Pub Date : 2022-04-11DOI: 10.17650/2222-1468-2022-12-1-65-71
M. R. Savchuk, N. Shved, N. Savelov, I. Plaksa
The study objective – to identify specific morphological criteria characteristic of papillary thyroid cancer with translocations in the NTRK genes.Materials and methods. A retrospective analysis of 130 cases of morphologically confirmed papillary thyroid cancer from the archives of the Moscow City Oncology Hospital No 62, Moscow Healthсare Department was performed. The morphological selection criteria for the immunohistochemical study were: metastatic lesions of the lymph nodes, microcalcifications, extrathyroid spread of the tumor, the presence of a capsule / intratumorous areas of connective tissue, invasion (into the tumor capsule, blood vessels, lymphatic vessels), the presence of intranuclear pseudo-inclusions, the follicle quantity <5 %. Thus, all criteria of thyroid cancer with detected translocation in NTRK genes found in the literature were used. If the tumor met the criteria we performed an immunohistochemistry study with Ventana pan-TRK (EPR17341) Assay antibodies was performed on a BenchMark Ultra immunoassayer. In case of a positive immunohistochemistry reaction, next-generation sequencing on the Illumina HiSeq high-throughput genome-wide sequencing system.Results. Of the 130 cases analyzed, we identified 10 cases of tumor with histological features characteristic of NTRK positive thyroid cancer. In all cases, the disease was characterized by an indolent course, a slow increase in the tumor over a long time. In patient 5, a tumor of the thyroid gland was combined with extra-organ sarcoma of the retroperitoneal space. The sizes of the tumor node varied from 0.5 . 0.5 cm to 4.0 . 3.0 cm. All patients had metastases to the lymph nodes, in 3 cases the tumor grew beyond the thyroid capsule. According to the results of an immunohistochemical study with antibodies to NTRK (out of 10 applicants) mutation was detected in 1 case. Cytoplasmic expression of varying severity was observed in 95 % of tumor cells. TPM3‑NTRK1 translocation was confirmed by next-generation sequencing.Conclusion. The presented study demonstrates the possibility of using morphological criteria for detecting thyroid tumors with mutations in the NTRK genes. In the case of a larger sample, it will be possible to identify the structural features of tumors with NTRK mutations. This will clarify morphological criteria and increase the probability of detecting a mutation, which is essential when choosing treatment methods (prescribing targeted therapy).
{"title":"Papillary thyroid cancer with translocation in the TPM3‑NTRK1 gene","authors":"M. R. Savchuk, N. Shved, N. Savelov, I. Plaksa","doi":"10.17650/2222-1468-2022-12-1-65-71","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-65-71","url":null,"abstract":"The study objective – to identify specific morphological criteria characteristic of papillary thyroid cancer with translocations in the NTRK genes.Materials and methods. A retrospective analysis of 130 cases of morphologically confirmed papillary thyroid cancer from the archives of the Moscow City Oncology Hospital No 62, Moscow Healthсare Department was performed. The morphological selection criteria for the immunohistochemical study were: metastatic lesions of the lymph nodes, microcalcifications, extrathyroid spread of the tumor, the presence of a capsule / intratumorous areas of connective tissue, invasion (into the tumor capsule, blood vessels, lymphatic vessels), the presence of intranuclear pseudo-inclusions, the follicle quantity <5 %. Thus, all criteria of thyroid cancer with detected translocation in NTRK genes found in the literature were used. If the tumor met the criteria we performed an immunohistochemistry study with Ventana pan-TRK (EPR17341) Assay antibodies was performed on a BenchMark Ultra immunoassayer. In case of a positive immunohistochemistry reaction, next-generation sequencing on the Illumina HiSeq high-throughput genome-wide sequencing system.Results. Of the 130 cases analyzed, we identified 10 cases of tumor with histological features characteristic of NTRK positive thyroid cancer. In all cases, the disease was characterized by an indolent course, a slow increase in the tumor over a long time. In patient 5, a tumor of the thyroid gland was combined with extra-organ sarcoma of the retroperitoneal space. The sizes of the tumor node varied from 0.5 . 0.5 cm to 4.0 . 3.0 cm. All patients had metastases to the lymph nodes, in 3 cases the tumor grew beyond the thyroid capsule. According to the results of an immunohistochemical study with antibodies to NTRK (out of 10 applicants) mutation was detected in 1 case. Cytoplasmic expression of varying severity was observed in 95 % of tumor cells. TPM3‑NTRK1 translocation was confirmed by next-generation sequencing.Conclusion. The presented study demonstrates the possibility of using morphological criteria for detecting thyroid tumors with mutations in the NTRK genes. In the case of a larger sample, it will be possible to identify the structural features of tumors with NTRK mutations. This will clarify morphological criteria and increase the probability of detecting a mutation, which is essential when choosing treatment methods (prescribing targeted therapy).","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90321574","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 : 2022-04-11DOI: 10.17650/2222-1468-2022-12-1-35-52
L. Bolotina, T. V. Ustinova, T. . Dеshkina, P. Golubev, N. N. Lyubavina, A. Fedenko, A. Kaprin
This article discusses current approaches to first-line chemotherapy for non-resectable head and neck squamous cell carcinoma and describes factors affecting the choice of treatment regimen according to the results of randomized clinical trials. We provide a rationale for creating a long-term strategy of chemotherapy in different clinical situations. We also report two cases of concomitant administration of cetuximab and platinum-based therapy as an example of high efficacy of monoclonal antibodies.
