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At least 19 recordsLinked to original sources
PubMed2002

[Indication and clinical radical effect of functional neck dissection for head and neck neoplasm].

BACKGROUND & OBJECTIVE: The functional neck dissection was first described by Bocca in 1967. It has been used on clinical practice for years. But still controversial between supporters and opponents of functional neck dissection. This study was designed to evaluate application and radical effectiveness of functional neck dissection(FND). METHODS: One hundred and fifty-two cases underwent FND were reviewed with analysis of pathological specimen and follow-up data. RESULT: One hundred and fifty-two cases of FND include tongue carcinoma 20 cases, larynx carcinoma 23 cases, thyroid papillary adenocarcinoma 96 cases, follicular adenocarcinoma 9 cases, medullary adenocarcinoma 4 cases; Five years recurrence rate of tongue and larynx carcinoma was 12.5%, 14.3%, 40.0% and 20%, 16.7%, 50.0% in N0, N1, N2, respectively. 5 years recurrence rate of thyroid papillary adenocarcinoma is 6.5%, 7.1% in N1a, N1b, respectively. CONCLUSION: Functional neck dissection is suitable for head and neck neoplasm, was result in satisfactory radical effects.

Adenocarcinoma, Follicular↗
PubMed2003

TP53 and head and neck neoplasms.

Head and neck cancer is an important health problem around the world, accounting for approximately 500,000 new cases each year of head and neck squamous cell carcinoma (HNSCC). Carcinogenesis of head and neck results from a dysregulation of cellular proliferation, differentiation, and cell death. The major etiologic agents are tobacco and alcohol consumption and for some cases, human papilloma virus (HPV) infection. All three factors are associated with the disruption of a cellular pathway essential for the maintenance of cellular integrity, the p53 pathway. The objective of this review is to point out the specificity of p53 gene (TP53) alterations in head and neck cancer in relation with chemocarcinogenesis and to discuss whether or not the determination of p53 alterations will be of clinical relevance in the management of head and neck cancer in terms of prognosis and response to treatments.

Alcohol Drinking↗
PubMedDate not supplied

[Importance of upper digestive endoscopy using lugol dye solution for the diagnosis of superficial esophageal cancer and dysplasia in patients with head and neck neoplasms].

Head and neck cancer has a high incidence in Brazil, with cancer of the oral cavity being one of the five most common cancers among Brazilians. Alcohol and tobacco consumption may contribute to synchronous or metachronous head and neck cancer and esophageal cancer. A prospective study involving 60 patients with head and neck cancer was carried out at the State University of Campinas--UNICAMP, Campinas, SP, Brazil to screen for superficial esophageal cancer and dysplasia using endoscopy and a 2% lugol dye solution followed by biopsy of the suspicious areas. Five patients (8.3%) had superficial esophageal cancer, which was diagnosed as intraepithelial carcinoma in three of them (5.0%). In four patients, the superficial esophageal cancer was synchronous and in one it was metachronous to head and neck cancer. Five patients (8.3%) had dysplasias in the esophageal epithelium (three were classified as mild and two as moderate). These results demonstrate the value of endoscopic screening of the esophagus using lugol dye in patients with head and neck cancer, particularly since superficial esophageal cancer is extremely difficult to detect by conventional methods in asymptomatic patients.

Adult↗
PubMed2001

[Expression and significance of serum soluble tumor necrosis factor receptor-I in patients with head and neck neoplasm].

OBJECTIVE: To investigate the expression and significance of serum soluble tumor necrosis factor receptor-I (sTNFR-I) in patients with head and neck neoplasms. METHOD: The study was undertaken to detect serum sTNFR-I levels in 160 head neck cancer patients (including 12 cases of malignant lymphoma, 62 nasopharyngeal cancer, 56 laryngeal cancer, 22 hypopharyngeal cancer, 3 maxillary cancer and 5 thyrophyma), using Sandwich enzyme-linked immuno-sorbent assay. RESULTS: The sTNFR-I levels were significantly higher in patients with carcinoma than those of healthy controls (P < 0.01). The sTNFR-I levels of malignant lymphoma and nasopharyngeal carcinoma were the highest among patients with head and neck neoplasm. The correlations between the serum sTNFR-I levels and the stages of head and neck neoplasms and other laboratory parameters were also analyzed and discussed. CONCLUSION: The serum sTNFR-I levels may reflect the human immunity function, therefore it can be used as a helpful indicator to evaluate the therapeutic effect and monitor the relapses and metastasis of cancer.

