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Pearce H, Hamilton D, Sharp L, Deane J, Kennedy M, O'Hara J. Routes to diagnosis of hypopharyngeal cancer: A single-centre experience. Clin Otolaryngol 2024. [PMID: 38515125 DOI: 10.1111/coa.14156] [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] [Received: 05/26/2023] [Revised: 02/07/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Helen Pearce
- Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
| | - David Hamilton
- Department of Otolaryngology-Head and Neck Surgery, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Jennifer Deane
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Matthew Kennedy
- Department of Oral and Maxillofacial Surgery, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
| | - James O'Hara
- Department of Otolaryngology-Head and Neck Surgery, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
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2
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Wu SG, Wang RJ, Zhou Y, Luo XY. Neoadjuvant therapy with chemotherapy and immune checkpoint inhibitor for laryngeal function preservation in locally advanced hypopharyngeal cancer. Front Immunol 2024; 15:1364799. [PMID: 38524124 PMCID: PMC10958379 DOI: 10.3389/fimmu.2024.1364799] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/23/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose To evaluate the efficacy and laryngeal function preservation of neoadjuvant treatment with chemotherapy and immune checkpoint inhibitor for locally advanced hypopharyngeal cancer (LAHPC). Methods We retrospectively collected LAHPC patients who were diagnosed between February 2022 and June 2023. The patients received a combination of chemotherapy and immune checkpoint inhibitors as the neoadjuvant therapy. The response to treatment, laryngeal function preservation rate, and short-term survival were assessed. Results A total of 20 patients were included. Of these patients, 17 (85.0%) had stage IVA-B disease. Ten (50%) and four (20%) patients achieved pathological complete response (PCR) and major pathological response (MPR) to the primary tumor, respectively. In addition, 6 patients had incomplete pathological response (IPR). In the neck, 19 patients had node-positive disease before treatment, and only 5 patients (26.4%) had PCR to regional lymph nodes. Pathologically positive lymph nodes were still observed in 14 (73.6%) patients. Significant downgrading on narrow-band imaging assessment in primary tumors was associated with a higher probability of PCR or MPR than those with IPR (92.9% vs. 33.3%, P=0.014). The overall rate of laryngeal preservation was 95.0%. No severe perioperative complications or perioperative death were found. All patients completed the recommended postoperative radiotherapy/chemoradiotherapy. The median follow-up period was 12.1 months. The 1-year progression-free survival and overall survival were 94.1% and 92.9%, respectively. During the follow-up period, all 19 patients who underwent laryngeal preservation surgery had their laryngeal function preserved. Conclusion The addition of an immune checkpoint inhibitor to neoadjuvant chemotherapy effectively preserves laryngeal function without increasing complications related to surgery and postoperative radiotherapy in LAHPC.
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Affiliation(s)
- San-Gang Wu
- Department of Radiation Oncology, Xiamen Cancer Quality Control Center, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Run-Jie Wang
- Department of Radiation Oncology, Xiamen Cancer Quality Control Center, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Yi Zhou
- Department of Otolaryngology-Head and Neck Surgery, Xiamen Key Laboratory of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xian-Yang Luo
- Department of Otolaryngology-Head and Neck Surgery, Xiamen Key Laboratory of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Meliante PG, Battilocchi L, Costantino A, Lee K, Moon SJ, Ralli M, Minni A, Capaccio P, Pignataro L, de Vincentiis M, Kim SH. Transoral robotic vertical partial laryngectomy (hemilaryngectomy) extended to the hypopharynx. Head Neck 2024; 46:708-712. [PMID: 38221740 DOI: 10.1002/hed.27634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/30/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024] Open
Abstract
Locally advanced laryngeal cancers treatment often involves total laryngectomy, which some patients are unwilling to undergo, even if this choice reduces their survival probability. Therefore, the objective of laryngeal oncologic surgery is not only to remove the tumor, but also to preserve the organ and its functions. To overcome these concerns, several partial laryngectomy techniques have been developed. This article describes the surgical technique and a case study of a 64-year-old male patient with locally advanced laryngeal squamous cell carcinoma who underwent vertical partial laryngectomy extending to the subglottis and hypopharynx using transoral robotic surgery (TORS) with a da Vinci Single Port surgical robot. The video and article provide a detailed description of the surgical technique, which resulted in successful tumor removal with excellent oncological and functional outcomes.
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Affiliation(s)
- Piero Giuseppe Meliante
- Department of Sense Organs, Sapienza University of Rome, Rome (RM), Italy
- Azienda Ospedaliera Policlinico Umberto I, Viale dell'Università, Rome (RM), Italy
- Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ludovica Battilocchi
- Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Andrea Costantino
- Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Kyuin Lee
- Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seo Jin Moon
- Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome (RM), Italy
- Azienda Ospedaliera Policlinico Umberto I, Viale dell'Università, Rome (RM), Italy
| | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, Rome (RM), Italy
- Azienda Ospedaliera Policlinico Umberto I, Viale dell'Università, Rome (RM), Italy
| | - Pasquale Capaccio
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Lorenzo Pignataro
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Marco de Vincentiis
- Department of Sense Organs, Sapienza University of Rome, Rome (RM), Italy
- Azienda Ospedaliera Policlinico Umberto I, Viale dell'Università, Rome (RM), Italy
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Tan W, Bui R, Ranasinghe VJ, Coblens O, Shabani S. Transoral Robotic Surgery for Oropharyngeal and Hypopharyngeal Squamous Cell Carcinoma. Cureus 2024; 16:e57186. [PMID: 38681419 PMCID: PMC11056221 DOI: 10.7759/cureus.57186] [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] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
With oropharyngeal cancer incidence rising globally, largely due to human papillomavirus (HPV), and hypopharyngeal cancer known for poor outcomes, innovative treatments are needed. Transoral robotic surgery (TORS) offers a minimally invasive approach that may improve upon traditional open surgery and radiotherapy/chemoradiotherapy (RT/CRT) methods. We conducted a literature review and included 40 PubMed studies comparing TORS, open surgery, and RT/CRT for oropharyngeal and hypopharyngeal squamous cell carcinoma (SCC), focusing on survival rates and swallowing function outcomes. TORS provides favorable survival outcomes and typically results in superior swallowing function post-treatment compared to other therapeutic modalities in both oropharyngeal and hypopharyngeal SCCs. The clinical benefits of TORS, including improved operative precision and minimized tissue disruption, along with the elimination of surgical incision recovery and reduced RT toxicity, suggest it is a valuable surgical approach for head and neck cancers.
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Affiliation(s)
- Wilhelmina Tan
- Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch (UTMB), Galveston, USA
| | - Rebecca Bui
- Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch (UTMB), Galveston, USA
| | - Viran J Ranasinghe
- Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch (UTMB), Galveston, USA
| | - Orly Coblens
- Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch (UTMB), Galveston, USA
| | - Sepehr Shabani
- Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch (UTMB), Galveston, USA
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Huang YC, Lee MC, Huang SY, Chou CM, Yang HW, Chen IC. Polygenic Risk Score in Predicting Esophageal, Oropharyngeal, and Hypopharynx Cancer Risk among Taiwanese Population. Cancers (Basel) 2024; 16:707. [PMID: 38398100 PMCID: PMC10886704 DOI: 10.3390/cancers16040707] [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: 11/30/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Esophageal cancer shares strong associations with oropharyngeal and hypopharyngeal cancers, primarily due to shared risk factors like excessive tobacco and alcohol use. This retrospective study at Taichung Veterans General Hospital involved 54,692 participants, including 385 with squamous cell carcinoma (SCC) of the esophagus, oropharynx, or hypopharynx. Using a polygenic risk score (PRS) derived from 8353 single-nucleotide polymorphisms, researchers aimed to assess its correlation with cancer incidence and prognosis. The study found a 1.83-fold higher risk of esophageal, oropharyngeal, and hypopharyngeal SCCs in participants with a high PRS (Q4) compared to the low-PRS group (Q1). Esophageal cancer risk demonstrated a significant positive association with the PRS, as did hypopharyngeal cancer. Clinical parameters and staging showed limited associations with PRS quartiles, and the PRS did not significantly impact recurrence or mortality rates. The research highlighted that a higher PRS is linked to increased susceptibility to esophageal and hypopharyngeal cancer. Notably, a specific polygenic risk score, PGS001087, exhibited a discernible association with SCC risk, particularly in specific subtypes and advanced disease stages. However, it was not significantly linked to clinical cancer staging, emphasizing the multifactorial nature of cancer development. This hospital study reveals that a higher PRS correlates with increased susceptibility to esophageal and hypopharyngeal cancers. Notably, PGS001087 shows a discernible association with SCC risk in specific subtypes and advanced stages, although not significantly linked to clinical cancer staging. These findings enhance our understanding of genetic factors in upper aerodigestive tract cancers, particularly esophageal SCC, guiding future research and risk assessment strategies.
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Affiliation(s)
- Yu-Che Huang
- Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Ming-Ching Lee
- Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
- Department of Medical Education, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Sheng-Yang Huang
- Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (S.-Y.H.); (C.-M.C.)
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11267, Taiwan
| | - Chia-Man Chou
- Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (S.-Y.H.); (C.-M.C.)
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11267, Taiwan
| | - Hui-Wen Yang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - I-Chieh Chen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
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Ariizumi Y, Hanai N, Asakage T, Seto A, Tomioka T, Miyabe J, Kessoku H, Mukaigawa T, Omura G, Teshima M, Nishikawa D, Saito Y, Asada Y, Fujisawa T, Makino T, Nishino H, Sano D, Nakahira M, Tokashiki K, Uemura H, Ueda T, Sakai A, Masuda M, Tsujikawa T, Hiei Y, Nishio N, Matsui H, Kiyota N, Homma A. Extent of thyroidectomy and paratracheal lymph node dissection in total pharyngolaryngectomy for pyriform sinus cancer, and recurrence, survival, and postoperative hypoparathyroidism: A multicenter retrospective study. Head Neck 2024; 46:269-281. [PMID: 37955187 DOI: 10.1002/hed.27572] [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: 08/01/2023] [Revised: 09/19/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Total pharyngolaryngectomy (TPL) is standard treatment for hypopharyngeal cancer. However, extensive thyroidectomy and paratracheal nodal dissection (PTND) can cause hypoparathyroidism. We sought to determine the optimum extent of resection. METHODS We analyzed the clinicopathological information of 161 pyriform sinus cancer patients undergoing TPL from 25 Japanese institutions. Rates of recurrence and risk factors for hypoparathyroidism, as well as incidence of pathological contralateral level VI nodal metastasis and stomal recurrence, were investigated. RESULTS The extent of thyroidectomy and nodal dissection were not independent risk factors for recurrence. Incidences of contralateral level VI nodal involvement and stomal recurrence were 1.8% and 1.2%, respectively. Patients undergoing hemithyroidectomy/ipsilateral PTND did not develop stomal recurrence and had the lowest incidence of hypoparathyroidism. Prognosis in patients without tracheostomy prior to hemithyroidectomy/ipsilateral PTND was comparable to that with more extensive resections. CONCLUSIONS Hemithyroidectomy/ipsilateral PTND may be sufficient for pyriform sinus cancer cases without tracheostomy.
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Affiliation(s)
- Yosuke Ariizumi
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Seto
- Division of Head and Neck, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toshifumi Tomioka
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Junji Miyabe
- Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hisashi Kessoku
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Mukaigawa
- Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Go Omura
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Masanori Teshima
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Nishikawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yuki Saito
- Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Tokyo, Japan
| | - Yukinori Asada
- Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Japan
| | - Takuo Fujisawa
- Department of Otorhinolaryngology - Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Takuma Makino
- Department of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroshi Nishino
- Otolaryngology Head and Neck Surgery, Jichi Medical University, Shimotsuke City, Japan
| | - Daisuke Sano
- Department of Otorhinolaryngology - Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Mitsuhiko Nakahira
- Department of Head Neck Surgery, Saitama Medical University International Medical Cancer, Saitama, Japan
| | - Kunihiko Tokashiki
- Department of Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hirokazu Uemura
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Tsutomu Ueda
- Department of Otorhinolaryngology - Head and Neck Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Akihiro Sakai
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Muneyuki Masuda
- Department of Head and Neck Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Takahiro Tsujikawa
- Department of Otolaryngology - Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Hiei
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Naoki Nishio
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidetoshi Matsui
- Department of Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Akihiro Homma
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Ushiro K, Watanabe Y, Kishimoto Y, Kawai Y, Fujimura S, Asato R, Tsujimura T, Hori R, Kumabe Y, Yasuda K, Tamaki H, Iki T, Kitani Y, Kurata K, Kojima T, Takata K, Kada S, Takebayashi S, Shinohara S, Hamaguchi K, Miyazaki M, Ikenaga T, Maetani T, Harada H, Haji T, Omori K. Impact of cervical lymph node metastasis on transoral surgery for hypopharyngeal squamous cell carcinoma: A retrospective multicenter study. Head Neck 2024. [PMID: 38294099 DOI: 10.1002/hed.27666] [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: 11/04/2023] [Revised: 12/11/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Hypopharyngeal carcinoma is likely to spread to the lymph nodes, but there is no established strategy for management in transoral surgery. METHODS We compared oncologic and functional outcomes in a retrospective multicenter study of patients who underwent transoral surgery for hypopharyngeal carcinoma between 2015 and 2021. RESULTS Two-hundred and thirty-two patients were included. Comparing patients with and without adjuvant radiotherapy, 3-year regional recurrence-free survival (RRFS) was not significantly different in pN2b and pN2c, but was significantly worse in pN3b without adjuvant radiotherapy. In patients without neck dissection, the 3-year RRFS was 85.6%, 76.8%, and 70.0% for T1, T2, and T3 primary lesions, respectively, and was significantly worse for T2 or higher (p = 0.035). CONCLUSIONS In the absence of extracapsular invasion, regional control did not deteriorate without adjuvant therapy. If prophylactic neck dissection is not performed, careful follow-up is necessary if the primary lesion is T2 or greater.
