Laryngeal Cancers at the Pathological Anatomical Laboratory (ACP) in Dakar about 215 Cases

Introduction: Laryngeal cancer is the first cancer of upper aerodigestive tract. Dysphonia, dyspnea and dysphagia are evocative signs. Diagnosis is histological and squamous cell carcinoma is the most common type. The objective of our study was to discuss epidemiological and anatomo-pathological characteristics of laryngeal cancers diagnosed in different pathological anatomy and cytology (ACP) laboratories of Dakar hospitals. Material and method: This was a retrospective study spanning from January 2013 to December 2018 at the pathological anatomy laboratories of Fann, Aristide Le Dantec and Idrissa Pouye hospitals. All patients with laryngeal cancer confirmed at histology were included. Data collection was based on clinical records of the patients and archives of histological reports of the pathological laboratories. Data analysis was performed under the Excel software. Results: We collected 215 cases of laryngeal cancer. The average age was 58.01 years with extremes of 07 and 94 years. The male sex was predominant with 183 patients (85.12%) against 32 women (14.88%). The most noted risk factor was tobacco which affected 14 patients, or 60.87%. Three patients (13.04%) did not present any alcohol-smoking impregnation. Clinically, dysphonia was noted in 22 patients (26.51%). It was associated with dyspnea in 0.48% of cases and dysphagia in 3.61%. Laryngoscopy was performed in 62 patients or 28.83% of cases, nasofibroscopy in 6.45% of cases. Cord arythenoid fixity was noted in two patients (3.23%) and hypo-mobility in 1 patient (1.61%). The most frequent local extension was involvement of the piriform sinus with 11.29% of cases. Palpable lymphadenopathy reported in 17 patients (20.48%). Pathological examination was performed in all patients after post endoscopic biopsy in 92 patients (42.79%), and after obtaining the operative specimen in 123 cases (57.21%). The three floors affected 76 patients (35.35%). The ulcerative budding aspect most noted concerned 108 patients (60.97%). Histologically, it was a squamous cell carcinoma in 205 patients (95.34%). The most site invaded by the tumor was cricoid cartilage.T4 type was most found (45 patients or 40.90%) followed by the T3 type with 34.55%. There was no lymphadenopathy invasion (Type N0) in 74 patients (67.27%), capsular rupture was reported in five patients (6.77%), no evaluable metastasis in 110 patients (97.27%), and stage IVA predominated in 66 patients (60%). Conclusion: laryngeal cancer is a reality in our contexts, however, its incidence is poorly understood in Senegal. The main risk factors remain tobacco and alcohol. Histology confirms the diagnosis. Its management is multidisciplinary and must be early.

Effect of Individualized Nutrition Intervention Care Combined with Swallowing Training on Postoperative Nutritional Status in Patients with Laryngeal Cancer

Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or postoperative radiotherapy. The surgery is delicate, complex, time-consuming and traumatic. Postoperative patients are prone to dysphagia, leading to an increase in the incidence of malnutrition. Malnutrition can cause a series of negative effects, including weight loss, increased incidence of infection, reduced tolerance of anti-tumor treatment, and extended length of hospital stay. Therefore, how to effectively improve the nutritional status of laryngeal cancer patients through nursing intervention has become an important topic of nursing research. Objective: Investigate the effect of individualized nutrition intervention care combined with swallowing training on postoperative nutritional status in patients with laryngeal cancer. Methods: A total of 120 consecutive patients who underwent laryngeal surgery at our hospital for the first time between May 2018 and May 2021 were selected for the study and equally divided into the control group and the study group by the random number table method, with 60 patients in each group. Patients in the control group were given swallowing function training and health counseling, and the study group adopted individualized nutrition intervention care based on the control group. The nutritional status, swallowing function, and quality of life (QOL) of the patients were assessed using the Patient-generated Subjective Global Assessment (PG-SGA), MD Anderson Dysphagia Inventory (MDADI), and Quality of Life Questionnaire-Core30 (QLQ-C30) before the intervention and three months after the intervention. Results: Before the intervention, the scores of MDADI, PG-SGA, and QLQ-C30 were not significantly different between the two groups (P > 0.05), and three months after the intervention, the scores of MDADI and QLQ-C30 increased and the score of PG-SGA decreased in the study group, with significant differences (P 0.05). At three months after the intervention, patients in the study group had higher scores on MDADI, QLQ-C30 and lower scores on PG-SGA than the control group, with significant differences (P Conclusion: Combining individualized nutrition intervention care with swallowing training improves the postoperative nutritional status, swallowing function, and QOL of patients with laryngeal cancer.