Adolescent↗
PubMed1987

Evaluation of poorly differentiated head and neck neoplasms. Immunocytochemistry techniques.

Despite the use of strict morphologic criteria, some head and neck neoplasms remain classified as "poorly differentiated" or "undifferentiated." To circumvent this diagnostic quandary, newer techniques primarily based on immunocytochemistry are being utilized to study tumor specimens. These methods rely on the binding of specific antibodies to cellular antigens in order to better define the tumor according to cell type. We treated six patients in whom a definitive pathologic diagnosis could not be obtained without the use of immunohistologic stains. In each case, the definition of a specific tumor category altered patient management. The approach to the evaluation of patients with undifferentiated head and neck neoplasms is important. Close cooperation between the clinician and pathologist is necessary in such cases; this is assisted by a knowledge of the uses and limitations of the current diagnostic modalities being used, as well as proper tissue handling and processing.

Adult↗
PubMed1989

[Study of multiregression analysis on NK activities and related clinical factors in patients with head and neck neoplasms].

NK activity in patients with head and neck neoplasms treated with radiation and chemotherapeutics was studied on the influence of 19 factors by using the method of multiregression analysis. Of these factors, BUN, WBC, the size of radiation portal, chemotherapy, radiation doses, total protein (T.P.), age and GOT were significantly influenced on the fluctuation of NK activity (p less than 0.05). In the studies of the size of radiation portal and its doses, NK activity showed a tendency to increase with radiation dose in small size of radiation portal and a tendency to reduce in large size of it.

Adult↗
PubMed1986

Neck neoplasms: MR imaging. Part I. Initial evaluation.

Untreated neoplasms of the neck (tumors of the oropharynx, supraglottic area, carotid body, and thyroid, in addition to malignant lymphadenopathy) were evaluated in 23 patients with magnetic resonance (MR) imaging. The results were compared with computed tomographic (CT) scans in 20 patients. Contrast between tumor and fat was best on relatively T1-weighted images (500/30-35 [TR msec/TE msec]), whereas separation of tumor and muscle was best with relatively T2-weighted pulse sequences (1,500/90). Balanced images (1,500/30-35) provided best overall image quality and best demonstrated vascular anatomy. MR imaging was usually superior to CT in showing the relationship of tumor mass to muscle. MR imaging and contrast material-enhanced CT were equivalent in most patients in defining vascular anatomy, but MR imaging was superior when intravenous contrast material was not administered. However, CT was more helpful in showing bone and cartilage anatomy, and in some patients CT also was better in showing airway abnormalities. Despite these limitations, MR imaging is a promising imaging technique for studying neoplasms of the neck.

Adult↗
PubMedDate not supplied

Ultrasonic analysis of head and neck neoplasms. Correlation with surgical findings.

Ultrasonography of head and neck neoplasms is useful in the preoperative evaluation of patients. Inflammatory masses demonstrate high reflectivity in a homogeneous pattern and have diffuse borders. Similarly, lipomas show medium to high reflectivity and have a homogeneous pattern, but are well outlined. Mixed tumors of the major salivary glands have a characteristic heterogeneous pattern and are well outlined. Malignant lesions demonstrate low reflectivity in a homogeneous or heterogeneous pattern and have poorly outlined or diffuse borders. Cysts of the head and neck are well outlined and devoid of interior echoes.

Adolescent↗
PubMed1994

Head and neck neoplasms: magnetization transfer analysis.