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Affiliation(s)
- Koji Ushiro
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yoshiki Watanabe
- Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan
| | - Yo Kishimoto
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshitaka Kawai
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shintaro Fujimura
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryo Asato
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takashi Tsujimura
- Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Ryusuke Hori
- Department of Otolaryngology - Head and Neck Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Otolaryngology - Head & Neck Surgery, Fujita Health University, Toyoake, Japan
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Yohei Kumabe
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Kaori Yasuda
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Hisanobu Tamaki
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Takehiro Iki
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Yoshiharu Kitani
- Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Keisuke Kurata
- Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Tsuyoshi Kojima
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Kuniaki Takata
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Shinpei Kada
- Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Otsu Hospital, Otsu, Japan
| | - Shinji Takebayashi
- Department of Otolaryngology - Head & Neck Surgery, Shiga General Hospital, Moriyama, Japan
| | - Shogo Shinohara
- Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kiyomi Hamaguchi
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masakazu Miyazaki
- Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan
| | - Tadashi Ikenaga
- Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan
| | - Toshiki Maetani
- Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Hiroyuki Harada
- Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Tomoyuki Haji
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Koichi Omori
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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8
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Choi JH, Choi JY, Woo SK, Moon JE, Lim CH, Park SB, Seo S, Ahn YC, Ahn MJ, Moon SH, Park JM. Prognostic Value of Radiomic Analysis Using Pre- and Post-Treatment 18F-FDG-PET/CT in Patients with Laryngeal Cancer and Hypopharyngeal Cancer. J Pers Med 2024; 14:71. [PMID: 38248772 PMCID: PMC10817325 DOI: 10.3390/jpm14010071] [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: 11/23/2023] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The prognostic value of conducting 18F-FDG PET/CT imaging has yielded different results in patients with laryngeal cancer and hypopharyngeal cancer, but these results are controversial, and there is a lack of dedicated studies on each type of cancer. This study aimed to evaluate whether combining radiomic analysis of pre- and post-treatment 18F-FDG PET/CT imaging features and clinical parameters has additional prognostic value in patients with laryngeal cancer and hypopharyngeal cancer. METHODS From 2008 to 2016, data on patients diagnosed with cancer of the larynx and hypopharynx were retrospectively collected. The patients underwent pre- and post-treatment 18F-FDG PET/CT imaging. The values of ΔPre-Post PET were measured from the texture features. Least absolute shrinkage and selection operator (LASSO) Cox regression was used to select the most predictive features to formulate a Rad-score for both progression-free survival (PFS) and overall survival (OS). Kaplan-Meier curve analysis and Cox regression were employed to assess PFS and OS. Then, the concordance index (C-index) and calibration plot were used to evaluate the performance of the radiomics nomogram. RESULTS Study data were collected for a total of 91 patients. The mean follow-up period was 71.5 mo. (8.4-147.3). The Rad-score was formulated based on the texture parameters and was significantly associated with both PFS (p = 0.024) and OS (p = 0.009). When predicting PFS, only the Rad-score demonstrated a significant association (HR 2.1509, 95% CI [1.100-4.207], p = 0.025). On the other hand, age (HR 1.116, 95% CI [1.041-1.197], p = 0.002) and Rad-score (HR 33.885, 95% CI [2.891-397.175], p = 0.005) exhibited associations with OS. The Rad-score value showed good discrimination when it was combined with clinical parameters in both PFS (C-index 0.802-0.889) and OS (C-index 0.860-0.958). The calibration plots also showed a good agreement between the observed and predicted survival probabilities. CONCLUSIONS Combining clinical parameters with radiomics analysis of pre- and post-treatment 18F-FDG PET/CT parameters in patients with laryngeal cancer and hypopharyngeal cancer might have additional prognostic value.
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Affiliation(s)
- Joon Ho Choi
- Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Sang-Keun Woo
- Division of Applied RI, Korea Institutes of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Ji Eun Moon
- Department of Biostatistics, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea
| | - Chae Hong Lim
- Department of Nuclear Medicine, Soonchunhyang University Seoul Hospital, Seoul 04401, Republic of Korea
| | - Soo Bin Park
- Department of Nuclear Medicine, Soonchunhyang University Seoul Hospital, Seoul 04401, Republic of Korea
| | - Seongho Seo
- Department of Electronic Engineering, Pai Chai University, Daejeon 35345, Republic of Korea
| | - Yong Chan Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Seung Hwan Moon
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Jung Mi Park
- Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea
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Jeroen M, Alexander VB, Jens D, Annouschka L, Pierre D, Charlotte VL, Wouter H, Vincent VP. Salvage total laryngectomy for squamous cell carcinoma of the larynx and hypopharynx: Validated prognostic nomograms predicting oncological outcomes. Head Neck 2024; 46:46-56. [PMID: 37867317 DOI: 10.1002/hed.27556] [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: 06/07/2023] [Revised: 09/07/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Salvage total laryngectomy (STL) is a preferred treatment for patients with residual, recurrent, and second primary squamous cell carcinoma of the larynx/hypopharynx after (chemo)radiation. To individually estimate postoperative oncological outcomes, we designed and validated prognostic nomograms. METHODS We used a dataset of 290 patients who underwent STL. Nomograms predicting 2- and 5-year OS, DFS, and DSS were developed, using variables which are identified pre- or postoperatively. The nomograms were externally validated on a dataset of 109 patients. RESULTS The nomograms based on postoperative variables performed better than those based on preoperative variables (OS: C = 0.68 vs. 0.64; DFS: C = 0.70 vs. 0.64; DSS: C = 0.74 vs. 0.64). The nomogram predicting DSS based on postoperative variables performed best. CONCLUSIONS The presented prognostic nomograms for predicting oncological outcomes in patients who undergo STL are tools which allow for a reliable prognostic assessment.
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Affiliation(s)
- Meulemans Jeroen
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Leuven, Leuven, Belgium
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Van Boven Alexander
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Leuven, Leuven, Belgium
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Debacker Jens
- Department of Head and Skin, Ghent University, Ghent, Belgium
- Department of Nuclear Medicine, UZ Brussel, Brussels, Belgium
| | - Laenen Annouschka
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Leuven, Belgium
| | - Delaere Pierre
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Leuven, Leuven, Belgium
| | - Van Lierde Charlotte
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Leuven, Leuven, Belgium
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Huvenne Wouter
- Department of Head and Skin, Ghent University, Ghent, Belgium
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium
| | - Vander Poorten Vincent
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Leuven, Leuven, Belgium
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
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Ezeh UC, Al-Awady A, Buitron I, Lee M, Forman G, Peifer S, Deo A, Sweeny L, Weed D, Kobetz EK, Reis IM, Franzmann E. Investigating Disparities in Hypopharyngeal/Laryngeal Cancer Survival in Florida With Geospatial Mapping Analysis. Cancer Control 2024; 31:10732748241246958. [PMID: 38623948 PMCID: PMC11022680 DOI: 10.1177/10732748241246958] [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: 12/03/2023] [Revised: 03/01/2024] [Accepted: 03/21/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVE Identify predictors of overall survival (OS) after hypopharyngeal/laryngeal cancer in Florida. MATERIAL AND METHODS We conducted a retrospective cohort study using data from the Florida Cancer Data System (FCDS) on patients diagnosed with hypopharyngeal or laryngeal cancer from 2010-2017. Primary outcome was OS. Hazard ratios (HRs) were estimated from univariable and multivariable Cox regression models for OS. Data was analyzed from November 1, 2022, to June 30, 2023. RESULTS We analyzed 6771 patients, who were primarily male (81.2%), White non-Hispanic (WNH) (78.2%), publicly insured (70.1%), married (51.8%), and residents of urban counties (73.6%). Black patients were more likely to be younger at diagnosis (38.9%), single (43.4%), to have distant SEER stage disease (25.6%). Median OS were lowest among patients who were uninsured (34 months), with hypopharyngeal site disease (18 months), and a smoking history (current: 34 months, former: 46 months, no smoking: 63 months). Multivariable Cox regression analysis showed worse OS for single/unmarried vs married (HR 1.47 [95%CI: 1.36-1.59], P < .001), history of tobacco use (current: HR 1.62 [95%CI: 1.440-1.817], P < .001; former smokers: (HR 1.28 [95%CI: 1.139-1.437], P < .001) vs no history). Improved OS was observed among White Hispanics (WH) vs WNH (HR .73 [95%CI: .655-.817], P < .001) and women vs men (HR .88 [95%CI: .807-.954], P = .002). Geographical mapping showed that mortality rates were highest in census tracts with low income and education. CONCLUSION Our findings suggest that sociodemographic and clinical factors impact OS from hypopharyngeal/laryngeal cancer in Florida and vary geographically within the state. These results will help guide future public health interventions.
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Affiliation(s)
- Uche C. Ezeh
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Abdurrahman Al-Awady
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Ming Lee
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Garrett Forman
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sophia Peifer
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alana Deo
- University of California Santa Barbara, Santa Barbara, CA, USA
| | - Larissa Sweeny
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Donald Weed
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Erin K. Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isildinha M Reis
- Division of Biostatistics, Department of Public Health Sciences, Sylvester Biostatistics and Bioinformatics Shared Resource, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Elizabeth Franzmann
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Majitha CS, Nayak DR, Shetty S, Devaraja K, Basheer JI. Distant metastasis at the time of presentation of head and neck squamous cell carcinoma: a retrospective chart review from a tertiary cancer care centre. J Laryngol Otol 2023:1-6. [PMID: 38131132 DOI: 10.1017/s0022215123002323] [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: 12/23/2023]
Abstract
OBJECTIVE To evaluate the rates and patterns of distant metastasis in head and neck SCC at the time of presentation and to study the association between distant metastasis with pre-treatment, clinical, and pathological predictors of outcomes. METHOD This is a retrospective study conducted in a tertiary care hospital. All patients with primary head and neck squamous cell carcinoma that had been evaluated at our institute between October 2018 and December 2020 were included in the study. Various clinical data were analysed and pattern of metastasis was studied. RESULT Ten per cent (50 cases) of 501 studied patients had distant metastasis. The most common site of distant metastasis was lung. The rate of distant metastasis was high in patients with poorly differentiated cancers. By Kaplan-Meier analysis, the median survival duration after diagnosis of metastasis was four months. CONCLUSION The rate of distant metastasis was 10 per cent in the study. Patients with poorly differentiated tumours, locally advanced primary lesions, higher nodal stage, particularly with extra nodal extension, and hypopharyngeal primary, tend to exhibit increased risk for distant metastasis at the time of presentation.
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Affiliation(s)
- C S Majitha
- Department of ENT and Head & Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Dipak Ranjan Nayak
- Department of ENT and Head & Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Shama Shetty
- Division of Head and Neck Surgery, Department of ENT and Head & Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - K Devaraja
- Division of Head and Neck Surgery, Department of ENT and Head & Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Juhi Irfana Basheer
- Department of ENT and Head & Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
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12
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Lien CF, Hwang TZ, Lin TM, Liu KW, Lin BS, Wang CC, Yang CC, Yeh SA, Hsieh MC. Prognostic impact of cortactin in patients with hypopharyngeal cancer and its role for tegafur-uracil maintenance after adjuvant chemoradiotherapy. Am J Cancer Res 2023; 13:5504-5512. [PMID: 38058839 PMCID: PMC10695800] [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] [Received: 08/15/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023] Open
Abstract
The prognosis of patients with hypopharyngeal cancer (HPC) remains poor. Our study aims to investigate the prognostic impact of cortactin in patients with HPC and its role for tegafur-uracil (UFUR) maintenance after adjuvant chemoradiotherapy (CRT). Patients who were diagnosed to have HPC and underwent laryngopharyngectomy followed by adjuvant CRT were enrolled into our study. Immunohistochemical staining was performed for cortactin evaluation. Kaplan-Meier curves were depicted for recurrence-free survival (RFS) and overall survival (OS). A total of 157 patients were enrolled into our study. After stratified by cortactin, 53 patients were cortactin (+) and 104 patients were cortactin (-). The median RFS was 86.7 months in cortactin (-) and 10.2 months in cortactin (+) (P < 0.001). The median OS was 93.4 months in cortactin (-) and 16.9 months in cortactin (+) (P < 0.001). Patients were further classified according to UFUR maintenance or not after adjuvant CRT. In cortactin (+) patients, the median RFS and OS were 13.6 months versus 7.0 months (P = 0.006) and 24.0 months versus 10.0 months (P < 0.001) in UFUR (+) and UFUR (-), respectively. In cortactin (-) patients, the median RFS and OS were 96.0 months versus 72.2 months (P = 0.262) and 98.5 months versus 105.0 months (P = 0.665) in UFUR (+) and UFUR (-), respectively. Cortactin has a significantly impact in HPC patients. UFUR maintenance provided survival benefits in patients with cortactin (+) after adjuvant CRT.
