatin-induced changes in enzyme activities and/or oxidative status. Guinea pigs were intraperitoneally treated once daily with the following injections for seven consecutive days: sterile 0.9% saline control, cisplatin (5 mg/kg) only, D-met (300 mg/kg) only, or a combination of d-met (300 mg/kg) and cisplatin (5 mg/kg), respectively, with a 30 minute window in between. Each animal underwent the oVEMP and cVEMP tests before and after treatment. The changes in the biochemistry of the otolith organs, including membranous Na(+), K(+)-ATPase and Ca(2+)-ATPase, lipid peroxidation (LPO) levels and nitric oxide (NO) levels, were also evaluated. In the cisplatin-only treated guinea pigs, the mean amplitudes of the oVEMP tests were significantly (p<0.05) decreased when compared to the other three groups. In guinea pigs receiving both D-met and cisplatin, the amplitudes of their oVEMP tests were significantly larger (p<0.05) than those of the cisplatin-only group, but smaller (p<0.05) than those of the saline control or D-met-only group. However, no significant difference of the amplitudes of cVEMP tests was noted among the four groups. In comparison with the other three groups, the cisplatin-only group had the lowest (ps<0.05) mean Na(+), K(+)-ATPase and Ca(2+)-ATPase, and the highest (ps<0.05) LPO and NO levels. The oVEMP tests were feasible for the evaluation of cisplatin-related otolith dysfunction. D-Met attenuated the reduced ATPase activities and increased oxidative stress induced by cisplatin toxicity in the otolith organs.
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Affiliation(s)
- Wu-Chia Lo
- Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan; Oriental Institute of Technology, Taipei, Taiwan
| | - Chih-Ming Chang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Chi-Te Wang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Yi-Ho Young
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yih-Leong Chang
- Department and Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan; Oriental Institute of Technology, Taipei, Taiwan.
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Liao LJ, Hsu WL, Wang CT, Lo WC, Lai MS. Analysis of sentinel node biopsy combined with other diagnostic tools in staging cN0 head and neck cancer: A diagnostic meta-analysis. Head Neck 2015; 38:628-34. [PMID: 25524256 DOI: 10.1002/hed.23945] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2014] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The purpose of this was to find a staging strategy sensitive enough to reduce the risk of occult metastases in cN0 head and neck cancer to below 15% to 20%. METHODS A total of 73 articles were selected for analysis of the diagnostic performance in staging cN0 head and neck cancer. Hypothetical estimation of negative predictive value (NPV) was calculated based on the Bayesian theory. RESULTS The pooled estimates for sensitivity were 56.4% and 84.9% for ultrasound-guided fine-needle aspiration (FNA) and sentinel node biopsy (SNB). The pooled estimates for sensitivity were 47.0%, 56.6%, 48.3%, and 63.3% for CT, MRI, positron emission tomography (PET), and ultrasound, respectively. The pooled estimates for specificity were 88.9%, 82.5%, 86.2%, and 79.1% for CT, MRI, PET, and ultrasound. In estimation, the CT or MRI with SNB strategies had NPV higher than 85% even when the pretest metastatic rate was 60%. CONCLUSION The SNB procedure has the best performance. A combination of CT/MRI and SNB for cN0 head and neck cancer is preferred.