Incidence and mortality of laryngeal cancer in China, 2011

Objective： Laryngeal cancer is the common cancer of the upper aerodigestive tract. We aimed to use the national cancer registration data in 2011 to estimate the incidence and mortality of laryngeal cancer within China. Methods： Comparable, high-quality data from 177 population-based cancer registries were qualified for analysis. The pooled data were stratified by area, sex and age group. National new cases and deaths of laryngeal cancer were estimated using age-specific rates and national population in 2010. All incidence and death rates were age-standardized to the 2000 Chinese standard population and Segi＇s population, which were expressed per 100,000 populations. Results： All 177 cancer registries covered a total of 175,310,169 population （98,341,507 in urban and 76,968,662 in rural areas）, accounting for 13.01% of the national population. The data quality indicators of proportion of morphological verification （MV%）, percentage of cancer cases identified with death certification only （DCO%） and mortality to incidence ratio （Mr/） were 77.98%, 2.62% and 0.55, respectively. Estimated 20,875 new cases of laryngeal cancer were diagnosed and 11,488 deaths from laryngeal cancer occurred in China in 2011. The crude incidence rate of laryngeal cancer was 1.55/100,000 （2.69/100,000 in males and 0.35/100,000 in females）. Age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 1.13/100,000 and 1.14/100,000, respectively. Laryngeal cancer is much rarer in females than in males. The incidence rate was higher in urban areas than that in rural areas. The crude mortality rate of laryngeal cancer was 0.85/100,000 （1.42/100,000 in males and 0.25/100,000 in females）. Age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were both 0.61/100,000. The mortality rate in males was much higher than that in females. There was no definite difference in mortality rates of laryngeal cancer between urban and rural areas. Conclusions： Larynx is a specialized area and cancer of larynx significantly affects the quality of life for the patients. Comprehensive measures should be carried out to prevent the ascent of laryngeal cancer.

Incidence and mortality of laryngeal cancer in China,2008–2012

Objective：To analyze the incidence and mortality rates of laryngeal cancer in China from 2008 to 2012.Methods：Incident and death cases of laryngeal cancer were retrieved from the National Central Cancer Registry（NCCR）database collecting from 135 cancer registries in China during 2008–2012.The crude incidence and mortality rates of laryngeal cancer were calculated by area（urban/rural）,region（eastern,middle,western）,gender and age group（0,1–4,5–9,…,85＋）.China census in 2000 and Segi’s world population were applied for age standardized rates.Join Point（Version 4.5.0.1）model was used for time trend analysis.Results：The crude incidence rate of laryngeal cancer was 1.86/100,000 ranked the 21st in overall cancers.The age-standardized incidence rates by China population（ASIRC）and by World population（ASIRW）were1.22/100,000 and 1.23/100,000,respectively.The crude mortality of laryngeal cancer in China was 1.01/100,000and it was the 21st cause of cancer-related death in overall cancers.Both the age-standardized mortality rates by Chinese standard population（ASMRC）and by world standard population（ASMRW）were 0.63/100,000.Incidence and mortality rates of laryngeal cancer were higher in males than in females and higher in urban areas than in rural areas.Middle areas had the highest incidence and mortality rates followed by eastern and western areas.Incidence and mortality rates of laryngeal cancer retained low level before age of 40 years old but increased greatly after and peaked in age group of 75.Incidence showed significant down trends in recent 10 years by 1.27%annually[95%confidence interval（95%CI）：–2.2%,–0.3%].Mortality declined in females sharply by 5.18%per year although stable in males and both sexes combined.Conclusions：Appropriate targeted prevention,early detection and treatment programs should be carried out to control the local burden of laryngeal cancer.

