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PubMedDate not supplied

Genetic deletions of glutathione-S-transferase as a risk factor in squamous cell carcinoma of the larynx: a preliminary report.

PURPOSE: To test whether genetic deletions of glutathione-S-transferase (GST) are associated with squamous cell carcinoma (SCC) of the larynx. GST are a group of detoxifying enzymes that may help reduce the risk of developing cancer in response to environmental carcinogens. Polycyclic aromatic hydrocarbons, found in high concentration in cigarette smoke, are known carcinogens especially for SCC of the larynx. Individuals with absolute or relative deficiency of the GST enzyme system may therefore be at a higher risk of developing laryngeal carcinoma. MATERIALS AND METHODS: Genotyping for GST-M1 and GST-T1 was performed using polymerase chain reaction (PCR) assay on fresh frozen tissue specimens of 20 patients with SCC of the larynx and on 20 control subjects with a similar smoking history. Because this assay results in the absence of a PCR product in individuals expressing the GST-M1/GST-T1 null genotype, oligonucleotide primers that amplify a portion of the albumin gene were included in a multiplex PCR as a positive control for DNA quality and PCR conditions. The chi-square test was used for statistical analysis. RESULTS: GST-M1 gene was deleted in 80% of patients with laryngeal SCC and in 50% of control subjects (P <.05). No statistically significant difference was observed in the incidence of GST-T1 gene deletion in patients with SCC of the larynx and control subjects. CONCLUSION: GST-M1 gene deletion was significantly associated with SCC of the larynx and may produce a risk for this particular disease.

Carcinoma, Squamous Cell↗
PubMed2006

Concurrent chemoradiotherapy with cisplatin, 5-fluorouracil, methotrexate, and leucovorin in patients with advanced resectable squamous cell carcinoma of the larynx and hypopharynx.

CONCLUSIONS: This regimen of concurrent chemoradiotherapy was safe and well tolerated. In terms of larynx preservation, the present regimen appears to be useful for patients with advanced resectable squamous cell carcinoma (SCC) of the larynx and hypopharynx. OBJECTIVES: To evaluate the efficacy and toxicity of concurrent chemoradiotherapy in patients with advanced resectable SCC of the larynx and hypopharynx, and to demonstrate the feasibility of larynx preservation. PATIENTS AND METHODS: Forty-six eligible patients were treated. The chemotherapy regimen consisted of a combination of four drugs: cisplatin (60 mg/m(2), day 4), 5-fluorouracil (5-FU) (600 mg/m(2) given continuously for 120 h, days 1-5), methotrexate (MTX) (30 mg/m(2), day 1), and leucovorin (LV) (20 mg/m(2), days 1-5). Two cycles of this regimen were given every 4 weeks during radiotherapy. Radiotherapy was delivered 5 days a week using a single daily fraction of 1.8-2.0 Gray, to a total dose of 66.6-70.2 Gray. RESULTS: The 3-year disease-specific survival rates of patients with laryngeal or hypopharyngeal SCC were 81.3% and 78%, respectively. The 3-year disease-specific survival rates with larynx preservation of patients with laryngeal or hypopharyngeal SCC were 46.7% and 59%, respectively. The main toxicities were neutropenia, dermatitis, mucositis, and infection.

Adult↗
PubMed1996

Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group.

