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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We evaluate the importance of cancer spread to the lymphatic system in the posterior triangle. The posterior triangle tissues of 51 radical neck specimens were serially sectioned and studied for metastic involvement. The findings were correlated with the findings in the anterior triangle and the primary tumor. Of the 51 neck operations performed, 25 were elective and 26 were therapeutic for carcinoma of the larynx, pharynx, and oral cavity. Metastasis in the anterior triangles was detected in 88.4% of the therapeutic group and in 24.0% of the elective group. However, no metastasis in the posterior triangel was found in either group, regardless of the site of the tumor. We suggest that the posterior triangle can be totally preserved in radical neck surgery, which may make preservation of the spinal accessory nerve a more likely practice.
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PMID:The posterior triangle in radical neck surgery. 124 24

In the search of microscopic manifestations of cellular defense in tumor disease, larynx specimens removed surgically for carcinoma of the larynx and neighboring lymph nodes were studied morphologically. Blastic transformation of lymphocytes from the lymph nodes was also investigated. Activity of nuclear chromatin of these cells was assessed on the basis of its sensitivity to acid hydrolysis in the reaction of Feulgen and incorporation of labeled 3H-actinomycin D. The results indicate existence of cellular defense reaction in carcinoma of the larynx, around the primary tumor as well as in neighboring lymph nodes. Intensity of the reaction in lymph nodes increases with growth of the primary tumor.
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PMID:Concerning cellular defense in carcinoma of the larynx. 125 39

The recently completed VA Cooperative Study (CSP #268) of induction chemotherapy (cisplatin/5-FU) and definitive radiation (6600 to 7600 cGy) for organ preservation in advanced (stage III or IV) laryngeal cancer demonstrated that, although larynx preservation could be achieved in 64% of randomized preservation could be achieved in 64% of randomized patients, overall survival rates were not improved over conventional treatment (surgery/postoperative radiation). Of 166 patients randomized to induction chemotherapy, 46 had N2 or N3 disease and were analyzed to determine the effectiveness of the organ preservation treatment strategy on control of neck disease and survival. The clinical response of neck metastases to induction chemotherapy was significantly associated with subsequent salvage neck dissection (P = .008). The overall death rate was increased (P = .014) and survival time decreased in patients with less than a complete response in the neck after chemotherapy (P = .15). This was related primarily to failure to control the disease in the neck. The overall survival of patients achieving a complete response in the neck was improved over the randomized group of N2 or N3 patients treated with primary surgery. The findings suggest that response of neck nodes should be assessed independently of primary tumor response in trials of organ preservation strategies using induction chemotherapy, and that failure to achieve a clinical complete response in the neck warrants planned early salvage neck dissection in order to achieve improved overall survival.
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PMID:Effectiveness of salvage neck dissection for advanced regional metastases when induction chemotherapy and radiation are used for organ preservation. 149 57

The authors studied some demographic, clinical, pathologic, and therapeutic variables in relation to the disease-free interval (DFI) and to the overall survival of laryngeal cancer patients. The patient population consisted of 278 consecutive cases of primary laryngeal cancer who had been admitted to four head and neck surgery services in Sao Paulo and Curitiba (Brazil) between 1973 and 1986. All patients had surgical treatment. Although several variables exhibited individual associations with survival, only a few were deemed to have independent prognostic value using multivariate regression techniques based on Cox's proportional hazards model. The primary tumor stage (T index) represented the variable with the highest predictive strength with respect to survival. Hazard ratios for the risk of disease recurrence were 2.3 (T2-3 vs. T1) and 4.3 (T4 vs. T1). Hazard ratios for the risk of death were 1.6 (T2-3 vs. T1) and 3.3 (T4 vs. T1). The following additional factors were also independently associated with the DFI: age, site of primary tumor (transglottic, glottic, or supraglottic), extracapsular spread of lymph node metastasis, surgical margins, type of paratracheal node dissection, and prior tracheostomy. Except for extracapsular spread, the same factors related to the DFI were also significantly related to the overall survival. Race, sex, N-stage, vascular embolization, and histological grade were other independent predictors of the risk of death.
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PMID:Prognostic factors in laryngeal cancer patients submitted to surgical treatment. 192 4

