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Biomedical subjects

M Quer

Publications and source records attributed to M Quer.

At least 37 records · Page 2Linked to original sources
PubMed1998

Influence of age on laryngeal carcinoma.

The constant increase in human life expectancy has led to a higher proportion of oncologic patients of advanced age. The clinical characteristics of 272 patients with laryngeal carcinoma diagnosed when they were 70 or older are compared with those of a group of younger patients with the same kind of tumor. The advanced age group showed a higher proportion of women, less tobacco and alcohol use, a predominance of glottic location, and a higher previous morbidity. The T category was similar in both groups, but the advanced age group had a higher proportion of N0 tumors. The planning of treatment was similar in the two groups of patients, except for less use of both chemotherapy and partial larynx surgery in the advanced age group. Results in terms of local and regional control, distant metastasis, and 5-year adjusted survival were similar in both groups of patients. The results suggest that advanced age is not a determining factor when considering radical treatment in a patient with laryngeal carcinoma.

Adult↗
PubMed1998

[Differential features of transglottic carcinoma].

A study was made of the differential features of transglottic laryngeal carcinomas. We made a retrospective study of patients with laryngeal carcinoma diagnosed in our center from 1985 to 1996. In this period, 1212 laryngeal carcinomas were diagnosed, of which 99 (8%) were considered transglottic. In relation to factors such as sex, toxic habits, level of histological differentiation or affected nodes, patients with transglottic carcinomas had characteristics that were intermediate between patients with glottic and supraglottic carcinomas. An analysis was made of the treatments and the results obtained in patients treated with radical intention and a minimum follow-up of 3 years. The treatment most frequently used in patients with transglottic carcinoma was surgery (total laryngectomy) and complementary radiotherapy. The 5-year actuarial adjusted survival rate jor patients with transglottic carcinoma was 78%, which was intermediate between the survival rates of patients with glottic (90%) or supraglottic (69%) carcinoma.

Aged↗
PubMed1997

Laryngeal carcinoma in patients without a history of tobacco and alcohol use.

BACKGROUND: The medical literature on laryngeal carcinomas in patients without a history of tobacco and alcohol use is sparse. METHODS: A retrospective review of 933 laryngeal carcinomas treated in our center between January 1984 and December 1993 was made. Characteristics and results of patients with history of tobacco and alcohol use were compared with those who used neither. RESULTS: Of all patients with laryngeal carcinomas, 31 (3.3%) had no history of tobacco and alcohol use. In this group of patients, distribution between sexes was similar, and the mean age of patients was 70 years, compared with 63 years in the group with a history of tobacco and alcohol use. The survival rate was better in the former group. CONCLUSIONS: Patients without a history of tobacco and alcohol use who developed laryngeal cancer showed different characteristics compared with smokers or drinkers; they were an average of 10 years older, they showed no male predominance, and their lesions were mainly located in the glottis, which permitted early diagnosis and a higher survival rate.

Adult↗
PubMed1997

Foramen thyroideum: a comparative study in embryos, fetuses, and adults.

The incidence and characteristics of foramen thyroideum (FT) in embryonic and/or fetal larynges have not been established. In the present study, 90 adult larynges and 53 embryonic-fetal larynges were studied. The incidence of FT during the embryonic-fetal period (57%) was statistically different from the adult period (31%) (P = 0.005). All the FT found in the adult period contained vessels and/or nerves, while in the embryonic and fetal period only 63% presented neurovascular elements (P < 0.001). The origin of FT in the embryonic period and its persistence during adult life is discussed.

Adult↗
PubMed1997

[Results of salvage treatment of carcinoma of the larynx recurring after radiotherapy].

An analysis is made of salvage treatments and their results after unsuccessful radiotherapy in 113 carcinomas of the larynx. A group of 27 patients (24%) was excluded from salvage treatment. In the remaining 86 patients (76%), radical surgical salvage treatment was tried: total laryngectomy (74 cases) or partial surgery (12 cases). Four of the 12 patients treated with partial surgery suffered a second local relapse, which was rescued by new surgery. Treatment was successful in 72% of the laryngectomized patients and in all those treated with partial surgery. Survival correlated with local (T) and regional (N) extension of the initial tumor, its location, and simultaneous regional relapse. In contrast, survival did not correlate with the time interval between end of radiotherapy and relapse, or with local tumoral extension in the resection piece in surgically treated cases (rpT).

