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1.
Crit Rev Oncol Hematol ; 160: 103298, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33716199

RESUMO

INTRODUCTION: Recurrent early glottic cancer (rEGC) poses several issues in terms of timely diagnosis, correct re-staging, and treatment. We want to critically review the latest evidence about rEGC considering its epidemiology, biology, diagnostic challenges, and treatment strategies. METHODS: A systematic search of the literature using PubMed from 1990 to October 31, 2020 was performed. RESULTS: There are many different treatment options available (open surgery, transoral mini-invasive surgery, radiotherapy), and many factors related to the patient's status and previous treatments must be considered when planning the best management strategy for rEGC. While its overall prognosis remains satisfactory, it is of the utmost importance to appreciate all the clinical implications derived from the choice of the initial therapeutic modality, and from a correct primary and recurrent staging. CONCLUSION: The balance between oncological and voice and swallowing functions represents the fundamental principle underlying rEGC management. Future studies should focus on molecular profiling of rEGC, and on the results of the emerging radiation delivery techniques and mini-invasive procedures.


Assuntos
Neoplasias Laríngeas , Neoplasias da Língua , Glote/patologia , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/terapia , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/terapia , Estadiamento de Neoplasias , Prognóstico , Resultado do Tratamento
2.
DNA Cell Biol ; 40(2): 247-264, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33481663

RESUMO

Establishing epigenetic signature to improve the accuracy of survival prediction and optimize therapeutic strategies for laryngeal squamous cell carcinoma (LSCC) by a genome-wide integrated analysis of methylation and the transcriptome. LSCC DNA methylation datasets and RNA sequencing datasets were acquired from the Cancer Genome Atlas (TCGA). MethylMix was applied to detect DNA methylation-driven genes (MDGs), which developed an epigenetic signature. The predictive accuracy and clinical value of the epigenetic signature were evaluated by receiver operating characteristic and decision curve analysis, and compared with tumor-node-metastasis (TNM) stage system. In addition, prognostic value of the epigenetic signature was validated by external Gene Expression Omnibus (GEO) database. According to five MDGs of epigenetic signature, the candidate small molecules for LSCC were screen out by the CMap database. A total of 88 DNA MDGs were identified, five of which (MAGEB2, SUSD1, ZNF382, ZNF418, and ZNF732) were chosen to construct an epigenetic signature. The epigenetic signature can effectively divide patients into high-risk and low-risk group, with the area under curve (AUC) of 0.8 (5-year overall survival [OS]) and AUC of 0.745 (3-year OS). Stratification analysis affirmed that the epigenetic signature was still a significant statistical prognostic model in subsets of patients with different clinical variables. Multivariate Cox regression analysis indicated that the efficacy of epigenetic signature appears independent of other clinicopathological characteristics. In terms of predictive capacity and clinical usefulness, the epigenetic signature was superior to traditional TNM stage. In addition, the epigenetic signature was confirmed in external LSCC cohorts from GEO. Finally, CMap matched the 10 most significant small molecules as promising therapeutic drugs to reverse the LSCC gene expression. An epigenetic signature, with five DNA MDGs, was identified and validated in LSCC patients by integrating multidimensional genomic data, which may offer novel research directions and prospects for individualized treatment of patients with LSCC.


Assuntos
Epigênese Genética , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Adulto , Metilação de DNA , Feminino , Humanos , Neoplasias Laríngeas/patologia , Masculino , Estadiamento de Neoplasias , Prognóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Análise de Sobrevida
3.
BMJ Case Rep ; 14(1)2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504538

RESUMO

A 32-year-old man with Down's syndrome was referred to the ear, nose and throat (ENT) department in view of failed attempts at extubation, and subsequently, at decannulation of tracheotomy tube. He had previously required ventilatory support and had history of intubation for 1 week. A flexible fibre-optic laryngoscopy showed a smooth mass covering the laryngeal inlet which moved with respiration. Direct laryngoscopy under general anaesthesia revealed a smooth mucosa covered fleshy mass arising from the left aryepiglottic fold and arytenoid, obstructing the laryngeal inlet. The mass was removed using controlled plasma ablation, and histopathological examination of the same was consistent with lymphangioma. Endoscopic examinations during the regular follow-up visits revealed well-healed supraglottic area with adequate glottic chink and the patient could be successfully decannulated.


