Outcome after supracricoid laryngectomies in the material of ENT Department, Poznan University of Medical Sciences

All patients with T1 and T2 laryngeal cancer should be treated with the intent to preserve the larynx. In T3 glottic low-volume tumors, larynx preservation is an appropriate standard treatment option. Supracricoid partial laryngectomy remains a reasonable alternative to radiotherapy for patients with T2–T3 glottic cancer. Prospective clinical study aims to evaluate the oncological results of supracricoid partial laryngectomy as a treatment for selected glottic and supraglottic carcinoma, and to determine the different prognostic factors that may influence local control and survival. In the period of 2000–2007, 145 patients were treated at the academic tertiary referral medical center: ENT Department, University of Medical Sciences, Poznán, Poland. The ages of the analyzed group of patients ranged from 23 to 79, with mean 56.5 age for men and 25 for women. All of the patients had biopsy proven squamous cell carcinoma. Of the 145 patients 82 had glottic cancer and 63 had supraglottic cancer. The patients were staged according to the 2003 edition of the TNM classification established by the AJCC. The pathological TNM classification was additionally taken into consideration. All patients were treated by means of supracricoid and transglottic partial laryngectomy. The type of supracricoid partial laryngectomy was based on tumor localization and extension. Four patients underwent cricohyoidopexy, 57 cricohyoidoepiglottopexy, 65 reconstruction modo Calearo, and 19 modo Sedlacek-Tucker. We performed 21 unilateral selective neck dissections and none bilateral. A nasogastric feeding tube was inserted in all patients, and removed in patients that regained proper swallowing. As a result, we took into consideration the oncological and functional results. Histopathological examination of the operating specimen revealed the presence of dysplasia or invasive carcinoma at the margins, or a close margin of less than 5 mm from the edge of the resection (16 cases). The metastases were found on the neck in three cases, predominantly in the level II (2 cases) and III (1 case). Metastasis was found in one patient that had undergone CHP, Sedlacek-Tucker, and Calearo, respectively. Five patients received postoperative radiotherapy. The decision to use adjuvant radiotherapy was based on the presence of invasive carcinoma at the resection margin and on the presence of multiple positive neck nodes or extracapsular spread of the disease. The Kaplan–Meier estimated 3- and 5-year overall survival rates in the group of 122 because 23 patients did not report for medical check-ups

Evidence‐based review of treatment options for patients with glottic cancer

Evidence‐based medicine integrates the best available data in decision making, with the goal of minimizing physicians' and patients' subjectivity. In 2006, the American Society of Clinical Oncology edited clinical practice guidelines for the use of larynx preservation strategies. The objective of this review was to evaluate the current levels of evidence for glottic squamous cell carcinoma. Current guidelines for early stage glottic cancer are based on low‐level evidence. Conservation surgery (open or transoral) and radiation therapy are all valid options for T1 and selected T2 lesions. For advanced lesions, surgery and combined chemotherapy and radiation are options. High‐level evidence favors combined chemotherapy and radiation therapy or altered fractionation radiation therapy as nonsurgical strategies for organ preservation, compared with radiation therapy alone. The optimal combination of chemotherapy, targeted therapy, and radiation therapy remains to be demonstrated, however, and for high‐volume tumors, total laryngectomy may still be warranted. © 2011 Wiley Periodicals, Inc. Head Neck, 2011Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87151/1/21528_ftp.pd

Clinicopathological significance of mitochondrial D-Loop mutations in head and neck carcinoma

Mitochondrial DNA mutations have been reported in several types of tumours, including head and neck squamous cell carcinoma (HNSCC). The noncoding region of the Displacement-Loop (D-Loop) has emerged as a mutational hotspot and we recently found that they were associated with prognosis and response to 5 fluorouracil (5FU) in colon cancers. In order to evaluate the frequence of D-Loop mutations in a large series of HNSCC and establish correlations with clinicopathologic parameters, we sequenced the D-Loop of 109 HNSCC before a treatment by neoadjuvant 5FU-cisplatin-based chemotherapy and surgery. Then, we correlated these mutations with prognosis and response to chemotherapy. A D-Loop mutation was identified in 21% of the tumors, the majority of them were located in a C-tract (D310). The prevalence of D310 mutations increased significantly with the number of cytosines in the matched normal tissue sequence (P=0.02). Hypopharyngeal cancer was significantly more frequent (P=0.03) and tobacco consumption more important (P=0.01) in the group of patients with D-Loop mutation. The presence of D-Loop mutation was not associated with prognosis or with response to neoadjuvant chemotherapy. These results suggest that D-Loop mutations should be considered as a cancer biomarker that may be useful for the early detection of HNSCC in individuals at risk of this cancer

