Pub Date : 2020-04-11DOI: 10.17650/2222-1468-2020-10-1-47-54
Y. Alymov, A. Mudunov, S. Podvyaznikov, G. Margolin
Introduction. Patients with head and neck tumors are often require tracheostomy. This procedure represents complex surgical manipulation and is associated with risk of certain complications, including life-threatening. The study objective is to essess the results of percutaneous tracheostomy with the new SafeTrach technique. Materials and methods. The study included 21 patients. All patients had a tracheostomy performed using the SafeTrach technique. Results. Mean duration of tracheostomy with SafeTrach technique was 11.8 ± 3.4 minutes independently of patients’ body mass index or previous treatment (correlation coefficients r = 0.08, p = 0.7 and r = 0.08, p = 0.73, respectively). Among all possible complications of tracheostomy only 1 (4.7 %) case of bleeding in postoperative period was noted in our study. Conclusion. The SafeTrach technique combines all the benefits of open and percutaneous tracheostomy. It is characterized by simplicity, it does not require endoscopic control, that indicates the feasibility of its widespread implementation.
介绍。头颈部肿瘤患者通常需要气管切开术。该手术是一种复杂的手术操作，并伴有某些并发症的风险，包括危及生命的并发症。本研究的目的是评估新的SafeTrach技术经皮气管切开术的效果。材料和方法。该研究包括21名患者。所有患者均采用SafeTrach技术行气管切开术。结果。SafeTrach技术气管切开术的平均持续时间为11.8±3.4分钟，与患者体重指数和既往治疗无关(相关系数r = 0.08, p = 0.7和r = 0.08, p = 0.73)。在气管切开术可能出现的并发症中，仅有1例(4.7%)出现术后出血。结论。SafeTrach技术结合了开放和经皮气管切开术的所有优点。它的特点是简单，它不需要内窥镜控制，这表明其广泛实施的可行性。
{"title":"Percutaneous dilatational tracheostomy in patients with head and neck tumors: literature review and institutional experience","authors":"Y. Alymov, A. Mudunov, S. Podvyaznikov, G. Margolin","doi":"10.17650/2222-1468-2020-10-1-47-54","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-1-47-54","url":null,"abstract":"Introduction. Patients with head and neck tumors are often require tracheostomy. This procedure represents complex surgical manipulation and is associated with risk of certain complications, including life-threatening. The study objective is to essess the results of percutaneous tracheostomy with the new SafeTrach technique. Materials and methods. The study included 21 patients. All patients had a tracheostomy performed using the SafeTrach technique. Results. Mean duration of tracheostomy with SafeTrach technique was 11.8 ± 3.4 minutes independently of patients’ body mass index or previous treatment (correlation coefficients r = 0.08, p = 0.7 and r = 0.08, p = 0.73, respectively). Among all possible complications of tracheostomy only 1 (4.7 %) case of bleeding in postoperative period was noted in our study. Conclusion. The SafeTrach technique combines all the benefits of open and percutaneous tracheostomy. It is characterized by simplicity, it does not require endoscopic control, that indicates the feasibility of its widespread implementation. ","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67781153","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 : 2020-04-11DOI: 10.17650/2222-1468-2020-10-1-93-100
S. Lukyanov, S. V. Sergiyko, S. Titov, I. Reshetov, Y. Veryaskina, A. Vazhenin, A. Gostimsky, L. Ippolitov, M. Rogova
Introduction. Post-transcriptional mechanisms play a crucial role in the biological course and clinical manifestations of papillary thyroid cancer (PTC). Recent studies show that an increased content of oncogenic or reduced content of oncosuppressive microRNAs increases the aggressiveness of the tumor and correlates with an unfavorable prognosis of treatment, which allows them to be used in personalizing the treatment tactics of patients with PTC. The study objective is to compare the level of expression of 12 PTC-specific microRNAs and the frequency of V600E mutation of the BRAF gene in patients with different risk of relapse. Materials and methods. The study included 175 patients with PTC. For quantitative analysis of microRNA expression, a reverse transcription reaction followed by a real-time polymerase chain reaction in formalin-fixed paraffin blocks was used. Correlations between 12 microRNA expression and BRAF mutation with different clinical and anatomical features of PTC the risk of relapse according to the American Thyroid Association Risk Stratification System (2009) were analyzed. Results. We demonstrated that miR-146b, miR-221, miR-144, miR-451a, and miR-7 expression correlated with features such as extrathyroid tumor growth, larger size, multifocus, lymph node metastasis, and the presence of distant metastases of the PTC. Most importantly, miR-221, miR-144, miR-451a, and miR-7 expression correlated with risk levels, suggesting their potential significance in stratifying the risk of relapsing PTC. The dependence of the clinical behavior of PTC on the BRAF mutation has not been established.Conclusion. The result of the study will contribute to the individual choice of preoperative treatment tactics for patients with PTC.
