Pub Date : 2024-04-05DOI: 10.17650/2222-1468-2023-13-4-19-26
A. . Boyko, A. Karpenko, R. Sibgatullin, O. Nikolaeva, E. O. Levchenko, A. S. Kucherenko, M. A. Karpuschenko
Введение. Эффективность хирургического лечения опухолей околоушной железы определяется частотой развития локального рецидива и функциональными и эстетическими результатами, которые обусловливаются не только анатомической и функциональной сохранностью лицевого нерва. также очень важны нивелирование эстетических деформаций околоушной области и снижение выраженности синдрома Фрея. Цель исследования – ретроспективный анализ применения жировых графтов для устранения дефектов при операциях на околоушных железах. Материалы и методы. В исследование включены 7 пациентов (2 мужчины и 5 женщин), проходивших лечение в ленинградском областном клиническим онкологическом диспансере им. Л. Д. Романа с 2021 по 2022 гг. Средний возраст больных составил 49,7 года (42–64 года), средний срок наблюдения – 20,4 мес (19–22 мес). Всем пациентам выполнены тотальные / субтотальные резекции околоушной железы. Для закрытия дефекта использовали абдоминальный жировой графт. При гистологическом исследовании операционного материала в 5 случаях выявлена плеоморфная аденома околоушной железы, в 2 – злокачественная опухоль (аденокистозная и базальноклеточная карциномы слюнных желез), что потребовало проведения адъювантной лучевой терапии в радикальных дозах. Для оценки эстетических и функциональных результатов в реципиентной и донорских областях был разработан и использован опросник. Результаты. Через 6–8 мес после лечения 5 пациентов заполнили опросник. Полная симметричность лица наблюдалась у 4 больных, среднее углубление – у 1. Три пациента не отметили болевых ощущений в околоушной области. У 2 больных наблюдался незначительный дискомфорт, который не вызывал каких-либо проблем. Только 1 респондент отметил покраснение лица при приеме пищи. Остальные участники анкетирования данных изменений не обнаружили. Никто из респондентов не отметил появления пота на лице при приеме пищи. Заключение. Использование жировых графтов позволяет улучшить эстетические и функциональные результаты лечения у пациентов, которым выполнены операции на околоушных железах. Данная методика довольно проста в применении и не увеличивает значительно время хирургического вмешательства. Жировой графт не затрудняетотслеживание рецидивов заболевания.Перенести в английский вариант Introduction. The effectiveness of surgical treatment of parotid gland tumors is determined by the frequency of local relapse and functional and aesthetic results, which are determined not only by the anatomical and functional safety of the facial nerve. It is also very important to level aesthetic deformities of the parotid region and reduce the severity of frey’s syndrome. Aim. To retrospectively analyze the use of dermal fat grafts to correct defects during operations on the parotid glands. Materials and methods. Our study included 7 patients (2 men and 5 women) who were treated at the Leningrad Regional Clinical Oncology Dispensary named after L. D. Roman from 2021 to 2022. The average age of the patients was 49.7 year
{"title":"The use of derma-fat grafts to eliminate defects during operations on the parotid glands","authors":"A. . Boyko, A. Karpenko, R. Sibgatullin, O. Nikolaeva, E. O. Levchenko, A. S. Kucherenko, M. A. Karpuschenko","doi":"10.17650/2222-1468-2023-13-4-19-26","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-4-19-26","url":null,"abstract":" Введение. Эффективность хирургического лечения опухолей околоушной железы определяется частотой развития локального рецидива и функциональными и эстетическими результатами, которые обусловливаются не только анатомической и функциональной сохранностью лицевого нерва. также очень важны нивелирование эстетических деформаций околоушной области и снижение выраженности синдрома Фрея. Цель исследования – ретроспективный анализ применения жировых графтов для устранения дефектов при операциях на околоушных железах. Материалы и методы. В исследование включены 7 пациентов (2 мужчины и 5 женщин), проходивших лечение в ленинградском областном клиническим онкологическом диспансере им. Л. Д. Романа с 2021 по 2022 гг. Средний возраст больных составил 49,7 года (42–64 года), средний срок наблюдения – 20,4 мес (19–22 мес). Всем пациентам выполнены тотальные / субтотальные резекции околоушной железы. Для закрытия дефекта использовали абдоминальный жировой графт. При гистологическом исследовании операционного материала в 5 случаях выявлена плеоморфная аденома околоушной железы, в 2 – злокачественная опухоль (аденокистозная и базальноклеточная карциномы слюнных желез), что потребовало проведения адъювантной лучевой