The role of three-dimensional (3-D) treatment planning in the definitive treatment of carcinoma of the larynx with radiation was evaluated at four institutions as part of an NCI contract. A total of 30 different treatment approaches were devised for two patients with larynx cancer. CT scans were obtained for both patients and various treatment planning tools were employed to optimize beam arrangements and to evaluate the resulting dose distribution. The effect on dose distribution of a number of factors was also examined: 1) the use of dose calculation algorithms which correct for tissue inhomogeneities, 2) the variation of the CT numbers used for inhomogeneity corrections to simulate inaccuracies in the knowledge of the CT numbers, and 3) the modification of beam energy. A multitude of data was used in plan evaluation and a numerical score was given to each plan to estimate the tumor control probability and the normal tissue complication probability. We found 3-D treatment planning to be of potential value in optimizing treatment plans in larynx cancer. Improved target coverage was achieved when complete information describing 3-D geometry of the anatomy was utilized. In some cases, the treatment planning tools employed, such as the beam's eye view, helped devise novel beam arrangements which were useful alternatives to standard techniques. We found little effect of change in CT number on dose distributions. A comparison between dose distributions calculated with tissue inhomogeneity corrections to those calculated without this correction showed little difference. We did find some improvement in the dose to the primary tumor volume at lower beam energies, but with an increased larynx volume potentially receiving doses above tolerance.
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PMID:Three-dimensional photon treatment planning in carcinoma of the larynx. 203 87

We report the growth characteristics of seven human laryngeal carcinomas transplanted into athymic mice. Six of the tumors were harvested from surgical pathology specimens and one was from a laryngeal carcinoma cell line. Tumor tissue measuring 2-3 cubic millimeters was implanted subcutaneously into the flank of the mice. Time intervals between implantation and active growth were recorded and tumor volume was calculated weekly. Mice were sacrificed at various time intervals. For three tumors, second and third passages of the tumor were performed. Successful tumor growth was achieved in 6/7 (85.7%) tumors. Primary implantation of tumor was performed in a total of 26 mice, 17 of which grew successfully. The average time interval between tumor implantation and measurable tumor growth for the five zenografts derived directly from patients was 36 days (range 25-40 days). The mean doubling time was 16 days (range 7-30 days). The overall take rate per animal for serial passage of tumor was 36 out of 43 (83.7%). The lag phase and the mean tumor doubling time decreased with each successive passage. At autopsy most tumors were confined to the subcutaneous structures by a well-formed capsule. Lymph node metastases and disseminated metastases were not seen. We conclude that the athymic mouse model is suitable to establish primary tumor growth of human laryngeal cancer.
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PMID:Growth characteristics of human laryngeal carcinoma in athymic mice. 204 Oct 60

The role of chemotherapy in the multidisciplinary treatment of advanced squamous cell carcinoma of the head and neck remains to be defined. Uncontrolled adjuvant studies integrating chemotherapy with local therapies utilizing a 'sequential' or 'simultaneous' strategy have indicated that high response rates to initial chemotherapy and high complete remission rates are achievable. Both these factors appear to predict for improved survival. Unfortunately results of randomized, controlled studies generally have not confirmed any major overall survival advantage. However, these trials clearly failed to utilize optimal therapies: suboptimal trials yield suboptimal results. Encouraging data from large uncontrolled studies have now provided critical information regarding optimal trial design; a) Since primary tumor site has proved a significant predictive factor for response to treatment and survival, future trials must include sufficient numbers of patients for detailed site-by-site analyses, and b) radical surgery may be omitted without compromising survival by using initial chemotherapy followed by radiotherapy for advanced laryngeal cancer.
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PMID:The role of adjuvant chemotherapy in the treatment of advanced head and neck cancer. 222 38

