- PAG1 promotes the inherent radioresistance of laryngeal cancer cells via activation of STAT3. [Journal Article]
- ECExp Cell Res 2018 Jun 15
- Phosphoprotein associated with glycosphingolipid-enriched microdomains 1(PAG1) is a ubiquitous protein that is essential for the development and progression of various malignancies. A previous study ...
Phosphoprotein associated with glycosphingolipid-enriched microdomains 1(PAG1) is a ubiquitous protein that is essential for the development and progression of various malignancies. A previous study in our laboratory confirmed that PAG1 plays an important role in modulating the inherent radioresistance of laryngeal cancer cells, but the underlying mechanisms are still poorly defined. In this study, we found that PAG1 was significantly increased in laryngeal cancer tissues compared to adjacent non-tumor tissues (P < 0.05). The expression of PAG1 was positively correlated with lymph node metastasis (P < 0.05) and TNM stage (P < 0.05). High expression of PAG1 also predicted a poor prognosis in patients with laryngeal cancer. Moreover, gain-of-function and loss-of-function studies showed that PAG1 overexpression was able to promote growth, increase migration and invasion, and enhance inherent radioresistance of laryngeal cancer cells. Mechanistic investigations revealed that the activation of STAT3 was required for PAG1-mediated inherent radioresistance of laryngeal cancer. Inhibition of STAT3 activity with a chemical inhibitor sensitized radioresistant cells to radiation. Importantly, PAG1-integrin β1 complex was involved in the regulation of STAT3 activation. In addition, downregulation of PAG1 could suppress tumor growth and reverse inherent radioresistance in the nude mouse xenograft model. Taken together, these results suggested that PAG1 conferred inherent radioresistance by activating STAT3, which provided a novel therapeutic strategy for laryngeal cancer.
- Systemic therapy in non-conventional cancers of the larynx. [Review]
- OOOral Oncol 2018; 82:61-68
- Laryngeal cancer (LC) remains a challenging disease to treat. The majority of LCs diagnosed worldwide are squamous cell carcinomas (SCC), and current treatment guidelines are designed to address conv...
Laryngeal cancer (LC) remains a challenging disease to treat. The majority of LCs diagnosed worldwide are squamous cell carcinomas (SCC), and current treatment guidelines are designed to address conventional laryngeal SCC. However, several histologically rare tumor types can originate in the larynx. There is a lack of guidelines regarding the best therapeutic approaches to these tumors and their treatment is often modeled after their recommended management at non-laryngeal sites. Understanding the role for systemic therapy in these rare tumors is important, especially for patients with advanced disease or those who are not surgical candidates. We provide in this manuscript a detailed and comprehensive overview of systemic therapy considerations for the following histologic tumor types of the larynx: verrucous carcinoma (VC), HPV-related SCC, basaloid SCC (BSCC), lymphoepithelial carcinoma (LEC), adenosquamous carcinoma (ASC), typical and atypical carcinoid, small cell neuroendocrine carcinoma (SCNC), large cell neuroendocrine carcinoma (LCNC), NUT midline carcinomas (NUTMC), melanoma, adenoid cystic carcinoma, rhabdomyosarcoma (RMS), malignant fibrous histiocytoma (MFH), lymphoma, mucoepidermoid carcinoma (MEC), acinic cell carcinoma, and spindle cell carcinoma (SpCC).
- [Primary research of early oral feeding after total laryngectomy]. [Journal Article]
- ZEZhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018 Jun 07; 53(6):428-431
- Objective: To explore whether early oral feeding after total laryngectomy is safe and effective by evaluating the incidence of pharyngocutaneous fistula (PCF) and the hospital duration. Methods: A ...