Carcinoma↗
PubMed1995

Function preservation in stage III squamous laryngeal carcinoma: results with an induction chemotherapy protocol.

Until recently, standard treatment for stage III laryngeal carcinoma (LC) was total laryngectomy and radiotherapy. Recent data suggest that induction chemotherapy (ICH) plays a role in preserving function in advanced head and neck cancer. No reports to date prospectively evaluate ICH exclusively in stage III LC. The authors designed a sequential phase II trial to assess if ICH allowed a conservative treatment in this disease. The objective of the first part of the study was to rule out a complete response rate with ICH below 30% with P < .05. ICH protocol consisted of three courses of cisplatin 100 mg/M2 on day 1 and 5-fluorouracil 5000 mg/M2 continuous infusion over 120 hours. Radiotherapy was administered to patients who attained a complete response (CR). Functional surgery (FS) was planned for patients with partial response. A total laryngectomy followed by radiotherapy was performed when FS was not feasible. Fifty-two previously untreated patients (all males) with squamous stage III LC were diagnosed in our institution, and 46 were entered in the ICH trial. After 9 patients were included, data showed 7 (78%) CR, ruling out a CR rate of less than 30%. After ICH, a CR was achieved in 29 (63%) of 46 patients. At the end of treatment, 35 patients (76%) had a functioning larynx. With a median follow-up of 3 years, larynx function was preserved in 26 (57%) of 46 patients and in 64% of survivors. Four-year actuarial larynx function preservation, overall survival, and disease-free survival were 55%, 77%, and 67%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Small cell carcinoma of the larynx: results of therapy.

Small cell carcinoma is a rare malignant tumor of the larynx. Since this lesion was first described, only 58 cases have been reported in the literature. Between December 1985 and March 1992, five patients with small cell carcinoma of the larynx were treated at the Hospital de la Santa Creu i Sant Pau in Barcelona, Spain. One patient was treated with radiation therapy alone, three patients with chemotherapy and radiation therapy, and one patient with surgery, chemotherapy and radiation therapy. Local and distant control was achieved in only one patient who was observed for 12 months after radiation therapy. Four patients died, one of local disease without distant metastasis at 6 months following treatment, one of local and distant disease at 53 months after radiation therapy, and two of distant metastasis without local disease at 22 and 36 months following treatment. In spite of the fact that only one of the five patients presented in this series is alive and free of disease 12 months following treatment, recent published information suggests that chemotherapy and radiotherapy are currently the most effective form of therapy for small cell carcinoma of the larynx.

Aged↗
PubMed1993

[The treatment of carcinoma of the pyriform sinus at Santa Creu I Sant Pau Hospital of Barcelona. The role of surgery].

The paper deals with the retrospective review done by the AA. about the treatments used for squamous carcinomata of the pyriform sinus at Santa Creu i Sant Pau Hospital, Barcelona, between the years 1984-1990. In this term 76 sinus pyriform carcinomata were diagnosed, 12 of which (16%) were managed palliatively. In the other 64 cases radical treatment was advised and followed: 5 cases underwent radical cobalt-therapy; polychemotherapy followed by radiotherapy in 27; surgery plus radiotherapy in 7; and polychemotherapy completed with surgery and radiotherapy in the remaining 25 cases. Considerations on the realized pharyngectomies and their reconstructive steps and complications are commented. Inventory and end results in each group are reported. The beneficial local influence was evident when surgery was employed (100% with surgery plus radiotherapy and 92% with polychemotherapy, surgery and radiotherapy). Local control was inferior if surgery was discarded (20% in radiotherapy and 37% by polychemotherapy followed by radiotherapy). Actuarial survival for the lump sum amounted for the 40 percent after 5 years follow-up. It must be emphasized that these groups are not comparable because the choice treatment in each case was indicated in view of the initial stage.

Adult↗
PubMed1992

Primary tracheoesophageal puncture vs esophageal speech.