BACKGROUND: As a general rule, surgery whenever possible, followed by irradiation is considered to be the standard treatment for cancer of the hypopharynx, thus sacrificing natural speech. In most patients, surgery includes removal of the larynx. PURPOSE: A prospective, randomized phase III study was conducted by the European Organization for Research and Treatment of Cancer (EORTC) starting in 1990 to compare a larynx-preserving treatment (induction chemotherapy plus definitive, radiation therapy in patients who showed a complete response or surgery in those who did not respond) with conventional treatment (total laryngectomy with partial pharyngectomy, radical neck dissection, and postoperative irradiation) in previously untreated and operable patients with histologically proven squamous cell carcinomas of the pyriform sinus or aryepiglottic fold, but free of other cancers. METHODS: Patients were randomly assigned to one of two treatment arms: 1) immediate surgery with postoperative radiotherapy (50-70 Gy) or 2) induction chemotherapy (cisplatin [100 mg/m2] given as a bolus intravenous injection on day 1, followed by infusion of fluorouracil [1000 mg/m2 per day] on days 1-5). An endoscopic evaluation was performed after each cycle of chemotherapy. After two cycles, only partial and complete responders received a third cycle. Patients with a complete response after two or three cycles of chemotherapy were treated thereafter by irradiation (70 Gy); nonresponding patients underwent conventional surgery with postoperative radiation (50-70 Gy). Salvage surgery was also performed when patients relapsed after chemotherapy and irradiation. The trial was designed to test the equivalence of the two treatment arms; i.e., the induction chemotherapy treatment would be judged equivalent to immediate surgery if the relative risk of death for induction chemotherapy compared with immediate surgery was significantly less than 1.43 using a one-sided hypothesis test at the .05 level of significance. RESULTS: Two hundred two patients entered the trial and were randomly assigned; only 194 were eligible for treatment (94 in the immediate-surgery arm and 100 in the induction-chemotherapy arm). In the induction-chemotherapy arm, complete response was seen in 52 (54%) of 97 patients with local disease (primary tumor) and in 31 (51%) of 61 patients with regional disease (involvement of the neck). Treatment failures at local, regional, and second primary sites occurred at approximately the same frequencies in the immediate-surgery arm (12%, 19%, and 16%, respectively) and in the induction-chemotherapy arm (17%, 23%, and 13%, respectively). In contrast, there were fewer failures at distant sites in the induction-chemotherapy arm than in the immediate-surgery arm (25% versus 36%, respectively; P = .041). The median duration of survival was 25 months in the immediate-surgery arm and 44 months in the induction-chemotherapy arm and, since the observed hazard ratio was 0.86 (logrank test, P = .006), which was significantly less than 1.43, the two treatments were judged to be equivalent. The 3- and 5-year estimates of retaining a functional larynx in patients treated in the induction-chemotherapy arm were 42% (95% confidence interval = 31%-53%) and 35% (95% confidence interval = 22%-48%), respectively. CONCLUSIONS AND IMPLICATIONS: Larynx preservation without jeopardizing survival appears feasible in patients with cancer of the hypopharynx. On the basis of these observations, the EORTC has now accepted the use of induction chemotherapy followed by radiation as the new standard treatment in its future phase III larynx preservation trials.

Adult↗
PubMed1991

Larynx preservation using induction chemotherapy plus radiation therapy as an alternative to laryngectomy in advanced head and neck cancer. A long-term follow-up report.

Since 1977, we have used induction chemotherapy (CT) plus radiation therapy (RT) with curative intent in 35 advanced head and neck cancer (Ca) patients who otherwise would have required total laryngectomy. Fourteen patients had advanced Ca of the larynx or supraglottic larynx (SGL); 21 patients had Ca of the hypopharynx. In six patients the Ca was Stage III; in 26 patients it was Stage IV. Three patients had Stage II disease--2 with cancer of the pyriform sinus and one patient with Stage II SGL Ca who refused surgery. Chemotherapy consisted of platinum (P) + bleomycin in 18 patients until 1982, then P + fluorouracil in the next 17 patients. Total response rate was 77%--complete (CR) in 26% and partial (PR) in 51%. There were two toxic deaths. Surgery was limited to tracheostomy in 4 patients prior to CT and to radical neck dissection after CT in 4 others. Two patients required salvage laryngectomy at 11 and 31 months, respectively. One patient underwent partial laryngectomy with voice preservation. Thirty-two patients were evaluable for overall response after RT. Final disease-free status was achieved in 20/34. One long-term survivor was lost to follow-up (44 months) and 8 patients remained alive at 13+ to 109+ months. Median failure-free survival for all patients was no less than 24 months. Not counting 4 early deaths free of disease, 2-year local control using only chemotherapy plus radiation was 52% (16:31). Overall, 33 of 35 patients retained their voices. Sixteen patients (46%) have survived 2 years or longer. Survival of patients who achieved CR after induction chemotherapy was 48 months versus 14 months for those with less than a CR (p = 0.001). Patients with a hypopharyngeal primary had only a 33% 2-year local control rate with chemotherapy and radiation and a median survival of only 12 months versus 77% control and a minimum 39-month survival for those whose tumor arose in the larynx (p = 0.009). Induction chemotherapy plus radiation therapy is an effective strategy which can produce a high rate of larynx preservation, local control, and long-term survival in patients with advanced cancer of the larynx. Patients with hypopharyngeal primaries have a lesser rate of long-term survival and local control, despite similar overall response rates.