ABO blood group is a predictor of survival in patients with laryngeal cancer

Background: Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinico?pathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis.Methods: We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat?sen University Cancer Center between January 1993 and December 2009. The Chi?square test was used to assess the relationship between the ABO blood group and clinicopathologic characteristics. The Kaplan–Meier method was used to estimate 3?, 5?, and 10?year overall survival(OS) rates. The Cox proportional hazards model was used in univariate and multivariate analyses of OS.Results: No signiicant association was found between the ABO blood group and clinicopathologic characteristics except for primary tumor site. The median OS for patients with blood groups A, B, AB, and O were 87.0, 80.0, 90.0, and 72.5 months, respectively. The 3?, 5?, and 10?year OS rates were 82.4%, 76.0%, and 67.5% for patients with blood group A; 77.4%, 69.8%, and 58.4% for patients with blood group B; 82.2%, 73.1%, and 65.6% for patients with blood group AB; and 71.7%, 66.4%, and 55.5% for patients with blood group O, respectively. Univariate and multivariate analyses showed that the ABO blood group had signiicant efects on prognosis in patients with laryngeal cancer.Conclusions: The ABO blood group is associated with survival in patients with laryngeal cancer. Patients with blood group O had signiicantly shorter OS than patients with other ABO blood groups.

EXPRESSION OF mRNA FOR MEMBRANE-TYPE 1, 2, AND 3 MATRIX METALLOPROTEINASES IN HUMAN LARYNGEAL CANCER

To investigate correlation of expressions of membrane-type 1, 2, and 3 matrix metalloproteinases (MT1, MT2, and MT3-MMP) to the invasion and metastases in laryngeal cancer. Methods Reverse transcription-polymerase chain reaction (RT-PCR) was used to examine the mRNA level of MT1, MT2, and MT3-MMP in 24 patients with laryngeal cancer. The relationships of these three MT-MMP expressions to clinico-pathology were analyzed by statistics. Results The expressions of MT1, MT2, and MT3-MMP were significantly higher in laryngeal cancer tissues than those in para-tumorous tissues (P < 0.01) and had a close relationship with invasive depth (P < 0.05). But no significantly different expressions of these three MT-MMPs were found in different primary location and different histological grade of laryngeal cancer (P > 0.05). The expression of MT1-MMP was obviously higher in patients with metastatic lymph nodes than that in patients without metastatic lymph nodes (P < 0.05). Conclusion MT1, MT2, and MT3-MMP play an important role in the progression of laryngeal cancer, and MT1-MMP may serve as a reliable marker in estimating invasive and metastatic potency of laryngeal cancer. Suppressing expressions of MT1, MT2, and MT3-MMP early may inhibit the invasion and metastases of laryngeal cancer.

GROWTH INHIBITION OF HUMAN LARYNGEAL CANCER CELL WITH THE ADENOVIRUS-MEDIATED p53 GENE

Objective: In most laryngeal cancers, the function of p53 gene is down regulated. To explore the potential use of p53 in gene therapy of laryngeal cancer, by introducing wild-type p53 into laryngeal cancer cell line via a recombinant adenoviral vector, Ad5CMV-p53 and analyzing its effects on cell and tumor growth. Methods: A human laryngeal cancer, cell line Hep-2 was used. Recombinant cytomegalovirus-promoted adenoviruses containing human wild-type p53 cDNA was transiently introduced into Hep-2 line. The growth suppression of the Hep-2 cells and established s.c. squamous, carcinoma model was examined. The p53 protein expression was detected using immunohistochemical analysis. Results: The transduction efficiencies of Hep-2 cell line were 100% at a multiplicity of 100 or greater. The p53 protein expression peaked on day 2 after infection and lasted far 5 days. In vitro growth assays revealed cell death following Ad5CMV-p53 infected. In vivo studies, Ad5CMV-p53 inhibited the tumorigenicity of Hep-2 cell, and in nude mice with established s.c. squamous, carcinoma, nodules showed that tumor volumes were significantly reduced in mice that received peritumoral infiltration of Ad5CMV-p53. Conclusion: Adenovirus-mediated antitumor therapy carrying the p53 gene is an efficient method to inhibit laryngeal cancer growth. Transfection of laryngeal cancer cells with the wild-type p53 gene via Ad5CMV-p53 is a potential novel approach to the therapy of laryngeal cancer.