{"title":"Rational sequence of monoclonal antibodies in the treatment of non-resectable head and neck squamous cell carcinoma","authors":"L. Bolotina, T. V. Ustinova, T. . Dеshkina, P. Golubev, N. N. Lyubavina, A. Fedenko, A. Kaprin","doi":"10.17650/2222-1468-2022-12-1-35-52","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-35-52","url":null,"abstract":"This article discusses current approaches to first-line chemotherapy for non-resectable head and neck squamous cell carcinoma and describes factors affecting the choice of treatment regimen according to the results of randomized clinical trials. We provide a rationale for creating a long-term strategy of chemotherapy in different clinical situations. We also report two cases of concomitant administration of cetuximab and platinum-based therapy as an example of high efficacy of monoclonal antibodies.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"50 12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77835177","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 : 2022-04-11DOI: 10.17650/2222-1468-2022-12-1-26-34
D. Belov, V. Karakhan, A. Bekyashev, N. V. Sevyan, V. Aleshin, A. Mitrofanov, E. Prozorenko, D. Sashin, N. V. Garanina
Introduction. The surgical stage takes an important place in the complex treatment of patients with cerebral metastases of malignant tumors. In general, all efforts during surgical intervention should be aimed at restoring a good functional status, since severe neurological symptoms can deprive patients of the opportunity to continue complex treatment, which will negatively affect overall survival. The most pronounced neurological symptoms are observed in patients with metastases in the motor area. In this article, we tried to substantiate the need for surgery of cerebral metastases in patients with severe motor deficits, evaluate the results of surgical treatment and also to develop optimal surgical removal techniques.The study object – to assess the effectiveness of surgical removal of metastases in the motor cortex by evaluating the dynamics of motor function recovery and regression of paroxysmal symptoms.Materials and methods. An analysis of the surgical treatment of 18 patients with metastases in the motor area was carried out. Tumor localization was verified using magnetic resonance imaging, before surgery, neuronavigation system Brainlab during surgery. Мagnetic resonance tractography made it possible to assess the localization and degree of compression of the fibers of the cortico-spinal tract. Functional monitoring was not performed during the operation. The operations were performed using a ZEISS OPMI PENTERO 800 microscope.Results. Recovery of motor function after surgery was noted in 17 (94.5 %) cases. It was complete or partial. With metastases of a solid, solid-necrotic, solid-cystic structure, regression of pyramidal symptoms developed gradually, starting from 4 days after surgery. As a rule, rehabilitation therapy (therapeutic exercise, massage, electromyostimulation) is carried out on patients from 3 days after surgery, which accelerated the recovery process. The maximum effect developed on the 15th day after the operation. Faster recovery of motor function was observed in patients with large cystic metastases who underwent surgery in the volume of Ommaya reservoir implantation. They began to recover motor function a few hours after awakening. Regression of paroxysmal symptoms was noted in all cases. Although the patients continued to take anticonvulsants. The observation period was 6 months.Сonclusion. Surgical removal of cerebral metastases in the motor area allows achieving complete or partial regression of neurological symptoms. At the same time, the recovery period is short – from several hours to 14 days. It becomes possible to cancel glucocorticoids 7–10 days after the operation. Conditions are being created for the continuation of complex treatment of patients previously considered incurable.
{"title":"Surgical treatment of patients with cerebral metastases in the motor area","authors":"D. Belov, V. Karakhan, A. Bekyashev, N. V. Sevyan, V. Aleshin, A. Mitrofanov, E. Prozorenko, D. Sashin, N. V. Garanina","doi":"10.17650/2222-1468-2022-12-1-26-34","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-26-34","url":null,"abstract":"Introduction. The surgical stage takes an important place in the complex treatment of patients with cerebral metastases of malignant tumors. In general, all efforts during surgical intervention should be aimed at restoring a good functional status, since severe neurological symptoms can deprive patients of the opportunity to continue complex treatment, which will negatively affect overall survival. The most pronounced neurological symptoms are observed in patients with metastases in the motor area. In this article, we tried to substantiate the need for surgery of cerebral metastases in patients with severe motor deficits, evaluate the results of surgical treatment and also to develop optimal surgical removal techniques.The study object – to assess the effectiveness of surgical removal of metastases in the motor cortex by evaluating the dynamics of motor function recovery and regression of paroxysmal symptoms.Materials and methods. An analysis of the surgical treatment of 18 patients with metastases in the motor area was carried out. Tumor localization was verified using magnetic resonance imaging, before surgery, neuronavigation system Brainlab during surgery. Мagnetic resonance tractography