bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radical radiotherapy for T4 carcinoma of the skin of the head and neck: A multivariate analysis
Authors: Lee W. Robert , Mendenhall William M. , Parsons James T. , Million Rodney R. 
Published: February 2007

AbstractSixty‐seven patients with 68 stage T4 carcinomas of the skin of the head and neck were treated with radical radiotherapy at the University of Florida between October 1964 and November 1989. Thirty‐three lesions were previously untreated and 35 were recurrent. Twenty‐nine lesions were squamous cell carcinomas, 37 were basal cell carcinomas, and 2 were basosquamous carcinomas. Minimum follow‐up was 2 years. The 5‐year local control, local control including surgical salvage, and cause‐specific survival probabilities were 53%, 74%, and 75%, respectively. Local control rates with radiotherapy alone were poorer in patients with recurrent lesions (41% vs. 67%, p = .07) or bone involvement (40% vs. 62%, p = .08).Results were analyzed by multivariate methods using local control, local control with surgical salvage, and cause‐specific survival as endpoints. The parameters analyzed were histology; size of primary lesion; previous treatment (previously untreated vs. recurrent); involvement of bone, nerve, or cartilage; and skeletal muscle invasion. Three important prognostic factors were identified, each predictive of poorer ultimate local control and cause‐specific survival rates: (a) bone involvement (p < .01); (b) recurrent lesions (p < .01); and (c) nerve involvement (p < .02).Radiotherapy alone can control advanced carcinomas of the skin of the head and neck, although lesions that have recurred after prior treatment and those with involvement of bone or nerve are associated with a lower likelihood of cure.
Seven‐year follow‐up of vanishing bone disease in a 14‐year‐old girl
Authors: Schiel Harald , Prein Joachim 
Published: February 2007

AbstractA review of the literature revealed 91 cases of massive osteolysis since the first report by Jackson in 1838, including 31 in the maxillofacial region meeting the Heffez criteria. In seven cases, early irradiation was performed, after which no further progression of bone lysis was observed. The young female patient reported here has been followed up clinically and radiologically for 7 years after radiotherapy, during which time she has remained stable, with no progression of the osteolysis. Our experience with this patient appears to confirm that early radiotherapy with a dose of 30–40 Gy prevents further progression of the disease and can even lead to recalcification. On this basis, and provided the patient remains symptom‐free, reconstructive surgery appears a viable treatment option.
Clinical utility of intraoperative frozen section diagnosis in head and neck surgery: A quality assurance perspective
Authors: Gandour‐Edwards Regina F. , Donald Paul J. , Lie J. T. 
Published: February 2007

AbstractThe technical and professional issues that affect the clinical utility of intraoperative frozen section diagnosis in head and neck surgery are addressed from a quality assurance perspective. The most common reasons for sampling errors and interpretive errors are discussed. We offer several recommendations for head and neck surgeons and pathologists which will optimize the clinical utility of intraoperative frozen section consultation.
Therapeutic lymphadenectomy in melanomas of the head and neck
Authors: Van De Vrie Willem , Eggermont Alexander M. M. , Van Putten Wim L. J. , Wiggers Theo 
Published: February 2007

AbstractThis retrospective study describes patients with locoregionally metastasized melanoma of the head and neck. All patients underwent a therapeutic lymph node dissection. The 3‐year survival rate was 35%. Duration of disease‐free interval, number of lymph nodes involved, and extent of neck dissection proved of no influence on survival rates. Locoregional recurrence occurred in 10 patients and always proved to be a sign of systemic dissemination. Ultimately, 19 patients developed systemic disease. More than 40% developed cerebral metastases and the cerebrum was the second most involved site. As cerebral involvement occurs often in head and neck melanoma, a computed tomography or magnetic resonance imaging scan of the brain is recommended in the routine work‐up before lymph node dissection. Furthermore, because the extent of the surgical procedure had no influence on local recurrence rate and overall survival, a selective approach, preserving functional structures, is advocated.
Multivariate analysis results of radiotherapy for laryngeal cancer
Authors: Cano Elmer , Flickinger John , Johnson Jonas 
Published: February 2007