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Affiliation(s)
- Ching-Feng Lien
- Department of Otolaryngology, E-Da HospitalKaohsiung, Taiwan
- College of Medicine, I-Shou UniversityKaohsiung, Taiwan
- Institute of Imaging and Biomedical Photonics, National Chiao Tung UniversityTainan, Taiwan
| | - Tzer-Zen Hwang
- Department of Otolaryngology, E-Da HospitalKaohsiung, Taiwan
- College of Medicine, I-Shou UniversityKaohsiung, Taiwan
| | - Tsun-Mei Lin
- College of Medicine, I-Shou UniversityKaohsiung, Taiwan
- Department of Laboratory Medicine and Medical Research, Medical Laboratory Science, E-DA HospitalKaohsiung, Taiwan
| | - Kai-Wen Liu
- College of Medicine, I-Shou UniversityKaohsiung, Taiwan
- Department of Pathology, E-DA HospitalKaohsiung, Taiwan
| | - Bor-Shyh Lin
- Institute of Imaging and Biomedical Photonics, National Chiao Tung UniversityTainan, Taiwan
| | - Chih-Chun Wang
- Department of Otolaryngology, E-Da HospitalKaohsiung, Taiwan
- College of Medicine, I-Shou UniversityKaohsiung, Taiwan
| | - Chuan-Chien Yang
- Department of Otolaryngology, E-Da HospitalKaohsiung, Taiwan
- College of Medicine, I-Shou UniversityKaohsiung, Taiwan
| | - Shyh-An Yeh
- College of Medicine, I-Shou UniversityKaohsiung, Taiwan
- Department of Radiation Oncology, E-Da HospitalKaohsiung, Taiwan
| | - Meng-Che Hsieh
- College of Medicine, I-Shou UniversityKaohsiung, Taiwan
- Department of Hematology-Oncology, E-Da Cancer HospitalKaohsiung, Taiwan
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13
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Xiang Y, Huang G, Wang J, Hua Q. lncRNA HOXC-AS2 promotes the progression of hypopharyngeal cancer by binding to the P62 protein mediating the autophagy process. Aging (Albany NY) 2023; 15:12476-12496. [PMID: 37944249 PMCID: PMC10683610 DOI: 10.18632/aging.205192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023]
Abstract
Hypopharyngeal carcinoma is the most malignant type of head and neck squamous cell carcinoma, and lncRNAs play an important role in its formation and progression. However, the related specific mechanisms are rarely studied. lncRNAs closely associated with hypopharyngeal cancer were examined by lncRNA sequencing for in-depth exploration of the relationship between HOXC-AS2 and hypopharyngeal cancer pathogenesis. The mRNA expression of HOXC-AS2 and related genes was measured by qRT-PCR, and the biological function of HOXC-AS2 in hypopharyngeal carcinoma was demonstrated by gain- and loss-of-function experiments. RNA pulldown, RNA immunoprecipitation (RIP) and gene body truncation experiments and transcriptome sequencing were used to investigate the potential mechanism of HOXC-AS2 and its downstream genes, including P62, NF-KB and HMOX1. Finally, the biological function of HOXC-AS2 was confirmed in animal experiments. HOXC-AS2 and P62 expression was significantly upregulated in hypopharyngeal cancer tissues compared with normal hypopharyngeal tissues, while HMOX1 expression was decreased. Functionally, HOXC-AS2 overexpression can promote the viability, proliferation, migration and invasion of hypopharyngeal cancer cells and facilitate hypopharyngeal cancer progression. It was confirmed that HOXC-AS2 can bind to the P62 protein and activate the NF-KB signaling pathway, thereby affecting HMOX1 expression and regulating autophagy in hypopharyngeal cancer cells, ultimately regulating the formation and progression of hypopharyngeal cancer. In conclusion, our findings suggest that HOXC-AS2 regulates the progression of hypopharyngeal cancer by regulating autophagy and is abnormally highly expressed in hypopharyngeal cancer tissues. HOXC-AS2 may become a new target for the diagnosis and treatment of hypopharyngeal cancer.
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Affiliation(s)
- Yuandi Xiang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Guoquan Huang
- Hubei Selenium and Human Health Institute, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei 445000, China
- Hubei Provincial Key Lab of Selenium Resources and Bioapplications, Enshi, Hubei 445000, China
- Department of Gastrointestinal Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei 445000, China
| | - Jie Wang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Qingquan Hua
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
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14
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Agarwal P, Bloom J, Zhou Y, Zhao R, Huang S, Yajima M, Devaiah AK. Socioeconomic disparities in treatment and survival in patients with hypopharyngeal malignancy. Head Neck 2023; 45:2670-2679. [PMID: 37638612 DOI: 10.1002/hed.27492] [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: 03/15/2023] [Revised: 07/26/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND This retrospective study utilizes The Surveillance, Epidemiology, and End Results database to investigate socioeconomic factors leading to treatment disparities in hypopharyngeal malignancy. METHODS Treatment was compared to National Cancer Care Network guidelines. Novel analyses, including logistic modeling, allowed survival analysis and identification of socioeconomic variables not previously considered in staging and management guidelines. RESULTS Black and older patients, and residence in low-income areas predict lower likelihood of standard therapy (p < 0.05). Early-stage disease and standard therapy correlate with improved survival (p < 0.001). Medicaid, advanced age, advanced disease, and treatment outside of consensus guidelines correlated with lower survival (p < 0.0001). CONCLUSIONS There are clear socioeconomic factors impacting treatment and survival in hypopharyngeal malignancies. Standard therapy affords superior survival rate. Black, low socioeconomic status, and older patients are less likely to receive standard therapy. Education and language isolation do not predict treatment or survival. Understanding these discrepancies is paramount to palliating disparities in healthcare.
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Affiliation(s)
- Pratima Agarwal
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jacob Bloom
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Runqi Zhao
- Boston University, Boston, Massachusetts, USA
| | - Simu Huang
- Boston University, Boston, Massachusetts, USA
| | | | - Anand K Devaiah
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
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15
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Kang JW, Cheong HK, Kim SI, Lee MK, Lee YC, Oh IH, Eun YG. Association between Metabolic Syndrome and Risk of Hypopharyngeal Cancer: A Nationwide Cohort Study from Korea. Cancers (Basel) 2023; 15:4454. [PMID: 37760423 PMCID: PMC10526337 DOI: 10.3390/cancers15184454] [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: 08/08/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
This study evaluated the relationship between metabolic syndrome (MS) and the risk of hypopharyngeal cancer. This retrospective cohort study used data from the Korean National Health Insurance Research Database. A total of 4,567,890 participants who underwent a health checkup in 2008 were enrolled. The participants were followed until 2019, and the incidence of hypopharyngeal cancer was analyzed. We evaluated the risk of hypopharyngeal cancer according to the presence of MS, including obesity, dyslipidemia, hypertension, and diabetes, using a multivariate Cox proportional hazards model adjusted for age, sex, alcohol consumption, and smoking. During the follow-up period, 821 were newly diagnosed with hypopharyngeal cancer. MS was inversely associated with the risk of hypopharyngeal cancer (hazard ratio (HR), 0.83 [95% confidence interval (CI), 0.708-0.971]). Large waist circumference and high triglyceride levels among MS elements were both inversely related to the risk of hypopharyngeal cancer (HR: 0.82 [95% CI, 0.711-0.945] and 0.83 [95% CI, 0.703-0.978], respectively). The risk of hypopharyngeal cancer decreased with increasing comorbidity of MS in women (N = 0 vs. N = 1-2 vs. N ≥ 3; HR = 1 vs. HR = 0.511 [95% CI, 0.274-0.952] vs. HR = 0.295 [95% CI, 0.132-0.66]), but not in men. This study may improve our etiological understanding of hypopharyngeal cancer.
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Affiliation(s)
- Jeong Wook Kang
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (J.W.K.); (S.I.K.); (Y.C.L.)
| | - Hyeon-Kyoung Cheong
- Department of Internal Medicine, School of Medicine, Korea University, Ansan 02841, Republic of Korea;
| | - Su Il Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (J.W.K.); (S.I.K.); (Y.C.L.)
| | - Min Kyeong Lee
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (J.W.K.); (S.I.K.); (Y.C.L.)
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Young-Gyu Eun
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (J.W.K.); (S.I.K.); (Y.C.L.)
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16
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Ding T, Li W, Liu Y, Liu L, Dong Y. Prognostic Value of Preoperative Controlling Nutritional Status in Hypopharyngeal Cancer Patients Undergoing Surgery-Oriented Comprehensive Treatment. Ear Nose Throat J 2023; 102:590-597. [PMID: 36593089 DOI: 10.1177/01455613221148314] [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] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES The preoperative controlling nutritional status (pCONUT) score has been shown correlated with the prognosis of some cancerous diseases; however, little is known about the effect of pCONUT score on hypopharyngeal cancer (HPC). Therefore, the objective of our study was to demonstrate the relationship between the pCONUT score and the clinical outcome of patients with HPC. PATIENTS AND METHODS Ninety-four patients with HPC who underwent surgery between May 2012 and Dec 2020 were enrolled in this study. We evaluated retrospectively their pCONUT scores and calculated the cutoff value regarding the patients' overall survival using the X-tile software. Kaplan-Meier and Cox proportional hazard regression model were used to determine how the pCONUT score affected overall survival. RESULTS A cutoff level of 4 was determined to be optimal for the pCONUT score, by which the patients were grouped into high pCONUT score (≥4, n = 22, 23.4%) or low pCONUT score (<4, n = 72, 76.6%) groups. The univariate analysis showed that high pCONUT scores correlated with reduced overall survival (hazard ratio: 2.925, 95% confidence interval: 1.526-5.607, P = .001). Furthermore, the multivariate analysis also showed that high pCONUT scores increased the risk of overall death (hazard ratio: 2.639, 95% confidence interval: 1.365-5.101, P = .004). CONCLUSIONS The pCONUT score is considered a useful prognostic factor in patients with HPC.
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Affiliation(s)
- Teng Ding
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wanxin Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yuhe Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Liangfa Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yanbo Dong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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17
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Yang Y, Feng L, Zhong Q, Zhang Y, Huang Z, Zhang S, Li S, Gao J, Hou L, Ma H, He S, Shi Q, Lian M, Zhao Y, Shen X, Chen J, Wang L, Li H, Chen S, Xu J, Wang R, Fang J. Induction chemotherapy-based organ-preservation protocol improve the function preservation compared with immediate total laryngectomy for locally advanced hypopharyngeal cancer-Results of a matched-pair analysis. Cancer Med 2023; 12:17078-17086. [PMID: 37466348 PMCID: PMC10501291 DOI: 10.1002/cam4.6354] [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: 03/20/2023] [Revised: 06/03/2023] [Accepted: 07/09/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND We performed a paired analysis to compare the therapeutic effect between the induction chemotherapy-based organ-preservation approach and immediate total laryngectomy in hypopharyngeal squamous cell carcinoma patients requiring total laryngectomy. METHODS 351 patients who were treated with organ-preservation approach were compared with 110 patients who were treated with total laryngectomy. The main measures and outcomes were progression-free survival (PFS), overall survival (OS), and larynx function preservation survival (LFPS). RESULTS No statistical difference was observed for 3-, 5-, and 10-year PFS and OS in two groups. In the organ-preservation group, the 3-, 5-, and 10-year LFPS was 30.7%, 23.3%, and 16.6%, respectively. The LFPS of Stage III > Stage IV, N0 > N1 > N2 > N3, T2 > T3 > T4, CR > PR > SD > PD patients (all p values <0.05). CONCLUSIONS Survival outcomes did not significantly differ between the two groups. The organ-preservation approach allowed more than 70% of the survivors to retain their larynx function.
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Affiliation(s)
- Yifan Yang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Ling Feng
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Qi Zhong
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Yang Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Zhigang Huang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Shurong Zhang
- Department of Oncology, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
| | - Shuling Li
- Department of Radiology, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
| | - Junmao Gao
- Department of Radiotherapy, Seventh Medical CenterGeneral Hospital of the Chinese People's Liberation ArmyBeijingChina
| | - Lizhen Hou
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Hongzhi Ma
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Shizhi He
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Qian Shi
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Meng Lian
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Yanming Zhao
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Xixi Shen
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Jiaming Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Lingwa Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Haiyang Li
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Shaoshi Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Jiaqi Xu
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Ru Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
| | - Jugao Fang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tong Ren HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Otorhinolaryngology, Head and Neck SurgeryBeijing Institute of OtorhinolaryngologyBeijingChina
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Furue Y, Hori K, Tomioka T, Fujii S, Okano W, Shinozaki T, Kadota T, Yoda Y, Hayashi R, Yano T. Clinical outcome of endoscopic-assisted transoral surgery for superficial cancer of pharyngo-esophageal junction. Head Neck 2023. [PMID: 37350231 DOI: 10.1002/hed.27439] [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] [Received: 03/05/2023] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Endoscopic-assisted transoral surgery (TOS) for superficial cancer of the pharyngo-esophageal junction (PEJ) is risk of stricture, and therapeutic outcomes are unclear. This study aimed to evaluate clinical outcomes of endoscopic-assisted TOS for superficial PEJ cancers. METHODS We retrospectively compared clinical outcomes of endoscopic-assisted TOS for superficial PEJ cancers (group A) and of other sites in the hypopharynx (group B). RESULTS The group A comprised 12 lesions in 12 patients, and group B comprised 198 lesions in 146 patients. Group A and group B exhibited en bloc resection rates of 100% and 99%. Median operative times were 82 and 37 min (p < 0.001). The frequency of stricture and local recurrence in group A was significantly higher in group B (42% vs. 1%, p < 0.001; 25% vs. 6%, p = 0.036). All adverse events could be managed with conservative treatments. CONCLUSIONS Endoscopic-assisted TOS is not ideal for treating superficial PEJ cancers compared to other sites.
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Affiliation(s)
- Yasuaki Furue
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Keisuke Hori
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Gastroenterology, Ichinomiyanishi Hospital, Ichinomiya, Japan
| | - Toshifumi Tomioka
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Satoshi Fujii
- Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Wataru Okano
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeshi Shinozaki
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tomohiro Kadota
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yusuke Yoda
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Endoscopy, Saitama Cancer Center, Kitaadachi, Japan
| | - Ryuichi Hayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
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19
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Wang H, Liu F. LSD1 silencing inhibits the proliferation, migration, invasion, and epithelial-to-mesenchymal transition of hypopharyngeal cancer cells by inducing autophagy and pyroptosis. CHINESE J PHYSIOL 2023; 66:162-170. [PMID: 37322626 DOI: 10.4103/cjop.cjop-d-22-00137] [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: 06/17/2023] Open
Abstract
Hypopharyngeal cancer is a subtype of the head and neck malignancies. We aimed to explore the role of lysine-specific demethylase 1 (LSD1/KDM1A) in the progression of hypopharyngeal cancer and to identify the potential mechanisms. First, LSD1 expression in head and neck squamous cell carcinoma (HNSCC) tissues and the correlation between LSD1 and the stage of HNSC were analyzed by the University of ALabama at Birmingham CANcer data analysis Portal (UALCAN). Following LSD1 silencing, proliferation of pharyngeal cancer cell line FaDu cells was evaluated by cell counting kit-8 and colony formation assays. Wounding healing and transwell assays were used to measure the capacities of migration and invasion. In addition, expression of proteins related to epithelial-to-mesenchymal transition (EMT), autophagy, and pyroptosis was tested by Western blot analysis or immunofluorescence. After treatment with autophagy inhibitor 3-methyladenine (3-MA) or NLR family pyrin domain containing 3 (NLRP3) inhibitor MCC950, the malignant biological properties were measured again. High LSD1 expression was observed in HNSC tissues, which was correlated with stage. LSD1 knockdown significantly suppressed the proliferation, migration, invasion, and EMT of hypopharyngeal cancer cells. Moreover, autophagy and pyroptosis were induced by LSD1 depletion, observed by the enhanced fluorescence intensity of LC3, gasdermin-D (GSDMD)-N, and apoptosis-associated speck-like protein containing a CARD (ASC), accompanied by upregulated expression of LC3II/LC3I, Beclin-1, NLRP3, cleaved-caspase 1, ASC, interleukin (IL)-1β, and IL-18 and downregulated expression of p62. Importantly, 3-MA or MCC950 addition obviously reversed the inhibitory effects of LSD1 silencing on the proliferation, migration, invasion, and EMT of hypopharyngeal cancer cells. To sum up, LSD1 silencing could restrain the progression of hypopharyngeal cancer cells by inducing autophagy and pyroptosis.