made it possible to assess the localization and degree of compression of the fibers of the cortico-spinal tract. Functional monitoring was not performed during the operation. The operations were performed using a ZEISS OPMI PENTERO 800 microscope.Results. Recovery of motor function after surgery was noted in 17 (94.5 %) cases. It was complete or partial. With metastases of a solid, solid-necrotic, solid-cystic structure, regression of pyramidal symptoms developed gradually, starting from 4 days after surgery. As a rule, rehabilitation therapy (therapeutic exercise, massage, electromyostimulation) is carried out on patients from 3 days after surgery, which accelerated the recovery process. The maximum effect developed on the 15th day after the operation. Faster recovery of motor function was observed in patients with large cystic metastases who underwent surgery in the volume of Ommaya reservoir implantation. They began to recover motor function a few hours after awakening. Regression of paroxysmal symptoms was noted in all cases. Although the patients continued to take anticonvulsants. The observation period was 6 months.Сonclusion. Surgical removal of cerebral metastases in the motor area allows achieving complete or partial regression of neurological symptoms. At the same time, the recovery period is short – from several hours to 14 days. It becomes possible to cancel glucocorticoids 7–10 days after the operation. Conditions are being created for the continuation of complex treatment of patients previously considered incurable.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72882962","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 : 2022-04-11DOI: 10.17650/2222-1468-2022-12-1-72-78
B. G. Pkheshkhova, A. Mudunov, R. I. Azizyan, M. Pak, K. B. Ishchenko
Introduction. The increasing incidence of oropharyngeal squamous cell carcinoma observed globally in recent decades gave rise to research in this area. In 2005, human papillomavirus was proved to be an etiological factor of oropharyngeal squamous cell carcinoma. Currently, oropharyngeal squamous cell carcinoma associated with human papillomavirus is believed to have some unique characteristics. The analysis of oropharyngeal squamous cell carcinoma epidemiology appears to be highly relevant.Objective – to assess the incidence and prevalence of oropharyngeal squamous cell carcinoma associated with human papillomavirus in Russia on the example of a certain sample of patients.Materials and methods. We analyzed medical records of 199 oropharyngeal squamous cell carcinoma patients treated in N. N. Blokhin Russian Cancer Research Center between 2016 and 2021. We analyzed the frequency of tumors associated with human papillomavirus, age, sex, tumor spread and stage depending on р16 status.Results. More than half of the patients from our cohort (58.3 %) were р16‑positive. The peak incidence was observed in individuals aged 45 to 64 years (more than 60 % of cases). Males were twice as likely to have р16‑positive tumors than females. A total of 60.9 % of patients with р16‑positive tumors had stage I disease, whereas 51.2 % of patients with p16‑negative tumors had stage IV disease.Conclusion. The results obtained for a sample of Russian patients are comparable with the findings of foreign authors.
介绍。近几十年来，口咽鳞状细胞癌在全球范围内的发病率不断上升，这引起了对这一领域的研究。2005年，人乳头瘤病毒被证实是口咽鳞状细胞癌的一个病因。目前，口咽鳞状细胞癌与人乳头瘤病毒相关被认为具有一些独特的特征。口咽鳞状细胞癌的流行病学分析似乎是高度相关的。目的:以俄罗斯某患者为例，评估与人乳头瘤病毒相关的口咽鳞状细胞癌的发病率和流行程度。材料和方法。我们分析了2016年至2021年期间在N. N. Blokhin俄罗斯癌症研究中心治疗的199例口咽鳞状细胞癌患者的医疗记录。我们分析了与人乳头瘤病毒、年龄、性别、肿瘤扩散和肿瘤分期相关的肿瘤发生频率。在我们的队列中，超过一半的患者(58.3%)为 16阳性。发病率最高的人群为45 - 64岁(超过60%)。男性患阳性肿瘤的可能性是女性的两倍。60.9%的p16阳性肿瘤患者为I期疾病，而51.2%的p16阴性肿瘤患者为IV期疾病。从俄罗斯患者样本中获得的结果与外国作者的发现相当。
{"title":"Estimation of the prevalence of HPV-positive squamous cell carcinoma of the oropharynx on the example of a separate sample in the Russian Federation","authors":"B. G. Pkheshkhova, A. Mudunov, R. I. Azizyan, M. Pak, K. B. Ishchenko","doi":"10.17650/2222-1468-2022-12-1-72-78","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-72-78","url":null,"abstract":"Introduction. The increasing incidence of oropharyngeal squamous cell carcinoma observed globally in recent decades gave rise to research in this area. In 2005, human papillomavirus was proved to be an etiological factor of oropharyngeal squamous cell carcinoma. Currently, oropharyngeal squamous cell carcinoma associated with human papillomavirus is believed to have some unique characteristics. The analysis of oropharyngeal squamous cell carcinoma epidemiology appears to be highly relevant.Objective – to assess the incidence and prevalence of oropharyngeal squamous cell carcinoma associated with human papillomavirus in Russia on the example of a certain sample of patients.Materials and methods. We analyzed medical records of 199 oropharyngeal squamous cell carcinoma patients treated in N. N. Blokhin Russian Cancer Research Center between 2016 and 2021. We analyzed the frequency of tumors associated with human papillomavirus, age, sex, tumor spread and stage depending on р16 status.Results. More than half of the patients from our cohort (58.3 %) were р16‑positive. The peak incidence was observed in individuals aged 45 to 64 years (more than 60 % of cases). Males were twice as likely to have р16‑positive tumors than females. A total of 60.9 % of patients with р16‑positive tumors had stage I disease, whereas 51.2 % of patients with p16‑negative tumors had stage IV disease.Conclusion. The results obtained for a sample of Russian patients are comparable with the findings of foreign authors.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83829672","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 : 2022-04-11DOI: 10.17650/2222-1468-2022-12-1-79-85
