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Background: Early-stage glottic carcinomas can be treated with either laser surgery or radiotherapy. Both approaches have demonstrated similar cure rates. However, the question of which modality is superior in terms of voice outcomes remains a topic of debate. Methods: In our study, we conducted a comparison of short-term phonatory outcomes in patients with primary early glottic cancer who underwent treatment using both modalities. We assessed these outcomes using videostroboscopy and voice analysis software at three time points: immediately following treatment, at 1 month, and at 3 months post-treatment. Results: Voice analysis revealed that laser surgery had a more favorable immediate effect compared to radiotherapy in parameters such as jitter, shimmer, harmonics-to-noise ratio, and fundamental frequency. However, at the 3-month post-treatment mark, both treatment modalities demonstrated similar effects. Additionally, both modalities had comparable effects on maximum phonation time. Videostroboscopy observations showed that mucosal wave forms were more prominent immediately after laser surgery and gradually improved following radiotherapy. Furthermore, patients with incomplete glottic closure experienced recovery after both treatment modalities. Conclusion: Based on the results, there are better outcomes immediately following LS compared to RT. However, after a 3-month period, the outcomes of both treatment modalities become comparable. The treating physicians must consider various factors such as complications, patient-specific considerations, treatment costs, and duration to make informed decisions. A personalized approach considering the individual patient's circumstances is crucial in achieving optimal results in the management of T1 laryngeal cancer. [ABSTRACT FROM AUTHOR]

Early glottic cancer can be treated with laser resection or radiotherapy. In an earlier study, we found that voice function after laser resection was inferior to that after radiotherapy. This study was designed to determine if reduced margins at laser resection improved voice function without impairing oncologic results. A total of 268 patients with previously untreated T1–T2 glottic carcinoma were studied. They were primarily treated with either radiotherapy (n = 119) or laser resection (n = 149). Survival, need for additional treatment (radiotherapy and/or total layngectomi) and voice function was compared. Median follow up time was 7 years with range 0.5–16.6. There was no difference in the overall survival (p =.065) or disease-specific survival. (p =.126). After radiotherapy 32/119 patients and after laser resection 57/149 patients had recurrence. Total rate of laryngectomy was 24% in the radiotherapy group, and 8% in the laser resection group (p =.001). Voice analysis (T1A) showed more roughness in the radiotherapy group, otherwise no difference. By reducing the surgical margins, we have achieved a better voice function (T1A) but more patients have needed repeated laser excisions and some have also needed supplementary radiotherapy. The risk of laryngectomy and survival were apparently not affected. [ABSTRACT FROM AUTHOR]

Objective: Image enhancement systems are important diagnostic tools in the detection of laryngeal pathologies. This study aimed to compare three different image enhancement systems: professional image enhancement technology, Image1 S and narrow-band imaging. Method: Using the three systems, 100 patients with laryngeal lesions were investigated using a flexible and a 30° rigid endoscope. The lesions were diagnosed by three experts and classified using the Ni classification. The findings were compared. Results: Lesions classified as 'benign' were histopathologically confirmed in 50 per cent of patients, malignant lesions were confirmed in 41 per cent and recurrent respiratory papillomatosis were confirmed in 9 per cent. There was no significant difference between the experts' assessments of each image enhancement system. Conclusion: The three systems give comparable results in the detection of laryngeal lesions. With two additional systems, more users can perform image-enhanced endoscopy, resulting in a broadly available tool that can help to improve oncological assessment. [ABSTRACT FROM AUTHOR]

Background: Fungi are a readily available source of naturally generated colored compounds. These compounds might be used as radiosensitizers for treating cancer cells. Methods: Aspergillus nidulans was examined for its color-producing ability in Potato dextrose agar (PDA) broth medium. The pigment was characterized by Ultraviolet (UV) spectrophotometer and Gas Chromatography Mass Spectrometry (GC/MS). Pigment extracts from A. nidulans were studied for their cytotoxic effects on the growth of human larynx carcinoma cell line (HEp-2) with or without exposure to γ-radiation at three different doses (5, 10, and 15 Gy). A. nidulans pigment cytotoxic activity was tested against normal Vero cells. Cell apoptosis was studied using flow cytometry. Gene expression of P53, Caspase 3 and Bcl-2 were quantified. Results: Ultraviolet spectrum and GC/MS revealed the ability of Aspergillus nidulans to produce Rhodopin pigment. HEp-2 cells treated with A. nidulans pigment only give IC50 about 208 µg/ml. In contrast, when treated with the pigment +10 Gy γ-radiation, it give about 115 µg/ml. However, for normal cells, lower cytotoxic activity was detected. Treatment with pigment (208 g/mL) caused about 50% ± 1.0 total apoptosis level and gene expression of P53: 2.3 fold and Caspase 3: 1.84 fold in respect to untreated HEp-2), while Bcl-2 was decreased (Bcl-2: 0.63 fold in respect to untreated HEp-2). Furthermore, treated with pigment (115 µg/mL) + 10Gy caused about 47.41% ± 1.7 total apoptosis level and P53: 2.53 fold and Caspase 3: 2.0 fold in respect to untreated HEp-2, while Bcl-2 was downregulated (Bcl-2: 0.61 fold in respect to untreated HEp-2). Conclusion: This study concluded that the anti-cancer activity of Aspergillus nidulans pigment was enhanced by ionizing radiation at 10 Gy, as well as its low cytotoxic activity against normal Vero cells. [ABSTRACT FROM AUTHOR]

