Oral Oncol
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Despite the development and expansion of non-surgical organ preservation therapy, total laryngectomy continues to be the optimal therapy for far-advanced local disease and the only curative option for radiotherapy failures not amenable to partial laryngeal procedures. Laryngectomy, however, remains a life-altering operation with profound effects on swallowing and speech. In the nearly 150 years since the first total laryngectomy was performed, few ablative aspects have changed, but reconstructive techniques have undergone radical evolution. This review will trace the origins of laryngeal rehabilitation for voice and swallowing, the current state of the art with attention to pre-treatment considerations and post-operative management, current surgical management techniques, and the future of functional laryngeal reconstruction.
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To examine the utility of computed tomography (CT) imaging during routine surveillance for the detection of recurrent head and neck squamous cell carcinoma (HNSCC). ⋯ Routine surveillance for HNSCC patients with lung CT imaging had value but routine head and neck CT scans failed to identify any successfully salvaged patients. Given this finding, routine CT imaging surveillance in HNSCC patients should be restricted to annual lung screening with low-dose chest CT.
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Comparative Study
Survival impact and toxicity of metformin in head and neck cancer: An analysis of the SEER-Medicare dataset.
Recent preclinical research has renewed interest in the interplay between glucose dysregulation and cancer. Metformin holds promise as an adjunctive antineoplastic agent in head and neck cancer (HNC). We aimed to explore the impact of metformin in HNC patients from a population-based dataset. ⋯ HNC patients with diabetes taking metformin experience improved CSS. Prospective investigation of the addition of metformin to standard-of-care HNC therapy is warranted.
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Comparative Study
Low versus high activity radioiodine remnant ablation for differentiated thyroid carcinoma with gross extrathyroidal extension invading only strap muscles.
The efficacy of radioiodine remnant ablation (RRA) for patients with differentiated thyroid carcinoma (DTC) with gross extrathyroidal extension (ETE) is well described in observational studies. However, its role in gross ETE invading only strap muscles, T3b category in the newly proposed eighth edition of the TNM staging system, is currently unknown. ⋯ Long term oncologic outcomes did not significantly differ between low versus high activity RRA groups, which suggests that low activity RRA might be sufficient in patients with DTC with gross ETE invading only strap muscles. Further studies are needed to clarify the optimal activity of RRA in these patients.
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The prognostic role of obesity in head and neck squamous cell carcinoma (HNSCC) is not well defined. This study aims to determine its effect on disease-specific outcomes such as recurrence-free survival (RFS), locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) in addition to overall survival (OS). ⋯ Being overweight/obese at the time of HNSCC diagnosis is an independent prognostic factor conferring better survival, while obesity is independently associated with longer time to recurrence, primarily by improving distant control.