Aged↗
PubMed2004

Treatment of advanced cancer of the larynx and hypopharynx with chemoradiation.

AIM: To analyze the outcome of patients diagnosed with advanced cancer of the larynx and hypopharynx treated with combined chemotherapy and radiotherapy at Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia. METHODS: Analysis of prospectively gathered data concerning patients treated between 1994 and 2000 in a multidisciplinary, tertiary referral head and neck service. Outcome measures were: treatment toxicity, locoregional tumour control, and disease specific survival. RESULTS: Among 54 eligible patients, cancer involved the larynx in 31 patients and hypopharynx in 23 and, of these, 38 (70%) completed all the scheduled treatment. Chemotherapy and radiotherapy were given sequentially in 39 patients and concurrently in 15. The median age of patients was 63 years (range 35-79 years) and all but three had clinical stage III or IV disease. There were two treatment related deaths. Disease persisted in five patients and 14 others relapsed. Overall, 11 (24%) patients have had a laryngectomy; five for persistent disease, three for local recurrence and three for treatment related complications in the absence of disease. There were 15 cancer-related deaths. Cumulative disease specific survival at 2 years was 77% for the larynx cancer group and 72% for hypopharynx. The larynx was preserved in 26 of 30 patients alive at follow up. CONCLUSIONS: Patients diagnosed with advanced cancer of the larynx and hypopharynx may be considered for organ preservation treatment with chemoradiation, reserving surgery for persistent or recurrent disease. Careful patient selection is recommended because of the potential for significant treatment related toxicity.

Adult↗
PubMed2001

Functionally active duplications of the CYP2D6 gene are more prevalent among larynx and lung cancer patients.

The cytochrome P450 CYP2D6 is a polymorphic drug-metabolizing enzyme that is involved in the metabolism of several drugs and xenobiotics. Several independent studies indicate that the CYP2D6 metabolic status is a secondary factor in the risk of developing lung cancer, with individuals with high activity being at increased risk. The occurrence of functionally active duplications of the CYP2D6 gene is a phenomenon that affects 3-8% of Caucasians and up to 30% in some ethnic groups. These duplications cause ultrarapid metabolism of CYP2D6 substrates. In order to establish whether the highest CYP2D6 enzyme activity is associated with an increased risk of cancer, we analyzed the frequency of CYP2D6 gene duplications and enzyme-inactivating mutations in 199 Caucasian patients with lung or larynx cancer and in 335 healthy controls. A significantly increased frequency of carriers of the CYP2D6 gene duplication were found among lung and larynx cancer patients (13%), as compared with healthy controls (6.9%; p < 0.02). The frequency of the mutated active CYP2D6*9 allele was increased in lung cancer patients (p < 0.01) but not in larynx cancer patients. Global findings indicate that over 20% patients with lung or larynx cancer show CYP2D6 genotypes leading to ultrarapid metabolism or to the expression of an enzyme with altered kinetics (p < 0.01 vs. healthy controls). This may influence the metabolism of CYP2D6 substrates, including antineoplastic drugs and opioid derivatives used for pain relief in cancer patients. These patients would require higher doses than those considered as standard. We conclude that dosages for CYP2D6 substrates should be adapted to lung and larynx cancer patients.

Adult↗
PubMed2005

Unilateral vocal cord paralysis causes contralateral false-positive positron emission tomography scans of the larynx.