Introduction. In this study we analyzed CD105 (endoglin) and E-cadherin expression in laryngeal squamous cell carcinoma (LSCC) to evaluate their clinicopathologic significance. Material and methods. Expression of CD105 and E-cadherin was examined immunohistochemically using paraffin- -embedded archival tissues of 72 (35 glottic and 37 supraglottic) previously untreated LSCC male patients. The mean value of the positively-stained microvessels for CD105 counted in four hot spots for each case was used as the final intratumoralmicrovessel density (MVD). A staining score of E-cadherin was calculated based on the percentage of cells stained (0--100%). Results. MVD was significantly higher in patients with advanced TNM stage (P = 0.004) and younger than 65 (P = 0.008). Nodal metastases were more frequent in the cases with low E-cadherin expression (P = 0.000). Tumor recurrence was associated with advanced TNM stage (P = 0.035) and high MVD (P = 0.002). A high MVD was an independent predictor of malignancy recurrence (P = 0.021). The log-rank test showed a significant difference in the disease-free interval in patients stratified according to the MVD value (P = 0.016). Spearman's rank correlation test did not show a significant correlation between E-cadherin and CD105 expression. Conclusions. CD105-assessed MVD and expression of E-cadherin are promising prognostic factors for the outcome of patients with LSCC. Increased expression of CD105 could help predict patients with an increased risk of developing loco-regional recurrence after surgical treatment. Decreased E-cadherin expression is a potential predictor of lymph node metastases. (Folia Histochemica et Cytobiologica 2023, Vol. 61, No. 3, 183--192) [ABSTRACT FROM AUTHOR]

Background. The possible role and detailed mechanisms of Tumor-associated macrophages (TAMs) in laryngeal squamous cell carcinoma (LSCC) have not been revealed. Methods. The expressions of typical markers were evaluated by qRT-PCR. In macrophages cocultured with TU212 cells, CD163, and CD206 protein expressions were detected by western blot analysis; IL-10 and IL-12 expressions were detected by ELISA assay. Exosomes isolated from TU212 cells were characterized by TEM analysis. As for the TU212 cells cocultured with macrophages processed with HOK or TU212 cells derived exosomes, their viability, migration, and invasion were assessed by CCK-8 assay, wounding healing, and Transwell assays, respectively. Results. In this study, macrophages processed with exosomes from human TU212 cells notably advanced LSCC cell viability, migration, and invasion. miR-1246 inhibitor suppressed the M2 polarization of macrophages. Macrophages transfected with miR-1246 inhibitor suppressed LSCC cell viability, migration, and invasion. Conclusion. In summary, our data implied that the exosomal, miR-1246 of LSCC, induced polarization of M2 type macrophages and promoted the progression of LSCC. This trial is registered with 2020-13. [ABSTRACT FROM AUTHOR]

Objective: Patients with recurrent respiratory papillomatosis (RRP) have significant vocal dysfunction which affects their performance at work. This study aimed to evaluate voice-related work productivity before and after ablative treatment for RRP. Methods: This is a prospective case series conducted at 2 academic laryngology outpatient clinics. Adult employed patients with RRP completed the Work Productivity & Activity Impairment instrument (WPAI), Voice Handicap Index (VHI-10), WorkHoarse, Hospital Anxiety and Depression Scale (HADS), and a demographics questionnaire immediately before and 1 month after ablative treatment of papilloma. The primary outcome measure was the change in work productivity impairment domain of the WPAI, and changes in ratings before and after ablation were compared using a Wilcoxon Signed-Rank test. Results: The 32 participants (mean age 45, 84% male) had a median (interquartile range) voice-related work productivity impairment score of 48.8% (30.0) at baseline which was improved to 5.0% (10.0) at 1 month after surgical ablation of papillomata (difference 30.0% (30.0) improvement). For the secondary outcome measures, there were significant improvements in VHI-10 (P <.001), self-reported voice quality (P =.002), and Workhoarse (P =.001), but no significant change in HADS. Conclusion: Patients with RRP experience significant voice-related work productivity impairment, and ablation of papillomata significantly improves work productivity. [ABSTRACT FROM AUTHOR]

Simple Summary: The voice of a patient is expected to improve after successful radiotherapy for early glottic cancer. The aim of this study was to follow the changes in the voice for two years after a completed treatment. Subjective patient and physician assessments of the voice quality and objective acoustic analyses of the voice of each patient were used to follow up on the voice changes at regular intervals in 50 patients with T1 glottic cancer. A stroboscopy showed the progression of radiotherapy-induced fibrosis of the vocal folds, which influenced their vibration during phonation. A subjective assessment of the voice quality showed a gradual improvement, but an objective measurement showed a deterioration in a few voice parameters. Two years after the treatment, only 16% of patients had normal voices. The main cause of the impaired voice quality was post-radiotherapy scarring of the vocal folds. Our aim was to track the changes in voice quality for two years after radiotherapy (RT) for early glottic cancer. A videoendostroboscopy, subjective patient and phoniatrician voice assessments, a Voice Handicap Index questionnaire, and objective acoustic measurements (F0, jitter, shimmer, maximal phonation time) were performed on 50 patients with T1 glottic carcinomas at 3, 12, and 24 months post-RT. The results were compared between the subsequent assessments, and between the assessments at 3 months and 24 months post-RT. The stroboscopy showed a gradual progression of fibrosis of the vocal folds with a significant difference apparent when the assessments at 3 months and 24 months were compared (p < 0.001). Almost all of the subjective assessments of voice quality showed an improvement during the first 2 years, but significant differences were noted at 24 months. Jitter and shimmer deteriorated in the first year after RT with a significant deterioration noticed between the sixth and twelfth months (p = 0.048 and p = 0.002, respectively). Two years after RT, only 8/50 (16%) patients had normal voices. The main reasons for a decreased voice quality after RT for early glottic cancer were post-RT changes in the larynx. Despite a significant improvement in the voice after RT shown in a few of the evaluation methods, only a minority of the patients had a normal voice two years post-RT. [ABSTRACT FROM AUTHOR]

Social support has been shown to be positively associated with quality of life and adjustment after a cancer diagnosis. The present study investigates the course of social support up to one year after partial laryngectomy and its association with distress. Longitudinal questionnaire study. A total of 428 patients after partial laryngectomy (mean age: 64, SD = 11, 91% male). Patients completed questionnaires before treatment (t1), one week after a partial laryngectomy (t2), 3 months (t3), and one year (t4) thereafter. Social support was evaluated at t2, t3, and t4 using a brief version of the Social Support Questionnaire. Distress was measured at t2, t3, and t4 using the HADS. Descriptive statistics for social support were computed across the three measurement points. Changes were analyzed by Wilcoxon signed-rank tests. Associations with distress were identified using linear regression analyses. Social support increased between t2 and t3 and decreased to baseline level between t3 and t4. Distress at t2 was associated with social support at t2 (B = −0.15, p < 0.01) and distress at t3 with social support at t3 (B = −0.19, p < 0.01). Distress at t4 was related to social support at t2 (B = −0.10, p = 0.05). Although perceived social support increases after partial laryngectomy, it decreases again during the course of aftercare. Social support resources should be assessed to identify patients at risk for worse psychological well-being. [ABSTRACT FROM AUTHOR]