We studied the cost-efficiency profile of tracheoesophageal puncture with prosthesis insertion in alaryngeal patients who were given the opportunity of choosing between esophageal and prosthetic voice. A primary tracheoesophageal puncture was made in 28 patients who were undergoing total laryngectomy. Five of the patients were excluded from the study because of failure to phonate correctly with their prostheses. The remainder were given esophageal speech instruction while they were using tracheoesophageal speech, and were permanently allowed to shift between both techniques of alaryngeal voice. Seventy percent of the patients (16/23) left the prosthetic voice to use only esophageal speech, even though they agreed that prosthetic voice was superior to esophageal voice. The remaining 30% (7/23) continued to use tracheoesophageal speech almost exclusively. In the authors' opinion, primary tracheoesophageal punctures significantly provide both psychological and practical help, as they supply an immediate and clear postoperative voice, and one of every three patients will use them for daily oral communication. Nevertheless, esophageal speech is still the method of voice restoration preferred in our region by those of our patients who managed to learn it.

Adult↗
PubMed1991

[Adenolymphoma or Warthin's tumor: review of 30 cases].

Perusal of Warthin's tumors treated during the past 20 years (1969-1989) in our Hospital department. As a whole 229 tumors of salivary glands were operated upon, 30 of them being adenolymphomata. The parameters of our series were confronted with those given by the cases of the literature. In the paper are also reminded the several theories concerning the origin of this tumor.

Adenolymphoma↗
PubMed1990

[Nasopharyngeal carcinoma. An epidemiological and clinical study].

Clinical and epidemiological data from 46 cases of nasopharyngeal carcinoma retrieved from our E.N.T. department data base are analysed. These tumors represent about 5% of all head and neck carcinomas seen at our department between 1984 and 1989. Neither geographic origin nor occupation of patients have proved significant to the epidemiological analysis. Patients are most frequently in their sixth decade of life at presentation, with a clear male predominance, but not as marked as in other locations of head and neck tumours. As in other series, a significant relationship between nasopharyngeal tumours and alcohol and tobacco consumption has been discarded. Most patients were in good condition at diagnosis. Sublocation (usually on the lateral and/or posterior walls of the nasopharynx), predominance of undifferentiated carcinomas and isolated neck adenopathy as presenting symptom, are all features found in our series as well as in other reports. In contrast, the time between first symptom and diagnosis has been moderately longer in our patients. Cranial nerve and base of skull involvement have been found in 20% and 37% of cases, respectively. A great proportion of patients present with advanced disease: T3-T4 tumours in 67%; clinically detectable adenopathy in 69.5%; and distant metastasis in 4.3% of cases. Almost 75% of our patients showed stage IV disease at diagnosis.

Age Factors↗
PubMedDate not supplied

Prevention of stomal recurrence.

BACKGROUND: The authors reviewed the incidence of stomal recurrence (SR) in a population of laryngectomized patients to study associated risk factors and determine the usefulness of certain preventive procedures. METHODS: A retrospective study was performed in 296 patients with larynx and hypopharynx carcinoma treated by total laryngectomy. RESULTS: Of the 296 patients, 6 (2%) were initially seen with SR. In all cases, a risk factor was found to be involved: subglottic extension (5 cases), tracheotomy prior to laryngectomy (1 case). Since 1989, when preventive measures were systematically introduced in patients presenting risk factors, there have been no further cases of SR. The surgical measures in tumors with subglottic extension consisted of hemithyroidectomies, paratracheal lymph node dissection, and extensive tracheal resection; in the case of a tracheotomy prior to the laryngectomy, extensive resections of the tracheal stoma were carried out. CONCLUSIONS: The systematic use of preventive surgical measures together with postoperative radiotherapy to the stoma and superior mediastinum have led to a decrease in the appearance of SR.

Aged↗
PubMedDate not supplied

Blood transfusions in laryngeal cancer: effect on prognosis.

METHODS: To evaluate the influence of homologous perioperative transfusion on oncologic control and survival in patients with larynx and hypopharynx carcinomas, we conducted a retrospective study of 269 patients with larynx and hypopharynx carcinoma treated by major surgical procedures. A total of 20 variables were analyzed for each patient. RESULTS: Perioperative transfusion was required in 86 (32%) patients, with packed red blood cells being used in all cases. Recurrence at a local, regional, or distant level was 31% for nontransfused and 35% for transfused patients. The 5-year adjusted survival was 68% for patients without transfusion and 63% for patients with transfusion. Neither the univariate nor the multivariate analysis showed that perioperative transfusion or the number of units of packed red blood cells used had any prognostic capacity. CONCLUSIONS: Homologous perioperative transfusion did not imply a significant risk regarding global control or survival in our larynx or hypopharynx cancer patients.

Adult↗