D. E. Mikhalev, O. Baydik, M. Mukhamedov, P. Sysolyatin
Introduction. Nowadays discussed and actual issues of modern oncology are the diagnostics problems and care organization for patients with oral mucosa and lips precancerous diseases.Study purposes – to analyze the prevalence, structure, and primary diagnosis quality of oral mucosa and lips precancerous diseases and to identify the organizing medical care problems for the adult population with the oral cavity precancerous diseases in residents of Tomsk city and Tomsk Region.Materials and methods. For the period 2014–2019 1,664 patients were examined and treated for oral mucosa and lips diseases. The main complaints and medical history were clarified in all patients, according to the recommendations of the World Health Organization, assessed the state of the oral mucosa and lips according to the visual inspection data. To assess the primary diagnosis quality of an oral mucosa disease, we analyzed the data from a dental patient’s medical record, dentist’s referrals, and anamnesis data.Results. In the general oral mucosa and lips pathology structure almost a quarter (25.7 %) of patients were diagnosed with precancerous diseases – leukoplakia (12.5 %), lichen planus (10.8 %), viral papillomas (2.0 %) and Manganotti cheilitis (0.4 %). Malignant neoplasms of the oral cavity at different stages was established in 8.3 % of cases. A retrospective errors analysis revealed that in 100 % of leukoplakia, lichen planus, candidiasis and stomatitis cases the disease form was not indicated. In 22 % cases out of the total number of oral leukoplakia patients, the diagnosis was made mistakenly. In 12 cases of malignant neoplasm underdiagnoses, lichen planus and oral mucosa candidiasis prevailed. In half of the cases of the mistakenly diagnosed oral leukoplakia (10.2 %), oral cavity squamous cell carcinoma was detected. The average waiting time for the oncologist»s appointment was 44.3 ± 10 days.Conclusion. The results indicate a high prevalence of precancerous pathology in the oral mucosa structure diseases(25.7 %) and a long wait for specialized medical care.
{"title":"Prevalence and organization problems of medical care to patients with precanceral oral cavity mucosa diseases (on the Tomsk Region example)","authors":"D. E. Mikhalev, O. Baydik, M. Mukhamedov, P. Sysolyatin","doi":"10.17650/2222-1468-2022-12-1-79-85","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-79-85","url":null,"abstract":"Introduction. Nowadays discussed and actual issues of modern oncology are the diagnostics problems and care organization for patients with oral mucosa and lips precancerous diseases.Study purposes – to analyze the prevalence, structure, and primary diagnosis quality of oral mucosa and lips precancerous diseases and to identify the organizing medical care problems for the adult population with the oral cavity precancerous diseases in residents of Tomsk city and Tomsk Region.Materials and methods. For the period 2014–2019 1,664 patients were examined and treated for oral mucosa and lips diseases. The main complaints and medical history were clarified in all patients, according to the recommendations of the World Health Organization, assessed the state of the oral mucosa and lips according to the visual inspection data. To assess the primary diagnosis quality of an oral mucosa disease, we analyzed the data from a dental patient’s medical record, dentist’s referrals, and anamnesis data.Results. In the general oral mucosa and lips pathology structure almost a quarter (25.7 %) of patients were diagnosed with precancerous diseases – leukoplakia (12.5 %), lichen planus (10.8 %), viral papillomas (2.0 %) and Manganotti cheilitis (0.4 %). Malignant neoplasms of the oral cavity at different stages was established in 8.3 % of cases. A retrospective errors analysis revealed that in 100 % of leukoplakia, lichen planus, candidiasis and stomatitis cases the disease form was not indicated. In 22 % cases out of the total number of oral leukoplakia patients, the diagnosis was made mistakenly. In 12 cases of malignant neoplasm underdiagnoses, lichen planus and oral mucosa candidiasis prevailed. In half of the cases of the mistakenly diagnosed oral leukoplakia (10.2 %), oral cavity squamous cell carcinoma was detected. The average waiting time for the oncologist»s appointment was 44.3 ± 10 days.Conclusion. The results indicate a high prevalence of precancerous pathology in the oral mucosa structure diseases(25.7 %) and a long wait for specialized medical care.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82100139","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 : 2022-04-11DOI: 10.17650/2222-1468-2022-12-1-12-25
A. Mudunov, I. Gelfand, M. Kropotov, A. Akhundov, S. Podvyaznikov, A. S. Vilkova, A. Dubinina, M. Bilik, S. Kaspshik, A. Krylov