Background: The malignancy potential of the laryngeal lesions are one of the major concerns of the surgeons about choosing the treatment options, forming surgical margins, deciding the follow-up periods. Finding a biomarker to overcome these concerns are ongoing challenges and recently microRNAs (miRNAs) are attributed as possible candidates since they can regulate gene expressions in the human genome. The objective of our study was to investigate their capability as a transformation biomarker for malignant laryngeal lesions. Materials and methods: We investigated mature miRNA expressions in paraffin-embedded surgical specimens of human laryngeal tissues grouped as benign, premalignant or malignant (n = 10 in each). miRNA profiling was carried out by quantitative Real-Time polymerase chain reaction (RT-qPCR) and data were analyzed according to fold regulation. Results: Our results demonstrated that 9 miRNAs were upregulated as the lesions become more malignant. Among them Hs_miR-183_5p, Hs_miR-155_5p, and Hs_miR-106b_3p expressions were significantly 4.16 (p = 0.032), 2.72 (p = 0.028) and 3.01 (p = 0.022) fold upregulated respectively in premalignant lesions compared to the benign lesions. Moreover, their expressions were approximately 2.76 fold higher in the malignant group than in the premalignant group compared to the benign group. Besides them, significant 7.57 (p = 0.036), 4.45 (p = 0.045) and 5.98 (p = 0.023) fold upregulations of Hs_miR-21_5p, Hs_miR-218_3p, and Hs_miR-210_3p were noticed in the malignant group but not in the premalignant group when compared to the benign group, respectively. Conclusion: MiRNAs might have important value to help the clinicians for their concerns about the malignancy potentials of the laryngeal lesions. Hs_miR-183_5p, Hs_miR-155_5p, and Hs_miR-106b_3p might be followed as transformation marker, whereas Hs_miR-21_5p, Hs_miR-218_3p, and Hs_miR-210_3p might be a biomarker prone to malignancy. [ABSTRACT FROM AUTHOR]

Background: Laryngeal cancer is one of the most common head and neck cancers for which total laryngectomy is the preferred treatment in advanced stages. Major disabilities of this surgical procedure include loss of voice and nasal function, swallowing difficulties, and psychological consequences. Objectives: This study aimed to investigate the effect of the Polite Yawning technique on olfactory quality in patients undergoing total laryngectomy. Methods: In this cross-sectional study, after total laryngectomy, the patients with olfactory dysfunction were enrolled and the quality of olfaction was evaluated by the Quick Odor Detection test before and after receiving the Nasal Airflow Inducing Maneuver technique training. Statistical analysis was performed using SPSS 21 software by the Wilcoxon or McNemar's test. The significance level was considered for P≤0.05. Results: A total of 40 patients were evaluated. The mean age was 55.98±6.27 years. Eighty-five percent of the patients were male (n = 34). The difficulty score in learning maneuvering was 2.5±1.3, and 90% had no problem with learning it. Before maneuver, none of the patients had normal olfaction and had hyposmia mostly (n = 32, 80%). Immediately after the maneuver, there was a sensation of smell in all patients and the rate of hyposmia in patients was reduced to 65% (P = 0.008). Normal olfactory status was reported in half of the patients one month after the maneuver (21 patients, 52.5%, P = 0.0001), and there was a sense of smell in all patients (P = 0.0001). Conclusions: The results proved that olfactory quality can be rehabilitated after laryngectomy by the nasal airflow-inducing maneuver (the "Polite Yawning" technique). It is a patient-friendly method; however, a single training session is probably insufficient and most patients may need more training sessions. [ABSTRACT FROM AUTHOR]

Our study was performed with an aim to analyse the factors responsible for the formation of a carbon granuloma (CG) following transoral laser microlaryngeal cordectomy (TLMC) for early glottic carcinoma. Our study comprises of retrospective data analysis of 78 patients who underwent TLMC for early glottic carcinoma between 2012 and 2017 with the laser settings of an acublade with scanning system, size 1-2 mm, depth 1-3 (250-750 μm), power 10 watts in a repeat mode with time off 0.25 s. A total of 19 patients had undergone type 1 cordectomy, 38 patients a type 2 cordectomy, 20 patients a type 3 cordectomy and 1 type 4 cordectomy. In the follow-up period, patients were divided into two groups-group A, who healed well and group B, who developed a CG. Both groups were analysed based on surgical factors (type of cordectomy, postoperative surface of vocal fold and cautery use) and healing factors (presence of diabetes mellitus and laryngopharyngeal reflux). Of 81 cordectomies, 15 (18.5%) developed a CG at an average period of 4 weeks postoperatively. All 15 patients were managed medically and by 4-8 weeks, 13 carbon granulomas resolved. Surgical excision in 2 patients who did not improve revealed granulation tissue. Of 40 type 2 cordectomies, 9 developed a CG (22.5%); of 20 type 3 cordectomies, 5 developed a CG (25%) and the 1 patient of type 4 cordectomy developed a CG (100%). Patients with cautery use, diabetes mellitus (DM) and laryngopharyngeal reflux (LPR) had a higher rate of CG formation. To summarise, in our study, a CG developed in 18.5% of our TLMC patients at an average postoperative duration of 4 weeks. An algorithm for treating and preventing this type of lesion is recommended. [ABSTRACT FROM AUTHOR]

Objective: Many people seek health information from internet sources. Understanding this behaviour can help inform healthcare delivery. This study aimed to review Google Trends as a method for investigating internet-based information-seeking behaviour related to throat cancer in terms of quantity, content and thematic analysis. Method: Data was collected using Google Trends. Normalised data was created using the search terms 'throat cancer', 'cancer', 'HPV', 'laryngeal cancer' and 'head and neck cancer'. The search data was used to analyse the temporal and geographical interest pattern of these terms from 2004 to 2015. Results: Three important peaks in searches for 'throat cancer' were identified. The first and greatest increase in interest was in September 2010, and there were also peaks in June 2013 and in October 2011. Conclusion: Internet-search analysis can provide an insight into the information-seeking behaviour of the public. Mass media can hugely affect this information-seeking behaviour. Possessing tools to investigate and understand information-seeking behaviour may be used to improve healthcare delivery. [ABSTRACT FROM AUTHOR]

