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Schilling C, Collins L, Farrow A, McGurk M, Bisase B, Kerawala C, Wan S, Hall G, Thavaraj S. Incidental Thyroid Tissue in Sentinel Nodes From Oral Squamous Cell Carcinoma. Laryngoscope 2024; 134:1278-1281. [PMID: 37610258 DOI: 10.1002/lary.30996] [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: 04/13/2023] [Revised: 07/20/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Sentinel node biopsy (SNB) is a surgical staging test in which sentinel nodes (SNs) undergo intensive histological analysis. SNB diagnoses early cancer spread, but can also reveal unexpected findings within the SNs. We review cases of incidental thyroid cells (TC) found in SNs from patients with oral squamous cell carcinoma (OSCC) to assess the prevalence of TC, and the clinical significance of these. METHODS Multicenter retrospective review of SNB performed for cT1-T2N0 OSCC. Incidental TC were identified by TTF-1 or thyroglobulin positivity. Anatomical location of nodes containing TC, TC morphology, and ongoing management/follow up of this incidental finding was recorded. Neck dissections performed during the same period were reviewed to establish the expected incidence of TC in neck nodes without serial sectioning analysis. RESULTS 278 SNB cases were reviewed. Ten procedures detected TC in nine patients (10/278, 3.6%). During the same time period 725 neck dissections were performed, six containing TCs (6/725, 0.8%). One patient underwent SNB twice with TC identified on both occasions. Three patients had both OSCC metastasis and thyroid cells. All SNB patients with TC identified underwent thyroid USS with no primary tumours identified. Three patients underwent thyroidectomy, in all cases no primary thyroid tumour was found. CONCLUSION Prevalence of incidental TC in SNs appears to be higher than that reported in neck dissections, these are not likely to be clinically relevant and can be managed on a conservative basis in the absence of clear metastatic features. LEVEL OF EVIDENCE Multicentre retrospective cohort study, 3 Laryngoscope, 134:1278-1281, 2024.
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Affiliation(s)
- Clare Schilling
- Head and Neck Academic Centre, University College London, London, UK
- Head & Neck Surgery, University College London Hospital, London, UK
| | - Lisette Collins
- Head and Neck Pathology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Adrian Farrow
- Head & Neck Surgery, University College London Hospital, London, UK
| | - Mark McGurk
- Head and Neck Academic Centre, University College London, London, UK
- Head & Neck Surgery, University College London Hospital, London, UK
| | - Brian Bisase
- Department of Oral & Maxillofacial Surgery, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
| | - Cyrus Kerawala
- Head and Neck Unit, Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Simon Wan
- Institute of Nuclear Medicine, UCLH NHS Foundation Trust, London, UK
| | - Gill Hall
- Head and Neck Pathology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Selvam Thavaraj
- Head and Neck Pathology, Guy's & St Thomas' NHS Foundation Trust, London, UK
- Faculty of Dentistry, Oral & Craniofacial Science, King's College London, London, UK
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Madani G, Arain Z, Awad Z. The radiological unknown primary of the head and neck: Recommendations for imaging strategies based on a systematic review. Clin Otolaryngol 2024; 49:16-28. [PMID: 37846889 DOI: 10.1111/coa.14111] [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: 04/13/2023] [Revised: 09/24/2023] [Accepted: 09/30/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To develop recommendations for the radiological investigation of clinically occult primary cancer in the head and neck. DESIGN AND SETTING In accordance with PRISMA guidelines, a search was performed on Medline, Embase and Cochrane library databases to investigate the efficacy of ultrasound guided Fine Needle Aspiration (US FNAC), contrast enhanced CT (CECT), magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose PET-CT (18F-FDG PET-CT) in the investigation of head and neck squamous cell carcinoma from an unknown primary (HNSCCUP) presenting with a metastatic cervical lymph node (s). The Quality Assessment of Diagnostic Accuracy Studies Version 2 tool and SIGN 50 guidelines were used to assess the risk of bias and quality of the included studies. PARTICIPANTS Adult patients presenting with metastatic cervical lymph nodes from a HNSCCUP. MAIN OUTCOME MEASURES Utility of different imaging modalities (PET-CT, MRI, CE CT and US FNAC in the management of HNSCCUP). RESULTS Twenty-eight studies met inclusion criteria; these were meta-analyses, systematic reviews, prospective and retrospective studies. CONCLUSIONS The optimal imaging strategy involves utilisation of various imaging modalities. US FNAC can provide the initial diagnosis and HPV status of the occult primary tumour. CECT and MRI detect up to 44% of occult tumours and guide management. FDG PET-CT is the most sensitive imaging modality for the detection of CUP and should be performed prior to panendoscopy.
