[CEA and Cyfra 21.1 study pre-treatment in 252 patients with head and neck carcinomas]. / Estudio de CEA y Cyfra 21.1 pre-tratamiento en 252 pacientes con carcinoma de cabeza y cuello.

INTRODUCTION: Squamous cell carcinoma is the most frequent malignant tumor in the head and neck. As in most malignant tumors, the earlier the diagnosis, is made the longer the survivalis. Several molecules, including CEA and Cyfra 21.1, have been evaluated in an attempt to improve diagnosis and follow-up. OBJECTIVE: To investigate whether CEA and Cyfra 21.1 present pathological increased values prior to treatment, and to correlate tumor and patient characteristics with CEA and Cyfra 21.1 levels. MATERIAL AND METHODS: CEA and Cyfra 21.1 were measured pre-treatment in sera of 252 patients treated for head and neck tumors from1999 to 2003. RESULTS: Increases of CEA were detected in 23.6%, and increases of Cyfra 21.1 in 19.1% of patients. Significative differences were found between the concentrations of Cyfra 21.1 related to the tumor stage, local extension, histological grade, and an increasing relation with age. No differences were found in relation to the primary tumor site. Regarding CEA, the only finding was an increased relation between concentrations of this marker and cigarette and alcohol habits. CONCLUSIONS: Cyfra 21.1 does not appear to be a good marker for tumoral screening of head and neck carcinomas. However, a good correlation was observed between sera concentrations of Cyfra 21.1, tumoral burden, and histological grade of the tumor, but this was not the case with CEA.

Estudio de CEA y Cyfra 21.1 Pre-tratamiento en 252 pacientes con carcinoma de cabeza y cuello / CEA and Cyfra 21.1 Study pre-treatment in 252 patients with head and neck carcinomas

Introducción: El carcinoma escamoso es el tumor maligno predominante en cabeza y cuello. Como en la mayoría de tumores malignos, su diagnóstico precoz conlleva una mayor supervivencia. Diferentes moléculas, entre ellas el CEA y el Cyfra 21.1 han sido evaluadas en un intento de facilitar el diagnóstico y la evolución de la enfermedad. Objetivo: Demostrar si existe una elevación patológica de CEA y Cyfra 21.1 pre-tratamiento en nuestros pacientes, y buscar correlación entre sus concentraciones y diferentes parámetros con relación al tumor y al paciente. Material y métodos: Se midieron antes deltratamiento las concentraciones de CEA y Cyfra 21.1 en suero en 252 pacientes entre 1999 y 2003. Resultados: Se detectó una elevación de CEA en 23,6 por ciento, y de Cyfra 21,1 en 19.1 por ciento de pacientes. Se encontró una diferencia significativa de las concentraciones de Cyfra 21.1 en función del estadiaje tumoral, la extensión local y regional, entre los diferentes grados histológicos, y una relación de tendencia creciente con la edad. No hubo diferencias significativas para las localizaciones delprimario. Respecto al CEA sólo se encontró relación de tendencia creciente con el hábito tabáquico y enólico de los pacientes. Conclusiones: El Cyfra 21.1 está lejos de ser un marcador adecuado para cribaje del carcinoma en cabeza y cuello. Existe, sin embargo, correlación entre sus concentraciones séricas y la carga de tumor y su grado de diferenciación histológica, no siendo así para el CEA (AU)

INTRODUCTION: Squamous cell carcinoma is the most frequent malignant tumor in the head and neck. As in most malignant tumors, the earlier the diagnosis, is made the longer the survivalis. Several molecules, including CEA and Cyfra 21.1, have been evaluated in an attempt to improve diagnosis and follow-up. OBJECTIVE: To investigate whether CEA and Cyfra 21.1 present pathological increased values prior to treatment, and to correlate tumor and patient characteristics with CEA and Cyfra 21.1 levels. MATERIAL AND METHODS: CEA and Cyfra 21.1 were measured pre-treatment in sera of 252 patients treated for head and neck tumors from1999 to 2003. RESULTS: Increases of CEA were detected in 23.6%, and increases of Cyfra 21.1 in 19.1% of patients. Significative differences were found between the concentrations of Cyfra 21.1 related to the tumor stage, local extension, histological grade, and an increasing relation with age. No differences were found in relation to the primary tumor site. Regarding CEA, the only finding was an increased relation between concentrations of this marker and cigarette and alcohol habits. CONCLUSIONS: Cyfra 21.1 does not appear to be a good marker for tumoral screening of head and neck carcinomas. However, a good correlation was observed between sera concentrations of Cyfra 21.1, tumoral burden, and histological grade of the tumor, but this was not the case with CEA (AU)

[Selective neck dissection in patients presenting clinical node metastases]. / Vaciamientos selectivos en pacientes con metástasis ganglionares clínicas.

