Revision of classification of laryngeal cancer, is it long overdue?

Kleinsasser, O

doi:10.1017/s0022215100119073

Cited by 41 publications

(20 citation statements)

References 19 publications

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“…In contrast, cause-specific survival rates for all T-categories investigated in our study show very high disease-specific survival rates, leaving little opportunity for further improvement in final outcome: Only 3 patients in our overall series of 285 patients followed for 1-11 years died of causes related to laryngeal carcinoma. Since T1 and T2 glottic carcinomas seem to bear a largely identical prognosis, we believe that there is a need for a revised T-classification for these tumors [10,13].…”

Section: Discussionmentioning

confidence: 99%

Transoral laser surgery for early glottic carcinoma

Eckel¹,

Thumfart

Jungehülsing³

et al. 2000

European Archives of Oto-Rhino-Laryngology

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This prospective study evaluates the oncological results of transoral laser surgery (TLS) for glottic carcinoma categorized Tis, T1 and T2 in a large, unselected group of 285 consecutive patients from a university-based referral center that uses transoral laser surgery as the standard approach to these tumors. Patients were treated between 1 January 1987 and 31 December 1996. Thirty-three patients had Tis disease, 174 T1 tumors and 113 T2. Main outcome measures were local control with initial therapy, ultimate local control, regional control, organ preservation, overall survival and cause-specific survival. The 5-year uncorrected actuarial survival for all 285 patients was 71.1%, and cause-specific actuarial survival was 98.7%. Local control with initial treatment was 85.9%, ultimate local control with salvage for local treatment failures 98.5%, and regional control 98.4%. In all, 94.3% had their larynges preserved after 5 years. Although favorable oncological results for early laryngeal carcinoma treated with laser surgery are supported this study, no definitive recommendations can be given for the best single treatment. Partial laryngectomies lead to the highest local control rates reported so far, radiotherapy is believed to preserve voice best and laser surgery is associated with time- and cost-effectiveness, low morbidity, fair local control rates and excellent re-treatment options in case of local failure. All specialists dealing with the treatment of early glottic carcinoma should be able to offer these different treatment modalities to their patients and to deal specifically with each patient's individual needs and preferences.

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Section: Discussionmentioning

confidence: 99%

Transoral laser surgery for early glottic carcinoma

Eckel¹,

Thumfart

Jungehülsing³

et al. 2000

European Archives of Oto-Rhino-Laryngology

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“…Hence, to predict the biology of the tumor and the course of the disease in individual patient is importance for appropriate therapy and patient surveillance. The evaluation of a SSCC patient’s prognosis and predictive markers is primarily based on the clinical tumor-node-metastasis (TNM) staging [3]. However, patients with SSCC with similar clinical stage classifications usually have different clinical outcomes, suggesting that TNM staging is not sufficient for precisely determining a SSCC prognosis.…”

Section: Introductionmentioning

confidence: 99%

Tumorigenesis role and clinical significance of DJ-1, a negative regulator of PTEN, in supraglottic squamous cell carcinoma

Zhu

Wang

Lei

et al. 2012

J Exp Clin Cancer Res

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BackgroundDJ-1 can induce the tumor cell proliferation and invasion via down-regulating PTEN in many malignant tumors, and correlated to prognostic significance. However, the tumorigenesis role and clinical significance of DJ-1 in supraglottic squamous cell carcinoma (SSCC) is unclear. We aimed to evaluate the DJ-1 the relationship between DJ-1 and clinicopathological data including patient survival.MethodsThe expression of DJ-1 and PTEN in SSCCs (52) and adjacent non-cancerous tissues (42) was assessed by immunohistochemistry (IHC), and the relationship between DJ-1 and clinicopathological data was analyzed.ResultsDJ-1 was detected mainly in SSCCs (88.5%) and less frequently in adjacent non-cancerous tissues (21.0%). PTEN expression was detected in 46.2% of SSCCs and in 90.5% of adjacent non-cancerous tissues. DJ-1 expression was linked to nodal status (P = 0.009), a highly significant association of DJ-1 expression with shortened patient overall survival (5-year survival rate 88.0% versus 53.9%; P = 0.007; log rank test) was demonstrated.ConclusionsOur data suggested that DJ-1 over-expression was linked to nodal status, and might be an independent prognostic marker for patients with SSCC.

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“…In so doing, Friedrich and Kainz [5] were the first to investigate fresh sliced larynges for morphometry. There has been some discussion in recent years concerning a revision of the TNM system by adding morphometric data of tumor size [13]. Whole-organ sections of laryngeal tumor specimens should be an ideal method for supplying valuable information for the development of such a revised classification.…”

Section: Discussionmentioning

confidence: 99%

Plastination of the larynx for whole-organ sectioning

Sittel

Eckel

Sprinzl

et al. 1997

Eur Arch Otorhinolaryngol

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Whole-organ sectioning is an important technique for the assessment of laryngeal pathology. Since currently established methods require prior decalcification which causes morphological changes, the critical border area between cartilage and surrounding soft tissue cannot be investigated in the same specimen and morphometric studies are not possible. Plastination is a laboratory technique that has previously demonstrated its capacity to overcome these shortcomings. In so doing water and lipids are replaced by curable polymer within the laryngeal cells making decalcification unnecessary. In the present study, more than 50 human larynges were processed using block plastination (BP) and sheet plastination (SP). For BP the complete organ was plastinated as a whole and then cut into thin serial sections. For SP the fresh organ was sliced first and plastinated in a second step. Findings demonstrated that SP allowed for the production of whole-organ sections within a period of 1 week only. Section thicknesses were as thin as 15 mm using a diamond wire saw and an ultramilling device. Sectioning was possible in both coronary and horizontal planes. Following BP, specimens were cut in an industrial cutting machine to thicknesses of about 0.6 mm. Shrinkage of tissue was less than 10% for both methods. In all, SP was technically superior to routine paraffin histology, although cutting equipment is very expensive and delicate in handling. At present the technique of BP is the method of choice for macromorphometrical investigations on serial sections of the human larynx.

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Revision of classification of laryngeal cancer, is it long overdue?

Cited by 41 publications

References 19 publications

Transoral laser surgery for early glottic carcinoma

Transoral laser surgery for early glottic carcinoma

Tumorigenesis role and clinical significance of DJ-1, a negative regulator of PTEN, in supraglottic squamous cell carcinoma

Plastination of the larynx for whole-organ sectioning

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