Positron emission tomography (PET) is used in the management of head and neck cancers. It identifies tissue with increased metabolic activity and is not specific for malignancy. A false-positive PET scan of the larynx is associated with vocal cord paralysis. We reviewed PET scan reports of patients with lung cancer from 1998 to 2001 to identify patients with increased 18-fluoro-2-deoxyglucose uptake in the larynx without a known history of head and neck cancer and then correlated this increased uptake with laryngoscopic findings. There were 17 patients who had a positive PET finding in the larynx. Fifteen of those had a false-positive PET scan in the larynx. All had contralateral vocal cord paralysis. Two patients were noted to have head and neck cancer. We conclude that vocal cord paralysis can cause a false-positive PET scan on the contralateral side of the larynx due to overactivity of laryngeal muscles that compensate for the paralyzed cord.

Adult↗
PubMedDate not supplied

An evaluation of elective irradiation of neck nodes in patients with cancer of the supraglottic larynx.

Between 1964 and 1973, 152 patients with supraglottic cancer limited to the larynx with clinically negative neck were included in the controlled randomized study designed to evaluate elective irradiation of the neck. The patients were randomized to one of the 2 treatment groups: 1) "T+N": irradiation of the larynx and all neck nodes, tumor dose 5130 rad/6-7 weeks, 2) "T": irradiation of the laryngeal portals only, tumor dose 5130 rad/5 weeks. All patients received 250 kV orthovoltage irradiation. The biologic dose delivered to the larynx was greater in group "T" because of faster fractionation and shorter overall time of therapy. The calculated NSD value for the patients in group "T+N" varied from 1620 to 1690 ret, and in group "T" it was 1800 ret. Five-year survival rates with a preserved larynx and without cancer were 45.3% for group "T+N" and 66.2% for group "T". Seven patients of group "T" developed metastatic cancer in the neck, and 4 of them were cured by neck dissection. It is concluded that patients with early supraglottic cancer can be successfully irradiated through laryngeal portals only, including the larynx, and possibly midjugular and digastric nodes. The tumor dose should be at least equivalent to the NSD of 1800 ret in the condition of megavoltage therapy.

Carcinoma, Squamous Cell↗
PubMed1993

Reevaluation of a maneuver to visualize the anterior larynx after intubation.

Confirmation of translaryngeal placement of the tracheal tube can be unexpectedly difficult. This study examined the usefulness of displacing the larynx posteriorly with the tracheal tube during laryngoscopy with a straight laryngoscope blade to confirm tracheal tube placement. One hundred ASA Classes I, II, or III patients presenting for elective surgery whose normal anesthetic care included placement of an orotracheal tube via direct laryngoscopy were enrolled in this institutionally approved study after giving their written, informed consent. The view of the larynx at laryngoscopy was graded, and the tracheal tube was then inserted. When the larynx was incompletely exposed, the tracheal tube was displaced posteriorly while the laryngoscope was maintained in the intubating position in an attempt to better visualize the larynx. The effect of the maneuver on Mallampati grade for laryngeal exposure was noted. During laryngoscopy with a Miller blade none of the glottis was initially visualized in 17 patients (Mallampati laryngeal Grades 3 and 4). Thus, the tracheal tube actually was not seen to pass between these patients' vocal cords. Use of the maneuver resulted in improved visualization of the intubated larynx in 12 of these patients, and confirmed tracheal intubation. This maneuver is recommended as an aid to the anesthesiologist in the confirmation of tracheal intubation.

Adult↗
PubMed1976

Supraglottic larynx and its pathology as studied by whole laryngeal sections.

