bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of quality of life in head and neck cancer patients
Authors: Hassan Sammy J. , Weymuller Ernest A. 
Published: February 2007

AbstractSeventy‐five consecutive patients were selected to evaluate a disease‐specific quality‐of‐life questionnaire (UW QOL). The new test was compared to two established equality of life evaluation tools, the Karnofsky scale and the Sickness Impact Profile (SIP). Each test was administered on three separate occasions: (1) several days preoperatively; (2) immediately postoperatively; and (3) 3 months postoperatively.The Karnofsky scale is relatively crude and lacks the ability to measure subtle changes. The SIP is a detailed questionnaire that is quite sensitive to change. However, due to its length, the SIP is inefficient and expensive to administer, and patient noncompliance is often a problem.The three questionnaires were compared according to the following factors: Acceptability: 97% of the patients favored the UW QOL scale compared with the SIP because it was more concise and easier to complete. Validity: Validity indicates the ability of the test under investigation to measure what it was intended to measure. Using the SIP as a gold standard, the UW QOL scale demonstrated an average criterion validity of 0.849, whereas the Karnofsky average criterion validity was 0.826. Reliability: Reliability is a measurement of the reproducibility of the data. The UW QOL questionnaire scored >0.90 on reliability coefficients versus 0.80 for the Karnofsky and 0.87 for the SIP scale. Responsiveness: Responsiveness is the ability of the test to measure clinical change. The UW QOL scale faired better than the Karnofsky and the SIP scale in detecting change.The UW QOL scale is comparable to the Karnofsky and SIP scales when tested for validity and reliability. It was the preferred test format of 97% of patients and provided the greatest responsiveness to clinical change.
Comparison of the addition of T and N integer scores with TNM stage groups in head and neck cancer
Authors: Jones Glenn W. , Browman George , Goodyear Michael , Marcellus D. , Hodson D. Ian 
Published: February 2007

AbstractThe 1987 TNM classification system modified T and N definitions for squamous cell carcinomas of the head and neck. It did not change stage groupings (I through IV). The primary purpose of clinical staging is to divide patients into prognostically meaningful groups. The 1987 changes to the TNM T and N descriptions may not have removed the previously established heterogeneity within stage groups III and IV which existed before 1987. The development of a stage grouping system called TANIS (the T And N Integer Score), which is formed by adding the integer values of the T and N classifications, is reported herein.We compared the prognostic performance of T, N, TNM stage group, and TANIS stage for radiotherapy response and survival using data from 86 patients with newly diagnosed, measurable TNM II (oral cavity), and localized TNM III‐IV squamous cell carcinomas of the head and neck, excluding nasopharynx, who were randomized to test 5‐fluorouracil‐methotrexate sequencing. The sequencing of chemotherapy was shown to make no difference to prognosis. All patients received 60 Gy of radiotherapy in 6 weeks.As compared to T, N, and the TNM stage group system, TANIS was the single best predictor for a complete response to radiotherapy (p = 0.0005). TANIS was also the single best predictor for survival from randomization (p = 5 × 10−6). With the 86 patients divided into three groups (TANIS 2 to 3, 4, and 5 to 7), TANIS provided a better prognostic discrimination than did the TNM stage grouping method (TNM II, III, and IV). TANIS is a single index that combines T and N information in a simple way which was more strongly associated with radiotherapy response and survival than the traditional TNM stage groups.
Infrahyoid myocutaneous flap in head and neck reconstruction
Authors: Magrin Jose , Kowalski Luiz P. , Santo Gilmar E. , Waksmann Gilson , Dipaula Rafael A. 
Published: February 2007

AbstractInfrahyoid myocutaneous flap is one of the alternatives to be considered for the reconstruction of moderate defects following resection of the oral cavity, oropharynx, or hypopharynx cancers. The flap is based on the uni‐or bilateral superior thyroid pedicle; its major limitations are due to small flap volume and arc of rotation. The authors reviewed a series of 15 consecutive patients with carcinomas of the oral cavity or pharynx who underwent radical surgical resections followed by immediate reconstruction using an infrahyoid myocutaneous flap. Four of five cases with prior irradiation presented complications. The incidence of flap necrosis in this series (47%) was higher than that reported by others (10%). We consider the presence of massive neck metastasis and prior irradiation contraindications to the use of this flap.
Symptom‐directed selective endoscopy and cost containment for evaluation of head and neck cancer
Authors: Benninger Michael S. , Enrique Ronel R. , Nichols Richard D. 
Published: February 2007