терапии в радикальных дозах. Для оценки эстетических и функциональных результатов в реципиентной и донорских областях был разработан и использован опросник. Результаты. Через 6–8 мес после лечения 5 пациентов заполнили опросник. Полная симметричность лица наблюдалась у 4 больных, среднее углубление – у 1. Три пациента не отметили болевых ощущений в околоушной области. У 2 больных наблюдался незначительный дискомфорт, который не вызывал каких-либо проблем. Только 1 респондент отметил покраснение лица при приеме пищи. Остальные участники анкетирования данных изменений не обнаружили. Никто из респондентов не отметил появления пота на лице при приеме пищи. Заключение. Использование жировых графтов позволяет улучшить эстетические и функциональные результаты лечения у пациентов, которым выполнены операции на околоушных железах. Данная методика довольно проста в применении и не увеличивает значительно время хирургического вмешательства. Жировой графт не затрудняетотслеживание рецидивов заболевания.Перенести в английский вариант Introduction. The effectiveness of surgical treatment of parotid gland tumors is determined by the frequency of local relapse and functional and aesthetic results, which are determined not only by the anatomical and functional safety of the facial nerve. It is also very important to level aesthetic deformities of the parotid region and reduce the severity of frey’s syndrome. Aim. To retrospectively analyze the use of dermal fat grafts to correct defects during operations on the parotid glands. Materials and methods. Our study included 7 patients (2 men and 5 women) who were treated at the Leningrad Regional Clinical Oncology Dispensary named after L. D. Roman from 2021 to 2022. The average age of the patients was 49.7 year","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"10 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140738200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-05DOI: 10.17650/2222-1468-2023-13-4-10-18
S. Musin, K. Menshikov, A. V. Sultanbayev, I. A. Sharifgaleev, V. V. Ilyin, A. Guz, A. N. Rudyk, S. Osokin, N. Sharafutdinova, A. V. Chashchin, A. Garev, T. R. Baymuratov
Introduction. Surgical intervention remains the main method for treatment of the oral mucosa cancer. The generally accepted standard of the resection boundary that provides optimal local control is 5 mm. Adequate boundaries of indentation and choice of the reconstruction method are important issues facing specialists in head and neck tumors. Aim. To evaluate parameters of the resection edge in the surgical treatment of malignant neoplasms of the oral mucosa depending on the method of eliminating of the post-resection defect and its effect on the frequency of local relapse. Materials and methods. A retrospective analysis included 168 primary patients (50 % men and 50 % women) who received surgical treatment in the head and neck tumor department of the Republican Clinical Oncology Dispensary of the ministry of Health of the Republic of Bashkortostan (ufa) from 2019 to 2023. The median age of patients was 63 years (interquartile range (IQR) 55–69 years). most often, the primary tumor was located in the tongue – in 59.5 % (100/168) of cases. According to the method of post-resection defect removal, the patients were divided into 3 groups. In group 1, reconstruction was performed with local tissues (n = 71), in group 2 – with pedicle flaps (n = 41), and in group 3 – with revascularized flaps (n = 56). The median follow-up period was 18 months (IQR 8–28 months). Results. Resection boundaries in group 1 were 7.0 mm (IQR 5.0–12.5 mm), in group 2 – 6.5 mm (IQR 5–13 mm), and in group 3 – 12.5 mm (IQR 7.5–15.0 mm). The overall frequency of near/positive resection boundaries was 14.8 % (25/168). In group 1, it was 15.5 % (11/71), in group 2 – 19.5 % (8/41), in group 3 – 10.7 % (6/56). According to the analysis, relapse of the disease after radical treatment was noted in 32 % (55/168) of patients, of which 14.8 % (25/168) had a local relapse, 12.5 % (21/168) had a regional relapse, and 5.4 % (9/168) developed distant metastases. The frequency of local relapse in group 1 was 18.3 % (13/71), in group 2 – 23.8 % (10/41), in group 3 – 5.5 % (3/56). According to the analysis data, statistically significant differences in the boundary of indentation in the groups were revealed depending on the reconstruction method (p = 0.005). Conclusion. Based on the results of the present retrospective analysis, the choice of reconstruction method affects the resection boundary in real clinical practice. Limitations in the surgical indentation that surgeon faces when choosing a method for eliminating a post-resection defect are demonstrated.
