Aggressive Surgical Therapy After Irradiation Failure in Treatment of Cancer of the Oral Tongue

Mulholland, Michael W.; Megallanes, Fernando; Press, Barry H. J.; Shons, Alan R.; McQuarrie, Donald G.

doi:10.1001/archsurg.1984.01390160030007

Cited by 12 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The patients with recurrent oral and oropharyngeal cancer are usually considered to have a poor prognosis, even when submitted to salvage treatment. However, the 5‐year overall survival >30.0% shown in this and other series8, 29, 30 would hardly be reached with other treatment alternatives. Our results demonstrate that patients with recurrent tumors at initial clinical stages (rCS I and rCS II) and diagnosed after 1 year of initial treatment have the most favorable prognosis.…”

Section: Discussioncontrasting

confidence: 58%

“…In view of the supposedly poor prognosis of patients with recurrent disease, some authors suggest only palliative treatment, mainly in patients with advanced disease and those previously treated with surgery and adjuvant radiotherapy 26, 27. The reported 5‐year survival rates are variable and range from 9% to 59.7%,8, 22, 23, 28–31 including all cases of oral and oropharyngeal cancer and all clinical stages. Yuen et al28 reported a series of patients with recurrent SCC of the tongue who initially submitted to surgical treatment and found a 3‐year survival rate of 9.0%.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Temporal and spatial expression profile of the novelarmadillo-related gene,Alex2, during testicular differentiation in the mouse embryo

2005

View full text Add to dashboard Cite

In a screen for transcripts differentially expressed during gonadal development in mouse embryos, we identified the novel armadillo-related gene, Alex2. The armadillo (arm) family of proteins share a 42 amino acid tandem repeat motif called the arm domain, through which they interact with different binding partners. These intracellular proteins are implicated in a variety of developmental processes, including cell proliferation, migration, maintenance of tissue integrity, and tumorigenesis. Alex2 is a member of a novel subgroup within the arm family, encoding a protein with a single arm domain and a putative transmembrane or signal sequence. Alex2 has a developmentally regulated expression profile during embryogenesis in the mouse. In the urogenital system, it is strongly expressed in the developing testis but is down-regulated during ovarian development. Alex2 expression is localized within the interstitial cell lineage of the developing testis, which gives rise to peritubular myoid, endothelial, and fetal Leydig cells. Alex2 is also expressed in the developing forebrain and somites and in dorsal root ganglia. In testicular cell lines, Alex2 fusion proteins localize to membrane structures within the cell. The expression profile of Alex2 suggests that it plays a role in the development of several tissues during embryogenesis, notably testicular differentiation. In the developing testis, its expression profile suggests that Alex2 has a role in specification or development of the interstitial cell lineage. Developmental Dynamics 233:188 -193, 2005.

show abstract

Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Temporal and spatial expression profile of the novelarmadillo-related gene,Alex2, during testicular differentiation in the mouse embryo

2005

View full text Add to dashboard Cite

show abstract

“…Of these, 32 reports met minimal criteria and were included in the meta‐analysis. 8–39 Ten studies were excluded because they did not contain the information necessary to determine a survival figure, three studies were excluded because the data reported was derived from a duplicate or overlapping group of patients studied in other eligible reports, and three studies were excluded because all patients were treated according to a specific combined therapy strategy (one with surgery plus intraoperative radiotherapy, one with surgery plus brachytherapy, and one with surgery plus chemotherapy). Data were recorded on preprinted sheets and entered on a Microsoft Excel spreadsheet for review and analysis (see Appendix).…”

Section: Methodsmentioning

confidence: 99%

Salvage Surgery for Patients With Recurrent Squamous Cell Carcinoma of the Upper Aerodigestive Tract: When Do the Ends Justify the Means?