AbstractWe assess the impact of radiotherapy in the treatment of laryngeal cancer and evaluate the value of the standard dose (linear quadratic plus time model) and other variables to predict tumor control and survival. Between 1972 and 1989, 80 patients with laryngeal cancer received comprehensive radiotherapy. Patients with stage I laryngeal glottic cancer (T1‐NO‐MO) were excluded from this study. Mean follow‐up was 15 months (range 4 to 181). The mean age was 64.8 years (range 40 to 92). Standard dose varied from 32.65 to 81.81 Gy (mean 66.78). The 5‐year overall survival and tumor‐specific survival rates were 44.9 ± 5.8% and 51.4 ± 5.9%, respectively. Five‐year local control and locoregional control rates were 66.4 ± 5.7% and 61.9 ± 5.8%, respectively. Multivariate analysis showed that local control was significantly predicted by T stage (p=.032), but not by standard dose (p=.906). Independently significant factors predicting tumor‐specific survival included stage (p=.006), site (p=.019), and age (p=.001). Local control and survival were significantly predicted by the TNM‐staging classification. The standard dose did not predict local recurrence or survival.
Laryngeal cancer in Colorado
Authors: Harris James A. , Meyers Arlen D. , Smith Chris 
Published: February 2007

AbstractPrevious studies of laryngeal cancer have shown a decrease in the male‐to‐female ratio and that the sex ratio in glottic tumors is higher than that for other laryngeal sites. The purpose of this study was to characterize and identify changes in the demographics, laryngeal site predilection, geographic distribution, trends in tumor stage at diagnosis, and surgical caseload distribution in Colorado. The Colorado Central Cancer Registry for the years 1979 to 1990 was reviewed for cases of laryngeal cancer. The data were analyzed using chi‐square and gradient‐in‐proportions methods. One‐thousand two‐hundred sixty‐five (1265) cases were identified with a male‐to‐female ratio of 4.3:1. There was a significant trend of an increasing proportion of cases attributable to women. Glottic carcinoma accounted for 50.1% of cases, with a male‐to‐female ratio of 7.6:1. The Denver metropolitan area accounted for 57% of all cases, which was not disproportionate to the population. From 1981 to 1990 there was a significant decrease in the proportion of stage I cases and an increase in stage II cases. The teaching hospitals associated with the University of Colorado were responsible for performing 44.5% of all surgery for laryngeal cancer. The results indicate that laryngeal cancer in Colorado shares similar epidemiologic characteristics to those reported in other studies. Of most concern is the increasing proportion of women with laryngeal cancer and the decrease in cases diagnosed at stage I.
Squamous cell carcinoma of the hypopharynx—analysis of treatment results
Authors: Ho Chiu Ming , Lam Kam Hing , Wei William Ignace , Yuen Po Wing , Lam Lai Kun 
Published: February 2007

AbstractThe results of surgical treatment and causes of failure in 109 patients with squamous cell carcinoma of the hypopharynx were analyzed. The 5‐year survival was significantly related to the stage of the disease (stage I, 74%; stage II, 63%; stage III, 32%; and stage IV, 14%) and the preoperative nodal staging (NO, 57%; N1, 28%; N2, 6%; and N3, 0%), but not related to the extent of tumor resection. The local control rate was 86% and the majority of the local recurrences occurred at the upper resection margin. There was no significant difference in the local recurrence rate between those patients who had pharyngolaryngoesophagectomy and those who had pharyngolaryngectomy. However, the resection‐associated complications (bleeding, cardiac arrhythmia, pulmonary complications) were more frequent when total esophagectomy was performed. Reconstruction‐associated complications such as wound infection and anastomotic leakage occurred less often after gastric pull‐up reconstruction as compared with the use of myocutaneous flap, but was associated with more serious outcome after pharyngogastric anastomosis. Thirty‐seven patients (34%) had neck node recurrences and these were significantly related to the preoperative nodal staging (NO, 20%; N1 37%; N2, 48%; and N3, 83%). Additional primary cancers occurred in 17% of the patients and was a significant cause of death in those patients who survived more than 2 years.
Sedimentation rate and serum thymidine kinase activity: Prognostic factors in squamous cell head and neck cancer
Authors: Fontana Xavier , Dassonville Olivier , Néri Joël , Vallicioni Jacques , Santini José , Milano GéRard , Combon Pierre , Lapalus Françoise , Demard François 
Published: February 2007

