bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metformin Decreases Recurrence in Patients with Oral Cavity and Oropharyngeal Squamous Cell Carcinoma
Authors: Thompson Christopher F. , Kim Brandon , Elashoff David , Lai Chi , Wang Marilene B. , John Maie 
Published: February 2015

ObjectiveMetformin has been associated with decreased cancer risk and mortality. However, the effects of metformin on clinical outcomes in oral cavity and oropharyngeal squamous cell carcinoma (OC/OP SCCA) have not been defined. We aimed to evaluate the association of metformin use and cancer recurrence in diabetic patients with OC/OP SCCA.MethodWe performed a retrospective review of all patients with diabetes mellitus type II treated at our tertiary medical center for OC/OP SCCA from 2001 to 2011. The patients’ demographics, cancer TNM stage, treatment, and outcomes were analyzed.ResultsWe identified 69 patients with diabetes mellitus type 2 and OC/OP SCCA from 2001 to 2011. Twenty‐three patients were taking metformin (11 early stage and 12 late stage) and 46 patients were not taking metformin (20 early stage and 26 late stage). Kaplan‐Meier (KM) analysis and coproportional hazard univariate (Coph) analysis were performed. For early stage patients, the KM curve is promising, and the HR from the Comodel is 0.36 (P =. 34), suggesting a substantial effect. There is less of an effect in late stage patients.ConclusionThis is the first known clinical study evaluating the effect of metformin in head and neck cancer. Our results suggest metformin decreases recurrence for diabetic patients with early TNM stage OC/OP SCCA. Further study is needed to validate this benefit, as our limitation is likely related to sample size.
Montgomery Thyroplasty after Cordectomy: Vocal Outcomes
Authors: Pecorari Giancarlo , Raimondo Luca , Gallone Giorgio Oliviero , Nadalin Juri , Sensini Matteo , Riva Giuseppe , Giordano Carlo 
Published: February 2015

ObjectiveProviding good vocal outcomes to vocal fold cancer patients, after open or endoscopic cordectomy, is a hot topic. Several authors compared different phono‐surgical techniques focusing their attention on feasibility. The aim of our study was to evaluate objective and subjective vocal outcomes after Montgomery thyroplasty.MethodIn 2011, at the I ENT Division of Turin University, 8 patients underwent Montogomery thyroplasty followed by 6 months of speech rehabilitation. Inclusion criteria were: glottic incompetence and 3 years of follow‐up after cordectomy. Voice evaluation was performed using videolaryngostroboscopy, Multidimensional Voice Program (MDVP), and VHI‐10.ResultsSix months after the surgical procedure, the laryngostroboscopy showed an improved glottic closure during phonation even if irregular and incomplete. Preoperative and postoperative MDVP parameters were compared by means of Student t test, observing a statistically significant improvement of all parameters (P <. 05). The most relevant improvements were observed in: average fundamental frequency (192 Hz vs 161.7 Hz), absolute jitter (645 µs vs 57 µs), shimmer (2.1 dB vs 0.82 dB), amplitude perturbation quotient (17.6% vs 6.1%), and medium phonation time (3.5 s vs 5.12 s). VHI‐10 mean score improved from 33.4 to 25.7 (P <. 05).ConclusionOur data suggest that Montgomery thyroplasty, associated with speech rehabilitation, is an efficient and well‐ tolerated rehabilitative approach in order to improve vocal outcomes of vocal fold cancer patients treated with open or endoscopic laser cordectomies.
Multimorphic Vascular Anomaly
Authors: Sabri Alain N. , Musallam Khaled , Boulos Fouad 
Published: February 2015