Introduction. Oral squamous cell carcinoma is associated with a high risk of regional metastasis even in early stages (T1–2N0M0). Morphological examination reveals concealed metastases in 20 % of removed clinically unaffected lymph nodes.Objective – to evaluate the effectiveness of flow cytometry for detection of concealed metastases in sentinel lymph nodes as an indication for cervical lymph node dissection in patients with stage сT1–2N0M0 oral squamous cell carcinoma.Materials and methods. This study included 27 patients, including 13 patients (48.1 %) with stage T1N0M0 cancer and 14 patients with stage T2N0M0 cancer (51.9 %). At the first stage, all participants underwent primary tumor removal and cervical lymph node dissection with sentinel lymph node examination. After mobilization, half of these lymph nodes was used for routine morphological examination followed by immunohistochemical examination, while the second half of them was analyzed using flow cytometry. Then we compared the results obtained.Results. We examined 46 removed sentinel lymph nodes from 27 patients. Conventional histological examination revealed 4 concealed metastases (8.7 %). Polymerase chain reaction allowed us to detect another 16 metastases (37.8 %). Levels I, II, and III lymph nodes were most frequently affected. Flow cytometry demonstrated that 20 % of patients with a <4 mm invasion had concealed metastases, whereas patients with a 4 to 8 mm invasion had concealed metastases in 60 % of cases. Median follow-up time was 20.4 ± 11.7 months (range: 2.2 to 42.5 months; median 19.5 months). All participants were alive during this time. Seventeen out of 27 patients with stage T1–2N0M0 disease (63 %) were found to have concealed metastases, while the remaining ten patients (37 %) had no metastasis. One patient with stage T1N0M0 oral floor squamous cell carcinoma underwent the removal of the primary tumor and sentinel lymph node. Morphological examination and flow cytometry showed no metastatic lesions. After 14.8 months, the patient developed ipsilateral regional CN3 metastasis. The three-year progression-free survival rate was 94.7 ± 5.1 %.Conclusion. Highly sensible and rapid flow cytometry can become the method of choice in the diagnosis of metastases and deciding on cervical lymph node dissection in patients with cN0 disease. The study is still ongoing.
{"title":"Improved diagnostics of “concealed” metastases in patients with сТ1–2N0М0 oral squamous cell carcinoma","authors":"A. Mudunov, I. Gelfand, M. Kropotov, A. Akhundov, S. Podvyaznikov, A. S. Vilkova, A. Dubinina, M. Bilik, S. Kaspshik, A. Krylov","doi":"10.17650/2222-1468-2022-12-1-12-25","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-12-25","url":null,"abstract":"Introduction. Oral squamous cell carcinoma is associated with a high risk of regional metastasis even in early stages (T1–2N0M0). Morphological examination reveals concealed metastases in 20 % of removed clinically unaffected lymph nodes.Objective – to evaluate the effectiveness of flow cytometry for detection of concealed metastases in sentinel lymph nodes as an indication for cervical lymph node dissection in patients with stage сT1–2N0M0 oral squamous cell carcinoma.Materials and methods. This study included 27 patients, including 13 patients (48.1 %) with stage T1N0M0 cancer and 14 patients with stage T2N0M0 cancer (51.9 %). At the first stage, all participants underwent primary tumor removal and cervical lymph node dissection with sentinel lymph node examination. After mobilization, half of these lymph nodes was used for routine morphological examination followed by immunohistochemical examination, while the second half of them was analyzed using flow cytometry. Then we compared the results obtained.Results. We examined 46 removed sentinel lymph nodes from 27 patients. Conventional histological examination revealed 4 concealed metastases (8.7 %). Polymerase chain reaction allowed us to detect another 16 metastases (37.8 %). Levels I, II, and III lymph nodes were most frequently affected. Flow cytometry demonstrated that 20 % of patients with a <4 mm invasion had concealed metastases, whereas patients with a 4 to 8 mm invasion had concealed metastases in 60 % of cases. Median follow-up time was 20.4 ± 11.7 months (range: 2.2 to 42.5 months; median 19.5 months). All participants were alive during this time. Seventeen out of 27 patients with stage T1–2N0M0 disease (63 %) were found to have concealed metastases, while the remaining ten patients (37 %) had no metastasis. One patient with stage T1N0M0 oral floor squamous cell carcinoma underwent the removal of the primary tumor and sentinel lymph node. Morphological examination and flow cytometry showed no metastatic lesions. After 14.8 months, the patient developed ipsilateral regional CN3 metastasis. The three-year progression-free survival rate was 94.7 ± 5.1 %.Conclusion. Highly sensible and rapid flow cytometry can become the method of choice in the diagnosis of metastases and deciding on cervical lymph node dissection in patients with cN0 disease. The study is still ongoing.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75560296","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 : 2022-04-11DOI: 10.17650/2222-1468-2022-12-1-86-98
M. Brose, Yury Panaseykin, B. Konda, C. de la Fouchardière, B. M. Hughes, A. Gianoukakis, Y. J. Park, I. Romanov, M. Krzyzanowska, S. Leboulleux, T. Binder, C. Dutcus, R. Xie, M. Taylor