PURPOSE: Magnetization transfer (MT) imaging enables analysis of the contribution of restricted motion protons in the macromolecular pool to magnetic resonance (MR) signal intensity. The authors undertook this study to determine whether MT ratios (MTRs) could be used to predict pathologic characteristics of head and neck neoplasms. MATERIALS AND METHODS: Fifty-four patients with pathologically proved neoplasms (squamous cell carcinomas, n = 33; non-squamous cell carcinomas, n = 11; benign masses, n = 10) underwent MT imaging. MTRs were correlated with pathologic findings. RESULTS: No statistically significant correlations were noted between MTRs and degree of differentiation, keratinization, cells per high-power field, and rate of mitosis. Statistically significant differences were found between MTRs of malignancies and muscle (P < .01), cerebrospinal fluid (P < .001), fat (P < .001), and benign neoplasms (P < .001). MTRs of muscle were higher than those of benign, squamous cell, and non-squamous cell neoplasms. CONCLUSION: MT imaging shows promise in differentiation of benign from malignant head and neck neoplasms. No statistically significant differences in MTRs were noted among malignancies.

Carcinoma, Squamous Cell↗
PubMed2002

Treatment of patients with spinal metastases from head and neck neoplasms.

BACKGROUND: Spinal metastases are uncommon in patients with advanced head and neck cancer. Treatment strategies in this patient group have not been defined. Although it has been established that neurologic dysfunction in patients with spinal metastases and cord compression constitutes an oncologic emergency, the role of surgical treatment remains controversial. OBJECTIVE: To clarify the treatment options in patients with head and neck cancer who develop spinal metastases. METHODS: The clinical course of patients seen at our institution with head and neck neoplasms and spinal metastases from January 1992 to January 2000 was reviewed. RESULTS: Eleven patients were identified. Nine developed spinal metastases more than 3 months after the diagnosis of advanced head and neck cancer. The other 2 presented with synchronous spinal involvement and skull base neoplasms. Patients without neurologic symptoms were offered intravenous steroids and palliative radiation. Patients with neurologic symptoms were treated with either intravenous steroids and radiation or surgical decompression and spinal fusion. In 1 patient, no improvement occurred within the first 2 days of radiotherapy, and the patient underwent surgical decompression. Patients with an unstable spine underwent surgical decompression and spinal fusion. Patients with a life expectancy of more than 6 months and neurologic symptoms were offered surgical therapy. In the 9 patients with advanced cancer, the average survival time was 3 months. Two of these patients have survived longer than 6 months. CONCLUSIONS: We propose that surgical decompression is a viable, justifiable option for selected patients with advanced head and neck cancer and spinal cord compression. Furthermore, we recommend surgical decompression as a first option in patients with an unstable bony spine and/or in whom survival is expected to be longer than 6 months. Finally, we propose a patient management algorithm in these cases.

Adult↗
PubMed2000

[Radiologic diagnosis of outside-of-organs neck neoplasms].

To evaluate the efficiency of ultrasound (US) and computed tomography (CT) in diagnosis of neck neoplasms, 36 patients with 26 benign and 8 malignant tumors were examined. Also, 32 US-guided fine needle aspiration biopsies (FNAB) were performed. Both US and CT showed high efficiency in detecting neck masses but not in different diagnosis, except for lymphomas. However, FNAB discriminated between benign and malignant tumors with a sensitivity of 75%, specificity--96% and accuracy--90.9%.

Adolescent↗
PubMed1991

[Diagnostic reliability of ultrasonography in the preoperative staging of the N parameter in head and neck neoplasms].

The demonstration of metastatic involvement of neck nodes is a crucial step in the staging of patients with head and neck tumors. Diagnostic accuracy, sensitivity, and specificity of US in the detection of lymph node metastases were evaluated in 48 patients with this type of malignancy. The patients subsequently underwent surgical node dissection. Comparison of US, clinical and histological data demonstrated US to have 93.7% diagnostic accuracy, 100% sensitivity, and 84% specificity--the corresponding clinical values being 81%, 79%, and 84%, respectively. Among several US parameters, a substantial role in differentiating metastatic from tumor-free lymph nodes was played by the evaluation of roundness index (RI), and by the demonstration of an intranodal hyperechoic stria: RI value was always higher than 2 in tumor-free nodes and the hyperechoic stria was always absent in metastatic nodes. US approach never failed to demonstrate metastatic nodes while clinics missed them in 6 patients. Thus, US appears the most valuable diagnostic tool for staging head and neck tumors; its diagnostic accuracy can be increased by the combination with US-guided aspiration biopsy.

