Evolution of patients with squamous cell carcinoma of upper aerodigestive tract

Abstract

CONTEXT: Local and regional recurrences are frequent in patients with squamous cell carcinoma of the upper aerodigestive tract and early diagnosis is important for salvage treatment. OBJECTIVE: To identify the period of highest risk for the development of recurrences after surgical treatment of squamous cell carcinoma of the upper aerodigestive tract, in spite of radical therapy, in order to plan the follow-up for these patients. TYPE OF STUDY: Cross-sectional, descriptive. SETTING: Department of Head and Neck Surgery/Otorhinolaryngology, Heliópolis Hospital (Hosphel), São Paulo, Brazil. PARTICIPANTS: A review was made of the hospital records of 889 patients with squamous cell carcinoma of the upper aerodigestive tract surgically treated between October 1977 and December 1996: 364 had oral cavity tumors, 107 had tumors of the oropharynx, 152 of the hypopharynx and 266, larynx tumors. The disease was stage I in 14 patients, stage II in 117, stage III in 352, stage IV in 397 and 9 patients were not staged. MAIN MEASUREMENTS: The interval between treatment and recurrence of disease was evaluated. The results were expressed as medians, quartiles (25% to 75%) and percentiles (10% to 90%). The annual incidence of recurrences and second tumors was calculated. RESULTS: Seventy-four percent of the recurrences were diagnosed within 18 months post-treatment. The local and regional recurrences and distant metastases showed medians of 270, 210 and 435 postoperative days respectively. The incidence of a second primary tumor varied from 2 to 3.1% a year. CONCLUSION: The majority of recurrences occurred within 18 months after the initial surgical treatment. The incidence of a second tumor remained stable after the first post-treatment year.

Phase I trial of DNA-hsp65 immunotherapy for advanced squamous cell carcinoma of the head and neck

“…At the end of the fifth day, cells were incubated for 18 h with 2.5 mCi ml À1 3 H-thymidine (Amersham Biosciences, Little Chalfont, UK). 3 …”

“…1,2 It corresponds to 3% of all malignant cancers in the United States, but is much more prevalent in Brazil, where it accounts for 6% of all cancer deaths. 3 Although major advances in surgical, radiation and chemotherapeutic approaches have been made in the last 25 years, these efforts had no significant impact on the survival of patients with advanced HNSCC. 4,5 Therefore, novel therapeutic strategies aiming at improving survival and quality of life are needed.…”

Esvaziamento cervical no carcinoma epidermóide da tonsila

“…Reduced dissection extension was stimulated by positive outcomes in controlling regional disease and improvement of overall survival. Although cervical metastases were related to significantly low survival, poor outcomes mainly occur due to therapy failures on primary site and distantly, while isolated regional recurrences are early detected and treated at patients' follow-up 4,5 .…”

Avaliação de fatores demográficos e estadiamento clínico nos pacientes submetidos a resgate cirúrgico por carcinomas epidermóides de orofaringe

“…It is a consensus that the success rate of salvage surgery of the neck after prior neck dissection is poor. [4][5][6][7] Salvage surgery, even in potential cases for this form of treatment, is controversial; most patients have a second recurrence or persistence of the disease within six months of salvage therapy. 8 Physicians should take into account the morbidity, and mainly an unfavorable prognosis, when choosing the ideal treatment.…”