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At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Multicentric squamous-cell carcinoma of the upper aerodigestive tract.

In an attempt to define the true frequency of multiple primary squamous-cell carcinomas of the upper aerodigestive tract, 3 separate population groups were studied. The results of this investigation confirmed the high incidence of multicentric carcinomas in the upper aerodigestive tract, lung, and esophagus. The clinical significance of this phenomenon is discussed, particularly its effect on patient survival and its possible relationship to local tumor recurrence. The value of routine panendoscopy in the initial assessment is stressed as well as the need for a lifelong follow-up of these patients.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

The pathology of head and neck tumors: spindle cell lesions (sarcomatoid carcinomas, nodular fasciitis, and fibrosarcoma) of the aerodigestive tracts, Part 14.

The term spindle cell lesion, or tumor, is a purely descriptive one and if applied without further qualification is meaningless as a guide to therapy and prognosis. The three lesions presented in this report--sarcomatoid carcinomas, nodular fasciitis, and fibrosarcoma--serve to illustrate this point. One, the sarcomatoid carcinoma, is an epithelial malignancy in which the majority of the sarcoma-like spindle cells are believed to be variants of the epithelial cells. Nodular fasciitis, a self-limited and benign soft tissue lesion, is composed principally of myofibroblasts. Primarily an extramucosal lesion, it presents a pseudosarcomatous microscopic appearance. Fibrosarcomas represent the other end of the spindle cell lesion spectrum in that they are soft tissue malignancies of fibroblastic origin. Clinical, pathologic, and biologic implications of these lesions when they arise in the mucosae of the upper aerodigestive tracts of the head and neck are presented.

Carcinoma↗
PubMedDate not supplied

The current status of mandibular reconstruction using autogenous frozen mandibular grafts.

A review of recent developments in experimental canine surgery using autogenous frozen grafts for mandibular reconstruction has elicited enthusiasm for their human application in cancer surgery. They do reossify, even under adverse conditions of perioperative irradiation, to regenerate a mandibular graft in the dog. Our experience with six patients who underwent immediate autogenous mandibular graft reconstruction is dismal. All failed because of intraoral complications; none evidenced recurrence of tumor in bone. A delayed procedure, in which revascularization of the midportion of the bone graft may be improved, may prevent many of these problems.

Animals↗
PubMed1984

Surgical stents for the head and neck cancer patient.

Split-thickness skin graft reconstruction following intraoral cancer surgery maintains functional mobility within the oral cavity and gives excellent support for the final intraoral rehabilitative prosthesis. We describe the use of a dental material, called tissue conditioner, for skin graft immobilization as an alternative to the usual gauze bolus and thermoplastic materials following surgery in various intraoral anatomic sites.

Dentures↗
PubMedDate not supplied

Routes of entry of squamous cell carcinoma to the mandible.

A recent preliminary report of a study to determine the patterns of invasion of squamous cell carcinoma to the nonirradiated edentulous mandible indicated that tumor entered mainly through the residual alveolar occlusal ridge. This study has now been extended and includes both nonirradiated and irradiated mandibles. Of a total of 46 nonirradiated mandibles (10 partially dentate and 36 edentulous) invaded by tumor, 41 were invaded through the occlusal surface. This confirms the findings of the preliminary report. These findings indicate that there is a rational basis on pathologic grounds for adopting a conservative approach to the nonirradiated mandible. In 16 irradiated mandibles, the routes of tumor entry were found to be much more variable than in the nonirradiated mandible. In 16 irradiated mandibles, the routes of tumor entry were found to be much more variable than in the nonirradiated mandible, and multiple foci of tumor invasion of the bone were often present wherever tumor in adjacent soft tissues approached the bone. This variability of tumor entry means that a conservative approach to mandibular excision cannot be pursued in the previously irradiated mandible and full-thickness segmental resection is necessary if bone involvement appears likely.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Reactive changes in the mandible in the presence of squamous cell carcinoma.

