[CEA and Cyfra 21.1 study pre-treatment in 252 patients with head and neck carcinomas]. / Estudio de CEA y Cyfra 21.1 pre-tratamiento en 252 pacientes con carcinoma de cabeza y cuello.

INTRODUCTION: Squamous cell carcinoma is the most frequent malignant tumor in the head and neck. As in most malignant tumors, the earlier the diagnosis, is made the longer the survivalis. Several molecules, including CEA and Cyfra 21.1, have been evaluated in an attempt to improve diagnosis and follow-up. OBJECTIVE: To investigate whether CEA and Cyfra 21.1 present pathological increased values prior to treatment, and to correlate tumor and patient characteristics with CEA and Cyfra 21.1 levels. MATERIAL AND METHODS: CEA and Cyfra 21.1 were measured pre-treatment in sera of 252 patients treated for head and neck tumors from1999 to 2003. RESULTS: Increases of CEA were detected in 23.6%, and increases of Cyfra 21.1 in 19.1% of patients. Significative differences were found between the concentrations of Cyfra 21.1 related to the tumor stage, local extension, histological grade, and an increasing relation with age. No differences were found in relation to the primary tumor site. Regarding CEA, the only finding was an increased relation between concentrations of this marker and cigarette and alcohol habits. CONCLUSIONS: Cyfra 21.1 does not appear to be a good marker for tumoral screening of head and neck carcinomas. However, a good correlation was observed between sera concentrations of Cyfra 21.1, tumoral burden, and histological grade of the tumor, but this was not the case with CEA.

Estudio de CEA y Cyfra 21.1 Pre-tratamiento en 252 pacientes con carcinoma de cabeza y cuello / CEA and Cyfra 21.1 Study pre-treatment in 252 patients with head and neck carcinomas

Introducción: El carcinoma escamoso es el tumor maligno predominante en cabeza y cuello. Como en la mayoría de tumores malignos, su diagnóstico precoz conlleva una mayor supervivencia. Diferentes moléculas, entre ellas el CEA y el Cyfra 21.1 han sido evaluadas en un intento de facilitar el diagnóstico y la evolución de la enfermedad. Objetivo: Demostrar si existe una elevación patológica de CEA y Cyfra 21.1 pre-tratamiento en nuestros pacientes, y buscar correlación entre sus concentraciones y diferentes parámetros con relación al tumor y al paciente. Material y métodos: Se midieron antes deltratamiento las concentraciones de CEA y Cyfra 21.1 en suero en 252 pacientes entre 1999 y 2003. Resultados: Se detectó una elevación de CEA en 23,6 por ciento, y de Cyfra 21,1 en 19.1 por ciento de pacientes. Se encontró una diferencia significativa de las concentraciones de Cyfra 21.1 en función del estadiaje tumoral, la extensión local y regional, entre los diferentes grados histológicos, y una relación de tendencia creciente con la edad. No hubo diferencias significativas para las localizaciones delprimario. Respecto al CEA sólo se encontró relación de tendencia creciente con el hábito tabáquico y enólico de los pacientes. Conclusiones: El Cyfra 21.1 está lejos de ser un marcador adecuado para cribaje del carcinoma en cabeza y cuello. Existe, sin embargo, correlación entre sus concentraciones séricas y la carga de tumor y su grado de diferenciación histológica, no siendo así para el CEA (AU)

INTRODUCTION: Squamous cell carcinoma is the most frequent malignant tumor in the head and neck. As in most malignant tumors, the earlier the diagnosis, is made the longer the survivalis. Several molecules, including CEA and Cyfra 21.1, have been evaluated in an attempt to improve diagnosis and follow-up. OBJECTIVE: To investigate whether CEA and Cyfra 21.1 present pathological increased values prior to treatment, and to correlate tumor and patient characteristics with CEA and Cyfra 21.1 levels. MATERIAL AND METHODS: CEA and Cyfra 21.1 were measured pre-treatment in sera of 252 patients treated for head and neck tumors from1999 to 2003. RESULTS: Increases of CEA were detected in 23.6%, and increases of Cyfra 21.1 in 19.1% of patients. Significative differences were found between the concentrations of Cyfra 21.1 related to the tumor stage, local extension, histological grade, and an increasing relation with age. No differences were found in relation to the primary tumor site. Regarding CEA, the only finding was an increased relation between concentrations of this marker and cigarette and alcohol habits. CONCLUSIONS: Cyfra 21.1 does not appear to be a good marker for tumoral screening of head and neck carcinomas. However, a good correlation was observed between sera concentrations of Cyfra 21.1, tumoral burden, and histological grade of the tumor, but this was not the case with CEA (AU)

[Selective neck dissection in patients presenting clinical node metastases]. / Vaciamientos selectivos en pacientes con metástasis ganglionares clínicas.

