Nutrition in HNSCC: is it a matter for oncologists? The role of multidisciplinary team-a narrative literature review

Background: Malnutrition, defined as weight loss and unsatisfactory nutrient intake, is very common in patients with head and neck squamous cell carcinoma (HNSCC) in either the early or palliative setting. Despite increased awareness, nutritional programs are not yet adequately implemented in these patients. There are several reasons for this delay: differences in composition, the expertise of the multidisciplinary teams involved in HNSCC patients’ treatment, and economic and network resources conditioning faster or slower nutritional supply delivery. This situation affects the outcomes and the quality of life of HNSCC patients. Materials and methods: We investigated available literature about nutritional support in HNSCC patients and its impact on outcomes, prognosis, and quality of life, and we focused on the role of the multidisciplinary team. We considered 8,491 articles, and after excluding duplicates and manuscripts not written in English, 1,055 were analyzed and 73 were deemed eligible for the present work. Results: After the literature review, we can state that malnutrition, sarcopenia, and cachexia are associated with systemic inflammation and closely correlated with poor outcomes. An evaluation of the nutritional status of the multidisciplinary team before, during, and after therapy could improve patient outcomes, as the goal of the therapeutic approach is widely designed. Conclusions: We suggest that the treatment workflow definition is fundamental and propose a tailored nutritional approach that could benefit HNSCC patients’ outcomes and quality of life. These results could be achieved by a multidisciplinary team

Solitary thyroid metastasis from colon cancer: A rare case report

Malignant metastases to the thyroid are rare and are even rarer from a colorectal primary. As these metastases are often asymptomatic, they are usually discovered incidentally on imaging performed as follow-up for the primary tumour. In this report, we present a case of metastatic sigmoid adenocarcinoma to the thyroid diagnosed and treated at our institution

Total thyroidectomy versus lobectomy: surgical approach to T1-T2 papillary thyroid cancer

The incidence of papillary thyroid carcinoma, which accounts for 80-90% of all thyroid cancers, has recently been increasing. The current study aimed to compare the ontological and functional outcomes of total thyroidectomy (TT) and thyroid lobectomy (TL). To this end, a retrospective single-centre cohort study involving a tertiary care institution was conducted. Data regarding demographics. clinicopathology and postoperative complications from 586 patients with papillary thyroid cancer treated in a single institution were collected. Cox proportional-hazards models were utilised to determine differences in outcomes stratified according to propensity score. Our data suggested no significant difference in the risk for locoregional recurrence or distant metastasis between TL and TT among patients with pT1-2 pN0 papillary carcinoma. TT plays an important role in improving prognosis among patients with metastatic lymph nodes in the central neck compartment (pN1a) (p = 0.001). Moreover, TT had significantly higher rates of postoperative hypocalcaemia and recurrent laryngeal nerve paralysis compared to TL (p < 0.001 and p = 0.02, respectively)

R\uf6misches 6sterreich / R\uf6mische Inschriften aus Neckenmarkt (Sopronny\ue9k) im Spiegel eines Briefes von Iv\ue1n Pa\ufar

Der Beitrag bringt eingangs einen kurzen Lebenslauf und eine W\ufcrdigungder Verdienste von Iv\ue1n Pa\ufar um die Verdienste der R\uf6mischen Epigraphik in Pannonien bzw.im ungarischen Raum im 19. Jahrhundert. Anschlie fend werden drei Grabinschriften, davonein Sarkophag, aus Ny\ue9k/Neckenmarkt (heute 6sterreich, Burgenland) mit schwieriger Lesungbesprochen, die von Pa\ufar mit Zeichnungen ver\uf6ffentlicht wurden und die sp\ue4ter verloren gingenoder stark besch\ue4digt wurden.The article gives a short curriculum vitae of Iv\ue1n Pa\ufar and appreciates his merits inthe early research on Roman epigraphy in Pannonia, esp. the Hungarian area in the 19th century.Subsequently three inscriptions, published by Pa\ufar with drawings, but later lost or badly damaged,are discussed. All of them were found in Ny\ue9k/Neckenmarkt (today Austria, Burgenland)

Tumor size as measured at initial X-ray examination, not length of bile duct stricture, predicts survival in patients with unresectable pancreatic cancer

Background: The survival of unresectable pancreatic cancer patients is extremely poor. The aim of this study was to examine if tumor size could predict survival length in order to optimize patient care. Methods: A retrospective observational study was performed on 185 consecutive patients with unresectable pancreatic cancer (ICD10: C250-2 and C258) who were diagnosed from 2003 to May 2010. The patients' initial radiographs at presentation of symptoms were reviewed by the same radiologist, and tumor extent was determined. Results: The largest tumor diameter of the primary tumor was measured in 132 patients, 22 by an ultrasound and the other patients by a CT scan. In 53 patients, the tumor size could not be delimited and measured. Seventy-five patients (41%) had liver metastases at presentation of symptoms. Median survival for the entire patient group was only 119 days. The median diameter of the patient's largest tumor was 4.35 cm, while the sample groups ranged from 1.2 to 14 cm. Patients were divided into two groups: those with a largest tumor diameter of <= 4.3 cm (66 patients) and those with a largest tumor diameter of >4.3 cm (66 patients). Median survival for these groups was 149 and 94 days (p = 0.019), respectively. Cox regression showed a hazard ratio for tumor size of 1.48 (95% CI 1.02, 2.07) (p = 0.038), adjusted for the gemcitabine treatment which had been given to 49 patients and the presence of liver metastasis. In 88 patients, stricture length could be measured at ERCP. When comparing stricture lengths of >= 2 cm and >2 cm, no difference in survival time was noted within a Kaplan-Meier analysis. Conclusion: The size of the maximum tumor diameter of the primary tumor during the initial X-ray examination of patients with pancreatic cancer may predict survival time for those patients who had no surgical resection. Stricture length at ERCP gave no information on survival