{"title":"Comparative analysis of resection boundaries depending on the defect elimination method in oral mucosal cancer","authors":"S. Musin, K. Menshikov, A. V. Sultanbayev, I. A. Sharifgaleev, V. V. Ilyin, A. Guz, A. N. Rudyk, S. Osokin, N. Sharafutdinova, A. V. Chashchin, A. Garev, T. R. Baymuratov","doi":"10.17650/2222-1468-2023-13-4-10-18","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-4-10-18","url":null,"abstract":" Introduction. Surgical intervention remains the main method for treatment of the oral mucosa cancer. The generally accepted standard of the resection boundary that provides optimal local control is 5 mm. Adequate boundaries of indentation and choice of the reconstruction method are important issues facing specialists in head and neck tumors. Aim. To evaluate parameters of the resection edge in the surgical treatment of malignant neoplasms of the oral mucosa depending on the method of eliminating of the post-resection defect and its effect on the frequency of local relapse. Materials and methods. A retrospective analysis included 168 primary patients (50 % men and 50 % women) who received surgical treatment in the head and neck tumor department of the Republican Clinical Oncology Dispensary of the ministry of Health of the Republic of Bashkortostan (ufa) from 2019 to 2023. The median age of patients was 63 years (interquartile range (IQR) 55–69 years). most often, the primary tumor was located in the tongue – in 59.5 % (100/168) of cases. According to the method of post-resection defect removal, the patients were divided into 3 groups. In group 1, reconstruction was performed with local tissues (n = 71), in group 2 – with pedicle flaps (n = 41), and in group 3 – with revascularized flaps (n = 56). The median follow-up period was 18 months (IQR 8–28 months). Results. Resection boundaries in group 1 were 7.0 mm (IQR 5.0–12.5 mm), in group 2 – 6.5 mm (IQR 5–13 mm), and in group 3 – 12.5 mm (IQR 7.5–15.0 mm). The overall frequency of near/positive resection boundaries was 14.8 % (25/168). In group 1, it was 15.5 % (11/71), in group 2 – 19.5 % (8/41), in group 3 – 10.7 % (6/56). According to the analysis, relapse of the disease after radical treatment was noted in 32 % (55/168) of patients, of which 14.8 % (25/168) had a local relapse, 12.5 % (21/168) had a regional relapse, and 5.4 % (9/168) developed distant metastases. The frequency of local relapse in group 1 was 18.3 % (13/71), in group 2 – 23.8 % (10/41), in group 3 – 5.5 % (3/56). According to the analysis data, statistically significant differences in the boundary of indentation in the groups were revealed depending on the reconstruction method (p = 0.005). Conclusion. Based on the results of the present retrospective analysis, the choice of reconstruction method affects the resection boundary in real clinical practice. Limitations in the surgical indentation that surgeon faces when choosing a method for eliminating a post-resection defect are demonstrated.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140739297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-05DOI: 10.17650/2222-1468-2023-13-4-27-36
G. F. Allakhverdieva, E. Dronova, T. Danzanova, A. F. Bacev, M. Pak, F. Kamolova
Aim. To evaluate the capabilities of ultrasound using various approaches in determining the depth of invasion of squamous cell carcinoma of the oral cavity and to compare the results obtained with data obtained by the use of other diagnostic methods. Materials and methods. In our reserch, ultrasonography was performed on 193 patients with primary malignant tumors of the mobile part of the tongue, floor of the oral cavity and tumors of rare locations (mucous membranes of the lip, cheek, alveolar processes). The age of the patients ranged from 15 to 85 years. In all patients, tumors were squamous cell carcinoma. ultrasound was performed using submandibular, intraoral and transbuccal approaches. ultrasonic data were compared with the results of pathomorphological examination, as well as of X-ray computed tomography and of magnetic resonance imaging with contrast. Results. A statistically significantly high correlation was obtained for all ultrasound approaches (submandibular, intraoral and transbuccal) with the depth of invasion of the oral tumor determined pathomorphologically (r = 0.78; r = 0.89; r = 0.93; p <0.001). Ultrasound using all approaches shows statistically significantly better results in determining the thickness of tumorsof the tongue and mouth floor in comparison with X-ray computed tomography and magnetic resonance imaging (p <0.001). All diagnostic methods are characterized by an overestimation of the tumor invasion depth (overdiagnosis) as compared with pathomorphological examination. for exophytic tumors and oral cavity tumors of mixed growth with an exophytic component, the depth of invasion was less than the tumor thickness. Conclusion. Ultrasound is an accessible, easily reproducible, radiation-free method, the resolution of which makes it possible to accurately determine not only the depth of invasion of oral tumors, but also the distance from the tumor to the midline of the tongue, that represents an important information when choosing the extent of surgical intervention.