Введение. Ленватиниб является мультикиназным ингибитором, одобренным для лечения радиойодрефрактерного дифференцированного рака щитовидной железы (РЙР-ДРЩЖ) в стартовой дозе 24 мг / день. Данное двойное слепое исследование было проведено с целью определения, будет ли использование ленватиниба в стартовой дозе 18 мг / день наряду со снижением токсичности обеспечивать такую же эффективность, как и его применение в дозе 24 мг / день.Методы. Пациенты с РЙР-ДРЩЖ были рандомизированы в 2 группы в соответствии с дозировкой ленватиниба: 24 и 18 мг / день. Первичной конечной точкой эффективности была частота объективного ответа через 24 нед (ЧОО24 нед). Границей эквивалентности было принято значение 0,4. Первичной конечной точкой безопасности была частота тяжелых (III степени тяжести и выше) нежелательных явлений, возникших после начала лечения (НЯП), по состоянию на 24‑ю неделю. Опухоли оценивались с помощью Критериев оценки ответа солидных опухолей, версия 1.1 (Response Evaluation Criteria In Solid Tumors version 1.1, RECIST 1.1). Нежелательные явления, возникшие после начала лечения, тщательно мониторировались и регистрировались.Результаты. Частота объективного ответа через 24 нед в группе применения ленватиниба в дозе 24 мг / сут составила 57,3 % (95 % доверительный интервал (ДИ) 46,1–68,5), в группе применения ленватиниба в дозе 18 мг / сут – 40,3 % (95 % ДИ 29,3–51,2); отношение шансов (18 / 24 мг) 0,50 (95 % ДИ 0,26–0,96). К 24‑й неделе серьезные НЯП, возникшие после начала лечения, были зафиксированы у 61,3 % пациентов в группе применения ленватиниба в дозе 24 мг / сут и у 57,1 % в группе применения ленватиниба в дозе 18 мг / сут. Разница составила –4,2 % (95 % ДИ 19,8–11,4).Заключение. Использование стартовой дозы ленватиниба 18 мг / сут не продемонстрировало эквивалентной эффективности по сравнению с использованием стартовой дозы 24 мг / сут, что подтверждено показателями ЧОО24 нед у пациентов с РЙР-ДРЩЖ. Была выявлена клинически значимая разница в Ч ОО24 нед. Профили безопасности 2 дозировок ленватиниба были сопоставимыми, клинически значимых различий не наблюдалось. Полученные результаты подтверждают оправданность утвержденной стартовой дозы ленватиниба 24 мг / сут у пациентов с РЙР-ДРЩЖ и дальнейшей ее корректировки по мере необходимости.
{"title":"A randomized study to evaluate the safety and efficacy of two dosages of lenvatinib – 18 and 24 mg – in patients with radioiodrefract differentiated thyroid cancer","authors":"M. Brose, Yury Panaseykin, B. Konda, C. de la Fouchardière, B. M. Hughes, A. Gianoukakis, Y. J. Park, I. Romanov, M. Krzyzanowska, S. Leboulleux, T. Binder, C. Dutcus, R. Xie, M. Taylor","doi":"10.17650/2222-1468-2022-12-1-86-98","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-86-98","url":null,"abstract":"Введение. Ленватиниб является мультикиназным ингибитором, одобренным для лечения радиойодрефрактерного дифференцированного рака щитовидной железы (РЙР-ДРЩЖ) в стартовой дозе 24 мг / день. Данное двойное слепое исследование было проведено с целью определения, будет ли использование ленватиниба в стартовой дозе 18 мг / день наряду со снижением токсичности обеспечивать такую же эффективность, как и его применение в дозе 24 мг / день.Методы. Пациенты с РЙР-ДРЩЖ были рандомизированы в 2 группы в соответствии с дозировкой ленватиниба: 24 и 18 мг / день. Первичной конечной точкой эффективности была частота объективного ответа через 24 нед (ЧОО24 нед). Границей эквивалентности было принято значение 0,4. Первичной конечной точкой безопасности была частота тяжелых (III степени тяжести и выше) нежелательных явлений, возникших после начала лечения (НЯП), по состоянию на 24‑ю неделю. Опухоли оценивались с помощью Критериев оценки ответа солидных опухолей, версия 1.1 (Response Evaluation Criteria In Solid Tumors version 1.1, RECIST 1.1). Нежелательные явления, возникшие после начала лечения, тщательно мониторировались и регистрировались.Результаты. Частота объективного ответа через 24 нед в группе применения ленватиниба в дозе 24 мг / сут составила 57,3 % (95 % доверительный интервал (ДИ) 46,1–68,5), в группе применения ленватиниба в дозе 18 мг / сут – 40,3 % (95 % ДИ 29,3–51,2); отношение шансов (18 / 24 мг) 0,50 (95 % ДИ 0,26–0,96). К 24‑й неделе серьезные НЯП, возникшие после начала лечения, были зафиксированы у 61,3 % пациентов в группе применения ленватиниба в дозе 24 мг / сут и у 57,1 % в группе применения ленватиниба в дозе 18 мг / сут. Разница составила –4,2 % (95 % ДИ 19,8–11,4).Заключение. Использование стартовой дозы ленватиниба 18 мг / сут не продемонстрировало эквивалентной эффективности по сравнению с использованием стартовой дозы 24 мг / сут, что подтверждено показателями ЧОО24 нед у пациентов с РЙР-ДРЩЖ. Была выявлена клинически значимая разница в Ч ОО24 нед. Профили безопасности 2 дозировок ленватиниба были сопоставимыми, клинически значимых различий не наблюдалось. Полученные результаты подтверждают оправданность утвержденной стартовой дозы ленватиниба 24 мг / сут у пациентов с РЙР-ДРЩЖ и дальнейшей ее корректировки по мере необходимости.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"123 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77858789","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 : 2022-04-11DOI: 10.17650/2222-1468-2022-12-1-107-113
K. E. Roshchina, A. Bekyashev, D. Naskhletashvili, I. Osinov, A. Savateev, D. A. Khalafyan
According to the literature, metastatic brain damage in kidney cancer occurs in 6.5 % of patients. The introduction of new techniques associated with the use of targeted drugs, immune checkpoint inhibitors and innovative radiation therapy techniques can significantly increase patient survival. Effective drug therapy and local control of brain metastases are of paramount importance for predicting overall survival and quality of life for patients. This literature review summarizes the scientific literature data on the use of local and systemic methods of treatment in patients with metastases of kidney cancer to the brain.