OBJECTIVE: To evaluate the results obtained with selective neck dissection in patients with clinically positive neck nodes at diagnosis (N+). PATIENTS AND METHODS: Retrospective study of N+ patients treated with a lateral or supromohyoid selective neck dissection with prophylactic purpose (sides of the neck N0) or therapeutic purpose (sides of the neck N+). RESULTS: Forty nine selective neck dissections were carried out in 42 N+ patients. In 18 cases the neck dissection had a prophylactic purpose (sides of the neck N0), and in 31 of them a therapeutic purpose (sides of the neck N+). In 39 patients summary was followed by postoperative radiotherapy. There was no regional relapse in either side of the neck treated with a selective neck dissection. CONCLUSIONS: Selective neck dissections in selected N+ patients are an adequate surgical technique. The main advantages of selective neck dissections are to shorten the surgical time, and to avoid the morbility associated with the dissection of the neck zones not included.

Vaciamientos selectivos en pacientes con metástasis ganglionares clínicas / Selective neck dissection in patients presenting clinical node metastases

Objetivo: Evaluar los resultados obtenidos con el uso de vaciamientos selectivos en pacientes con metástasis ganglionares clínicas en el momento del diagnóstico (N+). Pacientes y métodos: Estudio retrospectivo de los pacientes N+ tratados con un vaciamiento selectivo lateral o supraomohioideo con finalidad profiláctica (lado de cuello N0) o terapéutica (lado de cuello N+). Resultados: Se llevaron a cabo un total de 49 vaciamientos selectivos en 42 pacientes N+. En 18 ocasiones los vaciamientos tuvieron una finalidad profiláctica (lados de cuello N0) y en 31 terapéutica (lados de cuello N+).Treinta y nueve pacientes siguieron tratamiento con radioterapia postoperatoria. No se produjo una recidiva regional en ninguno de los lados de cuello tratados con un vaciamiento selectivo. Conclusión: Los vaciamientos selectivos en casos seleccionados de pacientes N+ son una técnica adecuada de cirugía cervical, y cuentan con la ventaja de minimizar el tiempo operatorio y la morbilidad asociada a la disección de las estructuras cervicales (AU)

OBJECTIVE: To evaluate the results obtained with selective neck dissection in patients with clinically positive neck nodes at diagnosis (N+). PATIENTS AND METHODS: Retrospective study of N+ patients treated with a lateral or supromohyoid selective neck dissection with prophylactic purpose (sides of the neck N0) or therapeutic purpose (sides of the neck N+). RESULTS: Forty nine selective neck dissections were carried out in 42 N+ patients. In 18 cases the neck dissection had a prophylactic purpose (sides of the neck N0), and in 31 of them a therapeutic purpose (sides of the neck N+). In 39 patients summary was followed by postoperative radiotherapy. There was no regional relapse in either side of the neck treated with a selective neck dissection. CONCLUSIONS: Selective neck dissections in selected N+ patients are an adequate surgical technique. The main advantages of selective neck dissections are to shorten the surgical time, and to avoid the morbility associated with the dissection of the neck zones not included (AU)

Recidivas ganglionares aisladas en pacientes con carcinomas de cabeza y cuello / Isolated lymphatic recurrencies in patients with head and neck carcinomas

Objetivo: La existencia de una recidiva ganglionar comporta un empeoramiento notable en el pronóstico de los pacientes con carcinoma de cabeza y cuello. El objetivo del presente estudio es analizar las posibilidades de tratamiento de rescate tras una recidiva ganglionar aislada. Material y Métodos: Estudio retrospectivo de 144 pacientes con carcinomas de cabeza y cuello afectos de una recidiva regional aislada. Se analizaron los tratamientos empleados y los resultados de control regional y supervivencia. Resultados: Un 64 por ciento (92/144) de los pacientes no fueron candidatos a tratamiento de rescate con intención radical. Se efectuó un rescate quirúrgico en el 36 por ciento (52/144) restante de pacientes, obteniéndose una supervivencia ajustada en este grupo del 46 por ciento. La variable relacionada de forma más importante con la posibilidad de llevar a cabo un tratamiento de rescate fue el tratamiento inicial de las áreas ganglionares, contando con peor pronóstico los pacientes en los que el tratamiento inicial incluyó cirugía. Conclusiones: La aparición de una recidiva regional cuenta con mal pronóstico, con una supervivencia ajustada a los 5 años en nuestros pacientes del 16 por ciento. Tan sólo un 36 por ciento de los pacientes fueron considerados candidatos a un tratamiento de rescate, consiguiéndose una supervivencia en este grupo del 46 por ciento (AU)

