Rational treatment options for T1/2N0M0 squamous cell carcinoma of the anal canal: a population-based study combined with external validation.

BACKGROUND: Treatment options for T1/2N0M0 anal squamous cell carcinoma include chemotherapy, radiotherapy, chemoradiotherapy, and local excision, although the optimal treatment method has not been determined. METHODS: The National Cancer Institute Surveillance, Epidemiology and Results database was used to search and screen 1465 patients with cT1/2N0M0 anal squamous cell carcinoma who were clinically diagnosed between 2004 and 2016. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Cox proportional hazards regression analysis was performed to screen independent prognostic factors and build a nomogram survival prediction model. According to the risk score, patients were divided into low, medium, and high risk groups using X-tile software. RESULTS: Age, sex, grade and cT stage were identified as independent prognostic factors for cT1/2N0M0 anal squamous cell carcinoma and were included in the nomogram to construct a prediction model. The C-index of the model was 0.770 [95% confidence interval (CI), 0.693-0.856], which was higher than the C-index of T stage 0.565 (95% CI, 0.550-0.612). Low-risk patients benefited from local resection, moderate-risk patients benefited from radiotherapy, and high-risk patients benefited from radiotherapy or chemoradiotherapy. This was confirmed using external validation data from the center. CONCLUSION: The nomogram developed in this study effectively and comprehensively evaluated the prognosis of patients with cT1/2N0M0 squamous cell carcinoma of the anal canal. Local excision is recommended for low risk patients, radiotherapy for moderate-risk patients, and radiotherapy or chemoradiotherapy for high-risk patients.

LICHEN PLANUS AND COMORBID CONDITIONS (A REVIEW OF LITERATURE) LISZAJ PLASKI I CHOROBY WSPÓLISTNIEJACE (PRZEGLAD LITERATURY).

OBJECTIVE: Introduction: The studying of the comorbidity of skin diseases is a priority scientific direction in modern dermatology. Comorbid conditions aggravate the course of the underlying disease, reduce the effectiveness of diagnosis and treatment can lead to chronization of the process, disability of patients. Understanding of the commonality of pathogenesis and the mutually complicating nature of comorbidity makes a possible to prescribe individual rational treatment. The aim of the study was search and analysis of the data of review, experimental and clinical scientific and medical publications on the issues of the comorbidity of LP. PATIENTS AND METHODS: Materials and methods: an analysis of the studying of the scientific and medical literature was shown. Searching was carried out through the PubMed/MEDLINE portal from the databases of the National Center Biotechnology Information, U. S. National Library of Medicine, National Institute for Health and Clinical Excellence, as well as the portals «Scientific Electronic Library eLIBRARY.RU¼, «Russian Science Citation Index (RSCI)¼ and «Index Copernicus¼. CONCLUSION: Conclusions: The main global trends of comorbidity of LP are determined. The results of these studies can form the basis for updating of clinical guidelines for the management of patients with LP at the international and local levels.

A genuine pediatric parapharyngeal abscess a year after uneventful adenotonsillectomy.

Brescia G, Pedruzzi B, Stramare R, Pendolino AL, Martini A, Marioni G. A genuine pediatric parapharyngeal abscess a year after uneventful adenotonsillectomy. Turk J Pediatr 2017; 59: 715-718. It is unusual for a parapharyngeal abscess (PA) to occur late after an adenotonsillectomy. We report herein a 13-year-old female patient who developed a PA a year after an uneventful adenotonsillectomy. The patient underwent 2 surgical explorations and was given intravenous antibiotic treatment. She was discharged in good general condition after spending 7 days in hospital. The potential pathophysiological mechanisms behind PA formation late after tonsillectomy or adenotonsillectomy, and rational treatments for PA are critically discussed.