Search PubMed⌕ Search

Biomedical subjects

M F de Boer

Publications and source records attributed to M F de Boer.

15 recordsLinked to original sources
PubMed1996

Regional metastasis in head and neck squamous cell carcinoma: revised value of US with US-guided FNAB.

PURPOSE: To verify the acclaimed accuracy of ultrasound (US) combined with US-guided fine-needle aspiration biopsy (FNAB) in the detection of lymph node metastasis in the neck and to evaluate the interobserver variability. MATERIALS AND METHODS: In a prospective, multicenter study of 185 patients with head and neck squamous cell carcinoma, US (n=238 neck sides) with US-guided FNAB (n=178 neck sides) was used for evaluation of the lymph node status of the neck. Findings were correlated with those of histopathologic examination in 238 neck sides. RESULTS: US with US-guided FNAB had a sensitivity of 77% and a specificity of 100%. Nineteen of 178 aspirations were nondiagnostic. There were no significant differences between the four participating hospitals or the individual sonologists (P>.05). CONCLUSION: Sensitivity of US with US-guided FNAB was slightly lower compared with previous reports. Specificity was similar to previous reports. Interobserver variability appeared to be low. The validity of US with US-guided FNAB is high and warrants widespread use of the procedure for evaluation of the neck.

Adult↗
PubMed1995

[Supportive care].

Explore the source record for details and available documents.

Continuity of Patient Care↗
PubMed1995

Cervical metastasis from the unknown primary tumor.

A retrospective study was performed to examine the results of treatment for cervical lymph node metastases from an unknown primary between 1978 and 1988. We reviewed 66 patients treated with either surgery and/or radiotherapy (n = 41), radiation therapy and chemotherapy (n = 11), combined modality treatment with surgery (n = 8) or with management delayed to proven disease (n = 6). The male-to-female ratio was 5.6 to 1, and the median age was 64 years (range, 15-89 years). Intercurrent death-corrected 5-year survival was 50%. The most important prognostic factors were M category and involvement of supraclavicular nodes. Primary tumor was eventually discovered in 12 patients during follow-up, 6 of whom received treatment with curative intent. The most common site of primary tumor was found to be the lung (n = 5).

Adolescent↗
PubMed1993

[Uni- and multivariate analysis of prognostic factors in T3 laryngeal cancers].

In 511 patients with T3N0-3M0 laryngeal carcinoma, 24 possible prognostic factors were analysed retrospectively. The factors were age, sex, mode of treatment, duration of several clinical symptoms, the presence of sore throat, otalgia, dyspnoea, and dysphagia, previous tracheotomy, tumour extension, lymph node status (five items), histologic grading, smoking habits, and alcohol intake. For 300 patients in whom surgery was part of the primary treatment, pathologic staging of the primary tumour and of lymph nodes in neck dissection specimens, cartilage invasion, radicality of the operation, differentiation grade, and subglottic extension were also evaluated. Univariate analysis revealed prognostic significance on survival for tumour extension (limited to the glottic region), lymph node status (clinically palpable lymph nodes, cytologically confirmed positive lymph nodes), level of lymph node metastasis (high and midjugular site), histologic grading (poor differentiation grade), and treatment modality (planned combined therapy). In the group that underwent surgery, all factors derived from specimens of the larynx and neck dissections had prognostic significance. Multivariate analysis revealed that the glottic site of the tumour, the presence of cyto- and histopathologically proven metastatic lymph nodes, pretreatment tracheotomy, positive resection margins, and planned combined treatment had a significant influence on corrected actuarial survival.

Adult↗
PubMed1992

Types and causes of pain in cancer of the head and neck.

