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Objective: This study aims to investigate how the impact of preoperative sarcopenia and inflammatory markers for laryngeal cancer patients and develop a new scoring system to predict their prognosis. Materials and methods: Patients who underwent laryngectomy for laryngeal cancer (LC) from December 2015 to December 2020 at the Second Affiliated Hospital of Fujian Medical University were included. Independent prognostic factors were determined using univariate and multivariate analyses. A new scoring system (SFAR) was established based on FAR and preoperative sarcopenia, and statistically analyzed. Results: 198 cases included in this study that met the admission criteria. Multivariate analysis shown that preoperative sarcopenia, pTNM stage, and FAR were independent prognostic factors for laryngeal cancer. Based on these three indicators, we developed the SFAR scoring system. Multivariate analysis showed that SFAR was an independent predictor of laryngeal cancer (p < 0.001). SFAR was then incorporated into a prognostic model that included T-stage and N-stage, and a column-line graph was generated to accurately predict its survival. Conclusion: Systemic inflammation and sarcopenia are significantly associated with postoperative prognosis in laryngeal cancer. A new scoring system (SFAR) had implications for improving the prognosis of patients undergoing surgery for laryngeal cancer. [ABSTRACT FROM AUTHOR]

Life cycle assessment (LCA) along with a survey on epidemiologic and oxidative potential studies was used for analysing the current evidence of the impact of airborne emissions from municipal solid waste incineration (MSWI) on human health. The correspondence among investigated health outcomes and pollutants was discussed based on the Chemical Abstract Service (CAS) and the International Agency for Research on Cancer (IARC). LCA indicated the ability of MSWI in avoiding human health impact, about − 2 × 10−4 DALY/tonne together with avoided emissions of particulate matter (PM) and resource depletion, about − 2.5 × 10−3 kg Sbeq/tonne and about − 0.11 kg PM2.5 eq/tonne, respectively. Positive emissions were detected for greenhouses (about 900 kg CO2eq/tonne) and ecotoxicity (about 15,000 CTUe/tonne). Epidemiologic studies performed on population exposed to MSWI reported quite contrasting results. In some of these, hazard ratio (HR) ranging from about 0.7 to 2.2 was reported concerning the incidence of stomach, liver, breast and bladder cancer. Larger agreement was detected concerning the incidence of larynx and lung cancer with HR ranging from about 1 to about 2.6. Direct causal nexuses were not definitively identified. Oxidative potential of PM was characterized by a high Pearson correlation > 0.8 to the presence of CrVI, Cu and Zn. These heavy metals were also identified by both CAS and IARC as toxic (i.e. Cu and Zn) and cancerous (i.e. CrVI) substances affecting the organs of both respiratory and digestive apparatus. In general, even if more research is necessary, LCA, oxidative potential and the epidemiologic survey results showed a high level of accordance. This suggests their integrated exploitation for supporting the investigation of both direct and indirect consequences on environment and health related to waste incineration for both retrospective and predictive studies. [ABSTRACT FROM AUTHOR]

Objective: This study is aimed to evaluate the efficacy and safety of PD-1 inhibitors combined with neoadjuvant chemotherapy in patients with locally advanced hypopharyngeal and oropharyngeal cancer prior to surgical resection. Methods: This retrospective analysis included 42 patients diagnosed with locally advanced hypopharyngeal and oropharyngeal cancer. The efficacy, safety, survival, and laryngeal preservation rate were evaluated. Results: A total of 42 patients were included in this retrospective analysis, of whom 28 had hypopharyngeal cancer and 14 had oropharyngeal cancer. Of the 42 patients, 14 (33.3%) achieved a pathological complete response (PCR) at the primary site, 20 (47.6%) achieved a major pathological response (MPR), and 8 (19%) had an incomplete pathological response (IPR) at the primary lesion. A PCR at both the primary site and the neck lymph nodes was observed in 9 patients (21.4%). The laryngeal preservation rate was 92.9% (26/28) in patients with hypopharyngeal cancer. The median follow-up time was 10.5 months. The median progressionfree survival (PFS) was 26.42 months (95% CI, 23.416–29.424), and the median overall survival (OS) was 27.1 months (95% CI, 24.316–29.884). The 1-year PFS rate was 83.1%, and the 1-year OS rate was 85.9%. Conclusion: Combination therapy with PD-1 inhibitors and neoadjuvant chemotherapy has demonstrated superior efficacy and safety as a preoperative treatment for locally advanced hypopharyngeal and oropharyngeal cancer. Notably, this treatment regimen does not increase the risk of severe postoperative complications and has shown promising results in improving laryngeal preservation rates. [ABSTRACT FROM AUTHOR]

Background and Aim: This study aims to assess the impact of supraglottic cancer on swallowing functionality and its anatomical correlations before and after laser surgery. The study seeks to determine the extent of score changes post-surgery, pinpoint the most influential anatomical component in swallowing, predict post-surgery outcomes, and ascertain the effect on patients' quality of life. Methods: Patients with supraglottic cancer and dysphagia were identified through stroboscopy and indirect laryngoscopy. Exclusion criteria encompassed a history of prior radiotherapy, chemotherapy, or distant metastases. Demographic data, tumor stage, comorbidities, risk factors, and treatment details were documented. Swallowing evaluation employed the translated EAT10 self-assessment questionnaire, administered before and after transoral laser microsurgery (TLM) at baseline and 6 months later. Additional treatments, rehabilitation duration, NG tube use, and post-surgery complications were recorded. Results: At the six-month follow-up, 9 patients had EAT-10 scores ≥ 3, while 7 patients scored < 3. Five patients underwent post-TLM additional therapies, and 9 patients had neck dissections. Involved subunits were epiglottis (11 patients), arytenoid (5 patients), FVC (13 patients), and TVC (3 patients). Seven patients received dysphagia treatment. Analysis revealed significant associations between follow-up EAT-10 scores and dysphagia treatment (p = 0.04), smoking (p = 0.02), and FVC involvement (p = 0.02). Conclusion: Our study on supraglottic cancer treatment with transoral laser microsurgery (TLM) revealed variable EAT-10 scores after a six-month follow-up. Adjunctive therapies and neck dissections were administered to some patients. Significant associations were found between follow-up scores, dysphagia treatment, smoking history, and FVC involvement, highlighting the complex interplay between interventions and patient factors. Further research is needed for optimization. [ABSTRACT FROM AUTHOR]

Background: Laryngeal cancer is a common advanced head and neck cancer. Surgery, radiation, chemotherapy, or a combination of these treatments are used to treat locally advanced laryngeal cancer. Total laryngectomy is generally preferred for T3-4 laryngeal cancers, despite being an invasive procedure. Post-surgical hypocalcemia is a known complication of neck compartment surgeries, and patients who have undergone laryngectomy are at a higher risk of developing hypoparathyroidism, leading to hypocalcemia. This study aims to investigate the prevalence and risk factors of hypocalcemia in individuals following laryngectomy. Method: This retrospective study examined 50 consecutive laryngectomy patients over eight years. Data on demographic characteristics, medical history, surgical details, pre-and post-operative calcium levels, neck dissection laterality, history of radiotherapy were collected. Hypocalcemia was defined as calcium levels < 8.5 mg/dl or corrected calcium < 8.5 mg/dl. Statistical analyses included paired t-tests, Wilcoxon signed-rank tests, and binary logistic regression using R studio. Results: The mean age of participants was 59 years, predominating males (94%) and habitual smokers (94%). Squamous cell carcinoma was the most prevalent (98%) pathological diagnosis, and various surgical techniques were employed. While initial comparisons showed no significant changes in calcium levels pre-and post-operatively, adjusting for albumin levels revealed a significant association. Logistic regression identified neck dissection, low pre-operative calcium, radiotherapy, and total thyroidectomy as significant predictors of post-operative hypocalcemia (p < 0.05). Conclusion: Surgical factors such as neck dissection and total thyroidectomy, alongside albumin levels, significantly impact postoperative hypocalcemia. These findings underscore the need for meticulous monitoring and potential preventive measures to manage calcium imbalance post-laryngectomy. [ABSTRACT FROM AUTHOR]