Prognostic Factors and Survival of Laryngeal Cancer in Cameroon

Background: Laryngeal cancer is a major cause of morbidity and mortality worldwide. It is ranked worldwide as the second ENT cancer with 238,000 new cases and 106,000 deaths each year. In Africa, data on the prognostic factors and the survival of this pathology remain quite limited. Objective: To study the prognostic factors of laryngeal cancer and the survival of patients with laryngeal cancer in Yaoundé and Douala. Methods and Materials: We performed an analytical, longitudinal (retrospective) study over a period from January 1, 2009 to December 31, 2018 including all patients with histologically proven laryngeal cancer, at the ENT, oncological, anatomopathological, radiotherapy and surgery Department of three reference health structures in the cities of Douala and Yaoundé (Laquintinie Hospital and General Hospital of Douala, General Hospital of Yaounde). The data collected were recorded and analyzed by SPSS version 25 and Excel 2013 statistical computer software. Survival was determined by the Kaplan Meier method and the search for prognostic factors was carried out using the Cox proportional hazards model. The significance level was p = 0.05. Results: We selected 80 patients whose vital status we knew and who had been followed up after histological evidence. The sex ratio was 5.66. The median age at cancer diagnosis was 62 years old. 60 (75%) were exposed to tobacco, 52 (65%) had alcohol-tobacco poisoning. The Center and Littoral regions were the most represented with 37.5% and 48.8% respectively. Dysphonia was present in 98.8% of patients. The histological type encountered was squamous cell carcinoma in 78 patients;in the majority of cases the cancer was diagnosed at stage IV and the glottis was the most frequent site (86.2%). The median overall survival was 1.41 with 95% CI [1.08 - 1.74]. The overall survival rates at 1 year, 3 years, 5 years and 8 years were 70%, 18%, 3% and 1.5%, respectively. The poor prognosis factor found was: age greater than or equal to 70 years. Conclusion: Present study showed that survival in laryngeal cancer in Cameroon is very low with a median overall survival of 1.41 years. The overall survival rates at 1 year, 3 years, 5 years and 8 years are 70%, 18%, 3% and 1.5%, respectively. The age greater than or equal to 70 years is the poor prognosis factor, while receiving surgery in combination with neoadjuvant chemotherapy or surgery in combination with adjuvant radiotherapy is the factor of good prognosis.

Effects of RFTVR and CO2 laser on symptoms improvement, QOL and vas of patients with early laryngeal cancer

Objective: To study the effect of RFTVR and CO2 laser on the improvement of symptoms, QOL and vas of patients with early laryngeal cancer. Methods: In this study, 120 patients with laryngeal cancer diagnosed and treated from January 2015 to December 2016 were taken as research objects. All patients were randomly divided into observation group and control group, 60 patients in each group. Patients in observation group were treated with RFTVR, and patients in control group were treated with new-type fiber-optic CO2 laser. The patients in the two groups were treated with cisplatin injection. The differences of perioperative indexes, swallowing function, pronunciation function, survival period, QOL score and VAS score between the two groups were compared. Results: There was no significant difference in the amount of intraoperative bleeding, operation time and hospitalization time between the two groups (P > 0.05);the correct swallowing of the observation group was significantly higher than that of the control group. After treatment, jitter, shimmer and HNR of the two groups were significantly improved, and jitter and shimmer of the observation group were significantly lower than that of the control group, and HNR was significantly higher than that of the control group (P < 0.05) The QOL score and VAS score of the two groups were significantly improved, and the QOL score of the observation group was significantly higher than that of the control group and the VAS score was significantly lower than that of the control group (P < 0.05);the total survival period and tumor free survival period of the observation group were significantly higher than that of the control group. Conclusion: Compared with CO2 laser treatment, the swallowing function and voice function of patients treated by low temperature plasma radiofrequency ablation were significantly improved, and the life quality of patients was significantly improved by prolonging the survival period of patients..

