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3. Neck Surgery for Non-Well Differentiated Thyroid Malignancies: Variations in Strategy According to Histopathology

Author

López, Fernando, primary, Al Ghuzlan, Abir, additional, Zafereo, Mark, additional, Vander Poorten, Vincent, additional, Robbins, K. Thomas, additional, Hamoir, Marc, additional, Nixon, Iain J., additional, Tufano, Ralph P., additional, Randolph, Gregory, additional, Pace-Asciak, Pia, additional, Angelos, Peter, additional, Coca-Pelaz, Andrés, additional, Khafif, Avi, additional, Ronen, Ohad, additional, Rodrigo, Juan Pablo, additional, Sanabria, Álvaro, additional, Palme, Carsten E., additional, Mäkitie, Antti A., additional, Kowalski, Luiz P., additional, Rinaldo, Alessandra, additional, and Ferlito, Alfio, additional

Published
2023
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4. Management of Recurrent Well-Differentiated Thyroid Carcinoma in the Neck: A Comprehensive Review

Author

Cavalheiro, Beatriz G., primary, Shah, Jatin P., additional, Randolph, Gregory W., additional, Medina, Jesus E., additional, Tufano, Ralph P., additional, Zafereo, Mark, additional, Hartl, Dana M., additional, Nixon, Iain J., additional, Guntinas-Lichius, Orlando, additional, Vander Poorten, Vincent, additional, López, Fernando, additional, Khafif, Avi Hefetz, additional, Owen, Randall P., additional, Shaha, Ashok, additional, Rodrigo, Juan P., additional, Rinaldo, Alessandra, additional, Mäkitie, Antti A., additional, Silver, Carl E., additional, Sanabria, Alvaro, additional, Kowalski, Luiz P., additional, and Ferlito, Alfio, additional

Published
2023
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5. Papillary Thyroid Cancer-Aggressive Variants and Impact on Management : A Narrative Review

Author

Coca-Pelaz, Andres, Shah, Jatin P., Hernandez-Prera, Juan C., Ghossein, Ronald A., Rodrigo, Juan P., Hartl, Dana M., Olsen, Kerry D., Shaha, Ashok R., Zafereo, Mark, Suarez, Carlos, Nixon, Iain J., Randolph, Gregory W., Mäkitie, Antti A., Kowalski, Luiz P., Vander Poorten, Vincent, Sanabria, Alvaro, Guntinas-Lichius, Orlando, Simo, Ricard, Zbaren, Peter, Angelos, Peter, Khafif, Avi, Rinaldo, Alessandra, Ferlito, Alfio, HUS Head and Neck Center, Department of Ophthalmology and Otorhinolaryngology, University of Helsinki, and Helsinki University Hospital Area

Subjects
endocrine system diseases, CARCINOMA, FEATURES, 3122 Cancers, COLUMNAR CELL VARIANT, CASE SERIES, NEEDLE-ASPIRATION-CYTOLOGY, HOBNAIL VARIANT, Aggressive variants papillary thyroid cancer, DIFFUSE SCLEROSING VARIANT, TALL-CELL, Diffuse sclerosis variant, Tall cell variant, BRAF MUTATION, 317 Pharmacy, SOLID COMPONENT, 3125 Otorhinolaryngology, ophthalmology, Solid variant
Abstract

Introduction Aggressive variants of papillary thyroid cancer (PTC) have been described with increasing frequency. These variants include diffuse sclerosing variant, tall cell variant, columnar cell variant, solid variant, and hobnail variant. Methods We have performed a review of the more aggressive variants of PTC with respect to main characteristics, histological and molecular features, and the consequences that the knowledge of these variants should have in the treatment of the patients. Results At the present time, we do not know the prognostic value of these aggressive PTC variants. The extent of the surgical treatment and adjuvant therapy necessary should be decided on the basis of the extent of the tumor at presentation and the opinion of experienced clinicians. Conclusion These aggressive variants should be known by clinicians, to avoid underdiagnosis, and treated according to the latest recommendations in the literature.