OBJECTIVE: To evaluate the results obtained with selective neck dissection in patients with clinically positive neck nodes at diagnosis (N+). PATIENTS AND METHODS: Retrospective study of N+ patients treated with a lateral or supromohyoid selective neck dissection with prophylactic purpose (sides of the neck N0) or therapeutic purpose (sides of the neck N+). RESULTS: Forty nine selective neck dissections were carried out in 42 N+ patients. In 18 cases the neck dissection had a prophylactic purpose (sides of the neck N0), and in 31 of them a therapeutic purpose (sides of the neck N+). In 39 patients summary was followed by postoperative radiotherapy. There was no regional relapse in either side of the neck treated with a selective neck dissection. CONCLUSIONS: Selective neck dissections in selected N+ patients are an adequate surgical technique. The main advantages of selective neck dissections are to shorten the surgical time, and to avoid the morbility associated with the dissection of the neck zones not included.

Vaciamientos selectivos en pacientes con metástasis ganglionares clínicas / Selective neck dissection in patients presenting clinical node metastases

Objetivo: Evaluar los resultados obtenidos con el uso de vaciamientos selectivos en pacientes con metástasis ganglionares clínicas en el momento del diagnóstico (N+). Pacientes y métodos: Estudio retrospectivo de los pacientes N+ tratados con un vaciamiento selectivo lateral o supraomohioideo con finalidad profiláctica (lado de cuello N0) o terapéutica (lado de cuello N+). Resultados: Se llevaron a cabo un total de 49 vaciamientos selectivos en 42 pacientes N+. En 18 ocasiones los vaciamientos tuvieron una finalidad profiláctica (lados de cuello N0) y en 31 terapéutica (lados de cuello N+).Treinta y nueve pacientes siguieron tratamiento con radioterapia postoperatoria. No se produjo una recidiva regional en ninguno de los lados de cuello tratados con un vaciamiento selectivo. Conclusión: Los vaciamientos selectivos en casos seleccionados de pacientes N+ son una técnica adecuada de cirugía cervical, y cuentan con la ventaja de minimizar el tiempo operatorio y la morbilidad asociada a la disección de las estructuras cervicales (AU)

OBJECTIVE: To evaluate the results obtained with selective neck dissection in patients with clinically positive neck nodes at diagnosis (N+). PATIENTS AND METHODS: Retrospective study of N+ patients treated with a lateral or supromohyoid selective neck dissection with prophylactic purpose (sides of the neck N0) or therapeutic purpose (sides of the neck N+). RESULTS: Forty nine selective neck dissections were carried out in 42 N+ patients. In 18 cases the neck dissection had a prophylactic purpose (sides of the neck N0), and in 31 of them a therapeutic purpose (sides of the neck N+). In 39 patients summary was followed by postoperative radiotherapy. There was no regional relapse in either side of the neck treated with a selective neck dissection. CONCLUSIONS: Selective neck dissections in selected N+ patients are an adequate surgical technique. The main advantages of selective neck dissections are to shorten the surgical time, and to avoid the morbility associated with the dissection of the neck zones not included (AU)

[Assessment of the prognostic capacity improvement of the 5th edition of the TNM in patients with nasopharyngeal carcinoma]. / Evaluación de la mejoría en la capacidad pronóstica de la 5a edición del TNM en pacientes con carcinomas de nasofaringe.

OBJECTIVE: Evaluate the changes included in the 5th edition of the TNM classification in patients with nasopharyngeal carcinoma. PATIENTS AND METHODS: Retrospective study of 103 patients with nasopharyngeal carcinoma treated with radical intention in our centre from 1985 to 1997. A reclassification according to the criteria defined in the 5th edition of the TNM was carried out. The loco-regional control and survival obtained when patients were classified with the 4th and 5th editions of the TNM were compared. RESULTS: The use of the 5th edition of the TNM led to a decrease in local category (T) and stage grouping, improving the prognostic capacity in local control and survival. The changes included in the 5th edition of the TNM did not modify the regional classification in a essential way. CONCLUSIONS: The changes included in the 5th edition of the TNM improved the classification of patients with nasopharyngeal carcinoma.