Background: Laryngeal cancer accounts for a third of all head and neck malignancies, necessitating timely detection for effective treatment and enhanced patient outcomes. Machine learning shows promise in medical diagnostics, but the impact of model complexity on diagnostic efficacy in laryngeal cancer detection can be ambiguous. Methods: In this study, we examine the relationship between model sophistication and diagnostic efficacy by evaluating three approaches: Logistic Regression, a small neural network with 4 layers of neurons and a more complex convolutional neural network with 50 layers and examine their efficacy on laryngeal cancer detection on computed tomography images. Results: Logistic regression achieved 82.5% accuracy. The 4-Layer NN reached 87.2% accuracy, while ResNet-50, a deep learning architecture, achieved the highest accuracy at 92.6%. Its deep learning capabilities excelled in discerning fine-grained CT image features. Conclusion: Our study highlights the choices involved in selecting a laryngeal cancer detection model. Logistic regression is interpretable but may struggle with complex patterns. The 4-Layer NN balances complexity and accuracy. ResNet-50 excels in image classification but demands resources. This research advances understanding affect machine learning model complexity could have on learning features of laryngeal tumor features in contrast CT images for purposes of disease prediction. [ABSTRACT FROM AUTHOR]

Introduction: Stapling-assisted closure of pharyngeal mucosa during total laryngectomy was described in 1973.Few authors have demonstrated that this technique provides a faster and more reliable pharyngeal closure with ashorter operative period. However, the simultaneous placement of tracheoesophageal prostheses is quitechallenging and affects the patient's speech rehabilitation. Aim: We are reporting our novel concurrent tracheoesophageal prosthesis insertion technique in stapler-assistedtotal laryngectomy. Methods: A patient with locally advanced laryngeal cancer underwent total laryngectomy with stapler-assistedcloser and concurrent primary tracheoesophageal prosthesis. In a closed stapler-assisted reconstruction of theneopharynx, an inflate folye ballon was utilised to identify the ideal TEP puncture site. Results: The immediate postop course was uneventful, and the patient acquired fluent alaryngeal speech after thespeech rehabilitation. Conclusion: Our novel technique of concurrent tracheoesophageal prosthesis insertion in stapler-assisted totallaryngectomy is practically simple and shortens the operative time. [ABSTRACT FROM AUTHOR]

Background: The study evaluated the prognostic impact of the immune microenvironment in LSCC with markers of major immune cells to identify the key determinants of short-term disease-free survival (ST DFS) and reveal factors related to disease progression. Methods: The study cohort included 61 patients who underwent total laryngectomy, 83.6% of whom were male with a mean age of 64.3 years at the time of surgery. Twenty-five patients had long term DFS (over 5 years), 8 – had moderate DFS (between 2 and 5 years), and 28 had short-term DFS (less than 2 years). Immunohistochemical staining and evaluation were performed on samples collected after the laryngectomy. Results: The samples' assessment revealed that the mean expression of all analysed markers was the highest both in stroma and the tumor compartment for short term DFS (ST DFS) patients. Analysis confirmed that a high stromal density of CD8 cells (p = 0.038) significantly correlated with DFS, and that the increased presence of CD57 cells (p = 0.021) was significantly associated with ST DFS. Moreover, the high density of CD68 cells in the tumor epithelial compartment had a negative prognostic impact on DFS (p = 0.032). Analysis of overall survival in the studied cohort with Kaplan-Meyer curves revealed that a high stromal density of CD68 cells was a significant negative predictor of OS (p = 0.008). Conclusions: The observed associations of CD68 cells infiltration with progression and prognosis in patients with LSCC provide potential screening and therapeutic opportunities for patients with unfavourable outcomes. [ABSTRACT FROM AUTHOR]

Background: Laryngeal cancer is a prevalent malignancy in the head and neck region, often diagnosed at an advanced stage. The role of thyroidectomy in managing advanced laryngeal squamous cell carcinoma (LSCC) remains controversial due to inconsistent findings regarding the incidence and predictors of thyroid invasion. Aim of the work: This meta-analysis aims to assess the incidence of thyroid invasion in patients with advanced laryngeal cancer and recognize hazard facets for thyroid invasion to elucidate the need for thyroidectomy. The study also aims to decrease the happening of postoperative hypothyroidism and supply guidance for individualized treatment approaches. Patients and methods: A comprehensive search was conducted, and the meta-analysis included 6 studies encompassing 852 patients. Data regarding patient demographics, tumor characteristics, and incidence of thyroid invasion were extracted and analyzed. Results: The meta-analysis revealed a mean age of 57.7 years among patients with advanced laryngeal cancer, with a male predominance of 94.6%. Thyroid invasion occurred in 13.3% of patients who underwent complete laryngectomy. Subglottic tumor site and T4 classification were identified as significant risk factors for thyroid invasion, while supraglottis and glottis tumor sites and T3 classification were associated with reduced risk. The odds ratio for thyroid invasion was highest for patients with T4 stage tumors. Conclusion: Thyroidectomy during total laryngectomy should be considered for patients with subglottic tumor sites and T4 classification due to the increased risk of thyroid invasion. However, for patients with supraglottis or glottis tumor sites and T3 classification, the thyroid gland may be preserved to reduce the risk of postoperative hypothyroidism. [ABSTRACT FROM AUTHOR]

The European Larynx Organ Preservation Study (ELOS; NCT06137378) is a prospective, randomized, open-label, two-armed parallel group controlled, phase II multicenter larynx organ preservation (LOP) trial in locoregionally advanced (LA) stage III, IVA/B head and neck squamous cell carcinoma of the larynx or hypopharynx (LHSCC) amenable for total laryngectomy (TL) with PD-L1 expression within tumor tissue biopsy, calculated as CPS = 1. Induction chemotherapy (IC) with docetaxel and cisplatin (TP) followed by radiation will be compared to TP plus PD-1 inhibition by pembrolizumab (MK-3475; 200 mg i.v. starting day 1 q3w for 17 cycles). After a short induction early response evaluation (ERE) 21 ± 3 days after the first cycle of IC (IC-1), responders achieving endoscopic estimated tumor surface shrinkage (ETSS) =30% will get an additional two cycles of IC followed by intensity-modulated radiotherapy 70-72 Gy (EQD2/a/b = 10) aiming at LOP. Nonresponders (ETSS < 30% or progressing disease) will receive TL and bilateral neck dissection followed by postoperative radiation or chemoradiation as recommended by the clinic's multidisciplinary tumor board. Pembrolizumab treatment will be continued in the intervention arm regardless of ETSS status after IC-1 in both responders and laryngectomized nonresponders, independent of subsequent decisions on adjuvant therapy after TL. [ABSTRACT FROM AUTHOR]

Objective: To explore the potential role of miR-449a as biomarker for laryngeal squamous cell carcinoma (LSCC), especially in the decision strategy of neck dissection (ND). Methods: Each patient underwent total laryngectomy and bilateral ND (levels II–IV); during surgery, tissue samples of around 1 × 0.5 cm were extracted from both healthy tissue adjacent to the tumor and the visibly affected tumor tissue. The extraction of total RNA, encompassing miRNA, was performed using a mirVana PARIS kit. To detect miR449a, cDNA was synthesized from 200 ng of RNA using a TaqMan miRNA reverse transcription kit. Results: The study group was formed of 66 patients (62 males, and 4 females) with LSCC, aged between 39 and 77 years (mean 60 + 14.56 yr). MiR-449a was up-regulated in twenty-eight tumors (42%), while it was down-regulated in 38 samples (58%). In the present study, there was a statistical relevance for miR-449a tissue expression for pN staging (p = 0.017), and PNI (p = 0.005). Eight tumors (12%) cN0 became pN + showing occult cervical lymph node metastases at the final histopathological examination, and all of these patients showed miR-449a downregulation. Conclusion: Super-selective ND (sparing the sub evels IIb and IV) might be the approach to cT3-T4 N0 LSCCs with upregulation of miR-449a; on the other hand, to ensure and effective control of occult neck metastases it would be appropriate to reserve elective ND (including sublevels IIb and IV) for cT3-T4 N0 LSCCs with miR-449a downregulation. Although promising, due to the small size of the cohort, the results of this work can be considered preliminary and need to be confirmed by prospective and larger studies. [ABSTRACT FROM AUTHOR]