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Affiliation(s)
- Li-Jen Liao
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Wan-Lun Hsu
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Chi-Te Wang
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Mei-Shu Lai
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Center of Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan
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Wang CT, Liao LJ, Huang TW, Lo WC, Cheng PW. Comparison of treatment outcomes of transnasal vocal fold polypectomy versus microlaryngoscopic surgery. Laryngoscope 2014; 125:1155-60. [PMID: 25545269 DOI: 10.1002/lary.25088] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 10/19/2014] [Accepted: 11/17/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Office-based procedures have been proposed for the treatment of vocal polyps, including indirect laryngoscopic surgery and angiolytic laser photocoagulation. Our previous report documented good treatment outcomes by combining the two aforementioned procedures. This study was intended to further compare the treatment outcomes of office transnasal vocal fold polypectomy (VFP) with those of microlaryngoscopic surgery (MLS). STUDY DESIGN A matched cohort study. METHODS This study retrospectively enrolled 50 age-, gender-, and size-matched patients with vocal polyps treated by VFP or MLS at a tertiary teaching hospital from January 2012 to October 2013. Treatment outcomes were evaluated before, 2 weeks, and 6 weeks after the procedures via perceptual rating of voice quality, acoustic measurement of the speech signal, 10-item voice-handicap index, maximal phonation time, subjective rating of voice quality, and videolaryngostroboscopic evaluation. RESULTS Both VFP and MLS resulted in significant clinical improvements 2 and 6 weeks postoperatively. Study results exhibited similar objective outcomes between VFP and MLS, whereas patients who received VFP reported higher subjective voice quality than those receiving MLS 2 weeks postoperatively. Six weeks after the procedures, the objective and subjective treatment outcomes were not significantly different between the two treatment groups. CONCLUSION This study shows that transnasal VFP may be used as an effective alternative treatment for small vocal polyps. Patients who received office VFP experienced rapid symptomatic relief with a higher degree of subjective effectiveness than MLS 2 weeks postoperatively, whereas the overall treatment outcomes showed a comparable level of effectiveness for both modalities. LEVEL OF EVIDENCE 3B.
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Affiliation(s)
- Chi-Te Wang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan; Oriental Institute of Technology, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Hsieh CH, Shueng PW, Wang LY, Liao LJ, Lin YC, Kuo YS, Lo WC, Tseng CF, Tien HJ, Chou HL, Hsieh YP, Wu LJ, Chen YJ. Clinical effectiveness, toxicity, and failure patterns of helical tomotherapy for postoperative oral cavity cancer patients. Onco Targets Ther 2014; 7:405-14. [PMID: 24648744 PMCID: PMC3956740 DOI: 10.2147/ott.s59998] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The outcome of postoperative high- and intermediate-risk oral cavity cancer (OCC) patients receiving helical tomotherapy (HT) remains limited. Materials and methods Between November 2006 and November 2012, 53 postoperative high- and intermediate-risk OCC patients treated with HT were enrolled. Results The 4-year locoregional, local, and regional control rates were 66%, 76.4%, and 94.3%, respectively. The 4-year locoregional control rates of oral tongue and buccal mucosa cancer were 88.3% and 37.1%, respectively (P=0.012). Eleven (20.8%) patients experienced locoregional failure. In-field failure occurred in six of 53 (11.3%) in the primary area and three of 53 (5.7%) in the regional lymph-node area. No marginal failure was noted. Two of 53 (3.8%) experienced out-of-field failure. The rates of grade 3 dermatitis, mucositis, and dysphagia were 11%, 34%, and 13%, respectively. No grade 3 xerostomia was noted. Grade 2 xerostomia was 33% at month 6 and declined to 0 at month 48. A rate of 56% of grade 2 trismus at month 6 was noted, and declined to around 30% after 2 years. No grade 3 trismus was noted after 2 years. Conclusion HT as a postoperative modality provided satisfying results, especially for xerostomia and trismus, and was impressive in high- and intermediate-risk OCC patients receiving postoperative HT.