The need for additional data regarding the behavior of carcinomas of the supraglottic larynx was recognized during attempts to identify candidates for supraglottic laryngectomy. The crux of the matter was whether supraglottic carcinomas remain confined at the supraglottic larynx. If some do not, can these exceptions be detected preoperatively? Information gained from whole-organ study of 40 larynges with such tumors showed that most tumors do remain confined to the supraglottic larynx; however, there are exceptions, and these are usually high-grade tumors. Preoperative biopsy demonstrating undifferentiation in a tumor suggests a potential for atypical behavior. Patients with these high-grade lesions are not candidates for supraglottic laryngectomy. Fortunately, most supraglottic carcinomas are well-differentiated, behave in a typical manner, and fulfill the expectations gained from the preoperative mucosal appearance. Supraglottic laryngectomy is, therefore, feasible and successful in carefully selected candidates. The conclusions of this study are the following: 1. Most supraglottic cancers behave as expected, being typically well-differentiated tumors that remain confined to the supraglottic larynx. 2. Exceptions to such behavior are exemplified by tumors manifesting submucosal extension some distance away from the main tumor mass, tumors invading the thyroid cartilage, second primaries, and tumors disseminating emboli away from the main tumor. 3. Present preoperative diagnostic measures still fail to detect tumors with atypical behavior. Subsequent supraglottic laryngectomy in patients with such tumors would, therefore, leave residual tumor. 4. Carcinomas exhibiting atypical behavior are characteristically undifferentiated and aggressive. 5. The epiglottis and pre-epiglottic space are easily invaded by supraglottic cancer. The pre-epiglottic space is removed during either supraglottic or total laryngectomy. 6. The thyroid cartilage is an excellent barrier to the spread of supraglottic cancers. Tumors that invade it penetrate the anterior commissure first. 7. The pitfalls in the selection of candidates for supraglottic laryngectomy are assessment problems in which the tumor mass makes it difficult to see its full mucosal extent. Inadequate biopsy may also fail to detect a tumor. 8. In the preoperative assessment of a patient with supraglottic carcinoma, supraglottic laryngectomy is contraindicated if the biopsy does show high-grade differentiation and if the tumor is situated near the petiole. 9. Undetected extension submucosally to the level of the glottis will result in some failures with conservation surgery of the larynx.

Carcinoma, Squamous Cell↗
PubMed1994

Photodynamic therapy and the treatment of neoplastic diseases of the larynx.

Photodynamic therapy (PDT) is an innovative treatment involving the use of light-sensitive drugs to selectively identify and destroy diseased cells. Therefore, photodynamic therapy has the potential to treat and cure precancerous and early cancerous lesions (carcinoma in situ [CIS], T1 and T2) of the larynx while preserving normal tissue. Eleven patients with recurrent leukoplakia and carcinomas of the larynx were treated with PDT with follow-up to 27 months. One patient with a T1 verrucous carcinoma, 5 patients with T1 squamous cell carcinomas of the vocal cord failing radiotherapy, 1 patient with a T2 squamous cell carcinoma of the vocal cord failing radiotherapy, and 3 patients with CIS and severe atypia were treated with PDT and obtained a complete response and are disease free. One patient with a T3 carcinoma of the larynx was treated with PDT but died 4 weeks post-treatment of unrelated causes and could not be assessed. Photodynamic therapy is a promising therapy for treatment of precancerous and cancerous lesions of the larynx. This therapy may be particularly beneficial for the treatment of recurrent carcinomas of the larynx that have failed conventional radiotherapy, thereby preserving voice and eliminating the need for destructive laryngeal surgery.

Aged↗
PubMed1993

Distributions of the calcitonin gene-related peptide and substance P in the monkey larynx.

The distribution of calcitonin gene-related peptide (CGRP)- and substance P (SP)-like immunoreactivity in the monkey larynx was studied with light microscopy using the immunofluorescence method. We divided the larynx into the following six regions: epiglottis, arytenoid region, false cords, ventricle, vocal cords and subglottis. The distribution of immunoreactivity in the epithelium and subepithelial layer was determined. CGRP- and SP-like immunoreactive nerve fibers were observed in all regions of the laryngeal epithelium except in the vocal cords. In the epithelium of the epiglottis and arytenoid region, numerous taste buds containing several CGRP- and SP-like immunoreactive nerve fibers were observed. In the subepithelial layer, CRGP- and SP-like immunoreactive nerve fibers were observed in all regions of the larynx. In order of decreasing density, these fibers were found in the arytenoid region (especially the corniculate tubercle), the epiglottis, the false cords, the subglottis, the ventricle, and the vocal cords. In the corniculate tubercle, CGRP- and SP-like immunoreactive nerve fibers formed a network, whereas around the cuneiform tubercle, dense CRPG- and SP-like immunoreactive nerve fibers were noted parallel to the basement membrane. SP-like immunoreactive nerve fibers showed a very similar distribution to the CRPG fibers in the epithelium and the subepithelial layer, but SP-like fibers were sparser in all regions of the larynx. These results, together with previous findings indicate that the arytenoid region and the epiglottis of the monkey larynx play very important roles in airway protection, swallowing, and respiration.

