Parastomal Recurrence: A Therapeutic Challenge

Ferlito, Alfio; Silver, Carl E.; Rinaldo, Alessandra; Kim, Helen; Shaha, Ashok R.

doi:10.1080/00016480252814270

Cited by 5 publications

(5 citation statements)

References 61 publications

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“…The incidence of post-TL PSR reported has been variable, and it has been proposed that these differences are because of the variety of diagnostic criteria applied by each group of clinicians to retrospective clinical data. There has been a plethora of synonyms used to describe PSR, including tracheal metastasis, peritracheal recurrence, tracheal recurrence, stomal recurrence, persistent para-tracheostomal tumor, and tracheostomal metastasis [1]. Over time the clinical cases expanded to include different entities, from crusting or granulation, ulcer or plaque, at the stomal perimetry epithelium alone, to the inclusion of peristomal soft tissue swelling or masses or both [23].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…PSR rate was reported highest in African countries, followed by American, Asian, and European institutions [3]. The majority of cases are histologically SCC, though other varieties of laryngo-hypopharyngeal cancers have been reported [1]. The majority of PSR present within 2 years, however some cases have reported after 5 or more years, suggesting that long-term follow-up or patient education to recognize early possible signs of PSR is to be recommended [4]…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Peristomal recurrence (PSR) following total laryngectomy (TL) for squamous cell carcinoma (SCC) of the laryngo-hypopharynx has been reported widely since the early 1950s [1,2]. The incidence of PSR reported between 1952 and 2002 ranged from 1.7% to 25% [1]. A systematic review and meta-analysis of research studies published between 1967 and 2016 estimates the PSR rate to be 6.6% (95% confidence interval [CI], 5.40-7.90) [3].…”

Section: Introductionmentioning

confidence: 99%

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Peristomal recurrence following primary total laryngectomy: the enigma of the central compartment neck lymph nodes

Bradley¹

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewThe practice of primary total laryngectomy (TL) for advanced laryngo-hypopharyngeal cancer has significantly declined in the developed countries. The treatment options most frequently adopted have changed from open surgery to transoral laser or robotic approaches or nonsurgical (bio-chemo-) radiotherapy. Primary TL remains the treatment of choice in the developing world where healthcare resources are limited, especially for the treatment of cancer. Recent findingsPeristomal recurrence (PSR) is quite a serious complication, with an incidence of 6.6% from the published literature (mainly concerning the developed world), most diagnosed within 2 years, and associated with >80% mortality. The major risk factors include pretreatment tracheostomy, specific primary tumor subsites, positive surgical margins, and presence of nodal metastasis. The treatment options are limited and most success has been observed with surgery, especially when PSR is diagnosed at an early-stage, which is uncommon. Treatment of advanced-stage disease is usually palliative. Reduction and/or prevention of the known risk factors for PSR remain the goal when performing TL. In particular, central compartment (paraand pretracheal) lymph nodes dissection in case of large tumors with extra-laryngeal and/or subglottic extension or pretreatment tracheotomy plays a paramount role in PSR prevention. SummaryResearch is required to conclude the formulation of guidelines for proper dissection of the central compartment (level VI) lymph nodes as indicated either prophylactically or therapeutically during TL for preventing PSR.

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Section: Clinical Presentationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Peristomal recurrence following primary total laryngectomy: the enigma of the central compartment neck lymph nodes

Bradley¹

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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“…These lymph nodes are also considered to be an important etiological factor in patients suffering from parastomal recurrence (41). The understanding of the behavior of these lymph nodes in the paratracheal region and superior mediastinum is essential for modifying radiation portals in patients with cancer of the larynx and hypopharynx , as well as those who are at high risk of parastomal recurrence.…”

mentioning

confidence: 99%