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Affiliation(s)
- Hao Wang
- Department of Otorhinolaryngology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang Liu
- Department of Otolaryngology, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China, Chinas
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20
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Eita A, Mohamed N, Rybkin A, Kang JJ, Fiasconaro M, Zhigang Z, Zakeri K, Yu Y, Sadaka E, Sherman E, Dunn L, Cracchiolo J, Wong RJ, Cohen M, Lee NY. Outcomes for Organ Preservation with Chemoradiation Therapy for T4 Larynx and Hypopharynx Cancer. Laryngoscope 2023; 133:1138-1145. [PMID: 35801573 PMCID: PMC10547133 DOI: 10.1002/lary.30279] [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: 02/19/2022] [Revised: 05/27/2022] [Accepted: 06/09/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Limited data is available to guide non-surgical management of Stage T4 larynx and hypopharynx cancer patients who have inoperable disease or refuse surgery. We aim to review the nonoperative management of T4 laryngeal and hypopharyngeal cancer and report the long-term therapeutic and functional outcomes. METHODS We reviewed the nonoperative management of T4 laryngeal (n = 44) and hypopharyngeal (n = 53) cancer from 1997 to 2015 and performed a univariate analysis (UVA). RESULTS The 2-/5-year OS rates were 73%/38% for larynx patients and 52%/29% for hypopharynx patients. Locoregional failure (LRF) occurred in 25% and 19% of larynx and hypopharynx patients, respectively. On UVA of the larynx subset, N3 nodal status and non-intensity-modulated radiation therapy were negatively associated with OS; treatment with radiation therapy alone impacted disease-free survival; and age >70 was associated with LRF. On UVA of the hypopharynx subset, only T4b status significantly impacted OS. In the larynx and hypopharynx groups, 68% and 85% received a percutaneous endoscopic gastrostomy (PEG) tube and 32% and 40% received a tracheostomy tube, respectively. At the last follow-up visit, 66% of our larynx cohort had neither tracheostomy or PEG placed and 40% of our hypopharynx cohort had neither. CONCLUSION We report better than previously noted outcomes among T4 larynx and hypopharynx patients who have unresectable disease or refuse surgery. LEVEL OF EVIDENCE 4 Laryngoscope, 133:1138-1145, 2023.
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Affiliation(s)
- Amgad Eita
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, USA
| | - Nader Mohamed
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, USA
| | - Alisa Rybkin
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, USA
| | - Jung Julie Kang
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, USA
| | - Megan Fiasconaro
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering, New York, USA
| | - Zhang Zhigang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering, New York, USA
| | - Kaveh Zakeri
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, USA
| | - Yao Yu
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, USA
| | - Emad Sadaka
- Department of Clinical Oncology, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Eric Sherman
- Department of Medicine, Memorial Sloan Kettering, New York, USA
| | - Lara Dunn
- Department of Medicine, Memorial Sloan Kettering, New York, USA
| | | | - Richard J. Wong
- Department of Surgery, Memorial Sloan Kettering, New York, USA
| | - Marc Cohen
- Department of Surgery, Memorial Sloan Kettering, New York, USA
| | - Nancy Y. Lee
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, USA
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Kitano M, Koike S, Tamaki H, Iwamoto S, Miyamoto K, Ohira N, Kimura T, Sato M, Yasumatsu R. The Usefulness of Total Laryngectomy in Sarcopenic Patients With Hypopharyngeal and Laryngeal Cancer. Cancer Diagn Progn 2023; 3:347-353. [PMID: 37168963 PMCID: PMC10165371 DOI: 10.21873/cdp.10222] [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] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/22/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND/AIM Sarcopenia has an adverse effect on postoperative complications and prognoses in head and neck cancer. This study focused on hypopharyngeal and laryngeal cancer patients with sarcopenia and analyzed the body composition following treatment when the larynx was preserved and when total laryngectomy was performed to examine the usefulness of laryngectomy. PATIENTS AND METHODS We retrospectively reviewed 88 primary hypopharyngeal and laryngeal cancer patients aged 65 years or older with cT2N0M0 or higher who visited our department. RESULTS There were no significant differences in the 3-year overall survival rate and the 1-year local control rate between the laryngeal preservation group and laryngectomy group. The average change one year following treatment in the laryngeal preservation group, when compared to prior to treatment, was a significant decrease in the body weight (BW) of -0.035, skeletal muscle mass (SMM) of -0.030, skeletal muscle mass index (SMI) of -0.026, body mass index (BMI) of -0.034, and grip strength (GS) of -0.066. The average change one year following treatment in the laryngectomy group, compared with prior to treatment, was an increase in BW of +0.028, SMM of +0.026, SMI of +0.008, BMI of +0.032, and GS of +0.026. Although no changes in serum biochemical testing after treatment were observed in the laryngeal preservation group, albumin, transferrin, and transthyretin all exhibited significant improvement or a tendency toward improvement in the laryngectomy group. The patients with sarcopenia before treatment in the laryngeal preservation group had a significantly higher incidence of aspiration pneumonia. CONCLUSION The presence or absence of sarcopenia before starting treatment is considered to be an index for selecting total laryngectomy.
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Affiliation(s)
- Mutsukazu Kitano
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Satoru Koike
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Hisatomo Tamaki
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Shusuke Iwamoto
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Kazuhiro Miyamoto
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Noriko Ohira
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Takayuki Kimura
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Mitsuo Sato
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Ryuji Yasumatsu
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, Osaka, Japan
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22
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Hu X, Tian T, Zhang X, Sun Q, Chen Y, Jiang W. Neutrophil-to-lymphocyte and hypopharyngeal cancer prognosis: System review and meta-analysis. Head Neck 2023; 45:492-502. [PMID: 36367335 DOI: 10.1002/hed.27246] [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: 08/25/2022] [Revised: 10/12/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022] Open
Abstract
Several studies have reported the value of neutrophil-to-lymphocyte ratio (NLR) for the prognosis of hypopharyngeal cancer. However, contradictory findings have also been published. We aimed to clarify the effect of NLR on the prognosis of hypopharyngeal cancer through meta-analysis. Systematic search of PubMed and other database with study selection and data extraction. The combined hazard ratio (HR) and 95% confidence intervals (CI) were calculated using STATA, applying either a fixed-effects or random-effects model. Meta-regression, subgroup analysis, and sensitivity analysis were used to analyze sources of heterogeneity. Publication bias were also assessed. This meta-analysis included 2232 patients with hypopharyngeal cancer from seven studies. The combined HR (OS, HR = 1.80, 95CI%, 1.14-2.82; PFS, HR = 1.88, 95CI%, 1.26-2.79) suggested that high NLR was associated with poor overall survival (OS) and progression-free survival (PFS). Pretreatment NLR can be used as an effective serological indicator to assess the prognosis of patients with hypopharyngeal cancer.
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Affiliation(s)
- Xianyang Hu
- Department of Otolaryngology - Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China
| | - Tengfei Tian
- Department of Otolaryngology - Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Xueyan Zhang
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Qin Sun
- Department of Otolaryngology - Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Yanyang Chen
- Department of Orthopedics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Wenxiu Jiang
- Department of Otolaryngology - Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
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23
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Mattei P, Gal J, Chamorey E, Dassonville O, Poissonnet G, Aloi D, Barret M, Safta I, Saada E, Sudaka A, Culié D, Bozec A. Docetaxel-Cisplatin-Fluorouracil Induction Chemotherapy for Larynx Preservation in Patients with Locally Advanced Hypopharyngeal Cancer: Predictive Factors of Oncologic and Functional Outcomes. J Clin Med 2023; 12:jcm12031131. [PMID: 36769779 PMCID: PMC9918009 DOI: 10.3390/jcm12031131] [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: 12/27/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The aims of this study were to evaluate the clinical outcomes and their predictive factors in locally advanced hypopharyngeal cancer (HC) patients included in a docetaxel-cisplatin-fluorouracil induction chemotherapy (ICT)-based larynx preservation (LP) program. METHODS Between 2005 and 2021, 82 patients with a locally advanced resectable HC who received ICT in an LP program were included in this retrospective study. The predictors of oncologic and swallowing outcomes were determined in univariate and multivariate analyses. RESULTS The three- and five-year overall survival (OS) rates were 67 and 54%, respectively. The T4 tumor stage was the only predictive factor of poor response to ICT (p = 0.03). In multivariate analysis, a T stage = 4 (p = 0.02), an ICT cycle number < 3 (p = 0.003) and the absence of a response to ICT (p = 0.03) were significantly associated with worse OS. A low body mass index before therapy (p = 0.003) and enteral nutrition during therapy (p = 0.005) were significantly associated with severity of dysphagia 6 months after treatment. CONCLUSIONS The T stage, number of ICT cycles performed and response to ICT are the main predictors of oncologic outcomes. Patients with T4 HC are poor candidates for LP and should be referred to immediate radical surgery.
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Affiliation(s)
- Pierre Mattei
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Jocelyn Gal
- Department of Statistics, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Emmanuel Chamorey
- Department of Statistics, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Olivier Dassonville
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Gilles Poissonnet
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Déborah Aloi
- Department of Radiation Oncology, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Médéric Barret
- Department of Radiation Oncology, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Inga Safta
- Department of Medical Oncology, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Esma Saada
- Department of Medical Oncology, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Anne Sudaka
- Department of Pathology, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Dorian Culié
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
| | - Alexandre Bozec
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice, France
- Faculty of Medecine, Côte d’Azur University, 06107 Nice, France
- Correspondence:
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24
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Deganello A, Ruaro A, Gualtieri T, Berretti G, Rampinelli V, Borsetto D, Russo S, Boscolo-Rizzo P, Ferrari M, Bussu F. Central Compartment Neck Dissection in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Clinical Considerations. Cancers (Basel) 2023; 15. [PMID: 36765762 DOI: 10.3390/cancers15030804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 02/01/2023] Open
Abstract
Metastatic lymph node involvement represents the most relevant prognostic factor in head and neck squamous cell carcinomas (HNSCCs), invariably affecting overall survival, disease-specific survival, and relapse-free survival. Among HNSCCs, laryngeal and hypopharyngeal cancers are known to be at highest risk to metastasize to the central neck compartment (CNC). However, prevalence and prognostic implications related to the CNC involvement are not well defined yet, and controversies still exist regarding the occult metastasis rate. Guidelines for the management of CNC in laryngeal and hypopharyngeal cancers are vague, resulting in highly variable selection criteria for the central neck dissection among different surgeons and institutions. With this review, the authors intend to reappraise the existing data related to the involvement of CNC in laryngeal and hypopharyngeal malignancies, in the attempt to define the principles of management while highlighting the debated aspects that are lacking in evidence and consensus. Furthermore, as definition and boundaries of the CNC have changed over the years, an up-to-date anatomical-surgical description of the CNC is provided.
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25
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Siow TY, Yeh CH, Lin G, Lin CY, Wang HM, Liao CT, Toh CH, Chan SC, Lin CP, Ng SH. MRI Radiomics for Predicting Survival in Patients with Locally Advanced Hypopharyngeal Cancer Treated with Concurrent Chemoradiotherapy. Cancers (Basel) 2022; 14:cancers14246119. [PMID: 36551604 PMCID: PMC9775984 DOI: 10.3390/cancers14246119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/21/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
A reliable prognostic stratification of patients with locally advanced hypopharyngeal cancer who had been treated with concurrent chemoradiotherapy (CCRT) is crucial for informing tailored management strategies. The purpose of this retrospective study was to develop robust and objective magnetic resonance imaging (MRI) radiomics-based models for predicting overall survival (OS) and progression-free survival (PFS) in this patient population. The study participants included 198 patients (median age: 52.25 years (interquartile range = 46.88-59.53 years); 95.96% men) who were randomly divided into a training cohort (n = 132) and a testing cohort (n = 66). Radiomic parameters were extracted from post-contrast T1-weighted MR images. Radiomic features for model construction were selected from the training cohort using least absolute shrinkage and selection operator-Cox regression models. Prognostic performances were assessed by calculating the integrated area under the receiver operating characteristic curve (iAUC). The ability of radiomic models to predict OS (iAUC = 0.580, 95% confidence interval (CI): 0.558-0.591) and PFS (iAUC = 0.625, 95% CI = 0.600-0.633) was validated in the testing cohort. The combination of radiomic signatures with traditional clinical parameters outperformed clinical variables alone in the prediction of survival outcomes (observed iAUC increments = 0.279 [95% CI = 0.225-0.334] and 0.293 [95% CI = 0.232-0.351] for OS and PFS, respectively). In summary, MRI radiomics has value for predicting survival outcomes in patients with hypopharyngeal cancer treated with CCRT, especially when combined with clinical prognostic variables.
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Affiliation(s)
- Tiing Yee Siow
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333423, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Chih-Hua Yeh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333423, Taiwan
| | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333423, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology and Proton Therapy Center, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333423, Taiwan
| | - Hung-Ming Wang
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333423, Taiwan
| | - Chun-Ta Liao
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan 333423, Taiwan
| | - Cheng-Hong Toh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333423, Taiwan
| | - Sheng-Chieh Chan
- Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Tzu Chi University School of Medicine, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan
| | - Ching-Po Lin
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Correspondence: (C.-P.L.); (S.-H.N.)
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333423, Taiwan
- Correspondence: (C.-P.L.); (S.-H.N.)