{"title":"Stratification of papillary thyroid cancer relapse risk based on the results of molecular genetic studies","authors":"S. Lukyanov, S. V. Sergiyko, S. Titov, I. Reshetov, Y. Veryaskina, A. Vazhenin, A. Gostimsky, L. Ippolitov, M. Rogova","doi":"10.17650/2222-1468-2020-10-1-93-100","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-1-93-100","url":null,"abstract":"Introduction. Post-transcriptional mechanisms play a crucial role in the biological course and clinical manifestations of papillary thyroid cancer (PTC). Recent studies show that an increased content of oncogenic or reduced content of oncosuppressive microRNAs increases the aggressiveness of the tumor and correlates with an unfavorable prognosis of treatment, which allows them to be used in personalizing the treatment tactics of patients with PTC. The study objective is to compare the level of expression of 12 PTC-specific microRNAs and the frequency of V600E mutation of the BRAF gene in patients with different risk of relapse. Materials and methods. The study included 175 patients with PTC. For quantitative analysis of microRNA expression, a reverse transcription reaction followed by a real-time polymerase chain reaction in formalin-fixed paraffin blocks was used. Correlations between 12 microRNA expression and BRAF mutation with different clinical and anatomical features of PTC the risk of relapse according to the American Thyroid Association Risk Stratification System (2009) were analyzed. Results. We demonstrated that miR-146b, miR-221, miR-144, miR-451a, and miR-7 expression correlated with features such as extrathyroid tumor growth, larger size, multifocus, lymph node metastasis, and the presence of distant metastases of the PTC. Most importantly, miR-221, miR-144, miR-451a, and miR-7 expression correlated with risk levels, suggesting their potential significance in stratifying the risk of relapsing PTC. The dependence of the clinical behavior of PTC on the BRAF mutation has not been established.Conclusion. The result of the study will contribute to the individual choice of preoperative treatment tactics for patients with PTC. ","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67782203","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 : 2020-04-11DOI: 10.17650/2222-1468-2020-10-1-10-19
A. Pylev, A. A. Zhandarova, K. Petrov, D. Romanov, V. A. Lisovoy, S. Golub
Anaplastic thyroid cancer is one of the most prognostically unfavorable tumors. This disadvantage traditionally consisted of a rapid increase in the size of the primary tumor with a tendency to the development of asphyxia and the rapid appearance of distant metastases, as well as a poor response to the recommended treatment methods. The result of many years of efforts by oncologists around the world were several treatment regimens, including an ideal amount of surgical intervention, chemotherapy and radiation therapy, but the effectiveness of this treatment, as well as the patient’s life expectancy after it, could not be called satisfactory. Improving the understanding of the molecular genetic characteristics of tumors, including anaplastic thyroid cancer, provided us with information on two possible features of the genetic apparatus of tumor cells that can have clinical significance: V600E mutations in the BRAF gene and fusion of NTRK genes. The clinical example described in this article is probably the first Russian illustration of the effectiveness of anti-BRAF therapy in a patient with anaplastic thyroid cancer. From our point of view, the benefit of this example is not only to demonstrate the effectiveness of modern targeted therapy, but also the need not to abandon other treatment methods, in this case, radiation therapy to the area of the primary tumor (and by analogy with this, surgical removal of the thyroid tumor glands in case of its resectability).
{"title":"Anaplastic thyroid cancer. Is there a light at the end of the tunnel?","authors":"A. Pylev, A. A. Zhandarova, K. Petrov, D. Romanov, V. A. Lisovoy, S. Golub","doi":"10.17650/2222-1468-2020-10-1-10-19","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-1-10-19","url":null,"abstract":"Anaplastic thyroid cancer is one of the most prognostically unfavorable tumors. This disadvantage traditionally consisted of a rapid increase in the size of the primary tumor with a tendency to the development of asphyxia and the rapid appearance of distant metastases, as well as a poor response to the recommended treatment methods. The result of many years of efforts by oncologists around the world were several treatment regimens, including an ideal amount of surgical intervention, chemotherapy and radiation therapy, but the effectiveness of this treatment, as well as the patient’s life expectancy after it, could not be called satisfactory. Improving