Assuntos
Obstrução das Vias Respiratórias/diagnóstico , Neoplasias Laríngeas/diagnóstico , Linfangioma/diagnóstico , Técnicas de Ablação , Adulto , Obstrução das Vias Respiratórias/complicações , Obstrução das Vias Respiratórias/cirurgia , Infecções Comunitárias Adquiridas/terapia , Síndrome de Down/complicações , Humanos , Neoplasias Laríngeas/complicações , Neoplasias Laríngeas/cirurgia , Laringoscopia , Linfangioma/complicações , Linfangioma/cirurgia , Masculino , Pneumonia/terapia , /terapia , Traqueostomia
4.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33461999

RESUMO

Solitary neurofibromas of the larynx are extremely rare, with a total of 15 cases described in the literature. Nonetheless, acquaintance with this diagnosis is important, as misdiagnoses can have negative consequences. Presenting symptoms are non-specific and depend on tumour size and location. As well-defined submucosal masses with a broad differential diagnosis, they remain a clinical and radiological challenge. While some characteristics might favour a benign nature and subtle signs might help narrow the differential diagnosis, imaging alone is not sufficient for differentiation and definitive diagnosis requires a biopsy. Complete surgical resection and long-term follow-up is indicated. We share our experience on a case of a solitary laryngeal neurofibroma in a middle-aged woman, presenting with a large well-defined paraglottic lesion.


Assuntos
Neoplasias Laríngeas/diagnóstico , Neurofibroma/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade
5.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370978

RESUMO

A 57-year-old male chronic smoker with underlying diabetes mellitus presented with dysphonia associated with cough, dysphagia and reduced effort tolerance of 3 months' duration. Videoendoscope finding revealed bilateral polypoidal and erythematous true and false vocal fold with small glottic airway. The patient was initially treated as having tuberculous laryngitis and started on antituberculous drug. However, no improvement was observed. CT of the neck showed erosion of thyroid cartilage, which points to laryngeal carcinoma as a differential diagnosis. However, the erosion was more diffuse and appeared systemic in origin. The diagnosis of laryngeal perichondritis was made when the histopathological examination revealed features of inflammation, and the tracheal aspirate isolated Pseudomonas aeruginosa The patient made a good recovery following treatment with oral ciprofloxacin.


Assuntos
Doenças da Laringe/diagnóstico , Infecções por Pseudomonas/diagnóstico , Pseudomonas aeruginosa/isolamento & purificação , Antibacterianos/uso terapêutico , Ciprofloxacino/uso terapêutico , Tosse/microbiologia , Transtornos de Deglutição/microbiologia , Diagnóstico Diferencial , Disfonia/microbiologia , Humanos , Doenças da Laringe/complicações , Doenças da Laringe/tratamento farmacológico , Doenças da Laringe/microbiologia , Neoplasias Laríngeas/diagnóstico , Laringoscopia , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/microbiologia , Cartilagem Tireóidea/diagnóstico por imagem , Cartilagem Tireóidea/microbiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose Laríngea/diagnóstico , Prega Vocal/diagnóstico por imagem , Prega Vocal/microbiologia
6.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370999

RESUMO

Juvenile respiratory laryngeal papillomatosis is a subset of a larger clinical entity of recurrent respiratory papillomatosis. It is characterised by the development of recurrent papillomata in the vocal folds. Human papillomavirus types 6 and 11 has been implicated to be the most common strain of virus associated with the formation of laryngeal papilloma. Clinical diagnosis is based on typical appearance of warty lesion on endoscopy. Surgery is the primary line of management along with adjuvant therapy like antiviral drugs and immunomodulators. Thuja occidentalis is a tree native to North America whose leaves and leaf oil have antiviral, antibacterial and antifungal properties. It has been widely used for the treatment of condylomatous skin lesions and warts. Here we discuss the outcome of thuja as an adjuvant therapy in the treatment of laryngeal papillomatosis in an 8-year-old child.