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Affiliation(s)
- Gitta Madani
- Imperial College Healthcare NHS Trust, London, UK
| | - Zoya Arain
- Imperial College Healthcare NHS Trust, London, UK
| | - Zaid Awad
- Imperial College Healthcare NHS Trust, London, UK
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3
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Goldschmidt S, Soltero-Rivera M, Quiroz A, Wong K, Rebhun R, Zwingenberger A, Ren Y, Taylor S, Arzi B. The diagnostic yield of preoperative screening for oral cancer in dogs over 15 years, part 1: locoregional screening. J Am Vet Med Assoc 2023; 261:S14-S23. [PMID: 37863103 PMCID: PMC10956222 DOI: 10.2460/javma.23.05.0299] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/16/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVE Determine locoregional diagnostic yield of 4-site screening (head, neck, chest, and abdomen) to diagnose metastatic disease or clinically significant comorbid diseases in dogs with oral cancer. ANIMALS 381 dogs with histologically confirmed oral tumors. METHODS Medical records from 381 dogs with histologically confirmed oral tumors that underwent preoperative screening were retrospectively reviewed. RESULTS Skull and neck CT scan was performed on 348 patients. Bone lysis was present in 74.4% of tumors. Oral squamous cell carcinoma, sarcomas, and T2-T3 (> 2 cm) tumors had a significantly (P < .05) increased incidence of lysis compared to odontogenic and T1 (< 2 cm) tumors, respectively. Minor incidental findings were present in 60.6% of CT scans. Major incidental findings were found in 4.6% of scans. The risk of diagnosing an incidental finding increased by 10% and 20% per year of age for minor and major findings, respectively. Lymph node metastasis was diagnosed with CT or cytology in 7.5% of cases (10.7% of nonodontogenic tumors, 0% of odontogenic tumors). Oral malignant melanoma, oral squamous cell carcinoma, and T3 tumors had the highest prevalence of metastatic disease at the time of staging. The presence of bone lysis was not associated with cervical metastasis. CLINICAL RELEVANCE Major incidental findings were rare (< 5%) but primarily included secondary extraoral tumors. Lymphatic metastasis was diagnosed in 10.7% of nonodontogenic tumors, but cytology was not performed in the majority of cases and often included only a single mandibular node. Therefore, these results likely underestimate the incidence of lymphatic metastasis. Guided lymph node sampling is highly recommended, especially for oral malignant melanoma, squamous cell carcinoma, and T2-T3 tumors.
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Affiliation(s)
- Stephanie Goldschmidt
- Department of Surgical and Radiologic Sciences, University of California School of Veterinary Medicine, Davis, CA 95616, USA
| | - Maria Soltero-Rivera
- Department of Surgical and Radiologic Sciences, University of California School of Veterinary Medicine, Davis, CA 95616, USA
| | - Adrian Quiroz
- University of California College of Agriculture and Environmental Sciences, Davis, CA 95616, USA
| | - Kristen Wong
- University of California College of Agriculture and Environmental Sciences, Davis, CA 95616, USA
| | - Robert Rebhun
- Department of Surgical and Radiologic Sciences, University of California School of Veterinary Medicine, Davis, CA 95616, USA
| | - Allison Zwingenberger
- Department of Surgical and Radiologic Sciences, University of California School of Veterinary Medicine, Davis, CA 95616, USA
| | - Yunyi Ren
- Department of Biostatistics, Epidemiology, and Research Design, Clinical and Translation Science Center, University of California, Davis, CA 95661, USA
| | - Sandra Taylor
- Department of Biostatistics, Epidemiology, and Research Design, Clinical and Translation Science Center, University of California, Davis, CA 95661, USA
| | - Boaz Arzi
- Department of Surgical and Radiologic Sciences, University of California School of Veterinary Medicine, Davis, CA 95616, USA
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4
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Thoenissen P, Heselich A, Deeg S, Al-Maawi S, Tanneberger A, Sader R, Ghanaati S. Extent of Neck Dissection and Cervical Lymph Node Involvement in Oral Squamous Cell Carcinoma. Front Oncol 2022; 12:812864. [PMID: 35686113 PMCID: PMC9172998 DOI: 10.3389/fonc.2022.812864] [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: 11/10/2021] [Accepted: 04/15/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Tumor resection combined with neck dissection (ND) or radiotherapy are established methods for the treatment of patients with oral squamous cell carcinoma (OSCC). However, the extent of ND can lead to postoperative complications. Therefore, for the first time, this study aims to identify lymph node involvement in OSCC performed in a bilateral systematic approach based on oncologic board meetings relying on presurgical magnetic resonance imaging (MRI) and computed tomography (CT). Materials and Methods In a retrospective single-center study, patients with primary OSCC resection and systematic ND performed in 4 different manners (MRND III bilateral, MRND III left and SND right, MRND III right, SND left, and SND bilateral) were examined. Lymph node involvement allocated to levels was evaluated depending on primary localization and T-stage. Results A total of 177 consecutive patients (mean age 63.64; 92 female, male 85) were enrolled in this study. A total of 38.98% showed cervical lymph node involvement, and metastases were found in levels 1–4. The distribution of positive lymph node metastases (n=190 LNs) was 39.47% in level 1, 38.95% in level 2, 10.53% in level 3, and 11.05% in level 4. Discussion In a cohort of OSCC patients with systematic bilateral ND, levels 1 and 2 had positive lymph node involvement, and no lymph node involvement was seen at level 5. Without any clinical or imaging suspicion, ND expanding 5-level MRND should be avoided regardless of the primary tumor localization, T-stage and intraoperative proof of cervical metastases.