A series of 80 mandibles, which were removed as part of composite resections for primary intraoral squamous cell carcinoma, was examined. Of these, 58 were nonirradiated and 22 were previously irradiated. Several changes were observed in the nonirradiated mandible in response to invading tumor. Deposition of new bone was obvious on the periosteal and endosteal surfaces. Osteoclastic resorption of bone was prominent and there was replacement of hemopoietic marrow by fibrous tissue. By contrast, it was found in the irradiated specimens that osteoblastic activity was absent but that osteoclastic activity persisted. The hemopoietic marrow was replaced by fibrous tissue. The lack of osteoblastic activity was interpreted as being due to irradiation. The extent of these changes and their relationship to the invading tumor have implications for both surgeon and pathologist.

Carcinoma, Squamous Cell↗
PubMed1993

Cytologic diagnosis of oral, esophageal, and peripheral lung cancer.

Oral cavity. Most carcinomas in situ of the oral cavity present as red or pink lesions that do not have a keratinized surface. Scrapings of such lesions readily disclose abnormal squamous cells diagnostic of cancer. Scrapings of the keratinized white lesions (so-called leukoplakia) are of no diagnostic value. Dentists, who are most likely to uncover precancerous lesions, are apparently not aware of the diagnostic options based on simple scrape smears. The method is also applicable to follow-up of patients with treated cancer of the oral cavity. Esophagus. Cytologic evaluation of esophageal cancer, initially by washings and subsequently by brushings under endoscopic control, is an established method of diagnosis. The diagnostic results are very good in symptomatic cancer patients and have an accuracy reaching 85-90%. Unfortunately the results of treatment of advanced lesions are very poor, with 5-year survival of only about 5%. Serious efforts at detection of early esophageal cancer started in China in the 1960s, using an abrasive balloon technique which was applied to asymptomatic populations in high risk areas such as Linxian in the Henan province of Central China. The Chinese investigators reported the finding of numerous precancerous lesions of the esophagus classified as carcinoma in situ and as dysplasia. Surgical resection of some of the precursor lesions apparently resulted in a significant drop in the rate of invasive carcinoma, although the statistical results were not convincingly presented. The balloon technique has been tested by us and by others in South Africa and in Transkei, confirming its efficacy in the diagnosis of early esophageal cancer. Peripheral lung. Sputum and bronchial brush cytology may uncover bronchogenic carcinoma in situ and early invasive cancers located in the primary or secondary bronchi. Small, peripheral lung lesions usually do not shed cells in sputum or brushings, and their discovery is usually based on roentgenologic finding. The identity of such lesions can be confirmed in most cases by a transcutaneous aspiration. Most of the peripheral malignant lesions are small adenocarcinomas or epidermoid carcinomas, both resectable by routine surgical procedures. Less commonly, oat cell carcinomas may be observed and these lesions should not be treated by surgery. Benign lesions such as granulomatous inflammation and fungal infections may also be identified by aspiration techniques. The prognosis of the resectable carcinomas varies with their size and the presence or absence of regional lymph node metastases.(ABSTRACT TRUNCATED AT 400 WORDS)

Cytodiagnosis↗
PubMed1993

N-acetyl-l-cysteine.

The most commonly used chemopreventive agents in the prevention of oral leukoplakia, head and neck cancer, and lung cancer are beta-carotene, vitamin A, and other retinoids. One of the few chemopreventive agents not in this group and presently being used in a clinical trial is N-acetyl-l-cysteine (NAC). NAC, an antioxidant, is used in EUROSCAN, a European Organization of Research and Treatment of Cancer (EORTC) chemoprevention study in curatively treated patients with oral, laryngeal, or lung cancer. The rationale for choosing NAC is based on a variety of experimental data showing its ability to exert protective effects, including extracellular inhibition of mutagenic agents from exogenous and endogenous sources, inhibition of genotoxicity of reactive oxygen species, modulation of metabolism coordinated with blocking of reactive metabolites, protection of DNA and nuclear enzymes, and prevention of the formation of carcinogen-DNA adducts. NAC has also demonstrated an effect on mutagen-induced chromosomal sensitivity assays, and on anticarcinogenicity in experimental animal models. In addition, preliminary data from EUROSCAN show good compliance in treated patients and a low frequency of side effects.