Assuntos
Neoplasias Laríngeas/terapia , Recidiva Local de Neoplasia/terapia , Papiloma/terapia , Extratos Vegetais/administração & dosagem , Thuja/química , Traqueostomia , Quimioterapia Adjuvante/métodos , Criança , Relação Dose-Resposta a Droga , Esquema de Medicação , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/patologia , Laringoscopia , Laringe/diagnóstico por imagem , Laringe/patologia , Laringe/cirurgia , Masculino , Recidiva Local de Neoplasia/diagnóstico , Papiloma/diagnóstico , Papiloma/patologia , Reoperação , Resultado do Tratamento
7.
J Breath Res ; 14(4): 046013, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33021204

RESUMO

Volatile organic compound (VOC) breath testing of lung and head and neck squamous cell carcinoma (SCC) has been widely studied, however little is known regarding VOC profiles of in-situ SCC. A prospective study of VOC in patients with histologically proven SCC, either in-situ or advanced, and controls. Breath samples were analysed using the E-nose Cyranose ®320 and by gas chromatography/mass spectroscopy. Predictive models were developed using bootstrap forest using all 32 sensors. Data from 55 participants was analysed: 42 SCC cases comprising 20 bronchial (10 in-situ, 10 advanced) and 22 laryngeal (12 in-situ, 10 advanced), and 13 controls. There were 32 (76%) male SCC cases with mean age 63.6 (SD = 9.5) compared with 11 (85%) male controls with mean age 61.9 (SD = 10.1). Predictive models for in situ cases had good sensitivity and specificity compared to controls (overall, 95% and 69%; laryngeal, 100% and 85%; bronchial, 77% and 80%). When distinguishing in-situ and advanced tumours, sensitivity and specificity 82% and 75% respectively. For different tumour types (bronchial versus advanced laryngeal) sensitivity and specificity were 100% and 80% respectively. VOCs isolated from in-situ cancers included some previously demonstrated in advanced cancers and some novel VOCs. In-situ bronchial and laryngeal cancer can be detected by VOC analysis. Distinction from normal controls and between the two tumour types could allow screening in high risk groups for these curable lesions.


Assuntos
Testes Respiratórios/métodos , Neoplasias Brônquicas/diagnóstico , Carcinoma in Situ/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Neoplasias Laríngeas/diagnóstico , Compostos Orgânicos Voláteis/análise , Brônquios/patologia , Broncoscopia , Estudos de Casos e Controles , Feminino , Fluorescência , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Laringe/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
8.
J Otolaryngol Head Neck Surg ; 49(1): 59, 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32778168

RESUMO

With the COVID-19 pandemic, there has been significant changes and challenges in the management of oncology patients. One of the major strategies to reduce transmission of the virus between patients and healthcare workers is deferral of follow-up visits. However, deferral may not be possible in total laryngectomy patients. Urgent procedures may be necessary to prevent complications related to ill-fitting tracheoesophageal puncture (TEP) voice prostheses, such as aspiration or loss of voicing. In this paper, we describe the Princess Margaret Cancer Center's approach to managing this unique patient population.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Neoplasias Laríngeas/cirurgia , Laringectomia/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecção Hospitalar/prevenção & controle , Procedimentos Cirúrgicos Eletivos/métodos , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico , Laringectomia/métodos , Laringe Artificial , Masculino , Ontário , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Implantação de Prótese/métodos , Implantação de Prótese/estatística & dados numéricos , Medição de Risco
9.
HNO ; 68(10): 757-762, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32789706

RESUMO

The German S3 guideline on diagnosis, treatment, and follow-up of laryngeal cancer was developed in 2019 as part of the oncology guideline program of the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF) of the German Cancer Society (Deutsche Krebsgesellschaft, DKG) and German Cancer Aid (Deutsche Krebshilfe, DKH), published under the leadership of the German Society for Otorhinolaryngology, Head and Neck Surgery. The guideline was funded by DKH as part of the oncology guideline program. Since guidelines are an important tool for quality assurance and quality management in oncology, they should be incorporated into everyday care in a targeted and sustainable manner. The guideline should generally fulfil the interdisciplinary character of early diagnosis, diagnostics, treatment, rehabilitation, and follow-up, with the aim of developing evidence- and consensus-based recommendations and statements for treatment of laryngeal cancer with the aim of organ preservation, but also show their limits. The main recommendations of the original text are summarized. The guideline is available as a long and a short version in the guideline program of the DKG ( https://www.leitlinienprogramm-onkologie.de/leitlinien/larynxkarzinom/ ) and also as an app ( https://www.leitlinienprogramm-onkologie.de/app/ ).