AbstractPanendoscopy is commonly used for diagnosing synchronous primary neoplasms of the head and neck, although the yield and cost effectiveness has been questioned. To compare symptom‐directed selective endoscopy to panendoscopy, 100 consecutive patients with newly diagnosed and untreated squamous cell carcinoma were prospectively evaluated. Symptoms were used to select which studies might have been performed to discover synchronous primary lesions. All patients were subsequently evaluated with chest x‐ray, barium esophagram, direct pharyngolaryngoscopy, esophagoscopy, and bronchoscopy with bronchial washings. Seven synchronous primary neoplasms were discovered in six patients with one patient having three separate tumors. There were five synchronous pharyngeal and one oral cavity neoplasms with two of the pharyngeal tumors being asymptomatic. Two primary cervical esophageal tumors and one synchronous esophageal tumor were found in three patients all of whom had symptoms of dysphagia and odynophagia. Two pulmonary metastasis were discovered by chest x‐ray in patients with normal bronchoscopies with bronchial washings. Selective symptomatic evaluations would have resulted in one‐third savings in total cost and would have minimized excessive procedures and potential morbidity. Direct pharyngolaryngoscopy and chest x‐rays are recommended for patients with squamous cell carcinoma of the head and neck but esophagoscopy, esophagogram, and bronchoscopy might be reserved for patients with associated symptoms. Bronchial washings are not recommended.
Relative effect of surgery and radiotherapy on the internal jugular vein following functional neck dissection
Authors: Docherty James G. , Carter Rosamund , Sheldon Christopher D. , Falconer J. Stuart , Bainbridge L. Christopher , Robertson A. Gerard , Soutar David S. 
Published: February 2007

AbstractWe examined the internal jugular veins in three groups of patients who had undergone (1) a functional neck dissection and radiotherapy, (2) a functional neck dissection alone, or (3) radiotherapy alone, using a noninvasive color Doppler ultrasound scan. The internal jugular veins were ultrasonically bilaterally normal in 18% of patients who had undergone a functional neck dissection and radiotherapy, in 88% of patients who had undergone a functional neck dissection alone, and in 57% of patients who had undergone radiotherapy alone. The combination of a functional neck dissection and radiotherapy significantly affected the internal jugular vein when compared with a functional neck dissection alone.
Professional burnout among head and neck surgeons: Results of a survey
Authors: Johnson Jonas T. , Wagner Robin L. , Rueger Robert M. , Goepfert Helmuth 
Published: February 2007

AbstractBurnout may develop in highly productive, hard‐working individuals from all walks of life. Extending working hours under stressful circumstances may produce a sense of frustration resulting in emotional exhaustion, loss of empathy for patients, and a decreased sense of personal accomplishment.The membership of the American Society of Head and Neck Surgery and the Society of Head and Neck Surgeons was surveyed by mail relative to burnout. A total of 395 head and neck surgeons responded. Mean age was 48 years. The average individual worked an average of 66 hours per week. More than 70% of work was devoted to patient care of which 30% to 50% was devoted to the management of head and neck cancer. A total of 128 (34%) individuals responded that they felt “burned out.” Only 27%, however, indicated frustration with disease, whereas 67% indicated frustration by government and 58% indicated frustration by the economics of medical practice.Most respondents enjoy their work, nevertheless, the stress of extending working hours dealing with severely ill patients, and the increased need to deal with government and economic issues is of concern to the community of physicians practicing head and neck surgery. Discussion about and confrontation with these issues are appropriate to facilitate and enhance an individual's ability to continue to function productively in this environment.
Scintigraphic assessment of aspiration in head and neck cancer patients with tracheostomy
Authors: Muz Jaroslaw , Hamlet Sandra , Mathog Robert , Farris Ronnie 
Published: February 2007

AbstractTracheopulmonary aspiration commonly occurs in patients with dysphagia related to head and neck cancer. Scintigraphic studies were performed in 280 patients with head and neck cancer; 33% of these patients had tracheopulmonary aspiration. A subgroup of 18 tracheostomized patients had a tracheostomy tube with a removable obturator, so they could be studied with the tracheostomy open or occluded. When the tracheostomy was occluded the patients aspirated less frequently, and in significantly smaller quantities, than when it was open. When feasible, occluding the tracheostomy tube or permanent surgical closure may reduce or eliminate tracheopulmonary aspiration in these patients. © 1994 John Wiley & Sons, Inc.
Laryngeal preservation by induction chemotherapy plus radiotherapy in locally advanced head and neck cancer: The M. D. Anderson cancer center experience
Authors: Shirinian Mihran H. , Weber Randal S. , Lippman Scott M. , Dimery Isaiah W. , Earley Charles L. , Garden Adam S. , Michaelson Jacqueline , Morrison William H. , Kramer Alan , Byers Robert , Peters Lester , Hong Waun Ki , Goepfert Helmuth 
Published: February 2007