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Affiliation(s)
- Philipp Thoenissen
- Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Anja Heselich
- Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany.,Frankfurt Oral Regenerative Medicine (FORM), Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Stefanie Deeg
- Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany.,Frankfurt Oral Regenerative Medicine (FORM), Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Sarah Al-Maawi
- Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany.,Frankfurt Oral Regenerative Medicine (FORM), Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Anna Tanneberger
- Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Robert Sader
- Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Shahram Ghanaati
- Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany.,Frankfurt Oral Regenerative Medicine (FORM), Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
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Stembirek J, Cermakova Z, Kulnig M, Hurnik P, Cvek J, Resova K, Jonszta T, Litschmanova M, Stransky J. The use of a battery of examination methods for detection of cervical metastases in squamous cell carcinoma of the oral cavity. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 165:224-228. [PMID: 32597420 DOI: 10.5507/bp.2020.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/11/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In patients with squamous cell carcinoma of the orofacial area, the presence of cervical metastases represents a single most significant prognostic factor. This fact underlines the importance of thorough examination of the cervical lymph nodes for potential tumor involvement. To verify this, the most common investigative methods are physical examination (PE), sonography (US) and computed tomography (CT), which have also been used to assess the stage of the disease in the patients in our research. OBJECTIVE To evaluate the performance of individual methods (physical examination, sonography, computed tomography) and combinations. METHOD Patients with squamous cell carcinoma of the oral cavity, who had undergone physical, US and CT examinations at our department followed by radical neck dissection were included in this retrospective study. A total of 57 patients were included. RESULTS The sensitivity of PE, US and CT were 38%, 69% and 61%, respectively, however CT+US combination yielded 83% sensitivity and combination of all these methods 86% sensitivity. The number of false positives was however relatively high with specificity of the 3-way combination at 65%. CONCLUSION A combination of our three widely available inexpensive methods detected 86% of metastases in cervical nodes. The large number of false positives however indicates that the method should rather be used for screening in selecting patients who need additional and more expensive imaging than for diagnosing cervical metastases. Also, as 14% of cervical metastases pass undetected using our method, we would recommend an additional examination at least by US+PE several weeks to a few months after the initial examination.
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Affiliation(s)
- Jan Stembirek
- Department of Oral and Maxillofacial Surgery, University Hospital Ostrava, Czech Republic.,Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Czech Republic
| | - Zuzana Cermakova
- Faculty of Medicine, University of Ostrava, Czech Republic.,Department of Oncology, University Hospital Ostrava, Czech Republic
| | - Michal Kulnig
- Faculty of Medicine, University of Ostrava, Czech Republic
| | - Pavel Hurnik
- Department of Pathology, University Hospital Ostrava, Czech Republic
| | - Jakub Cvek
- Department of Oncology, University Hospital Ostrava, Czech Republic
| | - Kamila Resova
- Department of Oncology, University Hospital Ostrava, Czech Republic
| | - Tomas Jonszta
- Department of Radiology, University Hospital Ostrava, Czech Republic
| | - Martina Litschmanova
- Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, SB-Technical University Ostrava, Czech Republic
| | - Jiri Stransky
- Department of Oral and Maxillofacial Surgery, University Hospital Ostrava, Czech Republic
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Kumarasamy G, Balasubramanian A, Abdullah B. Cervical metastasis of testicular cancer: Case Report and Review of Literature. Gulf J Oncolog 2018; 1:73-77. [PMID: 30145556] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
Testicular cancer is an uncommon malignancy of the male reproductive organ, accounting for 1% of all cancers in men. Distant cervical metastasis from testicular cancer has been reported in 5% of patients. We present 2 cases of non-seminomatous testicular cancers that were diagnosed retrospectively in patients who presented with pure cervical lymph nodes. A comprehensive approach bearing in mind the possible differentials, pathogenesis and treatment options are discussed.