Animals↗
PubMed2000

[Larynx-preserving pharyngoesophagectomy in the treatment of cancer of the pharyngoesophageal junction].

UNLABELLED: Pharyngo-laryngo-esophagectomy has been the sole surgical option in the management of advanced tumors arising from the pharyngoesophageal junction. This operation is associated with high morbidity, mortality and poor quality of life due to loss of larynx. The aim of the author was to achieve a reduction in tumor size by means of neoadjuvant chemoradiotherapy and so to make the tumor amenable to a larynx preserving operation avoiding pharyngo-laryngo-esophagectomy. Between 1. January 1998 and 31. December 1999, 11 consecutive patients with advanced cancer of pharyngo-esophageal junction were treated with neoadjuvant chemoradiotherapy (carboplatin, 5-fluorouracil, 30-35 Gy telecobalt irradiation). The tumor regressed in all cases and moreover, in 6 patients a larynx preserving pharyngo-esophagectomy could be carried out. This operation consists of total esophagectomy, resection of posterior pharynx wall and Akiyama-type gastric pull up with side-to-side pharyngo-gastrostomy. All 6 patients recovered. In 2 cases after neoadjuvant therapy the tumor disappeared from the cervical esophagus and so that a pharyngo-laryngectomy and free jejunum transfer could be performed. 3 other patients remained irresectable due to lymph node metastases. CONCLUSION: Larynx preserving pharyngo-esophagectomy is a safe operation by means of which the larynx can be preserved even in those patients whose tumor is located at the level of pharyngo-esophageal junction, on the posterior wall of the pharynx.

Aged↗
PubMed2001

[Role of gastroesophageal reflux in precancerous conditions and in squamous cell carcinoma of the larynx: our experience].

The major risk factors for the onset of precancerous lesions and squamous cell carcinoma of the larynx are, above all, tobacco smoke, alcohol abuse and exposure to viral and toxic agents. In recent years, however, gastro-esophageal reflux (GER) has also aroused significant interest not only as carcinogen but also as co-carcinogen in association with smoking and alcohol consumption. The purpose of the present work is to provide an objective evaluation of the presence of distal and proximal esophageal reflux using multi-electrode pH monitoring in patients with precancerous lesions of the larynx and laryngeal and pharyngolaryngeal neoplasms. A total of 24 patients consecutively hospitalized during 2000 were evaluated: 20 with squamous cell carcinoma of the larynx and/or pharynx-larynx and 4 with precancerous vocal cord lesions. All the patients provided a case history using a validated questionnaire and underwent electronic videolaryngoscopy and 24-hour pH monitoring. Data analysis showed that in 83.3% of the cases (20/24) pH monitoring was indicative of pathological GER and 63.7% of these patients had no complaints related to reflux. Moreover, 7/24 patients have had a previous gastrectomy (Billroth II) strictly related to the presence of bile reflux. The Authors conclude that, according with recent literature, pH monitoring data further indicate that patients with precancerous or neoplastic pharyngeal-laryngeal lesions present often a positive history of GER, even though no direct cause-effect relationship can yet be established because of the co-existence of other important risk factors such as smoking and alcohol consumption. Additionally, the achlorhydria found in 7/24 patients with an history of gastrectomy could suggest a possible, as yet unproven, role of other reflux components--in particular, of bile (alkaline) and chlorhydro-peptic (acid) components--as a risk factor or co-factor for tonset of precancerous and/or neoplastic lesions of the larynx.

Adult↗
PubMed2003

[The study of the expression, effect and clinical relationship of TGF-beta 1 in the larynx squamous carcinoma].