In a series of 25 patients with head and neck cancer who had severe pain, the type and cause of the pain were analyzed. There were two types of pain: nociceptive and non-nociceptive. Nineteen (76%) patients had nociceptive pain that could be subdivided into actual nociceptive pain (9 patients), nociceptive nerve pain (8 patients), or referred pain (2 patients). The cause of nociceptive pain was secondary to tumor recurrence in 16 patients and secondary to benign inflammation in 3 patients. Of the six (23%) cases of non-nociceptive pain, all were diagnosed as neuropathic pain secondary to the sequels of neck dissection. World Health Organization guidelines were applied for the treatment of symptomatic pain of nociceptive pain; if necessary, nerve blocks were used after this treatment. Non-nociceptive pain was usually treated with amitriptyline or carbamazepine. If tumor recurrence was the cause of the pain, antitumor-directed therapy was applied, when possible. Relief was achieved in 52% of the patients after two attempts to treat pain, in 64% after three attempts, and in up to 72% after four attempts. Pain could not be controlled in 28% of the patients. Patients with tumor recurrence had a short median survival time of 3 months, regardless of pain control. Patients with neuropathic pain had a survival time of 16 months or more (median not reached). The authors conclude that the type and cause of the pain in cancer of the head and neck can be determined; this can lead to the administration of proper symptomatic therapy or treatment directed at the underlying cause. In most cases, several successive attempts to treat pain were made before relief was achieved.

Analgesics↗
PubMed1992

Prognostic factors for survival in patients with T3 laryngeal carcinoma.

In a total of 511 patients with T3,N0-3,M0 laryngeal carcinoma, 24 possible prognostic factors were analyzed retrospectively. The factors were age, sex, mode of treatment, duration of several clinical symptoms, the presence of sore throat, otalgia, dyspnea, and dysphagia, previous tracheotomy, tumor extension, lymph node status (five items), histologic grading, smoking habits, and alcohol intake. For 300 patients in whom surgery was part of the primary treatment, pathologic staging of the primary tumor and of lymph nodes in neck dissection specimens, cartilage invasion, radicality of the operation, differentiation grade, and subglottic extension ware also evaluated. In a univariate analysis for the whole group, tumor extension (limited to the glottic region), lymph node status (clinically palpable lymph nodes, cytologically confirmed positive lymph nodes), level of lymph node metastasis (high and midjugular site), histologic grading (poor differentiation grade), and treatment modality (planned combined therapy) were considered to be prognostic factors of corrected actuarial survival. In the group that underwent surgery, all factors derived from specimens of the larynx and neck dissections had prognostic significance. Multivariate analysis revealed that the glottic site of the tumor, the presence of cyto- and histopathologically proven metastatic lymph nodes, pretreatment tracheotomy, positive resection margins, and planned combined treatment had a significant influence on corrected actuarial survival.

Adult↗
PubMed1992

CO2-laser treatment of recurrent glottic carcinoma.

The records of 23 patients treated by CO2-laser surgery for recurrent glottic carcinoma after radiotherapy were studied retrospectively to assess treatment results and complications. 15 patients (65%) were cured with one or more laser procedures. The remaining 8 underwent a total laryngectomy for a second or third recurrence. One patient (4%) died of disease. No major complications from CO2-laser surgery were encountered. It is concluded that CO2-laser surgery is a safe method of treatment of recurrent glottic carcinoma.

Carbon Dioxide↗
PubMed1992

Carotid sinus syndrome after carotid artery surgery.

A 63 year old woman had been intensively treated for recurrent carcinoma of the neck. Following acute vascular surgery of the carotid artery, she developed the vasodilatory type of the carotid sinus syndrome. The presentation of this type of the syndrome was remarkable, since it is usually associated with primary or metastatic carcinoma in the neck region. Previous cancer treatment may have modified the course of disease in this patient, which ultimately had a lethal outcome.

Carotid Arteries↗
PubMed1991

Judging speech communication effectiveness in oral cancer patients.

An experiment was conducted to assess the effects of different types of sentences and recording methods on naive judges' evaluations of the speech communication effectiveness of four patients who had undergone surgery for oral cancer. As expected, judges understood patients better if they read meaningful rather than meaningless sentences and if their speech was evaluated under video rather than audio conditions. However, these general findings were qualified because of the powerful influence of individual differences among patients. For example, whereas the intelligibility of three of the patients increased under the audio condition if the sentences being read were meaningful, one patient was poorly understood no matter what type of sentence he read under the same condition. The results suggested that the identification of the unique personality characteristics of patients that are related to their intelligibility merits serious consideration by both researchers and rehabilitation clinicians.

Adolescent↗
PubMed1989

Evaluation of treatment results of squamous cell carcinoma of the buccal mucosa.

