Search

Background: The squamous cell carcinoma (SCC) of the posterior pharyngeal wall (PPW) is associated with poor oncological outcomes based on current literature data. We reported the preliminary outcomes of a potential new treatment protocol based on neoadjuvant chemotherapy (NCT) and transoral robotic surgery (TORS). Methods: A retrospective single-center case series was performed including a total of 20 patients diagnosed with a SCC of the PPW between October 2010 and September 2021. All patients successfully completed TORS with neck dissection after NCT. Adjuvant treatment was performed in the presence of adverse pathologic features. Loco-regional control (LRC), overall survival (OS), and disease-specific survival (DSS) were defined as the time from surgery to tumor recurrence or death, as appropriate. Survival estimates were calculated by Kaplan–Meier analysis. Surgical data and post-operative functional outcomes were also reported. Results: Estimated 3-year LRC, OS, and DSS rates (95% Confidence interval) were 59.7% (39.7–89.6), 58.6% (38.7–88.8), and 69.4% (49.9–96.6). The median hospital stay was 21 days (IQR 17.0–23.5). Oral diet and decannulation were achieved after a median of 14 days (IQR 12.0–15.0). Feeding tube and tracheostomy dependence after 6 months was observed in 3 (15%) and 2 (10%) patients, respectively. Conclusions: The use of NCT followed by TORS for PPW SCC treatment appears to have good oncological and functional outcomes for both early and locally advanced cancers. Further randomized trials and site-specific guidelines are needed. [ABSTRACT FROM AUTHOR]

Purpose: Head and neck cancer (HNC) is one of the fastest increasing cancer-types, where both disease and oncologic treatment have severe impact on health-related quality of life (HRQL). This study aimed to report HRQL prospectively up to 5-years following radiotherapy-treatment in HNC and to, if possible, identify trends in HRQL over time. Methods: This prospective study followed 211 patients receiving curatively intended radiotherapy pre-diagnosis, 3-, 6-, 12- and 60-months post-radiotherapy completion. HRQL was measured using EORTC QLQ-C30 and EORTC QLQ-HN35. Results: A deterioration three months post-radiotherapy was reported in 14/15 domains of EORTC QLQ-C30. Eight out of 12 domains had recovered to baseline-values at 12 months post-radiotherapy and remained unchanged up to study endpoint. Corresponding figures for EORTC QLQ-HN35 were deteriorations in 15/16 domains at three months post-radiotherapy, with recovery of 5 domain at 12-months, whereas the other 11 domains remained significantly worse at 5-years post-RT compared to baseline. Conclusion: Following the deterioration in HRQL seen immediately following radiotherapy, the continued course of HRQL can be divided into three trends: short-term deterioration, long-term deterioration and long-term improvements. The combination of disease- and diagnosis-specific questionnaires is crucial when assessing HRQL in the HNC population. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyze the impact of tumor volume (TV) measurements as prognosticator for recurrence-free survival (RFS) and overall survival (OS) from data of head and neck cancer (HNC) registries. TV measurements were performed in pre-treatment computed tomography (CT) or magnetic resonance images (MRI) of 392 unselected HNC patients. TV measurements were feasible in 275 patients (70 %). Median CT TV and MRI TV were 11.43 and 10.4 cm, respectively. The CT TV was significantly different only between T1 and T4. CT TV was significantly different only between T1 and T4 ( p = 0.041). MRI TV was significantly different between T1 and T4 ( p = 0.003) as well as between T2 and T4 ( p = 0.002). Median follow-up was 26.1 months. Median RFS was 80.7 months. Median OS was 66.5 months. On univariate analysis, significant prognostic factors for decreased RFS were advanced T stage ( p = 0.010); M1 ( p = 0.001) and an MRI TV > 10.4 cm ( p = 0.001). Significant prognostic factors for a decreased OS were advanced T stage ( p = 0.001), N+ ( p = 0 006), M+ ( p < 0.001), tumor recurrence ( p < 0.001), CT TV ( p = 0.005), and MRI TV ( p = 0.012). On multivariate analysis for RFS, MRI TV was the best independent prognosticator ( p = 0.003). On multivariate analysis for OS, T stage ( p = 0.006) was a better prognosticator than CT or MRI TV. Using CT and MRI data sets of an unselected series of HNC patients in a cancer registry, TV measurements were not feasible in all patients. MRT TV was a powerful prognosticator for RFS. [ABSTRACT FROM AUTHOR]

Functioning is recognized increasingly as an important study outcome with head and neck cancer (HNC). The International Classification of Functioning, Disability and Health, as adopted by the World Health Organization in 2001, is based on a comprehensive bio-psycho-social view. The objective of this study was to evaluate functioning from the patient perspective and to classify the results using the comprehensive view of the ICF. Patients with HNC were interviewed on their problems in daily life using qualitative methodology. Sampling of patients followed the maximum variation strategy. Sample size was determined by saturation. All individual interviews were digitally recorded and transcribed verbatim. Interview texts were divided into meaning units and the concepts contained in the meaning units were linked to the ICF according to established linking rules. The transcribed data were analyzed and linked by a second health professional and the degree of consensus was calculated using kappa statistics. Concordance of identified ICF categories among different tumor locations was also measured with kappa statistics. Until saturation was reached, 18 patients were interviewed: seven patients with oral cancer, five with hypopharyngeal cancer and six with laryngeal cancer. Thousand four hundred and sixty-two (1,462) different concepts were translated into the ICF using 104 different, second-level ICF categories. These ICF categories are presented in detail. From the patient perspective, the ICF components (a) Body functions, (b) Activities and participation and (c) contextual Environmental factors are equally represented, while (d) Body structures show by far the least number of categories. The concordance between different tumor locations rages between 0.53 and 0.58 (confidence interval 0.42–0.70). The degree of consensus in the linking process was 0.58 (confidence interval 0.45–0.73). The ICF classification can display problems with functioning following HNC sufficiently. For patients with HNC Body functions, Activities and participation in every-day life and contextual Environmental factors are equally relevant. Therefore, rehabilitation of these patients must not confine itself to anatomical and (patho-) physiologic changes, but should move towards a more comprehensive view including the individual patient’s demands on daily life and the given individual contextual circumstances. [ABSTRACT FROM AUTHOR]

In addition to panendoscopy and imaging for staging, ipsilateral tonsillectomy is a standard procedure in the search for the primary tumor in cervical cancer of unknown primary site (CUPS). It is not clear from the literature, whether bilateral tonsillectomy has been established as the standard procedure in cancer of unknown primary origin. A bilateral synchronous tonsillar carcinoma has thus far only been described three times in the literature. We report on a case of CUPS in which a bilateral tonsillar carcinoma was detected after bilateral tonsillectomy. We also discuss the inclusion of bilateral tonsillectomy as a standard procedure in the search for primary malignancies. To diagnose and adequately treat a bilateral synchronous tonsillar carcinoma without losing time, we recommend bilateral tonsillectomy as a standard procedure in cervical CUPS. [ABSTRACT FROM AUTHOR]

Recently, some studies have noticed a large number of patients with squamous cell carcinoma of the head and neck (SCCHN), who are infected with hepatitis C virus (HCV). The aim of this study is to determine the prevalence of HCV in these patients in our population. Patients with SCCHN in four tertiary centers in different regions of Iran were checked for HCV. The prevalence of HCV in 107 patients diagnosed with head and neck squamous cell carcinoma was 0.9%, which has no significant difference with its prevalence in normal population. It seems that HCV at least in Iran could not be considered as a risk factor for SCCHN. [ABSTRACT FROM AUTHOR]