Purpose: In laryngeal squamous cell carcinoma (LSCC) treated with transoral laser microsurgery (TOLMS), the status of margins significantly affected local control. When a positive or close margin is present, there is no ubiquitous consensus regarding further treatments. The rationale of the present systematic review and meta-analysis is to investigate the survival impact of the status of the margins in patients affected by LSCC treated with TOLMS. Data sources: PubMed, EMBASE, and Cochrane Library. Methods: We performed a systematic search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were: patients affected by LSCC, staged according to the American Joint Committee on Cancer Staging System and treated by TOLMS without any previous treatment; margins status (close, positive, negative) and the adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) of overall survival, disease-specific survival, and disease-free survival has to be reported. Results: Nine studies were deemed eligible for the qualitative analysis, and 3 for the quantitative analysis to investigate the association between margin status and OS. The cumulative number of patients was 3130. The sample size ranged from 96 to 747 patients. The follow-up period ranged from 0 to 201 months. The meta-analysis results show that positive margins have an aHR of 1.30 yet with CI range (0.56 to 2.97). Conclusions: Our current meta-analysis results are unable to definitively assess the real impact of resection margins on OS. Few authors provide accurate data regarding position and types of margins. Further prospective or high-quality studies are required. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The purpose of this multicenter study was to retrospectively investigate the prognostic significance of the tumor microenvironment, in relation to survival in a large cohort of patients with laryngeal squamous cell carcinoma (LSCC), using the method proposed by the International TILs Working Group in breast cancer. Methods: All consecutive patients with biopsy‐proven LSCC who underwent total laryngectomy (TL) between January 2014 and January 2023 were retrospectively included in the study. A retrospective review of medical records including surgical, pathological and follow‐up reports was performed. The density of TILs was determined according to the recommendations of the International TILs Working Group. Results: The study group included 186 patients with LSCC. High TILs were statistically correlated with reduced size and extension of primary tumor (pT stage) with a statistically significant value (S: p = 0.01; P: p = 0.0003) and without needs of salvage therapy (S: p = 0.03; P: p = 0.004). Low TILs were indicative of worse prognosis. Conclusions: Our study confirmed the protective value of TILs and the prognostic role of the tumor microenvironment in LSCC; furthermore, our results showed that the score proposed by the International TILs Working Group for breast cancer can be applied to LSCC. [ABSTRACT FROM AUTHOR]

Background: Head and neck cancer (HNC) incidence is on the rise, often diagnosed at late stage and associated with poor prognoses. Risk prediction tools have a potential role in prevention and early detection. Methods: The IARC‐ARCAGE European case–control study was used as the model development dataset. A clinical HNC risk prediction model using behavioral and demographic predictors was developed via multivariable logistic regression analyses. The model was then externally validated in the UK Biobank cohort. Model performance was tested using discrimination and calibration metrics. Results: 1926 HNC cases and 2043 controls were used for the development of the model. The development dataset model including sociodemographic, smoking, and alcohol variables had moderate discrimination, with an area under curve (AUC) value of 0.75 (95% CI, 0.74–0.77); the calibration slope (0.75) and tests were suggestive of good calibration. 384 616 UK Biobank participants (with 1177 HNC cases) were available for external validation of the model. Upon external validation, the model had an AUC of 0.62 (95% CI, 0.61–0.64). Conclusion: We developed and externally validated a HNC risk prediction model using the ARCAGE and UK Biobank studies, respectively. This model had moderate performance in the development population and acceptable performance in the validation dataset. Demographics and risk behaviors are strong predictors of HNC, and this model may be a helpful tool in primary dental care settings to promote prevention and determine recall intervals for dental examination. Future addition of HPV serology or genetic factors could further enhance individual risk prediction. [ABSTRACT FROM AUTHOR]

Background/Objectives: Laryngeal squamous cell carcinoma (LSCC) is among most frequent malignancies of the head and neck. Recent oncologic research focusses on advanced rather than on early stages. Thus, we aimed to improve the knowledge concerning prognostic factors and survival in early glottic (GC) and supraglottic cancer (SGC). Methods: We retrospectively investigated patients diagnosed in 2007 to 2020 with stage I or II GC (ICD-10-C32.0) or SGC (ICD-10-C32.1, C32.8 or C32.9). For precise discrimination of GC and SGC, pathology reports about biopsy and definitive excision were closely examined and information on clinical characteristics and risk factors were collected before analyzing patterns of risk factors for overall survival (OS) in multivariate Cox regression analyses (mvCox). Results: The cohort included 220 patients with early GC (n = 183) and SGC (n = 37). The GC patients showed significantly improved 5-year OS compared to SGC patients (83.6% vs. 64.9%; p = 0.004), whereas survival according to UICC stage (I vs. II) was not different (p = 0.177). Surgical resection was superior to definitive radiotherapy (RT) for 5-year OS (p < 0.001). Cumulative tobacco consumption of greater than 10 pack years drastically impaired OS (p = 0.024), especially in patients receiving RT (p < 0.001). Supraglottic localization, smoking, and re-resection after initial R1 status consistently were independent prognostic factors in mvCox. Conclusions: Our cohort of early LSCC patients demonstrates significant negative impact of supraglottic localization, older age, tobacco consumption, poor tumor differentiation, and re-resection on OS. Further research is required as there is still lack of evidence on optimal decision-making and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Objective: Open partial horizontal laryngectomies (OPHLs) represent a comparable alternative to total laryngectomy and nonsurgical protocols in selected cases. While short‐term functional outcomes of OPHLs have been widely investigated, few have focused on the effect of aging on residual laryngeal structures. Study Design: Retrospective cohort study. Setting: Tertiary care academic center. Methods: Patients who underwent OPHLs after at least 1 year follow‐up and optimal functional rehabilitation were included in the study. Swallowing function was assessed according to PAS (Penetration aspiration scale) and Pooling scores. Spectrogram analysis of voice was conducted according to Yanagihara classification and acoustic parameters were also recorded. Subjective questionnaire data about phonation and swallowing were also recorded. Data obtained were compared among patients according to age at time of surgery, evaluation and duration of follow‐up. Results: Ninety‐seven patients were enrolled with a mean age at surgery and evaluation of 63 and 70 years old, respectively. Median follow‐up length was 5 years. OPHL type II was mostly performed. No significant correlation was observed between most of the analyzed variables and patient's age at the time of surgery and at the time of evaluation. Some acoustic parameters were negatively correlated with follow‐up length, while Jitter, NHR (Noise‐Harmonic Ratio), and Global grade and Roughness were significantly higher in patients >65 years old. Conclusion: Patients who complete rehabilitation reach equally good results as their younger peers with stability over time. Finally, the effects of aging on residual larynx are of minor entity compared to the nonoperated patients. Level of Evidence: Level IV‐retrospective cohort study. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Inflammation plays an important role in the process of cancer development. The number of studies evaluating the ability of inflammatory biomarkers to predict survival has increased in recent years. This study aimed to comprehensively evaluate the predictive role of inflammatory biomarkers in patients with larynx cancer undergoing definitive radiotherapy. A total of 101 patients who underwent definitive radiotherapy for larynx cancer at our center were retrospectively examined. Blood samples were taken from the patients before radiotherapy to obtain biomarkers such as C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), pan-immune inflammatory value (PIV), hemo-eosinophil inflammation index (HEI), albumin, and Lactate dehydrogenase (LDH). The study examined the predictive value of parameters for progression-free survival (PFS), local recurrence-free survival (LRFS), and overall survival (OS) using both univariate and multivariate Cox regression analysis. In the univariate analysis, the biomarkers that predicted PFS were SII, PIV, CRP, and Eastern Cooperative Oncology Group Performance Status (ECOG PS). According to the multivariate analysis, only CRP was found to be a significant predictor of PFS. In the univariate analysis, the following biomarkers were found to predict OS: NLR, PLR, MLR, SII, PIV, CRP, HEI, stage, and ECOG PS. In the multivariate analysis, NLR and ECOG PS were found to be predictors of OS. A significant difference was found in MLR, PIV, and CRP values based on the presence of lymphatic metastasis. The current study is the first to comprehensively examine the relationship between larynx cancer and several inflammatory biomarkers. Many of these biomarkers have been shown to predict both PFS and OS in patients with larynx cancer undergoing definitive radiotherapy. It has been shown that PIV and CRP may predict the presence of lymphatic metastases in addition to PFS and OS. [ABSTRACT FROM AUTHOR]