AbstractStandard treatment of locally advanced laryngeal, hypopharyngeal, and some oropharyngeal cancers includes total laryngectomy. In an attempt to preserve the larynx through induction chemotherapy, we conducted two consecutive phase II studies. From March 1986 to February 1991, 64 patients with advanced untreated but resectable head and neck cancer who would require total laryngectomy were enrolled on one of two cisplatin‐based induction regimens: cisplatin‐bleomycin‐5‐fluorouracil (PBF) in 31 patients and cisplatin‐5‐fluorouracil (PF) in 33; all received definitive radiotherapy. Surgery was reserved for patients who achieved less than a partial response to chemotherapy and patients with residual or recurrent disease after sequential chemotherapy plus radiotherapy. Overall complete plus partial response rates to both cisplatin‐based regimens were comparable. The combined PF and PBF overall response rates were 75% for laryngeal cancer, 78% for hypopharyngeal cancer, and 75% for oropharyngeal cancer. Complete response rates after radiotherapy were 88%, 83%, and 50%, respectively. Neutropenia (<1,000 cells/mm3) was the most common hematologic toxic effect: it occurred in 44% of patients who received PF and 16% of those who received PBF. Grade ≥3 mucositis occurred in 50% of patients who received PF and 4% who received PBF. The data suggest that laryngeal preservation was feasible in all three primary‐site subgroups. With followup of 15+ to 54+ months, 44% of patients with laryngeal cancer, 28% with hypopharyngeal cancer, and 22% with oropharyngeal cancer are alive with laryngeal preservation. The overall 2‐year survival rates for patients with cancer of the larynx, hypopharynx, and oropharynx were 71%, 46%, and 38%, respectively. © 1994 John Wiley & Sons, Inc.
Free vascularized fascial flap in oral cavity reconstruction
Authors: Martin Ian C. , Brown Andrew E. 
Published: February 2007

AbstractOur experience with the free vascularized fascial flap based on the radial artery used for intraoral reconstruction is described. Thirteen patients underwent primary or secondary reconstruction following major resections for malignant disease. The osseofascial flap incorporating radial bone proved to be ideal when reconstruction of composite mandibular or maxillary defects was undertaken. The flaps rapidly underwent surface epithelialization, and submucosal fibrosis provided the ideal attached mucosal lining for prosthetic rehabilitation. © 1994 John Wiley & Sons, Inc.
Immunohistologic distribution of basement membrane in oral squamous cell carcinoma
Authors: Kumagai Shigehiro , Kojima Shinya , Imai Kazushi , Nakagawa Kiyomasa , Yamamoto Etsuhide , Kawahara Ei , Nakanishi Isao 
Published: February 2007

AbstractThe distribution pattern of the basement membrane (BM) around tumor cells was determined in 72 oral squamous cell carcinomas by immunohistochemical staining with antibodies against human type IV collagen, laminin, and heparan sulfate proteoglycan. An intact continuous BM was found in 29 cases, whereas partial or widespread loss of the BM was detected in the other 43 cases (59.7%). Statistical analysis showed that the degree of BM loss was correlated with the degree of differentiation of tumor cells, but not with tumor size, and, most significantly, with the mode of cancer invasion and the incidence of lymph node metastasis. Carcinoma with a well‐defined tumor‐stromal boundary generally expressed an intact continuous BM. In contrast, the majority of diffusely invasive carcinomas lacked a continuous BM. Carcinomas with a widespread loss of BM structures showed a high frequency of regional lymph node metastasis (16 of 18 cases, 88.9%). © 1994 John Wiley & Sons, Inc.
Superior vena cava syndrome and tracheal obstruction due to multinodular goiter
Authors: McKellar Daniel P. , Verazin Gary T. , Lim K. M. , Spiegel Jerome C. , Block Blaine L. 
Published: February 2007

