Bazex Syndrome with Hypoalbuminemia and Severe Ascites

Bazex syndrome is a rare paraneoplastic dermatosis. The underlying malignancy frequently is squamous cell carcinoma of the upper aerodigestive tract or cervical lymph nodes from an unknown primary site. We report a 63-year-old man with squamous cell carcinoma of cervical lymph nodes from an unknown primary site. He developed a mass on the right side of his neck, cutaneous lesions diagnosed as Bazex syndrome, hypoalbuminemia, and severe ascites. Right neck dissection was performed. After neck dissection, not only the cutaneous lesions, but also the severe hypoalbuminemia and severe ascites were improved. Bazex syndrome may be associated with hypoalbuminemia and ascites

The role of initial neck dissection for patients with node-positive oropharyngeal squamous cell carcinomas

Background: The current study sought to assess the role of initial neck dissection (ND) for patients with node-positive oropharyngeal squamous cell carcinomas (OPSCC). Methods: The data for 202 patients with previously untreated node-positive OPSCC were gathered from 12 institutions belonging to the Head and Neck Cancer Study Group in the Japan Clinical Oncology Group. These patients were categorized into two groups, consisting of the initial ND group and the wait-and-see group, according to treatment policy. Results: Regional recurrence was observed in 17 of 93 patients undergoing initial ND, whereas, recurrent or persistent diseases were observed in 40 of 109 patients who did not undergo initial ND. The 4-year overall survival rates (OS) for the wait-and-see group and initial ND groups were 74.0% and 78.7%, respectively, and the 4-year regional control rates (RC) for each group were 77.6% and 84.9%. There were no significant differences in either OS or RC (p = 0.3440 and p = 0.2382, respectively). However, for patients with N3 disease, the 4-year OS of the initial ND group (100%) was favorable. For patients with N2a disease, the 4-year RC of the initial ND group was higher than that of the wait-and-see group statistically (100% vs 62.5%, p = 0.0156). Conclusions: The role of initial ND was limited in patients with node-positive OPSCC. The treatment strategy not involving initial ND is considered feasible and acceptable when nodal evaluation after definitive radiotherapy or chemoradiotherapy is applied adequately. However, it is possible that initial ND improves outcomes in patients with resectable large-volume nodal disease. (C) 2014 Elsevier Ltd. All rights reserved

Multi-institutional retrospective study for the evaluation of ocular function-preservation rates in maxillary sinus squamous cell carcinomas with orbital invasion

Background. This study aimed to evaluate ocular function and survival rates among treatment modalities in patients with maxillary sinus cancer with orbital invasion. Methods. Eighty-seven patients were classified according to the main treatment modality. Ocular function preservation rates and survival rates were evaluated for each therapeutic modality. Results. The 5-year overall survival rate for the en bloc resection, conservative surgery, superselective intra-arterial chemotherapy and radiotherapy (RADPLAT), intra-venous chemoradiotherapy (IV-CRT) was 70%, 35%, 49%, and 31%, respectively. Ocular function preservation rate for each group was 15%, 27%, 30%, and 17%, respectively. In the en bloc resection group, there was no significant difference in the 5-year overall survival rate between patients with orbital exenteration and those without orbital exenteration (72% vs 71%, p=0.9321). Conclusions. The en bloc resection group showed a favorable survival rate, but a low preservation rate. Preservation of orbital contents did not reduce the survival rate

Renal function and oropharyngeal cancer

BACKGROUND: Renal function influences decisions regarding treatment for patients with squamous cell carcinoma of the oropharynx (SCC-OP). However, the importance of renal function in SCC-OP has not yet been reported. METHODS: Four hundred and sixty patients with SCC-OP treated with curative intent between April 2005 and March 2007 in 12 institutions in Japan were analyzed retrospectively. RESULTS: Four hundred and three patients (87.6%) showed a Ccr ≥50 mL/min and 57 (12.4%) a Ccr <50 mL/min. Age was associated with worse overall survival (OS), while stage IVB, radiotherapy, and Ccr<50 were associated with worse OS on univariate analyses. Surgery and hypertension were associated with better OS on univariate analyses. On multivariate analysis, age, stage, hypertension, and Ccr were also found to be significantly associated with OS. CONCLUSIONS: Based on this retrospective study, impaired renal function is an independent predictor of increased risk of death in patients with SCC-OP

Lymph Node Metastasis in T4 Maxillary Sinus Squamous Cell Carcinoma : Incidence and Treatment Outcome

The purpose of this study was to evaluate the incidence of lymph node metastasis among patients with T4 maxillary sinus squamous cell carcinoma (MS-SCC) as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. Consecutive series of all patients (n = 128) with previously untreated T4 maxillary sinus SCC between 2006 and 2007 were obtained from 28 institutions belonging to or cooperating in the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group. Of the 128 patients, 28 (21.9 %) had lymph node metastasis, and six patients (4.7 %) had distant metastasis at diagnosis. Among the 111 patients who were treated with curative intent, 98 had clinically N0 neck disease and did not receive prophylactic neck irradiation. A total of 11 patients (11.2 %) subsequently developed evidence of lymph node metastasis, of whom eight were among the 83 patients with an N0 neck and had not received elective neck treatment. There were 15 patients who received an elective neck dissection as part of the initial treatment, of whom three had pathologically positive for lymph node metastases. Of 11 patients, six patients with nonlateral retropharyngeal lymph node metastasis without primary or distant disease were successfully salvaged. This study identified the incidence of lymph node metastasis among patients with T4 MS-SCC as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. These results will be of assistance in selecting treatment strategy for T4 MS-SCC in the future