Recidivas ganglionares aisladas en pacientes con carcinomas de cabeza y cuello / Isolated lymphatic recurrencies in patients with head and neck carcinomas

Objetivo: La existencia de una recidiva ganglionar comporta un empeoramiento notable en el pronóstico de los pacientes con carcinoma de cabeza y cuello. El objetivo del presente estudio es analizar las posibilidades de tratamiento de rescate tras una recidiva ganglionar aislada. Material y Métodos: Estudio retrospectivo de 144 pacientes con carcinomas de cabeza y cuello afectos de una recidiva regional aislada. Se analizaron los tratamientos empleados y los resultados de control regional y supervivencia. Resultados: Un 64 por ciento (92/144) de los pacientes no fueron candidatos a tratamiento de rescate con intención radical. Se efectuó un rescate quirúrgico en el 36 por ciento (52/144) restante de pacientes, obteniéndose una supervivencia ajustada en este grupo del 46 por ciento. La variable relacionada de forma más importante con la posibilidad de llevar a cabo un tratamiento de rescate fue el tratamiento inicial de las áreas ganglionares, contando con peor pronóstico los pacientes en los que el tratamiento inicial incluyó cirugía. Conclusiones: La aparición de una recidiva regional cuenta con mal pronóstico, con una supervivencia ajustada a los 5 años en nuestros pacientes del 16 por ciento. Tan sólo un 36 por ciento de los pacientes fueron considerados candidatos a un tratamiento de rescate, consiguiéndose una supervivencia en este grupo del 46 por ciento (AU)

OBJECTIVE: Recurrencies of lymphatic metastasis implies a poor prognosis in patients with head and neck carcinoma. The aim of our study is to analyse the results of salvage treatment after an isolated regional tumour recurrence. MATERIAL AND METHODS: Retrospective study of 144 patients with head and neck carcinoma with an isolated neck recurrence. The treatments used, regional control and patient's survival were analysed. RESULTS: Sixty-four percent (92/144) of patients were not candidates to salvage treatment with radical intention. Salvage surgery was performed in 36% (52/144) of patients, with a survival of 46% in this group of patients. Previous treatment of the neck was the most relevant variable to decide a salvage surgery. Patients treated initially with neck dissection had the worst prognosis. CONCLUSIONS: The existence of a regional recurrence has a bad prognosis, with 16% 5-year survival. Only 36% of patients were considered candidates to salvage treatment, achieving 46% of survival (AU)

[Treatment for the early stages (T1-T2NO) of squamous cell carcinoma of the mobile tongue]. / Tratamiento de los estadios iniciales (T1-T2N0) del carcinoma de lengua móvil.

OBJECTIVE: The aim of this study is to define the best local treatment in patients with squamous cell carcinoma of mobile tongue in the early stages (I-II) and to establish the best election for neck management. MATERIAL AND METHODS: We evaluated 90 patients classified as stage I and II between 1984 and 1999. Sixty-eight patients out of the ninety (75%) were treated with radio-therapy and twenty-two (25%) with surgery. Neck dissection was used in 39% (35/90) of patients. RESULTS: The rates of ultimate local control for T1NO lesions were similar for both treatment groups (94% vs. 95%). For T2N0 lesions the ultimate local control did improved in those patients treated with surgery (100%) compared to those that had radiotherapy (77%). Regional control was better in the group that underwent neck dissection compared to the group that had just ganglionar control (89% vs. 79%). CONCLUSIONS: We recommend local surgical treatment for T1-T2NO and in our experience prophylactic treatment of lymph nodes leads to a better regional control.