the understanding of the molecular genetic characteristics of tumors, including anaplastic thyroid cancer, provided us with information on two possible features of the genetic apparatus of tumor cells that can have clinical significance: V600E mutations in the BRAF gene and fusion of NTRK genes. The clinical example described in this article is probably the first Russian illustration of the effectiveness of anti-BRAF therapy in a patient with anaplastic thyroid cancer. From our point of view, the benefit of this example is not only to demonstrate the effectiveness of modern targeted therapy, but also the need not to abandon other treatment methods, in this case, radiation therapy to the area of the primary tumor (and by analogy with this, surgical removal of the thyroid tumor glands in case of its resectability).","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67781667","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 : 2020-04-11DOI: 10.17650/2222-1468-2020-10-1-84-92
M. Kotov, Z. Radzhabova, S. Novikov, P. Krzhivitsky, O. Ponomareva, E. Kostromina, V. Kushnarev, M. A. Radzhabova
The study objectiveis to evaluate the informativeness of the biopsy technique of the signal lymph node (LN) in squamous cell carcinoma of the tongue cT1–2N0.Materials and methods.A prospective, single-center study included 26 patients with morphologically verified squamous cell carcinoma of the tongue cT1–2 and the lack of clinical and radiological data for metastatic damage to the LNs of the neck. All patients underwent a radioisotope study of the lymphatic flow from the primary tumor and the topography of the signal LNs. The informativeness of the biopsy of the signal LNs was evaluated in accordance with 2 diagnostic models. When using the first diagnostic model, all LNs accumulating colloids labeled with the 99mTc isotope were considered signal LNs. In the second model, only nodes accumulating radiocolloids and located in the immediate vicinity of the primary tumor of the tongue and / or connected with the primary tumor by the “pathway” of the lymphatic vessels were considered as signal LNs.Results.The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy, according to the 1st diagnostic model, were 66.6 % (95 % confidence interval (CI) 9.43–99.16), 100 % (95 % CI 85.18–100 %), 100 %, 95.83 % (95 % CI 82.28–99.13 %), 96.15 % (95 % CI 80.36–99.90 %), and when all LNs located along with the signal LNs were removed at the same levels as regional LNs, the sensitivity increased to 100 %. In the second model, the diagnostic values were: 33.3 % (95 % CI 0.84–90.57), 100 % (95 % CI 85.18– 100.00), 100 %, 92 % (95 % CI 83.78–96.24), 92.31 % (95 % CI 74.87–99.05 %).Conclusion.Evaluation of lymphatic outflow from the primary tumor and assessment of sentinel lymph node location in patients with stage cT1–2N0M0 squamous cell carcinoma of the tongue allow a doctor to determine the volume of lymph node dissection for each patient individually. Unilateral lymph node dissection is acceptable in patients with unilateral lymphatic outflow, whereas in patients with bilateral lymphatic outflow, it is associated with a quite high (up to 10 %) risk of metastatic lesions in the lymph nodes on the opposite side of the neck. It is necessary to excise all lymph nodes accumulating radiocontrast agent and regional lymph nodes located at the same levels.
本研究的目的是评价舌鳞癌cT1-2N0信号淋巴结活检技术的信息价值。材料和方法。一项前瞻性、单中心研究纳入了26例形态学证实的舌鳞癌cT1-2患者，缺乏颈部淋巴结转移损伤的临床和影像学资料。所有患者都接受了原发肿瘤淋巴血流和信号LNs地形的放射性同位素研究。根据两种诊断模型评估活检信号LNs的信息量。当使用第一种诊断模型时，所有以99mTc同位素标记的聚集胶体都被认为是信号LNs。结果第一种诊断模型的敏感性、特异性、阳性预测值、阴性预测值和诊断准确率分别为66.6%(95%置信区间(CI) 9.43 ~ 99.16)、100% (95% CI 85.18 ~ 100%)、100% (95% CI 85.18 ~ 100%)、100% (95% CI 85.18 ~ 100%)、100% (95% CI 85.18 ~ 100%)。95.83% (95% CI 82.28 - 99.13%)， 96.15% (95% CI 80.36 - 99.90%)，当所有与信号LNs一起定位的LNs都以与区域LNs相同的水平去除时，灵敏度增加到100%。第二种模型的诊断值分别为33.3% (95% CI 0.84 ~ 90.57)、100% (95% CI 85.18 ~ 100.00)、100%、92% (95% CI 83.78 ~ 96.24)、92.31% (95% CI 74.87 ~ 99.05%)。cT1-2N0M0期舌鳞癌患者原发肿瘤淋巴流出量的评估和前哨淋巴结位置的评估使医生能够确定每个患者单独淋巴结清扫的体积。单侧淋巴流出患者可以接受单侧淋巴结清扫，而双侧淋巴流出患者则有相当高(高达10%)的颈部对侧淋巴结转移病变风险。有必要切除所有积聚放射造影剂的淋巴结和位于同一水平的区域淋巴结。