From January 1965 until December 1979, 203 patients with squamous cell carcinoma of the supraglottic larynx were treated with curative intent. The mean follow-up time was 10 years. The policy was to try to aim for cure by radiation therapy (RT) only, reserving surgery (S) for radiation therapy failures. For 193 patients the treatment consisted of a first series of radiation therapy to a total dose of 40 Gy; if a good response to radiation therapy was obtained, the treatment was continued to a full course of 60-70 Gy (RT-I, n = 132). Patients with tumors considered to have responded poorly to the first series of radiation therapy but who refused surgery or were found medically unfit for operation, were also carried to a full dose of 60-70 Gy (RT-II, n = 33). Surgery was performed in 33 cases; 23 patients had a laryngectomy because of a poor response to radiation therapy and 10 were treated with surgery upfront because of severe respiratory distress. This paper focuses on the local control and survival in the defined treatment groups. In summary, with advancing T-stage a lower survival and higher local relapse rate was found; that is, a 5-year relapse-free survival (RFS) of 53% and corrected survival (CS) of 83% for T2 tumors vs 39% (RFS) and 52% (CS) for T4 tumors. Age more than 60 was associated with a 2.2 times higher risk of dying due to laryngeal cancer. A lower relapse-free survival (T3,4: 43% vs 61%) but a comparable corrected survival (T3,4: 64% vs 69%) for RT-I patients compared to the surgery treated patients was found, due to salvage of the radiation therapy failures. Although the relapse-free survival of RT-I and RT-II was similar (43% vs 38%), the corrected survival for the RT-II patients was worse (44% vs 69%). No influence of dose (Gy) per se on the local relapse rate was observed; however, a positive association between local relapse rate with overall treatment time was found. Death from intercurrent disease was almost twice as high as might have been expected for the normal Dutch population. More than half of the patients who died of intercurrent disease developed a second primary tumor.
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PMID:Squamous cell carcinoma of the supraglottic larynx without clinically detectable lymph node metastases: problem of local relapse and influence of overall treatment time. 229 29

In order to clarify possible alterations of membrane-, and cytoplasma-glycoconjugates of laryngeal cancer cells in metastatic process, a histochemical study was performed on laryngeal squamous carcinoma, using seven lectins conjugated with horseradish peroxidase (HRP); PNA, UEA-I, WGA, RCA-I, DBA, SBA and MPA. The author studied 32 primary tumors and 32 corresponding metastatic tumors obtained from 32 patients and primary tumors from 8 patients without histological evidence of lymph node metastasis. None of the patients underwent irradiation or chemotherapy before operation. The specimens were provided for routine lectin histochemistry. The present study revealed some significant differences in lectin-binding as follows. Primary tumor vs. metastatic tumor: There was a significant difference in lectin-binding between primary and metastatic cancer cells. 29 (90.0%) of 32 primary tumors were positive for MPA-staining. On the other hand, 21 (65.6%) of 32 metastatic tumors were positive for MPA-staining. There was a statistically significant (p less than 0.05) difference between primary and metastatic tumors with regard to MPA-binding. Primary tumor cells tended to more bind with lectins than with metastatic tumor cells. Well-differentiated primary tumor vs. moderately differentiated primary tumor: There was a significant difference in lectin-binding between these two types of tumors. Of 15 well-differentiated primary tumors, 13 (86.7%) showed SBA binding. The percentage of SBA-binding was significantly higher in well-differentiated tumor than in moderately differentiated primary tumors (50%, 8/16). Keratinization vs. non-keratinization: There was a significant difference in lectin-binding between keratinized and non-keratinized tumor cells in both primary and metastatic lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Lectin histochemistry of primary and metastatic tumor cells of laryngeal cancer]. 234 78

Multiple primary malignant neoplasms occur relatively frequently today and are quite important. If the primary tumor ("index tumor") develops in the upper aero-digestive tract, the incidence of these neoplasms ranges from 10 to 20%, especially in males. The most common second primary site is again in the upper aero-digestive tract and, less frequently, in the lungs or thoracic esophagus. Among head and neck tumors laryngeal cancer is certainly one of the neoplasms most often playing the role of index tumor in association with malignant cephalic and extracephalic tumors. Among the most frequent associations of multiple primary malignant tumors one finds: larynx-lung and larynx-esophagus. As a high incidence of metachronous primary pulmonary cancers were observed during follow-up of patients who had undergone laryngeal surgery, a preventive flexible bronchofiberscope study was performed in 101 patients who had undergone surgery for laryngeal cancer over the ten years period from 1978 to 1987. The patients had a median age of 58.7 years (range 42-81) and were prevalently males (98 males, 3 females). The incidence of second primary neoplasm in the lung was 3%. During this bronchoscopic study the chest x-ray for 2 of the 3 patients with second primary neoplasm in the lung was normal, all 3 had an evident familiar neoplastic predisposition, one had been treated for colon carcinoma prior to laryngectomy. The authors report some personal opinions regarding the larynx-lung neoplastic association and emphasize the application of bronchoscopy in following-up laryngeal cancer patients.
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PMID:[Early diagnosis of pulmonary tumors in patients treated for laryngeal cancer]. 266 38


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