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Padua PF, Fang HY, Young CK, Yeh CH, Lin CC, Liao CT, Chang TCJ, Tsao CK, Huang SF. Carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer. Medicine (Baltimore) 2022; 101:e31391. [PMID: 36397450 PMCID: PMC9666214 DOI: 10.1097/md.0000000000031391] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Laryngeal preserving concurrent chemoradiation has been advocated for hypopharyngeal cancers. The use of radiotherapy (RT) in the larynx could lead to increased rates of radionecrosis. In this study, we investigated a rare but disastrous complication, carotid blow-out syndrome (CBS), related with the persistent radionecrosis. Retrospective cohort study. This retrospective study enrolled hypopharyngeal cancer patients with biopsy-proven pharyngeal and laryngeal chondronecrosis (PLCRN), which was rated by the Chandler Grading System. From 2002 to 2018, a total of 346 hypopharygeal cancer patients received upfront radiation therapy, 13 PLCRN patients were identified in a rate of 3.8%. All PLRN patients received RT with a mean radiation dose of 70.81 ± 0.85 Gy. All patients had Chandler Grade IV at the time of presentation, which was a mean of 15.08 months (range: 5-109 months) from the time of cancer diagnosis to PLCRN diagnosis. In 5 of the 13 PLCRN patients developed CBS. Three of the CBS originated from superior thyroid artery, one from lingual artery and one from the carotid artery. Three (60%) of the 5 CBS patients expired due to loss of airway and hemodynamic instability. Two (40%) were rescued by emergent airway secure and emergent angiographic embolization. Persistent PLCRN could lead to disastrous vascular complications. CBSs were demonstrated to be more frequently originated from the branches of carotid artery rather than carotid artery per se. Clinical alert with early airway protection could strive for time to do interventions and prevent mortalities.
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Affiliation(s)
- Paula Francezca Padua
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial, Linkou Branch, Taoyuan, Taiwan
| | - Hsuan-Yeh Fang
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial, Linkou Branch, Taoyuan, Taiwan
- Department of Otolaryngology, MacKay Memorial, Hsin-Chu, Taiwan
| | - Chi-Kuan Young
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial, Keelung Branch, Keelung, Taiwan
| | - Chih-Hua Yeh
- Department of Medical Imaging and Intervention, Chang Gung Memorial, Linkou Branch, Taoyuan, Taiwan
| | - Chia-Chen Lin
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial, Linkou Branch, Taoyuan, Taiwan
| | - Chun-Ta Liao
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial, Linkou Branch, Taoyuan, Taiwan
| | | | - Chung-Kan Tsao
- Department of Plastic Surgery, Chang Gung Memorial, Linkou Branch, Taoyuan, Taiwan
| | - Shiang-Fu Huang
- Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial, Linkou Branch, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Shiang-Fu Huang, Department of Otolaryngology, Chang Gung Memorial Hospital, No. 5 Fu-Shin Street, Kwei-Shan, Taoyuan, Taiwan (e-mail: )
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Luo X, Huang X, Liu S, Wang X, Luo J, Xiao J, Wang K, Qu Y, Chen X, Zhang Y, Wang J, Zhang J, Xu G, Gao L, Wu R, Yi J. Synchronous Second Primary Cancers of Hypopharyngeal Carcinoma in the Image-Enhanced Endoscopy Era. Laryngoscope 2022. [PMID: 36321782 DOI: 10.1002/lary.30420] [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: 05/17/2022] [Revised: 08/12/2022] [Accepted: 08/30/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To explore the prevalence of hypopharyngeal carcinoma (HPC) with synchronous second primary malignancies (Syn-SPMs), their impact on clinical outcomes, and associated risk factors in the image-enhanced endoscopy era. MATERIALS AND METHODS We retrospectively analyzed 673 patients newly diagnosed with HPC at our cancer center between 2009 and 2019. The patients were divided into three groups: (a) no second primary malignancies (N-SPMs, n = 533); (b) synchronous carcinoma in situ (Syn-Tis, n = 60); (c) synchronous invasive tumors (Syn-invasive, n = 80). Propensity score matching was conducted to balance the N-SPMs and Syn-invasive groups at a 3:1 ratio. RESULTS Most (96.1%) underwent pretreatment esophagogastroduodenoscopy evaluation with image-enhanced endoscopy. The incidence rates were: Syn-SPMs, 20.8%; Syn-Tis, 8.9%; Syn-invasive, 11.9%. At a median follow-up of 66.7 months, the Syn-Tis and N-SPMs groups had a similar 5-year overall survival (OS; 45.6% vs. 44.5%; hazard ratio [HR], 0.956; 95% confidence interval [CI], 0.660-1.385; p = 0.806). Compared to the N-SPMs group, the Syn-invasive group had poorer 5-year OS (27.0% vs. 52.9%; HR, 2.059; 95% CI, 1.494-2.839; p < 0.001). Alcohol consumption was significantly associated with Syn-SPMs occurrence (odds ratio, 2.055, 2.414, and 3.807 for light, intermediate, and heavy drinkers, respectively). CONCLUSION The prevalence of Syn-SPMs among patients with HPC was high. Syn-invasive SPMs decreased the survival of patients with HPC. Routine screening with image-enhanced endoscopy should be recommended to detect early-stage SPMs, especially for heavy alcohol drinkers. LEVEL OF EVIDENCE III Laryngoscope, 2022.
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Affiliation(s)
- Xi Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaodong Huang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shaoyan Liu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaolei Wang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingwei Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianping Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Qu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuesong Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingbo Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianghu Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guozhen Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Gao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Runye Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junlin Yi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang, China
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Batchelor CJJ, Flukes SP. Tracheostomy dependence following "organ preservation" (chemo)radiation protocol for laryngeal and hypopharyngeal cancers. Head Neck 2022; 44:2779-2785. [PMID: 36121012 DOI: 10.1002/hed.27195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/15/2022] [Accepted: 08/31/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Patients receiving primary (chemo)radiotherapy for laryngeal or hypopharyngeal cancer risk developing severe laryngeal dysfunction and becoming tracheostomy dependent, detracting from the benefits of organ preservation. We aim to describe the airway outcomes for this cohort and identify risk factors for developing tracheostomy dependence. METHODS Patients with laryngeal or hypopharyngeal cancer who were recommended for and underwent primary (chemo)radiotherapy over a 6-year period were identified from a tertiary hospital Head and Neck cancer database. Patient, tumor, and treatment details were collected and analyzed. RESULTS Of 166 patients, 18.7% (N = 31) required tracheostomy insertion. Advanced tumor classification was the only significant predictor (p < 0.00001). Successful decannulation was observed in 12.9% (N = 4). Decannulation was observably less successful with advanced tumors, bilateral vocal cord immobility, tracheostomies inserted under emergency conditions. CONCLUSION We quantified tracheostomy insertion rates and dependence in patients undergoing "organ-preserving" (chemo)radiotherapy, to assist in the pre-treatment counseling of patients opting for this approach.
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Affiliation(s)
| | - Stephanie Patricia Flukes
- Otolaryngology Head and Neck Surgery, Fiona Stanley Hospital, Perth, Australia.,Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
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Liang Q, Hong S, Peng L, Liao J, Wen W, Sun W. Impact of prior cancer history on survival of patients with hypopharyngeal cancer. Cancer Med 2022; 12:2929-2936. [PMID: 36057955 PMCID: PMC9939181 DOI: 10.1002/cam4.5208] [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: 03/28/2022] [Revised: 08/16/2022] [Accepted: 08/24/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The impact of prior cancer history on survival of hypopharyngeal cancer patients remains unknown. The present study assessed the impact of prior cancer history on survival of patients with hypopharyngeal cancer. METHODS Patients with primary hypopharyngeal cancer diagnosed between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was conducted to balance baseline characteristics. One-to-one PSM, Kaplan-Meier method, and log-rank test were performed for survival analysis. RESULTS We included 5017 patients with hypopharyngeal cancer. Prior cancer history had no significant impact on overall survival of hypopharyngeal cancer patients in comparison with those without prior cancer history (p = 0.845, after PSM). Subgroup analysis showed that prior cancer history had no significant effect on overall survival of hypopharyngeal cancer patients. CONCLUSION More hypopharyngeal cancer patients with prior cancer history should be considered for clinical trials. However, further prospective studies are needed.
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Affiliation(s)
- Qi‐Wei Liang
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina,Department of Otorhinolaryngology Head and Neck SurgeryDepartment of Thyroid Center/Thyroid Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina,Department of Otorhinolaryngology of Longgang Center Hospital, the Ninth People's Hospital of ShenzhenShenzhenChina
| | - Shu‐Yi Hong
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina,Department of Otorhinolaryngology Head and Neck SurgeryDepartment of Thyroid Center/Thyroid Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Liang Peng
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Jing Liao
- Department of Otorhinolaryngology Head and Neck SurgeryDepartment of Thyroid Center/Thyroid Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Wei‐Ping Wen
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina,Department of Otorhinolaryngology Head and Neck SurgeryDepartment of Thyroid Center/Thyroid Surgery, The Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Wei Sun
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
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30
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Yorozu K, Kaibori M, Kimura S, Ichikawa M, Matsui K, Kaneshige S, Kobayashi M, Jimbo D, Torikai Y, Fukuzawa Y, Okamoto Y. Experience with Photodynamic Therapy Using Indocyanine Green Liposomes for Refractory Cancer. J Pers Med 2022; 12:1039. [PMID: 35887536 DOI: 10.3390/jpm12071039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 12/23/2022] Open
Abstract
We reported the development of an effective cancer treatment using a multidisciplinary treatment, including photodynamic therapy (PDT) with indocyanine green (ICG) liposomes and a combination of Lentinula edodes mycelia (LEM) and hydrogen gas inhalation therapy. ICG liposomes were prepared by adding 5 mg of ICG to 50 mL liposomes. Later, 25 mL of ICG liposomes were diluted with 250 mL of 5% glucose solution and administered intravenously to the patient. We selected the multi-laser delivery system (MLDS), a laser irradiator for performing PDT. Further, the patients received a combination of LEM and hydrogen gas inhalation therapy throughout the treatment. We reported two cases of PDT therapy, one with middle intrathoracic esophagus carcinoma and the other with hypopharyngeal cancer. In the first case, the MLDS laser was directly attached to the endoscope and directed to the cancer area with wavelengths of 810 nm. After the treatment, a biopsy demonstrated no tumor recurrence. In the second case, the patient was treated with endovascular PDT using ICG liposomes and MLDS fiber optics. Later, tumor shrinkage was demonstrated after the first round and disappeared after six months. In conclusion, the present findings suggest that the effect of PDT using ICG liposomes with LEM and hydrogen gas may eradicate cancer without burdening patients by enhancing tumor immunity.
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31
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Liu J, Yu R, Wang J, Deng D, Li L, Li B, Liu J, Chen F. Use of free modified jejunal flaps to reconstruct pharyngoesophageal defects with preservation of the larynx in three cases. Thorac Cancer 2022; 13:1870-1873. [PMID: 35567360 PMCID: PMC9200873 DOI: 10.1111/1759-7714.14469] [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: 04/03/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 02/05/2023] Open
Abstract
The larynx is often sacrificed in patients with hypopharyngoesophageal cancer before reconstruction using the jejunum to restore the continuity of the digestive tract and allow oral alimentation. We retrospectively collected and analyzed data from three patients who underwent hypopharyngoesophageal reconstruction by partial patch and partial tube free jejunal flap with preservation of laryngeal function. All three flaps survived in patients who underwent the modified jejunal flaps. The larynx was preserved in all three patients. Partial patch and partial tube jejunal flap is a possible option for reconstruction of large and complex defects after pharyngectomy and cervical esophagectomy with larynx preservation.
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Affiliation(s)
- Jifeng Liu
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Yu
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ji Wang
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Di Deng
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Linke Li
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Li
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Liu
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Chen
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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32
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Li WX, Dong YB, Lu C, Bradley PJ, Liu LF. Efficacy of Larynx Preservation Surgery and Multimodal Adjuvant Therapy for Hypopharyngeal Cancer: A Case Series Study. Ear Nose Throat J 2022:1455613221098784. [PMID: 35537143 DOI: 10.1177/01455613221098784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Larynx preservation surgery (LPS) combined with multimodal adjuvant therapy (MAT) is re-emerging as treatment option for hypopharyngeal cancer (HPC). This study aims to explore the survival and functional outcome of this combined approach. Methods: This is a retrospective cohort study. Selected patients with primary HPC treated by LPS and MAT at two large Beijing medical centers between 2005 and 2019 were included. In addition to LPS, patients received one or more of the following treatments: preoperative induction chemotherapy, postoperative intensity-modulated radiotherapy, chemotherapy, or targeted therapy. Results: In total, 64 patients were included (62 were men, and median age was 57.5 years). The disease in most patients was in stage III (28.1%) or IV (56.3%), or in stage T2 (34.4%) or T3 (45.3%), based on the TNM scale. Across all patients, the rate of overall survival (OS) was 60.7% at 3 yr and 47.3% at 5 yr. OS was significantly higher for patients with stage I or II disease than for those with stage III or IV disease (HR 8.64, 95% CI 3.69-20.2, log-rank P = .010). Decannulation was successful in 55 patients (85.9%), and swallowing function was satisfactory (stage 0-III, on Functional Outcome Swallowing Scale) for 50 (78.1%). Median Voice Handicap Index-10 score on voice performance was 19 (range 4-40), and median Functional Assessment of Cancer Therapy-General Questionnaire score for QoL was 75 (range 16-105). Conclusions: LPS and MAT can provide satisfactory oncologic control and good functional outcomes for selected patients with HPC, especially those with stage I or II disease.