ObjectiveTo describe a rare case of multimorphic vascular anomaly.MethodA 7‐year‐old boy presented for massive congenital tumors in the intraorbital, right frontoparietal, and nasal tip areas. After excision, pathological evaluation revealed the intraorbital lesion consistent with lymphatic malformation. The frontoparietal mass was a cavernous hemangioma. The nasal lesion was a soft tissue hamartoma.ResultsA growing body of clinical, histological, and radiological evidence supports the conclusion that vascular tumors of childhood represent a number of distinct entities with diverse etiologies and clinical behaviors. Immunohistochemical and gene expression analyses yielded important clues regarding these etiologies. An absolute requisite of meaningful diagnosis and study of these lesions is precise histopathological description, combined with clinical and radiological evaluation.ConclusionUnfortunately, overgeneric use of the term hemangioma has led to inappropriate grouping of entities that we now know are dissimilar, hampering research efforts and causing problems when making comparisons between cases reported in the literature. This patient had 3 different tumors according to pathological evaluation.
Neck and Mediastinal Node Metasis
Authors: Martins Antonio S. , Del Negro André , Tincani Alfio J. , Casarim André M. , Aguiar Camila G. , Manso Daniel G. , Fanni Renato V. 
Published: February 2015

ObjectiveEvaluate details of neck node metastasis (NM) and mediastinal node metastasis (MM) in carcinomas of the pharyngolaryngoesophageal (PLE) region.MethodChart review of 44 patients with gastric pull‐up for Ca of the PLE junction (cervical esophageal, hypopharyngeal and advanced laryngeal carcinomas). The mediastinal dissection (MD) resected mainly the paratracheal/paraesophageal lymph nodes down to the aortic arch.ResultsFifty neck dissections (ND) were performed in 28 patients (positive nodes in 47.7%). The NM occurred in 22.2%, 60%, 70%, and 66.6% of patients with esophageal, pyriform sinus, retrocricoid, and laryngeal carcinomas, respectively. The number of neck nodes averaged 22.8 to 27.5 nodes per ND (positive in 12.5%) and was concentrated in levels II, III, and IV (84.3%). Extra capsular invasion (IE) occurred in 80.9%. Eighteen (48.6%) out of 37 patients had MM. MM occurred in 16.6%, 47.2%, and 64.2% of the patients with laryngeal, hypopharyngeal, and esophageal Ca, respectively. MD yielded 222 nodes, positive in 17%. EI occurred in 33%.ConclusionA high number of ND was done with positive nodes in most therapeutic ND and nearly 50% of selective ND. EI was high (80.9%). Selective ND may suffice in esophageal carcinomas (NM in 22.2%). MM was significant, cervical esophageal carcinomas (64.2%) occurrence of MM in 47.2% of hypopharyngeal was disturbing.
Papillary Thyroid Carcinoma Arising in a Branchial Cyst
Authors: Ruhl Douglas S. , Sheridan Mark F. 
Published: February 2015

Objective1) Describe the diagnostic dilemma of finding a thyroid carcinoma in a lateral neck mass without a primary. 2) Understand the etiological theories of branchial cleft cysts. 3) Be able to manage a patient with thyroid carcinoma in a lateral neck mass without a primary site identified.MethodWe report a rare case of papillary thyroid carcinoma incidentally found within a branchial cleft cyst. Only 4 other cases have been described in the literature. A total thyroidectomy and selective neck dissection was performed and no evidence of occult primary disease was found after review of fine sections.ResultsBranchial cleft cysts are the most common lateral neck masses. Ectopic thyroid tissue within a branchial cleft cyst is an unusual phenomenon and papillary thyroid carcinoma arising from this tissue is extremely rare. Clinicians are left with a diagnostic dilemma when presented with thyroid tissue neoplasm within a neck cyst in the absence of a thyroid primary—is this a case of metastatic disease with a missed primary or rather carcinoma arising in ectopic thyroid tissue? A thorough discussion of the etiologies of these lateral neck masses is reviewed including the embryogenesis of thyroid tissue in a branchial cleft cyst.ConclusionThe prognosis of patients with papillary thyroid carcinoma in lateral neck cysts without a primary site identified appears to be good following excision of the cyst and total thyroidectomy. Other management recommendations regarding these unique lateral neck malignancies are also presented.
Prevalence of a HPV Laryngeal Squamous Cell Carcinoma and a Novel Cell Line
Authors: Chinn Steven B. , Walline Heather M. , McHugh Jonathan B. , Prince Mark E. , Carey Thomas E. 
Published: February 2015