Laryngeal cancer exhibits a notable global health burden, with later-stage detection contributing to a low mortality rate. Laryngeal cancer diagnosis on throat region images is a pivotal application of computer vision (CV) and medical image diagnoses in the medical sector. It includes detecting and analysing abnormal or cancerous tissue from the larynx, an integral part of the vocal and respiratory systems. The computer-aided system makes use of artificial intelligence (AI) through deep learning (DL) and machine learning (ML) models, including convolution neural networks (CNN), for automated disease diagnoses and detection. Various DL and ML approaches are executed to categorize the extraction feature as healthy and cancerous tissues. This article introduces an automated Laryngeal Cancer Diagnosis using the Dandelion Optimizer Algorithm with Ensemble Learning (LCD-DOAEL) method on Biomedical Throat Region Image. The LCD-DOAEL method aims to investigate the images of the throat region for the presence of laryngeal cancer. In the LCD-DOAEL method, the Gaussian filtering (GF) approach is applied to eliminate the noise in the biomedical images. Besides, the complex and intrinsic feature patterns can be extracted by the MobileNetv2 model. Meanwhile, the DOA model carries out the hyperparameter selection of MobileNetV2 architecture. Finally, the ensemble of three classifiers such as bidirectional long short-term memory (BiLSTM), regularized extreme learning machine (ELM), and backpropagation neural network (BPNN) models, are utilized for the classification process. A comprehensive set of simulations is conducted on the biomedical image dataset to highlight the efficient performance of the LCD-DOAEL technique. The comparison analysis of the LCD-DOAEL method exhibited a superior accuracy outcome of 97.54% over other existing techniques. [ABSTRACT FROM AUTHOR]

\nIntroduction: Laryngeal squamous cell carcinoma (LSCC) is the most common type of laryngeal cancer, with around 60% of patients being diagnosed at an advanced stage. Recently, cancer-derived sialylated immunoglobulin G (SIA-IgG) has been suggested to play a role in the progression of various epithelial tumors, but its significance in LSCC remains unknown. This study aimed to investigate the clinical significance of SIA-IgG as a novel biomarker in relation to the initiation, progression, and prognostication of LSCC. Methods: Immunohistochemistry (IHC) was utilized to assess SIA-IgG expression in tumor samples from 75 LSCC patients, aiming to investigate its correlation with clinical prognosis. In vitro functional experiments were conducted to explore the impact of SIA-IgG expression on the proliferative and migratory abilities of laryngocarcinoma cells. Results: High expression of SIA-IgG was associated with pT stage, pN stage, TNM stage, and recurrence during follow-up and was correlated with poor disease-free survival (DFS) and overall survival (OS). Multivariate Cox analysis demonstrated that SIA-IgG served as an independent risk factor for OS and DFS. Knocking down SIA-IgG significantly weakened laryngocarcinoma cells’ proliferation, clonogenesis, and migration abilities. Conclusions: The frequent expression of SIA-IgG in LSCC is significantly associated with poor prognosis. High levels of SIA-IgG can enhance proliferation and migration in laryngocarcinoma cells. These findings suggest that SIA-IgG has potential as a novel biomarker for LSCC. While cancer-derived sialylated immunoglobulin G (SIA-IgG) has been found to promote the development of various epithelial tumors, research on its role in laryngeal cancer remains blank. Therefore, the objective of this study is to investigate the correlation between LSCC expression and clinical prognosis as well as the proliferation and migration abilities of laryngeal cancer cells. [ABSTRACT FROM AUTHOR]

Background The impact of societal factors on the occurrence of head and neck cancers (HNCs) remains understudied, especially in the Nordic countries. Methods To quantify the association between socio-economic status (SES) and the occurrence of HNCs, this cohort study uses data from the Nordic Occupational Cancer project that combine occupational and cancer registry data from 1961 to 2005 of 14.9 million individuals aged between 30 and 64 years. Occupational categories were combined into seven socio-economic categories. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates. Results Altogether, 83 997 HNCs—72% in men and 28% in women—were recorded. Among men, a gradient of risk associated with SES was observed for cancers of the tongue, other oral cavity subsites, pharynx, oropharynx and larynx in groups with lower SES. Managers showed decreased SIRs of 0.50 to –0.90 also for cancers of the lip, tongue, other oral cavity subsites, oropharynx, nasopharynx, nose and larynx. In contrast, excess risks of tongue, other oral cavity subsites, pharyngeal, oropharyngeal and laryngeal cancers were observed among clerical (SIRs 1.05–1.16), skilled workers (1.04–1.14), unskilled workers (1.16–1.26) and economically inactive men (1.38–1.87). Among women, no risk gradient similar to that in men was revealed. Conclusions The current study underscores the influence of SES on the incidence of HNCs and highlights the need for targeted interventions, including tobacco and alcohol control policies, and improved access to healthcare services, particularly for socio-economically disadvantaged populations. [ABSTRACT FROM AUTHOR]

Objective: Develop an artificial intelligence assisted computer vision model to screen for laryngeal cancer during flexible laryngoscopy. Methods: Using laryngeal images and flexible laryngoscopy video recordings, we developed computer vision models to classify video frames for usability and cancer screening. A separate model segments any identified lesions on the frames. We used these computer vision models to construct a video stream annotation system. This system classifies findings from flexible laryngoscopy as "potentially malignant" or "probably benign" and segments any detected lesions. Additionally, the model provides a confidence level for each classification. Results: The overall accuracy of the flexible laryngoscopy cancer screening model was 92%. For cancer screening, it achieved a sensitivity of 97.7% and a specificity of 76.9%. The segmentation model attained an average precision at a 0.50 intersection-over-union of 0.595. The confidence level for positive screening results can assist clinicians in counseling patients regarding the findings. Conclusion: Our model is highly sensitive and adequately specific for laryngeal cancer screening. Segmentation helps endoscopists identify and describe potential lesions. Further optimization is required to enable the model's deployment in clinical settings for real-time annotation during flexible laryngoscopy. [ABSTRACT FROM AUTHOR]

Nuclear protein in testis (NUT) carcinoma is a rare neoplasm arising mainly from midline structures. It is an aggressive type of carcinoma associated with poor survival despite the use of multiple treatment modalities. Here, we present a case of a 17-year-old paediatric patient with NUT carcinoma of larynx, which is even rarer among all reported cases. The patient underwent surgery followed by radiotherapy and systemic treatment and he died 15 months after the diagnosis. The management of this rare disease requires further investigation. [ABSTRACT FROM AUTHOR]

Purpose: We intended to investigate the risk for second primary malignancy (SPM) development in Laryngeal Cancer (LC) survivors. We conducted a population-based analysis of SPM risk using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. Methods: Data of selected LC survivors from the SEER database between 2000 and 2020 were examined. Standardized Incidence ratios (SIRs) for SPM development were calculated, followed by detailed stratification according to anatomical site and different latency periods. Results: A total of 8413 SPMs were observed in our extracted cohort. The collective standardized incidence of SPMs was 2.12 (95% CI 2.07–2.17) compared to the US population, with an absolute excess risk (AER) of 201.73 per 10,000 individuals. The highest SPM risks were observed in patients with young age at diagnosis, females, and American Indians/Alaska natives. Increased SPM risks were reported in patients receiving all modalities of treatment including surgery, chemotherapy, and radiotherapy. Most SPMs were detected in solid organs such as the lungs and bronchus, oral cavity and pharynx, and prostate. The highest increased risks of developing SPMs were observed in Trachea, larynx, oral cavity and pharynx, lung and bronchus, and esophagus. Conclusions: The risk of SPMs in LC survivors was significantly increased compared to the general US population. Accordingly, a more impactful cancer surveillance strategy for LC patients should be implemented. [ABSTRACT FROM AUTHOR]

Purpose: Informative image selection in laryngoscopy has the potential for improving automatic data extraction alone, for selective data storage and a faster review process, or in combination with other artificial intelligence (AI) detection or diagnosis models. This paper aims to demonstrate the feasibility of AI in providing automatic informative laryngoscopy frame selection also capable of working in real-time providing visual feedback to guide the otolaryngologist during the examination. Methods: Several deep learning models were trained and tested on an internal dataset (n = 5147 images) and then tested on an external test set (n = 646 images) composed of both white light and narrow band images. Four videos were used to assess the real-time performance of the best-performing model. Results: ResNet-50, pre-trained with the pretext strategy, reached a precision = 95% vs. 97%, recall = 97% vs, 89%, and the F1-score = 96% vs. 93% on the internal and external test set respectively (p = 0.062). The four testing videos are provided in the supplemental materials. Conclusion: The deep learning model demonstrated excellent performance in identifying diagnostically relevant frames within laryngoscopic videos. With its solid accuracy and real-time capabilities, the system is promising for its development in a clinical setting, either autonomously for objective quality control or in conjunction with other algorithms within a comprehensive AI toolset aimed at enhancing tumor detection and diagnosis. [ABSTRACT FROM AUTHOR]