{"title":"Ultrasound diagnostics: assessment of tumor thickness and depth of invasion in squamous cell carcinoma of the oral cavity","authors":"G. F. Allakhverdieva, E. Dronova, T. Danzanova, A. F. Bacev, M. Pak, F. Kamolova","doi":"10.17650/2222-1468-2023-13-4-27-36","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-4-27-36","url":null,"abstract":" Aim. To evaluate the capabilities of ultrasound using various approaches in determining the depth of invasion of squamous cell carcinoma of the oral cavity and to compare the results obtained with data obtained by the use of other diagnostic methods. Materials and methods. In our reserch, ultrasonography was performed on 193 patients with primary malignant tumors of the mobile part of the tongue, floor of the oral cavity and tumors of rare locations (mucous membranes of the lip, cheek, alveolar processes). The age of the patients ranged from 15 to 85 years. In all patients, tumors were squamous cell carcinoma. ultrasound was performed using submandibular, intraoral and transbuccal approaches. ultrasonic data were compared with the results of pathomorphological examination, as well as of X-ray computed tomography and of magnetic resonance imaging with contrast. Results. A statistically significantly high correlation was obtained for all ultrasound approaches (submandibular, intraoral and transbuccal) with the depth of invasion of the oral tumor determined pathomorphologically (r = 0.78; r = 0.89; r = 0.93; p <0.001). Ultrasound using all approaches shows statistically significantly better results in determining the thickness of tumorsof the tongue and mouth floor in comparison with X-ray computed tomography and magnetic resonance imaging (p <0.001). All diagnostic methods are characterized by an overestimation of the tumor invasion depth (overdiagnosis) as compared with pathomorphological examination. for exophytic tumors and oral cavity tumors of mixed growth with an exophytic component, the depth of invasion was less than the tumor thickness. Conclusion. Ultrasound is an accessible, easily reproducible, radiation-free method, the resolution of which makes it possible to accurately determine not only the depth of invasion of oral tumors, but also the distance from the tumor to the midline of the tongue, that represents an important information when choosing the extent of surgical intervention.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"36 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140737638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-11DOI: 10.17650/2222-1468-2023-13-3-43-50
G. R. Abuzarova, R. R. Sarmanaeva, G. S. Alekseeva, S. V. Kuznetsov, A. Gevorkov, N. A. Fedorenko, D. A. Zaretskaya
In patients with head and neck tumors severe pain is more common than in patients with malignant neoplasms of other locations. At a third of patients, pain is the first characteristic of the disease, and after diagnosis, one half of the patients are already having pain syndrome. Аntitumor treatment often not only bring relief, but can intensify pain, which can reduce wish to treated. Part of cancer survivor continue to experience. Thus, orofacial pain syndrome should be share depending on the mechanism of appearence and tactics of treatment on three periods: pain at the stage of diagnosis, then pain syndrome in process antitumor therapy and pain in remission. It is actually if it necessary to prescribe opioid analgesics, especially for a long time. Intensity of orofacial pain syndrome is usually strong and often need to prescribe opioid analgesics. Option to opioid analgesics may be a representative of a new group of analgetics – peptide analgesics – tafalgin. The mechanism of action is due to highly selective agonism to the m1-opioid receptors. The presented clinical example demonstrates the good analgesic effect of tafalgin and the possibility use as option to analgesics of the second stage of pain management.
{"title":"Orofacial pain in oncology: use of a new analgesic peptide tafalgin","authors":"G. R. Abuzarova, R. R. Sarmanaeva, G. S. Alekseeva, S. V. Kuznetsov, A. Gevorkov, N. A. Fedorenko, D. A. Zaretskaya","doi":"10.17650/2222-1468-2023-13-3-43-50","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-3-43-50","url":null,"abstract":"In patients with head and neck tumors severe pain is more common than in patients with malignant neoplasms of other locations. At a third of patients, pain is the first characteristic of the disease, and after diagnosis, one half of the patients are already having pain syndrome. Аntitumor treatment often not only bring relief, but can intensify pain, which can reduce wish to treated. Part of cancer survivor continue to experience. Thus, orofacial pain syndrome should be share depending on the mechanism of appearence and tactics of treatment on three periods: pain at the stage of diagnosis, then pain syndrome in process antitumor therapy and pain in remission. It is actually if it necessary to prescribe opioid analgesics, especially for a long time. Intensity of orofacial pain syndrome is usually strong and often need to prescribe opioid analgesics. Option to opioid analgesics may be a representative of a new group of analgetics – peptide analgesics – tafalgin. The mechanism of action is due to highly selective agonism to the m1-opioid receptors. The presented clinical example demonstrates the good analgesic effect of tafalgin and the possibility use as option to analgesics of the second stage of pain management.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"15 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138978853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-11DOI: 10.17650/2222-1468-2023-13-3-106-110
A. Editorial
.
.