AbstractIdentification of prognostic factors in squamous cell head and neck cancers involves analysis of highly diverse clinical and biological parameters. This study analyzed the prognostic value of clinical variables (age, sex, tumor site, stage) and biologic parameters (squamous cell carcinoma antigen [SCC], serum thymidine kinase activity [TK], fibrin, sedimentation rate [SR]) at the time of diagnosis of squamous cell carcinoma of the head and neck (oral cavity, oropharynx, hypopharynx) in 189 patients. Among the clinical variables investigated, UICC stage III–IV disease (p < .0002), a hypopharyngeal site (p < .02), and age over 60 years (p < .01) were all associated with a poor prognosis. Similarly, analysis of biological blood variables allowed definition of cut‐off values above which the prognosis was poor: SCC 2.5 ng/mL (p < .01), fibrin 3.5 g/L (p < .01), TK 7 IU/L (p < .0005), and SR 15 mm per first hour (p < .0000). Cox regression analysis of overall survival identified the UICC stage (p < .000), the SR (p < .001), and serum TK (p < .02) as the main independent prognostic factors. A separate study on a small number of head and neck cancer patients revealed higher TK levels in malignant squamous cell carcinoma tissue than in adjacent healthy tissue.
Patterns of spread of squamous cell carcinoma to the ramus of the mandible
Authors: McGregor Alan D. , MacDonald D. G. 
Published: February 2007

AbstractPatterns of spread of squamous cell carcinoma to the ramus of the mandible have been studied. In nonirradiated mandibles, tumor in the ramus was found to have spread in continuity from tumor within the body. In 22 of 27 specimens (81.5%) with established invasion of the molar region of the body, tumor spread was either confined to the body or to the body and the anterior part of the ramus. The remaining five cases showed extensive spread within the ramus. It was concluded that a more conservative approach to resection of the ramus may be safe on pathologic grounds in the nonirradiated mandible. In postirradiation mandibles, direct invasion through cortical bone was seen in addition to direct spread from the body. Tumor spread to the ramus was seen in nine of 12 specimens (75%), and in each case was both diffuse and extensive. It was concluded that a conservative approach to resection of the ramus is not safe on pathologic grounds after radiotherapy.
Intracranial pressure changes during bilateral radical neck dissections
Authors: Weiss Kevin L. , Wax Mark K. , Haydon Richard C. , Kaufman Howard H. , Hurst Michael K. 
Published: February 2007

AbstractThe management of the contralateral neck in patients with head and neck cancer who have undergone a radical neck dissection (RND) is controversial. A number of these patients will require a second RND. Sacrifice of both internal jugular veins (IJV) has been felt to lead to increased intracranial pressure (ICP) with subsequent neurologic sequelae.From 1987 to 1991 four patients had staged bilateral RNDs at the West Virginia University. In these patients a subarachnoid bolt was placed to directly monitor ICP. Jugular bulb, mean arterial, pulmonary artery, and central venous pressures were monitored. Electroencephalographic (EEG) monitoring was also performed. All patients demonstrated elevations in ICP immediately on head rotation. Further marked elevations were noted immediately after IJV ligation with a maximum peak at 30 minutes. Pressure levels of greater than 40 mm Hg were observed in three of four patients. Systemic hypertension was observed in response to elevated ICP (Cushing's reflex). All patients studied recovered from surgery without significant sequelae. Within 24 hours the ICP had returned to normal in all patients. Three patients required intraoperative intervention to lower their ICP.We demonstrate that even in a staged second RND there are significant rises in ICP. These are to a level that suggests emergency medical intervention is required. We feel that when the second IJV is sacrificed an increase in ICP should be anticipated, monitored, and treated accordingly.
Metastatic squamous cell carcinoma to cervical lymph nodes from unknown primary mucosal sites
Authors: Nguyen Cam , Shenouda George , Black Martin J. , Vuong Te , Donath David , Yassa Miriam 
Published: February 2007