{"title":"Modern strategies for the treatment of patients with kidney cancer of brain metastases: literature review","authors":"K. E. Roshchina, A. Bekyashev, D. Naskhletashvili, I. Osinov, A. Savateev, D. A. Khalafyan","doi":"10.17650/2222-1468-2022-12-1-107-113","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-107-113","url":null,"abstract":"According to the literature, metastatic brain damage in kidney cancer occurs in 6.5 % of patients. The introduction of new techniques associated with the use of targeted drugs, immune checkpoint inhibitors and innovative radiation therapy techniques can significantly increase patient survival. Effective drug therapy and local control of brain metastases are of paramount importance for predicting overall survival and quality of life for patients. This literature review summarizes the scientific literature data on the use of local and systemic methods of treatment in patients with metastases of kidney cancer to the brain.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89013848","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 : 2022-02-14DOI: 10.17650/2222-1468-2021-11-4-64-72
L. Zhuikova, E. Choynzonov, O. Ananina, L. V. Pikalova, I. Odintsova, G. A. Kononova
Introduction. Malignant brain and other central nervous system tumors show a statistically significant increased incidence worldwide (GLOBOCAN, 2018).The study objective – to estimate the incidence of malignant brain and other central nervous system tumors in Siberia and the Russian Far East.Materials and methods. Using data from the population-based cancer registry in Siberia and the Russian Far East, we calculated the cancer incidence rates, the age-standardized incidence rates (ASIR), the index accuracy (the ratio of the number of cancer-related deaths to the number of new cases) of malignant brain and other central nervous system tumors during the period 2010 to 2019.Results. During the period 2010 to 2019, brain and other central nervous system malignances in males were the 14th most common cancers in Siberian and the Russian Far Eastern region, with the incidence of 1.6 % in 2010 and 1.5 % in 2019. In females, brain and other central nervous system malignances were the 16th most common cancers, with the equal incidence of 1.3 % in 2010 and 2020. Overall, the incidence rate of malignant brain and other central nervous system tumors in Siberian and the Russian Far Eastern regions increased from 5.1 to 5.6 per 100 000 with rate of increase of 9.8 %, including the territories of the Republic of Kamchatka (238.5 %), Amur (147.8 %), Khakassia (89.1 %), Irkutsk (65,1 %), Krasnoyarsk (37.8 %), and Primorsky (33.3 %) regions. The incidence rate decreased in the Kemerovo region (34.4 %) and the Trans-Baikal Territory (44.4 %). In women of Siberian and the Russian Far Eastern regions, the incidence rate was slightly increased from 3.7 to 4.0 per 100 000, the overall rate of increase being 8.1 %. The highest incidence rate was registered in the Altai Territory (47.8 %), Novosibirsk region (33.3 %), the Republic of Khakassia (25.0 %), Amur region (246.2 %), but the lowest incidence rate was observed in the Kemerovo region (7.0 %) and the Trans-Baikal Territory (61.1 %).The index accuracy indicated problems with the quality of territorial cancer registries. In males, the reduced the index accuracy was observed in Siberian and the Russian Far Eastern regions as a whole and amounted to 0.81. The index accuracy was also observed in the Krasnoyarsk, Primorsky, Kamchatka, Novosibirsk and Amur regions, as well as in the Republic of Khakassia, whereas the increased index accuracy was observed in the Kemerovo Region, Altai Republic, Khabarovsk and Trans-Baikal Territories. In females, the increased index accuracy was observed Siberian and the Russian Far Eastern regions as a whole, being 0.78 in 2019, and in the Krasnoyarsk, Kamchatka, Tomsk regions, as well as in the Republic of Khakassia. The reduced index accuracy was noted in the Altai, Primorsky Territories and the Amur Region.Conclusion. The problems of registration and monitoring of malignant brain and other central nervous system tumors in Russia does not make it possible to present the true incidence ra
{"title":"Incidence of malignant brain and other central nervous system tumors (С70–C72) in Siberia and the Russian Far East","authors":"L. Zhuikova, E. Choynzonov, O. Ananina, L. V. Pikalova, I. Odintsova, G. A. Kononova","doi":"10.17650/2222-1468-2021-11-4-64-72","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-64-72","url":null,"abstract":"Introduction. Malignant brain and other central nervous system tumors show a statistically significant increased incidence worldwide (GLOBOCAN, 2018).The study objective – to estimate the incidence of malignant brain and other central nervous system tumors in Siberia and the Russian Far East.Materials and methods. Using data from the population-based cancer registry in Siberia and the Russian Far East, we calculated the cancer incidence rates, the age-standardized incidence rates (ASIR), the index accuracy (the ratio of the number of cancer-related deaths to the number of new cases) of malignant brain and other central nervous system tumors during the period 2010 to 2019.Results. During