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Introduction: The larynx is a organ of the upper aerodigestive tract that plays an essential role in protecting the airways during swallowing. Squamous cell carcinoma is the most common malignant neoplasm affecting this region and early diagnosis has an important role in treatment outcome. Objectives: This study aims to evaluate whether patients with hypopharyngeal and/or laryngeal squamous cell carcinoma (SCC) who underwent organ preservation therapy (OPT) present at the time of relapse some factor that determines the local recurrence of the disease. Methods: Patients submitted to OPT were selected at the Cancer Institute of the State of São Paulo (ICESP), at the end of treatment, from January 2012 to December 2017. We collected retrospective data on demographics, clinical staging, location of the primary tumor, presence or absence of recurrence, weight and percentage of weight loss at different moments, alimentary pathway and symptomatology at the time of relapse. Results: The absence of symptoms was associated with the absence of relapse (p <0.001). Fully oral diet at the last visit was a significant factor for the absence of relapse (p = 0.005). The weight comparison of all the patients before the beginning of OPT and after the end of the treatment, showed an average drop of 3.4 kg. In the group-separated analysis, patients who did not recur showed an average loss of 0.7%. Patients with relapse, showed a loss of 2.0% of the weight at the time of relapse. Conclusion: Weight loss and the presence of symptoms were important predictors of recurrence with statistical significance. These factors may help to better manage these patients, with earlier investigations and, therefore, the possibility of rescue treatments with a shorter duration.
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Objective@#To compare the treatment outcomes for locally advanced hypopharyngeal carcinoma between surgery plus radio(chemo) therapy(SRT) and non-surgery chemoradiotherapy(CRT).@*Methods@#A total of 119 patients diagnosed with advanced hypopharyngeal carcinoma without distant metastases between 2010 and 2014 were identified in the Chinese People′s Liberation Army General Hospital, and they were divided into 2 groups: 42 cases in SRT group and 77 cases in CRT group. Patients′ clinical information was collected. Survival rates and prognostic factors were analyzed by the Kaplan-Meier method with SPSS 23.0 software. The survival rates, laryngeal preservation rates and complication rates were compared between the two groups using the chi-square test.Among the 119 patients, 112 were males and 7 were females. Age ranged from 27 to 78 years, with an average age of 57 years.@*Results@#There were no significant difference between the SRT and CRT group for five-year disease-free survival (DFS, 53.9% vs. 45.1%, χ2=1.251, P=0.263) and overall survival (OS, 54.9% vs. 45.6%, χ2=1.749, P=0.186). Compared to SRT group, CRT group did not showed the significant increase of treatment complications (χ2=0.858, P=0.354), with a higher laryngeal preservation rate (50.0% vs. 71.4%, χ2=6.493, P=0.011).@*Conclusions@#Advanced hypopharyngeal carcinoma is of high malignancy and poor prognosis. Combined modality treatment is a main approach for advanced hypopharyngeal cancer. SRT offers disease-free survival and overall survival rates equivalent to CRT, but with a higher laryngeal preservation rate.
ABSTRACT
Synovial sarcoma in head and neck is an extremely rare cancer. Symptoms may occur depending on the location of tumor. Synovial sarcoma is divided into two main phenotypes-biphasic and monophasic. Surgical excision including optimal resection margin is generally recommended as a standard treatment of synovial sarcoma, if the tumor is resectable. Standard adjuvant therapy of synovial sarcoma has not been established yet. Recently, we have experienced a case of recurrent synovial sarcoma in pyriform sinus without regional or distant metastasis after initial resection of tumor. We successfully performed endoscopic excision of recurred tumor and obtained clear resection margin. We followed up the patient without any adjuvant therapy for 2 years. We report this rare case with literature review.
Subject(s)
Humans , Endoscopy , Head , Hypopharyngeal Neoplasms , Neck , Neoplasm Metastasis , Pyriform Sinus , Sarcoma, SynovialABSTRACT
OBJECTIVES: To evaluate the oncologic and functional results of larynx-preserving partial pharyngectomy (LPP) via lateral pharyngotomy approach as a primary treatment for small (T1 or T2) hypopharyngeal squamous cell carcinoma (HPSCC). METHODS: We performed a retrospective review of 23 patients who underwent LPP through lateral pharyngotomy approach for small HPSCC at the our department between January 1991 and June 2007. Fourteen (61%) patients had adjuvant postoperative radiotherapy. RESULTS: The 2-years and 5-years disease specific survival rate was 77% and 61%, respectively. Nine patients (39%) had tumor recurrence. The most common pattern of recurrence was isolated distant failure (n=4, 44%) followed by local (n=2, 22%) and loco-regional (n=3, 34%) recurrence. The ultimate cure rate of the primary tumor was 87% (20 of 23). Twenty-two of the 23 patients (95%) could be decannulated, tolerate an oral diet, and had acceptable postoperative phonatory function. CONCLUSION: LPP via lateral pharyngotomy approach appears to be a feasible procedure for selected small HPSCC patients in terms of both oncologic and functional outcomes.
Subject(s)
Humans , Carcinoma, Squamous Cell , Diet , Hypopharyngeal Neoplasms , Pharyngectomy , Radiotherapy, Adjuvant , Recurrence , Retrospective Studies , Survival RateABSTRACT
OBJECTIVES: To evaluate the oncologic and functional results of larynx-preserving partial pharyngectomy (LPP) via lateral pharyngotomy approach as a primary treatment for small (T1 or T2) hypopharyngeal squamous cell carcinoma (HPSCC). METHODS: We performed a retrospective review of 23 patients who underwent LPP through lateral pharyngotomy approach for small HPSCC at the our department between January 1991 and June 2007. Fourteen (61%) patients had adjuvant postoperative radiotherapy. RESULTS: The 2-years and 5-years disease specific survival rate was 77% and 61%, respectively. Nine patients (39%) had tumor recurrence. The most common pattern of recurrence was isolated distant failure (n=4, 44%) followed by local (n=2, 22%) and loco-regional (n=3, 34%) recurrence. The ultimate cure rate of the primary tumor was 87% (20 of 23). Twenty-two of the 23 patients (95%) could be decannulated, tolerate an oral diet, and had acceptable postoperative phonatory function. CONCLUSION: LPP via lateral pharyngotomy approach appears to be a feasible procedure for selected small HPSCC patients in terms of both oncologic and functional outcomes.
Subject(s)
Humans , Carcinoma, Squamous Cell , Diet , Hypopharyngeal Neoplasms , Pharyngectomy , Radiotherapy, Adjuvant , Recurrence , Retrospective Studies , Survival RateABSTRACT
Background and purpose:It was reported that chemokine receptor CXCR4 and its ligand stromal cell-derived factor 1(SDF-1)were involved in the proliferation,differentiation,and metastasis of tumor.This study was designed to observe the expression of chemokine receptor CXCR4 in hypopharyngeal squamous cell carcinoma tissue and study the relationship between the expression of chemokine receptor CXCR4 and different clinicopathlogical characteristics,and further to explore the clinical significance.Methods:For the detection of the expression of chemokine receptor CXCR4,43 primary hypopharyngeal squamous cell carcinoma tissues,27 normal hypopharyngeal tissues,34 lymph node metastastatic lesions and 9 normal lymph node lesions were detected by immunohistochemical method using rabbit anti-human CXCR4 polyclonal antibody.Results:The positive expression rates of CXCR4 in 43 hypopharyngeal carcinoma tissues and normal tissues were 95.3% and 22.2%,respectively(P