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Biomedical subjects

E M Skolnik

Publications and source records attributed to E M Skolnik.

47 records · Page 3Linked to original sources
PubMedDate not supplied

Radiation failures in cancer of the larynx.

Overwhelming statistics have been published regarding the success of radiation therapy in the management of laryngeal carcinoma. The fate of those patients whose cancers are not controlled by radiotherapy is often left to speculation. An analysis is made of 61 patients with early and advanced laryngeal cancer treated initially with radiation therapy and subsequently operated upon because of recurrent or persistent tumor. Frequently, diagnosis of recurrence is difficult or delayed. Preservation of voice can only be accomplished when recurrence of T1 and T2 lesions is detected early and strict criteria are followed. Conservation surgery is not feasible for early lesions which progress after radiation failure. Advanced T2 and T4 lesions which become radiation failures also require laryngectomy for salvage. In cancer of the larynx, there is a definite, identifiable group of patients in whom surgery would be advisable as the initial therapy.

Age Factors↗
PubMedDate not supplied

Evolution of the clinically negative neck.

A retrospective study was done of 602 patients with primary squamous cell carcinoma of the upper aerodigestive tract and a clinically negative neck (No) seen at the University of Illinois Hospital between 1960-1975. There was no uniform policy as to the treatment of No neck during this period; therefore in many of the patients, cervical lymph nodes were treated with elective neck dissection and others were followed until they became positive clinically. It was this difference which formed the basis for this study. All the patients were treated surgically; the patients were placed into two groups depending on whether they had radical neck dissection at the same time as resection of the primary. Group 1 consisted of 149 patients and had surgery for the primary only. The 253 patients of group 2 had surgery for the primary and also had a neck dissection. Both groups were analyzed for recurrences in the cervical region. In group 1, 12.9% of the patients developed either ipsilateral or contralateral metastases. Of the group 2 patients, 22% developed palpable nodal disease. The evolution of palpable nodal disease was analyzed by primary site, T-stage, and according to whether the tumor at the primary was controlled. Only 3% of the patients developed lymph nodes when the primary was controlled. The pathology reports of the neck specimens were studied to determine the relationship between a) positive node histology and b) number of nodes positive to the recurrence rate in the neck. Our results showed a 23% failure rate for the histologically positive group and a 21% failure rate for the negative group. The number of positive nodes did not seem to affect the recurrence rate.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Laryngotracheal invasion by thyroid-carcinoma.

Laryngotracheal invasion by well-differentiated thyroid carcinoma is an uncommon occurrence. Recommendations for therapy have primarily included total laryngectomy or shaving of the tumor from laryngeal or tracheal cartilages. Clear guidelines have not been established for the applicability of partial laryngeal resections. In a retrospective analysis of patients with thyroid carcinoma, 13 patients had airway invasion. Of the five patients with laryngeal involvement, three were treated by a partial laryngeal resection. An experimental study was undertaken to determine more precisely the amount of cricoid cartilage which could be resected without reconstruction. Varying amounts of cricoid cartilage were resected. The results indicate that 25% of the cricoid cartilage may be resected without appreciable airway narrowing. On the basis of the retrospective analysis and experimental study, we feel a partial laryngeal resection is possible in most cases of airway invasion by thyroid carcinoma.

Animals↗
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Otologic complications of radiation therapy.

Radiation therapy has proved to be a valuable modality in the management of patients with nasopharyngeal tumors. Routine follow-up of patients in the tumor clinic of the University of Illinois Eye and Ear Infirmary appeared to indicate an increasing incidence of otologic pathology. For this reason, a retrospective study focusing on the otologic findings in patients whose radiation therapy for nasopharyngeal tumors included the external auditory canal, middle ear space, or eustachian tube was performed. The results of this study are discussed in relationship to total radiation dosage, time of survival after therapy, and pretreatment otologic status. The complications covered a spectrum from intermittent serous otitis media to osteoradionecrosis of the external auditory canal. Possible contributing factors are discussed, and preventive neasures are suggested.

Ear↗
PubMedDate not supplied

Improved survival associated with postoperative wound infection in laryngeal cancer: an analysis of its therapeutic implications.

A retrospective analysis revealed improved survival rates in laryngeal cancer patients who had postoperative wound infection following total laryngectomy and radical neck resection. The overall five-year survival rates were 44% in the infection group and 31% in the control group. On further analysis, the beneficial effect of infection was most evident in patients with stage III disease. Seventy-three percent of these patients with wound infection were alive at five years, compared with 32% of the control group. The protection from recurrent cancer in these patients afforded by the bacterial contamination may be secondary to activated immune mechanisms. The therapeutic implications of our findings suggest that the immune adjuvant is given at the time of surgical treatment rather than when tumor burden is far advanced. Only a few such protocols are under analysis presently.

Adult↗