In Vivo Confocal Microscopic Corneal Images in health and disease with an emphasis on extracting features and visual signatures for corneal diseases: A review study

There is an evolution in the demands of modern ophthalmology from descriptive findings to assessment of cellular level changes by using in vivo confocal microscopy. Confocal microscopy, by producing grey-scale images, enables a microstructural insight into the in vivo cornea in both health and disease, including epithelial changes, stromal degenerative or dystrophic diseases, endothelial pathologies, and corneal deposits and infections. Ophthalmologists use acquired confocal corneal images to identify health and disease states and then to diagnose which type of disease is affecting the cornea. This paper presents the main features of the healthy confocal corneal layers, and reviews the most common corneal diseases. It identifies the visual signature of each disease in the affected layer and extracts the main features of this disease in terms of intensity, certain regular shapes with both their size and diffusion, and some specific region of interest. These features will lead towards the development of a complete automatic corneal diagnostic system which predicts abnormalities in the confocal corneal data sets

CARCINOMES EPIDERMOIDES DE L'EPILARYNX LATERAL TRAITES PAR LARYNGECTOMIE SUPRAGLOTTIQUE ETENDUE (RESULTATS CARCINOLOGIQUES A PROPOS DE 67 CAS)

ST QUENTIN EN YVELINES-BU (782972101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Mise au point de modèles cellulaires pour l'étude des effets toxicologiques infracliniques de thérapeutiques utilisées en ophtalmologie

Les études récentes en toxicologie oculaire se sont beaucoup intéressées aux effets toxiques des conservateurs contenus dans les préparations ophtalmologiques, en particulier du chlorure de benzalkonium. Or, le programme REACH avec la limitation de l utilisation d animaux de laboratoire en toxicologie impose de revoir les outils classiques d évaluation de la toxicité oculaire et de développer de nouvelles approches. En outre, les principales études in vitro réalisées jusqu à pre sent utilisaient comme modèle la lignée épithéliale conjonctivale de Chang présentant l inconvénient d un mélange avec des cellules tumorales HeLa. Nous avons donc validé l utilisation d une nouvelle lignée qui ne présente pas ce risque, la lignée IOBA-NHC, puis illustré l utilisation de cette lignée par l étude des effets d un nouveau collyre sans conservateur de la famille des dérivés des prostaglandines, le tafluprost en unidoses. Cependant, les lignées conjonctivales sont un modèle unicellulaire en monocouche qui ne reproduit pas les conditions structurelles de l in vivo, et qui ne permet pas d évaluer les interactions faisant intervenir d autres types cellulaires comme les mucocytes et surtout les cellules inflammatoires. Ainsi, nous avons complété la partie expérimentale de ce travail par l illustration de l utilisation d un modèle d épithélium cornéen reconstitué en trois dimensions, et par l étude d un modèle de coculture entre des cellules épithéliales en lignée et des lymphocytes, le développement de nouveaux outils toxicologiques permettant une meilleure compréhension des phénomènes physiopathologiques impliqués au niveau de la surface oculaire dans la toxicité des conservateursDuring the past ten years, several toxicological studies on ocular surface focused on the effects of ophthalmologic medications that contain preservatives, particularly benzalkonium chloride. Although, the REACH program, with the limitation of the use of laboratory animals, supports the replacement of classic toxicological tools, i.e. the Draize test, and the development of new strategies. In addition, the widely used Wong-Kilbourne derivative of Chang conjunctiva-derived cell line has been criticized owing to a possible contamination with HeLa tumoral cells. In the present work, we validated the new IOBA-NHC cell line for toxicological studies, showing similar toxicological profiles of BAC on both cell lines. To illustrate our findings, we further studied the effects of the preservative-free formulation of tafluprost, a new prostaglandin analog, on IOBA-NHC cells. However, these monolayer cell models do not take into account the structural properties of cornea in vivo. In addition, unlike on any epithelial cell model, other cell types like goblet and inflammatory cells that interact with epithelial cells play also a major role in the ocular surface protection in vivo. Thus, we hereby reported a new application of a 3D-reconstituted corneal epithelial model, i.e. the analysis of BAC-preserved and unpreserved antiallergic eye drops on this model, and the development of a coculture model between epithelial cells and lymphocytes. Indeed, these new approaches seem to be extremely relevant for the understanding of ocular surface physiopathology, particularly in relation with preservative toxicityPARIS-BIUP (751062107) / SudocSudocFranceF