Acetylcysteine↗
PubMed1985

Adjuvant Corynebacterium parvum immunotherapy for squamous cell epitheliomas of the oral cavity, pharynx, and larynx.

Patients with primary squamous cell epitheliomas of the oral cavity, pharynx, and larynx were stratified according to stage and site and randomized to receive either intratumoral immunotherapy with Corynebacterium parvum followed 2 weeks later by surgery and postoperative C parvum for 2 years or surgery alone. There were 209 patients entered into the trial and 176 were fully evaluable. All prognostic variables were similar between the two groups. There was no difference in disease-free survival or absolute survival between the two groups of patients. In addition, there was no difference noted for any stage and/or site. The only difference in sequential immunologic testing was that chemokinesis was increased following intratumoral C parvum, but neither this nor any other immunologic test correlated with ultimate recurrence or survival. These data demonstrate that immunotherapy using preoperative, intralesional C parvum and postoperative, subcutaneous C parvum is ineffective when used as an adjuvant to surgery for primary cancers arising in the oral cavity, pharynx, and larynx.

Adjuvants, Immunologic↗
PubMed1988

Thin cutaneous flap for intra oral reconstruction: the dorsalis pedis free flap revisited.

The dorsalis pedis flap provides thin, hairless tissue for a variety of intra oral defects. Due to concerns for the donor site, reconstructive surgeons have largely overlooked this flap, despite its numerous desirable qualities. The paper focuses on the anatomy of the first dorsal metatarsal artery and techniques which insure the preservation of adequate flap vascularity. The prevention of donor site complications centers around meticulous attention to the placement of skin grafts, with a secure tie-over dressing and the use of a posterior splint. Patients are allowed to ambulate in the early postoperative period only when venous compression is provided with an ace bandage. Vigorous attention to detail on reconstructing the foot has minimized donor site complications. The dorsalis pedis flap continues to be an important method of reconstruction in our armamentarium of free tissue donor sites.

Carcinoma, Squamous Cell↗
PubMed1994

Fibula osteoseptocutaneous flap for mandible reconstruction.

The fibula free flap has become an established flap for mandible reconstruction when vascularized bone is desirable. Recreating mandibular contour, providing soft tissue coverage, and restoring masticatory function are equally important in mandible reconstruction, and these can be provided by the fibula osteoseptocutaneous flap. This article is a summary of the anatomy, indications, and operative technique of the fibula osteoseptocutaneous flap accumulated from 49 consecutive mandible reconstructions.

Ameloblastoma↗
PubMed1994

The place of the iliac crest in vascularized oromandibular reconstruction.

The iliac crest is reevaluated with respect to the rapid evolution of vascularized mandibular reconstruction. With more flaps to choose from, indications for the crest have become more specific-playing to the strengths of this particular transfer. Ideally, defects should exclude soft tissue and occupy lateral segments of the mandibular arch-up to and including a complete hemimandible. The composite flap is capable of reconstructing external skin with ease, but the color match leaves something to be desired. Mucosal defects are less well handled. The flap can replace soft tissue bulk as well as mandibular height following through-and-through excisions in the region of the chin. Where donor site cosmesis is of paramount importance, the iliac crest is simply the best flap available.

Female↗
PubMed2006

Comparison of chronic toxicity and carcinogenicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in 2-year bioassays in female Sprague-Dawley rats.

