Three-dimensional imaging assessment of anatomic invasion and volumetric considerations for chemo/radiotherapy-based laryngeal preservation in T3 larynx cancer

Publication date: April 2018
Source:Oral Oncology, Volume 79
Author(s): Mona Kamal, Sweet Ping Ng, Salman A. Eraj, Crosby D. Rock, Brian Pham, Jay A. Messer, Adam S. Garden, William H. Morrison, Jack Phan, Steven J. Frank, Adel K. El-Naggar, Jason M. Johnson, Lawrence E. Ginsberg, Renata Ferrarotto, Jan S. Lewin, Katherine A. Hutcheson, Carlos E. Cardenas, Mark E. Zafereo, Stephen Y. Lai, Amy C. Hessel, Randal S. Weber, G. Brandon Gunn, Clifton D. Fuller, Abdallah S.R. Mohamed, David I. Rosenthal
ObjectivesTo investigate the impact of 3-Diminsional (3D) tumor volume (TV) and extent of involvement of primary tumor on treatment outcomes in a large uniform cohort of T3 laryngeal carcinoma patients treated with nonsurgical laryngeal preservation strategies.Materials and MethodsThe pretreatment contrast-enhanced computed tomography images of 90 patients with T3 laryngeal carcinoma were reviewed. Primary gross tumor volume (GTVp) was delineated to calculate the 3D TV and define the extent of invasion. Cartilage and soft tissue involvement was coded. The extent of invasion was dichotomized into non/limited invasion versus multiple invasion extension (MIE), and was subsequently correlated with survival outcomes.ResultsThe median TV was 6.6 cm³. Sixty-five patients had non/limited invasion, and 25 had MIE. Median follow-up for surviving patients was 52 months. The 5-year local control and overall survival rates for the whole cohort were 88% and 68%, respectively. There was no correlation between TV and survival outcomes. However, patients with non/limited invasion had better 5-year local control (LC) than those with MIE (95% vs 72%, p = .009) but did not have a significantly higher rate of overall survival (OS) (74% vs 67%, p = .327). In multivariate correlates of LC, MIE maintained statistical significance whereas baseline airway status showed a statistically significance trend with poor LC (p = .0087 and 0.06, respectively). Baseline good performance status was an independent predictor of improved OS (p = .03) in multivariate analysis.ConclusionThe extent of primary tumor invasion is an independent prognostic factor of LC of the disease after definitive radiotherapy in T3 larynx cancer.



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Comments on “Compositional and functional variations of oral microbiota associated with the mutational changes in oral cancer” by Yang et al.

Publication date: Available online 10 February 2018
Source:Oral Oncology
Author(s): Divya Gopinath, Rohit Kunnath Menon




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Closed-Eye Visualizations in the Setting of Hyponatremia

Purpose. To report a case of closed-eye visualizations and to clarify the different types of hallucinations and their etiologies. Methods. Retrospective case report of a patient with closed-eye visualizations secondary to hyponatremia. Clinical findings, physical exam, laboratory assessment, treatment, and disease course from the patient's hospitalization were used in creating this report. Follow-up data after discharge were also obtained. Results. Closed-eye visualizations were diagnosed as secondary to hyponatremia, as they did not occur with the eyes open, and potential alternate causes were excluded. Serum sodium nadir was 119 mEq/L. Symptoms resolved with correction of hyponatremia via fluid resuscitation and electrolyte replenishment. There has been no recurrence of the symptoms. Conclusion. This patient had hallucinations exclusively with the eyes closed, which must be differentiated from the release hallucinations seen with the eyes open in Charles Bonnet syndrome. This patient had no visual loss or retinal disease, which should be suspected in open eye hallucinations.

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Diagnosis and Management of Pemphigus: recommendations by an International Panel of Experts

Several European countries recently developed international diagnostic and management guidelines for pemphigus, which have been instrumental in the standardization of pemphigus management,

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Treatment of vitiligo with the topical Janus kinase inhibitor ruxolitinib: a 32-week open label extension study with optional narrow-band ultraviolet B

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Global Burden of Urticaria: Insights from the 2016 Global Burden of Disease Study

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Whole-exome sequencing reveals differences between nail apparatus melanoma and acral melanoma

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