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Affiliation(s)
- Guhan Kumarasamy
- Dept. of ORL-HNS, Hospital Raja Permaisuri Bainun, Jalan Hospital, 30990 Ipoh, Perak, Malaysia
- Dept. of ORL-HNS, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Anusha Balasubramanian
- Dept. of ORL-HNS, Hospital Raja Permaisuri Bainun, Jalan Hospital, 30990 Ipoh, Perak, Malaysia
| | - Baharudin Abdullah
- Dept. of ORL-HNS, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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7
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Stangenberg M, Viezens L, Eicker SO, Mohme M, Mende KC, Dreimann M. Cervical vertebroplasty for osteolytic metastases as a minimally invasive therapeutic option in oncological surgery: outcome in 14 cases. Neurosurg Focus 2018; 43:E3. [PMID: 28760030 DOI: 10.3171/2017.5.focus17175] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The treatment of cervical spinal metastases represents a controversial issue regarding the type, extent, and invasiveness of interventions. In the lumbar and thoracic spine, kypho- and vertebroplasties have been established as minimally invasive procedures for patients with metastases to the vertebral bodies and without neurological deficit. These procedures show good results with respect to pain reduction and low complication rates. However, limited data are available for kypho- and vertebroplasties for cervical spinal metastases. In an effort to add to existing data, the authors here present a case series of 14 patients who were treated for osteolytic metastases of the cervical spine using vertebroplasty alone or in addition to another surgical procedure involving the cervical spine in a palliative setting to reduce pain and restore stability. METHODS Fourteen patients consisting of 8 males and 6 females, with a mean age of 64.7 years (range 44-85 years), were treated with vertebroplasty at the authors' clinic between January 2015 and November 2016. In total, 25 vertebrae were treated with vertebroplasty: 10 C-2, 5 C-3, 2 C-4, 2 C-5, 3 C-6, and 3 C-7. Two patients had an additional posterior stabilization and 5 patients an additional anterior stabilization. In 13 cases, the surgical approach was a modified Smith-Robinson approach; in 1 case, the cement was injected into the corpus axis from posteriorly. Patients with osteolytic defects of the posterior wall of the vertebral body did not undergo surgery, nor did patients with neurological deficits. Preoperatively, on the 2nd day after surgery, and at the follow-up, neck pain was rated using the visual analog scale (VAS). RESULTS Twelve patients were examined at follow-up (mean 9 months). Neck pain was rated as a mean of 6.0 (range 3-8) preoperatively, 2.9 on Day 2 after surgery (range 0-5), and 0.5 at the follow-up (range 0-4), according to the VAS. The mean Neck Disability Index at follow-up was 3.6% (range 0%-18%). CONCLUSIONS Anterior vertebroplasty of the cervical spine via an anterolateral approach represents a safe and minimally invasive procedure with a low complication rate and appears suitable for reducing pain and restoring stability in cases of cervical spinal metastases. Vertebroplasties can be combined with other anterior and posterior operations of the cervical spine and, in the axis vertebra, can be performed transpedicularly from posteriorly. Thus, in cases in which the posterior wall of the vertebral body is intact, vertebroplasty represents a less invasive alternative to vertebral replacement in oncological surgery. Prospective randomized trials with a longer follow-up period and a larger patient cohort are needed to confirm the encouraging results of this case series.