Aged↗
PubMed1993

Radiotherapy for head and neck neoplasms.

This review presents several relatively new areas of interest in radiotherapy for head and neck neoplasms. In the clinical arena, improving radiotherapy outcome by altering radiation schedules has undergone rigorous testing in patients with squamous cell carcinomas. The initial results show that such an approach increases the local control rate in subsets of patients by 10% to 15%. Randomized multi-institutional studies, sponsored by large cooperative groups, are ongoing to assess the relative merits of various altered fractionation strategies. In the field of laboratory investigations, attempts have been made to develop tests reliable in predicting the radiation response of tumors and normal tissues. If successful, it would be possible to design the optimal radiation regimen for individual patients based on the results of these tests, thereby improving the therapeutic ratio. Technologic innovations have enhanced the flexibility to conform radiation to the target volume so that higher doses can be delivered to the tumor without exceeding the tolerance of the surrounding normal tissues. Large-scale clinical studies evaluating the value of conformal therapy are being developed. Finally, long-term results of radiotherapy in the management of chemodectomas have been reported in recent years. These data have clearly defined the role of radiotherapy in the treatment of skull-base paragangliomas.

Clinical Trials as Topic↗
PubMed1986

Neck neoplasms: MR imaging. Part II. Posttreatment evaluation.

Thirty-three patients who had undergone prior surgery and/or radiation therapy for malignant neoplasms of the neck were studied with magnetic resonance (MR) imaging. Twenty-seven of these patients were also evaluated with computed tomography (CT). Ten patients were healthy posttreatment volunteers, and 23 had documented tumor recurrence. MR images better demonstrated normal muscular landmarks, especially in patients with obliterated fat planes. Areas of posttreatment fibrosis or scarring were low in signal intensity with all MR pulse sequences. However, in three patients, high signal intensity from postradiation edema of the supraglottic area mimicked neoplasm. In patients with recurrent tumor, MR imaging was superior to CT in defining the relationship of tumor and muscle and in demonstrating vascular anatomy when no intravenous contrast material was given during the CT examination. In two patients tumor and fibrosis were separated on MR images because of signal intensity differences. CT scans, however, showed adjacent bone and cartilage anatomy better. Our data indicate that an MR examination may be helpful in patients in whom CT is indeterminate either because of anatomical distortion or suboptimal demonstration of vascular anatomy.

Head and Neck Neoplasms↗
PubMed1997

Comparison of dynamic contrast-enhanced gradient-echo and spin-echo sequences in MR of head and neck neoplasms.

PURPOSE: To investigate the utility of dynamic contrast-enhanced gradient-echo MR imaging of head and neck lesions and to compare this technique with the commonly used spin-echo contrast-enhanced fat-saturation technique. METHODS: Twenty-two patients with a total of 23 head and neck neoplasms underwent dynamic gradient-echo and spin-echo MR imaging studies. The spin-echo and dynamic gradient-echo images were compared in each case by consensus of three observers for differences in tumor conspicuity and delineation of margins, particularly with regard to invasion of adjacent structures. When possible, pathologic and/or surgical confirmation of tumor extent was obtained. Relative contrast was also calculated to determine objectively the degree of tumor enhancement with respect to background mucosa. RESULTS: The dynamic gradient-echo images showed better or equal delineation of the tumor margins by subjective observation in all but two cases. Temporally different enhancement patterns were noted for lesions, background mucosa, and adjacent reaction and edema. The dynamic gradient-echo technique provided better relative contrast than the spin-echo technique in 17 (77%) of 22 lesions. CONCLUSION: Dynamic gradient-echo MR imaging is superior to conventional contrast-enhanced spin-echo imaging in delineating the margins and extent of tumor. This technique provided observers with added confidence in their interpretations and suffered from fewer technical limitations.

Adult↗