OBJECTIVE: Recurrencies of lymphatic metastasis implies a poor prognosis in patients with head and neck carcinoma. The aim of our study is to analyse the results of salvage treatment after an isolated regional tumour recurrence. MATERIAL AND METHODS: Retrospective study of 144 patients with head and neck carcinoma with an isolated neck recurrence. The treatments used, regional control and patient's survival were analysed. RESULTS: Sixty-four percent (92/144) of patients were not candidates to salvage treatment with radical intention. Salvage surgery was performed in 36% (52/144) of patients, with a survival of 46% in this group of patients. Previous treatment of the neck was the most relevant variable to decide a salvage surgery. Patients treated initially with neck dissection had the worst prognosis. CONCLUSIONS: The existence of a regional recurrence has a bad prognosis, with 16% 5-year survival. Only 36% of patients were considered candidates to salvage treatment, achieving 46% of survival (AU)

[Isolated lymphatic recurrences in patients with head and neck carcinomas]. / Recidivas ganglionares aisladas en pacientes con carcinomas de cabeza y cuello.

OBJECTIVE: Recurrencies of lymphatic metastasis implies a poor prognosis in patients with head and neck carcinoma. The aim of our study is to analyse the results of salvage treatment after an isolated regional tumour recurrence. MATERIAL AND METHODS: Retrospective study of 144 patients with head and neck carcinoma with an isolated neck recurrence. The treatments used, regional control and patient's survival were analysed. RESULTS: Sixty-four percent (92/144) of patients were not candidates to salvage treatment with radical intention. Salvage surgery was performed in 36% (52/144) of patients, with a survival of 46% in this group of patients. Previous treatment of the neck was the most relevant variable to decide a salvage surgery. Patients treated initially with neck dissection had the worst prognosis. CONCLUSIONS: The existence of a regional recurrence has a bad prognosis, with 16% 5-year survival. Only 36% of patients were considered candidates to salvage treatment, achieving 46% of survival.

Prevalencia en el consumo de tabaco y alcohol tras tratamiento en pacientes con carcinomas de cabeza y cuello: un estudio transversal / Prevalence of tobacco and alcohol use following treatment in patients with head and neck squamous carcinoma: a transversal study

Objetivo: Evaluar la prevalencia en el consumo de tabaco y alcohol tras el tratamiento en los pacientes con carcinomas escamosos de cabeza y cuello en nuestro centro, y determinar posibles factores relacionados con dicho consumo. Material y Métodos: Se llevó a cabo un estudio transversal del consumo de tabaco y alcohol post-tratamiento en los pacientes con antecedentes de carcinomas de cabeza y cuello que acudieron a consulta ambulatoria. Resultados: Del total de 582 pacientes evaluados, un 13% persistía en el consumo de tabaco, y un 21% en el consumo habitual de alcohol. Las variables que se relacionaron con la persistencia de tabaquismo fueron el tipo de tratamiento empleado y el uso previo de tabaco. Las variables relacionadas con el consumo de alcohol post-tratamiento fueron la edad, el sexo, y los consumos previos de tabaco y alcohol. Conclusiones: A pesar de los consejos en contra, un 13% de los pacientes con antecedente de carcinoma escamoso de cabeza y cuello persistieron en el consumo de tabaco, y un 21% en el consumo de alcohol (AU)

OBJECTIVE: To evaluate the prevalence of tobacco and alcohol use following treatment in patients with head and neck squamous cell carcinoma, and to determine factors possibly related to this use. MATERIAL AND METHODS: A transversal study on tobacco and alcohol use following treatment for head and neck squamous cell carcinoma was performed in patients on ambulatory visits to our center. RESULTS: From 582 patients evaluated, 13% regularly smoked post-treatment, and 21% consumed alcohol. The related variables for tobacco use post-treatment were the kind of treatment received and previous tobacco use. The related variables for alcohol use post-treatment were age, sex and previous use of tobacco and alcohol. CONCLUSIONS: Despite warnings, 13% of patients with previous head and neck squamous cell carcinoma continued smoking and 21% persisted in alcohol use (AU)

[Prevalence of tobacco and alcohol use following treatment in patients with head and neck squamous carcinoma: a cross-sectional study]. / Prevalencia en el consumo de tabaco y alcohol tras tratamiento en pacientes con carcinomas de cabeza y cuello: un estudio transversal.

OBJECTIVE: To evaluate the prevalence of tobacco and alcohol use following treatment in patients with head and neck squamous cell carcinoma, and to determine factors possibly related to this use MATERIAL AND METHODS: A transversal study on tobacco and alcohol use following treatment for head and neck squamous cell carcinoma was performed in patients on ambulatory visits to our center. RESULTS: From 582 patients evaluated, 13% regularly smoked post-treatment, and 21% consumed alcohol. The related variables for tobacco use post-treatment were the kind of treatment received and previous tobacco use. The related variables for alcohol use post-treatment were age, sex and previous use of tobacco and alcohol. CONCLUSIONS: Despite warnings, 13% of patients with previous head and neck squamous cell carcinoma continued smoking and 21% persisted in alcohol use.