Cancer

Prognostic significance of tumor-infiltrating lymphocytes in oropharyngeal cancer

July 31, 2007     Samer Rajjoub, BA; Suzanne R. Basha, MD; Eugene Einhorn, MD; Marc C. Cohen, MD; Doug M. Marvel, BA; Duane A. Sewell, MD
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Abstract
The presence of tumor-infiltrating lymphocytes has been shown to significantly improve clinical outcomes in many types of cancer. However, their effects on outcomes in patients with oropharyngeal cancer specifically have yet to be elucidated. We conducted a retrospective study in an effort to shed light on this issue. We reviewed the records of 48 consecutively presenting patients with oropharyngeal cancer, and we performed immunohistochemistry to analyze their archived paraffin-embedded tissue samples for the presence of CD3-positive tumor-infiltrating lymphocytes. We also used real-time polymerase chain reaction testing to look for human papillomavirus type 16 (HPV-16) in the tumors. We found that patients with large numbers of tumor-infiltrating lymphocytes (CD3high) had a significantly lower incidence of metastasis at presentation than did those with low numbers of tumor-infiltrating lymphocytes (CD3low) (40.0 vs. 88.5%; p = 0.001), regardless of HPV status. When HPV status was taken into account, the correlation between a high CD3 count and a lower rate of metastasis was maintained in the HPV-positive patients but not in the HPV-negative patients. We also found that the CD3high patients had higher rates of overall survival and disease-free survival at 3 and 5 years than did the CD3low patients; however, these differences only approached but did not reach statistical significance.

Outpatient management of infected hardware in the oncology patient

July 31, 2006     Ryan F. Osborne, MD, FACS; Jason S. Hamilton, MD
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Early detection of gastric cancer with esophageal extension by transnasal esophagoscopy

April 1, 2006     Timothy D. Anderson, MD; Steven F. Nezhad, MD
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An assessment of risk factors for the development of a second primary malignancy in the head and neck

February 1, 2006     Neil Bhattacharyya, MD
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Abstract
This retrospective database study of 44,862 patients who had a history of a primary head and neck malignancy was conducted to identify any clinical variables that may predict the occurrence of a second primary head and neck malignancy. During a mean follow-up of 42.2 months, a second head and neck primary developed in 941 of these patients (2.1%). Statistical analyses revealed that a higher incidence of a second primary was associated with increased age and a location of the first primary in the larynx/hypopharynx, the oropharynx, a major salivary gland, or the nasopharynx. A lower incidence was associated with the presence of cervical nodal disease or treatment of the first primary with radiation therapy. Factors that had no effect on the risk of a second primary included sex, the size of the first primary tumor, a first-primary site in the oral cavity, and treatment of the first primary with cancer-directed surgery. The risk of a second primary head and neck cancer remained constant for at least 10 years.

The use of combined PET/CT for localizing recurrent head and neck cancer: The Pittsburgh experience

February 1, 2005     Lee A. Zimmer, MD, PhD; Carl Snyderman, MD; Melanie B. Fukui, MD; Todd Blodgett, MD; Barry McCook, MD; David W. Townsend, PhD; Carolyn C. Meltzer, MD
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Abstract
We performed a retrospective study of 47 patients to ascertain the ability of combined positron-emission tomography and computed tomography (PET/CT) to localize recurrent head and neck cancer. When clinically warranted, biopsies were performed in an attempt to obtain pathologic confirmation of the PET/CT findings. Of the 47 patients, 33 exhibited PET/CT findings consistent with recurrent cancer. Of the 33 patients, 25 underwent either biopsy or surgical excision of disease in an attempt to obtain a pathologic confirmation. Biopsy analysis confirmed the PET/CT findings in 22 of these patients; in the remaining 3 patients, pathologic findings were inconsistent with the PET/CT diagnosis. Based on the subset of 25 patients who underwent pathologic testing, the sensitivity of combined PET/CT was 95% and the specificity was 60%. We conclude that combined PET/CT imaging is a valuable tool for localizing tumor recurrence in patients with head and neck cancer.

Percutaneous endoscopic gastrostomy tube feeding in patients with head and neck cancer

May 31, 2004     Soly Baredes, MD; Daniel Behin, BA; Edwin Deitch, MD
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