Model prediction and validation of an order mechanism controlling the spatio-temporal phenotype of early hepatocellular carcinoma

The aggressiveness of a tumor may be reflected by its micro-architecture. To gain a deeper understanding of the mechanisms controlling spatial organization of tumors at early stages after tumor initiation, we used an agent-based spatio-temporal model previously established to simulate features of liver regeneration. Here, this model was further developed to simulate scenarios in early tumor development, when individual initiated hepatocytes gain increased proliferation capacity. The model simulations were performed in realistic liver microarchitectures obtained from 3D reconstruction of confocal laser scanning micrographs. Interestingly, the here established model predicted that initially initiated hepatocytes arrange in elongated patterns. Only when the tumor progresses to cell numbers of approximately 4,000, it adopts spherical structures. This model prediction was validated by the analysis of initiated cells in a rat liver tumor initiation study using single doses of 250 mg/kg of the genotoxic carcinogen Nnitrosomorpholine (NNM). Indeed, small clusters of GST-P positive cells induced by NNM were elongated, almost columnar, while larger GDT-P positive foci of approximately the size of liver lobuli, adopted spherical shapes. Simulation of numerous possible mechanisms demonstrated that only hepatocyte-sinusoidal-alignment (HSA), a previously discovered order mechanism involved in coordination of liver tissue architecture, could explain the experimentally observed initial deviation from sphericalshape. The present study demonstrates that the architecture of small hepatocellular tumor cell clusters early after initiation is still controlled by physiological control mechanisms. However, this coordinating influence is lost when the tumor grows to approximately 4,000 cells, leading to further growth in spherical shape. Our findings stress the potential importance of organ micro-architecture in understanding tumor phenotypes

Nodal Metastases in Acinic Cell Carcinoma of the Parotid Gland

The objective of this study was to evaluate the clinical outcome of patients with acinic cell carcinomas of the parotid gland after elective neck dissection (END). A retrospective chart review was performed including 66 patients with acinic cell carcinoma of the parotid gland. Clinical parameters were retrieved and statistically analyzed regarding disease-free survival (DFS) and disease-specific survival (DSS). An END was done in 27 (40.9%) patients, and occult metastases were detected in 4 (14.8%) patients of whom three were low-grade carcinoma. Positive neck nodes were associated with significantly worse DSS (p = 0.05). Intermediate and high-grade carcinoma (HR 8.62; 95% confidence interval (CI): 1.69–44.01; p = 0.010), perineural invasion (HR 19.6; 95%CI: 0.01–0.37; p = 0.003) and lymphovascular invasion (HR 10.2; 95%CI: 0.02–0.59; p = 0.011) were worse prognostic factors for DFS. An END should be considered in patients with acinic cell carcinoma of the parotid gland due to (i) a notable rate of occult neck metastases in low-grade tumors and (ii) the worse DSS of patients with positive neck nodes

Do Salivary Bypass Tubes Reduce the Risk of Pharyngocutaneous Fistula after Laryngopharyngectomy—A Systematic Review and Meta-Analysis

To evaluate the effect of salivary bypass tube (SBT) usage on the occurrence of pharyngocutaneous fistula (PCF) in patients after a laryngopharyngectomy, a total of 20 studies, published between 1988 and 2021, were identified including 2946 patients. We performed a meta-analysis assessing the risk of PCF occurrence in patients after SBT application compared to those without. PCF occurred in 26.8% of cases (669/2496) and SBT was applied in 33.0% of patients (820/2483). There was an overall trend towards lower PCF rates when using SBTs (22.2% vs. 35.3%; p = 0.057). We further selected five studies, comprising 580 patients who underwent laryngopharyngectomies, for meta-analysis showing that application of SBT reduced the risk of PCF formation (OR 0.46; 95% CI 0.18–1.18; p = 0.11). The meta-analysis demonstrates a beneficial effect of SBT insertion on PCF formation in patients after laryngopharyngectomy

Does Usage of Salivary Bypass Tube Could Reduce the Risk for Pharyngocutaneous Fistula in Laryngopharyngectomy? A Systematic Review and Meta-Analysis

To evaluate the effect of salivary bypass tube (SBT) usage on the occurrence of pharyngocutaneous fistula (PCF) in patients after a laryngopharyngectomy, a total of 20 studies, published between 1988 and 2021, were identified including 2946 patients. We performed a meta-analysis assessing the risk of PCF occurrence in patients after SBT application compared to those without. PCF occurred in 26.8% of cases (669/2496) and SBT was applied in 33.0% of patients (820/2483). There was an overall trend towards lower PCF rates when using SBTs (22.2% vs. 35.3% ; p = 0.057). We further selected five studies, comprising 580 patients who underwent laryngopharyngectomies, for meta-analysis showing that application of SBT reduced the risk of PCF formation (OR 0.46 ; 95% CI 0.18-1.18 ; p = 0.11). The meta-analysis demonstrates a beneficial effect of SBT insertion on PCF formation in patients after laryngopharyngectomy

Does Usage of Salivary Bypass Tube Could Reduce the Risk for Pharyngocutaneous Fistula in Laryngopharyngectomy? A Systematic Review and Meta-Analysis

To evaluate the effect of salivary bypass tube (SBT) usage on the occurrence of pharyngocutaneous fistula (PCF) in patients after a laryngopharyngectomy, a total of 20 studies, published between 1988 and 2021, were identified including 2946 patients. We performed a meta-analysis assessing the risk of PCF occurrence in patients after SBT application compared to those without. PCF occurred in 26.8% of cases (669/2496) and SBT was applied in 33.0% of patients (820/2483). There was an overall trend towards lower PCF rates when using SBTs (22.2% vs. 35.3% ; p = 0.057). We further selected five studies, comprising 580 patients who underwent laryngopharyngectomies, for meta-analysis showing that application of SBT reduced the risk of PCF formation (OR 0.46 ; 95% CI 0.18-1.18 ; p = 0.11). The meta-analysis demonstrates a beneficial effect of SBT insertion on PCF formation in patients after laryngopharyngectomy