Assuntos
Neoplasias Laríngeas , Seguimentos , Alemanha , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/terapia , Oncologia , Guias de Prática Clínica como Assunto , Sociedades Médicas
10.
BMC Surg ; 20(1): 173, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32736545

RESUMO

BACKGROUND: Laryngeal rhabdomyosarcomas (RMSs) mainly occurred in children, while were extremely rare in adults. Consequently, less information was available to guide clinicians to manage adult RMSs in larynx. CASE PRESENTATION: A 42-year-old man presented with a 2-year history of gradually worsening hoarseness. Then, he underwent a surgery with suspension laryngoscope with initially being diagnosed as vocal cord cyst. Unexpectedly, the lesion was proved to be embryonal rhabdomyosarcoma (ERMS), pathologically. Next, he underwent chemoradiotherapy, while the tumor relapsed 18 months after the last treatment. Subsequently, a vertical hemilaryngectomy and a right selective neck dissection was performed, and the chemotherapy according to the anticancer drug sensitivity in vitro was arranged. Until the last check-up 18 months after chemotherapy, the patient did not display clinical or radiological signs of local recurrence and metastases. CONCLUSIONS: Misdiagnosis and missed diagnosis of laryngeal RMSs might appear when tumors presented as smooth protuberance. We reported the first case of laryngeal RMSs in an adult with the multidisciplinary strategy based on the chemosensitivity assay in vitro. Furthermore, a systematic review of the literature was also discussed, highlighting the initial diagnostic pitfalls and subsequent management problems that may occur with this uncommon tumor.


Assuntos
Neoplasias Laríngeas , Laringe , Recidiva Local de Neoplasia/terapia , Rabdomiossarcoma Embrionário , Adulto , Quimiorradioterapia , Terapia Combinada , Erros de Diagnóstico , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/terapia , Laringectomia , Laringe/cirurgia , Masculino , Esvaziamento Cervical , Rabdomiossarcoma Embrionário/diagnóstico , Rabdomiossarcoma Embrionário/cirurgia , Rabdomiossarcoma Embrionário/terapia
11.
Rev Assoc Med Bras (1992) ; 66(6): 784-788, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32696866

RESUMO

OBJECTIVE Long noncoding RNA (lncRNAs) are frequently abnormally expressed in tumors and involved in the occurrence and progression of human cancer. Recently, a disease-related lncRNA, TMPO antisense RNA 1 (TMPO-AS1), was identified to be dysregulated in several tumors. Hence, we aimed to demonstrate whether TMPO-AS1 could be a promising prognostic marker for patients with laryngeal squamous cell carcinoma (LSCC). METHODS RT-PCR was performed to test TMPO-AS1 expressions in 187 LSCC specimens compared with matched normal specimens. Chi-squared tests were used to determine the associations between TMPO-AS1 expressions and the clinicopathological characteristics of LSCC patients. Then, the clinical outcome of LSCC patients who had lower or higher TMPO-AS1 expression was analyzed using Kaplan-Meier assays. Finally, a Cox proportional hazards model was carried out to evaluate the prognostic values of TMPO-AS1 and other clinical features. RESULTS We found that TMPO-AS1 was distinctly upregulated in human LSCC tissues compared with corresponding normal specimens (p < 0.01). Higher expressions of TMPO-AS1 were observed to be positively associated with the clinical stage (p = 0.020) and lymph node metastasis (p = 0.027). A clinical study in 187 patients revealed that patients with TMPO-AS1 low expressions had poorer survival than those with TMPO-AS1 high expressions (p = 0.0012). In addition, the result of multivariate assays demonstrated TMPO-AS1 expression is an independent predictor for the overall survival of LSCC patients. CONCLUSIONS TMPO-AS1 might be considered a novel molecule involved in LSCC progression, which provides a possible prognostic biomarker.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Neoplasias Laríngeas/diagnóstico , Timopoietinas/metabolismo , Óxidos N-Cíclicos , Humanos , Prognóstico , RNA Longo não Codificante
12.
Rev. Assoc. Med. Bras. (1992) ; 66(6): 784-788, June 2020. tab, graf
Artigo em Inglês | LILACS, Sec. Est. Saúde SP | ID: biblio-1136281