{"title":"Sentinel lymph node biopsy for oral tongue squamous cell carcinoma cT1–2N0: prospective single-center study","authors":"M. Kotov, Z. Radzhabova, S. Novikov, P. Krzhivitsky, O. Ponomareva, E. Kostromina, V. Kushnarev, M. A. Radzhabova","doi":"10.17650/2222-1468-2020-10-1-84-92","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-1-84-92","url":null,"abstract":"The study objectiveis to evaluate the informativeness of the biopsy technique of the signal lymph node (LN) in squamous cell carcinoma of the tongue cT1–2N0.Materials and methods.A prospective, single-center study included 26 patients with morphologically verified squamous cell carcinoma of the tongue cT1–2 and the lack of clinical and radiological data for metastatic damage to the LNs of the neck. All patients underwent a radioisotope study of the lymphatic flow from the primary tumor and the topography of the signal LNs. The informativeness of the biopsy of the signal LNs was evaluated in accordance with 2 diagnostic models. When using the first diagnostic model, all LNs accumulating colloids labeled with the 99mTc isotope were considered signal LNs. In the second model, only nodes accumulating radiocolloids and located in the immediate vicinity of the primary tumor of the tongue and / or connected with the primary tumor by the “pathway” of the lymphatic vessels were considered as signal LNs.Results.The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy, according to the 1st diagnostic model, were 66.6 % (95 % confidence interval (CI) 9.43–99.16), 100 % (95 % CI 85.18–100 %), 100 %, 95.83 % (95 % CI 82.28–99.13 %), 96.15 % (95 % CI 80.36–99.90 %), and when all LNs located along with the signal LNs were removed at the same levels as regional LNs, the sensitivity increased to 100 %. In the second model, the diagnostic values were: 33.3 % (95 % CI 0.84–90.57), 100 % (95 % CI 85.18– 100.00), 100 %, 92 % (95 % CI 83.78–96.24), 92.31 % (95 % CI 74.87–99.05 %).Conclusion.Evaluation of lymphatic outflow from the primary tumor and assessment of sentinel lymph node location in patients with stage cT1–2N0M0 squamous cell carcinoma of the tongue allow a doctor to determine the volume of lymph node dissection for each patient individually. Unilateral lymph node dissection is acceptable in patients with unilateral lymphatic outflow, whereas in patients with bilateral lymphatic outflow, it is associated with a quite high (up to 10 %) risk of metastatic lesions in the lymph nodes on the opposite side of the neck. It is necessary to excise all lymph nodes accumulating radiocontrast agent and regional lymph nodes located at the same levels. ","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67782558","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 : 2020-04-10DOI: 10.17650/2222-1468-2020-10-1-38-46
Д. В. Сикорский, Сергей Подвязников, Н. В. Канищева, М. В. Кулигин, Д. В. Скамницкий
The study objective is to analyze the results of combined antitumor therapy, which included glossectomy, to treat locally advanced and recurrent oropharyngeal squamous cell cancer. Materials and methods. We performed a retrospective analysis of multimodal antitumor therapy of 19 patients, who were treated in the Nizhny Novgorod Regional Clinical Oncologic Dispensary within 2009–2019. All patients underwent segmental resection of the mandible due to massive tumor invasion into the periosteum. After total glossectomy the defect was filled using pectoralis musculocutaneous flap. Due to the wide local tumor spread, a neck dissection (n = 7) or radical cervical lymphadenectomy (n = 12) were performed. During preventive surgery, metastases that were not detected before surgery were revealed in 2 patients in 1 neck lymph node. Results. Eleven patients had local purulent-necrotic postoperative complications. It was noted that after surgery but without radiation therapy complications developed in fewer patients (n = 4) and were less severe: of I degree – in 3 patients, of III degree – in 1 patient. Radiation therapy before surgery resulted in more severe purulent-necrotic complications in 7 patients: of I degree – in 2 patients, of II degree – in 1, of III degree – in 4. Mortality rates: 30-day, 60-day and 90-day – 10.5 %, 21 % and 37 %, respectively. The causes of death were complications of gastrostomy: profuse bleeding from the stomach wall (n = 1), acute psychosis complicated by cerebral edema (n = 1), increased heart failure (n = 1), necrosis of the anterior abdominal wall and cachexia, developed after gastrostomy (n = 1), continued tumor growth between chemotherapy courses (n = 3). Twelve patients survived more than 90 days after surgery, 3 patients – more than 2 years. As most of the patients could not swallow, they were administered a nasogastric tube, since a simultaneous gastrostomy increases the duration of a traumatic operation and aggravates the postoperative period. Conclusion. Multicomponent surgery after radiation therapy results in more often local purulent-necrotic postoperative complications than if the surgery is performed before radiation therapy. High mortality in the first 90 days after surgery (n = 7) due to local cancer spread is generally determined by the severe condition of patients with advanced cancer and the concomitant diseases. However, rejection of gastrostomy in favor of nasogastric tube seems reasonable, since several deaths in the early postoperative period may be occurred due to complications associated with gastrostomy.
