PubMed Health⌕ Search

Biomedical subjects

O Fini-Storchi

Publications and source records attributed to O Fini-Storchi.

28 records · Page 2Linked to original sources
PubMedDate not supplied

Glottic cancer involving anterior commissure: surgery vs radiotherapy.

A retrospective review of 182 patients with glottic cancer involving the anterior commissure (AC) is presented. Of these, 123 patients were first treated with conservative surgery and 59 underwent radiotherapy. Patients were staged according to the AJCC system and by the modality of neoplastic involvement of AC (pure AC cancer, glottic cancer involving AC up to the midline, and beyond the midline). Our results indicate a higher rate of local control and of specific-disease survival in the group of patients first treated with surgery than those treated with radiotherapy (86% vs 74% and 97.5% vs 84%, respectively) (p less than 0.05). For pure AC cancers, our results show better local control with primary radiotherapy than with conservation surgery (82% vs 76.5%), but surgical failures have been more successfully salvaged than have radiotherapy recurrences (ultimate local control, 97.5% vs 82%, respectively). These data suggest that the treatment of choice for AC cancers is conservation surgery, particularly frontolateral laryngectomy.

Adult↗
PubMedDate not supplied

Five-year results of 1000 patients operated on for cancer of the larynx.

The five-year results of 1000 consecutive cases of cancer of the larynx operated on at the Clinic of Otolaryngology of the University of Florence are presented. The treatment was cordectomy for T1a glottic cancers and total laryngectomy for the other cases. The five year cure rate is 66.5% of the 606 supraglottic cancers, 76.9% of the 294 glottic cancers and 54% of the 100 subglottic cancers. These crude survival rates consider the 7.6% of patients who died from non-tumoral causes and the 1.1% of untraced patients.

Evaluation Studies as Topic↗
PubMedDate not supplied

[Histopathological parameters and lymphatic metastasis in supraglottic laryngeal carcinoma].

Histopathologic parameters in predicting lymph node metastasis of supraglottic laryngeal carcinoma. A systematic clinical-pathological study was performed on fifty-three resected cases of supraglottic laryngeal squamous cell carcinoma, followed up for at least 5 years. The aim of the research was to evaluate histopathologic parameters in predicting lymph node metastasis (N+) as expression of biological malignancy of the neoplasm. The following neoplastic microscopical features were studied: histopathologic and cytologic grading, pattern of growth, peritumoral inflammatory infiltrate, stromal reaction, tumoral necrosis. The results are as follows: stromal reaction and cytologic grading are not useful to identify N+ and N- cases. Cases with high and low degree of differentiation (Broder's grading) are significantly correlated respectively to low (14.3%) and high (70%) incidence of lymph node metastasis (p less than 0.03). A clear correlation is present between the pattern of growth "pushing" and lacking of node metastasis (84.6%). A favorable prognosis significance seems to be linked with the presence of peritumoral lymphoplasmocytic infiltrate, which results to be a marker of cases in which lymph node metastasis incidence is very low (5.5%; p less than 0.001). On the contrary lymph node metastasis incidence increase when tumoral necrosis is present (76.5%; p less than 0.001).

Carcinoma, Squamous Cell↗
PubMedDate not supplied

[Surgical treatment in 155 cases of hypopharyngeal carcinoma: analysis of results and causes of failure].

A retrospective study has been performed on 155 cases of surgically treated hypopharyngeal carcinomas in order to bring to light what effect the type of surgery has on survival and the reasons for failure. The following operations were performed: 103 hemipharyngectomies with total laryngectomy (HPTL); 28 total circular pharyngectomies with total laryngectomy (CPTL); 16 hemipharyngectomies with partial laryngectomy (HPPL); 4 exereses in lateral pharyngectomy; 2 total laryngectomies and 2 hemipharyngectomies in lateral pharyngotomy. Analysis of the results is only performed on the three most numerous groups of patients. The overall neoplastic mortality rate at 5 years was 79% for the HPTL group while it was 50% and 61% in the CPTL and HPPL groups, respectively. The actuarial survival curves show a higher, statistically significant, cumulative 5-year survival rate for the CPTL group (55.9%) than for the HPTL group (30.5%). The authors conclude that, considering the particular submucosa spreading to which hypopharyngeal carcinoma is subject and the good functional recovery which can be obtained with modern reconstructive surgery of the alimentary tract, CPTL should be the treatment of choice, even in the less advanced cases, in order to significantly reduce the risk of local recurrences.