Purpose: Successful communication is influenced by communication partners, the community and communication environment. This study examines community members’ perceptions of voice function following laryngeal cancer management compared to ratings by clinicians and patients. Method: Sixty-six (Tis-T3) laryngeal cancer patients post-radiotherapy, 10 community members and three speech-language pathologists (clinicians) were recruited. Patients completed voice recordings and self-rated voice quality and acceptability, six months post-radiotherapy. Community members and clinicians rated patient voice recordings using (a) Voice Quality/Acceptability questionnaire, (b) Communicative Suitability Scale (voice function in different vocally demanding environments) and (c) a gender perception question. Result: Ratings for voice quality differed significantly (p < 0.001) between community members and clinicians and approached significance (p= 0.08) between community members and patients. No significant difference for voice acceptability was noted between community members and clinicians/patients. Community members rated the irradiated voice significantly different (p ≤ 0.02) across communication environments with more vocally demanding environments being rated as “Barely Sufficient”. Incorrect sex identification (gender perception) occurred with 25% of females. Conclusion: Community communication partners identify functional voice impairments post-radiotherapy, particularly across more vocally demanding environments and for female speakers. Implications for voice rehabilitation including appropriate patient selection is highlighted. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to investigate the effects of voice rehabilitation on health-related quality of life (HRQL) and voice function in patients treated for laryngeal cancer six months post-rehabilitation completion. A secondary aim was to identify factors that predict significant communication improvement. Study design: Longitudinal follow-up of randomised controlled trial. Methods: In total, 33 patients received voice rehabilitation post-radiotherapy and 32 patients constituted the control group. Outcome measures included patient-reported HRQL, communication and voice function (acoustic measures and perceptual analysis). Outcome measures were analysed one (baseline), six and 12 months post-radiotherapy, where voice rehabilitation was conducted between the first two time-points. Results: Patients improved after voice rehabilitation with regard to communication function and HRQL and remained unchanged after 12 months post-radiotherapy. A significant roughness deterioration in the control group occurred between six and 12 months post-radiotherapy, yet remained unchanged in the intervention group. A factors increasing odds of significant communication improvement 12 months post-radiotherapy was voice rehabilitation. Smoking affected communication negatively. Conclusion: Voice rehabilitation appears to have positive effect on voice function and HRQL, which persist up to 12 months of follow-up and appears to prevent deterioration of perceived roughness. Patients who experience voice and communication problems at baseline are most likely to benefit from voice rehabilitation. [ABSTRACT FROM AUTHOR]

Objectives: 8-Hydroxy-2’-deoxyguanosine is a biomolecule associated with DNA damage. We evaluated oxidative stress and DNA damage in patients with laryngeal cancer by measuring 8-hydroxy-2’-deoxyguanosine levels. Methods: This study enrolled 117 subjects, including 64 controls and 53 patients who had benign vocal cord lesions or laryngeal cancer. The benign excised lesions, tumor tissue, noncancerous laryngeal tissue, blood, and urine were subjected to high-performance liquid chromatography, and 8-hydroxy-2’-deoxyguanosine levels were compared between groups. Results: Blood and urine 8-hydroxy-2’-deoxyguanosine levels in patients with laryngeal carcinoma were significantly higher than in the controls (P = .00002, P = .00001). The 8-hydroxy-2’-deoxyguanosine level was significantly higher in tumor tissues than in non-tumor tissue and benign vocal cord lesion tissues (P = .00002, P = .000001). Conclusions: We determined that laryngeal cancer was associated with oxidative stress, which may be quantified by measuring 8-hydroxy-2’-deoxyguanosine. For a patient with a suspicious laryngeal lesion, 8-hydroxy-2’-deoxyguanosine levels in blood and urine can provide advance information about the likely diagnosis. [ABSTRACT FROM AUTHOR]

Conclusions:The aberrant expression of long non-coding RNA HOTAIR and transmethylase EZH2 played important roles in the progression and development of laryngeal squamous cell carcinoma (LSCC). Objectives:This research was aimed to explore the expression and correlation with clinicopathological characteristics of HOTAIR and EZH2 in LSCC, and to evaluate the function of the two in regulating the proliferation and cis-platinum resistance processes of LSCC. Methods:Quantitative real time-PCR (qPCR) was conducted to measure the expression of HOTAIR and EZH2 in tissue samples. Clinicopathological features were collected and statistically analyzed combining with the expression of HOTAIR and EZH2. The variance of EZH2 with down-regulating HOTAIR was measured by qPCR. CCK-8 proliferation test was conducted to detect the proliferation feature in LSCC cells. After cultured with a series of cis-platinum concentrations for 24 h, cell viability was detected using CCK-8 assay, and the inhibition rates were calculated. Results:HOTAIR and EZH2 were over-expressed in LSCC tissue. The higher expression was significantly related to T phase, pathological grades, and risk of lymphatic metastasis of LSCC. Suppressing HOTAIR expression stimulated EZH2 expressing, promoted the proliferation of AMC-HN8 cells, and increased the sensitivity to cis-platinum of the LSCC cells. [ABSTRACT FROM PUBLISHER]

Previous studies have found that miR-375 and miR-205 were significantly dysregulated in laryngeal squamous cell carcinoma, which contributed to the invasion and migration of LSCC. However, the mechanisms of miR-375 and miR-205 regulating the invasion and migration of LSCC remain unknown. qRT-PCR was performed in 40 pairs of tissue samples to investigate the expression of miR-375 and miR-205 in LSCC and paracarcinoma tissues. To investigate whether or not miR-375 and miR-205 regulated the invasion and migration of LSCC synergistically via AKT-mediated epithelial-mesenchymal transition, miR-375 mimic and miR-205 inhibitor were transfected into SNU899 cells and miR-375 inhibitor and miR-205 mimic were transfected into SNU899 cells, respectively, with or without AKT inhibitor. Then the expressions of miR-375 and miR-205 were validated by qRT-PCR, cell migration and invasion were determined by wound healing assay and transwell invasive assay, and western blot analysis was performed to detect the expression of related proteins. Our results showed that miR-375 and miR-205 regulated the invasion and migration of LSCC via AKT-mediated EMT synergistically. In conclusion, our findings provided not only new information about the molecular mechanism of miRNAs regulating invasion and migration of LSCC, but also a theoretical principle for potential targeting therapy of laryngeal squamous carcinoma. [ABSTRACT FROM AUTHOR]