the period 2010 to 2019, brain and other central nervous system malignances in males were the 14th most common cancers in Siberian and the Russian Far Eastern region, with the incidence of 1.6 % in 2010 and 1.5 % in 2019. In females, brain and other central nervous system malignances were the 16th most common cancers, with the equal incidence of 1.3 % in 2010 and 2020. Overall, the incidence rate of malignant brain and other central nervous system tumors in Siberian and the Russian Far Eastern regions increased from 5.1 to 5.6 per 100 000 with rate of increase of 9.8 %, including the territories of the Republic of Kamchatka (238.5 %), Amur (147.8 %), Khakassia (89.1 %), Irkutsk (65,1 %), Krasnoyarsk (37.8 %), and Primorsky (33.3 %) regions. The incidence rate decreased in the Kemerovo region (34.4 %) and the Trans-Baikal Territory (44.4 %). In women of Siberian and the Russian Far Eastern regions, the incidence rate was slightly increased from 3.7 to 4.0 per 100 000, the overall rate of increase being 8.1 %. The highest incidence rate was registered in the Altai Territory (47.8 %), Novosibirsk region (33.3 %), the Republic of Khakassia (25.0 %), Amur region (246.2 %), but the lowest incidence rate was observed in the Kemerovo region (7.0 %) and the Trans-Baikal Territory (61.1 %).The index accuracy indicated problems with the quality of territorial cancer registries. In males, the reduced the index accuracy was observed in Siberian and the Russian Far Eastern regions as a whole and amounted to 0.81. The index accuracy was also observed in the Krasnoyarsk, Primorsky, Kamchatka, Novosibirsk and Amur regions, as well as in the Republic of Khakassia, whereas the increased index accuracy was observed in the Kemerovo Region, Altai Republic, Khabarovsk and Trans-Baikal Territories. In females, the increased index accuracy was observed Siberian and the Russian Far Eastern regions as a whole, being 0.78 in 2019, and in the Krasnoyarsk, Kamchatka, Tomsk regions, as well as in the Republic of Khakassia. The reduced index accuracy was noted in the Altai, Primorsky Territories and the Amur Region.Conclusion. The problems of registration and monitoring of malignant brain and other central nervous system tumors in Russia does not make it possible to present the true incidence ra","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"521 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78151914","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 : 2022-02-14DOI: 10.17650/2222-1468-2021-11-4-119-130
E. Borodavina, V. Krylov, P. Isaev, A. Shurinov, A. Rodichev
Radioiodine therapy for differentiated thyroid cancer has been used for a long time, mainly in patients of intermediate and high risk, as well as in the presence of distant metastases. However, about 30–40 % of patients are refractory to radioiodine therapy, which significantly worsens the prognosis. In patients with radioiodine-refractory differentiated thyroid cancer, therapy with targeted agents, primarily tyrosine kinase inhibitors, is indicated.This review addresses the criteria for refractoriness and criteria for prescription of targeted therapy, and presents the results of clinical studies of the targeted agents used. As of today, lenvatinib is the most well-known targeted agent. In particular. In SELECT trial lenvatinib demonstrated efficacy in terms of progression-free survival and overall survival in patients with radioiodine-refractory differentiated thyroid cancer. As a result, lenvatinib was included in the international and Russian clinical guidelines for the management of this group of patients as a drug of the 1st line of targeted therapy.
{"title":"Historical aspects and modern concepts in the treatment of patients with differentiated thyroid cancer, refractory to radioactive iodine therapy","authors":"E. Borodavina, V. Krylov, P. Isaev, A. Shurinov, A. Rodichev","doi":"10.17650/2222-1468-2021-11-4-119-130","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-119-130","url":null,"abstract":"Radioiodine therapy for differentiated thyroid cancer has been used for a long time, mainly in patients of intermediate and high risk, as well as in the presence of distant metastases. However, about 30–40 % of patients are refractory to radioiodine therapy, which significantly worsens the prognosis. In patients with radioiodine-refractory differentiated thyroid cancer, therapy with targeted agents, primarily tyrosine kinase inhibitors, is indicated.This review addresses the criteria for refractoriness and criteria for prescription of targeted therapy, and presents the results of clinical studies of the targeted agents used. As of today, lenvatinib is the most well-known targeted agent. In particular. In SELECT trial lenvatinib demonstrated efficacy in terms of progression-free survival and overall survival in patients with radioiodine-refractory differentiated thyroid cancer. As a result, lenvatinib was included in the international and Russian clinical guidelines for the management of this group of patients as a drug of the 1st line of targeted therapy.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86925006","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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