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Introduction In the present study, we have reviewed the outcomes of patients with supracricoid partial laryngectomy (SCPL) in our institution. Our results show that SCPL is a well-tolerated procedure with generally good functional outcomes for patients with advanced laryngeal cancer. Objective We analyzed the oncological and functional results of a cohort of 35 patients who had undergone SCPL, and we highlighted the complications, identified the overall and disease-free survivals, demonstrating that the reconstructive laryngectomy guarantees the oncological safety and reproducibility of the oncological results, preserving the laryngeal functions and promoting an improvement in the patient's quality of life, favoring communication and interpersonal relationships. Methods Between 2010 and 2018, 35 patients underwent SCPL for primary and recurrent laryngeal squamous cell carcinomas, and they were divided into two subgroups: in 16 cases, the cricohyoidoepiglottopexy according to the Mayer-Piquet technique was performed, while the remaining 19 cases were submitted to the cricohyoidopexy according to the Labayle technique. In addition to evaluating the oncological results of patients undergoing reconstructive laryngectomy, the present study also aimed to evaluate the functionality of the residual larynx and the quality of life. Results The overall and disease-free survivals were of 83% and 76.3% respectively. All patients were able to swallow. The nasogastric tube was removed after a mean period of 21.8 days (range: 14 to 28 days). The mean decannulation time was of 23.4 days after surgery (range: 15 to 36 days). Conclusion The curves for the overall and disease-free survivals show that SCPL can guarantee oncological safety comparable to that of total laryngectomies in diseases in the intermediate stage and in carefully-selected advanced stages.

Folate deficiency may be directly associated with carcinogenesis. Folate supplementation may reduce the risk of progression in a mucosa that is already genetically altered. The aim of the present study was to determine the role of folic acid in the treatment of mild and moderate laryngeal dysplasia recurring after surgery. The data obtained by laryngoscopy, measurement of serum folate levels and functional vocal assessment with the GIRBAS scale and VHI questionnaire were compared in patients who had received folic acid with a homogeneous group of patients with dysplasia who had not undergone any therapy. A total of 24 patients suffering from recurrence of mild or moderate laryngeal dysplasia (n=12, group A) were treated with 400 mg folic acid per os, once daily for 6 months. The patients in group B (n=12) received no treatment and were used as the control group. In group A, 7 (58%) patients exhibited a complete response, with clinically evident regression of leukoplakia, 3 (25%) displayed a partial decrease in the lesions with reduced volume of the area involved, whereas 2 patients exhibited no change. As regards patients in control group B, 8 (67%) exhibited no change, in 1 case there was a spontaneous regression, and in 3 (25%) there was disease progression with suspected malignant transformation, leading to repeat surgery. Therefore, folate deficiency may be considered to be a factor predisposing to precancerous lesions, and dietary folate supplementation may prevent and reduce the emergence of cancer.

// Filippo Ricciardiello 1 , Michele Caraglia 3 , Brigida Iorio 2 , Teresa Abate 1 , Mariarosaria Boccellino 3 , Giuseppe Colella 4 , Flavia Oliva 1 , Pierpaolo Ferrise 1 , Silvia Zappavigna 3 , Mario Faenza 4 , Giuseppe A. Ferraro 4 , Giulio Sequino 1 , Giovanni Francesco Nicoletti 4 and Massimo Mesolella 2 1 Division of Otolaryngology, “A. Cardarelli” Hospital, Naples, Italy 2 Department of Neurological, Reproductive and Odontostomatological Sciences, University “Federico II” of Naples, Naples, Italy 3 Department of Biochemistry, Biophysics and General Pathology, University of Campania “L. Vanvitelli”, Naples, Italy 4 Department of Medical, Surgical and Dental Specialties, University of Campania “L. Vanvitelli”, Naples, Italy Correspondence to: Michele Caraglia, email: michele.caraglia@unina2.it , michele.caraglia@fastwebnet.it Keywords: laryngea lbasaloid squamocellular carcinoma (BSCC); prognosis of laryngeal basaloid squamous cell carcinoma; mortality of laryngeal BSCC; loco-regional recurrence in laryngeal BSCC Received: July 26, 2017 Accepted: August 23, 2017 Published: September 28, 2017 ABSTRACT Basaloid squamous cell carcinoma (BSCC) is a rare, aggressive and distinct variant of squamous cell carcinoma (SCC) of the upper respiratory and digestive tract. We have evaluated disease specific survival (DSS) and overall survival (OS) through Kaplan-Meier method and mortality risk through univariate statistical analysis of Cox in 42 cases of BSCC and other 42 of laryngeal SCC (LSCC) matched for both age and sex. We demonstrated that laryngeal BSCC is a more aggressive tumor than LSCC as is associated to higher nodal recurrence of pathology ( 5 vs 2 patients, overall risk, OR 2.7), a reduced survival (median survival 34 vs 40 months, OR 3.2 for mortality); in addition, basaloid patients have a higher risk to be affected by second primary tumors (13 vs 3 patients, OR 5.8) and a higher probability to die for this second tumor (Hazard Risk, HR 4.4). The analysis of survival shows an increased mortality risk concurrent with the parameters assessed by univariate analyses that assume a predictive and statistical significance in second tumor and grading in basaloid LSSC.

Objectives To evaluate the relationship between metabolic 18Fluoro-Deoxyglucose-Positron Emission Tomography (18FDG/PET) and morpho-functional parameters derived by Magnetic Resonance Imaging (MRI) in patients with histologically proven laryngeal cancer. To assess the clinical impact of PET/MRI examination on patient's staging and treatment planning. Methods 16 patients with histologically proven laryngeal cancer were enrolled and underwent whole body PET/CT followed by a dedicated PET/MRI of the head/neck region. Data were separately evaluated by two blinded groups: metabolic (SUV and MTV), diffusion (ADC) and perfusion (K trans , V e , k ep and iAUC) maps were obtained by positioning regions of interest (ROIs). Tumoral local extension assessed on PET/MRI was compared to endoscopic findings. Results A good inter-observer agreement was found in anatomical location and local extension of PET/MRI lesions (Cohen's kappa 0.9). PET/CT SUV measures highly correlate with ones derived by PET/MRI (e.g., p=0.96 for measures on VOI). Significant correlations among metabolic, diffusion and perfusion parameters have been detected. PET/MRI had a relevant clinical impact, confirming endoscopic findings (6 cases), helping treatment planning (9 cases), and modifying endoscopic primary staging (1 case). Conclusions PET/MRI is useful for primary staging of laryngeal cancer, allowing simultaneous collection of metabolic and functional data and conditioning the therapeutic strategies.