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Affiliation(s)
- Chen-Hsi Hsieh
- Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan ; Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Wei Shueng
- Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan ; Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan
| | - Li-Ying Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology, Oriental Institute of Technology, Taipei, Taiwan
| | - Yu-Chin Lin
- Division of Medical Oncology and Hematology, Department of Internal Medicine, Oriental Institute of Technology, Taipei, Taiwan
| | - Ying-Shiung Kuo
- Department of Dentistry and Oral Surgery, Oriental Institute of Technology, Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Oriental Institute of Technology, Taipei, Taiwan
| | - Chien-Fu Tseng
- Department of Dentistry and Oral Surgery, Oriental Institute of Technology, Taipei, Taiwan
| | - Hui-Ju Tien
- Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Hsiu-Ling Chou
- Department of Nursing, Far Eastern Memorial Hospital, Oriental Institute of Technology, Taipei, Taiwan ; Department of Nursing, Oriental Institute of Technology, Taipei, Taiwan
| | - Yen-Ping Hsieh
- Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Le-Jung Wu
- Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Yu-Jen Chen
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan ; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan ; Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan
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Hsieh LC, Chen JW, Wang LY, Tsang YM, Shueng PW, Liao LJ, Lo WC, Lin YC, Tseng CF, Kuo YS, Jhuang JY, Tien HJ, Juan HF, Hsieh CH. Predicting the severity and prognosis of trismus after intensity-modulated radiation therapy for oral cancer patients by magnetic resonance imaging. PLoS One 2014; 9:e92561. [PMID: 24658376 PMCID: PMC3962418 DOI: 10.1371/journal.pone.0092561] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 02/24/2014] [Indexed: 12/15/2022] Open
Abstract
To develop magnetic resonance imaging (MRI) indicators to predict trismus outcome for post-operative oral cavity cancer patients who received adjuvant intensity-modulated radiation therapy (IMRT), 22 patients with oral cancer treated with IMRT were studied over a two-year period. Signal abnormality scores (SA scores) were computed from Likert-type ratings of the abnormalities of nine masticator structures and compared with the Mann-Whitney U-test and Kruskal-Wallis one-way ANOVA test between groups. Seventeen patients (77.3%) experienced different degrees of trismus during the two-year follow-up period. The SA score correlated with the trismus grade (r = 0.52, p<0.005). Patients having progressive trismus had higher mean doses of radiation to multiple structures, including the masticator and lateral pterygoid muscles, and the parotid gland (p<0.05). In addition, this group also had higher SA-masticator muscle dose product at 6 months and SA scores at 12 months (p<0.05). At the optimum cut-off points of 0.38 for the propensity score, the sensitivity was 100% and the specificity was 93% for predicting the prognosis of the trismus patients. The SA score, as determined using MRI, can reflect the radiation injury and correlate to trismus severity. Together with the radiation dose, it could serve as a useful biomarker to predict the outcome and guide the management of trismus following radiation therapy.
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Affiliation(s)
- Li-Chun Hsieh
- Division of Medical Imaging, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Life Science, Institute of Molecular and Cellular Biology, Center for Systems Biology, National Taiwan University, Taipei, Taiwan
- Medical Imaging Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - John W. Chen
- Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Massachusetts, United States of America
| | - Li-Ying Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yuk-Ming Tsang
- Division of Medical Imaging, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Yu-Chin Lin
- Div. Medical Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Chien-Fu Tseng
- Department of Dentistry and Oral Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Ying-Shiung Kuo
- Department of Dentistry and Oral Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Jie-Yang Jhuang
- Department of Anatomical Pathology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Hui-Ju Tien
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Hsueh-Fen Juan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