Of the 49 patients with squamous cell carcinoma of the buccal mucosa referred to the Rotterdam Radio-Therapeutic Institute (RRTI) and Universital Hospital Dijkzigt Rotterdam (AZD) during 1970-1984, 31 patients had an advanced stage of disease, 21 patients had clinical evidence of lymph node metastasis. Forty patients were treated with curative intention. Treatment modalities were: radiation therapy, preoperative radiation followed by surgery, and primary surgery. Eighteen of the 40 patients (45%) developed a local tumor recurrence; nearly all recurrences occurred within 2 years. The incidence was equal in all treatment groups. Of the 22 patients with initial clinically negative neck, regional relapse occurred in 3 of the 14 patients, of whom the neck was not treated electively by radiation therapy; all three in combination with a local recurrence. None of the 8 patients with electively irradiated necks developed a regional relapse. Eight of the 18 patients with initial clinically enlarged lymph nodes treated either by radiotherapy or surgery, developed a regional relapse, 5 in combination with a local recurrence. Treatment of the clinically positive neck by neck dissection was superior to radiotherapy. Local recurrence carried a poor prognosis. Almost 70% died of their disease. The overall and corrected 5-year survival was 38% and 52% respectively.

Carcinoma, Squamous Cell↗
PubMed1985

Carcinoma of the paranasal sinuses. Results of a prospective pilot study.

Sixty patients with paranasal sinus cancer were treated from January 1976 until July 1981 according to a standard protocol in which surgery is combined with a low dose of irradiation and a topically applied cytostatic drug. The local control rate was 65%. Mutilation was clearly reduced. The actuarial 2-year and 5-year survival rate was 76% and 65%, respectively. The actuarial 5-year survival rate for squamous cell carcinoma and undifferentiated carcinoma of the maxillary sinus was 52%. For adenocarcinoma of the ethmoid sinus the actuarial 5-year survival rate was 100%. The results of this prospective pilot study suggest that it may be possible to achieve better results with less aggressive treatment.

Actuarial Analysis↗
PubMed1985

Adenoid cystic carcinoma of the upper digestive and respiratory tracts. A retrospective study of 59 cases.

Fifty-nine cases of adenoid cystic carcinoma (ACC) in the head and neck were reviewed and the treatment and follow-up results from 1950 to 1983 are reported. Nearly all patients were treated with combined therapy, i.e. surgery and radiotherapy, and the actuarial survival rate was 68% after 5 years, 45% after 10 years, and 30% after 15 years. Modern radiotherapy seems a very valuable means of treatment, not only as a palliative measure.

Adult↗
PubMed1985

Carcinoma of the base of the tongue. A review of 45 cases.

The treatment results of 45 patients with carcinoma of the base of the tongue treated in the Rotterdam Radio-Therapeutic Institute in the period 1970 to 1980 are evaluated. Most patients were treated with split course radiotherapy, three patients were operated after the first course of radiotherapy. Eighteen patients with stage III and IV disease were treated with a combination of chemotherapy and radiotherapy. Overall 5-year survival was 27%, intercurrent death corrected survival was 40%. Adequate staging is a problem in carcinoma of the base of the tongue, especially in T2 and T3 lesions. A systemic combined approach of radiotherapy and surgery is recommended.

Adult↗
PubMedDate not supplied

First results with the Blom-Singer adjustable tracheostoma valve.

The Blom-Singer adjustable tracheostoma valve (ATV) is a new tracheostoma valve, introduced in 1992 to improve voice rehabilitation after total laryngectomy. Little research has been done to evaluate the benefits of this valve. Our study evaluates the advantages and disadvantages of using this device. Eighteen laryngectomized patients with a low-resistance Provox voice prosthesis received an ATV, using minimal selection criteria. The patients are evaluated according to a specific protocol. The effectiveness of the humidifilter, valve and fixation method and the benefits are evaluated. Approximately 66% of the 18 patients are still using the ATV. We report the differences between the current users and the dropout group. Patient factors are discussed that seem to have an impact on the effective use of the valve, such as age and mucus production. We consider the ATV to be a valuable device for fingerless speech in the laryngectomized patient.

Adult↗