Is there any Association between Helicobacter Pylori Infection and Laryngeal Carcinoma

Objective: To investigate the possible role of Helicobacter pylori as a cause of squamous cell carcinoma of larynx in a case-control study in an otolaryngology ward at an academic university. Subjects and Methods: A total of 65 patients with laryngeal cancer and 65 matched cancer-free controls underwent esophagogastroduodenoscopy and biopsy of antral and body regions of the stomach for evaluation of Helicobacter pylori infection. Results:The proportion of subjects with a positive rapid urease test for gastric infection was similar between the two groups (49.2 % in cases vs. 40% in controls). However, a positive rapid urease test for body was less frequently seen in patients with laryngeal cancer whereas a positive rapid urease test for antrum was significantly higher (P=0.04). Conclusion: Our study failed to show Helicobacter pylori as one of the etiologies of laryngeal cancer. However, it supported the hypothesis that colonization of Helicobacter pylori only in the gastric body might have a protective effect against laryngeal cancer with decreasing gastric acid while antral Helicobacter pylori, increasing gastric acid due to G cell hyperplasia, may be a predisposing factor for laryngeal cancer, with acid reflux as a possible underlying etiology. Keywords: Helicobacter pylori - laryngeal cancer - rapid urease test - gastric acid - esophagogastroduodenoscop

Trends and inequalities in laryngeal cancer survival in men and women: England and Wales 1991-2006.

Laryngeal cancer in men is a relatively common malignancy, with a marked socioeconomic gradient in survival between affluent and deprived patients. Cancer of the larynx in women is rare. Survival tends to lower than for men, and little is known about the association between deprivation and survival in women with laryngeal cancer. This paper explores the trends and socio-economic inequalities in laryngeal cancer survival in women, with comparison to men. We examined relative survival among men and women diagnosed with laryngeal cancer in England and Wales during 1991-2006, followed up to 31 December 2007. We estimated the difference in survival between the most deprived and most affluent groups (the 'deprivation gap') at one and five years after diagnosis, for each sex, anatomical subsite and calendar period. Five year survival for all laryngeal cancers combined was up to 8% lower in women than in men. This difference is only partially explained by the differential distribution of anatomical subsites in men and women. Disparities in survival between men and women were also present within specific subsites. In contrast to men, there was little evidence of a consistent deprivation gap in survival for women at any of the anatomical subsites. The stark socioeconomic inequalities in laryngeal cancer survival in men do not appear to be replicated in women. The origins of the socio-economic inequalities in survival among men, and the disparities in survival between men and women at specific tumour subsites remains unclear

Trends of oral cavity, oropharyngeal and laryngeal cancer incidence in Scotland (1975 - 2012) - a socioeconomic perspective

Aim: To examine current incidence trends (1975–2012) of oral cavity (OCC), oropharyngeal (OPC) and laryngeal cancer in Scotland by socioeconomic status (SES). Methods: We included all diagnosed cases of OCC (C00.3-C00.9, C02-C06 excluding C2.4), OPC (C01, C2.4, C09-C10, C14) and laryngeal cancer (C32) on the Scottish Cancer Registry (1975–2012) and annual midterm population estimates by age, sex, geographic region and SES indices (Carstairs 1991 and Scottish Index of Multiple Deprivation 2009). Age-standardized incidence rates were computed and adjusted Poisson regression rate-ratios (RR) compared subsites by age, sex, region, SES and year of diagnosis. Results: We found 28,217 individuals (19,755 males and 8462 females) diagnosed with head and neck cancer (HNC) over the study period. Between 1975 and 2012, relative to the least deprived areas, those living in the most deprived areas exhibited the highest RR (>double) of OCC, OPC and laryngeal cancer, and an almost dose-like response was observed between SES and HNC incidence. Between 2001 and 2012, this socioeconomic inequality tended to increase over time for OPC and laryngeal cancer but remained relatively unchanged for OCC. Incidence rates increased markedly for OPC, decreased for laryngeal cancer and remained stable for OCC, particularly in the last decade. Males exhibited significantly higher RRs compared to females, and the peak age of incidence of OPC was slightly lower than the other subsites. Conclusion: Contrary to reports that OPC exhibits an inverse socioeconomic profile, Scotland country-level data show that those from the most deprived areas consistently have the highest rates of head and neck cancers

The Geographical Distribution of Laryngeal Cancer in Iran from 2004 to 2014

Background: Laryngeal cancer accounts for about 1 to 2 % of all cancers; this incidence rate depends on the geographical region and ethnicity. Due to the lack of a comprehensive epidemiological study on laryngeal cancer in recent years, we designed this study to investigate the incidence and geographical distribution of laryngeal cancer. Aim: This study aimed to investigate the incidence and geographical distribution of laryngeal cancer in Iran from 2004 to 2014. Methods: The data collected from the Iranian National Cancer Data System registry, all the cases of laryngeal cancer (with topography code 32 and histology of laryngeal cancer) have been retrieved and analyzed from a comprehensive cancer database during the 11 years' period. Then statistical data were analyzed by SPSS, version 16. Results: During the 11-year study, 13,241 new cases of laryngeal cancer were recorded, of which 11454 were men (86%) and 1788 were women (14%). According to this assessment, North Khorasan, Sistan and Baluchestan, and East Azerbaijan provinces had the highest growth rate, and North Khorasan, Gilan, and Kerman provinces with the highest incidence rates of 4.44, 3.29, and 2.23 per 100,000 respectively, between 2004 and 2014. Conclusion: According to the results of this study, the incidence rate of laryngeal cancer, especially in women, is increasing in Iran. Further studies are needed to investigate the causes of increased incidence

The Role of Laryngopharyngeal Reflux as a Risk Factor in Laryngeal Cancer: A Preliminary Report