ConclusionThe Th17 cell frequency in peripheral blood and levels of IL-17 showed significant differences between patients with laryngeal squamous cell carcinoma and those with vocal cords polyps. Serum levels of IL-17 were correlated with laryngocarcinoma staging.ObjectivesTo investigate associations among the frequency of Th17 cells, levels of IL-17, and laryngeal squamous cell carcinoma.MethodEighty in-patients with laryngeal squamous cell carcinoma and 114 in-patients with polypus of the vocal cord were enrolled. Th17 cell frequencies in peripheral blood and serum levels of IL-17 were measured by flow cytometry and enzyme-linked immunosorbent assay, respectively. The tissue expression levels of IL-17 mRNA transcripts and protein were measured using quantitative RT-PCR or immunohistochemical detection, respectively.ResultsTh17 cell frequencies in peripheral blood and serum concentrations of IL-17 were significantly higher in patients with laryngocarcinoma compared with those in patients with polyps (p < 0.01 for both Th17 cells and IL-17 levels). Serum concentrations of IL-17 were significantly higher in patients with advanced laryngocarcinoma than in patients with early laryngocarcinoma (p < 0.01). The mRNA and protein levels of IL-17 were significantly higher in laryngocarcinoma tissues than in adjacent normal tissues (p < 0.01 for mRNA levels,p < 0.05 for protein levels). [ABSTRACT FROM PUBLISHER]

Background.To investigate the dose-volume factors in mastication muscles that are implicated as possible causes of trismus in patients following treatment with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy for head and neck cancers. Material and methods.All evaluable patients treated at our institution between January 2004 and April 2009 with chemotherapy and IMRT for squamous cell cancers of the oropharynx, nasopharynx, hypopharynx or larynx were included in this analysis (N = 421). Trismus was assessed using CTCAE 4.0. Bi-lateral masseter, temporalis, lateral pterygoid and medial pterygoid muscles were delineated on axial computed tomography (CT) treatment planning images, and dose-volume parameters were extracted to investigate univariate and multimetric correlations. Results.Forty-six patients (10.9%) were observed to have chronic trismus of grade 1 or greater. From analysis of baseline patient characteristics, toxicity correlated with primary site and patient age. From dose-volume analysis, the steepest dose thresholds and highest correlations were seen for mean dose to ipsilateral masseter (Spearman's rank correlation coefficient Rs = 0.25) and medial pterygoid (Rs = 0.23) muscles. Lyman-Kutcher-Burman modeling showed highest correlations for the same muscles. The best correlation for multimetric logistic regression modeling was withV68Gyto the ipsilateral medial pterygoid (Rs = 0.29). Conclusion.Chemoradiation-induced trismus remains a problem particularly for patients with oropharyngeal carcinoma. Strong dose-volume correlations support the hypothesis that limiting dose to the ipsilateral masseter muscle and, in particular, the medial pterygoid muscle may reduce the likelihood of trismus. [ABSTRACT FROM PUBLISHER]

There is a lack of data from phase III randomized studies to support an ideal approach for locally advanced oral cavity cancer patients. In general, surgery, radiotherapy and chemotherapy are valid treatment options, and combined approach is usually indicated given poor clinical outcomes with single modality therapy. The aim of this study is to review the current status and future perspectives of induction chemotherapy for locally advanced oral cavity cancer patients. [ABSTRACT FROM AUTHOR]

Objective: We report the treatment outcomes, including organ preservation, for patients with locally advanced (T3/T4a) laryngeal cancer receiving both surgical and nonsurgical approaches. We hypothesize that selection of treatment protocols aimed to optimize organ preservation does not compromise survival provided careful selection is done through the process of multidisciplinary treatment planning. Methods: Patients with T3-4a laryngeal squamous cell cancer were evaluated and recommended for primary treatment with total or partial laryngectomy (37 patients) or chemoradiotherapy (34 patients). Treatment outcomes were compared between the 2 cohorts. In addition, the laryngeal preservation rate and laryngoesophageal dysfunction-free survival (LEDFS) were determined for the chemoradiation group. Results: The 5-year overall survival rate for patients with T3 lesions was 41% and 40% for the surgical and nonsurgical groups, respectively, and for T4 lesions it was 54% and 53%, respectively. For the chemoradiation group, the rate of overall laryngeal preservation was 79%. LEDFS at 2 years was 40% for T3 lesions and 33% for T4 lesions. Conclusion: Through careful selection, some patients with locally advanced laryngeal cancer can be offered chemoradiation (organ preservation) without compromising survival. However, the patients selected to receive chemoradiation have a high rate of laryngeal and esophageal dysfunction. [ABSTRACT FROM AUTHOR]

Objective. This study aims to assess the effect of voice rehabilitation on health-related quality of life (HRQL) and communication experience for laryngeal cancer patients treated with radiotherapy. Method. This prospective randomised controlled trial included 74 patients with Tis-T4 laryngeal cancer treated curatively by radiotherapy, of which 37 constituted the intervention group receiving voice rehabilitation and 37 patients as a control group. Patients were followed at one and six months post-radiotherapy, with voice rehabilitation conducted between these time-points. Endpoints included patient reported outcomes, including HRQL as measured by European Organisation for Research and Treatment of Cancer (EORTC) Core30 (C30) and Head & Neck35 (H&N35) as well as communication function as measured by Swedish Self-Evaluation of Communication Experiences after Laryngeal cancer (S-SECEL). Results. The intervention group reported statistically significant improvements in communication experience as measured by S-SECEL environmental, attitudinal and total score domains compared to the control group. Similar improvements were seen in EORTC H&N35 Speech domain and the EORTC C30 domain Global quality of life. Moderate correlations were noted (r = 0.51-0.59) between three of four S-SECEL domains and the EORTC domains Speech and Global quality of life. Conclusion. Laryngeal cancer patients treated with radiotherapy who receive voice rehabilitation appear to experience beneficial effects on communication function and selected HRQL domains. Voice rehabilitation following radiotherapy is recommended but further research investigating potential target groups and long-term effects is required. [ABSTRACT FROM AUTHOR]

