BACKGROUND:The role of human papillomavirus (HPV) in the pathogenesis of squamous cell carcinomas (SCCs) of the sinonasal tract and its clinicopathological implications were evaluated.METHODS:All SCCs of the sinonasal tract diagnosed in the Hospital Clinic of Barcelona from 1981 to 2006 were retrospectively evaluated (N = 60). Clinical and pathological data were reviewed. HPV infection was determined and typed by amplification of HPV DNA by polymerase chain reaction using the SPF‐10 primers. p16INK4a expression was determined by immunohistochemistry. Overall and progression‐free survival for HPV‐positive and ‐negative patients was estimated by Kaplan‐Meier analysis and by the use of a multivariate Cox proportional hazards model.RESULTS:HPV DNA was detected in tumor tissue of 12 of 60 (20%) patients. HPV16 was identified in 11 tumors and HPV35 in 1. Immunohistochemistry for p16INK4a stained all HPV‐positive and no HPV‐negative tumors (P < .001). No differences were observed in terms of site and histological grade or stage at presentation between HPV‐positive and ‐negative tumors. However, HPV‐positive patients had a significantly better 5‐year progression‐free survival (62%; 95% confidence interval [CI], 23%‐86% vs 20%; 95% CI, 9%‐34%; P = .0043, log‐rank test) and overall survival (80%; 95% CI, 20%‐96% vs 31%; 95% CI, 15%‐47%; P = .036, log‐rank test) than patients with HPV‐negative tumors. In multivariate analysis, HPV‐positive tumors were associated with improved progression‐free survival (hazard ratio, 0.21; 95% CI, 0.17‐0.98; P = .012).CONCLUSIONS:A subgroup of sinonasal SCCs is associated with HPV infection. These tumors have a significantly better prognosis. Cancer 2009. © 2009 American Cancer Society.

Background. Endoscopic management of laryngeal carcinoma has gained popularity among laryngologists based on the good oncologic and functional results. We evaluated the voice quality after laser cordectomy for early glottic cancer in a variety of vocal situations and its relation with the extension of resection and the age.Methods. We conducted a cross-sectional study of voice quality in 42 consecutive male patients treated for T1 glottic carcinoma with laser cordectomy. Patients were compared with 21 controls. Voice quality was self-assessed by the patients. Perceptual analysis was done by a speech pathologist on a running speech sample [GRBAS (grade, roughness, breathiness, asthenicity, strain)]. Acoustic analysis included fundamental frequency (F0), jitter, shimmer, noise to harmonic ratio (N/H), and maximum phonation time (MPT) on the sustained vowels /a/ and /i/, and on various running speech voice samples.Results. Distribution of the patients included in the study by T classification was as follows: Tis, n ¼ 2 (4.8%); T1a, n ¼ 35 (83.3%); and T1b, n ¼ 5 (11.9%). Cordectomy types were: (I), 14%; (II), 26%; (III), 21%; and (V), 38%. Voice improved in almost 60% of patients, returning to normal in 45%. GRBAS showed significant differences between patients and controls and correlated with type of cordectomy. Acoustic analysis showed significant differences in F0, and jitter, with smaller differences in shimmer, N/H, and MPT.Conclusion. Voice quality after laser cordectomy differs from controls, but improves in a majority of patients after the surgery, with almost 50% of patients with subjective normal or near normal voice. Voice quality depends on type of cordectomy. V

Our conclusion is that TLM is a good alternative in a large number of T3 laryngeal tumors, with adequate survival and organ preservation rates above 60%.