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Affiliation(s)
| | - Lennart Viezens
- Department of Trauma Surgery, Orthopedics and Plastic Surgery, University Hospital Goettingen, Germany
| | - Sven O Eicker
- Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg; and
| | - Malte Mohme
- Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg; and
| | - Klaus C Mende
- Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg; and
| | - Marc Dreimann
- Departments of Trauma, Hand and Reconstructive Surgery, and
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Abstract
AIM In this study, we investigated the role of Y-box binding protein-1 (YB-1), c-Myb and miR-155 in human laryngeal squamous cell carcinoma (LSCC) progression. MATERIALS & METHODS Quantitative real-time PCR, western blot, MTT and Transwell were conducted to determine the expression and function of YB-1/miR-155 pathway. Univariate and multivariate analyses were used to determine the prognostic factors. RESULTS Expression of YB-1, c-Myb and miR-155 was higher in LSCC tissues. YB-1 promoted proliferation, invasiveness and migration of Hep-2 cells in vitro. Patients with higher YB-1 correlated with advanced T stage, poor differentiation and cervical metastasis. LSCC patients with high YB-1 expression showed poor overall survival. CONCLUSION YB-1 promotes LSCC progression by increasing miR-155 levels via c-Myb and acts as a prognostic factor.
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Affiliation(s)
- Xudong Zhao
- Department of Otorhinolaryngology, Shengjing Hospital, China Medical University, Shenyang, 110004, PR China
| | - Wei Zhang
- Department of Endocrinology Shengjing Hospital, China Medical University, Shenyang, 110004, PR China
| | - Wenyue Ji
- Department of Otorhinolaryngology, Shengjing Hospital, China Medical University, Shenyang, 110004, PR China
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9
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Abstract
AIM We sought to determine the function of miR-181a/GATA6 pathway in the progression of laryngeal squamous cell carcinoma (LSCC). MATERIALS & METHODS The expression of miR-181a and GATA6 were detected using quantitative real-time-PCR and western blotting in 127 LSCC samples and 32 corresponding control mucosa tissues. Cell death, migration and apoptosis were measured in Hep-2 cells using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT), Transwell migration assay and apoptosis assay, respectively. The prognosis was determined by the follow-up, univariate analysis and multivariate analysis. RESULTS We observed decreased miR-181a levels and increased GATA6 expression in LSCC samples compared with control mucosa tissues. Transfection of miR-181a decreased GATA6 expression, suppressed migration and promoted apoptosis in Hep-2 cells. Furthermore, silencing GATA6 suppressed cell migration and promoted apoptosis in Hep-2 cells. Notably, patients with high miR-181a levels had a longer life span. CONCLUSION MiR-181a inhibits LSCC progression via suppressing GATA6 expression. MiR-181a is an independent prognostic factor in LSCC patients.
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Affiliation(s)
- Xudong Zhao
- Department of Otorhinolaryngology, Shengjing Hospital, China Medical University, Shenyang 110004, PR China
| | - Wei Zhang
- Department of Endocrinology Shengjing Hospital, China Medical University, Shenyang 110004, PR China
| | - Wenyue Ji
- Department of Otorhinolaryngology, Shengjing Hospital, China Medical University, Shenyang 110004, PR China
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10
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Schilling C, Shaw R, Schache A, McMahon J, Chegini S, Kerawala C, McGurk M. Sentinel lymph node biopsy for oral squamous cell carcinoma. Where are we now? Br J Oral Maxillofac Surg 2017; 55:757-762. [PMID: 28864148 DOI: 10.1016/j.bjoms.2017.07.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 07/13/2017] [Indexed: 12/16/2022]
Abstract
Recent data have confirmed that elective surgical management of the cN0 neck improves survival in patients with early (T1-T2) oral squamous cell carcinoma (SCC), and is better than watchful waiting. However, elective neck dissection (END) may not always be necessary. Sentinel node biopsy (SNB), which is a reliable staging test for patients with early disease and a radiologically N0 neck, can detect occult metastases with a sensitivity of 86%-94%. Patients with no sign of metastases on SNB could avoid neck dissection, and individual treatment should reduce both morbidity and cost. Currently, SNB for oral SCC is available at a limited number of centres in the UK, but this is likely to change as national guidelines have recommended that it is incorporated into the standard treatment pathway. It is therefore important to understand the current evidence that supports its use, its limitations and related controversies, and to plan for a validated training programme.