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Affiliation(s)
- Wan-Xin Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
| | - Yan-Bo Dong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
| | - Cheng Lu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
| | - Patrick J Bradley
- Head and Neck Oncological Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, UK
| | - Liang-Fa Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China.,Department of Otolaryngology, Head & Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China
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Luo X, Huang X, Liu S, Wang X, Luo J, Xiao J, Wang K, Qu Y, Chen X, Zhang Y, Wang J, Zhang J, Xu G, Gao L, Wu R, Yi J. Evaluation of the prevalence of metachronous second primary malignancies in hypopharyngeal carcinoma and their effect on outcomes. Cancer Med 2022; 11:1059-1067. [PMID: 35080148 PMCID: PMC8855899 DOI: 10.1002/cam4.4501] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/06/2021] [Accepted: 11/26/2021] [Indexed: 01/08/2023] Open
Abstract
Background To investigate the clinical characteristics of metachronous second primary malignancies (Met‐SPMs) and its impact on prognosis in hypopharyngeal carcinoma (HPC). Methods We reviewed 593 newly diagnosed HPC patients without invasive synchronous SPMs (Syn‐SPMs) who were treated in our cancer center between 2009 and 2019. According to the status during follow‐up, patients were classified into three groups: (a) without SPMs (No‐SPMs, n = 440), (b) with tumors in situ in the esophagus or stomach (Tis, n = 80), or (c) with Met‐SPMs (n = 73). Results The median follow‐up time for entire cohort (n = 593) was 66.7 months. Met‐SPMs were present in 12.3% of the cohort (73/593). The predominant site of SPMs was esophagus, followed by lung, oral cavity, thyroid, stomach, and oropharynx. In Met‐SPMs group, both index tumor and SPMs were the main causes of death. Tis group exhibited comparable 5‐year overall survival (OS) and disease‐specific survival (DSS) with that of No‐SPMs group. The Met‐SPMs group had similar 5‐year OS rate and better 5‐year DSS rate of 47.3% versus 43.6% (odds ratio [OR], 0.931; 95% confidence interval [CI], 0.681–1.274, p = 0.657) and 66.3% vs. 46.2% (OR, 0.600; 95% CI, 0.402–0.896, p = 0.012), respectively, compared with the No‐SPMs group. Conclusion The overall incidence of Met‐SPMs in HPC was 12.3%. The occurrence of Met‐SPMs does not jeopardize the survival outcome of HPC. Routine surveillance of Met‐SPMs was requisite for patients with HPC.
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Affiliation(s)
- Xi Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaodong Huang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shaoyan Liu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaolei Wang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingwei Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianping Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Qu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuesong Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingbo Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianghu Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guozhen Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Gao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Runye Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junlin Yi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Vageli DP, Doukas PG, Siametis A, Judson BL. Targeting STAT3 prevents bile reflux-induced oncogenic molecular events linked to hypopharyngeal carcinogenesis. J Cell Mol Med 2021; 26:75-87. [PMID: 34850540 PMCID: PMC8742186 DOI: 10.1111/jcmm.17011] [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] [Received: 06/29/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 12/26/2022] Open
Abstract
The signal transducer and activator of transcription 3 (STAT3) oncogene is a transcription factor with a central role in head and neck cancer. Hypopharyngeal cells (HCs) exposed to acidic bile present aberrant activation of STAT3, possibly contributing to its oncogenic effect. We hypothesized that STAT3 contributes substantially to the bile reflux‐induced molecular oncogenic profile, which can be suppressed by STAT3 silencing or pharmacological inhibition. To explore our hypothesis, we targeted the STAT3 pathway, by knocking down STAT3 (STAT3 siRNA), and inhibiting STAT3 phosphorylation (Nifuroxazide) or dimerization (SI3‐201; STA‐21), in acidic bile (pH 4.0)‐exposed human HCs. Immunofluorescence, luciferase assay, Western blot, enzyme‐linked immunosorbent assay and qPCR analyses revealed that STAT3 knockdown or pharmacologic inhibition significantly suppressed acidic bile‐induced STAT3 activation and its transcriptional activity, Bcl‐2 overexpression, transcriptional activation of IL6, TNF‐α, BCL2, EGFR, STAT3, RELA(p65), REL and WNT5A, and cell survival. Our novel findings document the important role of STAT3 in bile reflux‐related molecular oncogenic events, which can be dramatically prevented by STAT3 silencing. STA‐21, SI3‐201 or Nifuroxazide effectively inhibited STAT3 and cancer‐related inflammatory phenotype, encouraging their single or combined application in preventive or therapeutic strategies of bile reflux‐related hypopharyngeal carcinogenesis.
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Affiliation(s)
- Dimitra P Vageli
- The Yale Larynx Laboratory, Department of Surgery (Otolaryngology), Yale School of Medicine, New Haven, Connecticut, USA
| | - Panagiotis G Doukas
- The Yale Larynx Laboratory, Department of Surgery (Otolaryngology), Yale School of Medicine, New Haven, Connecticut, USA
| | - Athanasios Siametis
- The Yale Larynx Laboratory, Department of Surgery (Otolaryngology), Yale School of Medicine, New Haven, Connecticut, USA
| | - Benjamin L Judson
- The Yale Larynx Laboratory, Department of Surgery (Otolaryngology), Yale School of Medicine, New Haven, Connecticut, USA
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35
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Li WX, Dong YB, Lu C, Bradley PJ, Liu ALF. Survival and swallowing function outcome impact factors analysis of surgery-oriented comprehensive treatment for hypopharyngeal cancer in a series of 122 patients. Ear Nose Throat J 2021; 101:532-541. [PMID: 34792398 DOI: 10.1177/01455613211058108] [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: 11/16/2022] Open
Abstract
OBJECTIVE Under current standards of treating highly aggressive hypopharyngeal cancer (HPC), oncological control and functional outcome are still unsatisfactory worldwide. This study explored the surgery-oriented comprehensive treatment approach based on 15 years of practice. METHODS A retrospective cohort of HPC patients treated by the senior author at Chinese PLA General Hospital between Nov 2005 and Aug 2012 and Capital Medical University Beijing Friendship Hospital between May 2014 and Nov 2019 was studied. Oncological control, swallowing function, and quality of life (QoL) were assessed. RESULTS In total, 122 patients were included in this study, with 11 (9.0%) cases in the early stage and 111 (91.0%) cases in the advanced stage. Five-year overall survival (OS) and disease-free survival (DFS) were 40.0% and 36.1%, respectively. The swallowing outcome was satisfactory in 90 (73.8%) patients. Tracheostomy-free survival was achieved in 55 (45.1%) patients. Multivariate cox regression analysis showed that the size of the surgical defect, local-regional recurrence, and distant metastasis were independent impact factors for OS and DFS (P < .05). Multivariate analysis showed that the logistic regression coefficients (standard error) of pharyngo-cutaneous fistula and local-regional recurrence on swallowing function were 1.274 (.532) and 1.283 (.496), respectively (P < .05). In addition, the logistic regression coefficients (standard error) of the clinical stage, local-regional recurrence, decannulation, and feeding tube on QoL were -7.803 (3.593), -7.699 (3.151), 13.853 (3.494), and -20.243 (3.696), respectively (P < .05). CONCLUSIONS Surgery-oriented comprehensive treatment can give rise to good swallowing function without jeopardizing oncological control. The size of the surgical defect, local-regional recurrence, and distant metastasis were independent factors impacting OS and DFS. Pharyngo-cutaneous fistula and local-regional recurrence were independent factors impacting swallowing function. Clinical stage, local-regional recurrence, decannulation, and feeding tube were independent factors impacting QoL.
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Affiliation(s)
- Wan-Xin Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
| | - Yan-Bo Dong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
| | - Cheng Lu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
| | - Patrick J Bradley
- Head and Neck Oncological Surgeon, Queens Medical Centre Campus, Nottingham University Hospitals, Nottingham, UK
| | - And Liang-Fa Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China.,Department of Otolaryngology, Head & Neck Surgery, Chinese PLA General Hospital, Institute of Otolaryngology, Beijing, China
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Murakami N, Honma Y, Yoshimoto S, Shima S, Kashihara T, Takahashi K, Kaneda T, Inaba K, Okuma K, Masui K, Yoshida K, Igaki H, Itami J. Gel spacer to protect carotid artery and reconstructed jejunum in image-guided interstitial brachytherapy for recurrent hypopharyngeal cancer: a technical report. J Contemp Brachytherapy 2021; 13:583-7. [PMID: 34759983 DOI: 10.5114/jcb.2021.109806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 08/30/2021] [Indexed: 02/07/2023] Open
Abstract
In this technical report, patient with total pharyngolaryngectomy and jejunum interposition experienced lymph node metastasis in the reconstructed mesenteric lymph nodes. Because this patient received 45 Gy of whole neck radiation therapy 24 years ago and small bowel's tolerance dose of the reconstructed jejunum was considered to be low, spacer gel injection was applied during image-guided interstitial brachytherapy to decrease doses to the reconstructed jejunum and previously irradiated carotid artery.
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Tsuzuki N, Wasano K, Kawasaki T, Minami S, Kurita A, Hashimoto Y, Sahara S, Ogawa K. The impact of second-hand smoke on ear, nose, and throat diseases and head and neck cancers in Japan: a cross-sectional study using a questionnaire and secondary data from the national health and nutrition survey. Acta Otolaryngol 2021; 141:1000-1004. [PMID: 34669563 DOI: 10.1080/00016489.2021.1989486] [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: 10/20/2022]
Abstract
BACKGROUND The risk of head and neck cancers (HNCs) and ear, nose, and throat (ENT) diseases due to second-hand smoke (SHS) have not been fully assessed. OBJECTIVE To determine which ENT diseases or HNCs are associated with SHS. MATERIAL AND METHODS Data from a survey of a cross-sectional sample of ENT patients (n = 1228) on SHS exposure were compared to control-subject data (n = 6598) from a Japan National Health Survey. Multivariate logistic regression and estimated odds ratios (ORs) determined whether SHS-disease associations were related to exposure location and disease occurrence. RESULTS SHS was significantly associated with acute tonsillitis (OR in workplaces, 2.24 [95% CI, 1.34-3.75]; OR in restaurants, 4.24 [95% CI, 2.50-7.19]; OR in leisure places, 4.72 [95% CI, 2.93-7.62]); recurrent tonsillitis (OR in restaurants, 4.24 [95% CI, 2.52-7.13]; OR in leisure places, 5.29 [95% CI, 3.31-8.46]); facial palsy (OR in home, 2.18 [95% CI, 1.25-3.81]; OR in leisure places, 3.41 [95% CI, 1.97-5.89]); hypopharyngeal cancer (OR in home, 2.51 [95% CI, 1.18-5.36]; OR in workplaces, 2.53 [95% CI, 1.24-5.15]); and laryngeal cancer (OR in home, 2.44 [95% CI, 1.04-5.68]; OR in leisure places, 2.25 [95% CI, 1.00-5.07]). CONCLUSIONS AND SIGNIFICANCE SHS may contribute to HNCs and ENT diseases, suggesting that merely being in the presence of smokers could increase the risk of head and neck morbidities.
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Affiliation(s)
- Nobuyoshi Tsuzuki
- Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku, Japan
| | - Koichiro Wasano
- National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Meguro, Japan
- Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Meguro, Japan
| | - Taiji Kawasaki
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka-City, Japan
| | - Shujiro Minami
- National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Meguro, Japan
- Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Meguro, Japan
| | - Akihiro Kurita
- Department of Otolaryngology, Japanese Red Cross Saitama Hospital, Saitama-City, Japan
| | - Yosuke Hashimoto
- Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Meguro, Japan
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka-City, Japan
| | - Sosuke Sahara
- Department of Otolaryngology, Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu-City, Japan
| | - Kaoru Ogawa
- Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku, Japan
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Sato MP, Otsuki N, Kitano M, Ishikawa K, Tanaka K, Kimura T, Doi K. Up-front neck dissection followed by chemoradiotherapy for T1-T3 hypopharyngeal cancer with advanced nodal involvement. Head Neck 2021; 43:3810-3819. [PMID: 34549854 PMCID: PMC9292839 DOI: 10.1002/hed.26881] [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: 02/12/2021] [Revised: 08/19/2021] [Accepted: 09/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background The advantage of up‐front neck dissection (UFND) followed by chemoradiotherapy (CRT) for hypopharyngeal cancer (HPC) with advanced neck involvement remains controversial. We aimed to determine the indications. Methods The data of 41 and 14 patients with stage IVA/B (T1–T3 and ≥N2a) HPC who underwent UFND followed by CRT and received CRT, respectively, were retrospectively analyzed and compared. Results The 5‐year overall survival (OS) and disease‐specific survival rates for the UFND and CRT groups were 61% and 52% (p = 0.1019), and 89% and 74% (p = 0.2333), respectively. Moreover, patients aged ≥70 years or those with a pulmonary disease history had a significantly poorer prognosis due to aspiration pneumonia in the UFND group. The 5‐year regional control (RC) for the UFND and CRT groups were 92% and 57%, respectively (p = 0.0001). Conclusions UFND followed by CRT was feasible with satisfactory RC. To further improve OS, aspiration pneumonia prevention is essential.
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Affiliation(s)
- Mitsuo P Sato
- Department of Otorhinolaryngology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Naoki Otsuki
- Department of Otorhinolaryngology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Mutsukazu Kitano
- Department of Otorhinolaryngology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Kazuki Ishikawa
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Kaoru Tanaka
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Takayuki Kimura
- Department of Otorhinolaryngology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Katsumi Doi
- Department of Otorhinolaryngology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
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Matsui H, Iwae S, Yamamura Y, Horichi Y. Pathological Level VI Lymph Node Metastasis in Clinical N3b Pyriform Sinus Squamous Cell Carcinoma. Ann Otol Rhinol Laryngol 2021; 131:824-828. [PMID: 34514862 DOI: 10.1177/00034894211045779] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The frequency of metastasis to level VI lymph nodes in advanced pyriform sinus squamous cell carcinoma (PSSCC) is unknown. We intended to analyze the clinical features and pathological presence or absence of level VI lymph node metastasis in patients with PSSCC. METHODS The data of 270 patients with previously untreated hypopharyngeal squamous cell carcinoma from 2006 to 2016 were obtained. Patients who underwent pharyngolaryngectomy for the pyriform sinus subsite with a curative intent with level VI dissection were included. We retrospectively analyzed the clinical Tumor-Node (TN) status (TNM classification of malignant tumors, eighth edition) and the presence or absence of pathological level VI lymph node metastasis. RESULTS A total of 34 patients were included. Eight patients (24%) had pathological level VI lymph node metastasis. The rate of pathological level VI lymph node metastasis was directly proportional to the clinical N status (P = .0002, Chi-square test for trend). In all, 5 patients with cN2b- 3 were classified as cN3b. Ipsilateral pathological level VI lymph node metastasis was observed in 1 patient, and bilateral metastasis was observed in 3 patients. There was no association between clinical T status or pyriform sinus apex invasion and pathological level VI metastasis (both P > .99, Fisher's exact test). CONCLUSIONS PSSCC with cN3b is prone to bilateral level VI metastasis. We recommend that patients with PSSCC with cN3b should undergo bilateral level VI lymph node dissection.