Incidence and mortality of laryngeal cancer in China, 2015

Objective: Using data from cancer registries to estimate laryngeal cancer incidence and mortality in China, 2015.Methods: Data submitted from 501 cancer registries were checked and evaluated according to the criteria of data quality control and 368 registries’ data were qualified for the final analysis. Data were stratified by area(urban/rural), sex, age group and combined with national population data to estimate laryngeal cancer incidence and mortality in China, 2015. China population census in 2000 and Segi’s population were used for agestandardized.Results: The percentage of cases morphological verified(MV%) of laryngeal cancer was 74.18%. The percentage of death certificate-only cases(DCO%) was 2.10%. And the mortality to incidence(M/I) ratio was 0.55.About 25,300 new cases of laryngeal cancer were diagnosed in 2015 and 13,700 deaths were reported. The crude rate of laryngeal cancer was 1.84 per 100,000(males and females were 3.20 and 0.42 per 100,000, respectively).Age-standardized incidence rates by Chinese standard population(ASIRC) and by world standard population(ASIRW) were 1.18 and 1.19 per 100,000, respectively. The cumulative incidence rate(0-74 years old) was 0.15%.The crude mortality rate was 1.00 per 100,000. Age-standardized mortality rates by Chinese standard population(ASMRC) and by world standard population(ASMRW) were 0.61 and 0.61 per 100,000, respectively, with the cumulative rate(0-74 years old) was 0.07%. Incidence and mortality of laryngeal cancer in males were higher than those in females. And the rates in urban areas were higher than those in rural areas.Conclusions: The incidence and mortality of laryngeal cancer in China were low. And the rates were significantly higher in males than in females. Risk factor control and targeted prevention should be strengthened.

Correlation of survivin,p53 and Ki-67 in laryngeal cancer Hep-2 cell proliferation and invasion

Objective: To investigate the mechanism of survivin, p53 and Ki-67 on Hep-2 human laryngeal cancer endothelial cell proliferation and invasion. Methods: Laryngeal squamous cell carcinoma and paracancerous normal tissues were collected, total RNA was extracted from tissues, survivin, p53 and Ki-67 gene m RNA expression levels in laryngeal cancer and the adjacent tissues were detected by Real-time PCR. Human laryngeal cancer Hep-2 epithelial cells were selected, survivin gene was overexpressed, and cell proliferation was detected by MTT. p53 and Ki-67 gene expression changes in overexpressed survivin gene were detected by Western blot. Changes in Hep-2 cell invasive ability were studied when survivin was overexpressed as detected by Transwell invasion assay. Results: In the adjacent tissues, survivin, p53 and Ki-67 gene relative expression levels were 1.72 ± 0.9, 13.7 ± 5.7 and 5.7 ± 1.3, respectively; while in cancer tissues, gene relative expression levels were 53.7 ± 8.3, 66.7 ± 5.2 and 61.0 ± 3.1, respectively, which was significantly increased. As detected by MTT, relative cell survival rate within 12 h of survivin overexpression were: load control group,(88.5±1.6)%; overexpressed group,(90.3±1.9)%. Transwell invasion assay results indicated that overexpressed survivin could significantly increase the relative survival rate of cells. Conclusions: Expressions of p53, Ki67 and survivin are increased in cancer; and there is a positive correlation between survivin, p53 and Ki67 expressions in laryngeal carcinoma.