Published
2020

6. Standardization for oncologic head and neck surgery

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Ronen, Ohad, Robbins, K. Thomas, de Bree, Remco, Guntinas-Lichius, Orlando, Hartl, Dana M., Homma, Akihiro, Khafif, Avi, Kowalski, Luiz P., López, Fernando, Mäkitie, Antti A., Ng, Wai Tong, Rinaldo, Alessandra, Rodrigo, Juan P., Sanabria, Alvaro, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Ronen, Ohad, Robbins, K. Thomas, de Bree, Remco, Guntinas-Lichius, Orlando, Hartl, Dana M., Homma, Akihiro, Khafif, Avi, Kowalski, Luiz P., López, Fernando, Mäkitie, Antti A., Ng, Wai Tong, Rinaldo, Alessandra, Rodrigo, Juan P., Sanabria, Alvaro, and Ferlito, Alfio

Published
2021

10. Impact of prophylactic central neck dissection on oncologic outcomes of papillary thyroid carcinoma: a review

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Centre de malformations vasculaires congénitales, Mamelle, Elisabeth, Borget, Isabelle, Leboulleux, Sophie, Mirghani, Haïtham, Suárez, Carlos, Pellitteri, Phillip K., Shaha, Ashok R., Hamoir, Marc, Robbins, K. Thomas, Khafif, Avi, Rodrigo, Juan P., Silver, Carl E., Rinaldo, Alessandra, Ferlito, Alfio, Hartl, Dana M., UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Centre de malformations vasculaires congénitales, Mamelle, Elisabeth, Borget, Isabelle, Leboulleux, Sophie, Mirghani, Haïtham, Suárez, Carlos, Pellitteri, Phillip K., Shaha, Ashok R., Hamoir, Marc, Robbins, K. Thomas, Khafif, Avi, Rodrigo, Juan P., Silver, Carl E., Rinaldo, Alessandra, Ferlito, Alfio, and Hartl, Dana M.

Abstract

Prophylactic neck dissection (PND) for papillary thyroid carcinoma (PTC) is controversial. Our aim was to assess current levels of evidence (LE) according to the Oxford Centre for Evidence-based Medicine (http://www.cebm.net/?O=1025) regarding the oncologic benefits of PND. Data were analyzed via MEDLINE keywords: PTC, differentiated thyroid carcinoma, PND, central lymph node metastases, central compartment, recurrence-free survival. There was conflicting evidence regarding the rate of reoperation for recurrence, with some studies showing a lower rate after PND with increased recurrence-free survival and a higher rate of undetectable pre- and post-ablation thyroglobulin levels (LE 4), whereas other studies did not show a difference (LE 4). Only one study (LE 4) showed improved disease-specific survival with PND. PND may improve recurrence-free survival, although this is supported by only a low LE. Current recommendations can only be based on low-level evidence.

Published
2015

11. The evolving role of selective neck dissection for head and neck squamous cell carcinoma

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Robbins, K Thomas, Ferlito, Alfio, Shah, Jatin P., Hamoir, Marc, Takes, Robert P., Strojan, Primož, Khafif, Avi, Silver, Carl E., Rinaldo, Alessandra, Medina, Jesus E., UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Robbins, K Thomas, Ferlito, Alfio, Shah, Jatin P., Hamoir, Marc, Takes, Robert P., Strojan, Primož, Khafif, Avi, Silver, Carl E., Rinaldo, Alessandra, and Medina, Jesus E.

Abstract

Neck dissection is an important part of the surgical treatment of head and neck squamous cell carcinoma (HNSCC). The historical concept of neck dissection implied the removal of all lymph node-bearing tissue in the neck, which began in the late nineteenth century. However, more conservative variations of neck dissection have been performed and promoted as well. Anatomic, pathologic, clinical investigations, and prospective studies have demonstrated that the lymphatic dissemination of HNSCC occurs in predictable patterns. Supported by these studies, selective neck dissection (SND), which consists of the removal of select levels of lymph nodes in the neck that have the highest risk of harboring undetected metastases, has become widely accepted in the treatment of the clinically uninvolved neck. More recently, evidence supports using SND in a therapeutic setting in selected cases of HNSCC with limited metastatic disease. Additionally, even more targeted dissections referred to as super-selective neck dissection have been explored for selected patients undergoing elective node dissection for supraglottic cancer and as an adjuvant therapy for salvage of residual lymphadenopathy confined to a single neck level following chemoradiation. In the future, the trend to tailor treatment to individual patients and to limit toxicity and morbidity may further increase the use of SND. The indications have to be guided by further research, in relation with non-surgical treatment options while optimizing oncological effectiveness.