AbstractBetween 1978 and 1991, 54 patients with metastatic squamous cell or undifferentiated carcinoma to the cervical lymph nodes, with unknown primary mucosal sites, were treated with curative intent at McGill University teaching hospitals. The median age at diagnosis was 58 years with a male:female ratio of 6:1. All patients presented with a painless neck mass. Five patients (9%) presented with N1 disease, 28 (52%) with N2a disease, four (7%) with N2b disease, three (6%) with N2c disease, and 14 (26%) with N3 disease. Twenty‐four patients (44%) underwent neck dissection, and 30 (56%) had only excisional lymph node biopsy. Fifty‐three patients (98%) were treated with radiotherapy to a median dose of 60 Gy (range 38 to 66 Gy) in 30 fractions. With a median follow‐up time of 49 months, the overall actuarial survival was 63% and 59% at 5 and 10 years, respectively. Three patients were found to have a subsequent primary head and neck tumor. The single most important prognostic factor was the N stage, which influences both neck control and long‐term survival. There was no statistically significance difference in survival or local neck control rates between patients who had neck dissection or excisional lymph node biopsy (p > 0.05). © 1994 John Wiley & Sons, Inc.
Mediastinal dissection and reconstruction for recurrent hürthle cell carcinoma of the thyroid
Authors: Sloan David A. , Vasconez Henry C. , Weeks Julia A. 
Published: February 2007

AbstractA 69‐year‐old man presented with recurrent Hürthle cell carcinoma of the thyroid. Successful surgical resection of the recurrent tumor included the larynx and trachea; skin, soft tissues, and lymph nodes of the neck; and the tissues of the anterior mediastinum, including upper sternum and clavicular heads. Coverage of the wound was accomplished with an inferiorly based parasternal fasciocutaneous flap and a long pectoralis myocutaneous flap. This represents the first reported case of Hürthle cell carcinoma treated with mediastinal dissection for extensive local disease. Radical surgical resection should be considered for any patient with Hürthle cell carcinoma of the thyroid in view of the ineffectiveness of nonsurgical modalities. © 1994 John Wiley & Sons, Inc.
Oral tongue cancer in young adults less than 40 years of age: Rationale for aggressive therapy
Authors: Sarkaria Jann N. , Harari Paul M. 
Published: February 2007

AbstractSquamous cell carcinoma (SCC) of the oral tongue in patients less than 40 years old is a rare but aggressive disease. Published reports suggest poor overall treatment results for young patients despite relatively early stage disease presentation. A 25‐year review of the English language literature (1968 to 1993) identifies 14 reports with 3 or more patients younger than 40 years of age with SCC of the oral tongue. Of 152 cases identified, 57% of patients developed locoregional failure and 47% of patients died secondary to their cancer. At the University of Wisconsin Hospital and Clinics, 6 patients under the age of 40 years have received treatment between 1971 and 1991 for SCC of the oral tongue. Despite presentation with relatively early stage disease, 5 of 6 patients have developed locoregional failure and 4 patients have died from their cancer. These results for the younger population reflect a higher locoregional failure and mortality rate than representative reports from the older population. An aggressive therapeutic approach to the young patient with SCC of the oral tongue appears warranted in an attempt to improve locoregional control and ultimate survival. © 1994 John Wiley & Sons, Inc.
Distribution of surviving tumor cells after chemoradiotherapy in tongue and floor of mouth carcinomas
Authors: Osaki Tokio , Hirota Jusui , Yoneda Kazunori , Yamamoto Tetsuya , Ueta Eisaku 
Published: February 2007

AbstractBackground. Conservative surgery according to the clinical response to induction therapy is applied in breast carcinomas but not yet in head and neck carcinomas. The possibility of conservative surgery after induction therapy for preservation of function was examined.Methods. Forty‐three tongue and 15 floor of mouth carcinomas that had received induction therapy and tumor resection were submitted for a comparative investigation on the clinical effect of induction therapy and cancer cell degeneration, which was examined in semiserial specimens from the bread‐loaf sections of the excised materials, and a classification of the surviving tumor cell distribution in the tissue was proposed. The distribution was divided into four patterns according to the dispersion and volume of the remaining tumor cells (pattern I, no surviving tumor cells; pattern IIA, viable tumor cells in the central superficial region of the original tumor tissue; pattern IIB, viable cells in the superficial portion, but distributed widely; pattern III, massive tumor cell nests in the deep portion, but centrally localized; pattern IVA, sporadical viable cell islands, but not in the periphery; and pattern IVB, diffuse viable cells scattered throughout the original tumor tissue).Results. The original tumor size did not affect the remaining viable tumor cell distribution pattern, but sporadic distribution patterns (patterns IVA and IVB) were observed in most of the T4 cases. In many cases, especially in tumors of the nondiffuse invasion type (invasion of grade 1 and 2), the tumor remission rate was inversely correlated with the dispersion of the viable tumor cells. However, some cases of grade 3 and 4 invasion exhibited sporadical surviving tumor cells even though a high tumor remission rate was obtained. These tumors, especially those located on the floor of the mouth, recurred with high frequency.Conclusions. Conservative surgery can be applied to nondiffuse invasion cases, according to the tumor remission rate. In T3 and T4 cases exhibiting grade 3 or 4 invasion, conservative surgery is ill‐advised, even if more than 90% tumor remission is obtained. © 1994 John Wiley & Sons, Inc.
Factors influencing functional outcome in supraglottic laryngectomy
Authors: Beckhardt Russell N. , Murray James G. , Ford Charles N. , Grossman Jeffrey E. , Brandenburg James H. 
Published: February 2007

