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Biomedical subjects

A M Sassler

Publications and source records attributed to A M Sassler.

4 recordsLinked to original sources

Surgery after organ preservation therapy. Analysis of wound complications.

OBJECTIVE: To determine the incidence and risk factors for the development of major wound complications in patients with squamous cell cancer of the head and neck that require surgical salvage after an initial treatment regimen of induction chemotherapy and definitive radiation therapy for organ preservation. DESIGN: Retrospective survey. SETTING: Academic tertiary care referral center. PATIENTS AND INTERVENTION: The medical records of 96 patients treated with induction chemotherapy followed by definitive radiation therapy were reviewed; 18 of these patients requiring a surgical salvage procedure after completing chemotherapy and radiation therapy and these constituted the study group. MAIN OUTCOME MEASURES: Major wound complications. RESULTS: Major wound complications occurred in 11 (61%) of the 18 patients. Surgical salvage within 1 year of initial treatment had a 77% incidence of major wound complications vs a 20% incidence if performed 1 year after initial treatment. The mean time to resolution of fistulae and flap necrosis was 7.7 months. Two deaths were attributed to major wound complications: one patient had a carotid blowout; one had postoperative pneumonia. CONCLUSIONS: Salvage surgical procedures performed after induction chemotherapy and definitive radiation therapy have a high rate of major wound complications. This should be considered when assessing organ preservation treatment strategies.

Carcinoma, Squamous Cell↗

Eosinophilic infiltration in advanced laryngeal squamous cell carcinoma. Veterans Administration Laryngeal Cooperative Study Group.

Tumor-associated tissue eosinophilia (TATE) has been related to prognosis in epithelial cancers, including cancers at several head and neck sites. This study prospectively examined 248 patients with stage III and IV laryngeal squamous cell carcinoma to determine prevalence and potential prognostic significance of TATE. Pretreatment tumor specimens were histopathologically evaluated. Presence and degree of TATE were analyzed with regard to other tumor characteristics, patient characteristics, and outcome criteria. Median follow-up was 48 months. Eosinophilia was found in 22.5% of specimens and was not related to tumor site, stage, patient age or sex, or treatment modality. Overall and disease-free survival rates and response to induction chemotherapy did not differ significantly with respect to TATE. This study represents the first long-term, prospective evaluation of TATE and its prognostic significance in a single head and neck site. Contrary to the findings of earlier preliminary reports, our results suggest that TATE is not a clinical useful prognostic parameter in advanced laryngeal squamous cell carcinoma.

Age Factors↗

Ionized serum calcium levels following combined treatment for cancer of the head and neck.

Thyroid function may be reduced after treatment of cancer of the head and neck, and hypothyroidism is much more common after combination therapy. Whether hypoparathyroidism and subsequent hypocalcemia also occur after such treatment is unknown. Few related studies have been published in which changes in total serum calcium have been studied after cancer treatment with radioactive iodine or external radiation. Twenty-two disease-free head and neck cancer patients were studied, 1 to 3 years after multimodal treatment, to determine if changes in serum ionized calcium levels or thyroid function were present. Our results suggest that parathyroid function, as represented by ionized calcium levels remains normal after multimodality (surgery, radiation and/or chemotherapy) combined treatment.

Adult↗