Published
2013

12. Proposal for a rational classification of neck dissections

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, Ferlito, Alfio, Robbins, K. Thomas, Shah, Jatin P., Medina, Jesus E., Silver, Carl E., Al-Tamimi, Shawkat, Fagan, Johannes J., Paleri, Vinidh, Takes, Robert P., Bradford, Carol R., Devaney, Kenneth O., Stoeckli, Sandro J., Weber, Randal S., Bradley, Patrick J., Suárez, Carlos, Leemans, C. René, Coskun, H. Hakan, Pitman, Karen T., Shaha, Ashok R., De Bree, Remco, Hartl, Dana M., Haigentz Jr., Missak, Rodrigo, Juan P., Hamoir, Marc, Khafif, Avi, Langendijk, Johannes A., Owen, Randall P., Sanabria, Alvaro, Strojan, Primož, Vander Poorten, Vincent, Werner, Jochen A., Bień, Stanisław, Woolgar, Julia A., Zbären, Peter, Betka, Jan, Folz, Benedikt J., Genden, Eric M., Talmi, Yoav P., Strome, Marshall, González Botas, Jesús Herranz, Olofsson, Jan, Kowalski, Luiz P., Holmes, Jon D., Hisa, Yasuo, Rinaldo, Alessandra, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, Ferlito, Alfio, Robbins, K. Thomas, Shah, Jatin P., Medina, Jesus E., Silver, Carl E., Al-Tamimi, Shawkat, Fagan, Johannes J., Paleri, Vinidh, Takes, Robert P., Bradford, Carol R., Devaney, Kenneth O., Stoeckli, Sandro J., Weber, Randal S., Bradley, Patrick J., Suárez, Carlos, Leemans, C. René, Coskun, H. Hakan, Pitman, Karen T., Shaha, Ashok R., De Bree, Remco, Hartl, Dana M., Haigentz Jr., Missak, Rodrigo, Juan P., Hamoir, Marc, Khafif, Avi, Langendijk, Johannes A., Owen, Randall P., Sanabria, Alvaro, Strojan, Primož, Vander Poorten, Vincent, Werner, Jochen A., Bień, Stanisław, Woolgar, Julia A., Zbären, Peter, Betka, Jan, Folz, Benedikt J., Genden, Eric M., Talmi, Yoav P., Strome, Marshall, González Botas, Jesús Herranz, Olofsson, Jan, Kowalski, Luiz P., Holmes, Jon D., Hisa, Yasuo, and Rinaldo, Alessandra