Adult↗
PubMedDate not supplied

[Contralateral metastasis in patients with cancer of the larynx and the hypopharynx. Analysis and critical review of our caseload].

Cancers of the hypopharynx (pyriform fossa, post-cricoid area and posterior wall) and larynx show a high tendency to invade the cervical lymph nodes. Such nodal extension is a well known prognostic factor. In general, those lesions that are in well-lateralized primary sites (pyriform sinus, aryepiglottic fold...) tend to metastasize to the ipsilateral side of the neck. This concept, however, is fraught with exceptions; any lesion, especially with ipsilateral metastases, creates a risk for contralateral node involvement. The present study is based on a retrospective review of 450 clinical records of patients affected by well-lateralized laryngeal (301 pt.) and hypopharyngeal (149 pt.) carcinomas. The incidence of contralateral metastases was analyzed for this group; 25 out of 310 patients with laryngeal cancer (8.3%) and 20 out of 149 with hypopharyngeal cancer (13.4%) showed metastatic involvement of the contralateral neck. In patients with laterally oriented primary lesions, the initial appearance of cervical adenopathy is rarely contralateral since contralaterality is almost a manifestation of bilaterality of metastases. A contralateral disease is rarely possible even if the homolateral neck has been surgically treated. This is because of shunted lymph flow through the submental and submandibular lymphatics. Isolated contralateral disease was only found in 4 patients (1.3%): such data do not suggest any systematic, elective treatment of the contralateral neck NO in patients with unilateral laryngeal and hypopharyngeal cancers.

Humans↗
PubMedDate not supplied

[Significance and prognosis of positive surgical section margins in surgery of laryngeal cancer].

During the surgical treatment of head and neck cancers the surgeon may have to face the problem of deciding what measures to adopt when the tissue at the margin of the surgical sections proves histologically to be cancerous. Many factors may influence the decision for supplementary therapy; among these, of primary importance are stage and site of the tumor, the effectiveness of non surgical therapy, and the psychophysical status of the patient. In order to better consider this problem a retrospective study, limited to laryngeal surgery, and a review of the literature have been carried out. Review of the patients undergoing surgery from 1972 to 1988 has revealed that histological examination of section margins during or after laryngeal surgery was performed in 56 cases: 10 stripping vocal cords, 11 cordectomies, 2 frontolateral laryngectomies, 2 hemilaryngectomies, 20 horizontal supraglottic laryngectomies, 10 total laryngectomies and 1 subtotal laryngectomy with cricohyoidopexis. The margin was negative in 35 cases while tumor lesions of various types were present in 21 cases. An invasive tumor was present in 14 patients and in 7 an 'in situ' tumor or premalignant diskeratosis was found. A policy of abstention was adopted in all but one of the cases. All cases of 'in situ' cancer and of invasive premalignant change were grouped together as they have in common base membrane integrity and the fact that the second lesion is to be considered precancerous. The following results were obtained: in 14 cases of invasive cancer at the section margin there were 8 recurrences (57.1%) 4 after total laryngectomy; 6 patients showed no evidence of disease (NED) after from 3 to 7 years. In the 7 cases of 'in situ' cancer and premalignant lesions at the surgical margin, 4 showed recurrence (57%) and of these 2 underwent surgery. The 3 other cases have been NED for 3 to 5 years. On the other hand, even in the group of 35 margin free patients 8 developed recurrences (22.3%) and of these 3 underwent surgery and 1 radiotherapy. It appears evident that in conservative surgery of the larynx the presence of tumor cells at the surgical margin does not necessarily lead to a recurrence; such recurrences vary from 18% to 60% depending on the study. Nonetheless, it is certain that a real possibility of recovery exists in 50% of these patients. It is, however, impossible to specify which patient manifesting a positive margin actually runs the risk of developing a recurrence.(ABSTRACT TRUNCATED AT 400 WORDS)

Carcinoma↗