AbstractTracheal obstruction and superior vena cava (SVC) syndrome are rare complications of retrosternal goiter. These two conditions present a difficult diagnostic and therapeutic challenge. Malignancy is the most common cause of SVC syndrome. Determining whether SVC syndrome is due to a benign or malignant process is imperative before instituting treatment, but this determination may be difficult. We present a case of a patient presenting with upper airway obstruction and SVC syndrome with a large mediastinal mass. The mass was determined to be a multinodular goiter. The patient was managed by surgical removal of the goiter with complete resolution of symptoms. This case illustrates the need for careful preoperative evaluation and the importance of establishing a histologic diagnosis prior to initiating treatment for SVC syndrome. © 1994 John Wiley & Sons, Inc.
Basic science reviews: Biology of interleukin‐1 (IL‐1), with respect to otorhinolaryngology‐head and neck surgery
Authors: Wustrow Thomas P. U. 
Published: February 2007

AbstractInterleukin‐1 (IL‐1) has a number of fundamental immunoregulatory, hematologic, metabolic, and physiologic effects and thus is instrumental in the coordination of tissue interactions, such as wound healing, inflammation, and host tumor response. IL‐1 stimulates the activation and differentiation of pre‐B cells and T cells, chemotaxis of neutrophils, recruitment of bone marrow stem cells, stimulation of arachidonic acid metabolism, degradation of proteoglycans, and increase in basal body temperature. Altered production of IL‐1 or IL‐1 regulatory factors may have profound clinical consequences, such as seen in AIDS, other viral and malignant diseases, and in uncontrolled inflammatory processes. A variety of positive and negative feedback mechanisms for regulation of IL‐1 production have been found; therapeutic interventions are aimed at these regulatory pathways. Through approaches interfering with the signal transduction or processing of IL‐1, especially by interleukin‐1‐receptor antagonists (IL‐1RA), future treatment modalities are on the horizon. © 1994 John Wiley & Sons, Inc.
Predictors of carcinomatous invasion of the mandible
Authors: Tsue Terance T. , McCulloch Timothy M. , Girod Douglas A. , Couper David J. , Weymuller Ernest A. , Glenn Michael G. 
Published: February 2007

AbstractThe preoperative assessment of mandibular invasion by oral or oropharyngeal squamous cell carcinoma poses a challenge for the head and neck surgeon. A study of 64 composite resection patients was performed to determine which variables in the patient's history, physical exam, and diagnostic workup had a predictive association with carcinomatous mandibular invasion. Four postoperative variables were included in this analysis. Thirty‐nine percent of the mandibular specimens demonstrated cancerous involvement.A multivariate recursive partitioning statistical analysis was performed to create a decision tree. Branching was based on the two statistically predictive variables: computed tomographic (CT) scan results and primary tumor location. The guide provides improved predictive accuracy with a 100% negative predictive value (NPV) and a 46% positive predictive value (PPV). This decision guide should help the surgeon provide accurate patient counseling, anticipate reconstructive needs, and maximize surgical oncologic effectiveness. © 1994 John Wiley & Sons, Inc.
Analysis of recurrence, complications, and functional results with free jejunal flaps
Authors: Bradford Carol R. , Esclamado Ramon M. , Carroll William R. , Sullivan Michael J. 
Published: February 2007

AbstractThe medical records of 20 patients undergoing revascularized jejunal flap reconstruction of hypopharyngeal defects were retrospectively reviewed to analyze the incidence of distal marginal recurrence, complication rates, and success of early functional restoration. This report is one of few in the literature to address distal marginal recurrence in patients undergoing jejunal free flap reconstruction of hypopharyngeal defects. In 15 evaluable patients, two (13%) developed distal marginal recurrences. Both patients had tumor involving the hypopharynx at the junction of the cervical esophagus. The major complication rate was five of 20 patients (25%) and included three flap failures, one death, and one intra‐abdominal hemorrhage. The minor complication rate was 35%. The median hospital stay was 15.5 days and the median time to successful swallowing was 14.5 days. The functional success rate for swallowing was 58%. Because of the aggressive nature of this disease, we feel partial esophagectomy with jejunal flap reconstruction is warranted to achieve early functional restoration in a select group of patients when a 2‐cm distal margin can be obtained above the cervical esophagus with frozen‐section control, and the distal esophagus is normal. © 1994 John Wiley & Sons, Inc.
Locally invasive papillary thyroid carcinoma: 1940–1990
Authors: McCaffrey Thomas V. , Bergstralh Erik J. , Hay Ian D. 
Published: February 2007