Evaluación de la mejoría en la capacidad pronóstica de la 5ª edición del TNM en pacientes con carcinomas de nasofaringe / Evaluation of the improved pronostic capacity of the 5th TNM edition in patient with nasopharyngeal carcinomas

Objetivo: Evaluar los cambios introducidos en la 5ª edición de la clasificación TNM en los pacientes con carcinoma de la nasofaringe. Pacientes y métodos: Estudio restrospectivo a partir de 103 pacientes con carcinomas de la nasofaringe tratados con intención radical en nuestro centro entre 1985-1997. Se procedió a la reclasificación de acuerdo con los criterios de la 5ª edición del TNM y a la comparación de los resultados obtenidos en el control loco-regional y la supervivencia al clasificar a los pacientes de acuerdo con la 4ª edición del TNM. Resultados: La aplicación de la 5ª edición del TNM condujo a una disminución en la categoría local (T) y la agrupación por estadios, mejorando la capacidad pronóstica en el control local y la supervivencia. Los cambios introducidos en la 5ª edición TNM no modificaron de forma sustancial la clasificación a nivel regional. Conclusión: Las modificaciones introducidas en la 5ª edición del TNM suponen una mejora en la clasificación de los pacientes con carcinomas de la nasofaringe (AU)

OBJECTIVE: Evaluate the changes included in the 5th edition of the TNM classification in patients with nasopharyngeal carcinoma. PATIENTS AND METHODS: Retrospective study of 103 patients with nasopharyngeal carcinoma treated with radical intention in our centre from 1985 to 1997. A reclassification according to the criteria defined in the 5th edition of the TNM was carried out. The loco-regional control and survival obtained when patients were classified with the 4th and 5th editions of the TNM were compared. RESULTS: The use of the 5th edition of the TNM led to a decrease in local category (T) and stage grouping, improving the prognostic capacity in local control and survival. The changes included in the 5th edition of the TNM did not modify the regional classification in a essential way. CONCLUSIONS: The changes included in the 5th edition of the TNM improved the classification of patients with nasopharyngeal carcinoma (AU)

[Consequences of the bilateral vagus nerve section at a cervical level]. / Consecuencias de la sección bilateral del vago a nivel cervical.

We present the consequences corresponding to a bilateral section of the main trunk of vagus nerve at cervical level in a patient with an oropharyngeal carcinoma with bilateral neck nodes. As a consequence of the bilateral resection of both vagus nerves during neck dissections, as well as motor and sensitive damage of the larynx and pharynx, we could observe affection of the normal tone of the oesophagus, stomach and duodenum which forced to enteral nutrition by direct jejunal access, and a disorder of the cardiac rhythm due to loss of the parasympathetic innervation appeared.

Tratamiento de los estadios iniciales (T1-T2N0) del carcinoma de lengua móvil / Treatment For The Early Stages (T1-T2N0) of squamous cell carcinoma of the mobile tongue

Objetivo: Analizar los resultados del tratamiento local en los pacientes afectos de un carcinoma de lengua móvil en estadios iniciales y establecer la mejor actitud en el manejo de las áreas ganglionares clínicamente negativas (N0). Material y Métodos: Se realizó un estudio retrospectivo sobre 90 pacientes clasificados como T1-T2N0 de lengua móvil, 68 (75 por ciento) tratados con radioterapia y 22 (25 por ciento) con cirugía entre los años 1984 y 1999. En el 39 por ciento (35/90) de los pacientes se realizó tratamiento ganglionar y en el 61 por ciento (55/90) seguimiento clínico estrecho. Resultados: El control local final en los pacientes T1N0 tratados tanto con cirugía como con radioterapia fue excelente (94 por ciento vs. 95 por ciento). En los T2N0 el control local final fue del 100 por ciento en los pacientes tratados quirúrgicamente superior al 77 por ciento de los pacientes irradiados. El control regional final fue superior en el grupo de pacientes donde se trataron las áreas ganglionares respecto al grupo donde se realizó seguimiento clínico (89 por ciento vs 79 por ciento). Conclusiones: Tanto la cirugía como la radioterapia son modalidades terapéuticas que ofrecen resultados similares. La tendencia actual es llevar a cabo un tratamiento quirúrgico en los T1-T2 N0, por la sencillez de la técnica y las mínimas secuelas encontradas. En nuestra experiencia, el tratamiento profiláctico de las áreas ganglionares conduce a un mejor control regional de la enfermedad. (AU)

