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Treatment of squamous cell carcinoma of the supraglottic larynx (SCCSL) in Denmark has changed in several ways from the year 2000 to 2014, including the introduction of IMRT radiation technique and the addition of concurrent chemotherapy (CRT), as well as systematic reduction in waiting times until treatment initiation. Our aim is to investigate the effect of the abovementioned factors on overall survival (OS) and locoregional control (LC) for SCCSL patients. Retrospective cohort study with data from the DAHANCA database. We used the Kaplan–Meier and Cumulative Incidence plots as well as Cox regression analysis. We found a statistically significant improvement of the 5-year OS of 19.3 percentage points (pp). Cox regression found LC was not improved in patients receiving CRT compared to radiotherapy (RT) alone. Introduction of CRT treatment for head and neck cancers in general is known to improve LC. We could not demonstrate this effect for SCCSL specifically, as our results were not statistically significant on this point. OS was significantly improved. [ABSTRACT FROM AUTHOR]

Glottic squamous cell carcinoma (SCC) in stages I or II can be treated by transoral CO2 laser microsurgery (TLM) or exclusive radiotherapy (RT). To compare the oncological results of patients treated with TLM, to those treated with RT, in a tertiary hospital. Data from patients diagnosed with glottic SCC in stages I and II between 2004 and 2018 were analyzed. Response to treatment was studied in terms of recurrence, local control and laryngeal preservation. Of 164 patients, 63.41% received treatment with TLM and 36.58% with RT. 26.21% presented a recurrence or progression of the tumor. Both treatments obtained good local control rates (84.15% in the case of TLM and 89.6% in the case of RT) and no significant association was found between tumor recurrence and type of treatment, nor with the involvement of the anterior commissure. However, treatment with RT obtained worse laryngeal preservation rate compared to TLM (81.6% and 100% respectively) (p <.001LR). Conclusions and significance: Both treatments obtained good oncological results. There were no significant differences regarding local control. However, TLM obtained a better laryngeal preservation rate. The involvement of the anterior commissure was not a poor prognosis factor for tumor recurrence. [ABSTRACT FROM AUTHOR]

Background: Incidence of thyroid gland invasion in advanced laryngeal cancers is low. Ipsilateral or total thyroidectomy along with total laryngectomy has been controversial and there has been no consensus over the management of thyroid gland in advanced laryngeal cancers. Objective: To determine the frequency of thyroid gland invasion in locally advanced laryngeal squamous cell carcinoma and the risk factors associated with it. Material and methods: A retrospective review of patients with laryngeal squamous cell carcinoma operated at our center between January 2011 and December 2018 was carried out. Patients undergoing upfront or salvage laryngectomy with or without neck dissection along with hemi or total thyroidectomy were included. Histopathology reports were reviewed to record the involvement of thyroid gland. Results: Invasion of thyroid gland by squamous cell carcinoma larynx was seen in 10 (10.9%) patients out of 92. All of the cases showed direct extension of the tumor. Trans-glottic, subglottic, and tumors with extra laryngeal spread were found to be significantly associated with thyroid gland invasion. Patients with thyroid gland invasion showed higher rate recurrence. Conclusion and significance: Incidence of thyroid gland invasion in squamous cell carcinoma larynx is low, allowing us not to address thyroid routinely in patients undergoing total laryngectomy for laryngeal carcinoma. [ABSTRACT FROM AUTHOR]

Background: Expression of the epidermal growth factor receptor (EGFR) and human papillomavirus (HPV) DNA can serve as independent prognostic factors in squamous cell carcinoma (SCC) of the larynx. EGFR correlation with the course of disease and its effect on survival makes EGFR expression a negative prognostic factor, whereas HPV DNA is a positive prognostic factor. Aim: To assess the association of EGFR expression with clinical outcome of laryngeal HPV SCC. Materials and methods: This retrospective study included 196 SCC patients operated on at the Department of ENT, Head and Neck Surgery, Split University Hospital Center in Split, Croatia, between 1 January 2000 and 31 December 2009. Results: The association of HPV infection and EGFR expression was found to be statistically significant, and so was the difference in survival between patient groups with different HPV to EGFR expression ratio. Conclusions: The group of laryngeal HPV SCC patients with increased EGFR expression had shorter survival, confirming EGFR as a major component in predicting patient prognosis and survival. Significance: This article confirms the importance of EGFR expression as a biomarker in laryngeal SCC. [ABSTRACT FROM AUTHOR]

Conclusion: The degree of midline crossing of lateral supraglottic cancer does not significantly change its rate of contralateral cervical metastasis. The rate of occult metastasis is too high to take the risk of contralateral regional recurrence. We support routine bilateral neck dissection even in lateral supraglottic cancers with no or minimal midline crossing. Objectives: Data on the rate of contralateral cervical metastasis of laterally located supraglottic cancer, the effect of its degree of midline crossing on contralateral cervical metastasis, and its treatment are still controversial. Methods: This was a retrospective cohort, chart review involving 305 surgically treated patients with T1-3 squamous cell carcinoma of the supraglottic larynx. In all, 184 patients had bilateral neck dissection; 86 N0 contralateral necks were followed up. Thirty-five patients who needed postoperative radiation therapy because of the primary tumor or ipsilateral neck dissection specimen also received radiation therapy to the contralateral neck. The degree of midline crossing at the epiglottis was measured on a laryngectomy specimen with a ruler and expressed as 'no,' '<5 mm' or '≥5 mm.' Results: The rates of occult and overall contralateral metastasis in our series were 16% and 28%, respectively. There was no statistically significant difference between contralateral neck metastasis and recurrence rates in the neck dissection, follow-up, and irradiation groups according to the degree of midline crossing. [ABSTRACT FROM AUTHOR]