2000

The Laryngoscope

544

510

View full text Add to dashboard Cite

Objectives/Hypotheses: Salvage surgery is widely viewed as a "double-edged sword." It is the best option for many patients with recurrent cancer of the upper aerodigestive tract, especially when original therapy included irradiation, yet it may provide only modest benefit at high personal cost to the patient. The stakes are high because alternatives are of limited value. The primary objective of this study was to fully assess the value of salvage surgical procedures in the treatment oflocal and regional recurrence. The following hypotheses were developed to focus the study design and data analysis. 1) The efficacy of salvage surgery correlates recurrent stage, recurrent site, and time to presalvage recurrence.2) The economic and noneconomic costs of salvage surgery increase with higher recurrent stage. 3) Information relating the value of salvage surgery to recurrent stage and recurrent site will be useful to these patients and the physicians who treat them. Study De-sign: Two complimentary methods of investigation were used: a meta-analysis of the published literature and a prospective observational study of patients undergoing salvage surgery for recurrent cancer of the upper aerodigestive tract. Methods: The metaanalysis combined 32 published reports to obtain an estimate of average treatment effect for salvage surgery with regard to survival, disease-free survival, surgical complications, and operative mortality. The prospective observational study included detailed data in 109 patients who underwent salvage surgery. In addition to parameters studied in the metaanalysis, we obtained baseline and interval quality of life d ata (Functional Living Index for Cancer [FLIC] Presented as a Candida te's Th esis to the America n La ryngologica l, Rhinologica l a nd Otological Society, Inc.From , length of hospital stay, and hospital and physician charges, and related this data primarily to recurrent stage, recurrent site, and time to presalvage recurrence. Results: The weighted average of 5-year survival in the meta-analysis was 39% in 1,080 patients from 28 different institutions. In the prospective study, median disease-free survival was 17.9 months in 109 patients, and this correlated strongly with recurrent stage, weakly with recurrent site, and not at all with time to presalvage recurrence. Noneconomic costs for patients and economic costs correlated with recurrent stage, but not with site. Baseline FLIC and PSS head and neck scores correlated with recurrent stage, but not with site. After salvage surgery the percentage of patients reaching or exceeding baseline was 51 % for FLIC scores, and this differed significantly with recurrent stage. Postoperative interval "success" in PSS head and neck subscale scores for diet and eating in public also correlated with recurrent stage. Conclusions: Overall, the expected efficacy for salvage surgery in patients with recurrent head and neck cancer was surprisingly good, but success was limited and costs were great in stage Ill and, especially, in stage IV recurrences. A ...

show abstract

“…Early data showed poor oncological outcomes with only a 50% local control rate when performing glossectomy after initial irradiation [22,23]. Mulholland et al later showed that patients who received initial organ preservation therapy who lateral recurred had similar five-year survival when recurrences were managed with aggressive surgical resection [24]. Similarly, in our study, neither initial organ preservation therapy nor adjuvant radiotherapy was associated with worse locoregional control or disease-specific survival, suggesting that organ preservation approaches can be utilized for OTSCC without negatively impacting long-term survival, even when recurrences do occur.…”

Section: Discussionmentioning

confidence: 99%

Oncologic Outcomes of Salvage Surgery in Recurrent Oral Tongue Squamous Cell Carcinoma

Farsi,

Amole,

King

et al. 2024

Cureus

View full text Add to dashboard Cite

Objective: This study aimed to determine the oncologic outcomes and identify prognostic factors in patients undergoing salvage glossectomy for recurrent oral tongue squamous cell carcinoma (OTSCC). Methods: A retrospective chart review was conducted encompassing all patients who underwent salvage oral glossectomy out of 259 individuals undergoing oral glossectomy at a tertiary academic center. Inclusion criteria comprised patients who met the following conditions: 1) biopsy-proven oral tongue recurrence, 2) salvage glossectomy performed with curative intent, 3) availability of imaging records, and 4) comprehensive documentation. Cases involving base of tongue tumors and second primaries were excluded from the analysis. Categorical data were expressed as proportions, and continuous data as medians/quartiles. Univariate analysis used Fisher’s exact test for categorical variables and Student’s t-test for continuous ones. Survival analysis employed Kaplan-Meier estimates and the log-rank test. Results: High-risk histopathological risk factors were significantly more common with recurrence compared to initial presentation. The mean locoregional disease-free interval was 35 months. Kaplan-Meier estimates for one- and three-year disease-free survival (DFS) were 62.7% and 33.4%, while disease-specific survival (DSS) rates were 73% and 38.9%, respectively. Recurrent T-stage was a predictor for DFS, while margin status was a strong predictor for both LR control (p = 0.024) and DSS (p = 0.030), as was perineural invasion (p = 0.001 and p = 0.030). Alcohol use was associated with worse overall survival (p = 0.024). In contrast to other reports, nodal status was not a predictor in this series. Conclusions: Upon recurrence, histopathological analysis unveils detrimental changes in tumor biology, which significantly influence disease control. Notably, consistent with findings from other studies, factors, such as recurrent T-stage, presence of perineural invasion, and, most importantly, margin status, play pivotal roles in determining oncologic outcomes. Consequently, the imperative for aggressive salvage surgery becomes evident in achieving sufficient disease control. This underscores the necessity for proactive management strategies aimed at addressing these factors to enhance patient outcomes.

show abstract

Aggressive Surgical Therapy After Irradiation Failure in Treatment of Cancer of the Oral Tongue

Cited by 12 publications

References 25 publications

Temporal and spatial expression profile of the novelarmadillo-related gene,Alex2, during testicular differentiation in the mouse embryo

Temporal and spatial expression profile of the novelarmadillo-related gene,Alex2, during testicular differentiation in the mouse embryo

Salvage Surgery for Patients With Recurrent Squamous Cell Carcinoma of the Upper Aerodigestive Tract: When Do the Ends Justify the Means?

Oncologic Outcomes of Salvage Surgery in Recurrent Oral Tongue Squamous Cell Carcinoma

Contact Info

Product

Resources

About