Objectives: To develop and assess a radiomics-based prediction model for distinguishing T2/T3 staging of laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC) Methods: A total of 118 patients with pathologically proven LHSCC were enrolled in this retrospective study. We performed feature processing based on 851 radiomic features derived from contrast-enhanced CT images and established multiple radiomic models by combining three feature selection methods and seven machine learning classifiers. The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity were used to assess the performance of the models. The radiomic signature obtained from the optimal model and statistically significant morphological image characteristics were incorporated into the predictive nomogram. The performance of the nomogram was assessed by calibration curve and decision curve analysis. Results: Using analysis of variance (ANOVA) feature selection and logistic regression (LR) classifier produced the best model. The AUCs of the training, validation, and test sets were 0.919, 0.857, and 0.817, respectively. A nomogram based on the model integrating the radiomic signature and a morphological imaging characteristic (suspicious thyroid cartilage invasion) exhibited C-indexes of 0.899 (95% confidence interval (CI) 0.843–0.955), fitting well in calibration curves (p > 0.05). Decision curve analysis further confirmed the clinical usefulness of the nomogram. Conclusions: The nomogram based on the radiomics model derived from contrast-enhanced CT images had good diagnostic performance for distinguishing T2/T3 staging of LHSCC. Clinical relevance statement: Accurate T2/T3 staging assessment of LHSCC aids in determining whether laryngectomy or laryngeal preservation therapy should be performed. The nomogram based on the radiomics model derived from contrast-enhanced CT images has the potential to predict the T2/T3 staging of LHSCC, which can provide a non-invasive and robust approach for guiding the optimization of clinical decision-making. Key Points: • Combining analysis of variance with logistic regression yielded the optimal radiomic model. • A nomogram based on the CT-radiomic signature has good performance for differentiating T2 from T3 staging of laryngeal and hypopharyngeal squamous cell carcinoma. • It provides a non-invasive and robust approach for guiding the optimization of clinical decision-making. [ABSTRACT FROM AUTHOR]

Laryngeal preservation and a radical cure are the treatment goals for laryngeal carcinoma, and larynx-preserving therapy is generally preferred for early-stage laryngeal carcinoma. When laryngeal carcinoma recurs locally, patients are often forced to undergo total laryngectomy, resulting in loss of vocal function. However, many patients with laryngeal carcinoma who have residual or recurrent disease after radiotherapy wish to preserve their voice. The purpose of this study was to investigate the possibility of using BNCT as a larynx-preserving treatment for residual or recurrent laryngeal carcinomas following radical irradiation. This study included 15 patients who underwent BNCT for residual or recurrent laryngeal carcinoma after radical laryngeal carcinoma irradiation. The number of treatment sessions for all patients was one irradiation. Before BNCT, the recurrent laryngeal carcinoma stage was rT1aN0, rT2N0, rT2N1, rT3N0, rT3N1, and rT4aN0 in one, six, one, three, one, and three patients, respectively. The median maximum tumor diameter before BNCT was 15 mm (8–22 mm). All patients underwent a tracheostomy before BNCT to mitigate the risk of upper airway stenosis due to laryngeal edema after BNCT. Treatment efficacy was evaluated retrospectively using monthly laryngoscopy after BNCT and contrast-enhanced CT scans at 3 months. The safety of treatment was evaluated based on examination findings and interviews with patients. The median hospital stay after BNCT was 2 days (1–6). The response rate at three months after BNCT in 15 patients with locally recurrent laryngeal carcinoma was 93.3 %, and the CR rate was 73.3 %. The most frequent adverse event associated with BNCT was laryngeal edema, which occurred in nine patients the day after BNCT. The average course of laryngeal edema peaked on the second day after BNCT and almost recovered after 1 week in all patients. One patient had bilateral vocal fold movement disorders. None had dyspnea because of prophylactic tracheostomy. No grade four or higher adverse events occurred. Other grade 2 adverse events included pharyngeal mucositis, diarrhea, and sore throat. Three months after BNCT, tracheostomy tubes were removed in nine patients, retinal cannulas were placed in three patients, and voice cannulas were placed in three patients. BNCT for locally recurrent laryngeal carcinoma can safely deliver radical irradiation to tumor tissues, even in patients undergoing radical irradiation. BNCT has shown antitumor effects against recurrent laryngeal carcinoma. However, further long-term observations of the treatment outcomes are required. [ABSTRACT FROM AUTHOR]

The Hounsfield unit density value (HUDV) is a relative quantitative measurement of radio density used by radiologists in the interpretation of computed tomography (CT) images. Our aim is to investigate the role of HUDV in evaluating pre-epiglottic space (PES) involvement of laryngeal carcinoma. Seventy-four patients treated for laryngeal carcinoma in our clinic between 2014 and 2019 were included in the study. The invasion status of PES was determined radiologically and pathologically. HUDV was measured with a circular selected region of interest, with a constant size of 10 mm2 for PES. The relationship between patological PES invasion, radiological PES invasion, and HUDV was evaluated. Measuring HUDV to determine PES invasion (74.3 %) was significantly higher than​​ conventional CT evaluation (59.5 %) (p = 0.001). The agreement coefficient (kappa value) of the conventional CT evaluation and the HUDV regarding PES involvement was 0.673, which was interpreted as 'good'. HUDV could be used as an additional tool in diagnosing pre-epiglottic space invasion in laryngeal cancer. [ABSTRACT FROM AUTHOR]

Tracheoesophageal puncture (TEP) is one of the most established methods for voice reacquisition following total laryngectomy. The most difficult complication following TEP is the management of saliva leakage or secretion into the trachea due to TE fistula enlargement. In this study, we devised a new strategy to close TE fistulas and confirmed its safety and effectiveness. Skin incision: If the tracheal mucosa around the voice prosthesis appears intact and normal, an arcuate incision, from 10 to 2 o'clock, is made on the skin 5 mm superior to the edge of the stoma. However, if the surrounding tracheal mucosa is fragile because of leaking, the incision is made on the superior edge of the stoma, with later reconstruction of the posterior tracheal wall. Separation of the trachea and esophagus: If the esophagotracheal spatium appears normal and is easy to dissect, the connective pipes can be found easily. After cutting the pipe, a ligature alone is sufficient for the tracheal side; however, the esophageal wall is closed with Gambee sutures. If the esophagotracheal spatium is compromised and the posterior tracheal wall is fragile (due to saliva leakage), we remove the posterior wall and reconstruct the area using the superior skin flap. We performed our novel method on four patients with intractable conditions; postradiotherapy for laryngeal cancer, total pharyngo-laryngo-esophagectomy (TPLE) with jejunum reconstruction, TPLE with gastric lifting reconstruction, and in a patient who underwent cervicothoracic incisional drainage for descending necrotizing mediastinitis. None of the cases showed postoperative leakage from the fistula, and oral intake was resumed without difficulty. This study showed that this strategy based on TE fistula conditions is effective even in difficult-to-treat cases. [ABSTRACT FROM AUTHOR]

Laryngeal cancer falls under the umbrella term of head and neck cancers and is the second commonest cancer type within this group. The condition often presents with symptoms shared with those of other less serious diseases, making diagnosis challenging. This article hopes to give nurses and non-medical prescribers an overview of symptoms, diagnosis, treatment, and prognosis with the aim of raising awareness and helping to get an earlier diagnosis of this devastating disease. [ABSTRACT FROM AUTHOR]

Background: Narrow-band imaging is an advanced endoscopic technology used to detect changes on the laryngeal tissue surface, employing a comparative approach alongside white-light endoscopy to facilitate histopathological examination. Objective: This study aimed to assess the utility and advantages of NBI (narrow-band imaging) in identifying malignant laryngeal lesions through a comparative analysis with histopathological examination. Methods: We conducted a systematic literature review, utilizing databases such as PubMed, the CNKI database, and Embase for our research. Results: We analyzed the articles by reviewing their titles and abstracts, selecting those we considered relevant based on determined criteria; in the final phase, we examined the relevant studies according to the specific eligibility criteria. Conclusions: Narrow-band imaging is an advanced endoscopic technology that demonstrates its efficacy as a tool for diagnosing malignant laryngeal lesions and comparing them to premalignant lesions. The European Society of Laryngology has implemented a standardized classification system for laryngeal lesions to enhance data correlation and organization. [ABSTRACT FROM AUTHOR]

Abstract Objective This study aims to investigate how the impact of preoperative sarcopenia and inflammatory markers for laryngeal cancer patients and develop a new scoring system to predict their prognosis. Materials and methods Patients who underwent laryngectomy for laryngeal cancer (LC) from December 2015 to December 2020 at the Second Affiliated Hospital of Fujian Medical University were included. Independent prognostic factors were determined using univariate and multivariate analyses. A new scoring system (SFAR) was established based on FAR and preoperative sarcopenia, and statistically analyzed. Results 198 cases included in this study that met the admission criteria. Multivariate analysis shown that preoperative sarcopenia, pTNM stage, and FAR were independent prognostic factors for laryngeal cancer. Based on these three indicators, we developed the SFAR scoring system. Multivariate analysis showed that SFAR was an independent predictor of laryngeal cancer (p