RESUMO

SUMMARY OBJECTIVE Long noncoding RNA (lncRNAs) are frequently abnormally expressed in tumors and involved in the occurrence and progression of human cancer. Recently, a disease-related lncRNA, TMPO antisense RNA 1 (TMPO-AS1), was identified to be dysregulated in several tumors. Hence, we aimed to demonstrate whether TMPO-AS1 could be a promising prognostic marker for patients with laryngeal squamous cell carcinoma (LSCC). METHODS RT-PCR was performed to test TMPO-AS1 expressions in 187 LSCC specimens compared with matched normal specimens. Chi-squared tests were used to determine the associations between TMPO-AS1 expressions and the clinicopathological characteristics of LSCC patients. Then, the clinical outcome of LSCC patients who had lower or higher TMPO-AS1 expression was analyzed using Kaplan-Meier assays. Finally, a Cox proportional hazards model was carried out to evaluate the prognostic values of TMPO-AS1 and other clinical features. RESULTS We found that TMPO-AS1 was distinctly upregulated in human LSCC tissues compared with corresponding normal specimens (p < 0.01). Higher expressions of TMPO-AS1 were observed to be positively associated with the clinical stage (p = 0.020) and lymph node metastasis (p = 0.027). A clinical study in 187 patients revealed that patients with TMPO-AS1 low expressions had poorer survival than those with TMPO-AS1 high expressions (p = 0.0012). In addition, the result of multivariate assays demonstrated TMPO-AS1 expression is an independent predictor for the overall survival of LSCC patients. CONCLUSIONS TMPO-AS1 might be considered a novel molecule involved in LSCC progression, which provides a possible prognostic biomarker.


RESUMO OBJETIVO RNAs longos não-codificantes (INcRNAs) são frequentemente expressos anormalmente em tumores e estão envolvidos na ocorrência e progressão do câncer humano. Recentemente, um INcRNA relacionado com a doença, o TMPO antisense RNA 1 (TMPO-AS1), foi identificado como desregulado em vários tumores. Por isso, procuramos demonstrar se o TMPO-AS1 poderia ser um marcador de prognóstico promissor para pacientes com carcinoma de células escamosas da laringe (LSCC). MÉTODOS RT-PCR foi realizado para medir as expressões do TMPO-AS1 em 187 espécimes de LSCC em comparação com espécimes normais correspondentes. Foram utilizados testes Qui-quadrado para determinar as associações entre as expressões do TMPO-AS1 e as características clínicas dos pacientes com LSCC. Em seguida, o desfecho clínico dos pacientes com LSCC que tinham uma expressão do TMPO-AS1 inferior ou superior foi analisado com ensaios Kaplan-Meier. Por último, o modelo de riscos proporcionais de Cox foi utilizado para avaliar o valor prognóstico do TMPO-AS1 e outras características clínicas. RESULTADOS Observamos que o TMPO-AS1 estava claramente super-regulado nos tecidos de LSCC humanos em comparação com os espécimes normais correspondentes (p<0,01). Expressões mais elevadas de TMPO-AS1 estavam positivamente associadas ao estágio clínico (p=0,020) e à metástase linfática (p=0,027). Um estudo clínico com 187 pacientes revelou que aqueles com expressões mais baixas de TMPO-AS1 tiveram uma sobrevida pior do que aqueles com expressões elevadas de TMPO-AS1 (p=0,0012). Além disso, o resultado de ensaios multivariados demonstrou que a expressão do TMPO-AS1 é um preditor independente para a sobrevida global de pacientes com LSCC. CONCLUSÕES TMPO-AS1 pode ser considerado uma molécula nova envolvida na progressão do LSCC, o que proporciona um possível biomarcador de prognóstico.