OBJECTIVE: The aim of this study is to define the best local treatment in patients with squamous cell carcinoma of mobile tongue in the early stages (I-II) and to establish the best election for neck management. MATERIAL AND METHODS: We evaluated 90 patients classified as stage I and II between 1984 and 1999. Sixty-eight patients out of the ninety (75%) were treated with radio-therapy and twenty-two (25%) with surgery. Neck dissection was used in 39% (35/90) of patients. RESULTS: The rates of ultimate local control for T1NO lesions were similar for both treatment groups (94% vs. 95%). For T2N0 lesions the ultimate local control did improved in those patients treated with surgery (100%) compared to those that had radiotherapy (77%). Regional control was better in the group that underwent neck dissection compared to the group that had just ganglionar control (89% vs. 79%). CONCLUSIONS: We recommend local surgical treatment for T1-T2NO and in our experience prophylactic treatment of lymph nodes leads to a better regional control (AU)

[Treatment of T1N0 glottis carcinoma with radiotherapy. Results at our center and review of the literature]. / Tratamiento de los carcinomas de glotis T1N0 con radioterapia. Resultados de nuestro centro y una revisión de la literatura.

OBJECTIVE: To evaluate the results of radiotherapy in the treatment of patients with T1N0 glottic squamous cell carcinoma. MATERIAL AND METHODS: Retrospective study of a cohort of 338 patients with T1N0 glottic carcinoma treated with radiotherapy at our institution between 1985-1997. A review of the literature published during the last ten years was carried out. RESULTS: Local control with radiotherapy in our patients was 82%, reaching 97% when salvage surgery was included. The local control with radiotherapy in most of the published series ranges between 81.90%. CONCLUSIONS: Treatment with radiotherapy achieves local control in early glottic carcinomas (T1N0) in 80-90% of cases. In our centre such treatment achieved local control in 82% of cases.

Consecuencias de la sección bilateral del vago a nivel cervical / Consequences of the bilateral vagus nerve section at a cervical level

Presentamos la clínica correspondiente a la sección bilateral del tronco principal del nervio vago a nivel cervical en un paciente con un carcinoma de orofaringe con afectación ganglionar bilateral. Como consecuencia de la exéresis de ambos nervios vagos en el curso de cirugía ganglionar, además de la afectación motora y sensitiva a nivel laringo-faríngeo, se produjo una atonía esófago-gastro-duodenal que obligó a nutrición enteral con acceso directo a yeyuno, y una alteración del ritmo cardíaco por pérdida de estimulación parasimpática (AU)

We present the consequences corresponding to a bilateral section of the main trunk of vagus nerve at cervical level in a patient with an oropharyngeal carcinoma with bilateral neck nodes. As a consequence of the bilateral resection of both vagus nerves during neck dissections, as well as motor and sensitive damage of the larynx and pharynx, we could observe affection of the normal tone of the oesophagus, stomach and duodenum which forced to enteral nutrition by direct jejunal access, and a disorder of the cardiac rhythm due to loss of the parasympathetic innervation appeared (AU)

Tratamiento de los carcinomas de glotis T1N0 con radioterapia. Resultados de nuestro centro y una revisión de la literatura / Radiotherapy in the treatment of T1N0 glottic carcinomas. Our results and review of the literature

Objetivo: Evaluar los resultados conseguidos con radioterapia en el tratamiento de pacientes con carcinomas escamosos de la glotis T1N0. Material y métodos: Estudio retrospectivo de una cohorte de 338 pacientes con carcinomas glóticos T1N0 tratados con radioterapia en nuestro centro durante el período 1985-1997. Se efectuó una revisión de la bibliografía publicada en los diez últimos años. Resultados: El control local con la radioterapia en nuestros pacientes fue del 82 por ciento, alcanzando un control local final al incluir la cirugía de rescate del 97 por ciento. La tasa de preservación de la función laríngea fue del 86 por ciento. El control local con radioterapia en la mayoría de las series publicadas en los últimos años osciló entre el 81-90 por ciento. Conclusiones: La radioterapia consigue un control local de los tumores incipientes del plano glótico (T1N0) en un 80-90 por ciento de las ocasiones. En nuestro centro este tipo de tratamiento consiguió un control local en el 82 por ciento de las ocasiones. (AU)

OBJECTIVE: To evaluate the results of radiotherapy in the treatment of patients with T1N0 glottic squamous cell carcinoma. MATERIAL AND METHODS: Retrospective study of a cohort of 338 patients with T1N0 glottic carcinoma treated with radiotherapy at our institution between 1985-1997. A review of the literature published during the last ten years was carried out. RESULTS: Local control with radiotherapy in our patients was 82%, reaching 97% when salvage surgery was included. The local control with radiotherapy in most of the published series ranges between 81.90%. CONCLUSIONS: Treatment with radiotherapy achieves local control in early glottic carcinomas (T1N0) in 80-90% of cases. In our centre such treatment achieved local control in 82% of cases (AU)

[Isolated lymphatic recurrences in patients with head and neck carcinomas]. / Recidivas ganglionares aisladas en pacientes con carcinomas de cabeza y cuello.