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Affiliation(s)
- C Schilling
- Department of Oral and Maxillofacial Surgery, St Georges Hospital, Blackshaw Road, Tooting, London, England, SW17 0QT.
| | - R Shaw
- Department of Molecular & Clinical Cancer Medicine, University of Liverpool & Aintree University Hospitals NHS Foundation Trust, Longmoor Lane, Liverpool, Merseyside, England, L9 7AL
| | - A Schache
- Department of Molecular & Clinical Cancer Medicine, University of Liverpool & Aintree University Hospitals NHS Foundation Trust, Longmoor Lane, Liverpool, Merseyside, England, L9 7AL
| | - J McMahon
- Department of Head and Neck Surgery, Southern General Hospital, 1345 Govan Rd, Govan, Glasgow, Scotland, G51 4TF
| | - S Chegini
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Watford Road, Harrow HA1 3UJ
| | - C Kerawala
- Department of Head and Neck Surgery, Royal Marsden Hospital, 203 Fulham Road, Chelsea, London SW3 6JJ
| | - M McGurk
- Department of Oral and Maxillofacial Surgery, University College London Hospital, 235 Euston Road, Fitzrovia, London NW1 2BU
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11
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Loganathan P, Sayan A, Hsu DWK, Paraneetharan S, Ilankovan V. Squamous cell carcinoma of the anterior tongue: is tumour thickness an indicator for cervical metastasis? Int J Oral Maxillofac Surg 2016; 46:407-412. [PMID: 27919662 DOI: 10.1016/j.ijom.2016.11.003] [Citation(s) in RCA: 13] [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] [Received: 03/14/2016] [Revised: 07/08/2016] [Accepted: 11/03/2016] [Indexed: 12/27/2022]
Abstract
The incidence of squamous cell carcinoma (SCC) of the tongue accounts for 90% of all malignancies affecting the oral cavity and oropharynx. The distribution between the anterior and posterior tongue is equal. Nodal metastasis is dependent on various factors including tumour thickness, site, size, differentiation, and perineural and perivascular invasion. There is increasing evidence of a close correlation between tumour thickness and metastasis. A retrospective study covering the 16-year period from 2000 to 2016 was performed. Eighty-one patients with anterior tongue SCC were included. The only primary treatment was surgery. All patients were T1/T2N0M0 stage. Sixty-five patients underwent local excision with simultaneous selective neck dissection; 29 of these patients were confirmed to have occult metastasis. Sixteen patients underwent local excision only as an initial treatment. Four of them subsequently developed neck metastasis within a 6- to 18-month period. The results of this study support recent publications associating tumour thickness with nodal disease. Therefore, it is postulated that prophylactic neck dissection should be considered when the tumour thickness of anterior tongue SCC exceeds 5mm, in order to prevent lymphatic spread and improve the survival rate.
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Affiliation(s)
- P Loganathan
- Department of Oral and Maxillofacial Surgery, Poole Hospital NHS Foundation Trust, Poole, Dorset, UK
| | - A Sayan
- Department of Oral and Maxillofacial Surgery, Poole Hospital NHS Foundation Trust, Poole, Dorset, UK.
| | - D W K Hsu
- Department of Oral and Maxillofacial Surgery, Poole Hospital NHS Foundation Trust, Poole, Dorset, UK
| | - S Paraneetharan
- Department of Oral and Maxillofacial Surgery, Poole Hospital NHS Foundation Trust, Poole, Dorset, UK
| | - V Ilankovan
- Department of Oral and Maxillofacial Surgery, Poole Hospital NHS Foundation Trust, Poole, Dorset, UK
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12
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Vallianou N, Gounari P, Skourtis A, Vourlakou C. Cervical mass as the presenting manifestation of hepatocellular carcinoma. Hippokratia 2014; 18:285-287. [PMID: 25694768 PMCID: PMC4309154] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Hepatocellular carcinoma is one of the most common cancers in the world due to its association with chronic hepatitis infections. Amongst the most usual metastasis of hepatocellular carcinoma are the lymph nodes, the lungs and the bones. Soft tissue metastases are extremely rare. CASE PRESENTATION Herein, we report the case of a 73-years-old male patient who presented with cervical and upper extremities muscle pain along with paresthesias and a palpable mass on the cervical region. CONCLUSION This unusual clinical manifestation along with the above-described rare presentations of hepatocellular carcinoma must be taken into account, especially among patients with chronic hepatitis infections. Hippokratia 2014; 18 (3): 285-287.
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Affiliation(s)
- Ng Vallianou
- Evangelismos General Hospital, Department of Internal Medicine, Athens, Greece
| | - P Gounari
- Evangelismos General Hospital, Department of Internal Medicine, Athens, Greece
| | - A Skourtis
- Evangelismos General Hospital, Department of Internal Medicine, Athens, Greece
| | - C Vourlakou
- Evangelismos General Hospital, Department of Internal Medicine, Athens, Greece
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