ObjectiveRecently, HPV has been associated with HNSCC. However its role in laryngeal SCC (LSCC) is unknown. The objective of this study is to 1) describe a novel HPV‐positive LSCC cell line and 2) report the prevalence of HPV‐positive LSCC in a select patient population.MethodCulture of an HPV‐positive LSCC primary tumor and derived cell‐line determined by p16 immunohistochemical (IHC) staining, HPV in‐situ hybridization (ISH), and HPV PCR‐MassArray using E6‐type‐specific primers. Retrospective analysis of the HPV‐status in 123 LSCC tissue micro array (TMA) patient specimens from 1985‐2000 as determined by p16‐IHC and HPV‐ISH staining.ResultsA 51‐year‐old man with no tobacco or alcohol history was diagnosed with a T4N0M0 of the true vocal cord. Tumor location was confirmed by laryngoscopy and CT‐imaging. After total laryngectomy the tumor was cultured into a cell line (UM‐SCC‐105). The primary tumor specimen and LSCC derived UM‐SCC‐105 are HPV‐positive and contain HPV‐18 as established by p16 IHC, HPV‐ISH and PCR‐MassArray. In the TMA cohort, 19% (23/123) of tumors were positive for p16, and 3 were positive for HPV‐ISH. Based on p16 and ISH results, 2.4% (3/123) of tumor samples were determined to be HPV‐positive.ConclusionIn this cohort, prevalence of HPV in LSCC was 2.4%. Given the HPV‐induced HNSCC cancer epidemic, greater understanding for HPV in LSCC is warranted. UM‐SCC‐105 is the first HPV‐18 positive LSCC cell line described, and it will aid in future research to better understand the pathogenesis of HPV in LSCC.
Prospective Evaluation of the McGill Thyroid Nodule Score
Authors: Dolev Yalon , Hier Michael P. , Tamilia Michael , Payne Richard J. 
Published: February 2015

Objective1) Familiarize the audience with the new McGill Thyroid Nodule Score (MTNS) scoring system for thyroid nodules. 2) Present the statistics on the MTNS and why we feel this is a great adjunct in the management of thyroid nodules. 3) Describe a new tool at the clinician’s disposal that will help better manage patients with thyroid nodules.MethodThis is a prospective study. A total of 245 consecutive patients were enrolled between July 2009 and March 2011. McGill Thyroid Nodule Score (MTNS), age, gender, and extent of surgery were recorded preoperatively. Final pathology was recorded postthyroidectomy. The percentage of malignancy was calculated for each MTNS score. Using Fisher exact test, the risk of malignancy for each group was compared to that anticipated based on the MTNS. We then used linear regression to plot a best fit curve for both the retrospective and prospective data and compared the 2.ResultsWe found no statistically significant difference when comparing the risk of malignancy between the retrospective group originally used to create the MTNS and the prospective group used to validate this tool with P >. 05 for all groups. Regression analysis revealed linear curves and also showed no significant difference between both groups (P =. 35).ConclusionThe MTNS system has been validated prospectively and is a unified and individualized tool to help clinicians with multiple aspects in the management of patients with thyroid nodules. This includes discussion with patients regarding the risk of their nodules harbouring malignancy, decisions regarding extent of surgery, and discussion between physicians.
Robot‐Assisted Neck Dissection in Papillary Thyroid Cancer
Authors: Kim Won Shik , Lee Hyoung Shin , Lee So‐Yoon , Hong HyunJun , Choi Hong‐Shik , Choi Eun Chang , Koh Yoon Woo 
Published: February 2015