{"title":"Тотальная глоссэктомия в комбинированном и комплексном лечении орофарингеального рака: ближайшие результаты","authors":"Д. В. Сикорский, Сергей Подвязников, Н. В. Канищева, М. В. Кулигин, Д. В. Скамницкий","doi":"10.17650/2222-1468-2020-10-1-38-46","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-1-38-46","url":null,"abstract":"The study objective is to analyze the results of combined antitumor therapy, which included glossectomy, to treat locally advanced and recurrent oropharyngeal squamous cell cancer. Materials and methods. We performed a retrospective analysis of multimodal antitumor therapy of 19 patients, who were treated in the Nizhny Novgorod Regional Clinical Oncologic Dispensary within 2009–2019. All patients underwent segmental resection of the mandible due to massive tumor invasion into the periosteum. After total glossectomy the defect was filled using pectoralis musculocutaneous flap. Due to the wide local tumor spread, a neck dissection (n = 7) or radical cervical lymphadenectomy (n = 12) were performed. During preventive surgery, metastases that were not detected before surgery were revealed in 2 patients in 1 neck lymph node. Results. Eleven patients had local purulent-necrotic postoperative complications. It was noted that after surgery but without radiation therapy complications developed in fewer patients (n = 4) and were less severe: of I degree – in 3 patients, of III degree – in 1 patient. Radiation therapy before surgery resulted in more severe purulent-necrotic complications in 7 patients: of I degree – in 2 patients, of II degree – in 1, of III degree – in 4. Mortality rates: 30-day, 60-day and 90-day – 10.5 %, 21 % and 37 %, respectively. The causes of death were complications of gastrostomy: profuse bleeding from the stomach wall (n = 1), acute psychosis complicated by cerebral edema (n = 1), increased heart failure (n = 1), necrosis of the anterior abdominal wall and cachexia, developed after gastrostomy (n = 1), continued tumor growth between chemotherapy courses (n = 3). Twelve patients survived more than 90 days after surgery, 3 patients – more than 2 years. As most of the patients could not swallow, they were administered a nasogastric tube, since a simultaneous gastrostomy increases the duration of a traumatic operation and aggravates the postoperative period. Conclusion. Multicomponent surgery after radiation therapy results in more often local purulent-necrotic postoperative complications than if the surgery is performed before radiation therapy. High mortality in the first 90 days after surgery (n = 7) due to local cancer spread is generally determined by the severe condition of patients with advanced cancer and the concomitant diseases. However, rejection of gastrostomy in favor of nasogastric tube seems reasonable, since several deaths in the early postoperative period may be occurred due to complications associated with gastrostomy.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"38-46"},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47555446","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 : 2020-04-10DOI: 10.17650/2222-1468-2020-10-1-20-28
R. Karabut, A. Vazhenin, E. Mozerova, T. Sharabura, M. M. Sarycheva, A. Guz, A. S. Zakharov
Introduction. There is no treatment for recurrence of head and neck squamous cell carcinoma, which significantly increases the overall survival (OS) of patients. The study objective is to analyze the results of treatment of patients with recurrences of squamous cell carcinoma of the head and neck and to assess the impact of risk factors for relapse, as well as different treatment options for relapse on OS. Materials and methods . In the period from 2012 to 2016, 182 patients with relapses of squamous cell carcinoma of the larynx, oral cavity and tongue received treatment in the Chelyabinsk regional clinical center of Oncology and nuclear medicine. The group 1 included 66 patients with resectable relapse who were operated. The group 2 consisted of 25 patients who received a course of radiation therapy. The group 3 consisted of 46 patients who underwent chemotherapeutic treatment of relapse. The group 4 was represented by combined treatment (surgery + radiation therapy), this group included 9 people. The group 5 consisted of those of patients who were not specifically treated for relapse because of the low Karnofsky index in patients (<70 %). Results. OS among patients who received special treatment was significantly higher compared with the group of symptomatic therapy. The median OS in the special treatment group was 40 months, and without it – 18 months. Comparing all types for treating relapse, the highest rates of OS were in the surgical treatment group. OS rates in combined therapy group and radiotherapy group were comparable rate in the radiotherapy. The lowest OS rate was after chemotherapy (only 21 months). Conclusion. Surgery is the optimal method for treating recurrent squamous cell carcinoma of head and neck, if it is resectable. If surgical treatment is not possible, no other method significantly increases the OS. If the overall status of the patient is normal, re-radiation or polychemotherapy may be performed. A limited category of patients can be subjected to combined treatment for relapse.