Objective: To explore whether early oral feeding after total laryngectomy is safe and effective by evaluating the incidence of pharyngocutaneous fistula (PCF) and the hospital duration. Methods: A retrospective cohort study was conducted, including 52 patients underwent total laryngectomy, plus partial tongue base resection (n=2), partial pharyngectomy (n=1), or pedicle flap (n=2) between January 2012 and October 2017. Patients who had a history of preoperative radiotherapy, chemotherapy or chemoradiotherapy, previous surgery for larynx or pharynx and who had severe complications were excluded. Early oral feeding started between 48 h and 72 h postoperatively, while delayed oral feeding started within postoperative day 8-10. The incidences of PCF in two groups were compared to evaluate whether PCF and early oral feeding was related. Multi-variables analysis was conducted to evaluate risk factors for PCF. Results: PCF rate was 19.2% among all patients, 11.1% in patients with early oral feeding and 23.5% in patients with delayed oral feeding. No significant statistically difference in PCF rate was found between two groups (χ(2)=0.506, P=0.477). Multi-variables analysis showed that oral feeding time (early or delayed) was not a independent risk factor of PCF (Two classification response variable Logistic regression, P=0.200, OR=0.242, 95%CI[0.028-2.118]). But low preoperative albumin level was observed as an independent risk factor for PCF (P=0.039, OR=0.848, 95% CI [0.726-0.992]). A negative correlation was observed between preoperative albumin level and PCF. And also there was not a significant difference in hospital duration between patients with early oral feeding and delayed oral feeding(U=268, P=0.464). Conclusion: For patients total laryngectomy with no previous history of radiotherapy, chemotherapy, chemoradiotherapy, early oral feeding after surgery is safe and effective.
- Target Volume Delineation Using Diffusion-weighted Imaging for MR-guided Radiotherapy: A Case Series of Laryngeal Cancer Validated by Pathology. [Journal Article]
- CCureus 2018 Apr 11; 10(4):e2465
- In radiotherapy treatment planning, tumor delineation based on diffusion-weighted imaging (DWI) by magnetic resonance imaging (MRI) is a promising technique. MR-only-based target definition becomes i...
In radiotherapy treatment planning, tumor delineation based on diffusion-weighted imaging (DWI) by magnetic resonance imaging (MRI) is a promising technique. MR-only-based target definition becomes important with the recent development of MRI integrated radiotherapy treatment modalities. In this case series, DWI-based gross tumor volume (GTV) was validated using pathology and compared with a clinical GTV based on computed tomography (CT) imaging and MRI. This case series includes three patients with a laryngeal tumor. Prior to total laryngectomy (TLE), imaging was performed on CT and MRI, including a DWI scan. After TLE, the surgical specimen was processed and cut into 3-mm thick slices. The tumor was delineated on hematoxylin-eosin (HE) stained sections by a pathologist (tumorHE). This pathological imaging, including the tumorHE delineation, was three-dimensionally reconstructed and registered to the imaging. The GTV was delineated by a radiation oncologist based on CT and MR imaging (GTVclinical) and semi-automatically delineated based on DWI (GTVDWI). The microscopic tumor extent outside the GTVDWI contour was 3.0 mm, 2.7 mm, and 11.3 mm for cases I, II, and III, respectively. The microscopic tumor extent outside the GTVclinical was 7.5 mm, 2.1 mm, and 1.5 mm for cases I, II, and III, respectively. The tumor, on histology, was covered by the GTVs for 80%, 74%, and 31% (GTVDWI) and 73%, 72%, and 89% (GTVclinical) for the three subsequent cases, respectively. The GTVDWI resembled the tumorHE more than the GTVclinical in case I and case II. In case III, GTVDWI missed the caudal part of the tumor that was included in the clinical delineation due to a lack of contrast and the heterogeneous signal intensity of the tumor in DWI. In this case series, we showed the potential of DWI for MR-guided radiotherapy treatment if a clear contrast is visible. DWI-based GTV delineation might be a fast alternative to manual delineation, which could speed up the on-table target definition using an MRI-linac system. A larger case series is needed to verify these results.
- Endotracheal Intubation and In-Hospital Mortality after Intracerebral Hemorrhage. [Journal Article]
- CDCerebrovasc Dis 2018 Jun 13; 45(5-6):270-278
- CONCLUSIONS: In this large hospital-based cohort of patients presenting with an acute spontaneous ICH, endotracheal intubation and MV were associated with increased odds of HAP and HM. These findings urge further examination of the practice of intubation in prospective studies.
