Quality of life in patients treated by organ preservation surgery for early laryngeal carcinoma

Allegra, Eugenia; Franco, Teresa; Trapasso, Serena; Aragona, Teodoro; Domanico, Rossana; Garozzo, A

doi:10.2147/oas.s37247

Cited by 6 publications

(10 citation statements)

References 12 publications

(13 reference statements)

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“…Our data analysis demonstrates the oncological safety of modified SCL and confirms the positive functional outcomes and quality of voice without any compliances as previously reported,7,8 which make this technique feasible in elderly patients.…”

Section: Discussionsupporting

confidence: 89%

“…Several papers have reported on the oncological and functional outcomes of SCL 13–15. Modified SCL was introduced in our department as an SCL variant,6 and a previous report7,8 has demonstrated improvements in quality of voice and quality of life after modified SCL, compared with the original SCL technique. This paper validates oncological safety and reports the functional outcomes of this new technique.…”

Section: Discussionmentioning

confidence: 99%

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Modified supracricoid laryngectomy: oncological and functional outcomes in the elderly

Allegra

Franco²,

Trapasso³

et al. 2012

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BackgroundSupracricoid laryngectomy is an organ preservation surgical technique for early-stage glottic tumors. Modified supracricoid laryngectomy using sternohyoid muscles for neoglottis reconstruction is a new surgical technique. This report evaluates oncological and functional outcomes of this new technique and its feasibility in elderly patients.MethodsClinical records from 21 consecutive patients affected by glottic cancer and treated by modified SCL between 2004 and 2009 were retrospectively reviewed. Postoperative parameters and quality of voice after modified SCL were retrospectively reviewed. Actuarial overall survival, disease-specific survival rates, and recurrence-free survival rates were assessed. The functional and oncological outcomes of patients over 65 years were compared with those of patients younger than 65 years of age.ResultsThere were no postoperative complications and all of the patients had complete swallowing rehabilitation. Twenty of the 21 patients had decannulation. Two patients received total laryngectomy for locoregional relapse. Overall survival and disease-specific survival rates were 100%. Recurrence-free survival rates were 90.1% and 90% in patients younger and older than 65 years of age, respectively. The larynx preservation index was lower in patients who were older than 65 years of age. The postoperative courses with regard to functional outcome and voice quality in elderly patients were similar to those of patients younger than 65 years of age.ConclusionModified SCL is a new open organ preservation surgical technique that is oncologically safe. The positive functional and oncological outcomes of this surgical procedure allow it to be performed in elderly patients.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Modified supracricoid laryngectomy: oncological and functional outcomes in the elderly

Allegra

Franco²,

Trapasso³

et al. 2012

CIA

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“…In the last 30 years, progress in the treatment of head and neck cancer has improved the quality of life of patients via the use of innovative surgical and endoscopic techniques that are aimed at the preservation of organ function, mainly in laryngeal tumors 1–3. However, the survival of patients with advanced disease has not improved 4,5.…”

Section: Introductionmentioning

confidence: 99%

Cancer stem cells in head and neck cancer

Allegra¹,

Trapasso²

2012

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Cancer stem cells (CSCs), also called “cells that start the tumor,” represent in themselves one of the most topical and controversial issues in the field of cancer research. Tumor stem cells are able to self-propagate in vitro (self-renewal), giving rise both to other tumor stem cells and most advanced cells in the line of differentiation (asymmetric division). A final characteristic is tumorigenicity, a fundamental property, which outlines the tumor stem cell as the only cell able to initiate the formation of a tumor when implanted in immune-deficient mice. The hypothesis of a hierarchical organization of tumor cells dates back more than 40 years, but only in 1997, thanks to the work of John Dick and Dominique Bonnet, was there the formal proof of such an organization in acute myeloid leukemia. Following this, many other research groups were able to isolate CSCs, by appropriate selection markers, in various malignancies, such as breast, brain, colon, pancreas, and liver cancers and in melanoma. To date, however, it is not possible to isolate stem cells from all types of neoplasia, particularly in solid tumors. From a therapeutic point of view, the concept of tumor stem cells implies a complete revision of conventional antineoplastic treatment. Conventional cytotoxic agents are designed to target actively proliferating cells. In the majority of cases, this is not sufficient to eliminate the CSCs, which thanks to their reduced proliferative activity and/or the presence of proteins capable of extruding chemotherapeutics from the cell are not targeted. Therefore, the theory of cancer stem cells can pose new paradigms in terms of cancer treatment. Potential approaches, even in the very early experimental stages, relate to the selective inhibition of pathways connected with self-renewal, or more specifically based on the presence of specific surface markers for selective cytotoxic agent vehicles. Finally, some research groups are trying to induce these cells to differentiate, thus making them easier to remove. For all these reasons, we have collected existing literature on head and neck cancer stem cells that correlate the biological characteristics of this subpopulation of cancer cells with the clinical behavior of tumors.

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“…In the last 30 years, progress in the treatment of head and neck cancer has improved the quality of life of patients through the use of more innovative surgical techniques and multimodal treatments aimed at organ preservation [47,48,49,50]. Markers of CSCs may identify specific subpopulations that are resistant to treatment and require more aggressive therapeutic strategies, based on the early detection of lymph node metastases and/or distance and on the identification of response predictors to conventional treatment.…”

Section: Discussionmentioning

confidence: 99%

The Role of BMI1 as a Biomarker of Cancer Stem Cells in Head and Neck Cancer: A Review

et al. 2014

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Emerging studies show that BMI1 (B cell-specific Moloney murine leukemia virus integration site 1) has an important function as a biomarker of cancer stem cells (CSCs), i.e. cells with self-renewal characteristics, capable of tumor initiation, progression, invasion, metastasis, tumor recurrence and resistance to chemotherapy and radiotherapy. The failure of current anticancer therapies can be attributed to the relative ineffectiveness of drug and radiation treatments on CSCs, thereby preserving the full capacity of the cells to reproduce tumors. The development of new strategies is currently hindered by the lack of reliable markers for the identification of these CSCs. At present, they have been isolated from solid tumors at various locations using a variety of surface markers, including CD34, CD133, CD24, CD44, CD29 and CD31, in addition to the methods of isolation and cell culture via the Wnt, BMI1, Notch and Hedgehog pathways. The discovery of specific tumor targets for CSCs would constitute a big step in the research for the definitive therapy against cancer. More studies are being conducted that consider the role of CSCs in head and neck cancers with potential for an impact on clinical-surgical outcomes from the knowledge that is being gained. A promising intracellular marker of CSCs in head and neck cancer is the oncoprotein BMI1, with specific data about its prognostic value based on the specific location.

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Quality of life in patients treated by organ preservation surgery for early laryngeal carcinoma

Cited by 6 publications

References 12 publications

Modified supracricoid laryngectomy: oncological and functional outcomes in the elderly

Modified supracricoid laryngectomy: oncological and functional outcomes in the elderly

Cancer stem cells in head and neck cancer

The Role of BMI1 as a Biomarker of Cancer Stem Cells in Head and Neck Cancer: A Review

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