{"title":"Resolution of the expert council on the question of strategy of tyrosine kinase inhibitor therapy initiation in differentiated thyroid cancer","authors":"A. Editorial","doi":"10.17650/2222-1468-2023-13-3-106-110","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-3-106-110","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"4 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138980323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-11DOI: 10.17650/2222-1468-2023-13-3-51-62
P. V. Nikitin, A. Belyaev, G. R. Musina, G. Kobyakov, I. N. Pronin, D. Usachev
Introduction. Malignant brain tumors, such as anaplastic astrocytomas and anaplastic oligodendrogliomas grade 3, are characterized by high aggressiveness and pose a serious clinical problem. This study focuses on assessing intratumoral heterogeneity in anaplastic astrocytomas and anaplastic oligodendrogliomas and its impact on disease prognosis.Aim. To study characteristics of intratumoral heterogeneity, in particular such morphological criteria as necrosis, vascular proliferation, mitoses, and mutations in the most significant for glioma progression genes in the groups of grade III astrocytomas and oligodendrogliomas, as well as analysis of prognostic significance of these parameters.Materials and methods. The study included 389 patients with IDH-mutant astrocytomas and 200 patients with oligodendrogliomas. The mean Ki-67 labeling index of astrocytomas was 12.78 %, while that of oligodendrogliomas was 8.54 %.Results. The presence of vascular proliferation, necrosis, of more than 20 % of the area of the specimen occupied by sarcomatous-like areas and the number of mitoses significantly affected not only disease-free survival but also overall survival of patients. In the clinical setting, mutations in the TERT promoter gene, amplification and mutation of the EGFR gene, deletion of the CDKN2A gene, and TP53 gene had a significant negative impact on recurrence-free and overall survival.Conclusion. The results of single-cell RNA sequencing showed additional factors, including sarcomatous-like areas, as well as TERT, EGFR, CDKN2A and TP53 mutations, in the progression of the tumors under consideration and in ensuring an increase in their malignant potential.
{"title":"Intra-tumoral molecular heterogeneity of grade 3 astrocytomas and oligodendrogliomas and its significance in disease prognosis","authors":"P. V. Nikitin, A. Belyaev, G. R. Musina, G. Kobyakov, I. N. Pronin, D. Usachev","doi":"10.17650/2222-1468-2023-13-3-51-62","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-3-51-62","url":null,"abstract":"Introduction. Malignant brain tumors, such as anaplastic astrocytomas and anaplastic oligodendrogliomas grade 3, are characterized by high aggressiveness and pose a serious clinical problem. This study focuses on assessing intratumoral heterogeneity in anaplastic astrocytomas and anaplastic oligodendrogliomas and its impact on disease prognosis.Aim. To study characteristics of intratumoral heterogeneity, in particular such morphological criteria as necrosis, vascular proliferation, mitoses, and mutations in the most significant for glioma progression genes in the groups of grade III astrocytomas and oligodendrogliomas, as well as analysis of prognostic significance of these parameters.Materials and methods. The study included 389 patients with IDH-mutant astrocytomas and 200 patients with oligodendrogliomas. The mean Ki-67 labeling index of astrocytomas was 12.78 %, while that of oligodendrogliomas was 8.54 %.Results. The presence of vascular proliferation, necrosis, of more than 20 % of the area of the specimen occupied by sarcomatous-like areas and the number of mitoses significantly affected not only disease-free survival but also overall survival of patients. In the clinical setting, mutations in the TERT promoter gene, amplification and mutation of the EGFR gene, deletion of the CDKN2A gene, and TP53 gene had a significant negative impact on recurrence-free and overall survival.Conclusion. The results of single-cell RNA sequencing showed additional factors, including sarcomatous-like areas, as well as TERT, EGFR, CDKN2A and TP53 mutations, in the progression of the tumors under consideration and in ensuring an increase in their malignant potential.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"17 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138980178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-11DOI: 10.17650/2222-1468-2023-13-3-72-81
D. Y. Azovskaya, D. Kulbakin, E. Choynzonov, D. N. Vasiliev
Introduction. The main treatment option for malignant neoplasms of the head and neck is combined. However, survival rates are still relatively unchanged. The surgical stage of treatment leads to extensive defects that are eliminated through reconstructive technologies. Despite the priority of performing reconstruction at the same time, delayed reconstructions are still being discussed 6–12 months after surgical treatment; therefore, it is necessary to develop new methodological and practical approaches.Aim. To determine the features of the delayed reconstructive-plastic stage in patients with malignant tumors maxillofacial region, evaluation of possible solutions for optimizing the stage.Material and methods. The analysis of available literature sources was taken in the database Medline, Pubmed, eLibrary, etc. The 101 studies were found, 60 were used to write a systematic review.Results. Delayed reconstructive plastic surgery should take into the possibility more complex and larger defects of soft and bone tissues during the reconstructive stage, previous surgery and/or radiation therapy create significant difficulties for the identification of recipient vessels. Computer-aided design (CAD)/computer-aided manufacturing (CAM) technologies allow projecting the design and positioning of reconstructive material at the preoperative stage. Mandibular reconstruction is the most difficult, that isn’t achieve only an aesthetic result, but also to restore the biomechanics of the temporomandibular joint. The development of specific complications hinders the improvement of the patient’s quality of life. In the early postoperative period is may develop necrosis of the flap, thrombosis of vascular pedicle, hematoma; in the late postoperative period plate extrusion is still one of the common complications, planning delayed reconstruction an important aspect is prevention or treatment of osteoradionecrosis. The combination of precarbohydrate loading and dalargin will allow to reduce the frequency of perioperative complications and improve the long-term results of surgical treatment.Conclusion. Reconstructive treatment in patients with defects requiring postponed reconstructive surgeries is a complex problem which requires development of an integrated approach with detailed analysis of the existing defect and previous antitumor therapy.
