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185 results on '"Hussey, David H."'

58. Management of the unknown primary carcinoma: Long-term follow-up on a negative PET scan and negative panendoscopy.

Author

Miller, Frank R., Karnad, Anand B., Eng, Tony, Hussey, David H., Stan McGuff, H., and Otto, Randal A.

Subjects
POSITRON emission tomography, HEAD & neck cancer diagnosis, BIOPSY, CANCER patients
Abstract

Background The unknown primary carcinoma in the head and neck has been estimated to represent up to 7% of all head and neck carcinomas. In an attempt to identify the occult primary tumor the evaluation of this patient population has included a complete head and neck examination, flexible fiberoptic endoscopy, and imaging with CT/MRI. More recently, positron emission tomography (PET) has been advocated as a tool to detect primary tumors. Methods A cohort of 31 patients with fine-needle aspiration biopsy–confirmed squamous cell carcinoma were prospectively entered into a diagnostic protocol to identify the occult primary tumor. The diagnostic protocol included a comprehensive head and neck examination (including flexible endoscopy) and CT and/or MRI. If the initial diagnostic evaluation failed to identify a primary tumor, the patients then underwent whole body PET imaging followed by staging endoscopy with biopsy of the at-risk occult tumor sites. The outcome measures included the accuracy of the PET to predict the presence of occult tumor at staging endoscopy and the accuracy of the negative PET and negative panendoscopy in predicting the subsequent development of a primary tumor in the upper aerodigestive tract during follow-up. Results The PET detected 9 occult primary tumors in the 31 patients (detection rate, 29%). Five occult primary tumors (2 base of tongue and 3 palatine tonsil) were detected during panendoscopy despite a negative PET. The combination of PET and panendoscopy detected 45.2% of the unknown primary tumors. Seventeen patients (N1, n = 7; N2a, n = 4; N2b, n = 2; N3, n = 4) had no primary tumor detected and were treated as an unknown primary carcinoma with primary neck dissection +/- radiation therapy +/- chemotherapy. In this series of 17 patients, there were 3 neck recurrences (17.6%). In addition, only 1 patient (5.8%) developed a primary tumor of the upper aerodigestive tract with a mean follow-up of 31.1 months (range, 21–60 months). Conclusion A negative PET study in patients with an occult primary head and neck carcinoma does not preclude the need for panendoscopy with biopsy to detect the occult primary tumor. The risk of subsequent primary tumor appears to be low in the patients with a negative PET and a negative panendoscopy (<6%). © 2007 Wiley Periodicals, Inc. Head Neck, 2008 [ABSTRACT FROM AUTHOR]

Published
2008
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66. Oncology specialties at the turn of the century: A Workforce analysis.

Author

Hussey, David H.

Abstract

Examines various workforce issues concerning oncology specialists in the United States. Comparison of workforce projections between oncologists and other medical practitioners; Factors which determine the supply of oncologists in the labor market; Difficulties associated with determining the workforce projections for oncologists.

Published
1999

77. Regional Radiotherapy as Adjuvant Treatment for Head and Neck Malignant Melanoma: Preliminary Results

Author

Ang, K. Kian, Byers, Robert M., Peters, Lester J., Maor, Moshe H., Wendt, Charles D., Morrison, William H., Hussey, David H., and Goepfert, Helmuth

Abstract

• From 1983 through 1988, 83 patients with high-risk cutaneous malignant melanoma (primary lesion thicker than 1.5 mm or palpable lymphadenopathy) of the head and neck region were enrolled in a study designed to assess the efficacy of a few large doses of radiation (24 to 30 Gy in 4 to 5 fractions). The actuarial 2-year locoregional control rates for the three groups were 95%, 90%, and 83%, respectively. Corresponding survival rates were 80%, 71%, and 69%. The majority of failures were due to distant metastases. Locoregional control rates were better than those reported earlier with surgery alone for comparable patients. The treatment morbidity was minimal.(Arch Otolaryngol Head Neck Surg. 1990;116:169-172)

Published
1990
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