Background: The goal of the study is to test medialization of the neocord after oncological surgery for glottic cancer, using autologous tragal cartilage and perichondrium by the direct approach. Materials and Methods: Sixteen patients underwent comprehensive assessment including auditory perceptual assessment, videostrobolaryngoscopy, and acoustic voice analysis. The cartilage graft was inserted into a pocket created in the tyroarytenoid -- lateral cricoarytenoid muscle complex or the excavated musculomembranous part of the neocord, and fixed by placing the perichondrium by the direct approach. The patients were evaluated preoperatively, and at 14 days, 60 days, and 6 months later. Results: Improvement of voice and breathiness was correlated with the increase of closed quotient and harmonic-to-noise ratio; the acoustic voice parameters studied showed significant differences between preoperative and postoperative voices, and these objective measurements of voice changes provided accurate and documentary evidence of the results of surgical treatment. Conclusion: This method may be considered a safe and efficient phonosurgical procedure for voice restoration. [ABSTRACT FROM AUTHOR]

Background. To provide further information about short-term effects on voice quality and health-related quality of life (HRQL) following radiotherapy for laryngeal cancer, comparing glottic and supraglottic tumours. Material and methods. Sixty-seven male patients who received radiotherapy for glottic and supraglottic tumours were included. Voice recordings were performed and patient reported outcome questionnaires filled in before radiotherapy and one-month post-completion. Acoustic and temporal measures were produced from the recordings and compared to an age-matched, vocally healthy control group (n = 23). Results. Deterioration of HRQL post-radiotherapy was noted for both the glottic and supraglottic cohort. Pre- radiotherapy the glottic cohort demonstrated acoustic and temporal measures that were statistically different from healthy controls, with improvements post-radiotherapy where several measures showed no statistically significant differences compared to healthy controls. The supraglottic cohort revealed voice measures comparable to the healthy controls but demonstrated statistically significant impairments in HRQL compared to the glottic cohort following radiotherapy. Conclusion. Patients with supraglottic tumours may experience more eating and swallowing related problems prior to radiotherapy compared to glottic tumours and demonstrate a more significant reduction in HRQL following treatment. However, in terms of voice measurements, subjective measures correlate poorly with objective acoustic parameters, thereby emphasising the importance of patient-reported outcomes as part of treatment evaluation. [ABSTRACT FROM AUTHOR]

Objective: Laryngeal malignancy known as the most frequently diagnosed cancer between head and neck tumor, covering 2.4% of all tumors and is the 11th most occurrence and deadliest tumor in the world. Research has shown that microRNAs (miRNAs) play a considerable role in the development of laryngeal malignancy. Moreover, studies also focus on the relationship between clinical relevance and miRNA deregulation in cancer illness. According to recent evidence, miR-205, miR-126, miR-302, and miR-132 have possible roles in the carcinogenesis process of the LSCC. Therefore, in this research, we aimed to investigate whether there are any considerable changes in the microRNAs expression level and also if they have any remarkable potential as a prognostic or diagnostic biomarker for laryngeal squamous cell carcinoma (LSCC). Methods: Thirty LSCC patients were included in this research, and tumor tissues and healthy normal tissues were collected during laryngectomy. Total RNA extraction from the normal and cancer tissues was accomplished and after the quality control, cDNA was synthesized, and finally, target miRNAs expression was determined by qPCR. The expression level of genes and their relationship with the patient’s clinicopathological characteristics were analyzed using appropriate statistical tests. Results: According to the study results, miR-302 (fold change: 1.o5, P-value = 0.0001) and miR-132 (fold change: 1.28, P-value = 0.0001), is considerably overexpressed in cancer tissues compare to normal peripheral tissues. We also found that miR-126 (fold change: 0.251, P-value = 0.0001) and miR-205 (fold change: 0.241, P-value<0.0001) is down-regulated in LSCC tumor tissue. Among these microRNAs, only mir-205 expression had no association with clinical-pathological features in tumor tissue. Conclusion: The results of this research revealed the potential of the miR-302, miR-132, miR-126, and miR-205 as prognostic or diagnostic biomarkers in LSCC. [ABSTRACT FROM AUTHOR]

Conclusion: The meta-analysis supported the proposition that the prevalence of gastroesophageal reflux disease (GERD) was associated with laryngeal cancer, particularly in the hospital-based control group and diagnosed by esophagogastroduodenoscopy (EGD) or esophageal pH monitoring. However, no significant association was found between GERD and pharyngeal carcinoma. Objectives: A number of studies have been conducted to investigate the relationship between gastroesophageal reflux and laryngeal or pharyngeal carcinoma. The conclusions are still debated. Methods: We conducted a systematic review of studies associated with the prevalence of GERD in laryngeal or pharyngeal cancer, published up to November 2013.Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using random effects models or fixed effects models, according to heterogeneity I2. Results: Ten studies were included in this meta-analysis. On average, GERD was significantly higher in the tumor tissue of the study group compared with normal tissue of the control group (OR = 2.17, 95% CI = 1.50, 3.14; random effects analysis). The pooled ORs for laryngeal carcinoma were 2.21 (95% CI = 1.53-3.19; I2 = 97, random effects model) and 3.76 (95% CI = 0.21-67.48; I2 = 94, random effects model) for pharyngeal carcinoma. [ABSTRACT FROM AUTHOR]