Objectives. To evaluate the significance of laryngopharyngeal reflux (LPR) as a risk factor in laryngeal cancer.Methods. We performed a case-control study with 29 consecutive laryngeal cancer patients who had undergone 24-hour ambulatory double pH monitoring from 2003 to 2006. The control group included 300 patients who had undergone 24-hour ambulatory double pH monitoring due to LPR-related symptoms. We analyzed the prevalence of LPR and numerous parameters from the 24-hour ambulatory double pH monitoring in the laryngeal cancer patient and control groups. Pathologic LPR is defined when more than three episodes of LPR occur in 24 hours.Results. The prevalence of pathologic LPR was significantly higher in the laryngeal cancer group than the control group (P=0.049). The reflux number of the upper probe was significantly higher in the laryngeal cancer group (P<0.001). However the effects of pathologic LPR on laryngeal cancer risk were diluted after adjusting for smoking and alcohol consumption in the multivariable logistic regression.Conclusion. The pathologic LPR might be a possible risk factor in the development of laryngeal cancer. A further study should be necessary to verify the exact role of LPR in laryngeal cancer

Feasibility of intensity-modulated and image-guided radiotherapy for functional organ preservation in locally advanced laryngeal cancer

Purpose: The study aims to assess the feasibility of intensity-modulated and image-guided radiotherapy (IMRT, and IGRT, respectively) for functional preservation in locally advanced laryngeal cancer. A retrospective review of 27 patients undergoing concurrent chemoradiation for locally advanced laryngeal cancers (8 IMRT, 19 IGRT) was undertaken. In addition to regular clinical examinations, all patients had PET imaging at 4 months and 10 months after radiotherapy, then yearly. Loco-regional control, speech quality and feeding-tube dependency were assessed during follow-up visits. Results: At a median follow-up of 20 months (range 6-57 months), four out of 27 patients (14.8%) developed local recurrence and underwent salvage total laryngectomy. One patient developed distant metastases following salvage surgery. Among the 23 patients who conserved their larynx with no sign of recurrence at last follow-up, 22 (95%) reported normal or near normal voice quality, allowing them to communicate adequately. Four patients (14.8%) had long-term tube feeding-dependency because of severe dysphagia (2 patients) and chronic aspiration (2 patients, with ensuing death from aspiration pneumonia in one patient). Conclusions and Clinical Relevance: Functional laryngeal preservation is feasible with IMRT and IGRT for locally advanced laryngeal cancer. However, dysphagia and aspiration remain serious complications, due most likely to high radiation dose delivery to the pharyngeal musculatures. © 2012 Nguyen et al

Raman spectroscopy to discriminate laryngeal squamous cell carcinoma from non-cancerous surrounding tissue

As for many solid cancers, laryngeal cancer is treated surgically, and adequate resection margins are critical for survival. Raman spectroscopy has the capacity to accurately differentiate between cancer and non-cancerous tissue based on their molecular composition, which has been proven in previous work. The aim of this study is to investigate whether Raman spectroscopy can be used to discriminate laryngeal cancer from surrounding non-cancerous tissue. Patients surgically treated for laryngeal cancer were included. Raman mapping experiments were performed ex vivo on resection specimens and correlated to histopathology. Water concentration analysis and CH-stretching region analysis were performed in the high wavenumber range of 2500–4000 cm−1. Thirty-four mapping experiments on 22 resection specimens were used for analysis. Both laryngeal cancer and all non-cancerous tissue structures showed high water concentrations of around 75%. Discriminative information was only found to be present in the CH-stretching region of the Raman spectra of the larynx (discriminative power of 0.87). High wavenumber region Raman spectroscopy can discriminate laryngeal cancer from non-cancerous tissue structures. Contrary to the findings for oral cavity cancer, water concentration is not a discriminating factor for laryngeal cancer.</p

Tumor bed brachytherapy for locally advanced laryngeal cancer: a feasibility assessment of combination with ferromagnetic hyperthermia

Purpose. To assess the feasibility of adding hyperthermia to an original method of organ-preserving brachytherapy treatment for locally advanced head and neck tumors. Methods and materials. The method involves organ-preserving tumor resection and adjunctive high-dose-rate (HDR) brachytherapy delivered via afterloading catheters. These catheters are embedded in a polymeric implant prepared intraoperatively to fill the resection cavity, allowing precise computer planning of dose distribution in the surrounding at-risk tumor bed tissue. Theoretical and experimental analyzes address the feasibility of heating the tumor bed implant by coupling energy from a 100 kHz magnetic field applied externally into ferromagnetic particles, which are uniformly distributed within the implant. The goal is to combine adjuvant hyperthermia (40 °C–45 °C) to at-risk tissue within 5 mm of the resection cavity for thermal enhancement of radiation and chemotherapy response. Results. A five-year relapse free survival rate of 95.8% was obtained for a select group of 48 male patients with T3N0M0 larynx tumors, when combining organ-preserving surgery with HDR brachytherapy from a tumor bed implant. Anticipating the need for additional treatment in patients with more advanced disease, a theoretical analysis demonstrates the ability to heat at-risk tissue up to 10 mm from the surface of an implant filled with magnetically coupled ferromagnetic balls. Using a laboratory induction heating system, it takes just over 2 min to increase the target tissue temperature by 10 °C using a 19% volume fraction of ferromagnetic spheres in a 2 cm diameter silicone implant. Conclusion. The promising clinical results of a 48 patient pilot study demonstrate the feasibility of a new organ sparing treatment for laryngeal cancer. Anticipating the need for additional therapy, theoretical estimations of potential implant heating are confirmed with laboratory experiments, preparing the way for future implementation of a thermobrachytherapy implant approach for organ-sparing treatment of locally advanced laryngeal cancer