{"title":"Delayed reconstructive plastic surgery in patients with tumors of the maxillofacial region: literature review","authors":"D. Y. Azovskaya, D. Kulbakin, E. Choynzonov, D. N. Vasiliev","doi":"10.17650/2222-1468-2023-13-3-72-81","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-3-72-81","url":null,"abstract":"Introduction. The main treatment option for malignant neoplasms of the head and neck is combined. However, survival rates are still relatively unchanged. The surgical stage of treatment leads to extensive defects that are eliminated through reconstructive technologies. Despite the priority of performing reconstruction at the same time, delayed reconstructions are still being discussed 6–12 months after surgical treatment; therefore, it is necessary to develop new methodological and practical approaches.Aim. To determine the features of the delayed reconstructive-plastic stage in patients with malignant tumors maxillofacial region, evaluation of possible solutions for optimizing the stage.Material and methods. The analysis of available literature sources was taken in the database Medline, Pubmed, eLibrary, etc. The 101 studies were found, 60 were used to write a systematic review.Results. Delayed reconstructive plastic surgery should take into the possibility more complex and larger defects of soft and bone tissues during the reconstructive stage, previous surgery and/or radiation therapy create significant difficulties for the identification of recipient vessels. Computer-aided design (CAD)/computer-aided manufacturing (CAM) technologies allow projecting the design and positioning of reconstructive material at the preoperative stage. Mandibular reconstruction is the most difficult, that isn’t achieve only an aesthetic result, but also to restore the biomechanics of the temporomandibular joint. The development of specific complications hinders the improvement of the patient’s quality of life. In the early postoperative period is may develop necrosis of the flap, thrombosis of vascular pedicle, hematoma; in the late postoperative period plate extrusion is still one of the common complications, planning delayed reconstruction an important aspect is prevention or treatment of osteoradionecrosis. The combination of precarbohydrate loading and dalargin will allow to reduce the frequency of perioperative complications and improve the long-term results of surgical treatment.Conclusion. Reconstructive treatment in patients with defects requiring postponed reconstructive surgeries is a complex problem which requires development of an integrated approach with detailed analysis of the existing defect and previous antitumor therapy.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138980779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-11DOI: 10.17650/2222-1468-2023-13-3-32-42
Ch. A. Ganina, M. Kropotov, O. A. Saprina, E. V. Kosova, T. A. Aketova, M. T. Isaeva, O. V. Gerasimov
Introduction. The main part among all malignant neoplasms of the oral cavity is tongue cancer, the leading method of treatment of which is surgery. Surgical treatment leads to a violation of such important functions of the language as speech and swallowing, which in turn reduces the quality of life of patients. However, to date, opinions differ on the issue of performing language reconstruction. In addition, there are no clear indications for the use of one or another type of defect replacement, with the help of which it will be possible to achieve the best functional results.Aim. To evaluate the functional results after hemiglossectomy for malignant neoplasms of the tongue, compare various reconstruction strategies (with and without a flap).Materials and methods. The study included 44 patients with tongue cancer with a follow-up period of at least 6 months. Functional results were assessed using a quality of life questionnaire and speech therapy assessment.Results. Patients who underwent tongue reconstruction had higher functional results and the best indicators of quality of life compared to patients who did not undergo reconstruction.Conclusion. Hemiglossectomy leads to impaired speech and swallowing functions and, accordingly, to a decrease in the quality of life. Since performing the reconstruction affects the functional results, it should be properly planned before the operation.