With the growing acceptance of nonsurgical therapies for laryngeal squamous cell carcinomas (LSCCs), it has become important to delineate surgical salvage strategies for disease recurrences. Total laryngectomy is often recommended, but appropriately selected laryngeal recurrences may be treated successfully with partial laryngeal surgery: laryngeal function can be preserved with oncological efficacy. The main available studies dealing with partial laryngeal surgery in recurrent carcinoma were critically reviewed. The most appealing feature of salvage transoral laser surgery (TLS) is the opportunity to make tumor-tailored excisions without any reconstructive limitations and retaining the option to switch to open partial laryngectomy. A recent detailed review of 11 series found a pooled local control rate of 57% after a first TLS procedure. Supracricoid laryngectomy (SCL) seems to achieve good local control rates in selected cases of recurrent supraglottic-glottic carcinoma: one review considering seven series calculated that 85% of the patients treated with salvage SCL after radiotherapy experienced no local recurrence; and total laryngectomy after failure of salvage SCL afforded an overall local control rate of 65%. Neck dissection is mandatory in all cases of local LSCC recurrence with evidence of neck metastases, and routine elective neck dissection is recommended for recurrent supraglottic and transglottic cancers. [ABSTRACT FROM AUTHOR]

Conclusions: Increased expression of Dicer may be a prognostic biomarker for patients with laryngeal squamous cell carcinoma (LSCC). Objectives: Recent studies have shown that many microRNAs (miRNAs) play an important role in the development and progression of human cancers. Dicer, one of the most important enzymes of the miRNA machinery, performs the final step of biogenesis of miRNAs. This study aimed to investigate the impact of Dicer expression on patient survival in human LSCC. Methods: We detected the expression of Dicer in larynx tissue specimens from 76 LSCC samples and 26 polyps by immunohistochemistry. The clinicopathological and prognostic significance of Dicer expression was investigated in LSCC. Results: Our data showed that the expression of Dicer was significantly higher in the LSCC than in the polyp tissue specimens. Moreover, the expression level of Dicer was significantly associated with the pTNM stage and tumor lymph node metastasis. Kaplan-Meier survival analyses revealed a strong association between tumor Dicer expression and the survival of the patients with LSCC. [ABSTRACT FROM AUTHOR]

Conclusion: Photodynamic therapy (PDT) is a viable and safe option for early laryngeal cancer that would be less suitably treated with radiation or trans-oral laser surgery (TLS). The cure rates with PDT appear to be comparable to those of conventional therapy, and the voice outcomes are also comparable. In the case of many sarcomas, PDT appears to be an organ- and function-sparing therapy, although it is more costly than other treatments. Objectives: The aim of this study was to show the results of PDT when it is used as a primary treatment of early laryngeal cancer. Methods: We studied the results of PDT when used as a primary treatment. We looked at survival, effect on tumor, side effects, voice, and costs. Results: The follow-up period was a median of 59 months. Nine of 10 patients were cured of their laryngeal cancer. PDT alone cured seven patients. All four of the sarcomas were cured using temoporfin. Two of three tumors that involved the anterior commissure were cured using only interstitial illumination with PDT. No serious side effects were noted. The patient's voices were improved after treatment in 5 of 10 cases, and none had a worsened voice. [ABSTRACT FROM AUTHOR]

Conclusions: Immunoglobulin (Ig) M is overexpressed in laryngeal squamous cell carcinoma (LSCC), and its expression has an independent protective impact on disease-free survival in LSCC. Objective: A number of studies have reported on the ectopic expression of Ig in cancer cells, yet there has been a lack of understanding of its clinical and prognostic significance. This study aimed to investigate the expression of IgM in resected specimens of LSCC and to evaluate its clinical significance and prognostic value. Methods: Immunohistochemistry (IHC) and Western blotting were used to detect the expression of IgM in LSCC and normal laryngeal tissues. The serum level of IgM was also analyzed by immunoturbidimetric assay. Results: IHC and Western blot studies demonstrated that IgM was overexpressed in LSCC specimens ( p < 0.001), while the serum level of IgM in patients with LSCC was not different from healthy controls. Chi-squared analysis revealed that the expression level of IgM was negatively correlated with regional lymph node metastasis and tumor stage ( p = 0.011 and 0.025, respectively). Univariate analysis showed that IgM expression was significantly correlated with enhanced disease-free survival (DFS) ( p = 0.004). In multivariate analysis, IgM retained its independent prognostic value for DFS ( p = 0.048, HR = 0.506, 95% CI = 0.257-0.995). [ABSTRACT FROM AUTHOR]