Conclusions: p53 overexpression (>5%) in the surgical margins was more valuable than in the primary tumor tissue for the prediction of local recurrence among surgically treated early glottic cancers. This is the first study to compare p53 values in both primary tumor and surgical margin tissues of the same patients with early glottic cancers. Objective: To assess the prognostic value of p53 expression in the surgical margins of early glottic cancers treated with external laryngeal surgery in the prediction of local recurrences. Methods: Fifteen patients with early glottic cancer with local recurrences (group 1) and 15 without any recurrences (group 2) were included in the study. p53 expression was determined in both the tumor and the tumor-negative surgical margins. Results: Median p53 in the primary tumor was 55% (interquartile range (IQR) = 67) and 5% (IQR = 71) in groups 1 and 2, respectively ( p = 0.178). Median p53 in the surgical margin was 11% (IQR = 13) and 2% (IQR = 2) in groups 1 and 2, respectively ( p = 0.001). In the logistic regression analysis only surgical margin p53 value was significant in the prediction of recurrences (odds ratio (OR) = 1.68, 95% CI = 1.1-2.6, p = 0.017). Receiver operating characteristic (ROC) curve analysis demonstrated that the area under the curve was 0.86 ( p = 0.002) and 0.65 ( p = 0.180) in the surgical margin and the primary tumor, respectively. [ABSTRACT FROM AUTHOR]

Epidermal differentiation complex (EDC) comprises a number of genes associated with human skin diseases including psoriasis, atopic dermatitis and hyperkeratosis. These genes have also been linked to numerous cancers, among them skin, gastric, colorectal, lung, ovarian and renal carcinomas. The involvement of EDC components encoding S100 proteins, small proline-rich proteins (SPRRs) and other genes in the tumorigenesis of head and neck squamous cell cancer (HNSCC) has been previously suggested. The aim of the study was to systematically analyze the expression of EDC components on the transcript level in HNSCC. Tissue specimens from 93 patients with HNC of oral cavity and 87 samples from adjacent or distant grossly normal oral mucosa were analyzed. 48 samples (24 tumor and 24 corresponding surrounding tissue) were hybridized to Affymetrix GeneChip Human 1.0 ST Arrays. For validation by quantitative real-time PCR (QPCR) the total RNA from all 180 samples collected in the study was analyzed with Real-Time PCR system and fluorescent amplicon specific-probes. Additional set of samples from 14 patients with laryngeal carcinoma previously obtained by HG-U133 Plus 2.0 microarray was also included in the analyses. The expression of analyzed EDC genes was heterogeneous. Two transcripts (S100A1 and S100A4) were significantly down-regulated in oral cancer when compared to normal mucosa (0.69 and 0.36-fold change, respectively), showing an opposite pattern of expression to the remaining S100 genes. Significant up-regulation in tumors was found for S100A11, S100A7, LCE3D, S100A3 and S100A2 genes. The increased expression of S100A7 was subsequently validated by QPCR, confirming significant differences. The remaining EDC genes, including all encoding SPRR molecules, did not show any differences between oral cancer and normal mucosa. The observed differences were also assessed in the independent set of laryngeal cancer samples, confirming the role of S100A3 and LCE3D transcripts in HNC. In HNC of oral cavity only one family of EDC genes (S100 proteins) showed significant cancer-related differences. A number of other transcripts which showed altered expression in HNC require further validation. (Folia Histochemica et Cytobiologica 2014, Vol. 52, No. 2, 79-89) [ABSTRACT FROM AUTHOR]

Background:Treatment for advanced laryngeal cancer includes surgery, and/or chemoradiotherapy or radiotherapy. Each of these treatments results in major changes to the swallowing mechanism. Dysphagia is strongly correlated with poorer quality of life. A good understanding of outcomes is needed for well-informed treatment decisions.Method:This study reports on patients' swallowing outcomes following surgical and non-surgical treatments based on the results of three different swallowing tests. A total of 123 data sets were collected in out-patient clinics across two hospitals in North East England.Results:There were no significant differences between treatment groups for patient-reported swallowing outcomes or swallowing performance. However, patients who had undergone chemoradiotherapy or radiotherapy (with or without laryngectomy) had significantly more diet restrictions than other groups.Conclusion:Long-term dysphagia is a common outcome of treatment for advanced laryngeal cancer. Patients treated with chemoradiotherapy and laryngectomy reported the worst overall outcomes. More longitudinal prospective research with large treatment groups is needed to investigate swallowing outcomes following different treatment methods. [ABSTRACT FROM PUBLISHER]

Conclusion: The overexpression of HMGA1 or Ezrin may contribute to the carcinogenesis, development, and metastasis of laryngeal squamous cell carcinoma (LSCC). Objective: To investigate the expression of HMGA1 and Ezrin in LSCC and analyze their clinical significance. Methods: The expression of HMGA1 and Ezrin was analyzed by immunohistochemistry (IHC) in 50 cases of LSCC. Thirty cases of laryngeal polyp and 30 cases of atypical hyperplasia of larynx were studied as controls. The expression of HMGA1 and Ezrin was analyzed by real-time PCR and by Western blot in 30 cases of LSCC; samples from adjacent normal epithelial tissues in 30 cases were studied as controls. Results: (1) IHC revealed that the positive rate of HMGA1 protein was 68.0% (34/50), 53.3% (16/30), and 13. 3% (4/30) in LSCC, atypical hyperplasia of larynx, and laryngeal polyp ( p < 0.05), and the positive rate of Ezrin protein was 64.0% (32/50), 50.0% (15/30), and 23.3% (7/30) ( p < 0.01), respectively. (2) Real-time PCR demonstrated that the mean relative mRNA expression levels of HMGA1 in LSCC and in normal tissues were 2.41 ± 0.40 and 1.05 ± 0.18, respectively ( p < 0.01). The mRNA levels of Ezrin in LSCC and in normal tissues were 1.79 ± 0.27 and 1.04 ± 0.22, respectively ( p < 0.05). (3) Western blotting revealed that the mean relative protein expression levels of HMGA1 in LSCC and in normal tissues were 1.73 ± 0.60 and 0.35 ± 0.17, respectively ( p < 0.01). The protein levels of Ezrin in LSCC and in normal tissues were 1.82 ± 0.77 and 0.42 ± 0.20, respectively ( p < 0.01). [ABSTRACT FROM AUTHOR]