Inhibitive effect of IL-24 gene on CD133^+ laryngeal cancer cells

Objective:To explore the inhihitive and apoptosis inductive effect of IL-24 genes on CD133^+laryngeal cancer cells in Hep-2 line.Methods:Human peripheral blood monocytes were isolated.The total RNA was extracted by using Trizol method and reverse transcripted into cDNA using RT-PCR method.Primers P1 and P2 was designed for the amplification of human IL-24 genes.After confirmation of agarose gel electrophoresis tests,TA was cloned into pMD19-T simple vector.Nhe Ⅰ and Xho Ⅰ double digesting human IL-24 and pIRES2-ZsGreen1 and eukaryotic expression vector were used to establish the pIRES2-ZsGreen1-hIL-24 vector,and detected by enzyme digestion and gene sequencing methods.Flow cytometry(FCM) was used to isolate CD133^+ cells from Hep-2 cells.CD133^+ cells were transfected with pIRES2-ZsGreen1-hIL-24 through liposome 2000.After detection,MTT and FCM were used to observe the effect of IL-24 gene on CD133^+ laryngeal cancer Hep-2 cells.Results:Lipotin mediated transfection of recombinant pIRES2-ZsGreen1-hIL-24 plasmid into CD133^+ Hep-2 could expressed IL-24 gene in cells stably.MTT results showed that IL-24 transfected group was significantly suppressed compared to empty vector group and control group(P<0.05);FCM results showed that the apoptosis rate of experimental group increased significantly compared to empty vector group and control group(P<0.05).Conclusions:IL-24 gene expressions can inhibit proliferation of CD133^+laryngeal cells in Hep-2 line and promote their apoptosis.

Radiotherapy and Chemotherapy in T2N0 Glottic Cancer: Does Chemotherapy Improve Local Control?

Purpose: To compare concurrent chemoradiotherapy with radiotherapy in T2N0 glottic cancer. Materials and Methods: Thirty nine patients were treated with radiotherapy alone. In detail, 30 patients treated between 1985 and 1995, and 9 patients treated between 1995 and 2010 were included in the radiotherapy alone group. Between 1995 and 2010, 22 patients were treated with concurrent chemoradiotherapy. Conventional fractionation was applied in 19 patients in the radiotherapy group and in 1 patient in the chemoradiotherapy group. Hyperfractionation was applied to 20 patients in the radiotherapy group and to 21 patients in the chemoradiotherapy group. Total dose ranged from 64 Gy to 76.8 Gy in the radiotherapy group and from 66 Gy to 76.8 Gy in the chemoradiotherapy group. Cisplatin or carboplatin was administered in the chemoradiotherapy group. Results: There were no differences in the 5-year preservation rate of vocal function (82.8% vs 87.4%, p = 0.652), local control rate (77.2% vs 92.9%, p = 0.163), and 5-year overall survival rate (86.4% vs 90.2%, p = 0.497) between the radiotherapy and chemoradiotherapy groups. Conclusion: In T2N0 glottic cancer, no difference was observed between radiotherapy alone and concurrent chemoradiotherapy groups.

Correlation of Six1, MTDH and TKTL1 expression in laryngeal cancer tissue with serum tumor marker levels and cell proliferation activity

Objective:To study the correlation of Six1, MTDH and TKTL1 expression in laryngeal cancer tissue with serum tumor marker levels and cell proliferation activity.Methods:A total of 48 patients who were diagnosed with primary laryngeal cancer in our hospital between June 2013 and December 2016 were collected as observation group, and 50 patients with vocal cord polyp who received laryngoscopy in our hospital during the same period were selected as control group. Fluorescence quantitative PCR was used to determine the expression of Six1, MTDH and TKTL1 as well as and the expression of oncogenes and tumor suppressor genes in lesion tissue of two groups of patients, and the contents of tumor markers in serum were detected. Pearson test was used to evaluate the correlation of Six1, MTDH and TKTL1 expression in laryngeal cancer tissue with serum tumor marker levels and cell proliferation activity.Results: Six1, MTDH, TKTL1, c-myc, STAT3 and ras mRNA expression in lesion tissue as well as tumor markers CA72-4, CA19-9, CYFRA21-1, SCC-Ag and TK1 levels in serum of observation group were higher than those of control group while LKB1, CDKN2 and PTEN mRNA expression were lower than those of control group;Six1, MTDH and TKTL1 expression in laryngeal cancer tissue were positively correlated with serum CA72-4, CA19-9, CYFRA21-1, SCC-Ag and TK1 levels as well as c-myc, STAT3 and ras mRNA expression, and negatively correlated with LKB1, CDKN2 and PTEN mRNA expression.Conclusion:Six1, MTDH and TKTL1 expression increase in laryngeal cancer tissue, and their specific expression are directly correlated with tumor malignancy.