ObjectiveRobot‐assisted neck dissection (ND) in papillary thyroid carcinoma (PTC) patients with lateral neck metastasis was proven to be feasible. However, approaches for upper neck levels are restricted. Thus, we designed novel approach for robotic ND to cover upper neck levels in PTC patients using transaxillary and retroauricular (TARA) incisions.MethodBetween January 2011 and October 2011, 11 patients underwent total thyroidectomy and comprehensive neck dissection using a da Vinci surgical robotic system via TARA incisions.ResultsIn all cases, successful comprehensive NDs via TARA incisions using robotic surgical system could be performed. Axis change of robot was unnecessary to align the robotic arms and endoscope for upper neck levels. Vital structures including major vessels and nerves were preserved. No perioperative complications were developed. The numbers of retrieved lymph nodes in robotic neck dissections were comparable with those in conventional neck dissections.ConclusionA robotic ND via a TARA approach to PTC patients with cervical lymph node metastasis was performed successfully. This new approach provides advantages especially in the dissection of levels IIb and V. This is a useful, alternative approach for addressing cervical lymph node metastasis in selected cases of PTC. Long‐term outcomes of robotic ND should be accumulated to determine the oncologic safety.
Robotic Thyroidectomy via a Transaxillary Approach
Authors: Koh Yoon Woo , Hong Hyun Jsun , Kim Won Shik , Lee Hyoung Shin , Lee So‐Yoon , Kim Se‐Heon , Choi Eun Chang 
Published: February 2015

ObjectiveRecently, various robotic surgical procedures have been performed, and most reports have proved that the application of robotic technology for surgery is technically feasible and safe. The feasibility and safety of robotic thyroid surgery was examined via transaxillary single port approach without gas insufflation.MethodThe study included 109 consecutive patients with papillary thyroid cancer who underwent robot‐assisted endoscopic thyroid surgery using a gasless transaxillary single port approach by a single surgeon (Y.W.K.) between May 2010 and August 2011 at the department of otorhinolaryngology, Yonsei University College of Medicine.ResultsThe console time for 50 hemithyroidectomy (HT) with ipsilateral central compartment neck dissection (CCND) was 45.67 min, and that of 59 total thyroidectomy (TT) with ipsilateral or bilateral CCND was 93.77 min. The amount of drainage was 194.07 mL, and the duration of drainage was 3.5 days. The hospital stay was 6.09 days. Mean primary tumor size was 6.58 mm. The average number of lymph nodes resected was 3.51 (range, 1‐19). Temporary hypoparathyroidism encountered with 24 patients in the TT group (40.7%, 24/59). There were 5 cases of temporary recurrent laryngeal nerve injury and 12 of seromas. One case of temporary brachial plexus injury occurred due to arm positioning.ConclusionThe technique of robotic thyroid surgery using a gasless transaxillary single port approach is a feasible, safe, and effective method for selected patients with thyroid cancer. The authors suggest that application of robotic technology for endoscopic thyroid surgeries could overcome the limitations of conventional endoscopic surgeries in the surgical management of thyroid cancer.
Symptoms‐Findings Correlation in Recurrent Head andNeck Cancer
Authors: Nisa Lluís , La Macchia Riccardo , Boujelbene Nouredine , Escher Anette , Khanfir Kaouthar , Giger Roland 
Published: February 2015