{"title":"Recurrent squamous cell carcinoma of head and neck: results of treatment in the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine in 2012–2016","authors":"R. Karabut, A. Vazhenin, E. Mozerova, T. Sharabura, M. M. Sarycheva, A. Guz, A. S. Zakharov","doi":"10.17650/2222-1468-2020-10-1-20-28","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-1-20-28","url":null,"abstract":"Introduction. There is no treatment for recurrence of head and neck squamous cell carcinoma, which significantly increases the overall survival (OS) of patients. The study objective is to analyze the results of treatment of patients with recurrences of squamous cell carcinoma of the head and neck and to assess the impact of risk factors for relapse, as well as different treatment options for relapse on OS. Materials and methods . In the period from 2012 to 2016, 182 patients with relapses of squamous cell carcinoma of the larynx, oral cavity and tongue received treatment in the Chelyabinsk regional clinical center of Oncology and nuclear medicine. The group 1 included 66 patients with resectable relapse who were operated. The group 2 consisted of 25 patients who received a course of radiation therapy. The group 3 consisted of 46 patients who underwent chemotherapeutic treatment of relapse. The group 4 was represented by combined treatment (surgery + radiation therapy), this group included 9 people. The group 5 consisted of those of patients who were not specifically treated for relapse because of the low Karnofsky index in patients (<70 %). Results. OS among patients who received special treatment was significantly higher compared with the group of symptomatic therapy. The median OS in the special treatment group was 40 months, and without it – 18 months. Comparing all types for treating relapse, the highest rates of OS were in the surgical treatment group. OS rates in combined therapy group and radiotherapy group were comparable rate in the radiotherapy. The lowest OS rate was after chemotherapy (only 21 months). Conclusion. Surgery is the optimal method for treating recurrent squamous cell carcinoma of head and neck, if it is resectable. If surgical treatment is not possible, no other method significantly increases the OS. If the overall status of the patient is normal, re-radiation or polychemotherapy may be performed. A limited category of patients can be subjected to combined treatment for relapse.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"20-28"},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48771659","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 : 2020-02-07DOI: 10.17650/2222-1468-2019-9-4-17-23
V. Parshin, A. A. Veselova, V. S. Medvedev, S. A. Ivanov, A. Kaprin
The study objective is to explore the potentialities of ultrasound in the detection of metastasis from papillary thyroid cancer (PTC) to cervical lymph nodes in levels II–IV.Materials and methods. In 97 patients with first diagnosed PTC, surgical removal of the cervical lymph node-bearing fat at levels II–IV was performed. All patients underwent preoperative neck ultrasound. The results were verified by histology.Results. Cervical levels II–IV lymph node metastases were revealed in 82 (84,5 %) cases by sonography and in 86 (88,6 %) cases by histology. Ultrasound showed a sensitivity of 93 %, specificity of 81 %, accuracy of 91 %, positive predictive value of 97 % and negative predictive value of 60 %. Of 1620 removed lymph nodes, 443 (27,3 %) showed metastases confirmed by histology. Sonography revealed 422 (26,0 %) metastatic lymph nodes. Metastasis from intra-thyroid tumors was noted in 94,1 % and from extra-thyroid tumors in 87,5 % of patients. Metastasis from solitary tumors occurred in 86,5 % and from multicentric tumors in 92,1 % of cases. Multiple metastases made up 89,5 % and solitary metastases – 10,5 %.Conclusion. Sonography is a highly informative diagnostic imaging method in detecting metastasis from PTC to levels II–IV cervical lymph nodes and can be used for basic assessment of thyroid abnormalities.
{"title":"Ultrasound diagnosis of cervical levels II–IV lymph node metastasis in patients with first diagnosed papillary thyroid cancer","authors":"V. Parshin, A. A. Veselova, V. S. Medvedev, S. A. Ivanov, A. Kaprin","doi":"10.17650/2222-1468-2019-9-4-17-23","DOIUrl":"https://doi.org/10.17650/2222-1468-2019-9-4-17-23","url":null,"abstract":"The study objective is to explore the potentialities of ultrasound in the detection of metastasis from papillary thyroid cancer (PTC) to cervical lymph nodes in levels II–IV.Materials and methods. In 97 patients with first diagnosed PTC, surgical removal of the cervical lymph node-bearing fat at levels II–IV was performed. All patients underwent preoperative neck ultrasound. The results were verified by histology.Results. Cervical levels II–IV lymph node metastases were revealed in 82 (84,5 %) cases by sonography and in 86 (88,6 %) cases by histology. Ultrasound showed a sensitivity of 93 %, specificity of 81 %, accuracy of 91 %, positive predictive value of 97 % and negative predictive value of 60 %. Of 1620 removed lymph nodes, 443 (27,3 %) showed metastases confirmed by histology. Sonography revealed 422 (26,0 %) metastatic lymph nodes. Metastasis from intra-thyroid tumors was noted in 94,1 % and from extra-thyroid tumors in 87,5 % of patients. Metastasis from solitary tumors occurred in 86,5 % and from multicentric tumors in 92,1 % of cases. Multiple metastases made up 89,5 % and solitary metastases – 10,5 %.Conclusion. Sonography is a highly informative diagnostic imaging method in detecting metastasis from PTC to levels II–IV cervical lymph nodes and can be used for basic assessment of thyroid abnormalities.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67780595","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 : 2020-02-07DOI: 10.17650/2222-1468-2019-9-4-62-73
A. Kuprin, V. Malyuga, I. V. Makedonskaya, A. A. Melnikova
According to the American Thyroid Association’s 2015 guidelines: “Since hyperfunctioning nodules rarely harbor malignancy, if one is found that corresponds to the nodule in question, no cytologic evaluation is necessary”. These findings are based on numerous studies proving the rareness of the combination of functional autonomy and thyroid cancer, and when such casuistry is detected, the non-aggressive course of the malignant process is observed.Rare revealing of malignant nodules functional autonomy can be attributed to several fundamental bases of non-medullary thyroid carcinoma pathogenesis. According to one of the hypotheses of carcinogenesis, dedifferentiation of thyrocytes occurs initially with the loss of the possibility of the sodium-iodine symporter synthesis, and later of the thyroid-stimulating hormone receptor synthesis by the cell, which reduces the hormone production by tumor cells. In addition, hyperthyroidism has a protective feature. It reduces the level of thyroid-stimulating hormone (which causes hypertrophy, hyperplasia of thyrocytes and has an antiapoptotic effect). This protective function is used in practice for suppressive therapy in the postoperative period, which reduces the progression, recurrence and mortality from thyroid cancer. The above circumstances prove the rareness of the clinical observation described below, which deserves additional attention and subsequent discussion.