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Affiliation(s)
- Hidetoshi Matsui
- Department of Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Shigemichi Iwae
- Department of Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Yuta Yamamura
- Department of Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Yuto Horichi
- Department of Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan
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Iritani K, del Mundo DAA, Iwaki S, Masuda K, Kanzawa M, Furukawa T, Teshima M, Shinomiya H, Morimoto K, Otsuki N, Nibu K. Prognostic factors after transoral resection of early hypopharyngeal cancer. Laryngoscope Investig Otolaryngol 2021; 6:756-763. [PMID: 34401500 PMCID: PMC8356885 DOI: 10.1002/lio2.611] [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: 12/03/2020] [Revised: 05/08/2021] [Accepted: 06/10/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE This study aimed to investigate risk factors predictive of local recurrence and/or lymph node metastasis after transoral resection of early hypopharyngeal cancer. METHODS Forty-nine consecutive patients who underwent transoral videolaryngoscopic surgery (TOVS) as an initial treatment for hypopharyngeal cancer were evaluated. On univariate and multivariate analysis, local recurrence rates were assessed respectively using log-rank test and cox regression analysis according to the following parameters: subsite, pT, mucosal margin, lymphatic invasion, vessel invasion, tumor thickness (> 4 mm vs ≤4 mm), history of esophageal cancer, and multiple Lugol-voiding lesions (LVLs) in the esophagus. Categorical variables were evaluated for their associations with lymph node metastasis using chi-squared test or Fisher's exact test. RESULT The subsites of primary lesions were piriform sinus in 24 patients, posterior wall in 15 patients, and postcricoid in 10 patients. Thirty patients had esophageal cancer. Local recurrence occurred in 14 patients. Three patients had lymph node metastasis at the time of diagnosis and four patients developed lymph node metastasis after the initial treatment, resulting a total of seven patients having lymph node metastasis. While mucosal margin and LVLs showed significant associations with local recurrence on univariate analysis, only LVLs remained as a significant risk factor on multivariate analysis (P = .0395; hazard ratio = 8.897; 95% confidence interval, 1.113-71.15). Most cases of local recurrence were satisfactorily controlled by repeated TOVS. While multivariate analysis could not be performed due to the small number of the patients with lymph node metastases, venous invasion (P = .0166) and tumor thickness (P = .0092) were significantly associated with lymph node metastasis on univariate analysis. CONCLUSIONS Local recurrence was more frequent in patients with LVLs, but most of them were salvaged by repeated TOVS. Patients with venous invasion and/or tumor thickness greater than 4 mm should be followed up with special attention to lymph node metastasis.Level of Evidence: 3.
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Affiliation(s)
- Keisuke Iritani
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
| | - Daryl Anne A. del Mundo
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
- Department of OtorhinolaryngologyUniversity of the Philippines Manila‐ Philippine General HospitalManilaPhilippines
| | - Shinobu Iwaki
- Division of Rehabilitation MedicineKobe University HospitalKobeJapan
| | - Kuriko Masuda
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
- Pennsylvania State UniversityState CollegePennsylvaniaUSA
| | - Maki Kanzawa
- Department of Diagnostic PathologyKobe University Graduate School of MedicineKobeJapan
| | - Tatsuya Furukawa
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
| | - Masanori Teshima
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
| | - Hirotaka Shinomiya
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
| | | | - Naoki Otsuki
- Department of OtolaryngologyKindai University HospitalOsakaJapan
| | - Ken‐ichi Nibu
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
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Xi J, Zeng Z, Li X, Zhang X, Xu J. Expression and Diagnostic Value of tRNA-Derived Fragments Secreted by Extracellular Vesicles in Hypopharyngeal Carcinoma. Onco Targets Ther 2021; 14:4189-4199. [PMID: 34285510 PMCID: PMC8286722 DOI: 10.2147/ott.s320176] [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] [Received: 05/18/2021] [Accepted: 06/29/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To detect the expression level of tRNA-derived fragments secreted by extracellular vesicles in hypopharyngeal cancer and explore the influence of tRNA-derived fragments on the occurrence of hypopharyngeal cancer and lung metastasis. METHODS After high-speed centrifugation, tRNA, which was extracted from the extracellular vesicles of patients with hypopharyngeal cancer and healthy subjects, was sequenced using microarrays. The expression of three differentially expressed tRNAs in hypopharyngeal cancer, healthy subjects, human normal laryngeal epithelial cells and hypopharyngeal cancer line was detected by qRT-PCR. The correlation between the upregulated tRNA, as identified by qRT-PCR, and the clinicopathological features of the non-lung metastatic patients was further analyzed. Finally, the expressions of upregulated tRNA were compared between the non-lung metastatic and lung metastatic patients. The risk factors of hypopharyngeal cancer with lung metastatic were identified by the Cox regression analysis. RESULTS By high-speed centrifugation, extracellular vesicles were extracted successfully. It was found that a variety of tRNAs in the extracellular vesicles from patients with hypopharyngeal cancer by sequencing. qRT-PCR validation indicated that tRF-1:30-Lys-CTT-1-M2 was significantly overexpressed in hypopharyngeal cancer patients and tumor cells, especially in lung metastatic patients. It was indicated that tRF-1:30-Lys-CTT-1-M2 overexpression was closely related to such pathological features as tumor staging, differentiation grade, smoking history and drinking history. According to the Cox regression analysis, stage III-IV, smoking history, drinking history and tRF-1:30-Lys-CTT-1-M2 overexpression were independent risk factors for metastasis of hypopharyngeal cancer. CONCLUSION tRF-1:30-Lys-CTT-1-M2 was overexpressed in patients with hypopharyngeal cancer and was identified as an independent risk factor for lung metastasis. It can be used as a novel biomarker for the diagnosis and lung metastasis monitoring of hypopharyngeal cancer.
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Affiliation(s)
- Jian Xi
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, People’s Republic of China
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
| | - Zhiming Zeng
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, People’s Republic of China
| | - Xin Li
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, People’s Republic of China
| | - Xin Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, People’s Republic of China
| | - Jing Xu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan Province, 410008, People’s Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, People’s Republic of China
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Imai T, Asada Y, Matsumoto K, Goto T, Matsuura K. Dissection of Cervical Lymph Node Metastasis With Internal Jugular-Subclavian Venous Junction Invasion Via an Approach Involving Resection of the Margin of the Medial Clavicle. Cureus 2021; 13:e16055. [PMID: 34345545 PMCID: PMC8323438 DOI: 10.7759/cureus.16055] [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] [Accepted: 06/30/2021] [Indexed: 11/05/2022] Open
Abstract
We report here a patient with a massive lymphatic metastasis involving the internal jugular-subclavian venous (IJ-SCV) junction that was safely resected with a new surgical procedure without significant complications. The patient, a 57-year-old man, had advanced hypopharyngeal cancer that had metastasized to the left IJ-SCV junction with a considerable invasion of the vessels, seemingly precluding a conventional surgical intervention. We, therefore, devised a new minimally invasive surgical approach involving resection of the margin of the medial clavicle, which provided an open view of the operation field. This enabled severance of both subclavicular and brachiocephalic veins and removal of the tumor. All procedures were accomplished safely and there were no postoperative circulatory disturbances, including arm edema and compartment syndrome, in the ipsilateral arm. Additionally, postoperative adjuvant chemoradiotherapy was completed uneventfully.
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Affiliation(s)
- Takayuki Imai
- Head and Neck Surgery, Miyagi Cancer Center, Natori, JPN
| | - Yukinori Asada
- Head and Neck Surgery, Miyagi Cancer Center, Natori, JPN
| | - Ko Matsumoto
- Diagnostic Radiology, Miyagi Cancer Center, Natori, JPN.,Diagnostic Radiology, Seiryo Clinic, Sendai, JPN
| | - Takahiro Goto
- Plastic and Reconstructive Surgery, Miyagi Cancer Center, Natori, JPN
| | - Kazuto Matsuura
- Head and Neck Surgery, Miyagi Cancer Center, Natori, JPN.,Head and Neck Surgery, National Cancer Center East, Kashiwa, JPN
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Ben-Arie E, Wei TH, Chen HC, Huang TC, Ho WC, Chang CM, Kao PY, Lee YC. Digestion-Specific Acupuncture Effect on Feeding Intolerance in Critically Ill Post-Operative Oral and Hypopharyngeal Cancer Patients: A Single-Blind Randomized Control Trial. Nutrients 2021; 13:2110. [PMID: 34205461 DOI: 10.3390/nu13062110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 12/13/2022] Open
Abstract
Malnourishment is prevalent in patients suffering from head and neck cancer. The postoperative period is crucial in terms of nutritional support, especially after composite resection and reconstruction surgery. These patients present with a number of risk factors that aggravate feeding intolerance, including postoperative status, prolonged immobility, decreased head elevation, mechanical ventilation, and applied sedative agents. Routine management protocols for feeding intolerance include prokinetic drug use and post-pyloric tube insertion, which could be both limited and accompanied by detrimental adverse events. This single-blind clinical trial aimed to investigate the effects of acupuncture in postoperative feeding intolerance in critically ill oral and hypopharyngeal cancer patients. Twenty-eight patients were randomized into two groups: Intervention group and Control group. Interventions were administered daily over three consecutive postoperative days. The primary outcome revealed that the intervention group reached 70% and 80% of target energy expenditure (EE) significantly earlier than the control group (4.00 ± 1.22 versus 6.69 ± 3.50 days, p = 0.012), accompanied by higher total calorie intake within the first postoperative week (10263.62 ± 1086.11 kcals versus 8384.69 ± 2120.05 kcals, p = 0.004). Furthermore, the intervention group also needed less of the prokinetic drug (Metoclopramide, 20.77 ± 48.73 mg versus 68.46 ± 66.56 mg, p = 0.010). In conclusion, digestion-specific acupuncture facilitated reduced postoperative feeding intolerance in oral and hypopharyngeal cancer patients.
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Johnson M, Porterfield JZ, Kejner AE. Assessing the Applicability of the TALK Score: A Modification for Concurrent Tobacco Use During Treatment. Otolaryngol Head Neck Surg 2021; 166:282-288. [PMID: 34126807 DOI: 10.1177/01945998211020310] [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: 11/15/2022]
Abstract
OBJECTIVE The previously described TALK score (T-stage, Albumin, Liquor, Karnofsky Performance Status) has been proposed as a method to predict laryngectomy-free survival (LFS) in patients undergoing definitive chemoradiation (CRT). This study assesses its use as well as a modification to include continued tobacco use. STUDY DESIGN Retrospective chart review. SETTING Academic institution from 2004 to 2020. METHODS Patients diagnosed with larynx or hypopharynx cancer undergoing CRT were reviewed. Clinically relevant variables were collected (TALK), which were dichotomized per previously set cutoffs. Concurrent tobacco use was evaluated and also dichotomized as 0 or 1. Multivariate analysis was conducted to determine which factors were most predictive of the key outcomes of survival and LFS. RESULTS A total of 2514 patient charts were evaluated. Patients treated for larynx cancer with primary CRT with complete data were included, ultimately totaling 300. Of these, 78 patients required salvage total laryngectomy (TL). Multivariate analysis demonstrated that LFS was best predicted by tobacco use during treatment (odds ratio [OR] 0.3465, 95% confidence interval [CI] 0.1862-0.6300) and Karnofsky Performance Status (OR 0.1646, 95% CI 0.0673-0.3662). Tobacco use during treatment was also strongly predictive of survival. Excluding T4 tumors, the utilization of tobacco in place of T-stage improved the accuracy of the predictive model in this cohort. CONCLUSION Given that a T-stage of 4 is typically treated with total laryngectomy, modification of the TALK score to include tobacco use during treatment (tALK) for patients with T < 4 can be used to improve prediction of 3-year LFS and overall survival.
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Affiliation(s)
- Mason Johnson
- University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - James Zachary Porterfield
- University of Kentucky Department of Otolaryngology-Head and Neck Surgery, Lexington, Kentucky, USA.,University of KwaZulu-Natal, Department of Otorhinolaryngology, Nelson Mandela School of Medicine, Durban, South Africa
| | - Alexandra Eva Kejner
- University of Kentucky Department of Otolaryngology-Head and Neck Surgery, Lexington, Kentucky, USA
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Ando Y, Hashimoto K, Sano A, Fujita N, Yanagawa R, Ono Y, Obuchi Y, Tatsushima D, Watanabe S, Tomifuji M, Tanaka Y. Frequent occurrence of postbreakfast syncope due to carotid sinus syndrome after surgery for hypopharyngeal cancer: A case report. Medicine (Baltimore) 2021; 100:e25959. [PMID: 34011078 PMCID: PMC8137094 DOI: 10.1097/md.0000000000025959] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/28/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Syncope often occurs in patients with advanced head and neck cancers due to the stimulation of the autonomic nervous system by the tumor. Here, we describe a case of frequent syncopal episodes after laryngopharyngectomy for hypopharyngeal cancer. As all syncopal episodes were observed during the forenoon, we also evaluated the heart rate variability using ambulatory electrocardiography to determine why the syncopal episodes occurred during a specified period of the day. PATIENT CONCERNS A 73-year-old Japanese man who underwent laryngopharyngectomy for recurrent hypopharyngeal cancer started experiencing frequent episodes of loss of consciousness that occurred during the same time period (10:00-12:00). He had never experienced syncopal episodes before the operation. From 23 to 41 days postoperatively, he experienced 9 syncopal episodes that occurred regardless of his posture. DIAGNOSES Pharyngo-esophagoscopy revealed an anastomotic stricture between the free jejunum graft and the upper esophagus. Swallowing videofluoroscopy confirmed the dilatation of the jejunal autograft and a foreign body stuck on the oral side of the anastomosis. Contrast-enhanced computed tomography revealed that the carotid artery was slightly compressed by the edematous free jejunum. The patient was diagnosed with carotid sinus syndrome (CSS) as the free jejunum was dilated when consuming breakfast, which may have caused carotid sinus hypersensitivity and induced a medullary reflex. INTERVENTIONS Administration of disopyramide was effective in preventing syncope. Heart rate variability analysis using ambulatory electrocardiography showed that parasympathetic dominancy shifted to sympathetic dominancy during 10:00 to 12:00. The significant time regularity of the syncopal episodes may have been affected by modified diurnal variation in autonomic tone activity. OUTCOMES After the surgical release and re-anastomosis of the pharyngoesophageal stenosis via an open-neck approach, no recurrent episodes of syncope were reported. LESSONS We reported a case of frequent syncopal episodes limited to the forenoon due to CSS after surgery for hypopharyngeal carcinoma. The patient was treated with anticholinergics followed by the release and re-anastomosis of the pharyngoesophageal stenosis. When syncope occurs after surgery for head and neck lesions, CSS due to postoperative structural changes should be considered as a differential diagnosis of syncope.