OBJECTIVE: Recurrencies of lymphatic metastasis implies a poor prognosis in patients with head and neck carcinoma. The aim of our study is to analyse the results of salvage treatment after an isolated regional tumour recurrence. MATERIAL AND METHODS: Retrospective study of 144 patients with head and neck carcinoma with an isolated neck recurrence. The treatments used, regional control and patient's survival were analysed. RESULTS: Sixty-four percent (92/144) of patients were not candidates to salvage treatment with radical intention. Salvage surgery was performed in 36% (52/144) of patients, with a survival of 46% in this group of patients. Previous treatment of the neck was the most relevant variable to decide a salvage surgery. Patients treated initially with neck dissection had the worst prognosis. CONCLUSIONS: The existence of a regional recurrence has a bad prognosis, with 16% 5-year survival. Only 36% of patients were considered candidates to salvage treatment, achieving 46% of survival.

Prevalencia en el consumo de tabaco y alcohol tras tratamiento en pacientes con carcinomas de cabeza y cuello: un estudio transversal / Prevalence of tobacco and alcohol use following treatment in patients with head and neck squamous carcinoma: a transversal study

Objetivo: Evaluar la prevalencia en el consumo de tabaco y alcohol tras el tratamiento en los pacientes con carcinomas escamosos de cabeza y cuello en nuestro centro, y determinar posibles factores relacionados con dicho consumo. Material y Métodos: Se llevó a cabo un estudio transversal del consumo de tabaco y alcohol post-tratamiento en los pacientes con antecedentes de carcinomas de cabeza y cuello que acudieron a consulta ambulatoria. Resultados: Del total de 582 pacientes evaluados, un 13% persistía en el consumo de tabaco, y un 21% en el consumo habitual de alcohol. Las variables que se relacionaron con la persistencia de tabaquismo fueron el tipo de tratamiento empleado y el uso previo de tabaco. Las variables relacionadas con el consumo de alcohol post-tratamiento fueron la edad, el sexo, y los consumos previos de tabaco y alcohol. Conclusiones: A pesar de los consejos en contra, un 13% de los pacientes con antecedente de carcinoma escamoso de cabeza y cuello persistieron en el consumo de tabaco, y un 21% en el consumo de alcohol (AU)

OBJECTIVE: To evaluate the prevalence of tobacco and alcohol use following treatment in patients with head and neck squamous cell carcinoma, and to determine factors possibly related to this use. MATERIAL AND METHODS: A transversal study on tobacco and alcohol use following treatment for head and neck squamous cell carcinoma was performed in patients on ambulatory visits to our center. RESULTS: From 582 patients evaluated, 13% regularly smoked post-treatment, and 21% consumed alcohol. The related variables for tobacco use post-treatment were the kind of treatment received and previous tobacco use. The related variables for alcohol use post-treatment were age, sex and previous use of tobacco and alcohol. CONCLUSIONS: Despite warnings, 13% of patients with previous head and neck squamous cell carcinoma continued smoking and 21% persisted in alcohol use (AU)

[Design, maintenance, and exploitation of an oncologic database for patients with malignant tumors of the head and neck]. / Diseño, mantenimiento y explotación de una base de datos oncológica para pacientes con tumores malignos de cabeza y cuello.

The oncological databases are essential in the evaluation of the results of patients with malignant tumours. We present the design of the database that collects the oncological information of patients with head and neck malignant tumours diagnosed in our centre since 1984, and the needs of maintenance and possibilities of exploitation.