{"title":"Graves’ disease with hyperfunctioning thyroid nodule harboring thyroid carcinoma. Case report and literature review","authors":"A. Kuprin, V. Malyuga, I. V. Makedonskaya, A. A. Melnikova","doi":"10.17650/2222-1468-2019-9-4-62-73","DOIUrl":"https://doi.org/10.17650/2222-1468-2019-9-4-62-73","url":null,"abstract":"According to the American Thyroid Association’s 2015 guidelines: “Since hyperfunctioning nodules rarely harbor malignancy, if one is found that corresponds to the nodule in question, no cytologic evaluation is necessary”. These findings are based on numerous studies proving the rareness of the combination of functional autonomy and thyroid cancer, and when such casuistry is detected, the non-aggressive course of the malignant process is observed.Rare revealing of malignant nodules functional autonomy can be attributed to several fundamental bases of non-medullary thyroid carcinoma pathogenesis. According to one of the hypotheses of carcinogenesis, dedifferentiation of thyrocytes occurs initially with the loss of the possibility of the sodium-iodine symporter synthesis, and later of the thyroid-stimulating hormone receptor synthesis by the cell, which reduces the hormone production by tumor cells. In addition, hyperthyroidism has a protective feature. It reduces the level of thyroid-stimulating hormone (which causes hypertrophy, hyperplasia of thyrocytes and has an antiapoptotic effect). This protective function is used in practice for suppressive therapy in the postoperative period, which reduces the progression, recurrence and mortality from thyroid cancer. The above circumstances prove the rareness of the clinical observation described below, which deserves additional attention and subsequent discussion.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67781515","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 : 2020-02-07DOI: 10.17650/2222-1468-2019-9-4-38-42
Z. Radzhabova, M. Kotov, Z. Bekyasheva, M. A. Radzhabova, E. Levchenko
The study objective is to provide data on the use of the Hedgehog signaling pathway inhibitor (vismodegib) in the treatment of recurrent locally advanced and metastatic basal cell skin cancer at the N. N. Petrov National Medical Research Center of Oncology.Materials and methods. Clinical data of 10 patients who participated in a multicenter, non-randomized clinical trial of phase II ERIVANCE BBC (ClinicalTrials. gov NCT833417). Patients took the daily studied drug vismodegib orally at a dose of 150 mg daily until disease progression or intolerance due to side effects. Efficiency and safety assessment was carried out once every 4 weeks.Results. Complete regression was achieved in 7 patients, while the average duration of use of the drug was 240 ± 65 days. Stabilization was observed in 2 patients, the minimum duration of the drug was 336 days. One patient showed progression after 728 days of taking the drug. Side effects of the 1 grade according to CTCAE (Common Terminology Criteria for Adverse Events), v. 3.0 were observed in all patients, in 9 they were expressed in muscle cramps, alopecia and changes in taste sensitivity, and in 1 patient isolated in the form of muscle cramps.Conclusion. The results show a good safety profile of vismodegib, which allows it to be used in elderly patients with concomitant pathology. The frequency of response to treatment, including the achievement of complete regression in 70 % of patients, makes vismodegib an acceptable treatment option for metastatic form of basal cell skin cancer and relapse of locally advanced forms.