OBJECTIVE: This study was to measure the expression of TGF-beta 1 in larynx squamous carcinoma, to investigate the relationship between TGF-beta 1 and pathological grading of tumours, the clinical staging and, through which the effect of TGF-beta 1 on the pathogenesis of the larynx squamous carcinoma was to be known. METHOD: RNA was extracted from the larynx squamous carcinoma tissues of 21 patients and from normal laryngeal tissues of 15 cases. Reverse transcriptional polymerase chain reaction (RT-PCR) was applied to detect the expression of the TGF-beta 1 mRNA. RESULT: Ten of the 21 specimens of the larynx squamous carcinoma showed positive expression of TGF-beta 1 mRNA, then the expression ratio was 47.62%. The expression of TGF-beta 1 mRNA had relationship to the pathological grading and the clinical staging of the larynx carcinoma. CONCLUSION: TGF-beta 1 can be used as a marker to evaluate the progression of laryngeal squamous cell carcinoma.

Adult↗
PubMed2003

[Four cases of primary neuroendocrine carcinoma in ear, nose, pharynx and larynx].

OBJECTIVE: To discuss the clinical pathologic features and therapeutic method of the primary neuroendocrine carcinoma in ear, nose, pharynx, larynx. METHOD: One case of atypical carcinoid tumor in larynx is treated by epiglottidectomy. One case of atypical carcinoid tumor in rhinopharynx is treated by radiotherapy. One case of typical carcinoid tumor in middle ear is treated by exploratory incision and radical mastoidectomy. One case of small cell neuroendocrine carcinoma in right nasal cavity is treated by resection and radiotherapy. RESULT: The patient of atypical carcinoid tumor in larynx died after 5 years and the patient of atypical carcinoid tumor in rhinopharynx died after 1 year. The patient of typical carcinoid tumor in middle ear was followed-up 3 years and the patient of small cell neuroendocrine carcinoma in right nasal cavity was followed-up 2 years, and the carcinomas didn't recrudesce. CONCLUSION: The primary neuroendocrine carcinoma in ear, nose, pharynx, larynx is classified in three states: typical carcinoid tumor, atypical carcinoid tumor and small cell neuroendocrine carcinoma. Typical carcinoid tumor is a kind of low malignant tumor and small cell neuroendocrine carcinoma is a kind of high malignant tumor and atypical carcinoid tumor is a kind of medium malignant tumor. The chief therapeutic method of the primary neuroendocrine carcinoma in ear, nose, pharynx, larynx is surgical intervention.

Aged↗
PubMed2003

[Malignant fibrous histiocytomas of larynx].

OBJECTIVE: To explore the histopathology, diagnosis and treatment of malignant fibrous histiocytomas (MFH) of larynx. METHODS: The clinical and pathologic features of 9 cases with MFH of larynx were reviewed retrospectively. RESULTS: All the 9 cases with MFH of larynx were adults (the age ranged from 43 to 87 years; average 56 years); 8 were men and 1 woman. The tumor of eight cases originated in glottic area and 1 case occurred in supraglottic area. The histological diagnosis was difficult, so the immunohistochemical studies in 5 cases were examined. Because surgical resection was a mainly treatment, seven patients underwent total laryngectomy and 2 cases underwent frontal partial laryngectomy. Six patients were followed up for more than 3 years and no patient died of MFH after surgical resection. CONCLUSION: The diagnosis of MFH of larynx was sometimes difficult and immunohistochemistry could be helpful. The mainly treatment of MFH of larynx was surgical resection by total laryngectomy or partial laryngectomy.

Adult↗
PubMed2005

[Expression and clinical value of KAI1/CD82 in carcinoma of larynx].

OBJECTIVE: To observe the levels of KAI1/CD82 in carcinoma of larynx and the relationship between it and their clinicopathological features,in association with the results of metastasis. METHOD: The expressions of KAI1/CD82 in 61 patients with carcinoma of larynx were detected by immunohistochemistry. The samples of tissue cutting from the edge of carcinoma of larynx (control group) were also studied,and the results were compared. RESULT: The expression of KAI1/CD82 protein in carcinoma of larynx was lower than that in control group (P < 0.05). Statistic difference about the expression of KAI1/CD82 between primary lesions and metastatic lesions was found (P < 0.05); The expression of KAI1/CD82 were closely correlated with lymph node metastasis (P < 0.05), but their expressions were not correlated with age, clinical staging, pathological differentiation (P > 0.05). CONCLUSION: KAI1/CD82 may play an important regulating role in metastasis of carcinoma of larynx, and they may be used as potential markers for tumor metastasis.

Adult↗