Assuntos
Humanos , Timopoietinas/metabolismo , Carcinoma de Células Escamosas/diagnóstico , Neoplasias Laríngeas/diagnóstico , Prognóstico , Óxidos N-Cíclicos , RNA Longo não Codificante
13.
Acta otorrinolaringol. esp ; 71(supl.1): 1-20, jun. 2020. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-199879

RESUMO

La elección del tratamiento más adecuado en el cáncer glótico en estadio precoz con afectación de la comisura anterior sigue siendo controvertida. La complejidad en su manejo terapéutico está justificada por ser un significativo indicador pronóstico de control local, con un porcentaje de recidiva del 37%, por la dificultad en establecer la extensión tumoral con una infraestadificación que llega a alcanzar el 40%, y por la comparación de resultados en series formadas por tumores de diferente comportamiento evolutivo, como son T1a, T1b y T2a con afectación comisural. A estos datos se suma la complejidad del abordaje quirúrgico mediante microcirugía transoral con láser CO2 que requiere habilidad quirúrgica, equipamiento adecuado y experiencia. Los aspectos a revisar en este documento son: definición anatómica actualizada de la comisura anterior, progresión tumoral en función de estudios histopatológicos, utilidad de la videoestroboscopia y la NBI en la precisión diagnóstica, validez de las pruebas de imagen, resultados oncológicos publicados en revisión de series, revisiones sistemáticas y metaanálisis, tratamiento de los márgenes y evaluación de la voz. Finalmente, y a modo de resumen, el documento incluye una serie de recomendaciones para el tratamiento de estos tumores


The choice of the most appropriate treatment in early-stage glottic cancer with anterior commissure involvement remains controversial. Its therapeutic management is complex because it is a significant prognostic indicator of local control with 37% recurrence, due to the difficulty in establishing tumour extension with understaging of up to 40%, and due to the comparison of results in series on tumours that behave variably as they progress, such as T1a, T1b and T2a with commissure involvement. Furthermore, the complexity of the surgical approach using transoral CO2 laser microsurgery requires surgical skill, appropriate equipment and experience. Aspects to be reviewed in this document are: an updated anatomical definition of the anterior commissure, tumour progression based on histopathological studies, usefulness of videostroboscopy and NBI in diagnostic accuracy, validity of imaging tests, oncological results published in series reviews, systematic reviews and meta-analyses, tumour margin treatment and voice evaluation.Finally, by way of a summary, the document includes a series of recommendations for the treatment of these tumours


Assuntos
Humanos , Neoplasias Laríngeas/terapia , Neoplasias Laríngeas/diagnóstico , Glote , Neoplasias Laríngeas/patologia , Progressão da Doença
14.
Ann Otol Rhinol Laryngol ; 129(9): 930-934, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32340473

RESUMO

OBJECTIVES: To report a case of laryngeal involvement of mycosis fungoides and its symptomatic treatment with laser-assisted surgical ablation. METHODS: Case report and literature review. RESULTS: A 76-year-old woman with longstanding MF previously treated with Brentuximab Vedotin who developed persistent cough and dysphonia. The patient's laryngeal disease burden was treated with KTP-laser ablation and further reduced with doxorubicin and radiotherapy. CONCLUSIONS: Although laryngeal, and especially glottic, involvement is a rare finding, suspicion should be maintained in symptomatic patients with cutaneous mycosis fungoides. This the first reported surgical laser treatment of laryngeal symptoms in this context, which can greatly improve a patient's quality of life.


Assuntos
Neoplasias Laríngeas , Micose Fungoide , Prega Vocal , Idoso , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/cirurgia , Terapia a Laser , Micose Fungoide/diagnóstico , Micose Fungoide/cirurgia
15.
Ann R Coll Surg Engl ; 102(7): e152-e154, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32306741

RESUMO

Laryngeal haemangiomas can commonly be seen in children, and first-line treatment is usually propranolol. However, in adults, cavernous haemangioma of the vocal cord(s) is an extremely rare condition - with this being the only published adult case presenting with acute respiratory distress - the mainstay of treatment is surgical excision under microlaryngoscopy. Presentation in adults can be unpredictable, but primarily consists of hoarseness which can be associated with, dyspnoea, dysphagia, and haemoptysis - and in one documented case stenosis of the aero-digestive tract led to death. Due to these airway difficulties, surgery can often prove challenging. In this study, we explore the unusual case of a previously well 71-year-old gentleman presenting to the Emergency Department, with worsening shortness of breath as his primary complaint. Uniquely, in this case, an awake fibre-optic intubation was undertaken to manage the difficult airway and a microlaryngoscopy was performed. A 20x10x15mm lesion was excised, which had characteristics in keeping with a cavernous haemangioma on microscopic examination.