{"title":"Quality of life of patients with tongue cancer after hemiglossectomy","authors":"Ch. A. Ganina, M. Kropotov, O. A. Saprina, E. V. Kosova, T. A. Aketova, M. T. Isaeva, O. V. Gerasimov","doi":"10.17650/2222-1468-2023-13-3-32-42","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-3-32-42","url":null,"abstract":"Introduction. The main part among all malignant neoplasms of the oral cavity is tongue cancer, the leading method of treatment of which is surgery. Surgical treatment leads to a violation of such important functions of the language as speech and swallowing, which in turn reduces the quality of life of patients. However, to date, opinions differ on the issue of performing language reconstruction. In addition, there are no clear indications for the use of one or another type of defect replacement, with the help of which it will be possible to achieve the best functional results.Aim. To evaluate the functional results after hemiglossectomy for malignant neoplasms of the tongue, compare various reconstruction strategies (with and without a flap).Materials and methods. The study included 44 patients with tongue cancer with a follow-up period of at least 6 months. Functional results were assessed using a quality of life questionnaire and speech therapy assessment.Results. Patients who underwent tongue reconstruction had higher functional results and the best indicators of quality of life compared to patients who did not undergo reconstruction.Conclusion. Hemiglossectomy leads to impaired speech and swallowing functions and, accordingly, to a decrease in the quality of life. Since performing the reconstruction affects the functional results, it should be properly planned before the operation.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138981606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-11DOI: 10.17650/2222-1468-2023-13-3-63-71
A. Avanesov, E. Gvozdikova, E. F. Khalil, E. Y. Kandakova, K. Avanesov
Introduction. One of the areas of maintenance therapy in oncology is dental support for patients, the effectiveness of which is currently low. The prevalence of complications of anticancer treatment reaches 100 % of cases. This negatively affects the prognosis of the treatment of an oncological patient and the quality of his life.Aim. To analyze the factors that reduce the effectiveness and efficiency of accompanying dental therapy.Materials and methods. Retrospective analysis of clinical observations of the Department of General and Clinical Dentistry named after V.S. Dmitrieva was carried out on the basis of the Russian Scientific Center of Roentgenoradiology.Results. Factors decreasing the quality and effectiveness of accompanying dental therapy are dental unpreparedness of patients prescribed antitumor treatment, very low level of personal hygiene of the oral cavity, as well as insufficient number of available highly effective techniques for treatment and prevention of radiation injuries.Absence of professionals having skills in dental care for oncological patients at all stages of routing (from diagnosis to rehabilitation after completion of antitumor treatment) is another factor contributing to low effectiveness of accompanying therapy and, in our opinion, the most significant. The current clinical guidelines governing the process of examination and treatment of patients with malignant tumors do not contain detailed instructions for dentists about the techniques, approaches of dental accompaniment, and the necessary medications.Conclusion. Factors that reduce the effectiveness and efficiency of dental accompanying therapy have been identified: the lack of trained dental personnel with the skills to provide care to cancer patients; underestimation of the role of a dentist in solving general clinical problems; lack of a systematic approach to providing accompanying therapy to cancer patients; lack of continuity between the polyclinic link and the stationary.
{"title":"Analysis of some factors reducing the efficiency and effectiveness of dental accompanying therapy in cancer patients","authors":"A. Avanesov, E. Gvozdikova, E. F. Khalil, E. Y. Kandakova, K. Avanesov","doi":"10.17650/2222-1468-2023-13-3-63-71","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-3-63-71","url":null,"abstract":"Introduction. One of the areas of maintenance therapy in oncology is dental support for patients, the effectiveness of which is currently low. The prevalence of complications of anticancer treatment reaches 100 % of cases. This negatively affects the prognosis of the treatment of an oncological patient and the quality of his life.Aim. To analyze the factors that reduce the effectiveness and efficiency of accompanying dental therapy.Materials and methods. Retrospective analysis of clinical observations of the Department of General and Clinical Dentistry named after V.S. Dmitrieva was carried out on the basis of the Russian Scientific Center of Roentgenoradiology.Results. Factors decreasing the quality and effectiveness of accompanying dental therapy are dental unpreparedness of patients prescribed antitumor treatment, very low level of personal hygiene of the oral cavity, as well as insufficient number of available highly effective techniques for treatment and prevention of radiation injuries.Absence of professionals having skills in dental care for oncological patients at all stages of routing (from diagnosis to rehabilitation after completion of antitumor treatment) is another factor contributing to low effectiveness of accompanying therapy and, in our opinion, the most significant. The current clinical guidelines governing the process of examination and treatment of patients with malignant tumors do not contain detailed instructions for dentists about the techniques, approaches of dental accompaniment, and the necessary medications.Conclusion. Factors that reduce the effectiveness and efficiency of dental accompanying therapy have been identified: the lack of trained dental personnel with the skills to provide care to cancer patients; underestimation of the role of a dentist in solving general clinical problems; lack of a systematic approach to providing accompanying therapy to cancer patients; lack of continuity between the polyclinic link and the stationary.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"21 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138978989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-11DOI: 10.17650/2222-1468-2023-13-3-98-105