Abstract Background Laryngeal cancer is a prevalent malignancy in the head and neck region, often diagnosed at an advanced stage. The role of thyroidectomy in managing advanced laryngeal squamous cell carcinoma (LSCC) remains controversial due to inconsistent findings regarding the incidence and predictors of thyroid invasion. Aim of the work This meta-analysis aims to assess the incidence of thyroid invasion in patients with advanced laryngeal cancer and recognize hazard facets for thyroid invasion to elucidate the need for thyroidectomy. The study also aims to decrease the happening of postoperative hypothyroidism and supply guidance for individualized treatment approaches. Patients and methods A comprehensive search was conducted, and the meta-analysis included 6 studies encompassing 852 patients. Data regarding patient demographics, tumor characteristics, and incidence of thyroid invasion were extracted and analyzed. Results The meta-analysis revealed a mean age of 57.7 years among patients with advanced laryngeal cancer, with a male predominance of 94.6%. Thyroid invasion occurred in 13.3% of patients who underwent complete laryngectomy. Subglottic tumor site and T4 classification were identified as significant risk factors for thyroid invasion, while supraglottis and glottis tumor sites and T3 classification were associated with reduced risk. The odds ratio for thyroid invasion was highest for patients with T4 stage tumors. Conclusion Thyroidectomy during total laryngectomy should be considered for patients with subglottic tumor sites and T4 classification due to the increased risk of thyroid invasion. However, for patients with supraglottis or glottis tumor sites and T3 classification, the thyroid gland may be preserved to reduce the risk of postoperative hypothyroidism.

Abstract Background The study evaluated the prognostic impact of the immune microenvironment in LSCC with markers of major immune cells to identify the key determinants of short-term disease-free survival (ST DFS) and reveal factors related to disease progression. Methods The study cohort included 61 patients who underwent total laryngectomy, 83.6% of whom were male with a mean age of 64.3 years at the time of surgery. Twenty-five patients had long term DFS (over 5 years), 8 – had moderate DFS (between 2 and 5 years), and 28 had short-term DFS (less than 2 years). Immunohistochemical staining and evaluation were performed on samples collected after the laryngectomy. Results The samples’ assessment revealed that the mean expression of all analysed markers was the highest both in stroma and the tumor compartment for short term DFS (ST DFS) patients. Analysis confirmed that a high stromal density of CD8 cells (p = 0.038) significantly correlated with DFS, and that the increased presence of CD57 cells (p = 0.021) was significantly associated with ST DFS. Moreover, the high density of CD68 cells in the tumor epithelial compartment had a negative prognostic impact on DFS (p = 0.032). Analysis of overall survival in the studied cohort with Kaplan-Meyer curves revealed that a high stromal density of CD68 cells was a significant negative predictor of OS (p = 0.008). Conclusions The observed associations of CD68 cells infiltration with progression and prognosis in patients with LSCC provide potential screening and therapeutic opportunities for patients with unfavourable outcomes.

Abstract Laryngeal cancer exhibits a notable global health burden, with later-stage detection contributing to a low mortality rate. Laryngeal cancer diagnosis on throat region images is a pivotal application of computer vision (CV) and medical image diagnoses in the medical sector. It includes detecting and analysing abnormal or cancerous tissue from the larynx, an integral part of the vocal and respiratory systems. The computer-aided system makes use of artificial intelligence (AI) through deep learning (DL) and machine learning (ML) models, including convolution neural networks (CNN), for automated disease diagnoses and detection. Various DL and ML approaches are executed to categorize the extraction feature as healthy and cancerous tissues. This article introduces an automated Laryngeal Cancer Diagnosis using the Dandelion Optimizer Algorithm with Ensemble Learning (LCD-DOAEL) method on Biomedical Throat Region Image. The LCD-DOAEL method aims to investigate the images of the throat region for the presence of laryngeal cancer. In the LCD-DOAEL method, the Gaussian filtering (GF) approach is applied to eliminate the noise in the biomedical images. Besides, the complex and intrinsic feature patterns can be extracted by the MobileNetv2 model. Meanwhile, the DOA model carries out the hyperparameter selection of MobileNetV2 architecture. Finally, the ensemble of three classifiers such as bidirectional long short-term memory (BiLSTM), regularized extreme learning machine (ELM), and backpropagation neural network (BPNN) models, are utilized for the classification process. A comprehensive set of simulations is conducted on the biomedical image dataset to highlight the efficient performance of the LCD-DOAEL technique. The comparison analysis of the LCD-DOAEL method exhibited a superior accuracy outcome of 97.54% over other existing techniques.

Objectives: Insulin resistance is associated with increased levels of IGF‐1. IGF‐1 has been shown to increase the risk of laryngeal squamous cell carcinoma. The Triglyceride‐glucose index (TyG index) is a marker of insulin resistance. Our study aimed to investigate the relationship between the TyG index and laryngeal squamous cell carcinoma. Design: Retrospective cohort study. Setting: Two tertiary care academic hospitals. Methods: The study included 53 patients with laryngeal squamous cell carcinoma (Group 1) and 48 healthy volunteers (Group 2). Laryngeal cancer patients were divided into two groups according to their stage. Stages I and II were named Group 1A, and Stages III and IV were called Group 1B. The TyG index was calculated as ln [fasting Triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. The effect of the TyG index on laryngeal cancer was investigated on the parameters of sex, age, body mass index, and stage of the disease. Results: There were no significant differences in age, sex, and BMI between the groups. The TyG index of group 1 (4.75 ± 0.33) was significantly higher than that of group 2 (4.59 ± 0.15). The TyG index value of group 1B (4.84 ± 0.31) was significantly higher than both group 1A (4.61 ± 0.32) and group 2 (4.59 ± 0.15). There was no significant difference between the TyG index values of group 1A (4.61 ± 0.32) and group 2 (4.59 ± 0.15). Conclusion: The TyG index may be a promising laryngeal squamous cell carcinoma biomarker. People with a higher TyG index may have a higher incidence of laryngeal squamous cell carcinoma and a higher risk of progression. [ABSTRACT FROM AUTHOR]

Background: Primary fit tracheoesophageal puncture (TEP) is widely preferred for individuals who have not undergone prior radiation. However, there is no consensus on the relative utility of primary‐fit TEP in the setting of salvage laryngectomy. Methods: A retrospective, single‐center review was conducted of individuals undergoing laryngectomy with primary fit TEP between 2012 and 2018. Multivariable analysis was conducted to compare short‐term and long‐term complications, as well as speech and swallowing outcomes, of those who underwent primary versus salvage laryngectomy. Results: In this study, 134 patients underwent total laryngectomy with primary fit TEP. Aside from a higher rate of peristomal dehiscence (13.1% vs. 1.4%) found in the salvage group, there was no difference in incidence of all other complications, including pharyngocutaneous fistula formation. The groups had comparable speech and swallow outcomes. Conclusion: Primary fit TEP is a safe and effective surgical choice for individuals undergoing salvage laryngectomy who desire a voice prosthesis. [ABSTRACT FROM AUTHOR]

Abstract Introduction Laryngeal cancers account for one-third of all head and neck cancers. We aimed to report the incidence trends of laryngeal cancer over 2000–2020 in the United States (US), by age, sex, race/ethnicity, and histological subtypes. Methods Data from the Surveillance, Epidemiology, and End Results 22 database were used to identify patients with laryngeal cancer based on the International Classification of Diseases for Oncology, version 3. Age-standardized incidence rates (ASIRs) for laryngeal cancer, adjusted for reporting delays, were calculated. The Joinpoint Regression Program was then utilized to determine annual percent changes (APCs) and average annual percent changes (AAPCs) in the trends. The analysis excluded data from 2020 to prevent potential bias related to the COVID-19 pandemic. Results A total of 104,991 cases of laryngeal cancer were identified in the US from 2000 to 2019. Squamous cell carcinoma was the predominant subtype, accounting for 94.53% of cases. Above 73.20% occurred among non-Hispanic whites, with the highest incidence observed among individuals aged 55–69 years (46.71%). The ASIRs were 5.98 and 1.25 per 100,000 population for men and women, respectively. Over 2000–2019, there was a significant reduction in ASIRs for laryngeal cancer in both sexes. Non-Hispanic black men exhibited the highest ASIR (9.13 per 100,000) and the largest decline in the ASIRs over 2000–2019 (AAPC: -3.26%). Conclusions Laryngeal cancer incidence rates showed a decline from 2000 to 2019, in addition to 2020, during the COVID-19 pandemic. Additional research is required to investigate risk factors and their influence on incidence rates of laryngeal cancer.