Larynx Organ Preservation in Patients with Hypopharyngeal-Laryngeal Cancer

Object: The therapeutic options for advanced laryngeal-hypopharyngeal cancer have broadened in the last decades, in the attempt to cure the cancer sparing laryngeal functions and to improve quality of life (functional surgery, chemo- radiotherapy, combined therapy). Methods: We propose a single-centre based retrospective study on the results of the treatment of larynx-hypopharynx cancer on the basis of the different therapies offered, focusing on advanced-stage cancers. Among 146 patients with laryngeal-hypopharyngeal cancer treated in the period 1999-2006, we focused on 64 patients with advanced stage resectable cancer. In the larynx cancer group ?n = 40-, 32 patients had surgery and 8 patients had CT-RT (refusal of laryngectomy or relative contraindications to surgery). In the hypopharynx cancer group ?n = 24-, 16 patients underwent surgery and 8 patients had CT-RT. The outcome measure considered has been overall survival. Results: Larynx cancer group. Overall survival: after surgery we observed a 3-year survival of 62%, and a 5-year survival of 44%, while after CT-RT we had a 3-year survival of 25% and a 5-year survival of 12%. Hypopharynx cancer group. Overall survival: surgery: 3-year survival: 40%, 5-year survival 32%;CT-RT: 3-year survival: 50%, 5-year survival: 34%. Conclusion: The results emphasize the use of larynx-preserving approaches for appropriately selected patients without a compromise in survival;in our case series, surgery had better outcome than CT-RT in advanced-stage larynx cancer;whilst no significant differences were observed in the treatment of hypopharynx cancer.

A Combination of Endoscopic CO₂Laser Microsurgery and Radiotherapy for Treatment of T2N0M0 Glottic Carcinoma

The aims of this study were to evaluate the results of CO2 laser surgery alone and CO2 laser surgery combined with radiotherapy in patients with T2N0M0 glottic carcinoma. A retrospective analysis was conducted of 35 cases of T2N0M0 glottic carcinoma. Fourteen patients with normal vocal cord mobility were treated with endoscopic CO2 laser surgery alone. The remaining 21 patients were treated with CO2 laser surgery followed by radiotherapy (44 - 70 Gy, including low-dose carboplatin chemoradiotherapy). Main outcome measures were local control, organ preservation, recurrence, 5-year survival, and successful salvage in cases of recurrence. We evaluated the patient’s voice with the psychoacoustics GRBAS scale, maximum phonation time (MPT), and airflow rate (AFR) obtained by aerodynamic tests. Mean follow-up period was 5 years. Among the 35 T2N0M0 patients, 5-year survival and 5-year voice preservation rates were 97% and 89%, respectively. Local recurrence occurred in 7 of these patients (20%);4 of 7 local recurrences were successfully re-treated by laser surgery. Total laryngectomy was necessary for salvage treatment in the remaining 3 patients. The post-treatment voice qualities were judged to be the same or improved over pretreatment qualities. There was little change in MPT and AFR after treatment in non-recurrence patients. CO2 laser microsurgery is an excellent tool for treating selected cases of T2N0M0

Association of gastroesophageal reflux disease and laryngeal cancer

Objective:Studies examining the association of reflux disease with the risk of developing laryngeal cancer have both proven and disproven the null hypothesis.Methods:This retrospective caseecontrol study examines the association of reflux in two populations exposed to similar risk factors,including tobacco,to the extent that end-organ malignant transformation has occurred.After IRB approval was obtained,a search of our hospital’s cancer center’s database was performed from 2000 to 2013.A retrospective chart review was then performed and the prevalence of gastroesophageal reflux disease among patients with laryngeal cancer(n Z 290)was determined.It was then compared to the prevalence of gastroesophageal reflux disease among patients presenting with lung cancer(n Z 2440)during the same time period.A multivariate logistic regression was performed to determine the association of reflux with laryngeal cancer.Results:Taking into consideration tobacco use,there was a strong association between male gender and occurrence of laryngeal cancer as opposed to lung cancer(OR Z 3.30;95%CI 2.53e4.36,P<0.001).There was a modest association between reflux and laryngeal cancer(OR Z 1.65;95%CI 1.19e2.25,P Z 0.003).However,there was no association between reflux and the propensity for carcinoma in specific laryngeal subsites(P Z 0.47).Conclusions:In this study examining a heterogeneous population with end-organ malignancy there was a modest association between reflux and laryngeal cancer.Further research is necessary to determine the biologic relevance of this finding.

