Evaluation of Surgical and Functional Outcomes of Supracri- coid Laryngectomy and Rehabilitation Protocols.

ABSTRACT: Laryngeal squamous cell carcinoma (LSCC) is the most common malignant neoplasms of the head and neck. Several treatment options exist for LSCC according to cancer location and stage at diagnosis; proposed treatments include surgery alone or in combination with chemotherapy and radiotherapy. In selected LSCC cases in the T2-T4 staging, supracricoid laryngectomy (SCL) is an organ-sparing surgical approach aimed at preserving the main laryngeal functions that has been proposed as an alternative to total laryngectomy. Rehabilitation for swallowing and respiratory functions plays a central role after SCL; functional outcomes after SCL may significantly vary among different centers but they are generally satisfactory when oncological radicality has been obtained and the rehabilitation protocol starts promptly. In this clinical review, we analyzed functional outcomes for swallowing and voice rehabilitation in patients after SCL, as well as the optimal SCL surgical technique, post-operative complications and comparison with total laryngectomy or radio-chemotherapy protocols.

Transoral laser microsurgery for Tis, T1, and T2 glottic carcinoma: 5-year follow-up.

The aim of this retrospective study is to evaluate the results obtained with CO2 TOLMS in patients with Tis, T1, and T2 glottic tumors at our Department from 2004 to 2016 treated with CO2 TOLMS. One hundred eighty-five patients having a median age of 67 years (range 42-88) were included in the present analysis. The tumor stages of the patients included 134 pTis-T1a, 12 pT1b, and 39 pT2 cases. Median duration of follow-up for the whole study cohort was 55 months (range 24-108 months). At 5-year follow-up, local control was 91%, 83%, and 79.4% for T1a, T1b, and T2 respectively. Disease-specific survival was 95.5%, 91.6%, and 92.3%. Overall survival was 73.8%, 91.6%, and 82%, and larynx preservation was 96.2%, 83%, and 84.6%. This study confirms that CO2 TOLMS is a safe and standard therapy for selected T1 and T2 glottic carcinoma, and our review on T2 glottic cancer suggests that CO2 TOLMS represents a reliable option in terms of overall survival, disease-specific survival, and laryngeal preservation. However, patients with anterior commissure involvement and T2 cancer should be evaluated with a preoperative MRI in order to exclude the infiltration of the laryngeal framework and to quantify the neoplastic involvement of para-glottic space.

Glomangiopericytoma-type glomus tumour/myopericytoma of the lip.

We describe the case of a 46-year-old man who presented with a four-month history of a reddish, otherwise asymptomatic, nodular lesion that involved the mucosal side of the upper lip. The lesion consisted of myoid glomus-like cells arranged around branching and thin-walled haemangiopericytoma-like vascular structures, and was classified as glomangiopericytoma. No recurrences occurred during an eight-month follow-up. To the best of our knowledge, this tumour has never previously been described in the mucosa of the lip.

Multiple positive and negative cis-acting elements of the STA2 gene regulate glucoamylase synthesis in Saccharomyces cerevisiae.

Expression of the glucoamylase-encoding gene (STA2) in Saccharomyces cerevisiae was previously shown to be regulated transcriptionally by both positive and negative factors. The objective of this work was to identify the cis-acting elements responsible for STA2 transcriptional activation as well as the transcriptional repressor effects of STA10 and MATa/MAT alpha. We identified two upstream activation regions (UAS). Three repressor regions responsive to STA10-mediated repression were identified, as well as two regions for down-regulation of STA2 expression. MATa/MAT alpha repression appears to effect STA2 expression either downstream from the translational start site or, indirectly, since no functional a1/alpha 2-responsive sequence was identified in the promoter region.