Abstract In this study, we investigated the role of the newly discovered lncRNA FLJ20021 in laryngeal cancer (LC) and its resistance to cisplatin treatment. We initially observed elevated lncRNA FLJ20021 levels in cisplatin-resistant LC cells (Hep-2/R). To explore its function, we transfected lncRNA FLJ20021 and cyclin-dependent kinase 1 (CDK1) into Hep-2/R cells, assessing their impact on cisplatin sensitivity and PANoptosis. Silencing lncRNA FLJ20021 effectively reduced cisplatin resistance and induced PANoptosis in Hep-2/R cells. Mechanistically, lncRNA FLJ20021 primarily localized in the nucleus and interacted with CDK1 mRNA, thereby enhancing its transcriptional stability. CDK1, in turn, promoted panapoptosis in a ZBP1-dependent manner, which helped overcome cisplatin resistance in Hep-2/R cells. This study suggests that targeting lncRNA FLJ20021 can be a promising approach to combat cisplatin resistance in laryngeal cancer by regulating CDK1 and promoting PANoptosis via the ZBP1 pathway. These findings open up possibilities for lncRNA-based therapies in the context of laryngeal cancer.

Abstract Background Exosomes are nanosized vesicles released from all cells into surrounding biofluids, including cancer cells, and represent a very promising direction in terms of minimally invasive approaches to early disease detection. They carry tumor-specific biological contents such as DNA, RNA, proteins, lipids, and sugars, as well as surface molecules that are able to pinpoint the cellular source. By the above criteria, exosomes may be stratified according to the presence of tissue and disease-specific signatures and, due to their stability in such biofluids as plasma and serum, they represent an indispensable source of vital clinical insights from liquid biopsies, even at the earliest stages of cancer. Therefore, our work aimed to isolate and characterize LCa patients’ derived exosomes from serum by Flow Cytometry in order to define a specific epitope signature exploitable for early diagnosis. Methods Circulating exosomes were collected from serum collected from 30 LCa patients and 20 healthy volunteers by the use of antibody affinity method exploiting CD63 specific surface marker. Membrane epitopes were then characterized by Flow cytometry multiplex analysis and compared between LCa Patients and Healthy donors. Clinical data were also matched to obtain statistical correlation. Results A distinct overexpression of CD1c, CD2, CD3, CD4, CD11c, CD14, CD20, CD44, CD56, CD105, CD146, and CD209 was identified in LCa patients compared to healthy controls, correlating positively with tumor presence. Conversely, CD24, CD31, and CD40, though not overexpressed in tumor samples, showed a significant correlation with nodal involvement in LCa patients (p < 0.01). Conclusion This approach could allow us to set up a cost-effective and less invasive liquid biopsy protocol from a simple blood collection in order to early diagnose LCa and improve patients’ outcomes and quality of life. Graphical Abstract

Abstract Background YouTube, a widely recognized global video platform, is inaccessible in China, whereas Bilibili and TikTok are popular platforms for long and short videos, respectively. There are many videos related to laryngeal carcinoma on these platforms. This study aims to identify upload sources, contents, and feature information of these videos on YouTube, Bilibili, and TikTok, and further evaluate the video quality. Methods On January 1, 2024, we searched the top 100 videos by default sort order (300 videos in total) with the terms “laryngeal carcinoma” and “throat cancer” on YouTube, “喉癌” on Bilibili and TikTok. Videos were screened for relevance and similarity. Video characteristics were documented, and quality was assessed by using the Patient Education Materials Assessment Tool (PEMAT), Video Information and Quality Index (VIQI), Global Quality Score (GQS), and modified DISCERN (mDISCERN). Results The analysis included 99 YouTube videos, 76 from Bilibili, and 73 from TikTok. Median video lengths were 193 s (YouTube), 136 s (Bilibili), and 42 s (TikTok). TikTok videos demonstrated higher audience interaction. Bilibili had the lowest ratio of original contents (69.7%). Treatment was the most popular topic on YouTube and Bilibili, while that was the prognosis on TikTok. Solo narration was the most common video style across all platforms. Video uploaders were predominantly non-profit organizations (YouTube), self-media (Bilibili), and doctors (TikTok), with TikTok authors having the highest certification rate (83.3%). Video quality, assessed using PEMAT, VIQI, GQS, and mDISCERN, varied across platforms, with YouTube generally showing the highest scores. Videos from professional authors performed better than videos from non-professionals based on the GQS and mDISCERN scores. Spearman correlation analysis showed no strong relationships between the video quality and the audience interaction. Conclusions Videos on social media platforms can help the public learn about the knowledge of laryngeal cancer to some extent. TikTok achieves the best flow, but videos on YouTube are of the best quality. However, the video quality across all platforms still needs enhancement. We need more professional uploaders to ameliorate the video quality related to laryngeal carcinoma. Content creators also should be aware of the certification, the originality, and the style of video shooting. As for the platforms, refining the algorithm will allow users to receive more high-quality videos.

(1) Background: The interplay between coronavirus disease 2019 (COVID-19) and laryngeal cancer represents a substantial challenge for both patients and healthcare. To garner information on recent mortality data for laryngeal cancer, including during the COVID-19 pandemic, we analyzed real-world data from the US Centers for Disease Control and Prevention (CDC). (2) Methods: We searched the CDC WONDER online database 2018–2022 using the ICD-10 code for laryngeal cancer (C32; malignant neoplasm of the larynx). We also performed a sub-analysis between genders and across ten-year age groups. The data were analyzed with one-way analysis of variance (ANOVA) and Tukey’s post hoc test. (3) Results: The trend of age-adjusted mortality ×100,000 did not change significantly between the years 2018 and 2022 (p = 0.553). Males had higher age-adjusted mortality rates (M/F ratios between 4.6 and 5.0), but no significant variation was found in both genders (males: p = 0.676; females: p = 0.596). Although the mortality rate remained unchanged in people aged 35–84 years, the variation reached statistical significance in those aged 85 or older (p = 0.004), displaying a significant increase in 2021 compared to 2018 (p = 0.006) and 2019 (p = 0.039). (4) Conclusions: The impact of the COVID-19 pandemic on mortality for laryngeal cancer seems to be relatively modest in the general US population. Nevertheless, closer attention must be paid to older people, for whom the unfavorable consequences of misdiagnosis or mistreatment of this and other types of cancers can be exacerbated.

Background: The aim of this study is to examine the outcomes of an accelerated fractionated irradiation for N0 glottic carcinoma. Methods: In this retrospective analysis, 29 patients with N0 glottic carcinoma treated by radiation therapy were enrolled. Thirteen patients had T1a disease, six had T1b disease, and ten had T2 disease. A fractional dose of 2.1 Gy was administered to seven patients. The total doses were 65.1 and 67.2 Gy in four and three patients, respectively. A fractional dose of 2.25 Gy was administered to 22 patients. The total doses were 63 and 67.5 Gy in 21 patients and 1 patient with T2 disease, respectively. Additionally, 13 patients underwent the use of TS-1 (80–100 mg per day). Results: The median follow-up period was 33 months, and the 3-year local control rate was 95.6%. No patient had a lymph node or distant recurrence. As acute adverse events, grades 2 and 3 dermatitis were observed in 18 patients and 1 patient, and grades 2 and 3 mucositis were observed in 15 patients and 1 patient. As a late adverse event, one patient required tracheotomy because of laryngeal edema occurring. Conclusions: Accelerated fractionated irradiation may be an option in the radiation therapy of N0 glottic carcinoma because of its ability to shorten the treatment time.