AbstractWell‐differentiated thyroid carcinoma infrequently invades the upper aerodigestive tract. However, when invasion occurs, it is the source of significant morbidity. The most common structures invaded by thyroid carcinoma are the recurrent laryngeal nerves, larynx, pharynx, and esophagus. Invasion of these structures produces symptoms of airway insufficiency, dysphagia, and hemoptysis.This study was designed to define more clearly the significance of invasion of papillary thyroid carcinoma on survival. At the Mayo Clinic, 262 patients treated for invasive papillary thyroid carcinoma between 1940 and 1990 were retrospectively evaluated. In this group the sites of invasion were muscle 53%, trachea 37%, laryngeal nerve 47%, esophagus 21%, larynx 12%, and other sites 30%. Complete tumor removal was accomplished in 56% of cases. Kaplan‐Meier survival curves were calculated for the population. The over‐all survival was 79% at 5 years, 63% at 10 years, and 54% at 15 years. When the Cox proportional hazard model was applied to the survival data, the factors that had significant influence on survival were invasion of the trachea and the esophagus. Completeness of resection approached statistical significance. Muscle invasion, laryngeal invasion, and recurrent laryngeal nerve invasion had no significant independent influence on survival. These data suggest that when papillary thyroid carcinoma extends beyond the thyroid capsule and invades adjacent structures, the site invaded will influence survival. Survival may be improved in those cases in which complete surgical excision of the tumor is performed. © 1994 John Wiley & Sons, Inc.
Retropharyngeal node dissection in cancer of the oropharynx and hypopharynx
Authors: Hasegawa Yasuhisa , Matsuura Hidehiro 
Published: February 2007

AbstractThe purpose of this study was to investigate the incidence of metastases to retropharyngeal (RP) nodes and to evaluate the results of RP node dissections in advanced carcinomas of the oropharynx and hypopharynx. Twenty‐four patients with stage III/IV squamous cell carcinomas of the oropharynx and hypopharynx were treated with standard resection, RP node dissection up to the base of the skull, and radiotherapy of 50 Gy postoperatively to the RP space if RP nodes were involved. Fifty percent (12 of 24) of the patients had positive RP nodes, 36% (4/11) with carcinoma of the oropharynx and 62% (8/13) with carcinoma of the hypopharynx. Six patients had recurrences and of them five died of the disease. The cumulative 3‐year survival rate (Kaplan‐Meier) was 53%. Because of the high incidence of metastases to RP nodes in stage III/IV oropharynx and hypopharyngeal cancers, we recommend the adding of RP node dissection in these patients. © 1994 John Wiley & Sons, Inc.
Amyloidoma of the neck: Case report and review of the literature
Authors: Clevens Ross A. , Esclamado Ramon M. , Delgaudio John M. , Myers Michael W. 
Published: February 2007

AbstractWe present a case report of reactive amyloidoma of the neck in a patient with chronic calcaneal osteomyelitis. Localized deposits of amyloid may occur throughout the upper aerodi‐gestive tract, but are rarely observed in the soft tissues of the neck. This is the first report in the literature of localized head and neck amyloidosis secondary to a chronic inflammatory or infectious process. A clinicopathologic review of amyloidosis is presented with particular attention to its head and neck manifestations. © 1994 John Wiley & Sons, Inc.
Osteosarcoma of the jaw
Authors: Delgado Ricardo , Maafs Eduardo , Alfeiran Antonio , Mohar Alejandro , Barrera Jose‐Luis , Zinser Juan , Beltran Arturo 
Published: February 2007

AbstractBackground. Osteogenic sarcoma of the jaw has clinical and prognostic differences from that of long bones.Methods. We reviewed 23 confirmed cases of osteosarcoma of the jaw seen at the Instituto Nacional de Cancerologia of Mexico between 1972 and 1990.Results. Fifty‐seven percent of the patients were women. Median age for all patients was 28 years. In 52% of cases, the neoplasm involved the maxilla. Tumor size ranged from 5 to 24 cm (median 10 × 7 cm) and 87% of the neoplasms were grade III or IV (Broder's). Twenty one (91%) patients were treated with surgery (s); radiotherapy (Rt) was administered to 14 (61%) and chemotherapy (Ct) to 11 (48%) patients. Clear (negative) surgical margins were obtained in 43% of surgically treated patients. Median follow‐up for 20 patients eligible for evaluation was 16.5 months. Survival at 5 years was 10%.Conclusions. We found that tumor size and surgical margins were significant prognostic factors. Early diagnosis of these tumors is mandatory to improve survival; the role of Ct and Rt is still unknown. © 1994 John Wiley & Sons, Inc.