Schwannoma originating from the recurrent laryngeal nerve in a thyroid cancer patient: A case report and review of the literature

BACKGROUND Schwannoma rarely originates from the recurrent laryngeal nerve, and there are few reports on schwannoma originating from the recurrent nerve in the mediastinum. Herein, we present an extremely rare case of schwannoma originating from the recurrent laryngeal nerve in the neck.CASE SUMMARY This is a case report of one patient diagnosed with thyroid cancer with schwannoma originating from the recurrent laryngeal nerve in the neck, which was incidentally found during a thyroidectomy, and a review of the literature.CONCLUSION Preoperative diagnostic examinations are of less use for detecting schwannoma originating from a recurrent laryngeal nerve in the neck in such small size, which may only incidentally be found during a thyroidectomy. Surgical excision with opening the capsule and shelling out the tumor is the treatment of choice. If the nerve is unable to be preserved, end-to-end recurrent laryngeal nerve anastomosis may be a simple and minimally invasive reconstruction procedure to improve phonation.

Clinical significance and characteristics of recurrent laryngeal nerve lymph node metastasis of thoracic esophageal cancer

Objective To investigate the clinical significance and characteristics of recurrent laryngeal nerve lymph node metastasis of thoracic esophageal cancer. Methods One hundred and twenty-four patients who had undergone thoracic esophageal resection with recurrent laryngealnerve lymph node dissection in our hospital from March 2007 to February 2010. All clinical data were retrospectively analysed. Results Recurrent laryngeal

血清CC型趋化因子2、CC型趋化因子18与声门型喉癌患者临床病理参数和预后的关系

目的研究血清CC型趋化因子2(CC type chemotactic factor 2,CCL2)、CCL18与声门型喉癌患者临床病理参数和预后的关系。方法选择邯郸市中心医院和河北工程大学附属医院2015年8月~2018年12月收治的168例声门型喉癌患者为研究对象,受试者工作特征(ROC)曲线确定血清CCL2、CCL18最佳截点,将患者分为CCL2高表达组和低表达组、CCL18高表达组和低表达组,分析血清CCL2、CCL18水平与声门型喉癌患者临床病理参数的关系,采用Kaplan-Meier曲线和Log-Rankχ^(2)检验分析血清CCL2高表达组和低表达组、CCL18高表达组和低表达组的5年无病生存率,采用Cox回归模型分析声门型喉癌预后的影响因素,并分析血清CCL2和CCL18表达与肿瘤复发/转移的关系。结果根据ROC曲线计算得出CCL2、CCL18的最佳截点分别为100.81、218.99 pg/ml。相较于CCL2、CCL18低表达组,CCL2、CCL18高表达组T3~T4a级、N1~N3级、肿瘤低分化占比明显升高(P<0.05)。168例声门型喉癌患者随访5年失访8例,完成随访160例。67例发生复发/转移,39例因复发/转移而死亡,肿瘤复发/转移率为41.88%(67/160),无病生存率为58.13%(93/160)。Kaplan-Meier生存曲分析显示,血清CCL2、CCL18高表达组5年无病生存率均明显低于血清CCL2、CCL18低表达组(P<0.05)。Cox回归分析显示,T分级升高、颈淋巴结复发、N分级升高、咽喉部复发、CCL2高表达、CCL18高表达是声门型喉癌预后不良的危险因素(P<0.05)。分析血清CCL2和CCL18表达与肿瘤复发/转移的关系发现,CCL2和CCL18均高表达时其复发/转移率明显高于CCL2和CCL18均低表达、CCL2低表达且CCL18高表达、CCL2高表达且CCL18低表达,差异比较有统计学意义(χ^(2)=10.450,P=0.015)。结论声门型喉癌患者血清CCL2、CCL18高表达与T分级、N分级、肿瘤低分化和预后不良显著相关。