In the time period 1996–2004, we conducted a case-control study in Montevideo, Uruguay with the objective of exploring the role of foods and alcoholic beverages in the etiology of cancers of the upper aerodigestive tract (UADT). In brief, 563 male cases and 1099 male controls were frequency matched on age and residence using random sampling. All the participants were drawn from the 4 major public hospitals in Montevideo. We used exploratory factor analysis among controls. Through Scree plot test, the model retained 4 factors, which were labeled asprudent,starchy plants, Western, anddrinker. These dietary patterns explained 34.8% of the total variance. Whereas the prudent pattern was inversely associated with UADT cancer [odds ratios (OR) for the upper tertile vs. the lowest one 0.52, 95% confidence intervals 0.32–0.76,Pvalue for trend = 0.0005), the remaining patterns were significantly and positively associated with UADT cancers. We conclude that these patterns were similar among the oral and laryngeal cancers, both in the direction of the ORs and in the magnitude of the associations, suggesting that these cancer sites share the effect of dietary patterns in the etiology of cancer of the upper aerodigestive tract. [ABSTRACT FROM PUBLISHER]

Conclusion: Patients who received concurrent chemoradiation therapy or radiation therapy alone were followed over a long term. The complete response (CR), 10-year survival, and 10-year larynx preservation rates were 87.5%, 95.3%, and 75.1%, respectively. Statistically, concurrent chemoradiation therapy contributes to laryngeal preservation but not to the survival rate. Objective: To determine the additive and synergistic effects of anticancer chemotherapy combined with chemoradiation therapy for squamous cell carcinoma (SCC) of the glottic larynx. Methods: Eighty-nine patients with untreated T2N0M0 SCC of the glottic larynx were included. Thirty-two patients received treatment cycles consisting of intravenous cisplatin (CDDP) on day 1 (80 mg/m2) and intravenous 5-fluorouracil (5-FU) over 120 h on days 2-6 (600 mg/m2/day) every 4 weeks. Radiotherapy was delivered by a 4 MV linac X-ray machine at a dose of 66 Gy. Fifty-seven patients received radiotherapy alone. Results: After chemoradiation therapy, the overall response, CR, 10-year survival, and 10-year larynx preservation rates were 100%, 87.5%, 95.3%, and 75.1%, respectively. Side effects included leukopenia, neutropenia, mucositis, and dermatitis. Seven patients (21.9%) required salvage surgery. Pathological findings confirmed that the treatment regimen caused marked cancer tissue degeneration. Histologic examination of surgical specimens suggested that the safety margin for partial laryngectomy was 4 mm from the gross tumor. [ABSTRACT FROM AUTHOR]

Conclusion: Concurrent chemoradiation therapy with docetaxel (DOC) at a dose of 10 mg/m2 twice a week contributed to laryngeal preservation. Objective: To determine laryngeal preservation following concurrent chemoradiation therapy with DOC. Methods: A total of 141 patients with untreated T2N0M0 squamous cell carcinoma of the glottic larynx were included in the study. The treatments were either radiation therapy alone or DOC intravenously administered at a dose of 10 mg/m2 once or twice a week during radiotherapy with 4 MV linac X-ray (total of 66 Gy for 33 days). Results: The response and CR rates were 100% and 90.5% in the once-weekly combination group, and 100% and 97.6% in the twice-weekly combination group, respectively. The 5-year survival rates were 76.8% in the once-weekly combination group and 96.8% in the twice-weekly combination group. The 5-year laryngeal preservation rates were 83.8% in the once-weekly combination group and 97.6% in the twice-weekly combination group. The most common side effects were mucositis, dermatitis, and alopecia. The patients who received DOC twice a week showed more severe cancer tissue degeneration, and pathological examination of serial sections indicated that the safety margin for partial laryngectomy was considered to be 3 mm from the gross tumor with good glottal closure. [ABSTRACT FROM AUTHOR]

The authors prospectively assessed the independent association between weight loss and deterioration in quality of life (QOL) in patients treated by radiotherapy for head and neck cancer. In 533 head and neck cancer patients treated by curative radiotherapy, changes in weight and QOL were assessed between baseline (before radiotherapy) and follow-up (12 wk after the start of radiotherapy). Patients were categorized into 4 weight loss categories: 0%, 0.1%–5.0%, 5.1%–10.0%, and >10% weight loss. The association between weight loss and change in QOL was analyzed by linear regression analysis, adjusted for sociodemographic and tumor-related characteristics, and additionally for disease specific symptoms and tube feeding. Thirty percent of patients lost 0.1%–5.0% weight, 26% lost 5.1%–10.0% weight, and 24% lost >10% weight. Adjusted regression analyses showed a significant association between weight loss and deterioration of global QOL, physical functioning, social functioning, social eating, and social contact. After additional adjustment for disease-specific symptoms and tube feeding, weight loss (>10%) remained significantly associated with global QOL, social eating, and social contact (P< 0.05). More than 10% weight loss during and directly after radiotherapy has a significant impact on social eating, social contact, and QOL in head and neck cancer patients. [ABSTRACT FROM PUBLISHER]

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Discrimination of the etiology of arytenoid fixation in cT3 laryngeal squamous cell carcinoma (SCC) is crucial for treatment planning. The aim of this retrospective study was to differentiate among possible causes of arytenoid fixation (edema, inflammation, mass effect, or tumor invasion) by analyzing related signal patterns of magnetic resonance (MR) in the posterior laryngeal compartment (PLC) and crico-arytenoid unit (CAU). Seventeen patients affected by cT3 glottic SCC with arytenoid fixation were preoperatively studied by state-of-the-art MR with surface coils. Different signal patterns were assessed in PLC subsites. Three MR signal patterns were identified: A, normal; B, T2 hyperintensity and absence of restriction on diffusion-weighted imaging (DWI); and C, intermediate T2 signal and restriction on DWI. Signal patterns were correlated with the presence or absence of CAU and PLC neoplastic invasion. Patients were submitted to open partial horizontal or total laryngectomy and surgical specimens were analyzed. Pattern A and B did not correlate with neoplastic invasion, while Pattern C strongly did (Spearman's coefficient = 0.779, p < 0.0001; sensitivity: 100%; specificity: 78%). In conclusion, MR with surface coils is able to assess PLC/CAU involvement with satisfactory accuracy. In absence of Pattern C, arytenoid fixation is likely related to mass effect and/or inflammatory reaction and is not associated with neoplastic invasion. [ABSTRACT FROM AUTHOR]