- Medical Imaging Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Chung CS, Liao LJ, Lo WC, Chou YH, Chang YC, Lin YC, Hsu WF, Shueng PW, Lee TH. Risk factors for second primary neoplasia of esophagus in newly diagnosed head and neck cancer patients: a case-control study. BMC Gastroenterol 2013; 13:154. [PMID: 24456340 PMCID: PMC4028981 DOI: 10.1186/1471-230x-13-154] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 10/21/2013] [Indexed: 02/07/2023] Open
Abstract
Background The prevalence of esophageal neoplasia in head and neck (H&N) cancer patients is not low; however, routine esophageal surveillance is not included in staging of newly-diagnosed H&N cancers. We aimed to investigate the risk factors for synchronous esophageal neoplasia and the impact of endoscopy on management of H&N cancer patients. Methods A total of 129 newly diagnosed H&N cancer patients who underwent endoscopy with white-light imaging, narrow-band imaging (NBI) with magnifying endoscopy (ME), and chromoendoscopy with 1.5% Lugol’s solution, before definite treatment were enrolled prospectively. Results 60 esophageal lesions were biopsied from 53 (41.1%) patients, including 11 low-grade, 14 high-grade intraepithelial neoplasia and 12 invasive carcinoma in 30 (23.3%) patients. Alcohol consumption [odds ratio (OR) 5.90, 95% confidence interval (CI) 1.23-26.44], advanced stage (stage III and IV) of index H&N cancers (OR 2.98, 95% CI 1.11-7.99), and lower body mass index (BMI) (every 1-kg/m2 increment with OR 0.87, 95% CI 0.76-0.99) were independent risk factors for synchronous esophageal neoplasia. NBI with ME was the ideal screening tool (sensitivity, specificity, and accuracy of 97.3%, 94.1%, and 96.3%, respectively, for detection of dysplastic and cancerous esophageal lesions). The treatment strategy was modified after endoscopy in 20 (15.5%) patients. The number needed to screen was 6.45 (95% CI 4.60-10.90). Conclusions NBI-ME surveillance of esophagus should be done in newly-diagnosed H&N cancer patients, especially those with alcohol drinking, lower BMI, and advanced stage of primary tumor.
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Cheng PW, Chou HW, Wang CT, Lo WC, Liao LJ. Evaluation and development of a real-time predictive model for ultrasound investigation of malignant thyroid nodules. Eur Arch Otorhinolaryngol 2013; 271:1199-206. [PMID: 23846666 DOI: 10.1007/s00405-013-2629-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
Abstract
Ultrasound investigations and correct identification of malignant thyroid nodules depend on the experience and qualifications of the investigators; thus, a model that provides better evaluation before needle aspiration is desired. Data from 687 patients with 726 thyroid nodules comprising 65 malignant nodules (61 papillary and 4 follicular carcinoma) and 661 benign nodules were used to construct a predictive model. Presence of micro-calcification, taller-than-wide shape, predominant solid echostructure, and irregular margins were shown to be good independent predictive parameters. A thyroid nodule was predicted as malignant with a score ≥3.3. Internal validation of this predictive tool by the bootstrapping method showed excellent overall model performance.
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Affiliation(s)
- Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, #21, Section 2, Nan-Ya South Road, Pan Chiao, New Taipei, 220, Taiwan
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Chang YC, Lo WC, Lo CY, Liao LJ. Occult Papillary Thyroid Carcinoma Initially Presenting as Cervical Cystic Lymph Node Metastasis: Report of Two Cases. J Med Ultrasound 2013. [DOI: 10.1016/j.jmu.2013.04.005] [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: 10/26/2022] Open
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Lo WC, Cheng PW, Wang CT, Yeh ST, Liao LJ. Pain levels associated with ultrasound-guided fine-needle aspiration biopsy for neck masses. Head Neck 2013; 36:252-6. [DOI: 10.1002/hed.23303] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 11/09/2022] Open
Affiliation(s)
- Wu-Chia Lo
- Department of Otolaryngology; Far Eastern Memorial Hospital; Taipei Taiwan
- Oriental Institute of Technology; Taipei Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology; Far Eastern Memorial Hospital; Taipei Taiwan
- Oriental Institute of Technology; Taipei Taiwan
| | - Chi-Te Wang
- Department of Otolaryngology; Far Eastern Memorial Hospital; Taipei Taiwan
- Oriental Institute of Technology; Taipei Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Shu-Tin Yeh
- Endocrine and Metabolism; Department of Internal Medicine; Far Eastern Memorial Hospital; Taipei Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology; Far Eastern Memorial Hospital; Taipei Taiwan
- Oriental Institute of Technology; Taipei Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
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