Summary: Objectives: The systemic inflammatory response is strongly involved in the progression of malignant tumors, and it is useful for predicting survival time and determining therapeutic effects. The inflammatory biomarkers, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) are used to assess post-treatment survival and recurrence in various malignant tumors.(Walsh et al., 2005; Burt et al., 2011; Smith et al., 2009) 1,2,3 These indicators may be effective as predictive markers for head and neck malignancies. Methods: The participants were 125 glottic laryngeal and supraglottic cancer cases who received primary treatment in our department from 2010 to 2016. The NLR, LMR, and PLR for each patient were calculated in addition to the association with overall survival (OS) rate, disease-specific survival (DSS) rate, and laryngeal preservation rate for tumor location, T and N classification, TNM stage classification, treatment, and smoking. We investigated whether inflammatory biomarkers are useful for predicting prognosis. Results: The cutoff values for NLR, LMR, and PLR on the ROC curve were 1.88, 5.57, and 108, respectively. Multivariate analysis with LMR 5.57 as the cutoff value showed significant differences in OS, DSS, and laryngeal preservation. However, setting the cutoff values for NLR 1.88 and PLR 108 showed significant differences only in OS and laryngeal preservation. Conclusion: LMR may be a total survival predictor of laryngeal cancer, including OS, DSS, and laryngeal preservation.

Objective: High risk of degraded quality of life and psychological distress is observed in patients diagnosed with sinonasal, nasopharyngeal, and laryngeal cancers, which could be caused by exposure to carcinogens in workplaces. This review aimed to investigate the psychological impact of diagnosis associated with the possible occupational etiology of such neoplasms and to explore the instruments that evaluate the quality of life (QoL), anxiety, and depression in these patients. Methods: Studies were considered for the review only if they described aspects of the psychological impact of the diagnosis of sinonasal, nasopharyngeal, and laryngeal cancers and reported results distinguished by the tumor site. The psychological impact was assessed in terms of health-related QoL, anxiety, and depression using reliable psychometric questionnaires administered at the time of diagnosis and 1 year later. Results: In more than 5,900 records identified, 442 studies fulfilled the eligibility criteria and 436 were excluded after full-text screening, resulting in six studies to be finally included in the review. The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30), EORTC QLQ-H&N35, and Functional Assessment of Cancer Therapy (FACT) were used to evaluate the QoL, whereas the Hospital Anxiety and Depression Scale (HADS) and Center for Epidemiologic Studies Depression Scale (CES-D) questionnaires were employed to assess anxiety and depression. QoL scores were similar to those of the general population at the time of diagnosis and remained unchanged or slightly improved at 1 year since diagnosis. In contrast, a higher prevalence of anxiety and depression was observed compared with the general population, although the results were inconsistent across the very few studies identified. No study investigating the association between the potential occupational etiology and QoL or distress was found. Conclusion: Exploring the existing scientific literature on emotional distress in sinonasal, nasopharyngeal, and laryngeal cancer patients was prompted by concerns over the disfiguring nature of treatment and the additional emotional burden resulting from their occupational etiology. Unfortunately, neither a crucial element nor other risk factors (lifestyle, smoking, drinking, etc.) were examined in any study. Patients' employment history should be considered in order to assess the possible impact of believing they are affected by an occupational exposure disease in the evaluation of their psychological distress. This history would support evidence-based recommendations about dedicated psychological interventions. [ABSTRACT FROM AUTHOR]

Laryngeal cancer is a malignant tumor that originates from the mucous membrane of the larynx. Currently, the specific involvement mechanism of copper death in laryngeal cancer patients has not been deeply studied. This study aims to explore the molecular characteristics and clinical survival significance of copper death-related genes in laryngeal cancer. Relevant transcriptomes and clinical data were retrieved and downloaded from the GEO database. Differential expression genes related to laryngeal cancer and copper death were selected, and the immune function, clinical risk correlation, and survival prognosis were analyzed. The differential analysis results showed that the differential expression genes related to laryngeal cancer and Cu-proptosis included SLC31A1 and ATP7B, and there was interaction between the immune cell groups in the differential genes of copper death in laryngeal cancer. Decreasing the expression of the gene ANXA5 or increasing the expression of the gene SERPINH1 can increase the susceptibility to laryngeal cancer. Copper death-related genes can affect the survival prognosis of laryngeal cancer patients. Detection of changes in their expression can provide new diagnostic and treatment directions for the progression of early-stage laryngeal cancer. [ABSTRACT FROM AUTHOR]

Human voice is an important signal that, if analyzed cautiously, will reveal various disorders and diseases of the human body. Vocal profiling is emerging as a new technique for assessment of voice disorders. This work has focused mainly on vocal tract acoustic measurements to detect voice disorders, especially dysphonia. Dysphonia is a communication disorder that, if not detected at an early stage, may lead to serious complications like laryngeal cancer thus affecting health and quality of life. The voice recordings of 52 subjects (26 dysphonic and 26 healthy) were taken from Saarbrucken Voice Database, 28 live samples (14 dysphonic and 14 healthy) were recorded using CSL 4500 tool and 169 subjects (111 dysphonic and 58 healthy) were taken from VOICED Database. These voice samples were used to extract five acoustic parameters: fundamental frequency, jitter, shimmer, pitch, and formants. The results obtained had an accuracy of around 85% which confirms the potentiality of these fundamental parameters in the successful detection of dysphonia as well as other voice disorders. [ABSTRACT FROM AUTHOR]

Numerous studies have reported lower overall cancer mortality rates among immigrants compared to native populations. However, limited information exists regarding cancer mortality among immigrants based on specific birth countries and cancer types. We used population‐based registries and followed 10 million individuals aged 20 years or older in Sweden between 1992 and 2016. The Cox proportional hazard model was used to explore the disparities in cancer mortality by country of birth and cancer type, stratified by gender. Age‐standardized mortality rates were also computed using the world standard population. Hazard ratio (HR) of all‐site cancer was slightly lower among immigrants (males: HRm = 0.97: 95% confidence interval: 0.95, 0.98; females: HRf = 0.93: 0.91, 0.94) than Swedish‐born population. However, the immigrants showed higher mortality for infection‐related cancers, including liver (HRf = 1.10: 1.01, 1.19; HRm = 1.10: 1.02, 1.17), stomach (HRf = 1.39: 1.31, 1.49; HRm = 1.33: 1.26, 1.41) cancers, and tobacco‐related cancers, including lung (HRm = 1.44: 1.40, 1.49), and laryngeal cancers (HRm = 1.47: 1.24, 1.75). The HR of mesothelioma was also significantly higher in immigrants (HRf = 1.44: 1.10, 1.90). Mortality from lung cancer was specifically higher in men from Nordic (HRm = 1.41: 1.27, 1.55) and non‐Nordic Europe (HRm = 1.49: 1.43, 1.55) countries and lower in Asian (HRm = 0.78: 0.66, 0.93) and South American men (HRm = 0.70: 0.57, 0.87). In conclusion, there are large variations in cancer mortality by country of birth, and cancer type and require regular surveillance. Our detailed analyses lead to some novel findings such as excess mortality rate of mesothelioma and laryngeal cancers in Immigrants in Sweden. A targeted cancer prevention program among immigrants in Sweden is needed. [ABSTRACT FROM AUTHOR]

Introduction: Recurrent respiratory papillomatosis (RRP) is a benign tumor caused by the human papillomavirus that mainly occurs in the larynx; the tumor is known to show malignant transformation in a small percentage of cases. In this report, we describe a case of rapidly growing cervical metastasis due to malignant transformation of RRP that was successfully treated with pembrolizumab. Case Presentation: A 79-year-old man diagnosed as having laryngeal papilloma was referred to our department, and we resected the tumor by transoral laser microsurgery (TLM). Postoperative histopathology showed papillary lesions with mild cellular atypia, suggestive of papilloma. Six years later, the patient visited our hospital again with worsening hoarseness of the voice and an enlarged papillary lesion of the larynx. We performed a second TLM and postoperative histopathological examination revealed a papillary squamous cell carcinoma. In the early postoperative period, the patient developed a recurrence at the primary site and received radiotherapy (70 Gy). Three months after the completion of radiotherapy, a rapidly enlarging metastatic lymph node was observed in the right cervical region, and we performed neck dissection. Five months after the surgery, a rapidly enlarging mass appeared in the anterior cervical subcutaneous region, and the patient received palliative radiation. Since an immunohistochemical examination of a specimen obtained at the time of neck dissection showed high PD-L1 expression, with a combined positive score of 100, the patient was initiated on treatment with pembrolizumab 1 month later. Although the patient developed fever and a skin rash as adverse events, the tumor disappeared almost entirely within 3 weeks. Thereafter, we have observed no evidence of recurrence for over 1 year. Conclusion: The PD-1/PD-L1 pathway has been implicated in the tumorigenesis of RRP. This pathway may also play an important role in the malignant transformation of RRPs. Therefore, evaluation of tumor PD-L1 expression is recommended in these cases. [ABSTRACT FROM AUTHOR]