N. A. Ognerubov, A. O. Khizhnyak, М. A. Ognerubova, R. S. Sergeev, L. V. Polyakova
Introduction. Malignant tumors of the salivary glands account for 3–5 % of all cases of head and neck cancer. Squamous cell carcinoma is the rarest histological variant of this pathology. It accounts for an average of 1.6 %. Among large salivary gland tumors, squamous cell carcinoma most often occurs in the parotid salivary gland.Aim. To present a clinical case of primary disseminated cancer of the parotid salivary gland with squamous cell structure.Clinical observation. A 70-year-old patient was under observation who was diagnosed with a primary squamous cell tumor of the parotid salivary gland with multiple metastases during a complex examination. He was sick for about 6 months when asymmetry of left half of the face appeared due to a painful neoplasm in the parotid salivary gland. Recently, the patient has noted increased tumor growth. Objective examination revealed peripheral paralysis of the facial nerve on the left. In the parotid-masticatory region on the left, with a transition to the zygomatic region, there is a dense painful immobile exophytic tumor with infiltration into soft tissues of the face and skin 6.5 × 5.0 cm in size with an ulcer in the center. Laterally, it reaches the tragus, and at the bottom-the angle of the lower jaw. In the submandibular region on the left, metastatic lymph nodes 2.5 × 2.0 cm in size are palpated. A biopsy was collected. Histological conclusion: non-keratinizing squamous cell carcinoma. Expression of the programmed death receptor ligand (PD-L1) in the tumor is negative. Mutations of genes Her2-neu and BRAF were not detected. According to medical imaging methods, multiple metastases were found in the lungs, liver, zygomatic bone and tumor growth in the maxillary sinus on the left. The diagnosis was established: cancer of the parotid salivary gland, stage IVC, cT4N1M1, with metastases to the liver, lungs and bones. Polychemotherapy was prescribed according to the scheme: 5-fluorouracil + cisplatin + cetuximab + bisphosphonates. After 3 cycles, a partial regression is obtained.Conclusion. The primary squamous cell carcinoma is prone to an aggressive course and has an unfavorable prognosis, especially in patients over 60 years of age with skin and facial nerve damage, as well as the presence of regional and distant metastases. Differential diagnosis is necessary to exclude the secondary nature of the tumor. The presented case is a rare example of primary squamous cell carcinoma of the parotid salivary gland with extensive metastatic lesion and regression of the pathological process after polychemotherapy in combination with targeted therapy.
{"title":"Primary squamous cell carcinoma of the parotid salivary gland: a clinical observation","authors":"N. A. Ognerubov, A. O. Khizhnyak, М. A. Ognerubova, R. S. Sergeev, L. V. Polyakova","doi":"10.17650/2222-1468-2023-13-3-98-105","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-3-98-105","url":null,"abstract":"Introduction. Malignant tumors of the salivary glands account for 3–5 % of all cases of head and neck cancer. Squamous cell carcinoma is the rarest histological variant of this pathology. It accounts for an average of 1.6 %. Among large salivary gland tumors, squamous cell carcinoma most often occurs in the parotid salivary gland.Aim. To present a clinical case of primary disseminated cancer of the parotid salivary gland with squamous cell structure.Clinical observation. A 70-year-old patient was under observation who was diagnosed with a primary squamous cell tumor of the parotid salivary gland with multiple metastases during a complex examination. He was sick for about 6 months when asymmetry of left half of the face appeared due to a painful neoplasm in the parotid salivary gland. Recently, the patient has noted increased tumor growth. Objective examination revealed peripheral paralysis of the facial nerve on the left. In the parotid-masticatory region on the left, with a transition to the zygomatic region, there is a dense painful immobile exophytic tumor with infiltration into soft tissues of the face and skin 6.5 × 5.0 cm in size with an ulcer in the center. Laterally, it reaches the tragus, and at the bottom-the angle of the lower jaw. In the submandibular region on the left, metastatic lymph nodes 2.5 × 2.0 cm in size are palpated. A biopsy was collected. Histological conclusion: non-keratinizing squamous cell carcinoma. Expression of the programmed death receptor ligand (PD-L1) in the tumor is negative. Mutations of genes Her2-neu and BRAF were not detected. According to medical imaging methods, multiple metastases were found in the lungs, liver, zygomatic bone and tumor growth in the maxillary sinus on the left. The diagnosis was established: cancer of the parotid salivary gland, stage IVC, cT4N1M1, with metastases to the liver, lungs and bones. Polychemotherapy was prescribed according to the scheme: 5-fluorouracil + cisplatin + cetuximab + bisphosphonates. After 3 cycles, a partial regression is obtained.Conclusion. The primary squamous cell carcinoma is prone to an aggressive course and has an unfavorable prognosis, especially in patients over 60 years of age with skin and facial nerve damage, as well as the presence of regional and distant metastases. Differential diagnosis is necessary to exclude the secondary nature of the tumor. The presented case is a rare example of primary squamous cell carcinoma of the parotid salivary gland with extensive metastatic lesion and regression of the pathological process after polychemotherapy in combination with targeted therapy.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138982106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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