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Affiliation(s)
- Yuya Ando
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
- Department of Family Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Rempei Yanagawa
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Daisuke Tatsushima
- Department of Otolaryngology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Shun Watanabe
- Department of Otolaryngology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Masayuki Tomifuji
- Department of Otolaryngology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
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Doukas PG, Vageli DP, Sasaki CT, Judson BL. Pepsin Promotes Activation of Epidermal Growth Factor Receptor and Downstream Oncogenic Pathways, at Slightly Acidic and Neutral pH, in Exposed Hypopharyngeal Cells. Int J Mol Sci 2021; 22:ijms22084275. [PMID: 33924087 PMCID: PMC8074291 DOI: 10.3390/ijms22084275] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 02/07/2023] Open
Abstract
Pepsin refluxate is considered a risk factor for laryngopharyngeal carcinogenesis. Non-acidic pepsin was previously linked to an inflammatory and tumorigenic effect on laryngopharyngeal cells in vitro. Yet there is no clear evidence of the pepsin-effect on a specific oncogenic pathway and the importance of pH in this process. We hypothesized that less acidic pepsin triggers the activation of a specific oncogenic factor and related-signalling pathway. To explore the pepsin-effect in vitro, we performed intermittent exposure of 15 min, once per day, for a 5-day period, of human hypopharyngeal primary cells (HCs) to pepsin (1 mg/mL), at a weakly acidic pH of 5.0, a slightly acidic pH of 6.0, and a neutral pH of 7.0. We have documented that the extracellular environment at pH 6.0, and particularly pH 7.0, vs. pH 5.0, promotes the pepsin-effect on HCs, causing increased internalized pepsin and cell viability, a pronounced activation of EGFR accompanied by NF-κB and STAT3 activation, and a significant upregulation of EGFR, AKT1, mTOR, IL1β, TNF-α, RELA(p65), BCL-2, IL6 and STAT3. We herein provide new evidence of the pepsin-effect on oncogenic EGFR activation and its related-signaling pathway at neutral and slightly acidic pH in HCs, opening a window to further explore the prevention and therapeutic approach of laryngopharyngeal reflux disease.
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García-Cabo P, López F, Sánchez-Canteli M, Fernández-Vañes L, Álvarez-Marcos C, Llorente JL, de la Rúa MÁ, Blay P, Rodrigo JP. Matched-Pair Analysis of Survival in the Patients with Advanced Laryngeal and Hypopharyngeal Squamous Cell Carcinoma Treated with Induction Chemotherapy Plus Chemo-Radiation or Total Laryngectomy. Cancers (Basel) 2021; 13:cancers13071735. [PMID: 33917434 PMCID: PMC8038732 DOI: 10.3390/cancers13071735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 01/04/2023] Open
Abstract
Simple Summary There are no randomized studies comparing organ-preservation protocols with chemo-selection to the classical total laryngectomy plus (chemo)radiotherapy. Thus, we performed a matched-pair analysis to compare these two treatments with respect to locoregional control, disease-specific survival (DSS), and overall survival (OS) in patients with locally advanced squamous cell carcinoma of the larynx and hypopharynx. The results did not show differences between the two treatments for patients with T3/T4a larynx and T2–T4a hypopharynx cancer with respect to OS and DSS, locoregional control, and metastasis-free survival. Abstract Background: We performed a comparative analysis between an organ-preservation protocol and surgery followed by radiotherapy in patients with locally advanced squamous cell carcinoma of the larynx and hypopharynx; Methods: 60 previously untreated patients who were treated with induction chemotherapy followed by chemoradiotherapy in responders were compared with a control group of 60 patients treated with up-front surgery. Both groups were statistically comparable, according to the subsite, TNM (tumor-node-metastasis) stage, age, and sex; Results: Mean age was 58 years and 92% were male. No significant statistical difference was observed for overall survival (OS) (HR 0.75; 95% CI 0.48–1.18; P = 0.22) and disease-specific survival (DSS) (HR 0.98; 95% CI 0.52–1.83, P = 0.96). Also, there was no significant difference for recurrence-free survival (HR 0.931; 95% CI 0.57–1.71; P = 0.81), metastases-free survival (HR 2.23; 95% CI 0.67–7.41; P = 0.19), and the appearance of second primary tumors (HR 1.22; 95% CI 0.51–2.88; P = 0.64); Conclusions: The results of the organ-preservation approach did not appear inferior to those of surgery plus (chemo)radiotherapy for patients with T3/T4a larynx and T2–T4a hypopharynx cancer with respect to OS and DSS, locoregional control and metastases-free survival.
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Affiliation(s)
- Patricia García-Cabo
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (P.G.-C.); (M.S.-C.); (L.F.-V.); (C.Á.-M.); (J.L.L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, IUOPA, CIBERONC-ISCIII, 33011 Oviedo, Spain
| | - Fernando López
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (P.G.-C.); (M.S.-C.); (L.F.-V.); (C.Á.-M.); (J.L.L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, IUOPA, CIBERONC-ISCIII, 33011 Oviedo, Spain
- Correspondence: (F.L.); (J.P.R.)
| | - Mario Sánchez-Canteli
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (P.G.-C.); (M.S.-C.); (L.F.-V.); (C.Á.-M.); (J.L.L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, IUOPA, CIBERONC-ISCIII, 33011 Oviedo, Spain
| | - Laura Fernández-Vañes
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (P.G.-C.); (M.S.-C.); (L.F.-V.); (C.Á.-M.); (J.L.L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, IUOPA, CIBERONC-ISCIII, 33011 Oviedo, Spain
| | - César Álvarez-Marcos
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (P.G.-C.); (M.S.-C.); (L.F.-V.); (C.Á.-M.); (J.L.L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, IUOPA, CIBERONC-ISCIII, 33011 Oviedo, Spain
| | - José Luis Llorente
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (P.G.-C.); (M.S.-C.); (L.F.-V.); (C.Á.-M.); (J.L.L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, IUOPA, CIBERONC-ISCIII, 33011 Oviedo, Spain
| | - Maria Ángeles de la Rúa
- Department of Radiation Oncology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain;
| | - Pilar Blay
- Department of Medical Oncology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain;
| | - Juan P. Rodrigo
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (P.G.-C.); (M.S.-C.); (L.F.-V.); (C.Á.-M.); (J.L.L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, IUOPA, CIBERONC-ISCIII, 33011 Oviedo, Spain
- Correspondence: (F.L.); (J.P.R.)
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Wu J, You K, Chen C, Zhong H, Jiang Y, Mo H, Song J, Qiu X, Liu Y. High Pretreatment LDH Predicts Poor Prognosis in Hypopharyngeal Cancer. Front Oncol 2021; 11:641682. [PMID: 33777804 PMCID: PMC7991725 DOI: 10.3389/fonc.2021.641682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/02/2021] [Indexed: 12/30/2022] Open
Abstract
Background Elevated pretreatment lactate dehydrogenase (LDH) has been associated with poor prognosis in various malignancies; however, its prognostic role in hypopharyngeal cancer remains elusive. In this study, we aimed to assess the association between pretreatment LDH and clinical outcome of hypopharyngeal cancer. Methods We retrospectively collected 198 hypopharyngeal cancer patients treated with surgery in our institution between 2004 and 2018. The prognostic role of pretreatment LDH was explored by using univariate and multivariate analyses. Besides, subgroup analysis was performed based on T stage. Results Three-year and Five-year of disease-free survival (DFS, 67.0 vs. 57.4%, 65.8 vs. 39.8%, p = 0.007) and overall survival (OS, 74.8 vs. 68.9%, 66.8 vs. 50.8%, p = 0.006) exhibited significant differences between low LDH level and high LDH level groups. Univariate analysis showed that pretreatment elevated serum LDH served as an unfavorable determinant with regard to DFS and OS. Further multivariate analysis also confirmed that LDH was an independent predictor for DFS and OS. Additionally, N status and age were also found to be significantly associated with both DFS and OS. Conclusion Pretreatment elevated serum LDH is an inferior prognostic factor for patients with hypopharyngeal cancer. These results should be validated by more multicenter and prospective studies.
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Affiliation(s)
- Jialing Wu
- Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Kaiyun You
- Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Changlong Chen
- Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Huimin Zhong
- Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yanhui Jiang
- Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Huaqian Mo
- Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Juanjuan Song
- Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xingsheng Qiu
- Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yimin Liu
- Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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Sasaki CT, Doukas SG, Doukas PG, Vageli DP. Weakly Acidic Bile Is a Risk Factor for Hypopharyngeal Carcinogenesis Evidenced by DNA Damage, Antiapoptotic Function, and Premalignant Dysplastic Lesions In Vivo. Cancers (Basel) 2021; 13:852. [PMID: 33670587 DOI: 10.3390/cancers13040852] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/13/2021] [Accepted: 02/14/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary The etiologic role of biliary reflux in hypopharyngeal cancer is supported by clinical data. Although, reflux episodes often occur at pH 4.0, they can also occur at weakly acidic pH (5.5–6.0). The carcinogenic effect of bile at strongly acidic pH (pH 3.0) was recently documented in vivo. Here, we provide novel in vivo evidence that a weakly acidic pH of 5.5, similarly to a strongly acidic pH of 3.0, increases the risk of bile-related hypopharyngeal neoplasia. We document that chronic exposure of hypopharyngeal mucosa to bile at pH 5.5 promotes premalignant lesions with DNA damage, NF-κB activation, and deregulated mRNA and miRNA phenotypes, including Bcl-2 and miR-451a. The oncogenic effects of bile over a wider pH range suggests that antacid therapy may be insufficient to fully modify the effects of a bile induced oncogenic effect. Abstract Background: There is recent in vivo discovery documenting the carcinogenic effect of bile at strongly acidic pH 3.0 in hypopharynx, while in vitro data demonstrate that weakly acidic bile (pH 5.5) has a similar oncogenic effect. Because esophageal refluxate often occurs at pH > 4.0, here we aim to determine whether weakly acidic bile is also carcinogenic in vivo. Methods: Using 32 wild-type mice C57B16J, we performed topical application of conjugated primary bile acids with or without unconjugated secondary bile acid, deoxycholic acid (DCA), at pH 5.5 and controls, to hypopharyngeal mucosa (HM) twice per day, for 15 weeks. Results: Chronic exposure of HM to weakly acidic bile, promotes premalignant lesions with microinvasion, preceded by significant DNA/RNA oxidative damage, γH2AX (double strand breaks), NF-κB and p53 expression, overexpression of Bcl-2, and elevated Tnf and Il6 mRNAs, compared to controls. Weakly acidic bile, without DCA, upregulates the “oncomirs”, miR-21 and miR-155. The presence of DCA promotes Egfr, Wnt5a, and Rela overexpression, and a significant downregulation of “tumor suppressor” miR-451a. Conclusion: Weakly acidic pH increases the risk of bile-related hypopharyngeal neoplasia. The oncogenic properties of biliary esophageal reflux on the epithelium of the upper aerodigestive tract may not be fully modified when antacid therapy is applied. We believe that due to bile content, alternative therapeutic strategies using specific inhibitors of relevant molecular pathways or receptors may be considered in patients with refractory GERD.
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Tsai MH, Chuang HC, Lin YT, Huang TL, Fang FM, Lu H, Chien CY. Survival Outcomes and Predictors for Patients who Failed Chemoradiotherapy/Radiotherapy and Underwent Salvage Total Laryngectomy. Int J Environ Res Public Health 2021; 18:E371. [PMID: 33418958 DOI: 10.3390/ijerph18020371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/26/2020] [Accepted: 01/01/2021] [Indexed: 11/17/2022]
Abstract
Background: To assess the presence of adverse pathological features at the time of salvage total laryngectomy (TL) associated with oncologic outcome. Methods: Ninety patients with persistent/locally recurrent disease and who subsequently underwent salvage TL after definitive treatment by radiation alone (RTO) or concurrent chemo-radiation (CCRT) from 2009 to 2018 were retrospectively enrolled. Kaplan–Meier methods were used to estimate overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). Results: Lymphovascular invasion (LVI), perineural invasion, positive margin, and stage IV disease were associated with worse survival in the univariate analysis. In the multivariate analysis, the presence of LVI and positive margin were both independent negative predictors in OS (LVI: adjusted hazard ratio (aHR) = 2.537, 95% CI: 1.163–5.532, p = 0.019; positive margin: aHR = 5.68, 95% CI: 1.996–16.166, p = 0.001), DSS (LVI: aHR = 2.975, 95% CI: 1.228–7.206, p = 0.016); positive margin: aHR = 11.338, 95% CI: 2.438–52.733, p = 0.002), and DFS (LVI: aHR 2.705, 95% CI: 1.257–5.821, p = 0.011; positive margin (aHR = 6.632, 95% CI: 2.047–21.487, p = 0.002). Conclusions: The presence of LVI and positive margin were both associated with poor OS, DSS, and DFS among patients who underwent salvage TL after failure of RTO/CCRT. The role of adjuvant therapy for high-risk patients after salvage TL to improve the chance of survival requires more investigation in the future.
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