[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.

[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.

[Leiomyosarcoma of the larynx. Based on one case]. / Leiomiosarcoma de laringe. A propósito de un nuevo caso.

Leiomyosarcoma is a malignant tumour of smooth muscle cells. Usually is found in the gastrointestinal and female genital tracts, but is extremely rare in the larynx. Diagnosis is based in immunohistochemical studies. From the related literature is concluded that this tumour has a very aggressive behavior, with a very bad prognosis in spite of a radical surgery. A case of glottic Laryngeal Leiomyosarcoma (LL) treated with partial surgery is presented, There isn't any evidence of recurrent or metastases after a two years follow-up.

Can cure be achieved in patients with head and neck carcinomas? The problem of second neoplasm.

The improvement in locoregional control of head and neck carcinomas over the last few decades does not appear to modify the final survival of these patients, mainly due to the appearance of distant metastases and second neoplasms. This article reviews the topic of second neoplasm in patients with an index tumor in the head and neck, making a special point of the incidence and epidemiology of second neoplasms, the influence on prognosis, etiopathogenic theories and the possibility of prevention.

Distant metastases in head and neck cancer patients who achieved loco-regional control.

BACKGROUND: One of the reasons for failure in patients with head and neck carcinoma who achieve locoregional control with treatment is the appearance of distant metastases. The objective of this study was to evaluate the frequency of distant metastases in this group of patients and to determine the relative role of several prognostic factors in the subsequent development of distant metastases. DESIGN: Retrospective study from a database that collects the information prospectively in a cohort of patients with head and neck carcinoma. Patients and Methods The study was carried out in 1244 patients with oral cavity, pharyngeal, or laryngeal carcinoma who achieved locoregional control. We evaluated the frequency of distant metastases and the influence of different variables in their appearance. RESULTS: Five percent of patients with locoregional control had distant metastases. In the univariate study, the variables that influenced the appearance of distant metastases were tumor site, T stage, N stage, and histologic differentiation. On multivariate analysis, the variables that increased the risk of distant metastases were N stage, T stage, and the location of the tumor at the hypopharynx and the supraglottis. CONCLUSIONS: Five percent of patients with oral cavity, pharyngeal, or laryngeal carcinomas who achieved locoregional control died as a consequence of the development of distant metastases. The factors that significantly increased the risk of distant metastases in this group of patients were the advanced local and regional extension of the tumor and the location at the hypopharynx or supraglottis.

[Differential features of transglottic carcinoma]. / Características diferenciales de los carcinomas transglóticos.

A study was made of the differential features of transglottic laryngeal carcinomas. We made a retrospective study of patients with laryngeal carcinoma diagnosed in our center from 1985 to 1996. In this period, 1212 laryngeal carcinomas were diagnosed, of which 99 (8%) were considered transglottic. In relation to factors such as sex, toxic habits, level of histological differentiation or affected nodes, patients with transglottic carcinomas had characteristics that were intermediate between patients with glottic and supraglottic carcinomas. An analysis was made of the treatments and the results obtained in patients treated with radical intention and a minimum follow-up of 3 years. The treatment most frequently used in patients with transglottic carcinoma was surgery (total laryngectomy) and complementary radiotherapy. The 5-year actuarial adjusted survival rate jor patients with transglottic carcinoma was 78%, which was intermediate between the survival rates of patients with glottic (90%) or supraglottic (69%) carcinoma.