Prognostic factors in mammary analogue secretory carcinomas of the parotid gland: Systematic review and meta-analysis

Mammary analogue secretory carcinomas (MASCs) of the parotid gland are considered as low-grade malignancies with good clinical outcome but lacking data regarding prognostic factors. We performed meta-analysis assessing prognostic factors for disease-free survival (DFS) and overall survival (OS) in 256 patients with MASCs of the parotid gland. A total of 73 studies have met the inclusion criteria and 76.3% of patients were seen with T1 and T2 tumors and negative neck nodes. Lymph node metastasis (57.4%) and distant recurrences (46.2%) were particularly found in T4 tumors (p < 0.001). DFS at 5 and 10 years was 77.9% and 47.2% compared to 88.1% and 77.2% for OS at the same time points. Male sex, T3-T4 tumors, and recurrent disease represented independent worse prognosticators for survival outcome. Altogether, parotid gland MASCs show good long-term outcome, but T4 tumors behave significantly more aggressive and require extended treatment strategies along with close follow-ups

Editorial

no abstract availableThe first issue of the VLR showcases its international and interdisciplinary focus. In the first article, Rosa Duarte and Clara Ifsits confront a question that is as sensitive as it is topical, ie the obligation Austria – and by extension, other European countries – may have to prosecute and punish returning ISIS fighters for the crime of genocide against the Yazidi community, both from the perspective of national public law and of international criminal law. The second article, by Sebastian Grund, deals with the Greek financial crisis and subsequent debt restructuring of 2012, and explores the possibilities and limits of enforcing sovereign debt in court. In the fourth article of this issue, Hannah Berger tackles the impact European and national legislation has on the use of toxic chemicals in the textile industry, and explores legal and extra-legal avenues of enforcing the compliance of textile producers and resellers. Finally, Maria Y. Lee confronts the thorny issue of categorisation in anti-discrimination law, proposing a solution that reconciles category-based legislation with the need for a broader and more inclusive perspective on discrimination. New content will be added at regular intervals; we therefore encourage our readers to register for the content notification service on the VLR’s homepage

Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after Radiotherapy

Objective: To evaluate the impact of radiotherapy (RT) on dysphagia and long-term swallowing outcome in patients with stage III and IV head and neck squamous cell carcinomas (HNSCCs). Material and Methods: Between 2005 and 2008, 189 patients with HNSCCs underwent primary or adjuvant RT in a curative setting. Long-term swallowing outcome was evaluated in 50 patients. Among them, 26 were further eligible for prospective analysis of long-term swallowing and dysphagia outcome. Medical charts were retrospectively reviewed regarding pre- and post-treatment dysphagia (3 months after last irradiation setting) as well as persisting long-term dysphagia (2019–2021). Results: Pre-treatment dysphagia was observed in 24 (48%) of 50 patients, particularly in oropharyngeal or hypopharyngeal stage III–IV tumors (OR 9.3; p = 0.003). Conversely, 46 patients (92%) complained about post-treatment dysphagic symptoms, which were more commonly seen in patients with positive neck nodes (OR 10.5; p = 0.037). The post-treatment dysphagia rate dropped from 92% to 24% (p p = 0.019), dysgeusia (OR 9.9; p = 0.036) and free flap reconstruction (OR 6.1; p = 0.022). Conclusion: Pretreatment dysphagia is common in advanced stage HNSCCs and almost all patients complain about dysphagia at the end of RT. Importantly, applied RT protocols did not affect long-term dysphagia, which improves significantly in the majority of patients over time. Meeting Information: Preliminary results have been presented at the 65th Annual Meeting of the Austrian Society of Otorhinolaryngology, 22–26 September 2021, Austria

A New Classification System to Predict Functional Outcome after Laryngectomy and Laryngopharyngectomy

Simple Summary: Evaluation of the long-term functional outcome after primary or salvage laryngopharyngectomy. Long term functional outcome mainly depends on extent of pharyngectomy and salvage situation, which is reflected by our new classification system

A new nomogram to predict oncological outcome in laryngeal and hypopharyngeal carcinoma patients after laryngopharyngectomy

Abstract Background: To create nomograms for better prediction of the oncological outcome in advanced laryngeal (LxCAs) or hypopharyngeal (HpxCAs) cancer after laryngopharyngectomy. Materials: 239 patients who underwent total laryngectomy or laryngopharyngectomy due to LxCA (52.7%) or HpxCA (47.3%) were included in this study. Based on clinical risk factors (tumor site, lymph node involvement, salvage setting), we created nomograms for prediction of disease-specific survival (DSS) and disease-free survival (DFS). Results: HpxCAs showed a higher rate of lymph node involvement (p < 0.001), a 2.47-fold higher risk of a 2nd head and neck cancer (p = 0.009) and significantly worse loco-regional control rates (p = 0.003) compared to LxCAs. Positive neck nodes and salvage procedures were associated with significantly worse outcome. Nomograms demonstrated that hypopharyngeal tumors with positive neck nodes in salvage situations had the worst oncological outcome with a 5-year DSS of 15-20%. Conclusions: The oncological outcome is worse in hypopharyngeal carcinomas and could be easily quantified by our nomograms that are based on tumor site, lymph node involvement and salvage situation