ObjectiveTo assess the correlation between subjective symptom evaluation and tumor recurrence status in the 2 first years of follow‐up of patients treated for head and neck squamous cell carcinomas (SCC).MethodRetrospective study of patients treated curatively for oral, oropharyngeal, hypopharyngeal, and laryngeal SCC between 2008 and 2010. Review of reported symptoms and tumor recurrence status during the first 2 years posttherapy. Assessment of the degree of correlation with Phi coefficient and Student t test.ResultsOne hundred one patients were included, of which 33% presented local and/or regional recurrence. Twenty‐one percent of the patients with recurrent disease were asymptomatic, and 50% of the patients with recurrences did not report any change in symptom’s intensity. On the other side, 66% of recurrence‐free patients mentioned various symptoms, and of these 15% reported an increase in symptom’s intensity during the 2 years following treatment. The symptom‐recurrence correlation is better in patients treated with unimodal therapy (P <. 05) and in patients with initial early‐stage tumors (stages I‐II; P <. 05).ConclusionSpecialized and close follow‐up in head and neck cancer patients is mandatory because of the inconstant correlation between symptoms and recurrence status and due to the fact that more than 20% of the patients with recurrences are asymptomatic.
The Role of Fine‐Needle Aspiration in Parotid Pleomorphic Adenoma
Authors: Fundakowski Christopher E. , Castano Jonathan , Abouyared Marianne , Rivera Andrew , Ojo Rosemary , Sargi Zoukaa 
Published: February 2015

ObjectiveFine‐needle aspiration (FNA) biopsy is often used as a well‐accepted and both sensitive and specific diagnostic adjunct in the workup of parotid masses. In the case of pleomorphic adenoma, the most common benign tumor of the parotid gland, we examine cytopathologic reports to assess the performance of FNA for this particular histologic diagnosis.MethodA total of 317 patients who underwent parotidectomy over the past 5 years and met eligibility criteria of 1) primary parotid tumor, 2) age greater than 18 years, and 3) availability of pathology (FNA, intraoperative frozen section, final pathology) were reviewed. Clinical history and demographics, physical exam findings, and intraoperative findings were noted.ResultsPleomorphic adenoma was noted on final pathology in 136 patients (42.9%). Interestingly 24 (17.6%) of these patients had initially undergone FNA and been given a incorrect diagnosis, despite the FNA being “diagnostic.” One patient received false positive diagnosis of malignancy by FNA. Of the 24 patients with incorrect diagnosis on FNA, 15 (62.5%) received the correct diagnosis of pleomorphic adenoma with intraoperative frozen section, though one patient received a false positive for malignancy and underwent surgical upstage unnecessarily. For pleomorphic adenoma, it appears that diagnostic sensitivity increases from 82% for FNA to 92% with frozen section.ConclusionWhile FNA is commonly used as preoperative diagnostic adjunct for parotid masses, one must exercise caution, even in the context of a diagnostic sample, as nearly 18% of pleomorphic adenomas were not identified. Fortunately, misdiagnosis was benign 95% of time, and subsequently had no surgical implications.
The Role of G9a in Tumorigenesis in Head and Neck Cancer
Authors: Tan Ching‐Ting , Ko Jenq‐Yuh , Tsai Hung‐Huey 
Published: February 2015

ObjectiveHead and neck squamous cell carcinoma (HNSCC) represents a major worldwide health problem with patients, exhibiting a 5‐year average survival rate lower than 50%. G9a is a histone methyltransferase (HMTase) for histone H3 lysine 9 dimethylation (H3K9me2), and it was reported that G9a‐mediated H3K9me2 aberrantly repressed tumor suppressor genes in many cancers. However, the mechanistic understanding of the role of G9a in HNSCC progression remains largely unknown.MethodIHC of patients’ tissues were performed. RT‐PCR, western blot, cell viability assay, and anchorage‐independent growth analysis of HNSCC cells were performed. Age‐matched NOD‐SCID mice were used to establish the mouse model for tumorigenesis. Microarray analysis was scanned with the AffymetriGeneChip scanner to evaluate the signal pathway regulated by G9a.ResultsThe results revealed that mRNA expression level of G9a was higher in tumors compared with normal parts. G9a was over‐expressed in cancerous specimens compared with mucosa. Inhibited G9a expression by shRNA or treated G9a enzymatic activity inhibitor BIX‐01294 in HNSCC cells, the results showed that both can significantly inhibit HNSCC cell growth and anchorage‐independent growth. The in vivo animal model also revealed that G9a knockdown would decrease tumor growth. We discovered that DUSP4 was upregulated in G9a‐downregulated HNSCC cells and the expression level of phospho‐ERK was inhibited. DUSP4 expression could also be inhibited after treatment with BIX‐01294 in HNSCC cells.ConclusionOur findings suggested that G9a possessed strong oncogenic properties and correlated with sustained malignant phenotype. Inhibition of G9a expression could suppress HNSCC cells growth and in vivo tumorigenecity.
Thyroid Nodules in a Veterans Affairs Population
Authors: Leblanc Blake J. , Ryan Sherry , Martin Elizabeth , Milligan Edward , Nathan Cherie‐Ann O. 
Published: February 2015