AbstractBackground. The relationship between preoperative pulmonary function tests (PFTs) and postoperative aspiration and deglutition complications in supraglottic laryngectomy (SL) has not been adequately analyzed. The effects of numerous other variables are either controversial or have not been studied.Methods. A retrospective chart review was performed on 46 SL patients, analyzing preoperative PFTs and arterial blood gases, demographic factors, stage of disease, extended resections, cricopharyngeal myotomy, hyoid preservation, neck dissection, and postoperative radiotherapy with regards to aspiration and deglutition problems.Results. Eighteen (39%) patients had no problems, 15 (33%) had moderate problems, and 13 (28%) had severe problems; of these, 39 (85%) were ultimately successful with no further swallowing dysfunction, whereas seven (15%) suffered intractable aspiration difficulties. Decreasing FEV1/ FVC was significantly correlated with a poorer outcome, as was a greater number of pack‐years of smoking. The effect of FEV1/FVC was shown to be independent from pack‐years, whereas the converse was not clearly demonstrated. Extensions of the standard procedure did not correlate significantly with increased problems.Conclusions. An FEV1/FVC less than 50% signifies a greater risk for severe aspiration and deglutition complications, although it must be regarded as one factor among many in determining operability. With careful attention to reconstruction, extensions of the standard SL procedure can be safely performed. © 1994 John Wiley & Sons, Inc.
Periosteal fasciitis of the mandible
Authors: Mighell Alan J. , High Alec S. , Stassen Leo F. A. 
Published: February 2007

AbstractBackground. Periosteal fasciitis is rare in the head and neck. We believe only two cases of fasciitis‐induced erosion through the mandibular cortical plate have previously been reported.Results. Management of a case of periosteal fasciitis with bone erosion at the mandibular angle is reported in a 38‐year‐old man.Conclusions. Misdiagnosis of fasciitis in the past has led to inappropriate management and unnecessary morbidity. The principles of diagnosis and management of this unusual and confusing disorder are highlighted. © 1994 John Wiley & Sons, Inc.
Speech and swallowing function after oral and oropharyngeal resections: One‐year follow‐up
Authors: Pauloski Barbara Roa , Logemann Jerilyn A. , Rademaker Alfred W. , McConnel Fred M. S. , Stein David , Beery Quinter , Johnson Jonas , Heiser Mary Anne , Cardinale Salvatore , Shedd Donald , Graner Darlene , Cook Barbara , Milianti Frank , Collins Sharon , Baker Theresa 
Published: February 2007

AbstractBackground. The purpose of this study was to determine whether the speech and swallowing function of surgically treated oral cancer patients improves between 1 month and 1 year after surgery.Methods. Speech and swallowing performances were assessed for 28 men and 10 women preoperatively and at 1, 3, 6, and 12 months postoperatively following a standardized protocol. Speech tasks included an audio recording of a brief conversation and of a standard articulation test; swallowing function was examined using videofluoroscopy. Data were also collected on the number and duration of speech/ swallowing therapy sessions, as well as the amount and duration of radiotherapy.Results. Statistical analyses revealed that the speech and swallowing function of surgically treated oral and oropharyngeal cancer patients did not improve progressively between 1 and 12 months postsurgery; the level of functioning that these patients demonstrated at the 1‐ and 3‐month posthealing evaluations was characteristic of their status at 1 year after surgery.Conclusion. The lack of improvement between 1 and 12 months postsurgery may be related to the relatively small amount of therapy that these patients received during that period. Several outcome variables worsened significantly at the 6‐month evaluation; the reversal of function at the 6‐month evaluation point could be the effect of postoperative radiotherapy, because irradiated and nonirradiated patients differed in their pattern of recovery on oropharyngeal swallow efficiency and several speech variables. © 1994 John Wiley & Sons, Inc.