The cancer bioassay for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) conducted by the Dow Chemical company in the mid 70s has been used extensively for conducting quantitative cancer risk assessments for human exposure to TCDD. More recently the National Toxicology Program (NTP) conducted a cancer bioassay of similar design as part of its evaluation of the dioxin toxic equivalency factor methodology. This report compares the design and the results of these two cancer bioassays. This comparison confirms, in most cases, previously published and widely used carcinogenic response characteristics with respect to dose, time course, organ selectivity, tumor type and maximum intensity of TCDD-induced carcinogenicity and toxicity in the Sprague-Dawley rat. Specifically, increases in the incidences of neoplasms were seen in both studies in the liver, lung and oral mucosa. The most notable difference was the significant increase in the incidence of cholangiocarcinoma of the liver seen in the NTP study but not in the Dow study. The experimental designs for the two studies are similar but some protocol parameters differed, such as vehicle, dosing schedule, diet and rat sub-strain utilized. Differences in the shapes of the dose response curves for several neoplasms were noted between the studies, with the NTP study showing non-linearity for all neoplasms. This may result from differences in the experimental protocols as well as divergence in the biological behavior of the different stocks of Sprague-Dawley rat strains used.

Animals↗
PubMed2001

Detailed gene expression analysis but not microsatellite marker analysis of 9p21 reveals differential defects in the INK4a gene locus in the majority of head and neck cancers.

The INK4a gene locus on chromosome 9p21 encodes two proteins, p16(INK4a) and p14(ARF), which influence cell cycle control regulated by pRb and p53. The objective of this study was to use different methods for the analysis of the incidence of changes at the INK4a locus in head and neck cancer (HNSCC). Primary tumours were analysed for allelic imbalances (AI) with microsatellite markers for chromosome 9, by immunohistochemistry (IHC) and IHC with enhanced sensitivity by tyramide signal amplification (TSA-IHC), and by RT-PCR. No homozygous deletions at 9p21 were detected. AI at 9p21, which was found in approximately 60% of the tumours, completely failed to indicate the functional inactivation of the two INK4a gene products. Immunostaining of normal squamous epithelia revealed very low levels of p16(INK4a), whereas p14(ARF) was readily detectable. In 160 tumours, IHC suggested a loss of p16(INK4a) expression in 90%. However, by TSA-IHC, only 53.7% showed loss of p16(INK4a) expression, and this was consistent with the RT-PCR analyses. In 100 tumours analysed for both proteins, selective loss of p16(INK4a) occurred in 37%; loss of p14(ARF) was found in only 15%, and selective loss in only 4%; 11% of the tumours had lost both proteins. We conclude that only IHC with high sensitivity and the combined expression analysis of mRNAs and proteins is suitable for studying the role of INK4a in HNSCC. The INK4a gene expression defects are frequent but not universal and primarily affect p16(INK4a). Their clinical impact is still not clear.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Staging of head and neck cancer.

Revised staging systems for cancers of the upper aerodigestive tract, the major salivary glands, and the thyroid are presented. The staging has been accepted by both the American Joint Committee on Cancer and the International Union Against Cancer and is gaining worldwide acceptance.

Carcinoma, Squamous Cell↗
PubMed1995

Risk factors and genetic susceptibility.

Tobacco use is such a major determinant of head and neck cancer risk that classical epidemiologic techniques were more than adequate to document and characterize the etiologic association. However, the new emphasis in epidemiologic research is multidisciplinary, centering on the role of interindividual differences in susceptibility to carcinogenic exposures and particularly on the interaction of genetic susceptibility and environmental forces, that is, ecogenetics. For upper aerodigestive tract cancers, measurements of carcinogen metabolic activation and DNA repair capability are especially relevant. These susceptibility markers will enable the identification of high-risk population subgroups who can be targeted for the most intensive primary and secondary preventive strategies.

Animals↗
PubMed1978

Combined use of bleomycin with radiation in the treatment of cancer.

1. The data accumulated in this study up to the present time shows that combined treatment of radiation and bleomycin in intra-oral carcinoma resulted in marked tumor regression and a significantly higher tumor disappearance rate as compared with radiotherapy alone. The 18 month survival rate for the combined treatment group exceeded the rate for the control group by about 20%. 2. In esophagal carcinoma, bleomycin in combination with radiation markedly improved the regression rate of polypoid type tumor, while no significant improvement was observed in other types. The 18 month survival rate of the control group was about 10% higher than that of the combined treatment group. 3. In bronchogenic carcinoma, no significant difference was observed in tumor regression or survival rate of either group.

Bleomycin↗