Diseño, mantenimiento y explotación de una base de datos oncológica para pacientes con tumores malignos de cabeza y cuello / Design, maintenance and explotation of an oncological database for patients with malignant head and neck tumours

Las bases de datos oncológicas son imprescindibles en la evaluación de resultados en los pacientes con tumores malignos. Presentamos el diseño de la base de datos que recoge la información oncológica de los pacientes con tumores malignos de cabeza y cuello diagnosticados en nuestro centro desde el año 1984, así como los requerimientos de mantenimiento de dicha base de datos y las posibilidades de explotación. (AU)

The oncological databases are essential in the evaluation of the results of patients with malignant tumours. We present the design of the database that collects the oncological information of patients with head and neck malignant tumours diagnosed in our centre since 1984, and the needs of maintenance and possibilities of exploitation (AU)

[Prevalence of tobacco and alcohol use following treatment in patients with head and neck squamous carcinoma: a cross-sectional study]. / Prevalencia en el consumo de tabaco y alcohol tras tratamiento en pacientes con carcinomas de cabeza y cuello: un estudio transversal.

OBJECTIVE: To evaluate the prevalence of tobacco and alcohol use following treatment in patients with head and neck squamous cell carcinoma, and to determine factors possibly related to this use MATERIAL AND METHODS: A transversal study on tobacco and alcohol use following treatment for head and neck squamous cell carcinoma was performed in patients on ambulatory visits to our center. RESULTS: From 582 patients evaluated, 13% regularly smoked post-treatment, and 21% consumed alcohol. The related variables for tobacco use post-treatment were the kind of treatment received and previous tobacco use. The related variables for alcohol use post-treatment were age, sex and previous use of tobacco and alcohol. CONCLUSIONS: Despite warnings, 13% of patients with previous head and neck squamous cell carcinoma continued smoking and 21% persisted in alcohol use.

[Glottic immobility: retrospective study of 229 cases]. / Inmovilidad glótica: estudio retrospectivo de 229 casos.

A retrospective study of the unilateral and bilateral vocal fold immobility cases diagnosed at our hospital between 1985 and 1998 was carried out. Of the 229 cases studied, vocal fold immobility was bilateral in 58 patients (25%), unilateral right in 60 (26%), and unilateral left 111 (49%). The most frequent etiologies in the bilateral cases were thyroid surgery (38%) and prolonged intubation (31%); idiopathic cases (32%) and thyroid surgery (23%) in the unilateral right cases; and idiopathic cases (28%) and extralaryngeal tumors (22%) in the unilateral left cases. Clinical compensation was achieved in more than 85% of cases of unilateral immobility when the etiology was idiopathic or due to surgical damage to the recurrent or vagus nerves, 70% when it was a prolonged intubation, 56% in neurological patients and 38% in extralaryngeal tumors. In patients with bilateral vocal fold immobility, 14% did not require any treatment, 34% had a permanent tracheostomy, and 52% recovered adequate naso-oral ventilation after surgery (tracheostomy only in 12 patients and arytenoidectomy in 18 patients).

Results of salvage surgery for local or regional recurrence after larynx preservation with induction chemotherapy and radiotherapy.

BACKGROUND: After treatment of locally advanced laryngeal carcinomas with induction chemotherapy and radiotherapy, some patients suffer a local or regional failure of the tumor, and salvage surgery is required. The aim of this study was to review the results of such salvage surgery in this group of patients. METHODS: A retrospective study of a cohort of 110 patients diagnosed between 1989 and 1996 with a locally advanced laryngeal carcinoma (T3-T4) treated with induction chemotherapy and radiotherapy was performed. The results of salvage surgery in patients with a local and/or regional failure of the treatment were analyzed. RESULTS: Forty-two patients presented a local and/or a regional recurrence of the tumor: 26 patients in the larynx, eight in the neck, and a further eight in both in the larynx and the neck. Salvage surgery was carried out in 28 patients (67%), consisting of total laryngectomies with neck dissections (24 cases), endoscopic resection of the tumor (one case), and radical neck dissections (three cases). Five-year adjusted survival for the 42 patients was 38%. Five-year survival for the 28 patients treated with salvage surgery was 57%. Five patients had postoperative complications: four had pharyngo-cutaneous fistulas and one had wound infection. CONCLUSIONS: After a local and/or regional recurrence, 67% of patients with advanced laryngeal carcinoma treated with induction chemotherapy and radiotherapy were candidates to salvage surgery. Five-year adjusted survival for this group of patients was 57%.