Assuntos
Hemangioma Cavernoso/complicações , Neoplasias Laríngeas/complicações , Prega Vocal , Idoso , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/cirurgia , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/cirurgia , Laringectomia/métodos , Laringoscopia , Masculino , Microcirurgia/métodos , /diagnóstico
16.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(2): 261-263, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32220198

RESUMO

A 75-year-old male patient was hospitalized in hoarseness for 2 months. Laryngoscopy showed a mass protruding in right laryngeal chamber and covering the middle part of right vocal cord. Since tumor biopsy showed low differentiation cancer, he received total laryngectomy, and post-operative pathological result found composite carcinoma, which containing medium differentiated squamous cell carcinoma (about 5%) and low differentiated neuroendocrine carcinoma (about 95%). The growth status of tumor indicated it was collision carcinoma. After postoperative regular radiotherapy, no recurrence was found at 6 months of follow-up. The incidence of head and neck collision carcinoma is quite low, and the majority of them occurs in thyroid, which is rare in larynx. The confirmed diagnosis of larynx collision carcinoma is based on postoperative pathological study. The choice of treatment for collision cancer is closely related to the pathological components, the location of the disease and whether there is distant metastasis.


Assuntos
Carcinoma Neuroendócrino , Carcinoma de Células Escamosas , Neoplasias Laríngeas , Idoso , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/patologia , Carcinoma Neuroendócrino/cirurgia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Diferenciação Celular , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Laringe/patologia , Masculino , Recidiva Local de Neoplasia
18.
Sci Rep ; 10(1): 4676, 2020 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-32170175

RESUMO

Laryngeal cancer (LC) patients who meet the age and smoking criteria of the U.S. Preventive Services Task Force (USPSTF) for annual CT lung screening were analysed for pulmonary nodules (PN) detection and secondary lung cancer (SLC) diagnosis. This is a retrospective chart review of LC patients treated at Johns Hopkins Hospital from January 2010 to December 2017. The study population included patients who met USPSTF criteria by age and smoking history for annual chest screening and were followed for at least 3 consecutive years. A total of 998 LC patients' records were reviewed, of which 151 met the inclusion criteria. Inadequate follow-up period (37% of excluded cases) was the most common reason for exclusion, followed by not meeting USPSTF age criteria (27% excluded cases). In seventy-eight patients (n = 78, 52% of analysed patients) PN were reported. Nine individuals (6% of analysed patients) were diagnosed with SLC. Age over 70 (p = 0.003) was an independent predictor of malignancy. White race and smoking history over 40 pack-years were positively associated with a pulmonary nodule detection (p = 0.037 and p = 0.044, respectively). The incidence of PN and SLC in patients with LC is high. Many patients with laryngeal cancer meet the formal guidelines for USPSTF screening, and should be screened annually according to evidence-based medicine for the early detection of secondary lung cancers.


Assuntos
Neoplasias Laríngeas/epidemiologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/epidemiologia , Tomografia Computadorizada por Raios X , Idoso , Idoso de 80 Anos ou mais , Detecção Precoce de Câncer , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Fatores de Risco , Nódulo Pulmonar Solitário/diagnóstico , Nódulo Pulmonar Solitário/epidemiologia , Carga Tumoral
19.
Int J Surg ; 76: 163-170, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32173614