Abstract

Proposal for a rational classification of neck dissections

Published
2011

13. Proposal for a rational classification of neck dissections

Author

Department of Otolaryngology???Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy ; Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy, Division of Otolaryngology???Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, Head and Neck Service, Memorial Sloan???Kettering Cancer Center, New York, New York, Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, Departments of Surgery and Otolaryngology???Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, Department of Otolaryngology???Head and Neck Surgery, King Hussein Medical Center, Royal Medical Services, Amman, Jordan, Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa, Department of Otolaryngology???Head and Neck Surgery, Newcastle upon Tyne Foundation Hospitals NHS Trust, Newcastle upon Tyne, United Kingdom, Department of Otolaryngology???Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands, Department of Pathology, Allegiance Health, Jackson, Michigan, Department of Otorhinolaryngology???Head and Neck Surgery, Kantonsspital, St. Gallen, Switzerland, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, Department of Otorhinolaryngology???Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, United Kingdom, Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain ; Instituto Universitario de Oncolog??a del Principado de Asturias, Oviedo, Spain, Department of Otolaryngology???Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands, Department of Otolaryngology???Head and Neck Surgery, Uludag University School of Medicine, Bursa, Turkey, Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi, Department of Otolaryngology???Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France ; Laboratoire de Phon??tique et de Phonologie, Sorbonne Nouvelle, Paris, France, Department of Medicine, Division of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and Cancer Center, Brussels, Belgium, Head and Neck Surgery and Oncology Unit, A.R.M. Center for Advanced Otolaryngology???Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel, Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Department of Surgery, Division of Metabolic, Endocrine and Minimally Invasive Surgery, Mount Sinai School of Medicine, New York, New York, Department of Surgery, Universidad de La Sabana???Fundacion Abood Shaio, Bogota, Colombia, Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia, Department of Otorhinolaryngology???Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium, Department of Otolaryngology???Head and Neck Surgery, Philipp University, Marburg, Germany, Department of Otolaryngology???Head and Neck Surgery, Holy Cross Cancer Centre, Kielce, Poland, Oral Pathology, University of Liverpool Dental Hospital, Liverpool, United Kingdom, Department of Otorhinolaryngology???Head and Neck Surgery, University Hospital, Berne, Switzerland, Department of Otorhinolaryngology???Head and Neck Surgery, 1st Faculty of Medicine, Faculty Hospital Motol, Charles University, Prague, Czech Republic, Department of Otorhinolaryngology???Head and Neck Surgery, Karl Hansen Medical Center, Bad Lippspringe, Germany, Department of Otolaryngology???Head and Neck Surgery, The Mount Sinai Medical Center, New York, New York, Head and Neck Service, The Chaim Sheba Medical Center, Tel Hashomer and Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel, Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, Department of Otorhinolaryngology, University Hospital A Coru??a, A Coru??a, Spain, Department of Otolaryngology???Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway, Department Otorhinolaryngology???Head and Neck Surgery, Centro de Tratamento e Pesquisa Hospital do Cancer A.C. Camargo, S??o Paulo, Brazil, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, Alabama, Department of Otolaryngology???Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan, Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy, Ferlito, Alfio, Robbins, K. Thomas, Shah, Jatin P., Medina, Jesus E., Silver, Carl E., Al-Tamimi, Shawkat, Fagan, Johannes J., Paleri, Vinidh, Takes, Robert P., Bradford, Carol R., Devaney, Kenneth O., Stoeckli, Sandro J., Weber, Randal S., Bradley, Patrick J., Su??rez, Carlos, Leemans, C. Ren??, Coskun, H. Hakan, Pitman, Karen T., Shaha, Ashok R., de Bree, Remco, Hartl, Dana M., Haigentz, Missak, Rodrigo, Juan P., Hamoir, Marc, Khafif, Avi, Langendijk, Johannes A., Owen, Randall P., Sanabria, Alvaro, Strojan, Primoz, Vander Poorten, Vincent, Werner, Jochen A., Bien, Stanis??aw, Woolgar, Julia A., Zb??ren, Peter, Betka, Jan, Folz, Benedikt J., Genden, Eric M., Talmi, Yoav P., Strome, Marshall, Gonz??lez Botas, Jes??s Herranz, Olofsson, Jan, Kowalski, Luiz P., Holmes, Jon D., Hisa, Yasuo, Rinaldo, Alessandra, Department of Otolaryngology???Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy ; Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy, Division of Otolaryngology???Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, Head and Neck Service, Memorial Sloan???Kettering Cancer Center, New York, New York, Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, Departments of Surgery and Otolaryngology???Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, Department of Otolaryngology???Head and Neck Surgery, King Hussein Medical Center, Royal Medical Services, Amman, Jordan, Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa, Department of Otolaryngology???Head and Neck Surgery, Newcastle upon Tyne Foundation Hospitals NHS Trust, Newcastle upon Tyne, United Kingdom, Department of Otolaryngology???Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands, Department of Pathology, Allegiance Health, Jackson, Michigan, Department of Otorhinolaryngology???Head and Neck Surgery, Kantonsspital, St. Gallen, Switzerland, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, Department of Otorhinolaryngology???Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, United Kingdom, Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain ; Instituto Universitario de Oncolog??a del Principado de Asturias, Oviedo, Spain, Department of Otolaryngology???Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands, Department of Otolaryngology???Head and Neck Surgery, Uludag University School of Medicine, Bursa, Turkey, Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi, Department of Otolaryngology???Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France ; Laboratoire de Phon??tique et de Phonologie, Sorbonne Nouvelle, Paris, France, Department of Medicine, Division of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and Cancer Center, Brussels, Belgium, Head and Neck Surgery and Oncology Unit, A.R.M. Center for Advanced Otolaryngology???Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel, Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Department of Surgery, Division of Metabolic, Endocrine and Minimally Invasive Surgery, Mount Sinai School of Medicine, New York, New York, Department of Surgery, Universidad de La Sabana???Fundacion Abood Shaio, Bogota, Colombia, Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia, Department of Otorhinolaryngology???Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium, Department of Otolaryngology???Head and Neck Surgery, Philipp University, Marburg, Germany, Department of Otolaryngology???Head and Neck Surgery, Holy Cross Cancer Centre, Kielce, Poland, Oral Pathology, University of Liverpool Dental Hospital, Liverpool, United Kingdom, Department of Otorhinolaryngology???Head and Neck Surgery, University Hospital, Berne, Switzerland, Department of Otorhinolaryngology???Head and Neck Surgery, 1st Faculty of Medicine, Faculty Hospital Motol, Charles University, Prague, Czech Republic, Department of Otorhinolaryngology???Head and Neck Surgery, Karl Hansen Medical Center, Bad Lippspringe, Germany, Department of Otolaryngology???Head and Neck Surgery, The Mount Sinai Medical Center, New York, New York, Head and Neck Service, The Chaim Sheba Medical Center, Tel Hashomer and Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel, Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, Department of Otorhinolaryngology, University Hospital A Coru??a, A Coru??a, Spain, Department of Otolaryngology???Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway, Department Otorhinolaryngology???Head and Neck Surgery, Centro de Tratamento e Pesquisa Hospital do Cancer A.C. Camargo, S??o Paulo, Brazil, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, Alabama, Department of Otolaryngology???Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan, Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy, Ferlito, Alfio, Robbins, K. Thomas, Shah, Jatin P., Medina, Jesus E., Silver, Carl E., Al-Tamimi, Shawkat, Fagan, Johannes J., Paleri, Vinidh, Takes, Robert P., Bradford, Carol R., Devaney, Kenneth O., Stoeckli, Sandro J., Weber, Randal S., Bradley, Patrick J., Su??rez, Carlos, Leemans, C. Ren??, Coskun, H. Hakan, Pitman, Karen T., Shaha, Ashok R., de Bree, Remco, Hartl, Dana M., Haigentz, Missak, Rodrigo, Juan P., Hamoir, Marc, Khafif, Avi, Langendijk, Johannes A., Owen, Randall P., Sanabria, Alvaro, Strojan, Primoz, Vander Poorten, Vincent, Werner, Jochen A., Bien, Stanis??aw, Woolgar, Julia A., Zb??ren, Peter, Betka, Jan, Folz, Benedikt J., Genden, Eric M., Talmi, Yoav P., Strome, Marshall, Gonz??lez Botas, Jes??s Herranz, Olofsson, Jan, Kowalski, Luiz P., Holmes, Jon D., Hisa, Yasuo, and Rinaldo, Alessandra