- Glottic neurogenic tumor: A highly uncommon site for schwannomas. [Letter]
- JCJ Cancer Res Ther 2018 Apr-Jun; 14(3):687-689
- Schwannomas are benign encapsulated neurogenic tumors, arising from Schwann cells embedded in neurilemal sheath as multinucleated syncytial network. Head and neck schwannomas account for 25%-45% of a...
Schwannomas are benign encapsulated neurogenic tumors, arising from Schwann cells embedded in neurilemal sheath as multinucleated syncytial network. Head and neck schwannomas account for 25%-45% of all schwannomas, majority developing in parapharyngeal space. Laryngeal schwannoma in itself is a rarity, and a glottic origin further complicates its diagnosis. To the best of our knowledge, this is the second case of glottic schwannoma being reported in medical literature. Symptomatology is attributable to mass effect of a slow-growing laryngeal tumor, ranging from sore throat to stridor. The gold standard method for their excision is still debatable. For small tumors, endoscopic or direct laryngoscopic approach is preferred, but for large glottic tumors, external approach is advocated for better exposure and facilitating mucosal grafting. Index case is being presented not only for its rare site of origin, but also to stress on the importance of meticulous histopathological examination to advocate appropriate treatment.
- Use of a folded extended vertical lower trapezius island myocutaneous flap to repair large pharyngocutaneous fistulae developing after salvage total laryngectomy. [Journal Article]
- IJInt J Oral Maxillofac Surg 2018 Jun 07
- The purpose of this study was to evaluate the outcomes of surgery involving the use of folded trapezius flaps to repair large pharyngocutaneous fistulae (PCFs) developing after salvage total laryngec...
The purpose of this study was to evaluate the outcomes of surgery involving the use of folded trapezius flaps to repair large pharyngocutaneous fistulae (PCFs) developing after salvage total laryngectomy. Folded extended vertical lower trapezius island myocutaneous flaps (TIMFs) were created to repair large PCFs that developed after salvage total laryngectomy in eight patients. The maximum fistula dimension was 4.5×3.0cm and the minimum was 2.0×1.8cm. The skin paddle of the extended vertical TIMF ranged from 5cm to 9cm in width and 10cm to 23cm in length. The inner lining ranged from 3cm×3cm to 6cm×6cm in dimension and the outer lining from 6cm×5cm to 16cm×9cm. The folded flaps provided both inner mucosa and outer lining. All flaps survived. No fistula recurrence or stricture developed. After 6-24months of follow-up, six patients showed no evidence of disease, one was alive with disease, and one had died of local recurrence at 20months. The folded flap was very reliable and is well-suited for repairing large PCFs, even early large PCFs and those featuring carotid artery rupture.
- Comparative genomic analysis of oral versus laryngeal and pharyngeal cancer. [Journal Article]
- OOOral Oncol 2018; 81:35-44
- CONCLUSIONS: Despite showing a similar mutational profile, our comparative genomic analysis revealed distinctive features in OSCC and L/P-SCC. Some of these genes and cellular processes are likely to affect the cellular response to radiation or cisplatin. Genomic characterizations may guide or enable personalized treatment in the future.
- Long-term outcomes of 530 esophageal squamous cell carcinoma patients with minimally invasive Ivor Lewis esophagectomy. [Journal Article]
- JSJ Surg Oncol 2018; 117(5):957-969
- CONCLUSIONS: MIE Ivor Lewis is a safe and feasible procedure in ESCC patients. It offers satisfactory perioperative outcomes, rapid QOL improvement, and acceptable long-term oncologic survival. Adjuvant chemoradiotherapy may improve OS and DFS in advanced stage patients.
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- Prognostic Role of p16 in Nonoropharyngeal Head and Neck Cancer. [Journal Article]
- JNCIJ Natl Cancer Inst 2018 Jun 05
- CONCLUSIONS: Our findings support the hypothesis that p16 has a similar prognostic role in both nonoropharyngeal and oropharyngeal cancer. Consideration should be given to increased testing for p16 in laryngeal, hypopharyngeal, and oral cavity primaries.