RESUMO

BACKGROUND: Recurrence is still major obstacle to long-term survival in laryngeal squamous cell carcinoma (LSCC). We aimed to establish and validate a nomogram to precisely predict recurrence probability in patients with LSCC. METHODS: A total of 283 consecutive patients with LSCC received curative-intend surgery between 2011 and 2014 at were enrolled in this study. Subsequently, 283 LSCC patients were randomly assigned to a training cohort (N = 171) and a validation cohort (N = 112) in a 3:2 ratio. According to the results of multivariable Cox regression analysis in the training cohort, we developed a nomogram. The predictive accuracy and discriminative ability of the nomogram were evaluated by calibration curve and concordance index (C-index), and compared with TNM stage system by C-index, receiver operating characteristic (ROC) analysis. Decision curve analysis (DCA) was performed to estimate clinical value of our nomogram. RESULTS: Six independent factors rooted in multivariable analysis of the training cohort to predict recurrence were age, tumor site, smoking, alcohol, N stage and hemoglobin, which were all integrated into the nomogram. The calibration curve for the probability of recurrence presented that the nomogram-based predictions were in good correspondence with actual observations. The C-index of the nomogram was 0.81 (0.75-0.88), and the area under curve (AUC) of nomogram in predicting recurrence free survival (RFS) was 0.894, which were significantly better than traditional TNM stage. Decision curve analysis further affirmed that our nomogram had a larger net benefit than TNM stage. The results were confirmed in the validation cohort. CONCLUSION: A risk prediction nomogram for patients with LSCC, incorporating readily assessable clinicopathologic variables, generates more accurate estimations of the recurrence probability when compared TNM stage alone, but still needs additional data before being used in clinical implications.


Assuntos
Neoplasias Laríngeas , Recidiva Local de Neoplasia , Nomogramas , Adulto , Idoso , Área Sob a Curva , Calibragem , Carcinoma de Células Escamosas/patologia , Estudos de Coortes , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Análise de Regressão , Estudos Retrospectivos
20.
Rev. Hosp. Ital. B. Aires (2004) ; 40(1): 4-10, mar. 2020. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1100756

RESUMO

Se realizó un estudio prospectivo y descriptivo, incluyendo 103 pacientes que fueron tratados por cáncer de laringe en etapa inicial (T1-T2) con cirugía transoral. De ellos, 55 se diagnosticaron en estadio T1, 16 en estadio T1-b y 32 en estadio T2. El control local inicial (CLI) en pacientes con tumores malignos de laringe estadificados T1 fue 91%, el control local con rescate (CLR) 96%, la preservación de la función de la laringe (PFL) 93% y la sobrevida específica 96%. En T1-b, el CLI fue 81%, el CLR 94%, la PFL 94% y la sobrevida específica 94%. En T2, el CLI fue 63%, el CLR 94%, la PFL 72% y la sobrevida específica 78%. La cirugía transoral en cáncer de laringe con T inicial tiene resultados oncológicos similares a otros tratamientos (cirugía externa o radioterapia), pero consideramos que es la mejor opción por su baja morbilidad, menor duración del tratamiento, y porque deja abiertas todas las posibilidades para tratar posibles recurrencias. (AU)


A prospective and descriptive study was conducted, including 103 patients who were treated for early stage laryngeal cancer (T1-T2) with transoral surgery. Of these, 55 were diagnosed in stage T1, 16 in stage T1-b and 32 in stage T2. The initial local control (CLI) in patients with malignant T1 laryngeal tumors was: 91%, local control with rescue (CLR) 96%, preservation of larynx function (PFL) 93% and specific survival 96%. In T1-b the CLI was 81%, the CLR 94%, the PFL 94% and the specific survival 94%. In T2 the CLI was 63%, the CLR 94%, the PFL 72% and the specific survival 78%. Transoral surgery in laryngeal cancer with initial T has oncological results similar to other treatments (external surgery or radiotherapy), but we consider that it is the best option because of its low morbidity, shorter duration of treatment, and because it leaves open all the possibilities to treat possible recurrences. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Laríngeas/cirurgia , Recidiva Local de Neoplasia/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Cirúrgicos Operatórios/métodos , Prega Vocal/patologia , Qualidade da Voz , Traqueostomia/estatística & dados numéricos , Neoplasias Laríngeas/classificação , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/fisiopatologia , Neoplasias Laríngeas/mortalidade , Neoplasias Laríngeas/radioterapia , Estudos Prospectivos , Epiglote/patologia , Duração da Terapia , Intubação Gastrointestinal/estatística & dados numéricos
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