ABSTRACT
OBJECTIVE: The tumour-node-metastasis staging system has a dynamic structure that is continuously being updated as scientific data develops. This review discusses some suggested revisions on tumour-node-metastasis staging of human papillomavirus negative upper aerodigestive tract cancers. METHODS: The seventh edition of The American Joint Committee on Cancer Staging Manual was reviewed and important issues that could be considered for revision were identified and discussed. RESULTS: According to our assessment of the oncological outcomes of previous studies, the following factors should be considered for revision: anterior commissure involvement and subglottic extension in laryngeal cancers; underlying bone involvement in hard palate and upper alveolar ridge cancers; tumour thickness in oral cancers; and extracapsular spread and carotid artery involvement in neck metastases. CONCLUSION: Sufficient data on the prognostic importance of these issues have been reported. Suggested revisions in line with current knowledge on the clinical behaviour of upper aerodigestive tract cancers would improve the relevancy of staging.
Subject(s)
Laryngeal Neoplasms/pathology , Lymph Nodes/pathology , Mouth Neoplasms/pathology , Neoplasm Staging/methods , Papillomaviridae/isolation & purification , Female , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/surgery , Humans , Laryngeal Neoplasms/mortality , Laryngeal Neoplasms/surgery , Male , Mouth Neoplasms/mortality , Mouth Neoplasms/surgery , Neoplasm Invasiveness/pathology , Papillomavirus Infections/diagnosis , Prognosis , Risk Assessment , Survival AnalysisABSTRACT
OBJECTIVE: To report and discuss the outcome of a treatment algorithm for patients with tumour stage 1 glottic squamous cell carcinoma. METHOD: A retrospective outcome analysis study was performed using data from a tertiary referral centre. RESULTS: Sixty-nine patients were treated with radiotherapy and 26 with surgery, in accordance with the treatment algorithm. Five-year overall survival rates were the same for both treatment groups (92 per cent). Five-year disease-specific survival rates were 100 per cent for surgery, 98 per cent for radiotherapy and 99 per cent overall. The overall 5-year laryngeal preservation rate was 89.1 per cent, being 95.7 per cent for surgery patients and 86.7 per cent for radiotherapy patients (p = 0.502). There was no significant association between laryngeal preservation rates and age (p = 0.779), anterior commissure involvement (p = 0.081), tumour stage (1a or 1b) (p = 0.266) or treatment modality (surgery or radiotherapy; p = 0.220). There was no significant difference in local recurrence rates between the two treatment groups (19.3 per cent for radiotherapy vs 10.0 per cent for surgery; p = 0.220). The overall 5-year regional recurrence rate was 1.2 per cent. CONCLUSION: Tumour stage 1 glottic carcinoma can be managed with different treatment modalities, following an individualised treatment algorithm, with results comparable to published outcomes.
Subject(s)
Algorithms , Carcinoma, Squamous Cell/mortality , Head and Neck Neoplasms/mortality , Laryngeal Neoplasms/mortality , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Female , Glottis , Head and Neck Neoplasms/radiotherapy , Head and Neck Neoplasms/surgery , Humans , Kaplan-Meier Estimate , Laryngeal Neoplasms/radiotherapy , Laryngeal Neoplasms/surgery , Laryngectomy/mortality , Laser Therapy/mortality , Male , Middle Aged , Neoplasm Recurrence, Local , Retrospective Studies , Squamous Cell Carcinoma of Head and Neck , Treatment OutcomeABSTRACT
OBJECTIVE: We present the first report of agenesis of the middle nasal turbinate. METHOD: We present a case report and briefly discuss the world literature. RESULTS: A 57-year-old man presenting with sinonasal symptoms was evaluated clinically and radiologically. Agenesis of the patient's left middle turbinate was detected. Coronal computed tomography images showed a septal spur replacing the absent left middle turbinate. CONCLUSION: The lateral nasal wall has complex anatomy, and several anatomical variations have been reported. The most common anatomical variation of the middle nasal turbinate is concha bullosa. Unilateral agenesis of the middle nasal turbinate has not previously been reported; the presented patient represents the first reported case.
Subject(s)
Turbinates/abnormalities , Humans , Male , Middle Aged , Sinusitis/diagnostic imaging , Tomography, X-Ray Computed , Turbinates/diagnostic imagingABSTRACT
OBJECTIVE: To evaluate the relationship between disease stage and duration of symptoms for squamous cell carcinoma of the larynx. METHOD: We evaluated retrospectively data from 102 laryngeal squamous cell carcinoma patients seen in the otorhinolaryngology department of the Gazi University School of Medicine between December 1996 and June 2004. Inclusion criteria were a histologic diagnosis of laryngeal squamous cell carcinoma, no previous medical, surgical or radiological treatment for carcinoma, and the absence of any other primary tumours or distant metastatic disease. RESULTS: There was no relationship between duration of symptoms and stage of the disease, both for glottic and supraglottic tumours. When glottic and supraglottic tumours were compared, no significant difference in symptom duration could be found. CONCLUSION: There is no correlation between symptom duration and the stage of the disease for squamous cell carcinoma of the larynx. Therefore, symptom duration does not reflect the stage of the tumour.
