Oncologic safety of cervical nerve preservation in neck dissection for head and neck cancer

Abstract

Background

Although the functional merits of preserving cervical nerves in neck dissection for head and neck cancer have been reported, the oncologic safety has not yet been determined. Therefore, the purpose of this study was to evaluate the safety of cervical nerve preservation.

Methods

A retrospective chart review was performed on patients with head and neck cancer who had been treated by neck dissection between 2009 and 2014 at Kyoto Medical Center. Management of cervical nerves and clinical results were analyzed.

Results

A total of 335 sides of neck dissection had been performed in 222 patients. Cervical nerves were preserved in 175 neck sides and resected in 160 sides. The 5-year overall survival (OS) rate calculated by the Kaplan-Meier method was 71%. The 5-year neck control rate was 95% in cervical nerve preserved sides and 89% in cervical nerve resected sides.

Conclusion

Preserving cervical nerves in neck dissection is oncologically safe in selected cases.

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Evolving trends in head and neck cancer epidemiology: Ontario, Canada 1993-2010

Abstract

Background

Given the dramatic changes in global head and neck cancer epidemiology, the purpose of this study was to present the findings of our investigation on patterns of head and neck cancer incidence/survival within the province of Ontario, Canada.

Methods

Temporal variations in age/sex adjusted incidence and survival were analyzed for all incident head and neck cancer cases (n = 20 781) managed within Ontario from 1993-2010.

Results

From 1993-2010, the incidence of oropharyngeal (average annual percentage change [AAPC] 4.56%; P < .001) and salivary gland (AAPC 4.99%; P < .001) carcinomas increased, whereas oral cavity (AAPC -1.44%; P < .001) and laryngeal/hypopharyngeal (AAPC -3.20%; P < .001) carcinomas declined, and nasopharyngeal carcinoma (NPC) remained static (AAPC 0.28%; P = .72). A general trend for improved 5-year overall survival (OS), was observed for all tumor sites.

Conclusion

Consistent with previous studies, our results suggest a simultaneous decline in tobacco-associated and increase in human papillomavirus (HPV)-mediated carcinomas. The rising incidence of salivary malignancy and improvement in 5-year OS are novel findings, in need of future investigation.

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Salvage surgery for oropharyngeal squamous cell carcinomas: a retrospective study from 2005 to 2013

Abstract

Background

In the case of a locoregional recurrence of oropharyngeal squamous cell carcinoma, the curative standard of care is surgery. Our main purpose of this study was to determine the preoperative prognostic factors that would allow us to select the patients on whom we could expect good results with salvage surgery.

Methods

We conducted a monocentric retrospective study from 2005 to 2013. It included all patients treated for a recurrence of oropharyngeal squamous cell carcinoma with surgery. Their initial treatment included radiotherapy.

Results

Fifty-two patients were included. Poor prognostic factors for survival were the cT status (P = .0039) and local recurrences versus secondary localizations in irradiated areas (P = .016) and a relapse less than a year after the end of the initial treatment (P = .050). Recurrence-free survival was 19% at 5 years. Twenty-nine percent of patients presented local complications, which were mainly fistulas and hemorrhaging at the surgical site.

Conclusion

According to the high morbimortality, it is important to carefully select the right patients for surgery.

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Heat girdling does not affect xylem integrity: an in vivo magnetic resonance imaging study in the tomato peduncle

Heat girdling is a method to estimate the relative contribution of phloem vs xylem water flow to fruit growth. The heat girdling process is assumed to destroy all living tissues, including the phloem, without affecting xylem conductivity. However, to date, the assumption that xylem is not affected by heat girdling remains unproven. In this study, we used in vivo magnetic resonance imaging (MRI) velocimetry to test if heat girdling can cause xylem vessels to embolize or affect xylem water flow characteristics in the peduncle of tomato (Solanum lycopersicum cv Dirk). Anatomical and MRI data indicated that, at the site of girdling, all living tissues were disrupted, but that the functionality of the xylem remained unchanged. MRI velocimetry showed that the volume flow through the secondary xylem was not impeded by heat girdling in either the short or the long term (up to 91 h after girdling). This study provides support for the hypothesis that in the tomato peduncle the integrity and functionality of the xylem remain unaffected by heat girdling. It therefore confirms the validity of the heat girdling technique as a means to estimate relative contributions of xylem and phloem water flow to fruit growth.

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Relationship between non-standard work arrangements and work-related accident absence in Belgium

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Cosine based and extended transmissibility damage indicators for structural damage detection

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Numerical prediction of fretting fatigue crack trajectory in a railway axle using XFEM

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