Abstract

No abstract.

Published
2011

17. Assessing the effectiveness of Dead Sea products as prophylactic agents for acute radiochemotherapy-induced skin and mucosal toxicity in patients with head and neck cancers: a phase 2 study.

Author

Matceyevsky D, Hahoshen NY, Vexler A, Noam A, Khafif A, and Ben-Yosef R

Subjects
Acute Disease, Adult, Aged, Aged, 80 and over, Chemoprevention, Dermatitis etiology, Female, Humans, Israel, Male, Middle Aged, Mineral Waters, Mucositis etiology, Mucous Membrane drug effects, Mucous Membrane radiation effects, Oceans and Seas, Skin drug effects, Skin radiation effects, Dermatitis prevention & control, Emollients therapeutic use, Head and Neck Neoplasms drug therapy, Head and Neck Neoplasms radiotherapy, Mouthwashes therapeutic use, Mucositis prevention & control, Treatment Outcome
Abstract

Background: Mucositis and dermatitis are frequently encountered in patients treated with radiochemotherapy. Dead Sea products that contain minerals and other properties have proven effective in treating various skin diseases., Objectives: To evaluate the effectiveness of Dead Sea products in reducing acute radiochemotherapy-induced side effects in patients with head and neck cancer., Methods: In this phase 2 study we compared the outcomes in 24 treated patients and 30 conventionally treated patients matched for age, tumor site, and type of treatment. The Dead Sea products comprised a mouthwash solution (Lenom) and a skin cream (Solaris) used three times daily for 1 week before, during, and up to 2 weeks after completion of radiotherapy. Mucositis and dermatitis were evaluated using common toxicity criteria., Results: Thirteen treated patients (54%) had grade 1-2 and none had 3-4 mucositis, while 17 controls (57%) had grade 1-2 and 4 (13%) had grade 3-4 mucositis. Thirteen treated patients (54%) had grade 1-2 dermatitis; there was no instance of grade 3-4 dermatitis, while 11 patients in the control group (37%) had grade 1-2 and 5 (17%) had grade 3-4 dermatitis. More patients in the control arm needed a break than did patients in the treatment the control arm needed a break than did patients in the treatment arm (P = 0.034)., Conclusions: The two Dead Sea products tested decreased skin and mucosal toxicity in head and neck cancer patients receiving radiochemotherapy.

Published
2007

18. A comprehensive algorithm for anterior skull base reconstruction after oncological resections.

Author

Gil Z, Abergel A, Leider-Trejo L, Khafif A, Margalit N, Amir A, Gur E, and Fliss DM

Abstract

Objective: To present our method for anterior skull base reconstruction after oncological resections., Methods: One hundred nine patients who had undergone 120 anterior skull base resections of tumors (52 malignant [43%], 68 benign [57%]) via the subcranial approach were studied. Limited dural defects were closed primarily or reconstructed using a temporalis fascia. Large anterior skull base defects were reconstructed by a double-layer fascia lata graft. A split calvarial bone graft, posterior frontal sinus wall, or three-dimensional titanium mesh were used when the tumor involved the frontal, nasal, or orbital bones. A temporalis muscle flap was used to cover the orbital socket for cases of eye globe exenteration, and a rectus abdominis free flap was used for subcranial-orbitomaxillary resection. Pericranial flap wrapping of the frontonaso-orbital segment was performed to prevent osteoradionecrosis if perioperative radiotherapy was planned., Results: The incidence of cerebrospinal fluid (CSF) leak, intracranial infection, and tension pneumocephalus was 5%. Histopathological and immunohistochemical analysis of fascia lata grafts in reoperated patients (n = 7) revealed integration of vascularized fibrous tissue to the graft and local proliferation of a newly formed vascular layer embedding the fascial sheath., Conclusion: A double-layer fascial graft alone was adequate for preventing CSF leak, meningitis, tension pneumocephalus, and brain herniation. We describe a simple and effective method of anterior skull base reconstruction after resections of both malignant and benign tumors.

Published
2007
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19. Necrotizing Fasciitis of the Skull Base and Neck in a Patient with AIDS and Non-Hodgkin's Lymphoma.

Author

Cavel O, Gil Z, Khafif A, Leider-Trejo L, Segev Y, Werner B, Pivarov A, and Fliss DM

Abstract

Necrotizing fasciitis is a rapidly progressing, life-threatening soft tissue bacterial infection found more frequently in immunocompromised subjects and rarely in the head and neck. We report a rare case of a patient with acquired immunodeficiency syndrome (AIDS) and non-Hodgkin's lymphoma (NHL) who presented with a high fever and supraorbital cellulitis 1 week after undergoing chemotherapy. He received intravenous antibiotic therapy but soon developed dyspnea and trismus with rapid extension of the cellulitis to the face, ipsilateral infratemporal fossa (ITF), and bilateral neck. An awake tracheotomy was followed by surgical exploration and drainage and debridement of the supraorbital and ITF areas, parotid gland, and bilateral neck. He received intravenous antibiotic therapy and the surgical wound was regularly debrided for 10 days. Following a gradual recovery, the patient was discharged 2 weeks later. Early antibiotic therapy, wide surgical exploration, and a secured airway are the therapeutic mainstay for necrotizing fasciitis of the skull base and neck.

Published
2006
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