{"title":"Use of the Hedgehog signaling pathway inhibitor in the treatment of recurrent locally advanced and metastatic basal cell skin cancer","authors":"Z. Radzhabova, M. Kotov, Z. Bekyasheva, M. A. Radzhabova, E. Levchenko","doi":"10.17650/2222-1468-2019-9-4-38-42","DOIUrl":"https://doi.org/10.17650/2222-1468-2019-9-4-38-42","url":null,"abstract":"The study objective is to provide data on the use of the Hedgehog signaling pathway inhibitor (vismodegib) in the treatment of recurrent locally advanced and metastatic basal cell skin cancer at the N. N. Petrov National Medical Research Center of Oncology.Materials and methods. Clinical data of 10 patients who participated in a multicenter, non-randomized clinical trial of phase II ERIVANCE BBC (ClinicalTrials. gov NCT833417). Patients took the daily studied drug vismodegib orally at a dose of 150 mg daily until disease progression or intolerance due to side effects. Efficiency and safety assessment was carried out once every 4 weeks.Results. Complete regression was achieved in 7 patients, while the average duration of use of the drug was 240 ± 65 days. Stabilization was observed in 2 patients, the minimum duration of the drug was 336 days. One patient showed progression after 728 days of taking the drug. Side effects of the 1 grade according to CTCAE (Common Terminology Criteria for Adverse Events), v. 3.0 were observed in all patients, in 9 they were expressed in muscle cramps, alopecia and changes in taste sensitivity, and in 1 patient isolated in the form of muscle cramps.Conclusion. The results show a good safety profile of vismodegib, which allows it to be used in elderly patients with concomitant pathology. The frequency of response to treatment, including the achievement of complete regression in 70 % of patients, makes vismodegib an acceptable treatment option for metastatic form of basal cell skin cancer and relapse of locally advanced forms.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67780882","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 : 2020-02-07DOI: 10.17650/2222-1468-2019-9-4-24-31
A. Pronin, M. Dolgushin, D. Sashin, N. Meshcheryakova, O. D. Ryzhova, T. G. Gasparyan
The study objective is to evaluate the diagnostic capabilities of complex method based on the use of 18 F-fluoroethyltyrozine positron emission tomography (PET) combined with computed tomography (CT) and CT perfusion in the differential diagnosis of glial brain tumors.Materials and methods. One hundred and two patients with glial brain tumors were included in the study. Depending on the degree of malignancy patients were divided into 2 groups: group 1–38 (37.26 %) patients with grade I–II tumors; group 2–64 (62.74 %) patients with grade III–IV tumors. Perfusion CT was performed in 20 (52.6 %) patients from the group with grade I–II tumors and 37 (57.8 %) patients from the group with grade III–IV gliomas. The sensitivity and specificity of such indicators as the maximum standardized uptake value (maxSUV) and the tumor to brain ratio (TBR), in combination with CT perfusion indicators (cerebral blood flow (CBF), cerebral blood volume (CBV), vascular permeability (FED) were studied.Results. The highest diagnostic accuracy was demonstrated by the following parameters: maxSUV 1 (sensitivity and specificity 81 and 82 %, threshold value 2.51, AUC 0.87); TBR 1 (sensitivity and specificity 90.6 and 81.6 %, threshold value 2.07, AUC 0.89). The comprehensive evaluation of CT perfusion and 18 F-fluoroethyltyrozine PET / CT parameters: sensitivity and specificity of TBR 1 + CBF – 97.1 and 94.4 %, respectively; TBR 1 + CBV – 96.6 and 94.4 %, respectively; TBR 1 + FED – 94.6 and 92.3 %, respectively.Conclusion. According to results of obtained analysis, an increase in diagnostic accuracy was revealed for all studied parameters with complex use of two methods – 18 F-fluoroethyltyrozine PET / CT and CT perfusion, in differential diagnosis of glial brain tumors.
{"title":"18F-fluoroethyltyrozine positron emission tomography combined with computed tomography and computed tomography perfusion in complex diagnostic of glial brain tumors","authors":"A. Pronin, M. Dolgushin, D. Sashin, N. Meshcheryakova, O. D. Ryzhova, T. G. Gasparyan","doi":"10.17650/2222-1468-2019-9-4-24-31","DOIUrl":"https://doi.org/10.17650/2222-1468-2019-9-4-24-31","url":null,"abstract":"The study objective is to evaluate the diagnostic capabilities of complex method based on the use of 18 F-fluoroethyltyrozine positron emission tomography (PET) combined with computed tomography (CT) and CT perfusion in the differential diagnosis of glial brain tumors.Materials and methods. One hundred and two patients with glial brain tumors were included in the study. Depending on the degree of malignancy patients were divided into 2 groups: group 1–38 (37.26 %) patients with grade I–II tumors; group 2–64 (62.74 %) patients with grade III–IV tumors. Perfusion CT was performed in 20 (52.6 %) patients from the group with grade I–II tumors and 37 (57.8 %) patients from the group with grade III–IV gliomas. The sensitivity and specificity of such indicators as the maximum standardized uptake value (maxSUV) and the tumor to brain ratio (TBR), in combination with CT perfusion indicators (cerebral blood flow (CBF), cerebral blood volume (CBV), vascular permeability (FED) were studied.Results. The highest diagnostic accuracy was demonstrated by the following parameters: maxSUV 1 (sensitivity and specificity 81 and 82 %, threshold value 2.51, AUC 0.87); TBR 1 (sensitivity and specificity 90.6 and 81.6 %, threshold value 2.07, AUC 0.89). The comprehensive evaluation of CT perfusion and 18 F-fluoroethyltyrozine PET / CT parameters: sensitivity and specificity of TBR 1 + CBF – 97.1 and 94.4 %, respectively; TBR 1 + CBV – 96.6 and 94.4 %, respectively; TBR 1 + FED – 94.6 and 92.3 %, respectively.Conclusion. According to results of obtained analysis, an increase in diagnostic accuracy was revealed for all studied parameters with complex use of two methods – 18 F-fluoroethyltyrozine PET / CT and CT perfusion, in differential diagnosis of glial brain tumors.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67780635","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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