Objective1) Determine if follicular thyroid lesions in a Veteran Affairs (VA) population are at increased risk of harboring malignancy compared to the general population. 2) Analyze imaging modalities leading to diagnosis.MethodRetrospective analysis of 107 patients undergoing partial or total thyroidectomy from 2005 to 2010 at a single Veteran Affairs hospital. Outcome measures included age, sex, method of nodule detection, fine needle aspiration (FNA) cytopathology, final histopathology, associated 2deoxy‐2[18F]fluoro‐D‐glucose positron emission tomography (FDG‐PET) uptake, and incidence of cancer compared with previously published data.ResultsAge range was 27 to 84 years (mean, 60 years). Fine needle aspiration (FNA) cytopathology results were benign in 31% (n = 33), follicular lesion in 41% (n = 46); suspicious for malignancy or malignant in 11.2% (n = 12). The overall malignancy rate was 36.4% (n = 39). Of the indeterminant FNA lesions, 41% (n = 19) had malignancy confirmed histopathologically. This is higher compared to recently published rates of malignancy in follicular lesions (15%‐30%). In 9 of the 10 patients who underwent 2deoxy‐2[18F]fluoro‐D‐glucose positron emission tomography (FDG‐PET), focal thyroid uptake was identified and was significantly (P <. 01) associated with malignancy. This percentage is also much higher prevalence than the approximately 33% reported.ConclusionFollicular thyroid nodules of undetermined significance on FNA may harbor malignancy more frequently in the VA population compared to the general population. Focal FDG‐PET uptake is significantly associated with malignancy.
Videoflouroscopic Evaluation of Swallowing in Glossectomy
Authors: Meera P. C.s , Menon Jayakumar , Iyer Subramania 
Published: February 2015

ObjectiveThe swallowing deficits that result from oral or oropharyngeal resections vary considerably depending on the site, extension of the resection, and type of reconstruction. Most patients will experience some degree of dysphagia despite the reconstructive effort.MethodA prospective evaluation of 16 glossectomy patients (15 men and 1 woman), aged 40 to 60 years, who underwent glossectomy with reconstruction were volunteers in this study. Tumor stages were T1 in 1 patient, T2 in 8 patients, T3 in 5 patients, T4 in 2 patients, and node.ResultsPatients who underwent a total glossectomy with laryngeal preservation had an increase in oral transit time and stasis of food in the oral cavity, the pharynx. Patients who underwent a partial glossectomy (lateral border of tongue involvement only) had difficulties with formation and antero‐posterior propulsion of the bolus in the oral cavity. The stasis in the oral cavity/valleculae and oral transit delay was comparatively less and was evident only with materials of thicker consistencies. All patients benefited from rehabilitative and compensatory swallowing maneuvers.ConclusionVideo‐fluoroscopic analysis of swallowing could characterize swallowing dysfunction in patients who underwent a glossectomy with flap reconstruction. Videoflouroscopic analysis of swallowing is not only a mere diagnostic tool but also a prognostic tool. Appropriate swallowing intervention benefited the patients in regaining swallowing function.